Article of the Week: Week Two

The Main Course

My favourite psychiatric article this week was on schizophrenia.  Specifically, the piece from X-Ray Technican Schools (I agree that this seems a curious place to have an article on schizophrenia) provided a concise, accessible but intelligent refutation of the many myths that surround this illness.

One of my pet hates is the mistaken belief that so many seem to hold that schizophrenia is, or at least shares key symptoms with, dissociative identity disorder.  I suspect I’m preaching to the converted on a blog about mental illness, but lest there be any doubt schizophrenia does not involve multiple personalities!!!

Another mistaken and highly stigmatic belief that I despise is that mentally ill individuals (especially schizophrenics) are more dangerous and/or violent than normals.  This simply is not true, as statistics frequently demonstrate.

This article analyses these two myths, plus eight others, discussing how they’ve arisen and why they are false.  Many thanks to Wounded Genius for posting this for us to find.

10 Myths About Schizophrenia

For Afters

There were so many excellent articles upon which I stumbled this week that it’s hard to narrow them down.  Here’s the runners-up that I’ve come up with.

A close second to the above schizophrenia article is a piece in the New York Times that discusses the “Americanisation” of mental illness.  By “Americanisation”, as far as I can tell they really mean “Westernisnation” (not that that’s a word).  This is quite a long article, but its well worth sticking with.  It goes into considerable and fascinating detail as to how some mental illnesses are (or were) culturally dependant, and how they now seem to be becoming increasingly homogenised – in line with Western interpretations.

The Americaisation of Mental Illness

Jonah Lehrer at Science Blogs have a post on daydreaming, and why it isn’t necessarily such a waste of time:

Intelligence and the Idle Mind

Science Daily reports that migraines may have links to child abuse.  This could explain a lot…

Abuse in Childhood Linked to Migraine and Other Pain Disorders

Finally, I want to have a look at two articles from Psych Central that discuss transference and the therapeutic relationship, both written by Sonia Neale.  The first discusses how the therapist can never really return your transference – not in a manner in which you would know it anyway.  It discussing how what it terms ‘transference love’ is very real, given as all any of us ultimately want (allegedly) is to be loved, but will always (sadly) be one-sided.

Transference is Not Transferable

The second article explores a similar, but distinct, aspect of therapeutic relationships – that fantasy that we can or will, eventually, be friends with our psychotherapists.  Ms Neale discusses why this is a bad idea, but argues that it’s not necessarily transference but a genuine connection that drives this.

Why You Can’t Be Friends With Your Therapist – Ever!

*SI walks away, whistling innocently*

Anything Else?

Any suggestions for Article of the Week are very welcome, as are comments on those posted here.  Get in touch or leave a comment.

Intelligence and the Idle Mind

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.

Protected: Why Does He Hate Me? C: Week 34

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Countdown to Abandonment – C: Week 33

Those that follow the Twitter stream that I have allied with this blog will know that I did not intend to write a blog today (LATER: yesterday). I was feeling a bit low after CVM called me this morning to report that her father had sadly died early this morning (LATER: well – technically now yesterday morning). However, sitting here brooding won’t do either her nor me any good, so I decided to go ahead and write it anyway.

CVM is very much in my thoughts and I wish I could do something to ease the pain of her and her family. I am publicly sending my sincere condolences here. ❤ xxx

—

I know that I have an annoying tendency to open these posts on C with, "today was weird," or some such. Well, Thursday really was strange. It was totally bizarre. C was evidently puzzled by certain directions it took, and when I told him at the end that it had been “weird,” he actually responded by saying that it had, indeed, been “different” (for what it’s worth I feel reassured rather than invalidated by this).

I’m not sure if the written word can adequately convey the oddness of the session, because although it can look disjointed, it would take a better writer than I to convey the sudden and sharp shifts in mood, the nuances of the spoken tones, the randomness and subtlety of the non-verbal communication that took place. Nevertheless, as ever, I shall try.

It was very much a meeting of three parts. During the first – I dunno? – maybe 10 or 15 minutes I sat there petulantly, stubbornly avoiding his gaze and giving one word answers (at best) to any questions he posed. For once he had the decency to open proceedings, and not piss about waiting for me to do so. He said he was aware that part of me was attached to “here” (this annoyed me, though I did not say anything to him – I am not attached to his fucking office for Christ’s sake, I am attached to him!) and that I was concerned about the cessation of therapy. Wow, insightful. I’m absolutely profoundly impressed, Dr fucking Freud-Einstein-Mary Poppins.

I’m ranting about him now for stating the obvious, but I also got really pissed off when he strode into the territory of conjecture. He said he was also aware that I was unhappy that I only had 50 minutes of his time each week and that I was annoyed that I couldn’t just turn up or phone him or whatever outside that time.

This sent me into a rage. At no point have I ever said such a thing. Struggling to control my anger, I snarled that his comment was unfair, and that he was putting words in my mouth. I asked him to exemplify exactly when I had made these assertions to him.

He admitted that I hadn’t, and moved on, but I think I now realise where he got this from. Some months ago – I can’t find the relevant post offhand, sorry – I had asked him who I was meant to contact in an urgent situation (because if my life depends on it I still want to avoid the fucking Crisis Team). Could I have a CPN, a social worker – anyone at the two CMHTs based at C’s hospital? I don’t remember his answer but it was some nonsense about ringing Lifeline or the Samaritans. Yeah, thanks C. So he had obviously read this request – a reasonable one, in my view, given that CMHTs are meant to be multi-disciplinary and he is only one tiny part of them – as a demand for his attention outside of our sessions. This was profoundly irritating. If he had failed to understand my question, then he should have asked for fucking clarification.

Anyway. To follow on from the uncertainty of the last couple of weeks, he brought up the matter of how long he can continue to act as my psychotherapist. Apparently, he can offer 10 week blocks, with four weeks at the end to deal with the closing of the relationship. Fair enough? Well, no, not really; he can only offer me two of these blocks – ie. 24 further weeks (beginning on Thursday 10 December) in total. Now, that will amount to something like 57 total sessions (including the three assessment sessions at the beginning and the four ‘leaving’ sessions at the end) which ostensibly sounds fair enough. Unfortunately for me, BPD is well known to take a very minimum of a year to treat properly, and usually three or four.

I didn’t tell him this as, in the past, every time I’ve made reference to my diagnoses he’s come off with (or at least inferred) some crap about fixating on labels. Heard it all before, C. So instead I asked what I was supposed to do if things weren’t adequately improved by that point.

He said, “I would expect you to have made progress by then – I feel you have made progress.”

Great – I’m so glad one of us does. Most reassuring. I pressed on. “But what if I haven’t?”

He said something suggesting that I shouldn’t be expecting cures from psychotherapy, at which point I interrupted him by telling him I didn’t even believe in cures and, in fact, didn’t especially want them. My question, I insisted, was in the context of alleviating the worst of the psychological pain and providing me with coping mechanisms and greater understanding that I could take onward in life. What if that had not been achieved within his stated timeframe?

I honestly don’t recall his answer, but there was a strong inference in whatever it was that if we were unable to progress by then that there was effectively nothing he could do for me (an assertion with which I do not agree, but what do I know – I’m just the stupid mental that sits opposite him).

No arguing with that, then. That’ll be it. The end. Finito. Fuck you, SI. In response, I just sat there looking at the ground for a while. It’s difficult to articulate how I was feeling. It was a veritable cocktail of fear, dread, hurt, anger, bitterness and depression. I fought, ironically using the breathing exercises that C had so fervently espoused, against tears and rants. I fought them because I didn’t want to give him the satisfaction of knowing that this abject rejection completely fucking cut me to the core. But he knew. Of course he did.

After a minute or two, he proceeded with that usual question of ultimate annoyance, “how do you feel about that?”

One thing I’ll say in his defence was that at least he was completely straight for once. Often he dodges and dives from material that he doesn’t really want to bring up with me for fear of setting me off (or such is my supposition for why he avoids it), but on this occasion he was upfront and honest, and through my anger and hurt, I felt appreciation for that. I told him so.

He told me to think about this over the next week (“but not so much that you end up ruminating on it” – as if that wouldn’t happen!) and bring all of my thoughts and feelings on the matter to him in the next session. He said, “you’ll probably feel anger, frustration…”

Once again, I got really mad at him for putting words in my mouth, so he desisted from that angle of probing. Whilst it will indubitably be the case that I am angry – I already fucking am – and whilst it was indubitably the case that, in an ideal world, I could phone and/or meet him outside of scheduled sessions, how dare he presume any of that. If he wants to know my thinking on these matters he should fucking well ask me – it’s not like he’s never asked before. He shouldn’t just assume that his suspicions are gospel, regardless of the probability of their accuracy.

During the silence that ensued, I fought a mental battle with myself. One side was crying out, “but that’s another six months! You should be grateful!”

The other responded, “the NHS has failed you yet again, SI. They are ignoring all research on your diagnoses.”

For once, the negative side was, I am convinced, the more rational. BPD takes a long time to properly treat. It is as simple as that.

Finally I said to him, “why do you do this job?”

I knew he would respond with a question, and indeed he didn’t disappoint.

“Can you tell me why it is it important for you to know that?”

“I’m curious.”

Once more, I knew he would fail to answer, and instead question me again. Once more, I was correct.

“But what is it that gives rise to that curiosity?”

I laughed cynically in his face. “Just answer the fucking question,” I demanded. “Please.”

He looked away and appeared thoughtful for a minute. Eventually he said, “because I think it is of value.”

I nodded non-committally and waited for the backlash.

Well, apparently my questioning his decision to practice clinical psychology ties in with my intense rage towards him / the health service (because that couldn’t possibly be fucking justified could it? Oh wait, it could!) and my assertions last week that he was a ‘headfucking sadist’.

I winced. “Yes, sorry about that,” I muttered awkwardly.

“No, no,” he insisted. “You should bring that anger with you.”

I ignored him and said that it must be something of a nightmare to spend an hour with me every week.

He sort of laughed and said that I have to spend all the time with myself. (This could be read as an invalidating statement, which it shouldn’t be – there was more to it than this, but I don’t recall the specifics. Whatever the case, the point was actually made more sympathetically than I’ve made it sound).

“Yes, that is a disability,” I mused. “But honestly – I’ve been such an angry child here recently, it must be shit for you.”

I saw his eyebrow quiver slightly at my use of the term ‘angry child’. Excellent. It had been intended to pique his interest.

“I’ve been reading about schema models recently,” I proclaimed, triumphantly.

This is where part two of the discussion began. Let’s call it Intellectualise my Mentalism.

The other week, when I was convinced my therapy with C was coming to a dramatic and premature halt in January, I rushed to the Yellow Pages looking for suitable therapists. I was looking primarily for practitioners of psychodynamic therapy, as I have been receiving from C, because it’s the only type that I have found remotely effective to date. However, I was open to exploring both schema and gestalt therapy, having read quite a bit on both, and found practitioners of both in the vicinity. As two major studies have demonstrated its effectiveness for all symptoms of BPD (unlike stupid DBT), I have more faith in schema therapy, even though it does involve some wanky (if apparently advanced) CBT, for which (as you know) I have no time, so – convinced I was in imminent danger of abandonment from C – I Googled “Schema therapy borderline personality disorder” and came up with this book. On a whim, I bought it.

The book contends that people with BPD have five main strands to their character:

• The healthy adult (the authors admit this seems an unlikely component, but make the reasonably fair point that many with BPD are not always going mental. Not that they put it quite like that, of course).
• Detached protector – this mode sees the patient protecting the harmed brats that form part of her consciousness.
• Punitive parent – “everything is my fault” mode. Must punish myself. I am usually pretty good at this, especially in session.
• Angry or impulsive child – furious, mainly as a defence mechanism. It is convinced it will be fucked over. It is also angry that its needs / rights are not met. (I am a walking stereotype).
• Abandoned or abused child – alone, no one cares about it, whinges, cries, blah de blah.

I told C that today I was the protector. I was avoiding his questions, getting irritated when he probed me – classic protector traits, according to the book.

We had a discussion around the whole concept of schemas, schema therapy and its development, which to my amazement resulted in him bringing up the term ‘borderline personality disorder’ in a completely unsolicited way. He went on to explain the schemas seen in BPD in more detail, to the absolute delight of my ears and my mind.

Feeling that we were on something of a discursive roll, I presented him with a print-out of this post from Kathy Broady’s blog. I had analysed the piece bit by bit in terms of its applicability to me.

I pointed out that it was written by a DID therapist, however, and that therefore it might not all apply directly to me.

He sort of shook his head and said, “there’s a debate in psychiatry and psychology as to whether or not DID and BPD exist on a continuum. At the very least, there’s often an overlap of symptoms. So therefore I’m sure some of this stuff can apply.”

(For the record I think I’d identified about 18 of the 20 signs Kathy listed as being applicable to me to one extent or another. Fuck! Is there more I don’t know about?!).

Satisfied with this response, I gestured for C to go ahead and read the list. Not wanting to sit there like a numpty whilst he read it, I stood up and looked out the window.

I could see out of the corner of my eye that he was looking at me, puzzled. I turned to him.

“What, am I not allowed to stand up now?”

“Well, yeaa-ahhh, you are,” he began, doubtfully, “but I’m just wondering why you’re standing up.”

“You’re reading that, so I’m going to look out the window,” I replied.

“I think you’re trying to distance yourself from the material in this article,” he told me. “It would be better if you sat down and faced it.”

So, the mere gesture of looking out the window is reflective of an entrenched tendency to avoid confronting one’s problems, is it? Well, fuck me, I’ve heard it all now. I was going to argue, but decided against it, not really seeing any point. I made an arm gesture of “you win” and sat down, internally laughing at how absurd I felt his deep reading of my meaningless action had been.

C read the list – to my annoyance, he read a lot of it out loud – then paused on one particular point. I don’t remember which one it was, but I’d provided an ‘analysis’ at the end along the lines of, “I do this, I do that, blah de blah.”

“Blah de blah?” he queried. “What does that mean?”

“I don’t know,” I said. “It’s just flippancy.”

“Yeah,” he agreed, “but where does that flippancy come from?”

“It’s stylistic,” I argued (I’m sure most readers of this blog will agree that I have a penchant for flippant remarks). “It’s just my writing style. You haven’t read any of my writing…”

“But…” he went on.

Enter stage three of the session – the mad, maniacal bit.

“Right,” I said authoritatively. “You don’t believe me that that’s how I write? Well, let me show you.”

From my bag I pulled out a print out of this post, my (latest) rant on the NHS. I began randomly reading some of the more colourful parts of the rants, in a deliberately exaggerated and dramatic voice. When I finally drew breath at the part where I talked about reading Grey’s Anatomy at the age of five, the completely befuzzled C interrupted me, exclaiming, “what’s happening here today?!”

He looked completely bemused, and on reflection I can’t say I blame him. It was a bit of a random tangent.

I defended myself on the grounds that I wanted to demonstrate to him that the flippant comments he’d seen on the trauma list were sod all in comparison to the flippant comments made by me elsewhere.

“But,” he said, metaphorically stroking his chin, “we’ve been all over the place today [I’m not sure that he phrased it quite like that]. For the first while I thought you were quite upset, quite agitated…now I’m not sure what you are…angry? And in the middle we perhaps intellectualised matters a little.”

“Oh fuck, I’m sorry!” I cried. “I led you into that.”

“These meetings are a co-construction,” he insisted. “I’m just as culpable for any straying off course as you are – we just have to be careful not to head into intellectual territory too much.”

He pondered for a minute and, referencing point 10 on Kathy’s list of trauma signs, said, “your rush to apologise just now ties in with that.” He noted that I had commented on the list that my self-blame wasn’t excessive because that for which I blame myself is, in fact, my fault.

“You do realise, objectively, that it is excessive, don’t you?” C asked.

“No no no, it’s my fault. It’s my fault,” I contended. “Just now I seduced you into that discussion on academic psychology. It was my fault, I’m sorry.”

Readers, why – WHY?! – did I have to use the word ‘seduce’? Why? A dozen other words would have sufficed. It just rolled off my tongue, as hyperbolic metaphors often seem to do.

He raised his eyebrow and narrowed his eye slightly. “Seduced?” he enquired.

Fuck. FUCK. FUCK FUCK FUCK! Now he thinks I want to fucking fuck him. Fuck fuck fuck.

I felt my cheeks turn red in utter mortification and in my rush to defend my use of the term, on the grounds that it was figurative, probably made an utter tit of myself – thus reinforcing any belief he might have that my transference is of an erotic nature.

Fucky fuck, shit and damn. I did try my best to explain what I’d meant, but I was flustered, and in any case it probably looked like a case of the lady doth protest too much. So eventually I gave up, looked down and gestured for him to continue to read the trauma list.

Thankfully for once he had the grace to do as he was told and not press me. He read on in silence this time, and when he’d finished I asked him if he thought the points included were applicable to me.

He said that he thought they were, and indeed that a lot of it had already come out in therapy and that we were beginning to address those issues.

He handed me the list back, and I read over it. For some reason I then went into a dysphoric but energetic rant against myself, telling C that I was “nothing but histrionic” for thinking any of the list was applicable to me, and indeed for bringing it to him.

He listened to and watched me in a kind of bewildered way. Perhaps he’s not that familiar with mixed states.

“Well, this has been weird,” I declared.

He cleared his throat, as if for dramatic effect. “It’s certainly been…” – he searched for the word – “…different,” he acknowledged finally, with a slight wryness I thought, which I found bizarrely reassuring.

“I was nervous about telling you about the schema book,” I admitted to him, rather randomly. “I’ve always got the feeling from you that you think to so much as mention a diagnosis is to fixate on a label.”

“Not necessarily,” he began. “It’s very important not to fixate on it, indeed. You mustn’t allow yourself to be ‘built’ around a diagnosis. But it can have benefits, yes.”

“I’ve found it helpful,” I said. “For one thing it’s enabled me to connect with a range of people who have been a great support network.”

“Good,” he declared. “No, I have no problem with diagnoses. It’s just important that you know that it’s not ‘borderline personality disorder’ that comes into this room, it’s [my name].”

I nodded. I think I do keep a sense of perspective on the diagnoses; if someone asks me about myself, unless it has been directly in the context of mental illness, I’ll usually tell them I’m a rock bird with a love for reading, writing, pubs, sci-fi and Newcastle United. The illnesses are part of me, and I am not ashamed of having them, but they’re certainly not the whole story.

As I was about to leave, C asked me to think over the prospect of there being a maximum of 24 weeks of the process left in order for us to discuss it at the next session. He all but begged me to “bring the anger with [me].” I protested that I couldn’t do so with absolute impunity, as I couldn’t face being heard screaming at him by those in the offices adjoining his.

He looked extremely taken aback at this, which I still don’t fully understand. I have social anxiety for Christ’s sake, does he honestly expect that I can allow anyone but him to be party to my rants? In any case, his secretary phoned today. Having convinced myself at the weekend that he was dead (whilst simultaneously reckoning that he wasn’t dead, but nevertheless believing that he was), I was horrified about what she had to say. Mercifully, so far C is not dead and will see me on Thursday at the normal time – just not in the normal place, due to building work. He is temporarily moving back to VCB’s stomping ground.

In a way, it’s worse to lose it with him there than in his own office. The office in which I suspect I will meet him is next door to the one VCB shares with other psychiatrists. These cunts all have it in their power to section me should I really lose it, which is hopefully unlikely but frankly not impossible, especially with ‘They’ still hovering about from time to time (though wouldn’t you know it, the anti-psychotic has seemingly killed Tom. Just my luck to lose the ‘good’ psychosis and retain the ‘bad’). On the other hand, an advantage of this location is that the building is attached to the day bin and adjacent to the actual bin, so hopefully they’ll be used to having crazies losing it on them fairly often.

As for now, I don’t know what I think. The argument is still ongoing in my head – More NHS Fuckovery, I’m Calling an Advocacy Service vs. Well, It’s Another Potential Six Months, Be Grateful. The truth is I feel both at the same time. A little bit positive, but more than a little bit lost.

“I Hate You, Don’t Leave Me” – Therapy Sucks – C: Week 32

The best-selling text written on borderline to date is a book called I Hate You, Don’t Leave Me, by Jerold Kreisman. I am struck by how much that title applies to this weeks session with C, which was fraught. Fraught fraught fraught. In a way, given parts of the post regarding last week’s session and my slightly more generalised anti-NHS rant of Wednesday, this should not be a surprise. On the other, given how passive – nay, submissive – I am known to be towards C, the fact that I was able to let it be fraught was surprising.

Not unlike last week, my memories are rather skewed. My most clear recollections involve me shouting at and insulting him and then threatening to walk out, then later breaking down and crying for what seemed like ages, in a defeated, resigned sort of fashion. Am I defeated and resigned? I’ll see if I can make some sort of sense of it all, but don’t expect miracles.

OK, so I went into his office and sat there like a knob, as seems to be fairly typical these days, as I refuse to start the conversation (no doubt an avoidance tactic). I had vowed to A that I would bring up the material in the aforementioned NHS rant, but as I sat there under C’s silent and enquiring gaze, I felt that I was going to chicken out completely. Eventually the silence led to the usual miserable whinge from me about wasting his time.

I saw my opportunity here – an opportunity to somewhat surreptitiously bring up my concerns, under the pretence that I was concerned about wasting C’s time. So when he yet again asked me why I felt the silences were so bad (apparently they can be very revealing and useful – since when did this become psycho-fucking-analysis?), I responded with something like, “well, we have a limited amount of time to talk about a number of things about which I need to talk. 50 minutes today, something like five more weeks overall.”

I don’t remember his verbal reaction (if any), but I think I noticed a split-second narrowing of his eyes at this, denoting confusion at the statement.

I have no idea what happened next. He must have probed me on my assertion that we only had five weeks of therapy remaining, though I distinctly don’t recall him doing so until later. In any event, I started babbling on about how I’d spent the preceeding few days looking online and in Yellow Pages for an alternative psychologist of a similar therapeutic bent to assist me on a private basis, but that I was having no success so could he please recommend someone, because if he wasn’t going to treat me until I was well enough to face the world without a therapist, then someone else would have to do so.

Again, the sense of confusion emanating from him was palpable, and I think he actually questioned why I’d felt this exercise was necessary.

I can only imagine that this was the point where I demanded specific answers from him on whether or not we were going to discontinue our relationship in January. Most (though not all) of the rest of the session centred around this, but I can’t be bothered to break it down into a specific chronology, and am not sure that I could even if I wanted to.

The very much paraphrased essence of this bit of the meeting was:

• C – I never said it would discontinue in January.
• SI – fuck you, you did.
• C – I said we would review it.
• SI – Same thing.
• Repeat 700,000 fucking times
• C – but you know it’s finite.
• SI – but it would be irresponsible of you to make it finite now. MEGA RANT ABOUT THE NHS – Starting with point 1 from last post (if they’d done something with me when I first showed outward signs of being mental, then we’d probably not even be here), moving on to point 2 (it’s either the bin or C – latter is surely cheaper, but the NHS is such a stupid fucking bureaucratic mess that they won’t consider that).
• C – you may well be right but unfortunately that’s the way it is.
• SI – how do you expect to adequately reverse two decades of mental illness in less than a year?
• C – answer not recalled but probably some politican-esque answer of avoidance.

Blah blah blah. He kept refusing to tell me directly whether his reference to reviewing things in January was a suggestion that we would end things then. He did, however, have the audacity to ask me what I wanted him to say. Hmm, that wouldn’t be obvious or anything, would it?

I said, slowly and menacingly, through (very evident) gritted teeth, that what I wanted him to do was to give me a straight fucking answer.

I don’t remember what he said, but it wasn’t a straight fucking answer – so I lost it. I absolutely, completely fucking lost it. I felt the anger well up in my stomach, like some sort of raging inferno, and felt it rise through my internal organs, eventually finding its way to my vocal chords.

I screamed at him, “I’ve fucking had enough of this. I’m leaving right now!”

And, indeed, I got my things together and went to stand up, but he started blathering on again – so, curious though still furious (I’m a poet, didn’t know it), I relented and sat back down. I think he was asking me where this anger was coming from or some such other non-sensical wank given that it was profoundly fucking obvious where it was coming from. (Or maybe not. Maybe I am angry at my father for abandoning me and C, in his role as a temporary surrogate father, is now bearing the brunt of that anger thanks to the perceived threat of abandonment. Oh yes. It must all be to do with one’s subconscious, mustn’t it? Nothing to do with the fact this uncertainty is fucking with an already fragile mindset. Fuck off, psychology).

I threatened to walk out again, telling him that if we were going to end things that we might as well just do it now rather than waste more of our time, but he kept managing to entice me not to leave.

I then spat at him (in something of a stylistic homage to part of this post) that he was “nothing but a fucking sadist” because he and the profession to which he belongs do nothing but make people relive trauma and misery and that it takes “a special kind of twisted individual” to think that that’s an enjoyable career path. I asked, rhetorically, if he’d use the old cliché of ‘I want to help people’, sneering about that being used as some sort of defence of his decision to practice clinical psychology.

I continued with my contempt-filled bile, telling him that he didn’t want to help people, that instead he wanted to “headfuck” them (I was gratified to see how agog he was at this. “Headfuck?!” he repeated, apparently aghast and astonished. Hahaha). “You’ve had your fun with me,” I asserted, vindictively, “so now you want someone else to headfuck.

He harped on the ‘headfuck’ comment for a bit, asking me to explain it, but I don’t remember exactly what he said and neither do I remember my response. So let’s (regrettably, cos that was fun) move on; at one point he asked what it would be like to end therapy. I said that I would have no real outlet to help me cope with the enormity of what I feel and of what I want to talk about. I said that I was emotionally (yes!) fragile in the extreme and that being left alone with the totality of my mentalism might well send me over the edge.

And how would it feel to continue, then, he pressed. Well, we have reached a point in our relationship where I feel that I can trust him enough to fully explore all that needs to be explored (not that that will be easy, but at least I think I can do it now). Our relationship is, I feel, the only adequate vehicle that I have – and have had – for a recovery of sorts. Only with his support and guidance can I face these things and, hopefully, move on from them. Or something – I don’t remember the exact nature of what I said. It was something like that.

Was it at this point that I uttered those tiny but synchronously hugely vile, belittling words? I don’t know, but this post is so disjointed anyway that it hardly matters. I said, “you can’t have escaped the fact that I’m very attached to you.”

He didn’t specifically respond to that as I recall, but at some point or other he did say that terminating therapy was going to be “a problem” whenever it happened, irrespective of whether we continued now or not and whether we’d worked through things properly. He didn’t say it, but the clear implication was that that would be due to my attachment to him. He’s right; I can’t deny it, it will be fucking horrible. The only thing I can say is that I would hope to be in a better mental place to deal with such a difficult prospect further into the relationship; right now, I am convinced that it would merely result in a hospitalisation – or even a possible run to catch the bus.

The long and the short of it is this: (a) we will review progress this Thursday rather than in January, as he recognises the enormous pressure that Christmas places on me, which will be compounded by his fortnight’s worth of absence at said point; (b) again, he stressed, there would be at least four sessions in the run-up to a termination of treatment devoted entirely to how to deal with that cessation (and it would probably more like six sessions); and (c) he is happy to continue ‘working’ with me as long as there is actual work being done – he won’t just do it for the sake of avoiding ending it.

On (c), I accepted the reasonableness of this position, but told him that if there were occasions where I found it very hard to talk to him about a particular issue, I did not want him to be of the view that that was me simply trying to manipulatively (not that that’s a word) extend therapy. I wanted him to be aware that some issues are just difficult to face, and it will take yet more time to address them.

He seemed surprised that I thought he would think that I would try to draw out the process, but assured me that he wouldn’t and didn’t subscribe to such thinking.

It was probably here that I started crying. I babbled incoherently through my sobs and he couldn’t understand me, and kept trying, in this annoyingly understanding and compassionate tone, to get me to repeat myself. Eventually I managed to articulate that, although I desperately want to continue with psychotherapy, the idea simultaneously petrifies me as I really don’t want to think or talk about so many things that I probably need to think or talk about (deja vu, anyone?).

I sat and cried for a few minutes, then started (literally) beating myself about the head as punishment for crying. He told me to stop it and said that I should allow myself be upset and indeed that he would actively encourage my tears if I was feeling an emotion that may precipitate them. For once I did as I was told, sitting silently in tears for a few minutes. As I said at the start of the post, for some reason I just felt terribly defeated – even though I shouldn’t because it seemed like I had got what I wanted – ie, C was saying that we could continue the psychotherapeutic process. Perhaps I felt defeated because continuing is agreed with the qualification that we are actually still doing something constructive – my visceral desire, of course, is to have him in my life permanently in some way. But this is armchair psychological conjecture; I have no idea why I felt this weird resignation. Perhaps it is simply that I was exhausted by riding on the rollercoaster that this session had been.

At what I think was my instigation, there was a discussion around the fact that it’s basically taken me six months and more to even begin to open up to him properly. I have discussed many things in sort of superficial ways, but I’ve not gone into much detail about specifics relating to my past at least and certainly, I have very rarely – if ever – behaved in a fashion like I did in this or the preceeding meeting whilst in session. I, of course, lambasted myself left, right and centre for being a time-waster.

C disagreed, opining that it was perfectly reasonable for me to have taken all this time to ‘test’ him, to make sure that he was worthy of my trust. Apparently he does not believe this to be time-wasting at all.

Whilst that is ostensibly reassuring, of course I find this a rather curious declaration on his part. If it was reasonable for me to have taken so much time to get to know him (well, kind of) before opening the floodgates, then how can it be unreasonable for me to expect long-ish-term therapy from this point to examine relevant issues from my past, or of transference, or of my life right now? The notion of continuing on some sort of rolling contract, rather than setting an initial timeframe of, say, six further months, seems incompatible to me with the idea that it was a positive thing to have used up the first six months essentially getting to know each other.

Anyway, I dried my eyes and apologised for shouting at him and for “being nasty”. Ever the psychologist, C replied by stating that if that was something I was harbouring, that it was good to demonstrate it to him, and that he would encourage me to do the same in future. He’s right of course, but it seems so terribly cruel for me to sit and shout “sadist! Headfucker!” or some such across the room, when the reality is that I don’t actually believe that and that I probably just wanted to hurt him (which I have no doubt he realises).

One thing I remember clearly about this session was that he seemed reluctant to let me leave. Normally, on the 49th minute mark, he pipes right up with the “we’re going to have to leave it there” line, and uses the remaining seconds for very brief housekeeping or, simply, goodbyes. On Thursday, I kept grabbing my stuff to leave, but he kept interrupting. It was odd and, looking back now, seems a little unsettling; he must have been seriously troubled by my mental state at the time.

Indeed, he said that he was concerned about how much I ruminate on therapy and that, that day in particular, he wanted me to find something else to occupy my mind, noting how difficult I had found the session.

I told him I would go home and kill people on Grand Theft Auto: Liberty City Stories.

He laughed (I don’t know why because I was absolutely serious) but continued by asking me what I enjoyed.

“All my interests are solitary pursuits,” I advised. “Aside from GTA and other video games, I don’t do much and don’t enjoy much. I do enjoy writing the blog, but one needs a specific mindset to write about difficult things and I am really not in it right now.”

(As an aside apparently C now thinks this blog is a good thing, despite the cuntified whinging that I reported here. Well, not that he thought it was a bad thing then per se – he just thought I was too fucking braindead to be careful in what I wrote here. Anyway, he now believes, correctly, that I seem to find the composition of posts cathartic and that I have found immeasurable support through the people that read what I write. If you don’t already know, folks, this is absolutely true. Thank you).

In the end we agreed that I would make an effort to rejoin the gym – as they all bloody do, C thinks exercise is imperative in promoting mental health. What’s more, though, he seems to be of the view that the physical effort required in exercise alleviates anger, stresses, blah blah. Personally, I find the gym insurmountably boring, but I’m unlikely to try and do myself in there I suppose, what with the other fuckers about. I haven’t rejoined it yet, but I will tomorrow. As for that day, despite my expectations that I would go back to A’s and my promise to C to actively take my mind off the session, in the end I went to my mother’s house and straight to bed. Rather than reveal why, I let her think I was ill.

So, how do I feel now, several days later? To be honest I don’t know. Although C said he was happy to continue working with me as long as we were not just avoiding the end of therapy for its own sake, the lack of a more definite answer and indeed timeframe still annoys me, and I am nervous about this week’s session as of course we are to review progress to that point. I do think significant advances have been made, as it happens, and I assume that C must too otherwise he wouldn’t have felt it was reasonable for me to take six months to get to this juncture. But nevertheless – I am dubious about what he’ll arrange next. Another 10 or 12 weeks – or something more meaningful?

I am sorry that this entry is so confused and disjointed, but that’s an accurate representation of my mental state during this session and, to a lesser extent, of the entire session itself.

Be Angry With The Filthy Whore – C: Week 31

Thursday was fucking traumatic, a state of affairs of which you are probably aware given my citation of the disturbing imagery of Metallica’s Until It Sleeps that evening. You’ll have seen on that post that my iPod was reading my mind again in playing it – and other songs on similarly dark themes – but what is most interesting about this is that this strange form of electronic ESP took place as I was driving home from an utterly pointless dissociative trip to a coastal town about 20 miles from home.

My first proper awareness of going to said town was when I realised I was in the centre of it. I do have a very vague recollection of noticing my normal turn off and thinking that the traffic was heavy, but at no time did I think, “why the fuck are you not in that heavy traffic?” I don’t remember deciding to drive on, and I don’t remember the journey. Another small-scale fugue-like episode. Sweet.

I had been quite good on the self-harm front of late, but the good spell has been broken. ‘Bitch’ and ‘grief’ are the latest, though I don’t remember doing the former (it must have bled like fuck though as I had seemingly used a towel to stem the bloodflow). Grief. Am I grieving for myself, or for what I should have been? If so, is that good? Presumably one is meant to say, “well, the self-harm bit isn’t good,” but you know me folks – not really one to listen to that sort of argument. A is raging with C; in A’s eyes, it is C’s fault that I have taken to cutting myself again. But it isn’t. It really isn’t. All C has done is facilitate triggering discussions, and been someone to whom I am hopelessly attached, which is hardly his fault. We can’t avoid matters of this importance simply because there is a risk it may act as a trigger; the entire psychotherapeutic process would then be pointless, and I’d be left as mental as I ever was.

I’m unsure as to what exactly this entry will amount to, as I remember surprisingly little of the session – perhaps unsurprisingly. But let’s start at the very beginning and see what happens.

C pointed out that he’d been looking through his diary and saw that our current contract was due to end shortly (he thought there were two sessions remaining after Thursday; I thought one, but as it turns out it will not matter). This was something of which I was horribly well aware. Having only begun to open up to C properly in the last few weeks, I was convinced that he’d see me as a manipulative bitch – it looked, to my cynical mind, like I was trying to wrangle more time out of him by leaving the avalanche of confessions until this point. Given that my primary diagnosis is borderline personality disorder, it reasonably follows (in my eyes) that he could believe me to be manipulative, as the psychiatric establishment still seems to think that about those who have BPD more than any other psychiatric problem.

Of course, he didn’t like either the idea that he would find me manipulative, nor in particular that he would think this because I have BPD – that fixates on labels, don’t you know. Actually, it doesn’t, because it’s what I think he should think anyway – the fact that BPD is the only psychiatric diagnosis to still be treated with open contempt by mental health professionals just reinforces that point – though to be fair, I have not experienced that disdain personally, thank God.

I honestly don’t think I was being manipulative – not consciously, anyhow – but it did look like it, and that had been my worry all week. Of course, C refused to concede that this was the case in his eyes. Did he point blank deny it? I think he may well have done, but I don’t remember clearly enough to say for certain. What he was willing to admit to was that I may, consciously or otherwise, fear the end of the relationship, and act accordingly to preserve it. Which is apparently not manipulative. Hmm.

The issue of the end of therapy raised its ugly head a couple of times during the meeting. What he said at this juncture was that we should “…continue seeing each other until Christmas, at which point [he’ll] be off for a fortnight, and then we’ll review the situation in January.”

Review the situation in January. You can take a wild guess as to what I think about that. He is going to throw me out with the dirty water in cunting January. Just over a month away, after the most stressful time of the year for me (ah yes, I’m sure you’ll be treated to a delicious rant about fucking Christmas in the near future, dearest readers). A tells me that this is not what C meant; apparently, he literally meant that we shall review the situation, and if further therapy is required (as if it won’t be), then that is what the case shall be. Well, Ms Rationality of course says, “yeah, right” to that. He is going to abandon me.

I honesty don’t remember how I reacted in session to the comment about ‘reviewing things in January’. I think I simply agreed and didn’t voice the aforementioned rejection worries, but I wouldn’t swear to it. As I said, it did indeed come up again, but I don’t remember under what circumstances. I can and do appreciate that the relationship can’t be permanent – in the most rational of ways, I don’t want it to be. I want to live an independent life, free of a need for a surrogate daddy. But can C realistically expect to change 13+ years of misery and being fucked about by the NHS in seven-ish months, particularly when I have such a strong neurotic attachment to him? Trying to be objective about it, I cannot honestly fathom that as reasonable, except in especially productive scenarios (which are about as applicable to me as…um…er…something that is very un-applicable to me). This is a personality disorder. It is ingrained into every metaphorical fibre of my self, the conscious, the unconscious, whatever – and it is causing me to self-destruct. Can something of such enormity and longevity honestly be treated adequately in just over half a year?

In any case, eventually the discussion – predictably enough – returned to the eminently delightful subject matter of the preceeding week. Eugh. It was me that raised it, though not exactly through choice; we were talking about something else (no idea what now) which triggered some sort of memory – it’s a shame I’ve forgotten what that subject was, as it would be useful to know these triggers, especially in cases where there is no obvious correlation, as I think the case was in this instance.

I became rather agitated and told C that I wasn’t “going there”. I hid.

Despite my telling him to leave it, he continued to probe me – but gently and quite subtly, to be fair. I eventually admitted that I was thinking about the Pandora’s Box.

My memory is even more fragmented from here on in, though some things do stick out in my mind very clearly. I was very, very careful not to verbally articulate much at all; at one point I desperately begged, “look, don’t you see where I’m going with this?” But it appears that he believes that I need to say the words. I still have not used the word ‘rape’, and strictly speaking he could still be under the impression that it was something other than rape – but he’s not that stupid.

He must have asked what was so troubling about verbalising this material, because I remember then telling him that I am fairly tolerant of articulating the gruesome information on this blog.

“Which is odd,” I mused, “given that it is all the more real when it is written down, even more so than if I verbally discuss it. It’s there, on the blog, in black and white.” (See here, for example).

I went on to postulate the idea that perhaps it is easier to deal with in writing because I can rationalise everything; life events become something that is seen in the third person, by a narrator, an observer with at least a modicum of theoretical knowledge of that about which she writes. If I have to talk about it, I have to feel it. I am there, in the midst of it, with the rawness, the vileness, the trauma of it all.

He agreed. He didn’t say so, but a sense that he wants me to feel that repressed pain was very palpable. Maybe that is why he was such a cock when I put this, and other shit, in writing for him – in fact, I’m certain it is. What kind of profession capitalises on other people’s grief? If I asked him why he became a clinical psychologist, I’m sure he’d respond along the lines of that old cliché, “I want to help people.” What, by making them relive their darkest memories, by making them suffer through them all again? Does that not take a special kind of sadism?

I am, of course, being a little facetious; I don’t believe C to be a sadist in the least, and I do believe he is in his job for the right reasons. But the human mind, and the sciences that arise therefrom, are odd things indeed. It strikes me as strange that it is an apparent psychological necessity to directly face that which you most revile in your past, before you can heal from the wounds it inflicted.

But this is not a post about the curious concept of psychology as an academic discipline, nor is it a post about the mindsets of those practising this form of figurative alchemy; it is a post about a session I had with my therapist. So…was it at this point that I lost it? I’m not sure, but anyway, in my next clear memory, all I could see in my head was the INCIDENT, or more specifically, the moments during which I was pushed to the floor of the outhouse in which it took place and served up as tasty piece of young meat for the delectation of my uncle. I recall very strongly that (in C’s office, not in my mind) I had my head in my lap and was pelting my skull with both fists with as much strength as I could muster. I have never done anything of this ilk in C’s company before.

And so he too did something that he has never done before; he raised his voice to me. He didn’t shout, but he did raise his voice just enough to try and penetrate through the mentalism that had tenaciously gripped my mind.

“SI!” he called. Well, he didn’t of course – perhaps it will surprise some of you to learn that I have a name, a normal, very ordinary name, and he used that instead – but you know what I mean. One thing I’ll not forget about this session was that he actually used my name three times, and at one point I used his too – these things are unheard of in the whole time we’ve known each other. Does it mean something? Why do I attach such importance to something so apparently normal and trivial? Is it because using names is personal, and that I want to see him as a person, not a canvas? Who knows. I certainly don’t, but I do know that that memory sticks with me.

I think he must have somehow brought me back from this mental place, but I don’t remember the specifics. The next part of the conversation that I recall was when he asked me how I felt about myself and that I told him that I felt like a “dirty, fetid little slut.” I then rationalised things for a bit, proclaiming that I am in actuality not a slut. Unfortunately, I still felt (feel) like one.

Then I lost it again. “I’m a filthy whore,” I spat, hiding from him again with my hands.

I think he actually went as far as to tell me that I am not a whore, but that could be a phantom memory. I mean, how the fuck would he know? I could have sold sex in 28 European capitals for all he knows. One thing he definitely did do was try and help me regain my composure. I sat up and pretended to be fine, sticking out my hand to measure how much it was shaking. I have used an incident when I was about 15 as a yardstick to measure anxiety; the day after I found out about an incredibly twisted lie from my first real boyfriend (a long story that I will have to detail some day), I went into school and, in English, happened to notice how much my hand was shaking. That denotes severe anxiety and/or anger. If the shaking is less than that, things could be worse.

I told C about this. However, a brief reference to the lying cunt of an ex must have touched on the self-disgust I was already feeling over my own lying to C about the INCIDENT (when we first met I told him it was ‘mere’ touching, but that was only part of it, obviously. More on this shortly). I told him this – still without using that word – and went into a major self-invective of utter disgust and abhorrence. It was filled with ranting about how much of a shameful, lying, grotesque, hateful slag I am, lying to the one person that might be able to bring me back a little hope in this sorry mental battle, and about how guilty and sorry I am, blah blah de blah.

When I took a second to draw breath, he jumped in to try and (a) reassure me that I had nothing to feel guilty about and (b) establish exactly what it was that I felt I’d lied about.

I answered (b) first, at least to the best of my recollection. He’d specifically asked in our initial assessment sessions what form the sexual abuse took. As is my wont, I had avoided articulating myself properly, and instead managed to answer the question merely by his probing. I think, though I am not certain, that he asked if I was raped, and that I said ‘no’. I am sure that when he asked if it was inappropriate touching that I said ‘yes’, and that I led him to believe that that was all. In my defence – and I told him this in the session to which this post refers – I have dissociated a lot of the INCIDENT. I remember ghastly, loathsome pieces of it in fleeting glimpses, like looking at still pictures in an album or, sometimes, short video clips. I remember the sensations of pain and terror in these moments too. I am grateful that the memories are so brief, but also resentful of it too, as it feels like it removes my power to understand the INCIDENT and my reactions to it. Furthermore, obviously part of me does remember it, and that part is mentally fucked – perhaps it would be easier to address were it all consciously there at the front of my mind.

Anyhow, I then proceeded to respond C’s (a) point. “I lied to you,” I said simply. “Aren’t you angry with me?”

“No, of course I’m not angry with you.”

“Why not? You should be.”

He sort of laughed (he mustn’t have realised I was serious), but seeing the look on my face, he desisted from doing so abruptly.

“SI,” he said again, firmly, looking straight at me. “Do you seriously think that I should be angry with you?” His tone was a more compassionate version of ‘incredulous’.

“Yes,” I began, “fucking dirty, lying, grotesque little bitch, fucking…”

“One,” he interrupted, rather dramatically, leaning forward and counting on his fingers as he did. “We had only just met and you can’t honestly have expected yourself to deeply discuss such sensitive matters with someone you didn’t know. Two, you didn’t lie, you omitted some information…”

“But then that’s a lie of omission…” I began.

“Three!” he went on, raising his eyebrow in a surprisingly authoritative fashion, signaling that I was to let him finish, “three, this is hard for you to talk about, so it is not surprising you withheld it. What is there to be angry with?! I am not angry with you, and neither should I be.”

Well, that was me told, then. I was quite taken aback by the forcefulness of his tone. Actually, ‘forcefulness’ is a horrid word to use as it has negative connotations – let’s say ’emphatic’ instead. He was incredibly emphatic. I gaped at him in a sort of stupefied disorientation for a minute or two.

He sat back in his chair, recovered his blank canvas and either asked me how I felt, or signalled for me to speak.

“Um…” I muddled. “That’s reassuring. I do feel reassured. But it also confuses me; you have a completely different attitude to it from me.”

He seemed to understand that in fairness, which not an awful lot of people would. He was able to see the black-and-white chain of logic that I was following in believing that he ought to be angry, but luckily for C things in his world do not seem to be as black and white as they are in mine.

I don’t remember how things ended. I know that I was battered and bruised psychologically (and physically to boot what with punching my head). At no point had I been tearful, but one does not need to weep to mentally suffer. I went and sat in the car and phoned A for catharsis and reorientation purposes. Although the trauma of reliving the INCIDENT had been the most awful aspect of the session, the fact that I fixatedly whined to A that C ‘wants to abandon me’ before I even touched on the rest of things is very telling.

In later discussions A urged me to tell C about this abject fear. What’s the point? C already knows I’m terrified of him abandoning me. Perhaps the real question is ‘is my attachment to him healthy?’ There have been mixed views on this from the readership of this blog. cbtish, for example, thinks it puts me in an intolerable position (cbtish is a therapist). Vanessa from eTransference, a clinical psychologist in training who has a particular interest in the phenomenon of transference, thinks it ought to be encouraged in many ways. Others undergoing therapy – bourach and thesamesky (who’s also a counsellor) for example – have their own struggles with the therapeutic dyad (bourach in particular will understand why I thought C should be angry with me, given this post of her’s).

I don’t know what the answer is; just that the attachment is very real. Just that I feel guilty for withholding information and for lying (though he wants me to stop that – and I’ve just remembered that the session ended with him asking me, again, to try and not post-mortem things in therapy. Oops. He was also worried, after what happened with VCB’s SHO in September, that his actions or words could have a…er…detrimental effect on me. Double oops. All I can say is that I think our current dialogue is progress, regardless of any self-harm that follows). And at least I am far from alone in withholding, and even lying.

But it’s still all a bit of a quagmire, yes?

Until It Sleeps

The iPod has been acting as a mindreader again.

I’m not in the habit of doing this as this blog is mine; my life, in my words. However, sometimes others just say it (whatever ‘it’ is) better than me, and this is very much one such occasion.

So, ladies and gents, I give you the nature of my present sorry existence – as presented by Metallica.

Until It Sleeps

Where do I take this pain of mine
I run but it stays right by my side

So tear me open and pour me out
There’s things inside that scream and shout
And the pain still hates me
So hold me until it sleeps

Just like the curse, just like the stray
You feed it once and now it stays
Now it stays

So tear me open but beware
There’s things inside without a care
And the dirt still stains me
So wash me until I’m clean

It grips you so hold me
It stains you so hold me
It hates you so hold me
It holds you so hold me
Until it sleeps

So tell me why you’ve chosen me
Don’t want your grip, don’t want your greed
Don’t want it

I’ll tear me open make you gone
No more can you hurt anyone
And the fear still shakes me
So hold me, until it sleeps

It grips you so hold me
It stains you so hold me
It hates you so hold me
It holds you, holds you, holds you
Until it sleeps

I don’t want it, I don’t want it…

So tear me open but beware
There’s things inside without a care
And the dirt still stains me
So wash me ’till I’m clean

I’ll tear me open make you gone
No longer will you hurt anyone
And the hate still shames me
So hold me
Until it sleeps

(c) James Hetfield and Lars Ulrich, Metallica (from the Load album, 1996).

I will write properly tomorrow, but in the meantime you can listen to and watch the video for the above here.

Remonstrations with C – Week 29

I was absolutely dreading seeing C last week, after the disaster of the previous week.  Although the rawness of my hurt and anger had abated somewhat, I still felt fucked over and undermined, and obviously had no idea what he was thinking.  In fact, I’d arrived at a position of relative indifference towards him, something I’ve never really felt during the whole time we’ve known each other.

My initial thinking was that, from a psychodynamic perspective, this was a very bad thing.  You can’t just switch transference off, not well before the relationship has fulfilled its duties anyway (which as you can tell, ours as yet has not). I mean, one is surely supposed to feel strongly – or at least not ambivalently – about the therapist in the course of this type of psychotherapy.  But perhaps it wasn’t such a bad thing after all.

As I walked behind him from the waiting room to his office, I couldn’t help but observe how much his bald spot has grown since I first met him back in February.  He has lovely fluffy hair, like a man about 40 years his senior (old people always have lovely fluffy hair, don’t they?).  But now it is falling out.  By odd coincidence, I noticed my first grew hair on the evening of the disaster session that this meeting followed.  I must not allow myself to be deluded into thinking that I am encouraging or in some way perpetuating C’s hair loss.  That would be fucking stupid.

I sat down, and immediately cast my eyes downwards, so as to avoid his gaze when he sat down.  I don’t recall what he said at first – maybe he offered some salutation or asked where I wished to begin, but in any case he paused for a few minutes (during which I sat in a fiddly silence) and then told me that I “seem[ed] very agitated.”

Well, look at Dr fucking Insight. Your powers of perception astound me, C!  Well, actually, they do at times – but I think on this occasion the observations could have been made by a dead giraffe with its neck twisted in a strait jacket.

I elected to ignore him beyond a mere shrug.  ‘They’ were laughing spitefully at the back of my head and getting on my tits, though I don’t think they influenced my behaviour around C particularly. He hadn’t mentioned the previous week, and I hadn’t the balls to bring it up unsolicited, so what did I have to say to him?

Eventually, of course, he broke the silent deadlock with that perennially irritating question, “what’s going through your head as we sit here?”

As I recall, I told him that very little was going through my head.  Apart from the grammatically- and personality-challenged ‘They’, not much really was happening in my head.  It felt as if I existed in a thought vacuum.  I didn’t feel good by an stretch of the imagination, but I didn’t exactly have anything tangible to exemplify that at that particular point.

This impasse continued for a few minutes, as ‘They’ assessed C.  Perhaps unsurprisingly, their conclusion was not especially positive.

Eventually, after having ‘They’ berate C for a few minutes I took a deep breath and told him that I was seriously considering voluntary admission due to the danger posed by ‘They’.  I went ahead and explained about ‘They’ in detail.

“I don’t want to go, C, I don’t want to go,” I told him, anxiously.  “But I’m concerned that I’m in dangerous position and that I ergo have no choice.”  It’s funny; it’s the the first time I recall using his name when addressing him directly.  Not that it matters really – but it seems more personal or something.

He talked for a while about the procedure one has to follow to seek admission to an NHS psychiatric ward.  Unfortunately, it doesn’t seem that it is as simple as it used to be.  You have to meet your GP or psychiatrist, but rather than them referring you directly, they then send you to one of those fuckwit Crisis Teams who decide how mental you are.  Based on my experience, you’d need admitted after meeting them, not that they’d realise that, because apparently a cup of tea and some meditating will cure all mental illnesses and emotional difficulties.  Yep.  That’s why people in my position are considerably more likely to end up topping themselves than the general population, you pathetic cunts.

Anyhow, I was actually reasonably impressed with C’s non-judgmental take on on both ‘They’ and my hospitalisation proposal.  It is often his wont to tell me that I can be in control of stuff like this, which to my mind is (mostly) horseshit.  Although we later discussed the possibility of exploring non-medical ways of dealing with ‘They’, certainly at this juncture, his tone was accepting, as was the content of what he said.  That was encouraging.

After the discussion around hospitalisation, I admitted to him that ‘They’ didn’t like him.

This enraged ‘They’.  “That is not what we said,” ‘They ‘ shrieked at me.  “We said he was a cunt.  Tell him.  Tell him…TELL HIM!”

For the first time, in utter frustration, I actually spoke aloud to them – or rather, I shouted at them.

“Alright, for fuck’s sake, I know!” I yelled.  I had actually been in the middle of a sentence directed at C at the time, and he must surely have been taken aback by this random outburst – but he managed not to bat an eyelid.

I don’t remember how the discussion of my anger at the previous week’s annoyances arose, but eventually arise it did.  I do remember that he said that I hadn’t commented on that, and my responding that he hadn’t asked.

Rather than express my raw hurt, I simply said, “let’s put it this way; I wasn’t in the best of moods last Thursday.”

His response surprised me slightly, though I think I hid it well.  He said, self-referentially, “what a bastard, right?”

“Um…well.  Am I allowed to say ‘yes’ to that?”

“You’re allowed to say whatever you like.”

“Then yes, exactly.”

He nodded, apparently unoffended (not that he should be given his job), then we discussed the issue in a fairly forthright and adult manner.  There’s little point in going over it, as most of my annoyances were discussed in the letter – though I didn’t give it to him as I said I would in the comments of that post.  I did tell him about it, though, and admitted to having a printed copy in my bag.

C actively encouraged me to read it to him, but I refused.  I don’t know why; I’m annoyed with myself for chickening out, but it just didn’t feel ‘right’ at the time.  I told him I would think about it, and indeed I have the letter ready to take again tomorrow.

I had made the point that I had taken an awful lot of time to prepare the stuff I’d taken to him the week before, and told him that I’d found it horribly invalidating when that work was “thrown back in my face because [he] couldn’t be arsed to read it.”

He didn’t bother to defend himself in anyway.  Instead, he went to what seemed to me to be great pains to tell me that he really did understand my upset.

“And maybe you felt rejected?” he later queried.

Rather than duck out of this, as I would normally have done, I went ahead and confirmed his suspicion.

I wasn’t overly emotional throughout this discussion (though had been a bit during the discussion of ‘They’), but I had been out the day before wearing eye make-up (and hadn’t been arsed to wash it off – I know, I know, how disgusting), and my reluctance to express myself in this fashion in front of C had more to do with the possibility of having big black mascara-streaks down my face rather than my usual ‘must-fight-against-it-it-is-evil-and-weak’ stance.  For the first time I began to get a sense that I could and should talk openly to C about things I’d deliberately avoided, and that I could maybe start to demonstrate exactly how I might feel – and if that includes crying, or ranting or kicking things, then so be it.

There was nothing clear in the discussion that led to this, but for whatever reason, I felt the dynamic had subtly changed for the better – not that it’s generally been a bad one, of course, but perhaps it took an argument for me to fully trust him not to abandon me; ie. that if he was still there, still very much part of my life – and if anything more supportive – after a major disagreement, that just maybe he could be trusted with a range of unpleasantries.  Not that I ever consciously doubted that, but I don’t know – the subconscious is a funny thing I suppose, and I’ve always been firmly of the view that one should trust no one until they have definitively proven themselves trustworthy.  And even then, the trust should be cautiously administered.

Whatever subtleties took place last week, I hope they can sustain the future of the therapy.  Far from wanting to seek an alternative therapist, as I did the day I wrote the letter, I am quietly encouraged by things with C as they stand.

But it could all change tomorrow…

An Open Letter to My Therapist – C: Week 28

Dear C

Previous meetings, specifically that of today (Thursday 29 October), refer.  I should like to enquire as to what you feel that the mandate of our work together is.  It has been my long-held understanding that the point of psychotherapy is to improve the mental health and emotional difficulties of the personnel that the psychotherapeutic community refer to as ‘clients’, ‘patients’, or patronisingly, ‘service users’.  I should be grateful if you could confirm that this perception is in fact an accurate representation of the nature of your profession.

Assuming that I am indeed correct in this apparently nefarious and naive assumption, I should like you to clarify exactly why the opposite seems to be so frequently the case as regards the relationship that we presently share.

You were, quite reasonably in my view, asked today to read some material prepared by me, primarily from my online journal.  A great deal of effort was put into a proper and considerably redacted construction of this diary by me, an effort that I deemed to be worthwhile owing to the fact that the diary records some very personal and incredibly painful memories, thoughts and feelings that I feel utterly incapable of expressing verbally.

I should imagine that from the interaction between us since your refusal to read these words this morning, that you realise that said refusal has distressed me considerably.  I hold you responsible for this, and therefore again would question the mandate of our relationship.

If you have failed to recognise that I am a highly intelligent individual, then let me remind you that I have a tested IQ of 148.  Therefore, I should assume that someone who has your own level of intelligence would be cognisant of the fact that I am thoroughly aware of the concept of therapeutic boundaries, and indeed that I am not the only person on whom you need to concentrate in your work.

Notwithstanding this, C, I feel that your rejection of this simple request was unreasonable and frankly unfair in the extreme.  Firstly, given as I am aware that you take notes on me, speak about me behind my back to VCB and quite possibly LGP and are willing to fill out administrative forms pertaining to my social security status, it surprises me that it would be considered inappropriate by you to take half an hour to read a few pages that would give you considerable insight into my past, and into my mind.  This is, after all, the crux of what you, as a clinical psychologist, are meant to be doing, is it not?  I fail to see how this breaks any boundaries, and given the relatively small timeframe required to complete the task, I do not feel that the level of effort required by you to complete this reading is unreasonable when weighed against the value you would obtain from it in terms of my psychotherapeutic treatment, which you are meant to be conducting.  Indeed, I believe that what you would gain from it is considerably disproportionate to the (in universal terms) infintessimal amount of time you would invest in it.

As I told you this morning, if you cannot be arsed to engage with the material, I would appreciate that honest response from you.  Instead, you claim that you were unwilling to participate in this exercise owing to the supposed fact that it would be “unhelpful” for me to fail to verbally articulate these details.  I believe this excuse to be what is colloquially termed a ‘cop-out’.

Whilst I could appreciate and understand this position were the behaviour of giving you written material consistent, as I pointed out several times I was giving you these documents on a one-off basis as a catalyst for discussion.  My apparently idealistic view was that you might read the stuff, then probe me on specifics therein, which I would then be unable to avoid discussing.  Instead, you chose to infer this isolated behaviour as the start of an entire methodology of avoidance on my part.

May I just point out again – as I did this morning – that I thoroughly and utterly resent the implication that I may behave like some silly little schoolgirl, passing you notes back and forth.  This was intended to be a one-off, and if you had given it a chance, it would indeed have been such a thing.

If you think that I am stupid enough not to recognise your probing on me passing you notes back and forth as an investigation of the transference I feel towards you, then pleased consider yourself corrected.  If you want to discuss the nature of transference, please just ask me.  I have been upfront and honest with you on this subject in the past and do not intend to discontinue such candour.  Please do not dress your enquiries up, as you later in the session did, as something vague and nebulous like, “what’s happening between us at the minute?”  (On a sidenote, this is a surprising question coming from a psychologist to a dolescum!).

At two points you enquired as to my position on your failure to accept my written work.  Whilst I do not remember the specific phrasing of the first such question, I do remember finding it offensive in the extreme, as there was an implied suggestion in your words that you would find any distress on my part as being manipulative.  You will recall that I told you that this insinuation was not welcomed by me.  Whilst you stated that you did not feel that the word ‘manipulation’ was appropriate, you did not, however, make a forthright denial that that was indeed what you thought my reaction might be.

When I am having a panic attack in your company, C, please do not condescend me with encouragement into practicing Zen buddhist breathing with you.  I find this an incredibly uncomfortable pursuit (no doubt you are curious as to why); for some reason, it creates a frisson (on my part) between us, and I find it horribly inappropriate.  I shall find my own methods of managing panic attacks, thank you.  I have been experiencing them for 12 years; I have known you for six months.

As I recall, the aforementioned panic attack led you to muse somewhat on the issue of my vulnerability, and the fact that I hide my face from you (by keeping my hair down) and fail to articulate some personal issues to you as I do not want to be vulnerable.  This is a rational position on my part.  I used a rape analogy to exemplify my point; that if I walk home alone at 3am, drunk, wearing a short skirt and a low-cut top, that I am putting myself at risk by virtue of my vulnerability (and for Christ’s sake, please do not read anything into that particular example.  Nor should you make the assumption that in this example ‘at risk’ equates with ‘deserves’.  That is not the case).  In fairness, this point was accepted by you, but was nevertheless diminished on the grounds that your office is a safe and confidential place that allows me to express a vulnerable side of myself with impunity.  Whilst I am willing to accept the good intentions of this statement, it is still and withall a fallacy, C.  Your office is not a safe place, and you are not a safe ‘object’ (in the psychological sense).  You are not safe because sooner or later, understandably, and by your own frank admission, you too will reject and abandon me, just like everybody else has done.

You will be aware that today was probably the first time in our entire relationship that I have expressed hostility beyond mild irritation towards you.  On that note, towards the end of the session, I found myself engaging in yet another self-vituperation, using a range of perjorative nouns and adjectives including, “dick,” “bitch”, “self-obsessed,” “hateful” and “monster”, amongst a multitude of others.  Whilst not denying these self-beliefs, I believe that this particular invective was actually a projection onto myself of my then-feelings towards you.  Arguably I could simply have stated how furious and disgusted I was with you, but then I would have caused myself even more distress, as I would have feared abandonment by you (even though I was ((am)) intensely angry with you) and wiould have felt horribly guilty (I feel guilty about everything).  So the fact that I manifested any hostility at all is somewhat remarkable.

Another related incident of note is that during the aforementioned invective, I accused myself of being a “childish brat, throwing toys out of the pram in all directions”.  You stated that this was “only part of [me].”  The strong suggestion to be inferred therefrom is that you agree with this assessment, at least to some extent.  I cannot criticise you for this position, as it is indubitably correct.  However, I have chosen to bring it up as an interesting reflection of the current state of our dyad.

At a juncture towards the end of the meeting, you asked for a second time how I felt vis a vis your failure to take my documentation.  I stated that I was “not best pleased.”

In future when I make an unambiguous statement of this nature, can you please accept my words without asking me to articulate further what it is that I mean.  I would think it unwise for me to give you my completely uninhibited view, which is that I think you’re a lazy, selfish, irresponsible piece of shit.  Beyond providing said view, there is little more I can add to the sentiments already expressed.

On a similar but unrelated note, when I am banging my fists on the chair and throwing my glasses on the floor, you are the Master of Understatement to suggest that I “must be quite agitated.”  Again, saying what you actually mean would be greatly appreciated.

I believe that you caused me an unnecessary amount of upset both in and outside of your company today.  In session with you, as observed, I was extremely agitated.  Your continual verbal pushing of me did not aid my psychological state in any way, unless you consider increasing mental pain to be a move towards better mental health.

I can recognise why you consider it imperative to investigate my reluctance to actually face my history and feelings with you directly, and why you want to find out why I find it so difficult to look at you, or to be looked at by you.  I do understand that.  Nevertheless, I fail to see how it is mutually exclusive to reading the documentation presented.

You were right in your assertion that I “want to connect with [you] in some way.”  I do not think it would be a massive leap of faith for that inference to be made based on the fact that I have been trying to find adequate therapy for 12 years.  My only wish is that you would be willing to meet me half-way on how that connection is achieved.  As you are so fond of pointing out, our alliance is a co-construction.

Finally, please do not assume that I fail to recognise that you have other work to do and a life to lead.  On the other hand, please do remember that through your own volition you have put yourself in a position of great power and responsibility, and that it is not reasonable from anyone’s point of view for you to knowingly abdicate from that.

In light of the strength of that responsibility, may I return to my original point, and question the exact point of psychotherapy.  A prompt, detailed and honest answer would be much appreciated.  Thank you.

Anyway, C, do take care of yourself* and I can’t wait to see you next week**.

Yours affectionately***

SI [hugs and kisses]****

Translations

*  I hope you contract some incredibly painful (though admittedly non-fatal) illness.
**  I’d certainly be unable to wait if I could find a baseball bat with spikes through it.
***  Fuck you, you balding, scrawny cuntfuck.
****  [slaps and punches]

Addendum

I am sure this negative attitude will be relatively ephemeral, but Christ almighty it is strong as of this moment.

What I Want in Therapy is Exactly What I Can’t Have – C: Week 27

Today’s session with C was one of the oddest I’ve had.  It’s kind of hard to articulate exactly why.  I was experiencing acute senses of depersonalisation and derealisation, for no reason that I can discern.  I didn’t really feel anything throughout the entire 50 minutes.  I know I spend all my time with C trying to pretend that I never feel anything anyway, but of course that’s rarely actually true, and despite my pretences, he knows that it’s false.  But today it was accurate, and interestingly it was quite obvious that my complete lack of feeling anything was apparent to him.

We spent some time initially discussing the fact that I have lost my job.  Naturally, he asked me how I felt about that.  Whilst I admitted to some sadness, I said my main sense of things was one of overwhelming relief.

“Sadness?” he asked, apparently slightly puzzled by that.

That might well sound like a stupid thing for him to say – I mean, wouldn’t it be normal to be sad over losing a job – but I knew exactly why he was asking it.

“I suppose that didn’t particularly come across in my discussion of the matter,” I told him.

“Yeah, that’s the thing.  You don’t sound sad.  You don’t seem sad in any way.”

I shrugged.  “Only in subtle ways, I suppose, and it is slight.  It’s a weight off my shoulders really, so I’m not really feeling that upset over it, no.”

We talked about some of the good points in the office, some of the bad things, what I had come to think of the place in general.  Eventually that particular conversation came to a natural end, and we sat in silence for a few minutes.

It was C that chose to bring last week’s difficulties up.  He asked how I had felt about it in its aftermath.  To one degree or another, the rest of the session was about this, or at least followed on from it directly.

I won’t profess to recalling everything that we went over in a lot of detail, unfortunately.  As stated, and as I later told C, I was feeling a little depersonalised and disconnected from the discussion.  I am not sure why; I had been fine when I left A off near his office only about an hour beforehand.  Maybe I was starting to dissociate in preparation for the hardship I foresaw with C.  I did expect this to be a very hard session, as it had been my intention to open up to him.  But that’s easy to plan and easy to say – not easy to actually achieve.

He was concerned that I had reacted with worry or anxiety as far as last week’s session went.  I assured him that this actually hadn’t been the case, stating that we were allowed to disagree, as long as disagreement didn’t permeate the entire relationship, which of course it doesn’t.

He accepted that, but asked me to be more specific in how I had perceived his attitude.

I didn’t want to say, “you didn’t take me seriously,” because he does take me seriously – but there was something slightly invalidating about his insistent belief that what I was experiencing during the episode to which this alludes was, to some extent, within my control.

So, prefacing my statement with a diplomatic disclaimer, I did say, “you didn’t take me seriously,” simply as I couldn’t think of a more adequate way to put it.

I’m not entirely sure where this went.  The next thing I remember clearly was him saying that he still held to his position, but he didn’t want me to see that as some sort of blame or criticism.  He said he had no doubt that my perception of the whole thing was very real to me, but that he still felt that I could have some control over it.

I asked, “would you think that someone with full-blown schizophrenia would have some level of control?”

He thought about this for a moment, and then said that he felt that actually, people with that disorder could learn – to differing extents, depending on the individuals – to recognise triggers for major psychotic episodes.  He conceded that he felt that by the time the psychosis set in, however, the schizophrenic individual was at best significantly debilitated in their ability to control themselves.

“But,” he went on, “in the case of an individual with schizophrenia, psychoses are a complete disconnection from reality.  Again, I don’t want you to perceive this as blame, but I think you were there, you were connected to the reality of the situation – even if on a limited basis.”

I mulled this over for a bit, then said that I could maybe meet him half way.  “I can possibly agree with and accept that part of me was there, but really, it was a small part.”

Again, I don’t remember the outcome of this.  Eventually he asked me how I was “experiencing” the discussion.

“It’s like it’s someone else speaking for me,” I told him.  “I feel like I’m an observer of this conversation.  The word ‘depersonalised’ is perhaps strong, but I certainly feel pretty…I don’t know, disconnected.”

He asked if this was something that happened with frequency; obviously he knows that there are times when I have completely disassociated, but we haven’t spoken in perhaps as much detail as we should regarding the episodes of depersonalisation and derealisation.  I told him that yes, this was fairly common.

Another jump.  I don’t know what happened next.  I hadn’t eaten, and my stomach kept rumbling ludicrously loudly.  I shouted at it to shut up and apologised to C.  He was semi-amused but asked how I felt about its cacophony.  He was, presumably, under the impression that I was embarrassed about it, which I wasn’t especially.  It was just irritating.

I went on to say that despite my not-inconsiderable size, I usually don’t eat that much.  This prompted C to ask if I exercised at all.  I told him that since I got the car I don’t do all the walking I used to, but that I do go swimming from time to time.

“But,” I complained, “the problem is that when one is in the throes of depression, say, it becomes terribly hard to get motivated to do same…”

I was going to continue, but he interjected at this juncture, saying, “there – again – you’re speaking in the third person, abstracting what you’re saying, avoiding talking about yourself.”

“It’s a turn of phrase,” I sneered.

“Maybe so, but you see what I mean – it’s not ‘when I’m depressed’ or whatever.”

“I have a tendency to speak in the passive voice,” I retorted.  “It’s a habit I picked up in GCSE English.”

“You’re going to great pains to justify it now.  Don’t you think it’s an avoidance technique?”

I thought about it.  It probably is, actually, in most circumstances, though it certainly would be subconscious.  My best mate D and I got into using the habit of using the passive voice all the time, as far as I can recall in order to annoy our English teacher (though,in contrast, in scientific classes you were expected to use it).  But I have a tendency to use it (or generic terms) with much more frequency than anyone else I know, nevertheless.

“Can I say something that you may find ridiculous, please?” I asked.

He gestured for me to go ahead.

“You told me once that you weren’t my teacher.[this was since I’ve kept this blog, on an occasion where I asked about object relations theory, but I didn’t include this detail on any post, which is a shame].  Yet this is an education.  I would never have thought about any of this stuff as being remotely relevant, yet it is – it’s insightful as regards my intellectual interest in psychology.”

C said something that has concerned me ever since – he said that he wasn’t sure what use the relationship would be if I saw it as a teacher-pupil situation.

Naturally, I take this as a sign of his intention to abandon me.  I therefore started into a self-defence of “oh, only in this particular session, that’s not generally the case,” and whatnot.  But I’ve been obsessing over the comment since.

He can’t abandon me.  He can’t.  I know and I accept that therapy is not permanent, but I genuinely cannot foresee any ability to cope on my part without my weekly meetings with this virtual fucking stranger for – I don’t know – another long while anyway, certainly not within the timeframe of our current contract (due to finish at the end of November).

I think I must’ve realised at that point – not that I haven’t before, but more acutely and strongly at that point – that I have no choice but to open up to him if he is going to continue to work with me, and if he is going to help me.  As such, I instigated a conversation on my resistance in therapy (not his term, by the way).

This is kind of timely.  The fabulous author of the Behind the Couch blog (as was) has now put up archives of the blog in question at this URL (*SI does a happy dance*).  As I was reading through them after seeing C this morning, I came across this post on the client’s resistance in therapy, which could have (in many  ((though not all)) of its points) been written directly about me.

I was very honest with C for once and admitted that I hadn’t told him all I needed to tell him.  I admitted that I was scared of confronting all the hurt.  So much hurt.

He was quite good about this and said that he could understand why that might be the case.  “But,” he predictably went on, “I would encourage you to share these things.”

Well, no shit.  No shit.  It’s just so fucking hard.

He doesn’t know about the rape (he knows that something inappropriate happened, but he doesn’t know the full extent of it.  In this case, for the purposes of avoidance, I actually outright lied to him 😦  I’m sorry.  Really, I am.).  He doesn’t know much about my utter loneliness and despair whilst at school, nor about the bullying.  He doesn’t know, in any adequate detail, about the misery inflicted on me by my first boyfriend (something I have deliberately avoided discussing here too, for the same reason.  I do not want to think about the sheer emotional ((yes, yes, I said that Satanic fucking word)) agony of that).  We haven’t discussed how much I still miss my grandfather.

We have discussed my abandonment issues pertaining to V, but unsurprisingly I abstracted everything and didn’t really show much of the dreaded emotion.  The time I remember being the most ’emotional’ in front of C was when I confessed to him about my stream-of-consciousness mental fantasy.  I wept without saying anything for about 20 minutes – and God love him, the poor man just sat there with me and I felt like he empathised and like he gave a fucking toss – then I spent the next 20 minutes apologising to him for weeping in front of him, whilst he went to great pains to reassure me that I apparently had nothing for which to apologise.

I’m sure there’s plenty more in my subconscious that I could bring to his attention with some probing too.  Hur-fucking-rah.

I have been very brave today and taken extracts from this blog to give to him.  They take some of the most relevant details and discuss them, meaning that C will have the benefit of being as well informed as possible before questioning me on the matters concerned.  I am thinking of posting it to him to avoid my inevitable chickening out of presenting him with it, but I don’t know if that brakes boundaries – it might, and I don’t want to go there.  I’ll think about it.

One thing I haven’t mentioned to him (or, in any great detail, anyone else) is one of the worst things; confronting the exact nature of the transference felt towards him.  I read this post by bourach this afternoon, in which she detailed how she had bravely admitted (to all intents and purposes) that her transference towards her psychotherapist was distinctly maternal.

Reading this kind of catalysed me out of my depersonalised state.  Aside from feeling bourach’s pain, and wanting to reach out and hug her, I so selfishly felt my own.

I want him to take care of me.  I do.  I want him to protect me from everything from which my father should have protected me.  At the very least, I want him to comfort me.  Like bourach, I want to be liked by him.  ‘Love’ is a strong word, and I don’t like it because it carries connotations of romantic love, which is not what it’s about at all.  But, if I am entirely honest, yes; I want him to be a surrogate father, and if that involves my wanting him to love me as my own father so clearly didn’t, then I suppose that is what I want.  It seems utterly pathetic written down, but I can no longer hide this from myself.

This is what I want.  I want what he can’t give me, what is impossible.  I know this is impossible.  I know.  But I hate that the relationship is somehow ‘not real’.  I want it to be real, I really do, and I know it can’t be but I hate that.  I hate it so profoundly.  I hate it SO MUCH.

This is what I want.  THIS. IS. WHAT. I. WANT. Why can’t I have it?

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.

I Hate the Therapeutic Relationship – C: Week 25

I don’t hate this bizarre relationship because I hate C – quite the opposite today, as it happens, but I’ll get to that later.  What I hate is the power this one individual can have over me; he has the power to make me go about smiling, or, alternatively, to leave his office seriously contemplating throwing myself in the local lough.

I can hardly bear the thought that I am so spellbound by him.  It’s even more annoying because he doesn’t consciously try to captivate my fragile consciousness; his mission in his interactions with me is to try and help me to manage being mental overall of course, but I very much doubt he sets out to influence my moods on a week-to-week basis.  Yet he does.  I would hate anyone having this level of control over me, let alone someone I don’t even bloody well know.  Transference is a pile of shit.

Anyway, it was a good session, despite it being the first one I’ve had in a month.  I was expecting it to be thoroughly unproductive, the way it had been the last time we were reunited after a lengthy separation (where we had to ‘get to know’ each other all over again), but it was actually fairly comprehensive.  I was also surprised by the intensity of relief that I felt when I saw him again.  After stating that I’d hardly missed him in this post, I now realise how much I actually did.

That didn’t mean that I wasn’t nervous though.  It’s always odd after not seeing him for a bit, I tend to feel anxious each week anyway and I’d been up until 1.30am reading the Paul Gilbert book for my ‘homework’, and I was worried about telling C that I thought the suggestions therein were a pile of crap.  Luckily for me, mindfulness and DBT weren’t mentioned directly at all today.

As ever, things commenced with the two of us staring at each other.  I really, really wish he’d just take the lead sometimes.  I understand why he doesn’t – he wants to afford me the opportunity to bring whatever’s on my mind to the fore – but I always feel awkward about speaking first.  I could theorise as to why – he is he ‘authority figure’ and I don’t want to open my mouth without permission, maybe? – but it doesn’t really matter.  Eventually, he recapped on what we had discussed in the last session, which had essentially been a mega-vituperation on my part about the failed meeting with VCB’s SHO.

So I told him about my meeting with VCB last week, and about the fact that she had increased the Venlafaxine.  I sighed.  “I understand why she can’t give me additional medication at the same time as she increases the dose of anti-depressants,” I acknowledged, “but I just don’t think it’s all I need.”

He enquired as to what it was that I felt I did need, and I advised that I felt mood stabilisers and anti-psychotics were probably necessary.

“But she’s a consultant psychiatrist and I’m a Wikipedia-qualified one,” I shrugged, “so what do I know?”

I thought about this later and am annoyed that I berated myself in this manner.  I’m not going to sit here and say, “oh, well, I should be taking Seroquel and Lamotrigine plus Risperidone” or something.  I don’t know the specifics of medications relative to the symptoms I present.  But I do know how I feel, and quite honestly the VCB doesn’t; I can try to verbalise it to her, but words never really grasp it.  The only ones that can begin to understand it are other mentals.  In any case, C had once told me, when I whinged that he – not I – was the expert, that I was “the expert in myself”.  I can agree with that, and so maybe the VCB should damn well listen to my wishes next time.

C must have responded with something to the effect of, “so you’re still not 100% satisfied with the service?” because I remember replying that I was waiting to see if she actually bothered to see me in six weeks as she said she would before I passed judgment.

He nodded thoughtfully.  “And what about here?” he asked.

Uh-oh.  I hadn’t prepared for that one.  On the one hand, I can hardly say, “I am completely platonically [is that a word?] obsessed with you,” without feeling like the world’s neediest cock, and on the other, I can’t say, “sorry C, but there are times when I want to claw your fucking eyes out.”  But there’s no point sitting on the fence and saying something vague and meaningless like, “it’s alright.”

So I avoided the question by pretending not to know what he meant.

“Well,” he started, “what would you like to achieve by coming here?”

Um…maybe not to feel completely mental/depressed/manic/like a freak all the time?  What the fuck does anyone want to “achieve” in psychotherapy?

I committed that most cardinal of sins in C’s gospel, and came out with a load of intellectualised diagnostic analysis.  In short, I said something along the lines of that as I understood it, bipolar disorder can only be treated medically, save for recognition of triggers and whatnot, but that BPD could be treated through psychotherapy, so I wanted to be able to control it, not have it control me.  I made some sort of disclaimer in order to pre-empt the inevitable whinging about labels, but it didn’t really work.

He nodded in his characteristically musing way, and said, “OK, but in saying that I’m wondering if you’re avoiding how that feels for you?”

I wonder, can you have figurative (as opposed to literal, obviously) eyes?  If so, then I rolled them.  You’re nothing if not predictable, C.  How does that feel.  What are your feelings about that.  How might you interpret that feeling.  Feel this, feel that, feel the other [ooh-er].  I feel that feelings feel like something I don’t want to fucking feel.

[/rant]  Where was I?  I said that I wasn’t trying to avoid how that feels for me; I was merely using the diagnostic terms as short-hand for a particular set of symptoms.

“But you’re still conceptualising it,” he argued.  “Can you tell me the specifics?”

I hate it when he gets me in a checkmate situation.  Other than saying ‘no’, I had no means of avoiding the question.

But then I get angry with myself, because in this type of situation I then try and answer the question in a rational, robotic sort of way, and if he were then to accuse me of avoiding something in doing that, he would be right.  But I just can’t make myself be more expressive with him.  It’s all very well for someone to say, “oh you just have to do it,” but fuck that, I can’t just switch [whispers] emotions [/whispers] on, at least not so ostensibly as to make them obvious to C (or anyone else for that matter).  It’s just so far removed from my normal character that it’s presently inconceivable to me.

Anyhow, I told him that my goals were (a) to be able to functional socially because I either overcompensate with people by behaving in a manic and frankly arrogant fashion or I panic like fuck and completely withdraw into myself, and (b) to be able to return to work (though almost certainly not to my present job after last week’s OH, but that’s another story).

“That’s been my primary motivation,” I said.  He went to reply, but I had taken a second or two to think about this so I interrupted and said, “look, do you know what – it isn’t.  My primary motivation is to stop feeling like shit all the time.”

We discussed the social and work situations in a bit more detail, but there was little of consequence in these conversations, bar C’s perception (which is probably accurate) about my terror of scrutiny (more on this again later), but for some reason (I can’t remember the entire session with absolute clarity) the conversation eventually returned to the VCB.

C said, “she called me shortly after I last saw you.  I said that you had valid reasons for being dissatisfied with her service…”

Ha!  Hahaha!  Up yours, VCB!  This made me very pleased.  I interrupted him and said, “yes, she made reference to the fact that she knew I had been upset.  I expected an explanation and an apology, but I got neither.”

I don’t remember his specific reply to that, but what he did say is that he continued to VCB that I had had “an extreme emotional reaction” to her negligence (for that is what it was).  He continued in this vein for a few minutes, searching for words.  Pleased Me disappeared a bit.

“What you are trying to say, in a convoluted and roundabout way,” I spat, “is that I overreacted.”

“Um…well, I guess so, yes,” he reluctantly conceded.

“Hmm.  Perhaps so,” I admitted, “but if that’s true, then there were a hell of a lot of people that also overreacted.”

He winced a bit.  “I don’t like the term ‘overreacted’,” he said.  “It’s invalidating – it implies you didn’t have good reasons to feel disappointed and dissatisfied, and you did [pleased again].  It has negative connotations.  Can we not call it that?”

I prefer to call a spade a spade, and he knows that, and in this case I am of the belief that the spade was called ‘overreacting’, not ‘experiencing an extreme emotional reaction’ or whatever label of wank you wish to apply to it.  (Christ, I am still surprised by the level of physical disgust I feel at using the word ’emotion’).  Nevertheless, he was supporting my viewpoint in a way, whilst not wanting to condone the use of a carving knife – which I suppose is all he can do.

“I don’t choose to go completely mental, I just do,” I protested.

“Of course not,” he reassured, “but you recognise it when it starts though.”

“We go round and round in circles on this all the time, C,” I sighed.  “I know I say it all the time, but self-harm is quick and it works.  As for doing something as elaborate as I did that day, it was reflective of how I believed VCB [not that I called her that to him] felt about me.  Not that I felt that later when I was more rational, but you know what I mean.”

“There’s a few issues here.  Firstly, I don’t want you to think that I am sitting here completely condemning self-harm out of hand..,” he enforced this point a few times, then continued by saying, “I don’t think that [openly condemning self-harm] would be…helpful.”  Which obviously means that he does condemn self-harm but just doesn’t want me to know it.

“Secondly,” he went on, “everyone around you seemed to have a major reaction to this appointment – if you can begin to recognise your negative symptoms, and you have this support, is there something more meaningful you can do with them?”

“A suggested calling the Stephen Nolan show,” I said, apathetically.  “But I’m unsure as to what extent I want my mental health difficulties broadcast all over Northern Ireland by an obnoxious, odious git [said git being Nolan, not A].  A was still the most rational amongst the triumvirate of him, Mum and me, though.”

I thought about ranting about VCB on this blog.  “It was suggested that I write a strong complaint and/or go to an advocacy agency by people that read my blog,” I told him, in reference to these comments.

C’s ears pricked up and he suddenly seemed quite animated.  “Yeah!” he exclaimed, with evident enthusiasm.  “I think those are both really positive ways of translating that intense anger and disappointment.”  He babbled on about the advocacy services for a bit (well done, cbtish and bourach – C loves ya!).

“Yes, fair enough,” I agreed, “but what do you want me to do?  Be fucked over and not have some immediate reaction?  Do you want me just to immediately say, [puts on robotic voice] ‘I shall now phone Rethink and forget the fact that I am actually quite upset now’?”

“Of course you’re going to have an immediate reaction,” he acknowledged, again.  “But can we develop tools to take the edge of that, so as you can get to the point where contacting Rethink is viable?”

Why, yes C, yes we can.  We can use a knife.  Simples!  But in this case I didn’t bother to argue; I knew he wanted to say more, and we can revisit these so-called tools and play our little circular game again pretty much any other week.

“A third point [re: above comments on VCB] is that when you’re feeling less emotional [FUCK THAT FUCKING WORD] you feel differently about how you’re perceived.  Is it possible that there’s part of you trying to empathise with or reassure yourself?”

I made some cursory reply, then sat staring at the (empty) noticeboard behind his desk, stroking my chin in a stereotypical exposition of thought.

After a few minutes he unsurprisingly enquired as to what it was that I was “mulling over in my head.”

What I was considering was whether or not I should tell him about Tom.  The references to a ‘reassuring me’ reminded me of Tom – as I had stated in the relevant post, it was my prediction that C would say something like Tom represented my empathetic, understanding self.

I told C that I was mentally debating whether or not I should tell him something.

He asked about the content of the psychic debate.

Me 1:  He’s your psychotherapist, you stupid cunt – just tell him.

Me 2:  Go and fuck yourself.  If I tell him, he’ll be appalled and he’ll hate me.

1:  Don’t be so bloody stupid.  Do you honestly think he hasn’t seen worse?

2:  How the sodding blazes should I know?  I can’t take the risk.

1:  LOL.  Come on, it might benefit C to know this.

2:  No it won’t, he’ll hate me and then he’ll abandon me.

1:  Look, he fucking won’t.  This is his job!

2:  Yes, and it’s also his job to refer people who are disconnected from reality to relevant experts.  He’ll be all nice to my face, then he’ll close the door as I leave and he’ll go, “Jesus Christ, I’ll have to palm that fucking nutjob off onto someone else!”

1:  If you honestly think that, then you really are disconnected from reality.

Etc.

“So,” C began, “you think it might overwhelm me?”

“No no no,” I insisted (no doubt he was reminded of all the stuff about me protecting him).  Then, tentatively, “I just…I don’t want you to think I’m any more of a freak than you already do.”

He laughed at this, which I took to be a reassurance; he obviously thought my contention that he thought I was a ‘freak’ was silly which in turn, presumably, suggests that he does not think that.

“And you think it will ‘benefit’ me?” he queried, apparently a little perplexed by this contention.

“It’s not going to benefit you personally,” I answered cynically.  “It’s not going to enrich your life [he laughs].  I mean that it may benefit you in terms of your interactions with me.”

He probed a little bit more, and I answered his questions honestly but with deliberate omission of reference to Tom.  His interest was particularly piqued when I said, “I have a theory as to what you’d say about it if I told you.  I’m not sure if I agree.”  Eventually, the poor man just sat there looking completely confused.

Is this a tactic?  The last time I completely confused him by avoiding telling him something, I later felt so totally guilty about it that I apologetically confessed all in the next session.  Maybe he’s pieced that together.  Maybe not.  Either way, it worked; I felt bad about bewildering him, took a deep breath and said, “I’ve got an imaginary friend now.  He’s called Tom.”

I don’t remember his exact reaction, but he did say something acknowledging – without judgment – Tom’s ‘existence’.

I hummed and ha-ed a bit then told him that, “I was employing childish terminology to avoid saying the words, ‘I’ve started hearing a voice’.”

A long and, I think, fairly productive discussion ensued.

He asked how I “experienced” Tom.  I didn’t know what it was that he wanted know by his use of this term and asked for clarification.

He said, “well, if someone came here and asked me, ‘how do you experience your interactions with SI?’, I might say, ‘we meet once a week, we talk about things that are troubling her, I ask most of the questions…'”

I interrupted and added, “…’and she fails to answer any of them…'”

He laughed, and then sort of gestured for me to continue.

I tried to explain the same stuff that I had done on my last post here, the one about Tom.  I even told him about the debate in the comments section of said post, wherein my commentators and I discussed whether or not Tom was a psychosis, and whether or not I did believe, deep down, that he is real.

cbtish had provided what I thought was a good analysis of the reality, or otherwise, of Tom.  I told C that, in sensual terms, Tom could be considered as real as anyone that I encountered.

“But,” insisted C, “I’m not experiencing him.”

“Here’s not here at the minute,” I argued, being deliberately obtuse.

“Yeah, but you know what I mean.”

“Yes, but you take my point.  I may know he’s not real, but he certainly seems real to me.  An objective reality – if such a thing exists – may be different from my subjective reality, but I can only experience things subjectively, just as you can only experience things from your subjective position.”

He nodded, then grinned in rather cavalier fashion, and said, “we’re going to have to get a philosopher in here.”

“There’s no need,” I chuckled, “I already subscribe to solipsism.”  (Kind of).

“The thing is, people have this perception that those who hear voices hear persecutory voices,” I continued.  “Tom isn’t like that.  He’s…nice.”

I paused, disgusted with myself for using such a pathetic and inadequate adjective.  “I’m sorry,” I told C, explaining why.  “I’m trying to avoid bad language – you know [whispers] empathetic…reassuring [/whispers]…”

“…understanding…” C added, humouring me by also whispering, with a slight sardonic smile.  I nodded.

He mused for a minute or two, and then he said – wait for it – he said, “maybe Tom’s a part of you.”

I threw back my head and laughed heartily – perhaps maniacally.

“I knew you would say that!” I shrieked, jabbing my finger at him.  “I knew you would!”

He smiled broadly, but nonetheless he was clearly a little bemused.  I regretted behaving so oddly shortly after doing so and managed to calm myself.

“I don’t know, maybe you’re right,” I conceded.  “But why he is a bloke in his 30s?  Is it because I don’t get on with people my own age?  Is it because I don’t get on with myself?  Is that why my mind wants to invent random people to hear?”

(An aside – is Tom trying to emulate C?  Is he like a permanent, completely-my-own C, unlike the real C?  I didn’t suggest this to the real C, of course.  But Tom’s characteristics, insofar as a disembodied voice can have characteristics, are not totally dissimilar to those of C).

He shrugged.  “There’s any number of theories,” he said, “but all that really matters is that you’re experiencing it.”

C was rather taken aback to hear that Tom is outside my head, perhaps seeing this as a refutation of the suggestion that Tom is ‘part of me’ (not that I think that does invalidate that idea especially).  I complained that I have a running commentary between at least two voices in my head at any one time, but these are clearly me arguing with myself.  Of course, this – in at least a rudimentary form – will have been quite obvious to him before now.

We also spent some time discussing the delusions to which I alluded in the ‘Tom post’, in particular the hidden video camera thing and my fairly recent accusation to A that he was colluding with GCHQ.  He asked if I believed with 100% conviction that these things were real in the moment.

Regarding the GCHQ allegation, at the time I would say I believed it with the strength required in a criminal trial, ie. that I believed it beyond reasonable doubt.  As far as the video cameras went, I believe(d) that one “on the balance of probability”, in the moment.

“And you believed the day of the problematic psychiatric appointment, with absolute sincerity and however briefly, that VCB [not that he called her that] hated you,” he said.

“Yes.”

“It’s like the time you told me about the sun watching you.”

“Yes.”

“Scrutiny.”

“Yes.  But why do I care what people think of me?  Why?”

I (literally) rolled my eyes.  “But that’s too big a discussion for now, isn’t it?”

“I’m afraid we are going to have to leave it there for now,” he told me.  “But we’re back to once a week now, we have eight sessions left of our current contract, and I don’t think there’s any gaps from my side before Christmas.”

Yay!  Assuming that he holds to that, that kind of makes up for the annoying month-gap that I’ve just been through.  I am (pathologically) worried that the sessions will come to an end after the eight sessions in question, but he did assure me last time that we would spend at least four sessions preparing for any end to my psychotherapy, so at least if he gets it into his head that I’m well enough to be discharged (not that I think he’s that stupid), I can disabuse him of that idea in advance.

Anyway, although we didn’t directly achieve anything – how can you in one session – I felt we covered a lot of ground today (well, yesterday now – it’s 1.40am on Friday), and I am quite pleased that I was able to get up the courage to discuss the psychotic symptoms with him.  And I am reassured by his reactions to same.

So I like C today, but as I said, it’s rather disturbing that he has such power over me.  Such can be the nature of therapy, I suppose, and indeed of transference.  Better, though, to experience that and see some sort of strong alliance between us, than to feel nothing other than ambivalence about the process.

Three Days of Professional Madness, Genital Vinegar and C: Week 24

As you know, I’ve been on holiday, and as you also know, I promised I would go into more detail about the three mental health appointments I had in the days that preceded my departure. I had started this post well before going to Turkey, but despite my claim that I’d finish it on the plane, of course I didn’t; even flight-safe phones such as the iPhone were not allowed to be used onboard. Obviously in Turkey I was trying to enjoy myself, though as you will see in a later post that did indeed involve some forays into psychiatry. Anyway, I’ve finally got round to the post in question, so here it is.

—

Tuesday: The Psychiatrist

I said I’d go into more detail about how I responded to the psychiatric SHO on Tuesday 8th. Basically, I said I couldn’t deal things any more (I’m sick of my up-down moods and am worried about the effect some of my psychoses are having not just on me but the others around me). I said I’d been pushed from pillar to post by Dr C’s department – due to the ridiculous saga to be seen by them in the first place, then their cancelling an important appointment in July – and that I thought it was unacceptable.

The thing was, I was in a complete state and it sounded more than I was pleading with her than that I was angry with her. I was begging, effectively. My first reaction to her refusal to do anything was one of panicked desperation, and I half broke down, but she merely apologised and said she was too inexperienced to deal with a case like mine. She blamed the department’s failure to have me sitting there with Dr C on a “secretarial error”.

She said, “if you need help in the meantime, you can always get the Crisis Team to…”

Regular readers will know what I think of the CRT. See about three-quarters of the way down here, for example. So you can imagine my response.

“No,” I shrieked. “No, I can’t – they’re useless, they’re crap!”

“Well, they’re always there for you,” she started, but she seemed to realise the futility of continuing in this vein, so she changed tactics and continued by saying, “or your GP.”

She said, “Dr C will talk to your psychologist right away and see you as soon as possible – unfortunately she’s just doesn’t have a window today.”

Seems to be her curtains are always fucking pulled, but anyway – I told Dr A I would be on holiday until 21st September inclusive, so she agreed to organise a new appointment for sometime after the 22nd. I got up then, mumbled some sort of goodbye, and almost literally stumbled out of the building. Some other (male) mental sitting near the door tried to grope me on my way out (the “appointment” was in the psychiatric day hospital, rather than the usual outpatients clinic, so obviously he was ((erroneously?)) recently released from the actual bin).

As I was telling C the following Thursday, another thing of note was the physical environment of the “appointment”. As stated it was in the day hospital, which has much smaller one-to-one consultation rooms than outpatients. This was a problem as there was a window in the door, and I could see the other mentals looking in from time to time. Even worse than this was the fact that the room was near the entrance, meaning that all the others waiting for their cunty day therapy and other patronising OT-esque wank were directly outside the room smoking. Not a problem in itself – except that Dr A neglected to close the window, meaning that everyone else could hear the conversation.

I could have (reluctantly) lived with all of this imbecility if they had done something, but obviously they didn’t.

So anyhow, I went and sat in my car. Recognising that I was unfit to drive, I decided to ring A for cathartic discussion. I cried down the phone to him for about 20 minutes. He was absolutely livid with Dr C and her people. He authoritatively told me not to drive until I’d calmed down considerably, but said when I got back to my mother’s house that I should get her to phone them and kick up a fuss and demand answers – not to mention an actual definite date to see Dr C.

After a while I thought I’d calmed down and left, but I remember bawling my eyes out at times on the way home and practically fell through the door to my mother’s. Initially I was incapable of even rudimentary speech, but eventually I managed to convey a basic version of Dr C’s neglect to my mother.

My mother tried to calm me and I suppose she partially succeeded, because she managed to eventually tear herself away from me for long enough to phone Dr C’s admin department (a suggestion unsolicited by me), who emphatically denied a “secretarial error” but did say they would try and find out what had happened. Apparently the girl Mum spoke to was very nice and she said she would phone back with information later.

Then Mum contacted the GP; the one on call was the (only) one I hate in the ‘surgery’ (I’m indifferent to the others, mostly), because on more than one occasion she has blamed my mental health issues on being overweight. Sure, luv; wouldn’t be anything to do with personal pathology, rape, abandonment, bullying, lies or bereavement. Obviously not. As it happens, I think a lot of my excess weight is caused by depression rather than the other way about; partly because of comfort eating, partly as an annoying side effect of antidepressants. But that’s another issue.

Anyway, let’s call this woman Horrible GP, in contrast to her colleague, Lovely GP, with whom I was due to have a review appointment the next day. My ma outlined the issues involved and Horrible GP asked to speak to me. I refused, but she pushed my mother to get me to talk and thus I started to go mental, screaming that there was no way in hell that I was going to pick up the phone.

Mum said to HGP, “she’s panicking now.”

Query: is “going mental” the same as having a panic attack? I’ve certainly had the latter; for me, a panic attack is much more of a physical problem. Not that that doesn’t affect one mentally, of course, but going mental is almost a reverse course of action. It’s the shit in my mind, racing around in a whirlpool splitting my skull, that causes physical distress, rather than the other way about.

Whatever the case, the long and the short of it was that HGP agreed to provide emergency Valium, as I had left my main stash from my last meeting with LGP at A’s house, on the other side of town.

This agreed, Mum sat down with me again and ranted about Dr C and her negligent behaviour and about how she was thinking of going to the media. About this time, A sent me a text message saying that he was “so angry with these abject cunts” and also suggesting contacting a popular local consumer affairs programme.

Handbags at dawn, dearest readers!

Mum eventually went to get the Diazepam from the pharmacy, at which point I inflicted the self-harm that I posted a photo of, perhaps irresponsibly, here. It’s no big deal, self-mutilation is not uncommon for me as many of you know. It helps. I did it as I perceived the situation as Dr C hating me. Therefore, I was a hateful person. Therefore, that had to be acknowledged somewhere. That’s a logical(-ish) train of thought that wasn’t exactly present at the time, but it was at least the sense of my reasoning.

I bled and bled and bled and then worried that I wouldn’t be able to try and hide the injury from Mum, who has been mostly unaware of my cutting. I managed to bandage myself up, though, and the bleeding was adequately hidden just in time for her return.

I took the Diazepam, and the rest of the day was mostly uneventful. A was good enough to go back to our house, feed the cats and get my tablets, then come and stay with me at Mum’s (I wasn’t allowed to drive due to the Valium). He and Mum spent some time scathing about the morning’s occurrence, and the words “criminal negligence” were used. My mother queried what would actually happen if someone were seriously suicidal, little knowing of course that a few weeks ago, I tried to hang myself. Mind you, I hadn’t told Dr A that either. To be perfectly honest, I didn’t tell her because I had forgotten that I’d tried to hang myself. Who forgets trying to hang themselves?! It’s a good thing I did, though, as there’s always the possibility they’d have sectioned me. I am, after all, a danger to myself at times.

Wednesday: The General Practitioner

The next day I had a very long discussion with LGP (his colleague having related the previous day’s fun and games to him). Appointments are meant to be 10 minutes long, so if you’re the poor sod that was waiting at least 15 minutes after your appointment time, then I apologise. At least it shows LGP cares about his patients, unlike others I can fucking think of.

LGP asked to see the self-harm of the previous day, so I showed him, and in fact gave him the guided tour of the words and slashes that litter the flabby rolls of my abdomen. He appeared to be genuinely affected by this; not freaking out like normals do over this sort of thing, nor angry, but sorry that I was in the position where cutting seemed my best course of action (which I maintain it often is, to be honest). He wasn’t judgemental nor overly worried – he’s obviously aware this is quite normal in mental illness, certainly in BPD and very definitely for me on and off over the years – but just fucking caring. Just nice, supportive and caring.

He showed me the letter Dr C had sent him re: my diagnoses and medication change. I was interested to observe that whilst she wanked on and on about BPD, she had then said that “a differential diagnosis” was bipolar II. I thought a “differential diagnosis” was a diagnosis based on the elimination of most other illnesses based on symptoms presented? If correct, that would suggest to me that bipolar is considered my primary diagnosis, but contextually the letter presented it – as Dr C had done to me in June – as if BPD was my primary pathology. Her whinging about NICE’s mood stabilisers and anti-psychotics in BPD to both LGP and me would seem to confirm that. Can anyone, therefore, clarify the meaning of “differential diagnosis”?

One thing it did say that was moderately encouraging was that she was not totally against the use of mood stabilisers in future. She didn’t make further mention of anti-psychotics, but with regret I am beginning to wonder if I really should have them. (Incidentally, MMcF’s husband was put on an anti-psychotic a few years ago to combat his very severe paranoia. It changed his life for the better almost instantly. You can take a guess as to what I think about that).

LGP wasn’t happy with Dr C as well he might not be. He believes that additional medication (though he didn’t say which) seems appropriate, and furthermore that the dose of Venlafaxine is very low, despite its dodgy side effects. However, he said that he was in an awkward position. He certainly has knowledge of psychiatric illnesses, but he’s no expert, whereas Dr C (supposedly) is. He virtually said that in an ideal world after her lax approach he’d refer me to an alternative specialist, but after all the trouble we had had getting me to one in the first place, he didn’t really see that as a viable option.

That’s fair enough I suppose, although it didn’t help me much. Regardless, LGP has been the only one out of the three main health professionals with which I deal that has been a constant source of support, rather than frustration, so I’ll forgive his reluctance to interfere with the psychiatrist’s domain. We discussed sleeping pills and he suggested I return to Zopiclone over the holiday at least, as it worked for me before and I wouldn’t have to drive on the holiday (prolonged use of it has affected my vision in the past, though not on every occasion on which I’ve taken it). I remembered that he’d given me an inhaler when I was about 14 to help with panic attacks and asked if, in conjunction with the Valium, this would help me when I start to go mental. LGP agreed to provide this inhaler and as I left, after wishing me an enjoyable holiday, he said that if I hadn’t heard from Dr Cunt within the next few weeks, to phone him and he’d get slabbering.

Thursday: The Clinical Psychologist

So the next day’s measure of insanity was with twatting C. We had agreed to spend most of that day’s session discussing coping methods of mentalism on the holiday, and he reiterated that point at the start of the session.

However, he firstly wanted to discuss a few housekeeping issues. The selfish prick chose to take leave the week I came back from Turkey (ie. what would have been today’s session), rather than taking it the same bloody week that I was away.

Is this annoyance on my part unreasonable? Probably, but sometimes I really wonder if mental health professionals, including C, realise the positions of responsibility, authority and trust in which they are placed by their patients. Anyway, at least he’d given me notice of this unfortunate absence before; I sat seething in silent rage as he then explained that the week after that, he’d be on a training course. This means three missed sessions, as opposed to the original expected one.

Fuck. Fuck. FUUUUUCCCKKK!!! Fuck you, C!!! [As it happens, so far I have hardly missed him at all, but (a) there’s still two weeks until the next session so Christ knows what’ll happen between now and then, (b) I’m trying to replicate my frustrations from then rather than my feelings now and (c) whether or not I miss him is not the point. The fact that I am essentially entirely devoid of mental health support for nearly an entire month is the fucking point].

So anyway, C asked was there anything I wanted to bring to the table before we discussed preventing and coping with madness whilst on holiday. I decided to refrain from coming right out and asking him directly if he had spoken to Dr C, and instead enigmatically replied, “has anyone spoken to you about me?”

He furrowed his brow a little and said, “not since I spoke to your psychiatrist, Dr…Dr..,” he searched for her name.

I reminded him, and asked when the conversation to which he was referring took place. It was clear he couldn’t remember exactly, and he eventually replied with something vague like, “a few months ago.”

Great work, Dr C. You and your SHO claim you want to speak to C and see me as soon as possible thereafter. Clearly it was right the fuck up there in your list of priorities.

I nodded at C, feigning casual indifference, eventually cracking under the pressure of his piercing stare of curiosity a few minutes later.

“You won’t be aware of the events of Tuesday, then?”

“It was Tuesday you saw her, wasn’t it?” he asked in all sincerity.

I laughed bitterly and made some vicious snipe about how useful “seeing” her was.

I went on to detail the circumstances in full. Those have all already been reported here so I can omit that part of the discussion from this summary of the meeting. Basically, two issues arose.

Firstly and of foremost interest was that C seemed utterly perplexed by the fact that I had cut myself in the wake of his colleague’s fuck up. Well, aside from the fact that’s a fucking hallmark trait of my illness, you twat, I was going totally up the walls and self-harm – as I have told about 496,960 times – is a quick, simple and effective tool to suppress such spiralling insanity.

OK, SI. Why the need for something so elaborate, then. Perception at time: Dr C hates me. I am hateful. That needs to be acknowledged.

Entirely predictably, C droned on for about 40 years on methods of “distraction” and “grounding myself in the moment”, all this bollocks we visit in a circular motion time and time again. I don’t remember my response to him. I just remember my metaphorical eye-rolling and desire that he’d move the fuck on from this DBT nonsense, because in its simplest form anyway, it doesn’t fucking work.

Anyhow, the second issue arising from the Dr C conversation was what he thought of the treatment meted out to me by Psychiatry. He seemed surprised by the strength of the reactions of A, Mum and (obviously) me, and his expressions and body language suggested, to me, something akin to nonchalance about the situation. Well – maybe ‘nonchalance’ is an unfair word. But I certainly did not get a vibe of overt concern like I had from LGP.

So, I set him a challenge. “If I ask you a straight question,” I began, “will you please give me a straight answer?”

This, of course, garnered a slight non-verbal reaction, because it was a strong inference that he often doesn’t answer straight questions. Well, he doesn’t. If he doesn’t like my directness about that on this occasion, that’s just too bloody bad.

“If I can,” he responded.

Ha! What you mean, C, is if you’re willing. Do you think I’m stupid? Can’t you even plan the answer in a straight fashion?!

I asked him if he thought I was being unreasonable in expecting better from the Health Service. I reminded him that I had been fucked about by Psychiatry from January to May, then fucked about again in July after a serious medication change to a seemingly effective but nonetheless insidious, potentially mind-altering, drug, then fucked about again in September. Was that fair? Was it fair, also, that such carelessness was exhibited vis a vis my privacy in my meeting with Dr A? Whilst acknowledging that to some extent the NHS is ‘free’ to use, was it fair that I had worked since I was 16 (insofar as my illnesses permitted) and will hopefully return to and continue to work until my 60s, thus facilitating the salaries of Dr C and her team via national insurance – only to be treated in this fashion? Was any of that actually fair? Was I being unreasonable?

When he didn’t immediately respond, I pointed out that my enquiry was serious. I genuinely wanted to know if something about my fury, and that of Mum and A, was somehow unjustified.

He eventually started wittering on about it being fair to expect certain standards from a service, regardless of what that service is, and certain frustrations were bound to be evident were those standards – or, more accurately, the expectations of standards (my distinction, based however on what I inferred from what he said) – were not met.

Exasperated, I said, “yes or no – do you think my anger is unreasonable?”

He sort of sighed, then said, “you talked about your main GP as being a good doctor, but the on-call one on Tuesday as being someone you strongly dislike. Dr C is, presently, in your mind, a second ‘bad’ doctor. If I answer ‘no’, I am just another ‘good’ doctor, affirming your present mindset. If I say ‘yes’, then I become a ‘bad’ doctor.”

He was obviously accusing me of black and white thinking, which is generally not a particularly unreasonable view for him to take, but nonetheless I resented every syllable of this fuck. Is what he said not profoundly black and white? Can’t he understand that if he can coherently and reasonably defend his position on the matter that I might have some insight, that if he disagrees with me that I might be able to derive some perspective from that? Oh no. Even in someone with an IQ of 148, it’s apparently as simple as a childlike concept of good v bad, with no room for relativism at all. I might have BPD, but I’m not completely colour-blind to shades of grey.

Rather than lose it with him, I tried to rationally explain my reasoning for my views on the GPs, the subject of his comments that had especially irritated me. My views on both have been developed over years. I first met LGP over 12 years ago. I first met HGP maybe six or seven years ago. I just didn’t meet either of them once or twice and form a view of them. My views on them, and on all other GPs and health professionals I’ve met, are based over time. They can change dramatically or quickly, I’ll admit, but not without very good reason.

In general, that is.

He conceded that perhaps there was more to it than good-doctor-bad-doctor, but pressed, “why self-harm though?”

This was irritating, as I’d already outlined my reasons. I sighed and said something like I wasn’t sure we’d ever see eye to eye on this.

He said, “I wouldn’t be sitting here with you if I didn’t believe you had other coping methods.”

Seeing my eyebrows raise, he added, “…or at least if I didn’t believe that you could develop them. What would be the point in that?”

I don’t recall my thinking now, but I looked him straight in the eye with what I think was some sort of oddly demanding expression and asked in a dark monotone, “are you going to leave me then? You’re going to abandon me?”

Poor C. The man was genuinely stunned. Reflecting on it now, so am I. Talk about adding two and two and getting half a million. There was absolutely no tangible link between expressing that he had hope for me and a suggestion he was going to desist from seeing me. None.

“Where did that come from?!” he exclaimed, mystified.

I honestly don’t remember my answer; I am writing this a fortnight later. I must have said one of two things; either I tried to justify my ridiculous belief that C had suggested he was going to ‘dump’ me, or I immediately apologised and submitted to him. Either way, we ended up in the submissive position, with me predictably following my Attack-Defend-Submit pattern. I said that my comments were clearly bullshit, that I was being daft and he should forget it.

“But it’s obviously something you’re bringing to this room,” C pointed out. “Why is that?”

As can be my won’t at times, I began playing psychologist. Interesting that I refuted any suggestion above that I was childlike, because I remember telling C that that’s exactly what I was. When he asked me why I thought this, I sardonically replied that I wasn’t allowed to intellectualise matters so I couldn’t answer his question.

He laughed and said, with a kind of amused defeatism, “go on then.”

Of course, I couldn’t. This was a PhD qualified clinical psychologist I was talking to. I’m a Wikipedia qualified psychologist. (Actually, I’m underselling myself, as I do have some knowledge of the subject, but it is from some time ago and was not even half as in-depth as a full undergraduate degree, nevermind a doctoral one). For the record, I was thinking of attachment and object relations theories and their roles in transference.

Anyway, my paranoid whining led to a monologue from C about ending therapy. Obviously I’m aware it’s not indefinite, it’s not a permanent fixture in neither his nor my life, aren’t I? But he’d like to assure me – again – that it will never just abruptly end. He envisions a minimum of four sessions of preparation before discharge, probably more, blah de blah.

I just sat there and looked at the floor, struggling to not burst into tears like a bloody newborn, struggling not to get down on my knees and beg him not to leave me to try and make some sense of insanity, my past, my future – my entire damn life – alone. I know I sit here and spout bile about the man and slag him off and call him names – but I do like him despite it all, and I need him and see hope with him and I can’t do it without him – not yet anyhow.

I was utterly overwhelmed by how much I don’t want him to abandon me and how inadequate and feeble I felt because of that. How sad and ridiculous that an intelligent woman of 26 wants a man she doesn’t even know to take the place of her missing father, grandfather and, frankly, friends, given that she only has a few close ones. How pathetic that she is vulnerable like a girl 20+ years her junior, and that she wants this unknown figure to scoop her up and take care of her. It’s so wretched that it’s almost kind of darkly amusing.

He interrupted this self-indulgent and piteous stream of consciousness by asking, “how are you feeling now, in this moment?”

I can return to ranting now. I swear to fucking God that I am sick to death of that phrase. He must surely use it as his meditation mantra. Is there some cadence in it that I’ve missed that makes it an attractive thing to say all the time?

I cleared my throat and said I was fine. He looked at my cynically, but decided against pressing the issue, presumably as there was very little time remaining in the session.

“When Dr C contacts me,” he began, “I can tell her nothing if you want. What we discuss here is confidential. Some people might not be at all comfortable with the idea of a discussion about them behind their back. Others may find it helpful. What’s your take on that? What do you want me to tell her?”

“It is weird to think of the two of you discussing me whilst I’m in absentia,” I admitted. “However, I don’t think that makes it unhelpful.”

I shrugged. “Use your discretion, I suppose. Answer her questions, give her any information you feel is relevant.”

He nodded, and I saw him look at the clock, which to my annoyance he’s moved to behind ‘my’ chair so (I presume) that it’s less obvious to the patient when he checks the time. Which it’s not as you can see his eyes shift above your head. And in any case it was pointless to hide it on this occasion, as he said, “we’ve left very little time to talk about your holiday.”

Oh really, I had no idea, I thought we had six hours. To be honest, I was glad. The preceding minutes had been pretty intense for me and I was tired.

We did conduct a quick and fairly basic discussion on coping if I were to go mental in Turkey, but beyond talking about getting A involved in the techniques, there was nothing new in what was discussed. I did talk about the inhaler from LGP and the Valium, but C kept whinging that these were external sources (oh really? I thought I had them sewn into my oesophagus) and that I needed to develop internal responses. To be honest, I just sat there and nodded, not really agreeing, not really even thinking about what he said, because I just wanted to leave. Not a good thing probably, but there you have it.

As I left, he said, “I hope the holiday goes OK.”

I ranted to A about this later. OK? You hope it is OK?! No “have a nice break” or “I hope you have a great time”?

To my surprise, A defended C. A contends that C had to be careful; had he said he hoped it was “great” or whatever, I would have been too cynical to really believe that he meant it, or that I expected it was possible that the trip could be great. I actually don’t agree that that would have been my view, but in fairness I can see why C might have thought that. So I can forgive his lack of enthusiasm to some extent. I suppose.

Friday: The Flight

OK, the title says ‘three’ days and this is a fourth day, but it doesn’t involve professionals attending to my madness, and in any case I’m not going into too much detail. You can probably tell from the style of writing here and here that I was (hypo)manic on Thursday night. This carried on right into Friday.

I suppose there is an argument that I could simply have been excited about going on holiday, but I don’t think that is the case. Forms of mania are, to me (and as far as I know to diagnostic manuals), different from contentment or excitement, in subtle ways at least. I understand that bipolar II in particular often goes undiagnosed because the hypomania therein often presents simply as an especially good mood. Maybe I seemed in an especially good mood on the Friday of that week, and I probably was, but I was also behaving oddly and saying really stupid shit.

I don’t have the best recollection of it, I’ll admit. I do remember sitting at the departure gate at the airport, delayed, babbling incoherently and in a racing fashion to A. I remember dropping my bag and having some sort of hysterical fit of laughter and more racing speech about this ludicrously uninteresting event. People around me were looking at me as if I was mad (which clearly I was). A found it amusing, and I can understand why it might have been to some – but it is also not ‘normal’; certainly, it was not appropriate behaviour for a public place.

And it very certainly, profoundly and completely wasn’t appropriate for a plane, and luckily I had enough cognisance to realise this. So, for the first and to my credit (?) only time from then to now, I took Valium to space me out and slow me down. It worked, to A’s self-proclaimed disappointment, but obviously it is not a long-term solution to episodes of mania.

Thus began our holiday. I will write in more detail about that shortly; it’s a separate issue from most of this post’s material. However, don’t worry; I’m not going to bore you to death by telling you what we did, what we ate etc etc etc – even if you actually know who I am, such things become dull very quickly. Of course, I keep this diary primarily for my own reasons – but more in relation to my mental health, not ‘normal’ stuff, if there even is any of that presently in my life. No, I want to think about how I felt on the holiday, how I behaved – whether there was an overt exhibition of madness thereon, or whether I actually managed to acquit myself well. I hope to write this tomorrow, but if not hopefully early next week.

Meh

When A and I were waiting for the plane, I received a message from my mother stating that a letter had arrived from Psychiatry offering an appointment on Tuesday 15th. LOLOLOLOL. Can’t they get anything right? I clearly told Dr A I would be away until the 21st. Mum rang them for me and whinged some more, pointing out they had not explained the situation as promised to her on the phone on Tuesday. They promptly and without question rearranged the meeting for Tuesday 29th. I am now terrified of it. It’s not great timing either as I have another bloody OH appointment on Thursday 1st October as well, but there’s not much I can do.

So, finally, you’re probably wondering what the reference to ‘genital vinegar’ in the title of this post relates to. It relates to Dr C. In ranting on Twitter, someone responded to me that Dr C was a “vinegar cunted bitch” – or so I thought. It turned out he was actually referring to some bint spreading more “Obama is a Nazi” bollocks in the US, but never mind – the title as one for my psychiatrist stuck.

Obviously there are a lot of ‘C’s in my life anyway. The actual C, CVM, Dr C…I’m sure there are more. Therefore, to avoid confusion and to reflect my current position on Dr C, I shall henceforth refer to her as the Vinegar Cunted Bitch, or VCB. I know I have a terrible penchant for acronyms, and when combined with usage of terms such as ‘BPD’ etc it is bound to get confusing – but I’m not going to start calling C ‘John’ or VCB ‘Dr Alfonso-Smythe-Hetherington VI’ just to anonymise them, so you’ll just have to bear with me. I have to bear with myself, after all.

In Session and Spaced Out – C: Week 23

C didn’t believe me when I told him this, but prior to Thursday’s session, I had had no more than about five hours’ sleep in the preceding three weeks. I believe that for a while I’ve been in something of a hypomanic state; my experiences have included racing thoughts, restlessness, insomnia even whilst on sleeping tablets, being over-talkative, creative but paradoxically easily bored, impulsive and reckless. The one thing I haven’t felt to any great extent is an elevated mood – fucking typical.

To this end, I’m not sure I was much use to either C nor myself the other day. I rambled and rambled and rambled, fiddled with my hair, got up, sat down, stared into space, laughed randomly and was just like a total crackhead or something. He would start talking about something and I would stare at him in apparent deep concentration, but in reality my mind might as well have been floating in the gases of Jupiter, because I didn’t really hear much of what he said.

Given these circumstances, perhaps it’ll be unsurprising to learn that I remember little of the session, which annoys me as of course I seek to record everything in detail here. Bollocks.  Well.  Here goes with what I do recollect.

One thing worthy of mention is that I am going on holiday on Friday, 11 September for 10 nights. A and I had both agreed that 10 nights was perfect, and given the day it fell on, it also had the beneficial side effect on only missing one session with C.

Imagine how irritated I was, therefore, when C announced he’d be off himself for the session immediately after I come back. Why didn’t he arrange whatever stupid, meaningless real-life activity for the week I was away?! I sat there calm, measured, controlled as he told me this – but I wanted to reach across the table and smite him.

I know how irrational and unreasonable this is. He is a person, with his own friends, his own family, his own life. But it winds me up to fuck whenever that impinges upon my time with him. For 50 minutes on a Thursday morning, C belongs to me. Me!!! In my line of work, I was always expected to take holidays at the convenience of the department and our clients. Surely it should be the shame for shrinks having to deal with their pathetically attached mentals? [/stupidrant]

Anyway. I had ended up buying a copy of the book he’d recommended to me last week, and presented it to him. I hadn’t read any of it, but based on a cursory flick-through, it didn’t seem to be as patronising as self-help books generally have been in my experience. In fact, the first half seems to be a more theoretical discussion of the issues the author has explored during his academic studies of compassion, which could be potentially interesting. The second half is more self-helpy. Later in the session C gave me homework; I am to read the first chapter of the second half for next week, and we’ll discuss it then. More wank on mindfulness, I see, based on flicking through it.  Hurrah.  Still, at least it’s likely to be better than the crap he had me read on same before!

I was telling him about my restlessness and exemplified it by telling him how I’d written over 8,000 words on this blog the day before seeing him. “I couldn’t have done that when depressed,” I contended, “as I wouldn’t have had the motivation.  I hate to use the term ‘hypomanic’, as that has connotations of being in a good mood, and I’m not particularly. But if Dr C thinks I have bipolar elements, and she does, well then, this is consistent with that.”

He nodded, then asked me if it was indeed next week I was seeing her again?

“Tuesday,” I confirmed. “If she fucking shows up this time.”

He ignored the insult and instigated a discussion regarding the Venlafaxine. “Are you going to discuss the medication with her?” he asked.

No, C. I’m going to go there and tell her that it’s a beautiful / shite day. I’m going to ask her what I should buy my mother for her birthday. I was thinking of asking her what “season” she thinks I am best represented by in Colour-Me-fucking-Beautiful (NB. Please don’t think for a second that I use this ridiculous ‘service’.  I have provided the link only for context and have heard of it only through work colleagues.  It’s probably a good thing, therefore, that I am off).

Rather than give such a response, though, I said that I was scared of the meeting in case Dr C tried to take the Venlafaxine away (not to mention the fact that I’m actually scared of Dr C, full stop). I said that it had certainly aggravated my bipolar symptoms, and as such I felt I needed something to counteract that, but that my ‘base’ mood seemed to have improved slightly, and as such I didn’t want her to remove the anti-depressant instead of giving me something to deal with the manic shit.

He looked thoughtful for a minute, then said, “if your base mood is improved…do you think that’s as a result of the medication?”

I said, almost (unfairly) sneeringly, “why? Do you think it’s you?!”

I think he misheard me and believed that I’d said, “No, I think it’s you,” because he smiled a big wide smile, and actually seemed to blush slightly.

Blank canvas, C! Blank canvas. No blushing. Bad C!

This led to a weird discussion of our relationship and what we hoped to achieve through it. I’m not going to sit here and detail it, because I’d be making it up; I don’t remember it well at all. I do remember rambling on for quite a while about how he was the first therapist I’ve seen that ‘gets’ me and that was because he was good at employing intellect and empathy and understanding in the right balance.

At some point during this I confessed to the content of Wednesday’s post and stated that C was the ninth psychotherapist I’d seen.

He was stunned. “I thought you saw a CBT therapist!” he exclaimed.

“I did,” I replied, “but she was one of eight others. I thought you knew this.” I thought this information had been included in the questionnaire I’d completed prior to first meeting C. I’m pretty sure it was. Why else would I sit and whinge each week about the NHS letting me down for 12 years?

He quizzed me in particular on Ian, the psychoanalyst. He seemed really taken aback that such therapy is still available at all, even if on a private basis.

For what it’s worth, I don’t put much faith in pure psychoanalysis, based on what I know of it (not a great deal, admittedly) – mainly because it takes too bloody long to have any demonstrable results.  Having said that, I think there’s a lot we can learn from the approach and the teachings of Freud, and presumably so does the NHS otherwise they wouldn’t have clinical psychologists like C practicing psychodynamic techniques (given as they are ultimately derived from psychoanalysis). So his perplexity confused me a bit.

In the end we briefly discussed my upcoming holiday to Turkey. I said that whilst I was looking forward to it, I felt slight trepidation too. For one, I’ve never been there; the last two holidays I’ve been on, I have been to the places before. Secondly, I don’t speak Turkish at all (I know in tourist resorts they speak English, but I still feel irresponsible for not speaking at least some of their language); previous holidays have been in North America, where they obviously speak English, or various parts of Spain, which is OK as I speak a little Spanish (I’ve been to Germany too, but A speaks German. I’ve been to Czech, but was motivated to learn enough of that language before I went there. When I was in Portugal, I was too young too give a damn). Mainly the issue is that this is the first time I’ve been on any sort of foreign trip whilst really mental.

“So you see,” I said to C, “I feel like I’m going a little out of my comfort zone.”

“Maybe,” he agreed, “but you can also see it as an opportunity.” He paused, and then laughed. “Plus don’t forget it’s a holiday!”

“Indeed,” I smiled. I did point out that I am looking forward to it, I just wondered what would happen if I lose it whilst there.

“Aside from the fact I don’t fancy a spell in a Turkish asylum, it’s not covered for in the fucking travel insurance,” I pointed out.

He suggested that we spend most of next week’s session discussing ways to manage being mental on the holiday, a proposition to which I agreed.  We also plan to look at the chapter from Paul Gilbert’s book that I mentioned earlier.

But that’s really all I remember of it, which is frankly appalling.   If anything more comes back to me, I’ll add it – this journal is still, primarily, for my own reference after all. For the rest of you, whilst this entry has been pointless and boring, at least it isn’t 8,000 words of verbose, narcissistic nonsense!

On Tuesday I see Dr C, on Wednesday I see Lovely GP and on Thursday it is back to C.  I will try my best to report on these meetings, last-minute traveling arrangements permitting. At least an entire week of stressful madness will be rewarded with 10 days in, I hope, the Turkish sunshine.

A (Half-)Life in Therapy: The Fabled Post of Therapists

As any of you who have read this blog since I began it in May will know, it has long since been my intention to write about each of the different therapists of one description or another that I’ve seen over the years. The idea was inspired by the same type of post by Introspective at Conversations with my Head, so hat-tip and thanks to you my dear.

It’s now September, so you can see how successful I’ve been to date in getting around to this. But here I am, finally, with all the fascinating (!) details.

Be warned; this is very, very long. I’d suggest you don’t even bother reading it if you wish to remain awake (possibly alive). If you really want to, try it in two parts or be prepared to be sitting at your screen for a while.

—

I was about 12 or 13 when I began to think that I had mental health problems. With the benefit of that wonderful thing called hindsight, I can see that I might have been a bit batty even as a child – I was a complete narcissist even then, and once tried to amputate my foot. I was an insomniac and experienced nightly hallucinations. I thought it was normal at the time.

But with the onset of adolescence (though not puberty, for I experienced that mostly in its entirety a bit earlier than most), I began to feel increasingly depressed. I felt hopeless, like my life was worthless, that the future was bleak and dark, that everything was utterly futile. Even I had the sense to recognise this as a bit unusual.

The realisation that I was depressed came one day when we were visiting my grandfather in hospital. In the corridor, there was a sign detailing the diagnostic criteria for a depressive episode. I hadn’t had five of the criteria for a few weeks; I’d had them all for several months.

I remember going back and looking at the poster over and over again, in the hope that my mother would notice that there was something on it that was piquing my interest. I never succeeded in that endeavour, but sooner or later she did, somehow, realise that my marked change in behaviour was quite long term, and off she marched me to the GP. Thus commenced about 12 years, to date, of on-off psychotherapy.

The GPs

Not therapists obviously, but it was of course one of my GPs that initially made the diagnosis of clinical depression; I was aged 14 at the time. To be honest, I think they just gave me a diagnosis and medication just to get rid of me. I am still of the view that I was initially seen as an angsty adolescent that they wanted off their hands. Best to give me Prozac, then say toodle-oo. Except it wasn’t so simple. Mum had me up at the practice more times than enough and eventually they sought the involvement of…

The Counselling Bloke

In all honesty, I remember very little of this guy. I don’t remember his name, and I don’t remember the precise point at which I saw him. I remember that he was a counsellor, of course, but I can’t recall whether he felt I needed more specialist help than he could give me, or whether we just closed the meeting and mutually agreed there was no point in continuing the brief alliance. Whatever the case, I’m fairly sure that I only saw him once, and I found the meeting utterly fruitless.

I do remember what he looked like; he was a short, thin, dark haired bloke, and actually reminds me a bit of C. It’s not beyond the realms of possibility that he in fact was C; although I’m not sure of C’s age, I’m guessing he’s in his mid-thirties. That would make this meeting just on the side of possible; he could have been an undergraduate or new graduate gaining some work experience. Perhaps I am creating a phantom memory, but it doesn’t really matter either way. The meeting was still useless.

The Trainee Child Psychiatrist – Anna

I’m not sure how I ended up with Anna, but it could have been one of two ways. Either the Counselling Bloke referred me, realising I needed more help than he could give, or Mum and I went back whining to the GPs and they eventually referred me. I don’t remember, but it doesn’t matter.

According to Anna herself, so my mother says anyhow, people under the age of 18 aren’t allowed to see psychiatrists. This seems ridiculous and unlikely to me, especially given that Anna – by her own admission – was a “medical doctor” (Mum asked her one day if she had a PhD in psychology), so surely the only mental health specialism of medicine is psychiatry?

Anyway. Whatever the case, she was based at a Child and Adolescent Mental Health Unit and I saw her for quite a few months. I liked her, and despite the bizarre situation and the fact that we never really made any headway, she liked me too (more on that in a minute).

I remember few of the specifics of the psychotherapy. I do remember her giving me stupid, patronising little sheets to fill in. You had to complete the end of the sentence, eg. “I secretly…” or “I really hate…” or whatever. Though in thinking about it, this maybe only happened a couple of times.

I think she was trying some sort of cognitive behavioural approach with me, because I remember thinking at the time that whilst she was well intentioned, her methods were unintentionally condescending (even though she herself wasn’t) and I just knew they were never going to work. I did apply myself to the therapy, though, and tried to work with her, but I never let my guard down and was always very careful in what I said to her. She knew I was bright and I think she actually found me quite entertaining; I remember one incident where I had the woman doubled-over laughing (thanks to some scathing remark I’d made about someone that was intended to be amusing, but I hadn’t predicted just how funny she’d find it).

I don’t remember the exact reason that my sessions with Anna came to a close. We must have agreed to have a break, though I don’t remember that happening exactly. All I do remember is that, whilst I hadn’t seen her for a week or two, I was expecting to see her again, when a little card arrived in the post from her, explaining that she’d been offered a new job on the other side of Northern Ireland and would not be able to see me again. The letter was kind, stating that she’d enjoyed working with me and wished me all the best for the future.

I wished her well and fully understood her reasons for moving on. Our therapy hadn’t much worked anyway, but nevertheless here I was left high and dry again.

The Education and Welfare Officer – Elaine

Actually, I’m not sure whether it was Elaine or Lorraine, but I’m going to go with Elaine as it’s quicker to type.

Elaine wasn’t a traditional psychotherapist; she was actually a social worker attached to the local education board, and was involved in my situation as – owing to my mental health problems – I missed a lot of school. Nevertheless, our relationship became one that more closely resembled a therapeutic one; she was more like a counsellor than someone involved to keep tabs on me. I would meet her each week on a Thursday – it was during GCSE Maths which of course was especially gratifying 🙂

As is the wont of social workers, especially (though not limited to) those not directly trained in managing mental health issues (or so I’d imagine), Elaine’s discussions with me would centre around practical measures I could take to help myself, rather than an psychoanalytical exploration.

Although she wasn’t much like Anna in her actual therapeutic approach, she was to some extent in her reaction to me: I distinctly got the impression she recognised that I was not being deliberately awkward as some of my teachers believed, and that she believed that I was a bright, not unpleasant kid, with some genuine difficulties. She liked me. I would take her in photographs of events I’d been at the odd time and she’d always compliment me on how well I looked in them. She took me out to lunch a couple of times as well. She was the only one (other than my best friend D) to whom I would show my prolific self-inflicted injuries (which were more than just silly little cuts, but long, occasionally complex words all over my body). I don’t remember whether Anna ever asked to see them or whether I just avoided it with her, but I’m pretty sure she never saw any of it.

I don’t remember, again, the exact reason why this relationship came to a close. I don’t think Elaine left her position; I think it must’ve been something to do with me taking my GCSEs and therefore potentially leaving school, and ergo, her remit. As it happens, despite my previous intentions, in the end I elected to return to school for sixth form, but by the time I got to that stage, things were more (not entirely, but more) settled anyway.

It was during my time with Elaine that I seriously tried to kill myself (the first attempt, a gesture in retrospect, had been about a year beforehand, catalysed by a break-up with a boyfriend). On this occasion, although I decided upon doing it on a whim, it was something I had been thinking about for a long time and I really intended to die. I took a massive overdose of everything I could find in the house – paracetamol, ibroprufen, various prescription medicines of my mother’s, my Prozac etc etc – thinking it would be enough to off me (I know better now, but I genuinely believed it would kill me then).

I am reminded that my time with Anna and Elaine must’ve overlapped, because I now recall Anna coming to see me the next day in hospital, after I’d had my stomach pumped. When I went back to school the next week, Elaine took me out for lunch. I remember asking her why she was rewarding my behaviour; she responded that she didn’t feel that she was ‘rewarding’ it, but she was upset that I had felt so desperate that I’d seriously tried to kill myself, and she wanted to do something to cheer me up. Well, as anyone who’s been there knows, it takes more than skiving off school for lunch – but I appreciated the gesture, as well as the rest of her tenure as my EWO.

It actually pains me to write about Elaine, because it reminds me very acutely of what was probably the bleakest period to date in my life. It was only through thinking about what I was going to write about on this post that so much came flooding back to me; clearly I had compartmentalised much of it (I was whinging about this to bourach here recently). In a way, one could argue that this past year of my life (ie. 2008 – 2009) has been even worse in the sense that I have experienced a lot more than ‘just’ depression, and that would most assuredly be true. But now, at least, I have a support network, and a network that understands this whole mess is not something of my choosing. I very distinctly didn’t have such support when I was 15/16. I had a few friends, yes, but with the best will in the world it was hard for them, not having been there, to understand a disease so often (and often unfairly) solely associated with adults (I’m not even sure they’d understand it then, but anyway). Although she recognised that I was mentally ill, my mother couldn’t fully grasp the enormity of my despair either, and reacted aggressively to my illness at times, although in fairness she did champion me a lot with the GPs/counsellors etc. I was picked on by a couple of teachers too, though in fairness there were a few good ones. All in all, it was a horribly dark period in my life, and rather than discuss the specifics thereof, I think I’ll just leave it be. Maybe another day.

—

After doing my GCSEs I existed in a relatively sane frame of mind for a while. My dosage of Prozac had been upped, and a lot of the wankers that had made my life so miserable at school had either left or had grown up a bit. Additionally, I was only having to do subjects I liked and was good at for A Level, so things were a lot more settled for a while. Things were far from perfect; I continued to miss a lot of school, and didn’t do as well in my A Levels as I could have done – but things were certainly better in those two years than they had been in the previous five. In fact, it is only through writing the above about Elaine that I am shown how much I wear rose-tinted glasses regarding school. I tend to be quite defensive of the place should anyone slag it off, and when I think back upon my time there in an abstract sense, I am sometimes overcome with fond nostalgia – this is based almost entirely on not absolutely hating those two years of sixth form. Clearly at least part of me blocks out the unbearable misery that were the preceding five years.

But anyway, that obviously didn’t spell the end to the madness…

—

The First Assessment Woman

I’m not sure when this was. After sitting my GCSEs, the next time I really remember losing it big style was when I was doing my postgraduate course, but I’m fairly sure the First Assessment Woman was earlier than that. Perhaps I had been feeling low for a while in sixth form (or whilst I was an undergraduate) and had yet again been at the GPs’ ‘surgery’; given my history, they might have referred me to the Psychological Therapies people. Who knows. Whatever the case, I went to see this woman at the same hospital in which I now see C and Dr C.

I believe the meeting was intended to assess what the most appropriate psychological treatment would be for me given my history. It was, short of the Crisis Response Team (see below), the most useless and frustrating mental health-related meeting I have ever had. The woman quite openly sneered at me as I tried to relate some very difficult information to her. I think it was because I expressed everything with a distinct absence of emotion and she therefore didn’t think there was actually much wrong with me (or such was my impression, anyway).

When I related a very abstruse outline of the sexual abuse, she decided that that alone must be the entire cause of my problems and gave me the number of the local Nexus Institute. I remember protesting that I didn’t want to phone someone (so clearly the phone phobia has been ongoing for a good while then) but she dismissively said it could be in confidence “if I wished” (thus totally missing the point) or that I could see them in person, if I preferred, and that that was all, I was to run along now. I didn’t have the energy to argue with her and that was that.

—

I had a major breakdown whilst undertaking my postgraduate degree. I had, at this point, only the dissertation left to write and had finished the taught part of the Masters programme, so took a full-time job which looked to be like a very good opportunity, and which was, unlike my previous and subsequent jobs, directly related to my academic background.

Unfortunately, I had been in a slow, but with hindsight obvious, downward spiral, largely thanks to my own doing. I had been feeling pretty good during my postgraduate year, so cut back on my Prozac without medical approval. DO NOT EVER DO THIS!!! By the time I realised I needed to remain on the dose I’d been at, the spiral had already taken its grip and the return to the full dose didn’t make a difference.

In fairness to myself, it would probably have happened sooner or later anyway, because at no point had I seriously tackled the underlying causes of my mental health difficulties – surely a recipe for disaster. It’s one thing to be aware of what they are, but it’s different to fully face them and be aware of all the subtleties therein. To mitigate their effects, or at least begin to reverse them, in my view I need to do this. Of course it had been my choice to never get into this detail, as I’d already seen a number of different ‘therapists’ by this point and had failed to utilise the opportunities presented. On the other hand, until you’ve been there, it’s impossible to understand how difficult this is, and how skilled a therapist needs to be to get it out of someone with so many defensive walls built around them, like me.

Anyhow, as ever, I digress. The breakdown meant I lasted a sum total of one week in my new job, and eventually had to leave my course with a postgraduate diploma rather than a Masters degree.

I returned to my GP. LGP had joined the practice by this point, but I didn’t see him consistently until more recently; it’s dog eat dog in our practice, and you take who you get unless you’ve planned the appointment for weeks. So I went to another one, who simply told me to “fight against it”. Unsatisfied with this, I went to the practice’s Nurse Practitioner, who prescribed me a new anti-depressant – Mirtazapine (in part because it’s good for insomnia) – and referred me for wanky CBT. I saw ‘wanky’ now, but I was hopeful at the time.

—

The Second Assessment Woman

She was a CBT Nurse at the main bin in Northern Ireland, Holywell. She was certainly better than the first bint of her ilk (see above), although I disagreed with her ultimate conclusion. I remember that she asked me the one question that every single one of them has consistently asked me: “don’t you have any female friends?”

I said that I didn’t like other women, adding, remembering her gender, that I meant “no offence” to her. (To qualify this a bit, I generally don’t get on well with other women in real life, though I felt more harsh about this at the time than I now do. Online, this isn’t the case at all – most of my online friends are women. I do have one real life female friend at the minute, so maybe I’m making progress! It all goes back to a terrible case of black and white thinking; because many women express emotion, want children and dream of white weddings, stuff I hate, I behave like I think they all do. Rationally of course I don’t think that at all, but then rationality and I are not always the best of friends, regardless of my desires to the contrary).

Anyway, Assessment Woman Two listened to me and, in fairness, seemed non-judgemental and accepting of the fact that there was something wrong. She did seem puzzled by my customary lack of emotion and even apparent amusement at some stuff, but she let it pass. Her conclusion was to refer me for group CBT. I protested vehemently against this – I was terrified of the group thing. The woman said, though, that she felt it would be beneficial in two ways: (1) the waiting list was shorter for group therapy than individual therapy and (2) it would help me confront my fear of group situations face-on. I reluctantly agreed.

The Psychoanalyst – Ian

As the waiting list for even the group CBT was six months, I went back to my GP’s ‘surgery’ and asked for a recommendation for a private therapist in the meantime. The physician I saw that day suggested Ian.

Ian was a very well regarded psychologist who’d even practiced as a forensic psychologist. Without detailing my academic background too much, this appealed to me strongly at an intellectual level and although he charged £70 per hour, I was happy to ‘try’ him.

I liked Ian. In a way, he reminds of me of C, the psychologist I now see; he was qualified to PhD level in his discipline, was clearly intelligent and astute, and seemed to be able to read my mind.

It was he who first suggested to me that my narcissism was an elaborate defence mechanism, built up over the years to disguise inherent and strong self-dislike. I remember arguing, “but I genuinely do think I’m better than some people,” and him responding by saying, “you genuinely think that you think you do, yes.”

We did discuss some of the stuff that effected me as a youngster, but although this was closer to psychoanalysis than any other therapeutic situation in which I’ve been, he was still primarily interested in here-and-now of my psychology. I believe that this was not because he wasn’t intending to explore everything else in more depth, but because if he had an understanding of what was now the case, it would allow him to work backwards. C did something similar, but has a more structured approach.

Again, though, my whole ‘lack of emotion’ thing was pronounced and perhaps he therefore didn’t realise how serious the situation was, or at least was becoming. Furthermore, if I am entirely honest the whole thing was kind of like an extended intellectual discussion between two parties interested in the way people’s minds work. To this end, I don’t feel that it was necessarily a particularly helpful relationship, even if it was an interesting one.

I think Ian could perhaps have helped me had I allowed him to break down more barriers, but then again, just because we liked each other at an intellectual level doesn’t mean that we ‘clicked’ especially; I don’t think we did, and there is increasing evidence suggesting that the dynamic of the therapeutic relationship is what allows the most useful and effective type of work to be done (see here or here, for example).

I went maybe five or six times, approximately every fortnight, though it became progressively less frequent as time went on. Aware that I wasn’t working, Ian suggested that I do some reading and practical things, and suggested I came back in a couple of months to save myself some money. In fairness, he did genuinely seem to want to provide me with a value for money service.

I didn’t go back, but not because I just gave up.

The Hypnotherapist – Edith

Having heard that I was paying out £70 per hour, the McF dynasty decided to get involved, recommending a hypnotherapist that S and her daughter SL had both gone to, finding her effective and more reasonably priced than Ian at £70 for two hours. I must confess that I was cynical, but my mother offered to pay for the treatment so I thought, “what the hell?” My intention was to have it compliment the work with Ian, rather than replace it, and for a short while nearing the end of my contact with Ian, the two did overlap.

Edith was the sweetest, most gentle woman you’re ever likely to meet. She oozed empathy and sympathy and absolutely tried her level best.

For my part, I did open up to her, but still in a pretty detached sort of way. For instance, I remember one discussion in which I was supposedly hypnotised where she was “regressing” me to my childhood. She asked if I could see the little SI in my mind’s eye, and I said that I could. There was a conversation about the kid’s actions, behaviours – I don’t remember it fully, but in any case, despite outward appearances, it became apparent that Child Me was probably not very happy. Big SI was very bad and said that she didn’t care that her mini-me was somehow unhappy. Edith said, “doesn’t she need to play? Shouldn’t she be enjoying these years of her life?”

I can’t remember my exact response, but it was certainly a definitive no. She kept pressing the issue – “but can’t you empathise with that little girl, that innocent child” blah blah blah – but no matter what way she tweaked it, or however she phrased it, I didn’t like Child Me and did not empathise with her. Edith kept trying and trying to instill empathy in my unconscious, but it never worked.

I’ve always wondered if I was completely hypnotised anyway. Whilst I obviously recognise that hypnosis is generally not like you see on the Paul McKenna show or whatever, but that it is rather just a heightened state of relaxation, my experience in Edith’s was distinctly different to both that of S and SL. S in particular had found that her body took on the characteristics of her abusive ex-husband – she spoke in his voice, she lashed out a couple of times and emulated his stature. SL hadn’t quite such an intense experience, but more so than I had, and neither remember much of it, whereas I remember a lot of it quite clearly (and anything I don’t recall is more to do with the passing of time rather than the hypnosis bit, I think).

I’m not faulting Edith; if I wasn’t hypnotised, then it is probably because I resisted it. I don’t know about the accuracy of the claim that some people can’t be hypnotised – maybe that’s part of it? But still, once more, I wasn’t fully willing to confront everything in detail. Again, yes, this is arguably stupid, but I still utterly despised the notion of expressing emotions (I still do) and was incredibly defensive.

One issue of difficulty was that I had to point blank lie about McMF-paedo-fuck to Edith. This is because she lives close to the McFs, and of course she treated MMcF’s husband’s daughter and granddaughter. Although I have more than one uncle that is still alive (and did then too), it would just have been too awkward to admit that it was an uncle. She did directly ask me who was responsible, so had I said, “my uncle,” there was nothing to stop her from asking which one. I therefore had to lie and say it was the husband of a friend of my Mum’s. This meant having to remain on guard about this issue a lot, which no doubt didn’t help the hypnotherapuetic process.

Having said all that, Edith must have done me some good. One thing she did do was set anchors, though as far as I know this is as much about neurolinguistic programming (NLP) as hypnosis. Occasionally I’ll still grab my wrist in a certain way to try and calm myself – that was one of the anchors.

Whether it was partly this, or partly expunging myself each week to her in general, even if still in a detached way, something must have helped in some way, because it was after seeing Edith for a few months that I started looking for work again.

—

(For the record – when I got a job, thinking I was back on track, I didn’t return to Ian. I did eventually receive a notification to attend a CBT session back at Holywell, but it was in the mornings, and that clashed with work, though as I was part-time back then, afternoons were ‘do-able’. I let Holywell know this, but was told that the group sessions only took place in the mornings and that therefore I’d have to wait another while for individual therapy. I never heard from them again).

A initially advised me against going to the four interviews I got at this point, as I would totally lose it each morning before the interview of that day. But I somehow forced myself to go to them all, and in the end was offered two of the four positions (I had temped briefly at the full-time one, and had other experience in the area, so no doubt that helped). Ultimately, I took the part-time one, because (a) I felt really encouraged by the staff I’d met at my interview, (b) it was in part working with animals and (c) I felt that a part-time position would be a better way to ease myself back into work.

Unfortunately, it didn’t entirely work out well, as despite appearances some of the staff weren’t quite so nice – but that’s another story. I did keep in touch with two of my colleagues from there (AC and DL), and thus am still grateful for the experience. Anyhow, I applied for another part-time job, got it, then a few months later got promoted to a more senior and full-time job. This is my ‘current’ job.

Things were fine for about a year, though the year had many stresses – V’s death and the will fiasco, a change of manager, a lot of stresses in the job itself that really shouldn’t have happened. Eventually, I was becoming increasingly agitated and depressed, and even dreading going to meetings as I knew I would only have a pile of extra work laid at my door, when it wasn’t possible to do any more. I was becoming increasingly neurotic and disillusioned with life in general, and one day I cracked and rang my mother in tears, begging her to put an appointment on with the bloody GPs the next day.

This she did, and that was the last day I was in work.

—

The Crisis Response Team (CRT)

I initially saw the Nurse Practitioner that day but when she heard I wanted to die and I couldn’t see a future for myself (amongst other things), she said, “you know, you’re really ill,” and decided to involve one of the partners in the practice.

He, in turn, decided that I needed to urgently see specialist mental health professionals and arranged for someone to come out to my house that day.

I am not sure that I have enough pejorative terms for the two women that turned up. Whilst the first one was friendly enough, when the other (apparently the more senior) one took over, she was incredibly passive and didn’t stand up for me, so I hold her as well as her colleague culpable for my annoyance.

Despite outlining how unbearably bad I felt, despite trying to tell them why, despite all the efforts I made to convey the longevity and seriousness of my condition to them, the more senior woman said I should “perhaps try meditation”. I actually laughed, thinking this was some sort of twisted piss-take, but her facial expression conveyed the information adequately that she was not joking. For the record, I have no problem with meditation, but don’t believe it’s a substitute for proven medical intervention.

She continued by asking me to analyse a scenario. Bloke A is in the park with his six brats running around screaming and doing my head in. What’s my reaction? “That Bloke A should die.”

“Alright,” she said, “now assume you approach Bloke A and tell him to shut his children up, and he apologises to you and says it’s just that his wife died that morning. What’s your reaction now?”

“My reaction is that while I am sorry for his loss, Bloke A should die.”

She looked puzzled and said, “but don’t you see that there are different ways of looking at things?”

“Yes,” I said, “I’m not stupid. What is your point?”

Apparently I was not recognising that there was an alternative viewpoint to the behaviour of Bloke A’s children and his inability (or unwillingness) to discipline them.

“That is incorrect,” I protested. “I do accept that there’s an alternative viewpoint. I still think he should die as his grief isn’t my problem. In fact, I’m offended on behalf of his wife. Shouldn’t he be taking his kids to see her parents or something? Or, in an alternative viewpoint, let’s assume the wife’s parents are dead – surely she has some family? Shouldn’t he be engaging with them and sharing grief? Or if he needed to be alone, why isn’t he alone? I appreciate that it’s possible that neither he nor his wife have any friends, family nor colleagues, but I think even you’d agree that that’s unlikely.”

But apparently I still missed the point.

After a long and protracted argument, about the above scenario, meditation and other issues, I admitted defeat and told the two of them that I was disgusted that my national insurance went towards their salaries.

This comment was ignored and they agreed to refer me to a…take a guess…wow-ee, a CBT therapist! Deja vu, anyone?

As they left, they told me it was “lovely” to have met me (so they’re liars as well as morons). Perhaps needless to say, I didn’t return the ‘compliment’.

The Cognitive Behavioural Therapist – Margaret

Given my previous experience of CBT therapists twatting about, I knew if the dumb bints from the CRT even did refer me (which it turned out they hadn’t), that I’d be waiting a while for it, so back I went to one of the GPs, and again asked for advice on a private therapist, though this time I specified that I wanted to try CBT rather than psychoanalysis.

Enter Margaret, at £90 an hour.

Although I liked her as a person, it was Margaret that gave me my intensely negative view of CBT. Initially, I was cautiously optimistic, but it didn’t last. As is apparently typical in CBT, now that I’ve read about the process more in-depth, she would have me analyse the likelihood of a perceived negative event. As a very rudimentary example, someone I know walks past me in the street without speaking to me. I can (a) assume (s)he hates me or (b) rationalise it – maybe (s)he didn’t have her glasses on, maybe (s)he was on his/her mobile, maybe they’re depressed.

Um…so? I know there are a million other explanations and I know that it is almost certainly not about me unless there has been a very clear reason for that, such as an argument. I already fucking know all that, I don’t need anyone to patronise me about it. The question is how does one really believe it? When I asked Margaret that, she said you just have to have an evidential base for the belief, which tallies with the literature on the subject, but that’s bullshit in my view as it’s already been recognised as utterly irrational by me; I already see and recognise that evidential base, but it’s doesn’t stop me from believing that the worst case scenario is the case, even if I don’t rationally believe it. If that makes any sense.

Another technique would be to directly face that which is most feared. As an example of this, I told her that I was freaking out about an interview for a job for which I’d applied, and she said I must go, as exposure to the event would be helpful.

I ended up in LGP’s office having gone totally batshit, and he gave me Diazepam for the first time.

In fact, I actually did go to this interview, and of course it didn’t go badly (in the sense that the panel weren’t Satan Incarnate; it did go badly in the sense that they were looking for someone much more qualified than me). But I already knew it would never be as bad as my panic was making it out to be. This happened another few times – I would utterly and completely lose it, even though I knew it could almost certainly not be as bad as my losing it would suggest. It doesn’t matter than I’m rationally aware of probable realities. It doesn’t matter that I know the worst that can happen is that the interview panel don’t like me or that I don’t get the job, and it doesn’t matter that neither of these things are likely to matter in the grand scheme of things.

I still fucking go mental when I’m under stress, or sometimes (mostly, actually) ‘just because’. Furthermore, in the case of the latter, I am not losing it because of any specific reason – as such, how can I rationalise what I fear? I mean, I don’t (consciously) know what the fear is in those moments. Even if I did, I already know anything a CBT-like approach could teach me.

Although I liked Margaret, I became increasingly disillusioned with the CBT approach, not to mention the fact that I was beginning to get into horrific debt – meaning that her employer’s ludicrously high charges were too much for me to pay. So that was the end of that.

—

My mother happened to be seeing the Nurse Practitioner at the GPs’ ‘surgery’ on an unrelated matter. The Nurse asked how I was getting on, and my mother said that things were not good. Upon a brief glance at my records, the Nurse saw that no referral had been made for me by the CRT for psychotherapy (I knew they were incompetent).

The Nurse therefore took it upon herself to make a referral. Fortunately for me, though, she cocked it up and didn’t make it specifically for CBT, like it was meant to have been when the bitches from CRT decided upon it.

I was really struggling during this period, and at my behest, had my medication changed to 40mg of Citalopram daily, which is the highest dose they were prepared to give me. It was at this juncture that the GP I saw decided to refer me to a psychiatrist, on top of the Nurse Practitioner’s referal to a psychologist. I finally saw her about five months later, despite the fact the waiting list was less than three months at the time. Contextual links follow later.

It was somewhere after my CBT with Margaret than I began to believe I probably had more than ‘just’ clinical depression and anxiety. I didn’t really investigate anything further at the time, but I recognised that for a while I’d been experiencing a wider set of symptoms. I assumed, rightly as it turned out, that seeing a psychiatrist would shed some light on this.

A relatively short period after my mother’s appointment with the Nurse Practitioner, I received a questionnaire through the post asking me to outline my psychological difficulties to help cut waiting times for a psychologist. I was prompt and, I hope, thorough in my completion of this document.

Some weeks later, I received a letter from the same hospital in which I’d seen the first assessment woman, asking me to attend an assessment with Dr C J, a clinical psychologist. Mum and I were both raging, as we wondered how many more fucking assessments it would take before they actually offered treatment? In both of my previous assessments, I then was simply moved to a waiting list for whatever the treatment deemed appropriate was. Still, I went along, because one has to do things the way the NHS wants.

—

The Multi-Disciplinary Psychologist – C

I’m not giving his first name. I’ve already told him I’ll keep all references to him here anonymous, and even though his first name wouldn’t give away his identity exactly, there’s always the chance that someone who doesn’t already know may find out who I am and work it out from there.

The ‘assessment’ session with C ended up turning into three assessment sessions, because he actually took the fucking time to discuss each of the points raised in the aforementioned questionnaire in detail with me. Surely he must have been breaking NHS protocol by actually taking his time over it?

I didn’t know what to make of him at first. His intellect was obvious, and I respected that, but there was something indefinable about him that I found quite irritating. Nonetheless, when I told him I thought CBT was a load of crap, even though I wasn’t a psychological expert, he accepted that and said that I was certainly the expert in myself, and that if that didn’t work for me, then it didn’t.

By the end of the three sessions, whatever it was that irritated me about the man was beginning to abate, and when he said that he would continue to treat me, rather than someone else, I was glad. We initially agreed to six weeks (his optimistic suggestion), shockingly commencing the following week! Progress at last. He did warn that although it might be mutually attractive, we couldn’t let our sessions become some sort of intellectual endeavour (as had been the case with Ian, though C is not entirely familiar with all that). I did stress that I couldn’t abide being talked down to, nor could I bear to not communicate comfortably because I had to ‘dumb down’ what I was saying. C accepted that and stated that he would be glad to have an intelligent dialogue with me, but it wasn’t to become a discussion of my issues as a psychological abstract; it still had to be directly about me. Given my narcissism, I was happy enough to acquiesce to this.

During those first six weeks, I began to grow from being pretty indifferent to him, to becoming really rather fond of him. He seemed to have got the mix right between employing intelligence and empathy in his approach – this is a position I still maintain about him. At the end of those first six weeks, I burst into tears in his office and begged him not to abandon me, as he was the first therapist to really ‘get’ me out of the many I’ve seen. We agreed to another 10 weeks at that stage, and when those came to an end, another 12 (of which we have presently had two sessions, with the third tomorrow). I see him once a week, first thing on Thursday mornings.

Perhaps because of his balance between intellect and empathy, rather than just one of them being in evidence, I have opened up considerably to him and have even shown the dreaded emotion, though I still curb it to some extent a lot of the time. I’ve told him stuff I’ve told no other living being.

In essence the therapy is mainly psychodynamic, though he has tried – usually to my annoyance – to bring stuff like DBT into the mix. His rationale is fair; psychodynamnic exploration is important, but when I lose it I need practical help too. I’m still dubious about DBT, but at least it has an ancient philosophical background which CBT doesn’t.

The main thing I’d say about my relationship with C is that there is a bond between us now. I am horribly attached to him, and whilst I won’t delude myself into pretending that he returns that attachment, I do think he likes and gives a damn about me. He is the first of all of these people that I have actually experienced transference towards, which is demonstrative of the fact that my psychotherapy with him just might be the vehicle I need to a recovery of sorts, as of course the phenomenon is generally expected to manifest if the therapy is to have any hope. Transference does cause me to get annoyed with him over very little at times. He causes me to get annoyed with him at times; the way he’ll avoid a question infuriates me, but this is him trying to avoid getting into a intellectual discourse with me, for the most part.

But all this transference, bonding etc is not to say that the process is fun; quite the opposite. It’s intense, overwhelmingly so at times. It often (ironically) depresses or angers me, saddens me, has made me lose it a couple of times. Even though I’ve opened up to him on many issues, I am still incredibly defensive and tend to (figuratively) run away if he hits a nerve. Yet somehow he manages to get most of it out of me eventually, showing his subtle but evident skill. I always crack up though. But then I always expected that things would get worse before they got better, because I have not faced any of my ‘baggage’ in any real depth before.

Overall, it’s possibly the most difficult sustained experience I have ever been through, but nonetheless, I think the relationship is a very good one, and despite the regression in my condition since I met him, in conjunction with his colleagues in Psychiatry, I have a glimmer of hope that, over time, C may be able to help me get some control back over my life.

The Psychiatrist – Dr C

Again, no names. In this case I don’t even know their first names anyway.

Obviously she’s not a psychotherapist and exists mainly to monitor my illnesses from a medical point of view. But I want to hat-tip her anyway, for providing my diagnoses back in June. Dr C also changed my medication to Venlafaxine on that occasion, but was open to the possibility of adding further medication to the cocktail should it prove necessary.

Unfortunately it took a hell of a lot of trouble to finally get to see her (it was only in discussing self-harm and suicide ideation with C that I was ever seen by them) and now that I have met her, it apparently takes a lot to continue to be seen on a regular basis. Basically, I feel fucked over by her, just like I have been by the NHS on several occasions, but meh. I ought to be used to it.

At least, though, when she does bother to show up, she seems to be willing to tackle my case in a straight-up fashion and to do something that might actually have something like a positive effect, so in conjunction with C, I have my fingers cautiously crossed.

—

So there you have it. The life of the Serial Insomniac through therapy. I realise that I have whinged an awful lot in the early part of this post that people kept attributing my madness to teenage angst. For what it’s worth, I do understand why this was thought to be the case, for the laypeople anyway, and I am working towards letting go of my anger in that regard, though it’s not easy.

It is only now, about 14 years after first really feeling that there was something psychologically wrong with me and about 13 after seeing someone about it, that I feel I might actually be finally moving in the right direction.

I expect it to be a slow process, but I’d rather have that than have no hope of regaining control at all.

Apparently BPD has a decent prognosis in the right circumstances, though I certainly won’t hold my breath. Bipolar disorder has no known cure. Either way, I’m not asking for ‘cures’. I accepted years ago that I will probably be on medication for the rest of my life; I am fine with that, and I am not against some sort of semi-regular ‘top-up’ psychotherapy after completing my main course, if that is what is required. Cures are not what I seek, as discussed in more detail here and here.

But I do want to be able to at least be functional, and I do hope that with C’s help, maybe – just maybe – I might be able to regain enough control to achieve that. I don’t know. The journey will continue to play out on this blog.

Lucky you, dear reader. If you’re still reading this post, then I’m amazed and don’t understand how you’ve not passed out or even died of boredom. Even by my verbose standards, this is fucking long. So, until ‘C: Week 23’, so long.