Reflections on 2009

Wasn’t it 1992 that the Queen said was her annus horribilis?  Well, let’s fast forward 17 years to now, New Year’s Eve, 2009. This year has turned out to be the annus horribilis of your humble narrator – mostly. I’ve been on the brink of sectioning on a number of occasions, the brink of suicide on others, I’ve developed serious psychoses, I’ve been twatted by the system and I lost my job.  Yet, there are a few glimmers of non-shit somewhere in there.

To that end, here, for your dubious delectation, is the good, the bad and the ugly (well, the bad and good anyway) of the last 12 months in the world of this PsychoFreakBitch…

THE BAD

Being Mental

Perhaps rather obvious, but yeah, being mental hasn’t been a great deal of fun.  I know I’ve argued that if I could flick that figurative switch to the sanity setting I wouldn’t do so, and I still hold to that, but nevertheless, the panics, depressions, mixed states, psychoses and frantic states are not exactly things that I enjoy.

As you know, faithful, darling readers, I have been mental for many years – my first diagnosis was in 1998, but in reality I did have some manifestations of madness well before that juncture.  However, 2009 was by far the worst year for it, as I think most of those close to me would attest.  The dysphorias, the exceptional levels of anxiety and the psychoses, all having existed before, have been exacerbated so considerably during the last 12 months.  I’m not sure why; maybe it is the intensity of psychotherapy, maybe it’s medication, maybe it’s simply the ‘proper’ development of BPD and/or bipolar disorder, given as they tend to manifest most strongly in one’s 20s, maybe it’s another psychiatric illness altogether.  Maybe it’s nothing more than coincidence.  Either way, it is.

Specific Issues on Mentalism

–> Psychoses

Tom was alright, but ‘They’ have been a hideous bloody curse.  Even with the anti-psychotic, ‘They’ are almost ever-present, though their severity was mostly reduced with said medication.  The worst manifestations of ‘They’ were when they tried to get me to kill myself and, worse again, when they wanted me to kill MW on Christmas Day.

Of course, the psychotic symptoms were not limited to hearing voices.  The shapes continued amok throughout 2009, though in retrospect I think I can say that I maybe noticed some abatement of their severity when I started taking Olanzapine.  However, I also developed new hallucinations, such as music, knocking and whimpering.  And I hallucinated my erstwhile stalker once.  Fuckin’ A.

Oh, and let’s not forget the delusions – A was in collusion with GCHQ, the sun and signs were watching and/or communicating with me, ‘They’ steal the thoughts from my mind, my cousin ScumFan was a drug dealer, A was not A but A’s sister, yadda yadda.

–> Dissociation

This has been pretty fucking annoying and at times highly disturbing.  There have been a number of times that I have found myself in dissociative fugue states – being in random places some distance from home, having no idea how or why I got there.  I need not explain the potential implications of these (admittedly relatively minor) fugues to my readership.

Of course, it does not take a fugue to make a dissociative episode.  Despite my ability to write 3,000 or more words on my sessions with C, my psychotherapist, it is not infrequent for me to dissociate parts of these meetings, particularly (unsurprisingly) when we are tackling something difficult together.  Several of the fugues have been in the wake of sessions with C.

I’ve also found myself in amnesiac states during or after arguments or highly stressful events, and of course I have the standard BPD features of depersonalisation and derealisation – forms of dissociation, I believe – on a frequent basis.

Although I’ve experienced depersonalisation and derealisation for years, I’ve only knowingly experienced full dissociative episodes – ie. proper periods of amnesia, losing time – in the last year.  Well…maybe it began in 2008, but it would mostly have been in 2009.

However, I only remember the rape and other parts of the sexual abuse in flashbacks, for example, and in discussion with C we have found that I have many ‘symptoms’ characteristic of someone who dissociated something traumatic in childhood.  The suggestion has been that, given the strength and quantity of these symptoms, there may be more than I don’t consciously remember.  I hate the idea for its own sake, obviously, but I hate it even more by virtue of the fact that it is not recalled (if indeed it did happen); it leaves me with a distinct lack of control over how I now react to triggers.  Perhaps that can be addressed in therapy over time (if therapy even fucking continues over time).

–>  Self-Harm

Is self-harm even bad?  Sometimes I really do wonder.  As a way to cope, it works.  As a way to fascinate (by virtue of watching the beautiful krovvy), it works.  As a way to seek absolution, it works (albeit temporarily).

Still, it serves as a permanent record of a very horrible year of my life, and I suppose in that way it could be considered a bad thing.  It’s something that, as of this writing, I feel quite nonchalantly about, but who’s to say in 10 years or something, I won’t look at my scars and feel triggered back into mentalism from which I may have found some relief?

I’m classing this as a bad thing of this year because, prior to 2009, I hadn’t engaged in any serious self-harm for years.  2009 saw it return on a relatively frequent basis.

Losing My Job

In reality, I was nowhere near as upset about this as I should have been, but one thing I really do detest is being in the hateful position of being dependent on the state for my living.  I had always dreamed of a career (not just a job) and the opportunity to use my intellect in a meaningful fashion.  I did not want to end up being a dolescum, and this is still something that I am hoping to change in seeking treatment for my madness.

So I suppose that is the worst part of losing my job; I now am officially everything that I never wanted to be in my adult life.  It’s also awkward from the perspective of my developing my career; having to explain a gap in employment of whatever length and an incapability dismissal will not be a lot of fun.

Trouble with the NHS

It all started with all the trouble with getting an appointment with, and then sustaining appointments with, the VCB.  Then C waded into the quagmire with his ‘I can only offer you 24 more sessions’ bullshit.  As you know, of course, I am fighting this.

Then there was Dr Arsehole just before Christmas (about whom I will write in the next ‘C’ installment), and the latest is that I have an appointment with Psychiatry on 20 January (more than a month after I was meant to have my most recent review appointment)…but not with VCB!  No, readers, apparently I am seeing ‘Dr M’.  What in the fuck..?  I might not like VCB, but at least I had got to know her to some extent.  But now they’re fucking me about again.  Arsecunt.

Christmas

It was fucking God-awful dreadful.  Enough said.

C

Not C himself; of course I don’t know the man in any realistic way, but my sense of him is positive.  OK, he does wind me up sometimes, and it is not at all unknown for him to actually anger me, but generally I am very fond of the man, regardless of whether or not that is simply a case of transference.  However, psychotherapy is not a fun process.  It’s not fun at all.  In fact, I believe firmly that it has made me more mental than I already was.

It therefore seems ridiculous to continue with it, but there’s method in the madness…

THE GOOD

C

‘Him again?  You just said he was a bad thing in this year!’

Yeah, I did, but he’s also been one of the most fabulous things.  Aside from my absolutely obsessive attachment to him, which I am pretty sure I wouldn’t have were I not very fond of him in a non-transferential sense, I believe the therapy is good for me, and is working.  Yes, it has made me more mental, but I believe this is a temporary state.

In being forced to (re)live some of the most horrible things about my past and, to a lesser extent, my present and potential future, it seems inevitable to me that my conditions would be exacerbated.  I had to get worse before I get better.  That was what I expected well before I commenced therapy with C, and that is still my belief.

Additionally, and this is probably related to the transference issues, C is the only person to whom I will talk completely openly.  For a long time, I would literally discuss many (not all) things with him, but it is only in the last couple of months that I really have stopped abstracting things.  I’ve now let my guard down and allow myself to be vulnerable around him, and I trust him.  That kind of relationship, however strangely asymmetrical, is a big achievement for me, and I think if it is allowed to continue as it should that it will pay dividends in terms of my mental health.

Diagnoses

Some people hate them.  There are a number of other mental health bloggers for whom I have the utmost respect that consider diagnoses ‘diagnonsense’.  I do get where they’re coming from, but I am grateful for mine.

It helps me to be able to attribute certain symptoms to an actual illness.  Now I’m not saying I use the conditions as excuses, but they do explain some erratic and bizarre behaviour, and I find that rather comforting.  Furthermore, in saying I have certain illnesses, it makes my range of symptoms part of something, rather than just a nebulous bunch of ‘things’; quantifying it in this way makes it seem more real, I am convinced, to others.  Just throwing the term ‘depression’ out makes it sound like a cop-out (NB. please note that this is not my view of real depression at all – I just think that some people, ignorant of mental health issues, view the word this way.  They believe that “I have depression” equals “I’m depressed,”, which of course those of us who have been there know to be a fallacy).

One further positive I’d add about the diagnoses is that they have enabled me to connect with others that have the same (or similar) disorders.  I will be eternally grateful for that, and for the support and kinship those individuals have given me (see more on this below).

Turkey

Our holiday to Turkey back in September was probably the happiest time of this year.  As I wrote at the time, I felt entirely contented throughout our stay, and indeed we enjoyed it so much that we are returning to a resort close to the one from 2009 again in May 2010.  I will never forget the crystal clear waters, the warmth of the locals and the sheer relaxation of lying about in secluded coves.  Whilst reading Social Factors in the Personality Disorders: A Biopsychosocial Approach to Etiology and Treatment, of course.  I mean, obviously!!!

This Blog

I will always be thankful that I started writing this blog, and indeed that I kept writing this blog.  My initial hope was that it might help me to identify triggers, but to be honest in that regard it hasn’t been as successful as I might have liked.  It has, however, given me a focus – writing is an activity that, despite the sometime difficulty of it, is something that I enjoy, and can direct my energy towards.  It also serves as a chronicle of what has been an extremely difficult period in my life, but one that is also likely to be a highly formative one too, if I don’t end up offing myself.  I’ve found it fascinating to rediscover diaries I kept in the past, and no doubt I shall find the same with this – though I hope that I will still be maintaining this journal well into the future.

I’ve been ever so grateful for the wonderful feedback I’ve been given on this blog too.  Some people find my writing style engaging, which is a huge compliment; others find solace in the fact that they are not alone, as what I’ve written correlates with their experiences and/or feelings; yet others seem to be grateful to learn directly what everyday life, therapy or whatever with my various diagnoses is like.

On a similar note, the blog has enabled me to meet so many people with whom I have found affinity.

Twitter

By far the best thing I have done this year was join Twitter (I’ve met many brilliant people through the account allied to this blog, but even more again through my ‘main’, slightly less anonymous, account).  I have met so many wonderful people – both mentals and non-mentals – through this service that I could not possibly thank them all here, much as I’d like to.  The support, friendship, empathy and, frankly, in some cases love that I have been shown has been a source of immeasurable help, more than the personnel concerned will ever know.

–>  Thank Yous – Twitter

CVM*
K*
@bourach
@woundedgenius / @behindthecouch
@notbovvered
@fromthesamesky
@error505
@an_other
@kimshannon
@helentaustin
@benpolar

* Both of whom I now consider ‘real life’ friends – I have met K and communicate with her most days; I haven’t met CVM, but again communicate with her most days and certainly will meet her when finances and circumstances allow the travel.  I love them both.

The above is far from an exhaustive list, but there are others that I cannot mention to protect either their or my anonymity.  Some to whom I am incredibly grateful are not even aware of the fact that I write this blog.  That does not mean I value them less, however.

–> Thank Yous – Blogging Buddies

Some of the above-named individuals of course keep blogs, but they are not people I met originally through this medium.  The following are.  Thank you to:

Alix Rites
Crazy Mermaid
Borderline Case
The Prozac Queen
Pumpkin
Vanessa
NiroZ (no longer blogging, alas)

Again this is not an exhaustive list.

It is my honestly held belief that were it not for the aforementioned individuals – both the Twitter friends and blogging mates – I would either have killed myself or been horribly sectioned this year.  So thank you to all of you listed, to many not listed, and extra special thanks to a select few – I hope you know who you are.

Friends

Of course, real life friends have been of immense value to me this year too.  I haven’t been fortunate enough to see my best friend D an awful lot, but we’ve have corresponded via email and communicated via the hated telephonic device, so of course I am very grateful for his support.  In spite of an acrimonious break-up of a serious relationship, not to mention other problems, D has still been there for me through all of this sorry year, and for that I am significantly in his debt.

B has also been very supportive.  It’s not that we tend to go into great detail about issues of concern, but he’s just there, and that means a lot.  In particular, like D, his ability to provide a metaphorical shoulder to cry on whilst dealing with significant difficulties in his own personal life is testament to his integrity and the strength of his friendship.

AC has also been great; as well as actually giving a shit and supporting me through mental illness, AC has also been there just for those ordinary, everyday things that friends do together – the theatre, lunch, whatever.  I also must hat-tip DL for this too.

Honourable mentions to A’s friends and family too.  Even though they’re (mostly) not conversant with the finer points of my mentalism, they nonetheless have been a source of fun and comfort.

And of course a re-acknowledgement of CVM and K 🙂

A

Saving the best for last.  He’s seen it all, and it all ain’t pretty.  Yet he is still there.  Still loving, still comforting, still supporting, still protecting, still fighting the corner, still providing, still entertaining, still staying sane.

There are no words.  ‘Thank you’ seems so woefully inadequate, but it is all I have.  I just want to make it publically known that I will always owe a debt of gratitude to A for everything he has put up with this year.

AND FINALLY…

This post might lead you to believe that there was more good than bad this year, and I suppose in the most objective of senses that may be true.  This is why something like CBT will never work therapy-wise for me; it doesn’t matter how much evidence there is or is not for a belief – the belief is still held.  The reasons for the belief need to be explored fully and processed.  But I digress.  My point: 2009 was an absolutely fucking shit year, and I will be glad to see the end of it.

But I have hope.  A small glimmer thereof, but a glimmer nonetheless.  Not of a miraculous cure, but of some stability maybe.  With the help of C (I hope) and the love and support of my fabulous friends, both those in the physical world and those online, there might just be a path to stability somewhere down the line.

Happy New Year folks.  If ‘happy’ is ambitious, then at least I wish you peace and something approaching sanity in 2010.

Yours ever

SI x

Christmas…Revisited

I feel I should say a few more words in addition to the last post.  Firstly, thank you all for your concern – to those that commented here, contacted me through Twitter or indeed those that contacted me directly.  I am OK, and all the better for your concern, for which I am extremely grateful.

Despite what I said on Boxing Night, I don’t think a hospital admission is necessary or desirable just at the minute (well, not that it would ever be desirable, but you know what I mean).  It is my belief that the delusions and the severity of the hallucinations the previous day were induced by severe stress, and are hopefully ‘just’ transient.  ‘They’ are usually there these days, even to the extent where they are stealing my thoughts (schizophrenic-esque thought-blocking?) but fortunately their desire to cause harm in the same way as the day they first arrived has not been present since I’ve been taking Olanzapine.

I was discussing with C at the last session (which I have yet to blog about – hopefully by early next week) about how I hadn’t been (consciously) bothered about my history with Paedo until fairly recently.  As this was towards the end of the session, we didn’t have time to explore the possible reasons for that, but no doubt it was lying in my unconscious, unprocessed, the whole time, subtly and insidiously contributing to my chronic depression and severe breakdowns.

Anyway, for whatever reason, it bothers me now, and the feeling of horror and dread about it and about him was very acute on Christmas Day.  The McFs were going out for Christmas Dinner (good, because it meant slightly less claustrophobia), but it started out badly when it was decided (after an unnecessarily protracted debate) that A and I would travel to the restaurant alone with Paedo and MMcF.  It was an utterly vile 20 minutes trying to make smalltalk with the two of them and when MMcF surreptitiously handed me £10 to buy A and myself a drink, she said, “I hope you have a very happy Christmas,” causing me to laugh incredulously in her face.

By the time we arrived at the restaurant I was highly agitated, and upon sitting down (trying and failing to not be close to Paedo) downed two Valium.  It was not just him.  It really was not just him.  There were about 16 or 17 people around the table, and I just cannot tolerate that.  Groups make me endlessly nervous, especially when they are all talking loudly and demandingly at once, and especially when (despite knowing them all my life) I am deeply nervous around and have nothing in common whatsoever with the personnel concerned.  My history with Paedo just exacerbated something that would have already been there.

The Valium helped, and I relaxed a bit, but it was still bloody awful.  The meal was nice enough, but I threw half of it up and my IBS was out of control.  A and I forced our way through it, but the worst was yet to come.  Rather than go back to MMcF’s house after dinner, it had been decided to go to SL’s.  I have nothing against SL and her husband, but for some reason the dynamic in their house is always different from elsewhere; everyone congregates in the same room on top of each other, whereas back at MMcF’s, at least people break into factions, making the group more manageable.

SL’s was tortuous.  The overbearing crowd, the inanity of the stilted conversation, the obsessive fixation with MW (whose nose will be put out of joint when his sibling is born in March), my mind recalling my history with Paedo and my Mum’s disbelief when I told her about it – it all got on top of me, and indeed of poor A.

‘They’ had been telling me all day what a horrid, fetid slag I am, but I’ve learnt to…not ignore them, and not push them to the back of my head, because that’s where they reside anyway.  I don’t know; I’ve learnt how to not respond to them, I suppose, when they are wittering on like this, which is a lot of the time.  However, it’s pretty much not possible to fight them when they turn into the all-powerful screaming cacophony that they were the first day I encountered them.

Well, didn’t they start it again, just as we had managed to escape the worst bit of sitting about in the living room, joining as we did ScumFan and DMcF, who were playing the X-Box in the kitchen.  ‘They’ started screaming at me that I was evil for keeping my mouth shut about the rape and the molestation, that I had put all the other generations at risk and that it would therefore be a mercy for me to “eliminate” MW, given that he could expect “nothing but” the same fate from his great-grandfather.  I tried to ignore them, really I tried, but the more I fought them, the more and more effort they put into their critical wailing.  I was ordered to go to where MW was sleeping and smother him.

Of course, the last thing in the world I want to do is kill someone, especially not an innocent kid, so by this point I was hiding behind A and covering my ears and muttering a poem (as well as some ‘shut ups’) in order to try and distract myself.  The next thing I remember was being in the utility room in tears banging my head against the washing machine (!).  I tried to get past A, who was standing their blocking my exit, but he wouldn’t let me past for fear that ‘They’ might have successfully compelled me to go to MW’s room.  I think I slid down the wall in defeated resignation then; I was convinced ‘They’ had finally taken complete control of my mind.  The fight was over.

Well, luckily ‘They’ hadn’t managed to take control, and the fight wasn’t over.  I honestly don’t recall how this all finished, but the next thing of which I do have a clear recollection was having a discussion about something or other with SL, MW’s mother, in a calm, almost seemingly jolly fashion.  Yet all the time I was thinking, “the voices in my head just now wanted me to murder your baby son, you know.”  Thank God people generally can’t read my mind.

When A and I went to bed, and I don’t remember saying any of this, apparently I was convinced that A was not A but in fact his sister.  I also apparently believed that ScumFan – surely the most innocent and naive of young men – was involved in a serious way with drugs.  Needless to say, these ridiculous delusions disturbed A considerably.  And then, thanks to Zopiclone…nothing.

Boxing Day was better than Christmas Day, but still awful.  In the morning, I completely defied ‘They’ by playing with MW as I normally would (obviously in others’ company).  ‘They’ mumbled and whined a little like they usually do, but mercifully it was nothing with which I could not deal, and at no point did they try to persuade me to harm the baby.  Shortly after midday, A and I headed off to his father’s house.

Normally, it’s just A, his father, step-mother and me for Boxing Day, but on this occasion his aunt and her husband turned up.  I just wanted to sit and vegetate, as is the norm on our visits to A’s Dad’s, but the aunt would not shut up for more than three seconds.  Nice enough woman, but she began to grate on me not just through her constant demands for conversation, but also as she made underhand insults directed at A, inferring (and not at all subtly) that he was less intelligent than her children (which is not true, but since they have degrees from Oxford she feels that it is so, apparently).  A told me later that she had been intensely jealous of his parents when it was realised that he was a smart kid, and she always wanted to better them.  What a poor, sad cow.  How pathetic and meaningless must one’s life be to be so utterly fixated on bringing up intelligent children simply to compete with others?

One thing I’ll say in her defence was that despite her laughable level of inebriation she didn’t at any point attempt to embarrass me by quizzing me on the reasons for my present lack of employment, presumably having been warned in advance by A’s step-mother not to do so.  It’s not that I’m ashamed of being mental, but it’s hard to convince people of the sincerity of the conditions sometimes, especially (I’d imagine) when they’re as plastered as she was.

Eventually A and I escaped to his mother and step-father’s house, which is always fairly relaxed.  Upon getting in, knowing I wouldn’t have to drive again, I opened a bottle of red and downed it in literally about five minutes.

And now it is over.  It is over.  There surely is a God!  We are keeping out of everyone’s way on New Year’s Eve, having booked into a hotel for the night.  We’re not attending any function – we’re just going to sit in either a quiet corner of the bar, or in our room with a bottle of wine.  Alone.  All a-fucking-amazingly-lone.  Then, on Sunday 3 January, we’re going to another hotel, this time for two nights, thus using a Christmas present from A’s mother.  Both hotels are fairly plush, with pools, nice restaurants and bars, beautiful settings and privacy.  AI hope these will prove just what is needed as a tonic to the horrors of the past week.

I had strongly considered killing myself on Boxing Morning, but I need to remain alive for the duration of these sojourns, as I hope they will serve to relax me and hopefully mentally prepare me in some small way for the year ahead.

The Fantasy World

Tonight, as I was editing the ‘About‘ page briefly, I was reminded that I had mentioned my pathetic little fantasy world there, but that I’d never discussed it in detail elsewhere on the blog.

Well – I’m not about to.  I don’t think I’ll reveal the specifics of it to anyone, ever.  But I will say a few words.

I suppose the best way to put the fantasy world is that it is just like a grandiose delusion (or such is my supposition) – except that I don’t believe it is real.  There’s a fine line here between creativity and madness; if I had written down all this stuff and sent it to a publisher, it probably would have made quite a successful (if far-fetched) novel (or set of novels).  Alas, any such attempt now would make people aware of the specifics of the fantasy world, and I couldn’t cope with the shame of that.  Plus I wouldn’t have the motivation to write a fucking novel anyway.

The only people that I’ve spoken to about the fantasy world are A and C.  C didn’t seem especially concerned about its presence, though I was interested to note recently that, after the development of ‘They’, he asked if ‘They’ were connected to the fantasy world in any way.  It had always been my concern that my use of the fantasy world as escapism would actually develop into an actual escapism – a complete break from reality.  And cevidently that was on C’s mind at this later juncture too.  So far it hasn’t happened, but it is still a worry.  Having said that, frankly sometimes I wish I would just lose all contact with reality and stop teetering on the brink of it…but that’s a whole another post.

Anyway, both A and C, and in fact all of the most significant personnel in my actual life, figure to some degree or another in this fantasy life.  However, they are supplemented by an entire cast of fictional people, some reflective to some extent of real people, others purely borne entirely out of my imagination.  The fictional people are crafted down to their wrinkles, down to whether or not they like brussel sprouts.

The universe itself is similarly crafted.  My living and working environments are also detailed to the nth degree, and on a major scale.  The streets I walk, the strangers I meet, the pubs and cinemas I go to, the books on my shelves.  Everything is covered.  It really is like an entire other life, and I can slip into it at will.

I am completely unsure as to what this means psychologically, but let’s not overcomplicate matters, and take it broadly at face value.  In the fantasy, I have a wonderful job and am very much the confident(-seeming) person that I was as a child.  I am surrounded by people who, despite my idiosyncrasies, like and respect me.  I have a stable and loving private life.  I have money, though not riches and my own home, though not a mansion.  Basically, I have the perfect young professional’s life.

From that, it would be easy to say, “well, it’s merely reflective of a longing, perhaps of regret over missed opportunities.”  And maybe it is.  Except, it’s not that simple.  In the fantasy world, I am still mental.  Does this go back to all the wank I wrote a few months ago about not flicking the metaphorical switch to sanity if given the chance?  Maybe.

Maybe also it’s reflective of my feelings on the stigma of mental illness.  I want to have achieved all of these things despite being mental, thus proving that mental illness is not a barrier to success.  But I have to ask myself, if this is indeed the case, is it because of altruism, or is it another narcissistic desire for me to achieve something?  Probably the latter to be honest.  What a self-centred bitch.

When I told C about it – probably back in April or early May – I broke down and cried for ages because of the shame and self-disgust I felt about not being content with my real life.  It was the first time I’d wept like that, and as regular readers will know, it is not something that I have done with frequency since.  I derided myself to C as “completely fucked up.”

And I am.  I really am.

The Malice of the Voices of ‘They’

Owing to the pain of this –

– I’ve been somewhat in absentia from the blogosphere recently.  Was this gash – which is actually worse than the above suggests, being as it was nearly a removed-tip-of-finger – deliberate?  Was it fuck!  I even commented on the annoying irony of this on Twitter.  On Saturday the lid to a toothpaste tube had become lodged in the sink plughole, and the only way to get it out, aside from amateur plumbing, was to edge it out at the side with a knife.  A certain angle, a lot of force, and it wasn’t just the offending lid that ended up deeply cut to pieces.

I was urged to go to A&E to get this stitched, and I should have; it’s deep, and it’s very, very open.  But I didn’t.  Inertia?  Yes.  Social phobia?  Yes.  But the fact that an XBox 360 Elite has arrived in the house didn’t help either, not that I could use this finger to use the controls.  Neither could I drive initially, nor type, so forgive my lack of posting.

I admit to some malaise re: blogging though – I can’t blame everything on my half-axed physical extremity, given as the blog has gone unwritten for just under a fortnight.  A post that I’d originally started on Wednesday afternoon was to be called ‘The Rollercoaster’, such was my mental state between the last post and then.  Most of it is faff and I could never be arsed finishing it, so I thought I’d condense (ha!) the salient points of it into this new post.

Of course, I am aware that I haven’t written about my last session with C; I shall try and rectify this tomorrow.  In short summary, we are, for now, friends again.  We discussed the previous week’s annoyances, and although I didn’t give him the letter as intended, I did tell him about it.  He actually wanted me to read it to him, but I’ll detail that later.  I was honest with him for a change, but because I’d been too lazy to wash my face from the previous day, when I had worn mascara, I refused as ever to cry in front of him.  I think I might have done, though, had I not been horrified by the thought of having black streaks down my face, so I suppose that’s progress.  A silly reason?  Well, if I was a therapist, I’d laugh at an individual in such a position, so I can’t expect C not to.  On the other hand, I’m probably just a sick fuck.

Anyway.

The main thing of interest since my last post is the development of ‘They’.

‘They’

Poor A has been doing a lot of home-based overtime recently, and the morning of Saturday 31st October saw no exception to this.  That morning, he was in the study working, whilst I was lying in bed trying to fight off the usual Saturday migraine (this used to happen when I was at work each week, but when I became a dolescum, it mostly disappeared.  In the six to eight weeks prior to this date, however, the weekly migraine has returned.  Reassuringly, A asked me to ask Lovely GP if this combined with recent hallucinatory behaviour could be symptomatic of a brain tumour.  Yippee).

For contextual reference, overnight on 26/27th October, I had been plagued by horribly frightening auditory hallucinations all night (see this tweet), indicating to me that the hallucinations had moved beyond ‘just’ Tom and the shapes.  The music was the most terrifying, for reasons I cannot really articulate.  It was only about four or five notes on what sounded like a xylophone, but it carried the same unspoken message of hostility that the shapes do.  Not that the knocking and the whimpering didn’t.

So, anyway, here I was trying to soothe this migraine by lying in the darkened bedroom, when someone who wasn’t A nor Tom told me to get up and brush my teeth.  For some reason, I acquiesced and did as I was told.

Upon completion of this, the ‘someone’ became a ‘they’ – instantaneously, yet simultaneously gradually.  I know that makes no sense.  The best way to put it, I suppose, is that it was like an operatic or orchestral crescendo.  The nebulous ‘they’ then instructed me to go to the top of the stairs.  Tom turned up and told them to leave me alone, but they laughed at them.  I (internally) enquired as to what I should do.  Tom said to go back to bed.  ‘They’ repeated their aforementioned direction.

‘They’ and Tom kept bickering about what I should do but, much as I don’t mind Tom, the collective voice of ‘They’ was so much stronger, and carried a weight I can’t explain.  It was a compulsion.  I went to the stairs.

I have fallen, and thrown myself, down the stairs at my mother’s house many a time, but the stairs there are relatively ‘safe’; they aren’t especially steep, are thickly carpeted and, until recently, had a…shall we say…deceleration zone.  This is not the case at A’s; the carpet is thin, the stairs are incredibly steep and there is maybe a foot of hallway at the bottom before you go crashing into the front door.  That’s if you don’t hit the radiator on the right.  In short, falling down A’s stairs could seriously injure me.  I doubt it would actually kill me, but it could definitely injure me.

Here I was at the top of these steep stairs.  It was almost as if they had morphed into a sheer cliff face – I mean, I didn’t see such a thing, but…I don’t know, it’s hard to describe; it just felt like that.  At this point ‘They’ started telling me that I was to throw myself down the stairs.  Tom tried to intervene, as did the voice of Me.  But ‘They’ were too strong.

When I didn’t immediately throw myself down, they became enraged and started chanting/screaming: “YOU MUST DIE!  YOU MUST DIE!  YOU MUST DIE!” followed shortly by, “THROW YOURSELF, THROW YOURSELF HARD!”.  Simultaneously, parts of ‘They’ were laughing in the manner that the dark monster’s under a child’s bed are supposed to.  Sinister.

I remember little of what was going on outside this mental cacophony, but I do recall that it was a physical effort to not throw myself down the stairs.  I have a very vivid memory of watching my bare toes teetering precariously on the edge of the step, trying – amidst this madness – to will them not to go over.

It’s funny really.  Given the almost perpetual suicidal ideation in which I engage, why not just go with the flow of ‘They’?  But I wanted to fight them.

Still ‘They’ went on, “die die die, throw yourself, throw yourself hard,” in their ritualistic chant.  Still Tom and Me tried, with considerable futility, to dissuade them that this was a desirable course of action.  But ‘They’ either just spat bile at or ignored us.  They called me (both me-me and the Voice of Me) a range of names such as “slut,” “cunt,” “bitch,” etc, but they just audibly sneered, if that’s possible, at Tom.

Somehow I sat down.  By this point, I presume in order to distract me, the amorphous ‘They’, were knocking at the side of my head, exacerbating the headache (as if their bloody noise hadn’t done enough of that).  I put my hands over my ears and started rocking back and forth, but of course that didn’t stop them.  That was a pointless gesture – they’re in my head so, how can covering my fucking ears shut them up?  But it was instinctive, I suppose.

Despite Tom’s best efforts to diffuse the situation, it wasn’t getting any better.  ‘Me’ wondered if taking my gaze away from the stairs would do anything to help things, so I lay my head down on the next step and hid under my arms.  They didn’t stop, but part of me ceased to be entirely sure of where I was, so the sheer compulsion to obey ‘They’ abated – but only slightly.

It was shortly after this that A emerged from the study and asked if I was OK.  He had been talking to himself whilst in the study and his voice had kind of morphed with that of ‘They’, so I didn’t even know if he was real.  Nevertheless, aside from Me and Tom, he was the only voice there with which I was familiar, so I told him what was happening.

A helped me down each individual step.  ‘They’ mocked him, sneered at him and wanted me to hurt him, but somehow, I managed to resist them.  When A finally managed to get me into the relative safety of the living room, he called ‘They’ “pathetic non-existent cunts” and told ‘They’ that he was going to “destroy” them.  Tom laughed agreeably and told ‘They’ to fuck themselves; ‘They’ were both insulted and incredulous.  ‘They’ called A a number of names that I no longer remember, continued to tell me to die, and although they didn’t ‘verbally’ say it, there was an intense sense in my head that ‘They’ found the notion that A could defeat ‘beings’ of such epic power an irritation and a source of amusement.

To cut what is already a very long story a wee bit shorter, eventually ‘They’ and Tom left.  A was disturbed; I was exhausted.  We were both worried about how this would turn out.

In fact, the possibility of voluntary admission was discussed.  My fear was not so much for myself – I don’t really matter to me, after all.  But ‘They’ hate A.  It turned out later that ‘They’ hate C too..  They’re more tolerant of Mum, but they still don’t like her.  ‘They’ haven’t met my friends yet, but I’m sure they’ll hate them too.  So, whilst if I want to do myself in I want it to be my decision and not theirs, and that side of things presents as an issue, my greater concern is that the complete control of ‘They’ over me would lead to harm of someone about whom I care.

I had an appointment with VCB today (more on that in a moment), and A and I both hoped that I could hold out to then before the drastic step of admission, but I did discuss that possibility with several individuals and, with a few qualifications, it was agreed amongst all that if ‘They’ returned with such hostility, that it was probably a good idea.

‘They’ did return a few days later.  ‘They’ were not demanding my death this time, nor the injury of anyone else, but they were chattering insults and laughing scornfully at a low level at the back of my head.  “Whore,” “cunt,” “slut,” “bitch” etc.  They were whispering spitefully and when A started into them again, the insults were then divided between him and me both.  But although distressing and unpleasant, there was no danger from this episode, so luckily I didn’t embark on a course to the bin.

‘They’ were there on Thursday morning when I went to see C.  This was the first time when I verbally spoke to them.  ‘They’ told me they thought he was a cunt, and I said to him, “they don’t like you.”

‘They’ got really mad at this; apparently, I was meant to tell C that he had been called a ‘cunt’ specifically.

“Tell him, tell him, tell him,” they ordered.

“Alright, for fuck’s sake, I know!” I yelled at them.  I’m not sure how C kept a straight face.

But they’ve not been there in a dangerous capacity since 31st October, thankfully, so I haven’t incarcerated myself.  As stated, I had an appointment with VCB today, which I had been anxiously waiting for thanks to ‘They’, but of which I was also simultaneously terrified, given as I am scared of VCB.

I was actually slightly surprised that she herself had the decency to see me today and not palm me off onto some minion.  Perhaps C told her about my threats of advocacy, media and contacting her boss from last time.  Anyhow, as usual I had developed my written list of symptoms from which she – unlike her stupid SHO – allowed me to work, recognising that it’s not always easy to remember everything.  She did quiz me on specifics – “what did ‘They’ say specifically?  Pretend you’re them talking,” or “what does Tom talk to you about?” – but mostly, she allowed me to speak freely about the last few weeks.

Essentially, the result of the meeting was that she wants me to decrease the Venlafaxine back to 75mg – not because of the hallucinations per se, as she actually does not seem to believe they are a side effect of it, but because being on 150mg hasn’t made any difference to the feelings of depression.  I’m not sure I like this.  I basically think Venlafaxine is crap (not to mention evil and insidious), but I’m scared of being on a low dose thereof again, and in particular I am petrified of a pseudo-discontinuation syndrome caused by a dosage reduction, despite VCB’s claims that there should not be any noticeable difference.  I am seeing LGP in the morning so will discuss this with him.

Secondly, and more helpfully, VCB says that the more recent hallucinations and delusions do represent outright psychoses.  Well, not that that in itself is nice – obviously it’s not, but it had a hopefully positive outcome.  She had been expecting to prescribe me a mood stabiliser today, but in light of the information I gave him, obviously decided that “a trial” of an anti-psychotic would be more appropriate.  I know how hideous side effects of such medications are, but frankly I’m glad because things as described above can’t go on.

She has decided upon 2.5mg of Olanzapine; she chose this drug because she thinks it’s better in terms of its secondary indication of mood stabilising than many of the other atypical anti-psychotics, despite most of the manufacturers’ claims that they all mood stabilise fabulously.  2.5mg is the lowest dose of this drug, but that’s fair enough I suppose.  VCB says it can be increased as necessary, but it is of course best to start on as low a dose as possible.  Unusually, she wants to see me in a month rather than six weeks.  Although she (obviously) didn’t bin me, this did suggest some concern on her part in my view.

I asked VCB if the revelations had any impact on my diagnoses, as I was aware that psychoses weren’t generally a feature of bipolar II, and whilst they are seen in BPD, it is usually (as far as I understand it) during episodes of considerable stress, which I hadn’t been experiencing especially during the development of ‘They’.  She said that she still felt the diagnosis was correct, as the episodes of psychosis have been transient, as is seen in borderline, rather than prolonged and sustained.  However, she did imply that she would be willing to reevaluate things in future, should the need arise.

She warned that the main side effect of Olanzapine is weight gain, which is not apparently caused just because the drug itself makes you fat, but because it increases your appetite.  She said that I have to try and develop methods of ignoring any new or unexpected bouts of hunger, which I suppose I can discuss with C.  She also recommended exercise (obviously I suppose), so when I get my windfall from work, I may rejoin the gym.  As a dolescum, I do get to use the local leisure centre for cheap, but it’s usually full of pricks all day long, whereas I know for a fact that the gym and its pool are both almost empty during the day.  In any case, I’ve lost a lot of weight recently, so whilst I don’t exactly want to regain any of it, I suppose I can deal with a little bit more whilst I try to address countering any new-found appetite.

A final side effect is strong sedation, but perhaps it won’t surprise you to learn that this would be a positive thing for me.  Unfortunately, apparently that tends to wear off as one gets used to the drugs, but hopefully I’ll have the lovely Zopiclone in waiting then.

I haven’t got the pills yet; I have to take VCB’s script to the GP’s for them to load it onto the system and then prescribe and sent to the pharmacy.  Had I done so today, I would not have got them until tomorrow anyway, and since I’m seeing LGP in the morning anyway, I can just get him to prescribe them directly.

So all in all the VCB was quite useful today – I just wish she’d make that state of affairs consistent.  Perhaps the best thing about this – and I know this is really sad and childish – is that she’s defied the NICE guidelines on BPD.  I suppose she had little choice given the circumstances, but she always wanted to adhere to them insofar as was possible.  But I think NICE are useless knobs, a waste of public money who sit about saying a lot about very little, so this pleases me.

Other Events

New Friend

On Wednesday 4th, I had the pleasure of meeting K (can we call her K?  There’s no other Ks on this blog, are there?), another BPD ‘diagnosee’ that I met via Twitter.  K is also from Northern Ireland, though now lives in England (she was here on a quick visit).

We spent a couple of great hours chatting over tea – the conversation was lively and wide-ranging, but in terms of mentalism specifically, it was a relief to discuss things with someone who has direct experience of many of the same problems I have.  I’ve relied on the internet for this to date, still do and probably always will – K and I agreed the temptation to catch the bus without the support of online friends would be considerably higher than it already is – but nevertheless it’s great to actually speak to someone in person that understands.

I would normally be very nervous about meeting someone new, as you can probably imagine from earlier ramblings.  However, I actually wasn’t with K, and even had I been, her easy-going charm would have relaxed me very quickly.  So thank you, K 🙂

GA

Fucking cunt of evil bastardry aunt GA was in situ for the second time within a few months last week.  Why come across the Atlantic twice in such a short timeframe?  Last week was for my cousin’s wedding, that was only organised recently.  Needless to say, I didn’t go.  I can’t presently think of circumstances that would in any way make me tolerate seeing that woman and her shit descendants.

What pisses me off when GA is here (and even when she isn’t) is that my mother wanks on about what a poisonous twat GA is – GA knows everything, GA always thinks it’s worse for her than for others, GA must interrupt people and be the focus of the conversation, etc – yet as soon as I open my mouth to make any vaguely critical remark about the old battleaxe, Mum rages at me for being so cruel about her.

Fuck that, and fuck GA.

Meh

There was another ‘other event’ that I wanted to add but alas its exact nature has evaded me.  Another time – in any case, I think I have drivelled on for long enough as usual.

Did I say something near the start of this post about ‘condensing’ my words?!

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.

Reflecting on Being a Psychotic Bitch

I am sure that one does not require the IQ of Einstein or his counterparts to work out, from the last post, that bleakness, futility and utter self-disgust presently permeate my existence. There were precipitating factors, but I am not prepared to discuss them in any detail here.  I do keep this blog primarily for my own reference, but I do not need to document this incident as I will never forget the evil of which I am capable. Never.  Even as I bounce my (very metaphorical) grandchildren about on my knee (if my ‘life’ ever gets that far), my psychotic break on Friday night will never be far from the forefront of my mind.

Rationally, I can tell myself that it wasn’t me behaving in the fashion that I did.  Rationally, I can sit here and say, “well, you’re mentally ill”.  Rationally, I can (and do) accept that I was not in control.

It doesn’t matter.  It isn’t an excuse.  I wouldn’t care if it were just about me, for fuck’s sake I’d gladly do myself in if it were just about me.  But I am ruining other lives as I continue on the destructive path on which my mind seems intent on following.

I rail against the idea of being committed, and to that end have been known to be careful in what I have said to C, LGP and VCB, so as to avoid them instigating a process that would end in that result for me.  Being sectioned, or even voluntary hospitalisation, would be about the most horrendous thing I can imagine – group therapy, disillusioned and overworked (and probably incompetent) staff, being in a ward with other fucking people.  I cannot bear the idea.  It makes me feel physically ill when I even contemplate it.

But I have enough insight, shockingly, to know that this isn’t just about me.  For the sake of my friends and family, it really may be the best option if throwing me in the asylum is exactly what the three of them (or whomsoever) choose to do.

I don’t think I’m being irrational in writing this.  Granted, you (the reader) don’t know the context under which this miserable spiel of crap has been created (with one or two exceptions), but I believe my self-condemnation is wholly appropriate.

I don’t want to have this out with C tomorrow, but I’m going to have to find some way to overcome my cowardice and discuss it all with him, because I have gone too far this time and I can’t guarantee that I’ll have the level of self-control required not to go too far again. Some proponent of the newer types of therapy such as behavioural techniques might wank on about my own responsibility, and yeah, I might be abdicating from my sense of it – I don’t know.  I just know I didn’t at any point choose the behaviour that has disturbed me so profoundly.  It was almost like what I imagine stage hypnosis is; you have some level of awareness, but you are not controlling your mind or body.

This week has been fucking awful.  I would use the phrase ‘downward spiral’, but that would be bollocks, as I’m thoroughly at the bottom of the spiral.

The little social contact I’ve had – on Twitter, in the main – might represent my status this week as relatively mentally intact, but nothing could be further from the truth.  I am still a consummate actress. Thinking about it, I’m narcissistic enough (though not thin enough, admittedly) to have a very successful Hollywood career.  Though that would send me even more insane, if that’s possible.

I’m sorry for turning the comments off in the last post. I figured some well-meaning people might say, “no, you’re not fetid/disgusting/depraved/whatever,” and whilst, indubitably, I appreciate the sentiment behind such words, they are in my present-thinking false words.  I need to reflect on what I have done, even though it causes horrible pain.

I really, really am a vile human being. Well, perhaps I’m not – that’s up for debate – but this mental persona, and whatever nefarious afflictions control it, most assuredly are.

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.

Hearing The Voice (and Other Psychoses)

I’ve mentioned the voice quite a bit lately, but I haven’t really gone into any detail about it. Largely, that’s because there’s not really a great deal about him to discuss. Still, I thought I’d make my best effort, as quite clearly hearing voices represents psychosis (or at least something odd), which clearly does not resemble anything approaching sane.

Let me start by introducing the voice. He is called Tom. He didn’t tell that he is called Tom – he just is. As discussed in the last couple of comments here, I don’t know why. I just thought of him as ‘Tom’ from the beginning, without consciously doing so. I thought about other names thereafter but dismissed them; ‘Tom’ still seemed the most appropriate. It just fitted.

You see, he sounds like he’s in his 30s – roughly speaking, anyway. One of the alternative names that I considered was ‘Ernie’, but that makes him sound like a sweet old man, and he’s not.

So he’s not old, but is he ‘sweet’? I’m not sure that that’s an appropriate description – not entirely. Nevertheless, many normals seem to believe that voices heard by mental freaks are all persecutory, or compelling the voice-hearer to commit heinous acts, or trying to convince the hearer that things of considerable distaste are imminently going to happen to them. Clearly, this happens quite a bit in this particular type of hallucination.

But not in all cases. Tom, so far, is none of those things. He’s friendly, comforting and reassuring and no doubt if I raise this with C – and I don’t think that I will – he’ll say my compassionate, vulnerable self is looking for an outlet, and it has provided it in Tom.

Hmmph. I’m more inclined to believe that Tom is a side effect of Venlafaxine, but it doesn’t really matter. Well, OK, it does, as hearing Tom speaking to me has implications for my diagnosis/es and, potentially, medication (and, again, C would no doubt say psychotherapy). But it doesn’t matter in the sense that I don’t mind Tom being there, and in that sense the reasons for his ‘existence’ don’t matter much to me.

Obviously, the voice is male, and as stated sounds circa early to mid 30s in age. I have more difficulty describing his accent. I keep wanting to say ‘normal’ or ‘non-accented’, but of course everyone has an accent so that fails at the first hurdle. I suppose he must be Northern Irish, but he doesn’t have some of the strong accents often heard here. Neither does he sound like a toff. An average, middle-class bloke, I’d say.

As to the content of his speech, it is totally innocuous stuff. The first time he spoke, he just said my name. That was a bizarre, surreal experience. I was alone in the house and the neighbours were out, so I knew there was no one there. Still, I walked in and out of each room to check, just to be sure. One thing it wasn’t, though, was frightening. Just one of those “what the fuck?” moments.

Since then, Tom will talk about stuff like the weather, what I’m watching on TV, what I have planned for the next few days. Utterly mundane and unfathomably dull smalltalk. However, he sometimes (not always) gets involved when I’m going mental. For instance, when I was losing my mind over the stalker the other week, he started talking to me. He was trying to be helpful, but unfortunately he wasn’t particularly. There is an inherent irony and curiously black humour in the fact that a voice that isn’t fucking there is trying to tell me that a visual hallucination is also not a part of what is understood to be reality.

The SHO I saw a few weeks ago – in the majorly fucked-up psychiatric appointment – asked me something that surprised me, though it really shouldn’t have done. She said, “is the voice inside your head?”

The obvious answer, from an outsider’s perspective, is “of course it fucking is”. But, in actuality, that would be false. Tom doesn’t sound like he’s ‘inside’ my mind – Christ knows there’s enough battling sides of myself chattering away in there, arguing interminably with one another. No, Tom sounds like he’s sitting or standing maybe two or three feet from me. Usually he’s on my right-hand side (my right-hand man?!), but sometimes he’s behind me. It’s odd; obviously I know he’s a product of my mind, but it really doesn’t feel (sound) like he’s in it.

I often reply to Tom, but not necessarily audibly. I might direct a thought at him – which apparently he can hear – or whisper ever so softly. Because I know he’s not real, I feel terribly silly about speaking out loud to him, even if alone. Even if there’s no one else there, I can’t bear the idea that someone might witness me talking to the shitting air (in fact, this has just reminded me of a long-held delusion – so long-held I’ve had it since I was a child; that someone – Mum, the paramilitaries, the government – had rigged secret cameras everywhereI was, and that they were always watching me. How come it’s only now, as I become more deranged by the day, that I’ve realised that that’s just a teensy-weensy bit abnormal?!).

So, overall Tom is not a bad thing. Having said that, I have heard of cases wherein the voice starts off to be completely benevolent, gaining your trust – only for it later to use that trust to manipulate you. I don’t necessarily think that’s as common as the media would have you believe – but it can happen. I hope I can retain enough rationality to recognise it if Tom ‘turns’; I do think I mostly have that quality, at present at least.

Which brings me to another point; since I recognise that Tom isn’t real, is he even a hallucination at all? Psychoses, as I understand them anyhow, require a clouding of the lines between reality and non-reality in the perception of the psychotic individual. In my case, that is definitely true of my delusional and paranoid beliefs – well, when I’m actually experiencing them anyhow. Yet I always know Tom isn’t there, not really. As for the main other hallucination that I experience – the shapes – well, I’m not actually sure about them. I think I know they’re not real, but perhaps because unlike Tom they are hostile, I feel greater distress over them. Bizarre stuff.

I briefly alluded above to the implications all this has in diagnostic terms. Psychoses are, as far as I understand it, not part of either BPD nor bipolar II. They can be part of bipolar I, whilst in mixed or manic states, but I haven’t been given that ‘upgrade’.

In fact, VCB made no reference to my diagnoses on Tuesday (not in relation to this material, anyhow). It’s possible that she considers Tom, and some of the more extreme delusions, to simply be a Venlafaxine side-effect (it’s uncommon to experience psychoses owing to it, but it’s certainly not unknown either). That is a viable explanation, especially given the timeframe of these symptoms’ arrival – but it can only explain some of the psychoses that I experience. Clearly, a lot of the paranoia was there well before I took this medication, as were the shapes. Both were, in fact, there years before I took any medication on a regular basis.

I’ve just remembered yet another childhood delusion (though not one I experience any longer): every night, when I went to bed, I was utterly convinced that an IRA gunman was on the landing, and that I was imminently going to be shot. Every creek or noise was evidence of him (or her, I suppose) being there. I used to creep out of bed and tiptoe, terrified, to the door of my room. I’d stand there, paralysed with fear, for a minute or two, then take a deep breath, fling open the door and look round the corner. Of course, the landing was always empty. Of course, that did not reassure me the next night.

This one is more understandable in some ways, as I was a child when The Troubles were still (to some extent) ongoing. The fact that I ‘grew out of it’ would support the idea that it was entirely circumstantial and not remotely organic nor chemical. Having said that, no one to whom I’ve relayed this story – including people that grew up or lived through the very worst of The Troubles – experienced anything similar.

I’ve recalled that one at various points over the years, but I seem to compartmentalise a lot about my childhood, so I hadn’t thought about it in some time. Ha – this post is turning into quite an education for me.

So anyway, my point had been that the psychoses kind of (or at least potentially) screw with my diagnoses. I’m not saying that I don’t have what VCB diagnosed me with in June, merely that there is maybe additional stuff which runs co-morbidly with it. Possibilities would be bipolar I (which as stated previous can produce psychoses – if this was correct, obviously I wouldn’t have bipolar II), schizoaffective disorder, bipolar subtype (this is my current self-diagnosis, even though I hate the idea) or even psychotic depression (if you can get that with mixed/manic states?). Yay! Of course, an alternative point of view is that I don’t have anything other than that with which I have already been diagnosed. As VCB told me in June, it’s not always just as simple as fitting people into one diagnostic box; some people present with symptoms that don’t fit with any specific disorder. She claimed it was not uncommon.

In conclusion – is Tom a good thing? I think that remains to be seen, to be honest; I don’t encounter him frequently enough at the minute, nor has he been ‘there’ for long enough as of this moment, for me to have formulated a definitive view on that. Having said that though, as of now he is certainly not a bad thing. I like him. He’s nice to me. It’s a start. InterVoice International argue that many people that hear voices should actually embrace them (assuming they’re not harmful, obviously) and not view them as psychotic or part of some disorder. I don’t agree entirely, of course – it sounds like PC Mad-Pride-esque nonsense to me. On the other hand, I can see the rationale for such beliefs; if your voice is benign, why not accept it – befriend it, even? (Incidentally, InterVoice’s website is well worth a look if you or someone you know hears voices – it has oodles of resources, information and real-life experiences there for your delectation).

I most assuredly do not like the delusions nor the shapes, though. Therefore, if it gets to the stage where VCB thinks I should take an anti-psychotic, I will gladly do so. I recognise they’re not necessarily miracle cures for psychotic symptoms, and in fact I’ve read that they don’t always eliminate the psychoses entirely anyway – they just lessen your reaction to them. But I would expect and hope some positive outcome in dealing with the delusional beliefs.

If they have the effect they’re meant to have (if I ever even get any, of course), then they’ll probably kill Tom. I’m not entirely thrilled with that idea, I have to be honest, and I will feel guilty for doing it. But in order to live a functional life, some bad things are necessary evils, and while I really don’t want Tom to go, ultimately, with regret, he may have to.

What’s Annoying Me Today, and Ruminations on Seeing the Psychiatrist

Well, fuck me, but didn’t the VCB actually manage to bother her arse seeing me today.  Will wonders ever cease?!

I took my Mum with me to the horrible, dilapidated, thoroughly depressing place as I wanted VCB to see that I was nervous about seeing her.  And was I nervous, oh yes.

I had had about half an hour’s miserable sleep on the sofa so was completely mentally fucked in any case.  This made the drive to my mother’s somewhat interesting, but anyway, she drove onward from there.

I began to regret requesting my mother’s company within minutes of sitting in the waiting room.  In my attempt to not appear mental and hyperventilating, I was a bit mental and hyperventilating.  I was rocking back and forth in the chair and covering my face with my hands.  The other nutters that were there had the courtesy to pretend they didn’t notice – initially, anyway.  When my bloody mother started going on that I didn’t “look OK” (10 out of 10 for observation, Mum), then they all turned round, as if her opening her mouth gave them a Licence to Gawk.  One of them looked like a bit of a freak.  The other one looked surprisingly normal.  I didn’t.  My hair was a mess, I was wearing the same trousers that I’ve worn on and off since about Wednesday and I was deathly pale, with big black circles under my eyes.  Not to mention the odd psychomotor movements.  Yeah.  A loon.

VCB kept me waiting, as well I suspected she might do.  Every time I heard the door open, I took a deep breath and got ready to face her, yet it wasn’t her.  Needless to say, this didn’t help my levels of anxiety.

Some rough-sounding bitch came in with what was, I presume, her father.  She had evidently already been seen by someone and was waiting for them to come back, but she was bloody raging.  She called the staff “dickheads” and said that her situation was “not fucking funny at all” and that her social worker was a bitch and that she was not taking any more of her crap.

Generally, I hope I don’t behave like this in public places, though I know I do here.  Nevertheless, I couldn’t help but feel the woman’s pain; these people are arseholes, and consistently seem to let patients down.  I also envied the girl’s ballsiness, if only temporarily.  I just knew I’d end up submitting to the VCB and I so desperately didn’t want to.  I wanted to stand my ground, demand answers and get help.

Another thing – the rough bint, as stated, referred to her social worker.  You may have read my rants on Twitter on Friday (here, here and here) that there are actually two Community Mental Health Teams (CMHTs) at the hospital in which the VCB and C are both based.  C and VCB will, in some way, be part of those teams, but as I understand it, CMHTs also include social workers, occupational therapists, CPNs, the stupid crisis teams and ‘duty’ teams who are there when your psychologist or psychiatrist isn’t.  The social workers, CPNs etc are, as far as I understand it, there for use alongside the professionals you normally see.

I’m not going to sit here and tell you that my mental health problems are the most serious in the whole vicinity.  They aren’t.  Mind you, I’m fairly sure that I’m not a million steps from sectionable behaviour, so they aren’t entirely innocuous either, are they?  So I’m wondering why it’s left to C to do all non-medical work with me.  As discussed in the comments of this post, it seems kind of odd that C is practicing psychodynamic therapy along with stupid DBT.  He is always banging on that whilst we need to tackle the underlying issues of madness, I also need practical measures to help me when I actually go mental.  I agree with him.  I just find it confusing to go from one to the other potentially several times during one 50-minute session.  bourach said to me that I should request a CPN to do all of the practical crap with me, leaving the actual ‘deep’ therapy to the psychologist.

In all honesty, I reckon a CPN or an OT or whatever would probably be shite; nevertheless, I think DBT itself is shite, so if it’s going to be insisted upon in my treatment, surely it is best served by someone specifically dealing with practical issues.

So, in short, I was very annoyed that LCP, C and VCB had failed to advise me of these CMHTs.  I did fantasise about ranting to VCB about it, but I reckoned that she’d only say it was nothing to do with her, which to be fair it isn’t especially as she is dealing with the medical side of things and fucking DBT and suchlike isn’t that by any means.  I do think I’ll have it out with C, though.  Was it his place to tell me?  I don’t know, but I do know that at least I can ask questions like this of him, whereas I’m way too scared of VCB to confront her, even if it were her domain.

OK, so that was a digression.  Sorry.  Eventually, VCB stuck her head around the door and summoned me.

Basically, the appointment was alright, but very little has changed.  Despite telling her about Tom, the voice, the delusions and paranoia, the increased mania and the stupid things I do whilst therein, and a full account of what happened on Friday, she is still not prepared to give me mood stabilisers and/or anti-psychotics (though thank Merciful Christ, she is not willing to section me either.  I think she realises that’s just about the worst thing that could happen right now).

In fairness, she has a fair rationale for not prescribing such drugs just right now.  Somewhere in this post, I outlined some of the mad things that have been happening to me since I started taking Venlafaxine – but I also drew attention to the fact that I thought it had made a very subtle improvement to my ‘base’ mood.

Encouraged by this, and at my own suggestion in fact, VCB wanted to double the dose to 150mg daily.  I begged her not to take it off me, as whilst it has a string of hideous side effects, at least it looks moderately encouraging as regards the depression side of things.

So, there are two things to consider in light of this.  The first was that she said that if I thought Venlafaxine had side-effects, then I should wait until I experienced mood stabilisers.  In fairness, she appreciated that I was probably quite aware of this, as she seems quite aware of how well informed I am about many psychiatric issues, including medication (C must have discussed this with her).  Secondly, and more pertinently from my point of view, she said that she would “never” make two medication changes at once (and by increasing the dosage of the anti-depressant, she is already making one).  She would – quite obviously, when you think about it – be unable to see what particular tablet was causing side effects or any changes in my mood if she made more than one change at the same time.

That’s fair enough, but the difficulty of this for me is that – given my original reactions to Venlafaxine – doubling the dose will probably send me utterly batshit again.  Even if it doesn’t cause me to react in such an extreme fashion, increasing the dose of this notorious drug is desperately unlikely to, in itself, stabilise my up-down moods and episodes of psychoses, is it?!  If she sees me again in six weeks, that’s probably bearable…but will she?

I actually specifically asked her this, and she said she would.  It fucking better be the case.

I also asked her, for the avoidance of doubt, if she would consider both anti-psychotics and mood stabilisers if things don’t change (which they won’t).  She said ‘yes’ to both.  I clarified that I actually quite like Tom, but that I recognised that hearing him was not normal (Obviously.  I mean…obviously!).  She agreed, but I think her greater concern (like mine) was regarding the other hallucinations, the delusions and paranoia.  Tom is benign (so far); they are not.  (Quotes to A – “why the fuck are you taking notes on me?  Are you in collusion with GCHQ?” //  “why is that sign trying to tell me something?”  //  “he [my stalker] is there, he’s fucking everywhere [he wasn’t there]”).

She did give me some fairly useful advice on dealing with the stalker. It’s nothing I didn’t really think of myself, but nevertheless it sometimes helps to have it verbalised by someone else.  I don’t think I have the balls to confront the bloke in the way she mentioned, unless I’m once more manic, and she did acknowledge that it’s easy for her to say.  Still, I have to do something about the fuckhead.  VCB said, “I’m not encouraging you to drink per se, but I do think it’s important that you retain the normal routine and do things you enjoy, such as going to your local.”  So I have to face up to him in some way.

Sensing disappointment regarding her unwillingness to prescribe additional medication, she said, “medication is not a cure, you know [no, I had no fucking idea given that I’ve been on it for 12 years.  If it was a cure I’d be cured by now, you old horse!].  The best route to recovery is via psychotherapy.  I know there’s nothing immediate happening in yours, but I spoke to C and he thinks there’s good work being done there.”

I laughed in her face.  I don’t know why; I’ve stated time and time again that I do think there’s hope with C, and my hopeless attachment to him is almost a textbook reaction to a functional therapeutic relationship.  I think I’m angry with C for fucking off for a fornight…again.  Additionally, I remember that when I told him about my planned discussion with VCB that he’d suggested an improved mood was down to him, not medication.  This is funny.  I don’t know why, but it is.

I told VCB about it.  “I’m terribly fond of him,” I admitted, “but really – any positive change like this is strongly attributable to the medication, I think.”

She didn’t seem sure about that, not entirely anyhow, but she didn’t argue either.  Her contention though was that, even though we are pretty agreed I have bipolar disorder as well as BPD, that that illness also requires psychotherapy.

Now she’s a psychiatrist and I’m not, but I always understood that any psychotherapy in bipolar was about trying to recognise triggers, managing mania and mixed states, etc.  I didn’t think there was any exploratory psychodynamnic-esque stuff within it (unless it is co-morbid, as in my case), mainly as it’s largely an organic illness, rather than one supposedly created in large part by traumatic events like BPD.

When I relayed this part of the conversation to A, he said it sounded like she hadn’t a clue what she is doing.  Hmm.  I don’t know.  I suppose research into causation of mental illness, including bipolar disorder, is still ongoing.

So, anyway, it wasn’t the most productive meeting ever, but assuming I actually do get to see her in six weeks as promised, it could have been worse.  If I don’t, well – the shit hits the fan for her crappy department.

Despite the relative non-shitness of it though, I am feeling remarkably low and unmotivated and sad today.  I didn’t get much sleep as already discussed, and even though I appreciate VCB’s reasons for not prescribing me some cocktail, I must confess to some level of disappointment in it.

I was also irrationally angry last night when A told me of a discussion he had with his friend, in which A told him I was diagnosed with clinical depression.  That’s so last decade lol!  A told him that because he (very much a layperson) wouldn’t understand the terms BPD or bipolar, but I’d have thought he’d have understood the old term ‘manic depression’ at least.  This annoyed me as any time any of that lot see me, I’m in pretty good form; thus if he believes I have ‘clinical’ depression, it looks like I’m faking this whole damn thing (plus I’ve developed a crackpot identity beyond just depression since I first realised last year that it was more than that).  This potential belief was exemplified the other day when the bloke in question asked me how work was.  I told him I’d been off and said I was dealing with some “mental health issues.”

He said, “in other words, you don’t like work.”

Jesus fucking Christ, such willful bloody ignorance.  If it were about hating work then I’d have gone and got myself another fucking job.

My annoyance was compounded by the fact that the bloke’s father has suffered from depression but hasn’t responded to treatment.  Yer man therefore opines that it could well be that his “dad is just a dick”.  This, as I saw it, is a refutation that there is anything wrong with me or anyone else that has difficulty responding to treatment.  It is also suggestive that he believes depressed people are ‘dicks’.  Maybe it isn’t, maybe that’s just paranoia, but one thing it definitely is is ignorant.  It’s not entirely his fault; it is, of course, a greater problem in society than just one man.  But this in itself makes me despair.

If this is what someone that knows and seems to like me thinks, what does the world at large believe?

So: (stress of VCB) + (complete exhaustion) + (societal denial that my illness is as real as anything physical) + (other things that I don’t want to write about that really upset me) + (worry about OH on Thursday) = NOT FUCKING HAPPY.

Still, VCB didn’t section me.  I really convinced myself during the night that she would, given some recent events, but she doesn’t think it’s at that point, so I suppose I ought to be grateful.

Things are Bad

Things are, indeed, bad.  I seem to have got myself a stalker.  Did I write here that a few weeks ago whilst manic I went up to some bloke in the pub and started talking to him?  Well, if I didn’t chronicle it, then there you go.

A was with me, and it was all totally innocent – the man in question is a grey-haired biker git, 20 years my senior.  Not that age matters a fuck to me, but really – there was nothing sexual or romantic about this liaison in any way.  He seemed fairly genuine too, and the three of us got on well, with shared interest in music and whatnot.

Unfortunately, I shortly realised my mistake and tried to get away; I’d nothing against having a pint with this man, but I didn’t want to spend all night with him.  But it wasn’t that simple, and to my horror I found myself agreeing to exchange phone numbers with him.

He harassed me on and off a few times but whilst it was bothersome, as I despise the fucking phone, it was little more than a nuisance.  However, just before we went on holiday, he rang me and was on the bloody phone for about an hour.  Towards the end of the conversation, he made a number of sexual comments that I don’t want to even think about.  I listened in horror, unable to hang up, though I eventually managed to ‘politely’ get away.

In consequence of this conversation, I have ignored the little contact he has recently directed at me.  He seemed to have got the message.

So, A and I went to the local after dinner last night.  We scouted it out for Blokey Bloke, and he wasn’t there, so we sat down and began to engage in conversation.  After about 20 minutes, though, to my horror, I saw Fuckhead cross the path of my peripheral vision.  I pretended not to notice him at first, but he’d clearly seen us and basically pushed me out of the way to sit down with us.

I wouldn’t say that A and I encouraged the conversation particularly, but what we didn’t do was tell the miserable son of a bitch to fuck the fuck off.  No, we both chickened out.  Pathetic, miserable wusses.  Me especially, as it was my fucking irresponsibility that had got me into the damn mess in the first place.

We pretended that we had only intended to come in for one drink and promptly left, and went to the other pub in the vicinity.  But by then I was so freaked out I kept seeing yer man.  He was there, in the bar – yet he wasn’t.  Then the bloody voice started wittering on.  Then I really lost it and was crying and panicking and begging A to protect me from everything and my skull was splitting and frankly, had A been a psychiatrist I think I’d have been sent to the bin right then and there.

Perhaps needless to say, A took me home.  I think I was able to feign having calmed down to some extent, but when he fell asleep I tried to sever the arteries in my ankles.  I momentarily tried my wrists too, but decided against that as the blood would be much more visible to me, what with one’s hands being much closer to one’s eyes.  I do like watching the blood from cutting, but I understand that severed wrists when done properly are actually pretty gruesome; you can see much more than just blood.  So I abandoned that.

As you can see, this pathetic suicide attempt failed.  The agony of trying to slit my ankles was indescribable, and the cuts that are there are little more superficial than any non-suicidal self-harm cuts.

I bandaged my feet and went to bed and did sleep briefly, but only for a couple of hours.  I woke at maybe 2am and have essentially been awake since.  The cat threw up on the landing and I used the bandages of my by-that-point dry wounds to clear up the vomit – how strange and surreal.

Today I can feel a migraine coming on, and I feel guilty about the cuts because I know it’s not fair to put A through this crap, and I’ve got to see the in-laws tonight (not that that’s a bad thing, however).  I’m also aware that I can hardly ever go for a quiet drink again without whatshisface harassing me, as he frequents both our locals.  I suck so utterly profoundly.  How irresponsible and stupid!  So, life could be better.

A wants me to tell VCB about last night but I think she needs to hear the redacted version.  I really don’t think being binned would help my fragile mental health; psychiatric wards sound like places of great evil to me (group therapy?  Fuck off.  Other mentals wanting to talk to you?  Fuck off.  NHS neglect, food and general wastage?  Fuck off).  I am seeing VCB on Tuesday and am terrified, then on Thursday I’ve got to go to occupational shitting health.  So another great week awaits.

Sorry for whinging.

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.

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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.

Venlafaxine / Effexor – A Med of Dread?

The below is a list of symptoms that I have experienced since starting to take Venlafaxine (75mg) from 15 June.  It is redacted in places, for either personal reasons or to help the ‘flow’ of this post, but essentially this is from a list I have been maintaining with the intention of showing Dr C when I finally see her again on 8 September.

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• Significant increase in (hypo?)mania – I am very much the ‘life of the party’, very confident (at times to the point of arrogance, or being very over-talkative)
• Significant increase in mixed episodes.
• In both of the above obviously fragmentation, pace and disorder of thoughts are of increased severity.
• Rapid cycling between (hypo?)mania and depression at times (ie – changes once or twice a week – occasionally more often, occasionally less so).
• Significant increase in compulsion to (and execution of) self-harm. Execution of ‘creative’ cutting reduced a little after the initial six or so weeks, but is still sometimes happening and I still feel the compulsion strongly and with great frequency.   Any lack of execution of cutting is mainly due to environmental factors or preventative measures I have previously taken (eg. hiding knife). Head-banging, hair pulling, scratching at self all still very frequent.
• Severe restlessness – compulsion to head-bang, to pace, get up, sit down, get up, sit down – noticed usually in tandem with severe anxiety and/or mixed states, but not necessarily limited to this (this was present before Venlafaxine but it was much less frequent and much less severe).
• Psychosis – Increased and more severe delusions (frequency – circa once a week? Though hard to say) – eg sun (watching me), signs (sending me messages), iPod (reading my mind/mood), severe paranoia (trust issues even worse – everyone is out to get me).  Some hallucinations are of similar frequency as before, but are more vivid – shapes especially clear.  Now also hearing voices/whispers which are very audible – as opposed to nebulous – at times (obviously unaccounted for).  The frequency of the voices – there are no hard and fast rules, some weeks this is frequent, some weeks there are none at all.  No specific time. Content is not ‘demanding’, it just says stuff like saying my name, asking what I’m doing – it is meaningless ‘small talk’. The shapes are there most (but not all) nights as before, same nebulous form as previously, except sometimes with greater clarity.
• Amnesia – eg. ending up in places with no idea how I got there or forgetting long discussions usually related to being mental.  Frequency of this is hard to determine – at a guess once a week? It depends – sometimes no such amnesia one week, sometimes several instances thereof.
• Increased mood swings, independent of mania-depression-mixed states – eg. extreme and uncontrollable irritability, anger, frustration, lethargy, anxiousness (again, these mood swings have been strongly present long since taking Venlafaxine but seem to have increased since taking it).
• Constantly exhausted – even more so than previously – except when I’m in a ‘manic’ state during which high energy levels are present.
• Fantasy world is still there but seems less intense than previously – not sure whether this is a result of tablets or psychotherapy though?
• Terrible forgetfulness – I go to do something and literally five seconds later I’ve forgotten what it was or what I went to do.  As with anyone this happened the odd time in the past but  for me it is now several times daily.
• Horrible, vivid nightmares when I do manage to sleep. Once or twice a fortnight.  I very rarely had such dreams before taking this tablet (approximately once every few years). They focus mainly around my being attacked (physically or sexually) or painfully trying to kill myself – despite suicide ideation this is not pleasant at the time!
• Suicide ideation seems increased to others (though not necessarily to me).
• Others say ‘default’ mood is slightly improved but not still not to extent they would have hoped.  My own view is mixed.   I still feel profoundly depressed most of the time, but perhaps the intensity of that profundity is very slightly reduced (not always – but I think in the main). Furthermore, given the substantial increase in (hypo)mania, depression occurs less frequently – but is felt very strongly when it does due to the strong divergence in mood. Mixed states, which are now very common, are probably the worst state as when I am very depressed I don’t have enough energy to self-harm or seriously consider suicide, etc – in a mixed episode I do.
• Others describe lows / mixed states as being of considerably worse severity.

Symptoms with No Change Since Taking It

• Still feel depressed though as stated others comment that I seem to them to be less depressed during ‘normal’ periods and own view is that it may be very marginally improved at times.
• Insomnia in a similar state, though general exhaustion and lethargy increased. Difficulty falling asleep – if and when I do, wake up frequently, even with medication (without sleep is usually non-existent beyond maybe half an hour or so).
• Dependency / abandonment issues unchanged.
• Narcissism, entitlement – though self-hate has definitely manifested more significantly since onset of psychotherapy (apparently unrelated to medication).
• Misanthropy.  Mistrust of people.  Abject terror of work, work-related issues, going to unfamiliar places – I fall about in a mess even thinking about this stuff. This is all the same as before.  Despite all this, I experience a lot of paradoxical loneliness.
• General levels and frequency of inappropriate anger is similar to before, though outbursts seem to be increased (as stated above).
• Self-analysis, overthinking.
• Dissociative symptoms – depersonalisation and derealisation seem mostly unchanged (apart from the development of amnesiac occurrences – presume this is related to dissassociation in some way?).
• Continued personification of inanimate objects, feeling sorry for such things – no such sympathy or empathy for people (in general).
• Fixation with death (as distinct from specific suicidal thoughts) is ‘stable’.
• Complete and utter lack of motivation – no interest in everyday activities eg tidying, dressing,cooking etc.  Same as before.
• Utter inability to concentrate or focus for anything more than a few minutes, except when mood is strongly elevated (and certainly not always then either). Very easily distracted, little ever gets done (applicable at all times).Memory rubbish too. Need to sit and plan things to have any grasp on them.
• Eating problems similar to before.
• Obsessional behaviour continues.
• Black and white thinking and behaviour.
• Post-morteming behaviour.
• Other issues that I can’t think of.

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In short, I think Venlafaxine could, potentially, help me with my depression – but the dosage would have to be increased, as the small improvements made in that regard are simply not sufficient to keep me sane.  More importantly, though, Venlafaxine is not only not helping all my other symptoms, but either it is making no difference or, more commonly, it is in fact increasing them.  I have described some of the horrors elsewhere on this blog.  The past few months have been fucking horrendous, by and large.  This is particularly the case, of course, as regards the bipolar symptoms.

As you can see from the link at the top of the page, Dr C refused to give me mood stabilisers when I last saw her as she believes that BPD is my primary diagnosis, and NICE advise against the use of them and anti-psychotics in BPD (though this seems to be the mainstay of treatment for borderline in other countries!).  That’s all well and good, but of course Venlafaxine is notorious for increasing or inducing manias and mixed states to those predisposed to them.  Given that circumstance, you would have thought that she would either have had the decency to listen to my plea for mood stabilisers at the time, or at the very least had her SHO keep the fucking July appointment that they cancelled.  If I, a complete psychiatric novice beyond my explorations on the internet, am aware of Venlfafaxine’s notoriety in this regard, surely a consultant psychiatrist, who herself diagnosed me with an illness on the bipolar spectrum, should have taken some bloody consideration of this?

In any case, I have forgotten to bring all my medications, including the bloody Venlafaxine, with me to an overnight visit to my mother’s house.  I am well aware of how hardcore missing doses of Venlafaxine can be, plus I also don’t have my sleeping pill so no doubt insomnia calls.  I’m sure, ergo, that tomorrow morning’s session with C will prove interesting…

I Hate my Colleagues II & Occupational Health Shenanigans II

This week has sucked, and I am glad it is nearing its completion.  I’m actually in a fairly good mood now as I write this, but it’s the first day that I have actually felt that right from getting up.

As you will know from Monday’s post, I’d been in bad form regarding the fucked-up status of my relationship with the psychiatrist.  However, no sooner had I published that post than an email arrived from the Horse that put me in an even worse mood.  My first reaction was of panic, but it was shortly replaced by anger.

Prior to Monday, the latest in the work saga had been that Horse had asked me to yet again outline any “aggravating factors” that had occurred in the workplace prior to my absence.  I had already done this back in March, and received a reply that was nothing but an unconstructive and condescending refutation of my comments.  So, when this second request came, I had simply outlined a few management issues that needed to be addressed.

They have agreed to increased supervision in the immediate aftermath of any return to work, as well as a phased returned facilitated by payment commensurate with hours of work rather than by use of annual leave to cover the out of office hours.  Yet again, though, everything else was refuted.  Frankly, it seems to me that the Horse is actually too braindead to even understand what I was saying.  I would have given my boss, with whom the Horse seems to be working closely, more credit, but I think that this is her first experience of managing an absence of this length and as such she seems to be delegating most of the responsibility to Personnel.

Work have picked the wrong person to fuck with.  A’s job is writing employment law.  His brother, DI, is an CAB advisor.  His best friend, W, is involved at a senior level with a charity law unit in a well-regarded university (my employers are a charity).  My mother is a former Personnel Officer.  My best friend, D, is a Personnel journalist.  One of my Twitter friends and regular commentators here, bourach, is a union rep.  I know where the fuck I stand, and if I don’t, I can soon fucking find out.

In exploring the relevant legislation, A has commented that I would probably need to put up more of a fight in regards to what would be considered reasonable by the ‘reasonable man on the street’, especially under the Disability Discrimination Act, if I were seriously to take them on.  Initially, I had not wanted to fuck the office over so hadn’t bothered to argue with them.  However, the more I hear from the Horse, and the more my boss doesn’t bother to stand up for me, the less I care.  I know things are over now.  I will almost certainly not be returning.  It’s illegal for them to give me a shit reference on the grounds of my disability, and I will be seeking assurances from the fuckstains that this does not happen.  The point I’m making is that I no longer feel I have much to lose by fucking back with them.

To demonstrate that she speaks in Fuckwit rather than English, I am including a few excerpts from her email.  Except for my [] points, these extracts are exactly as they appeared in the email, though I have bolded the especially hilarious bits.  Sigh.  I thought they still taught grammar in schools?

SI, as explained in previous correspondence, a priority system would be introduced so that [managers] and [others]  to adhered too (however there may be exceptions to this)

As you can understand that we wish to cause least distribution to the team, we would appreciate if GP appointments were made at the start of the day as I am lead to believe that your GP is based in [some distance away].

[Re:my request that work was clearly delineated between my assistant an me] Unfortunately we can not adhered too at all time.

Well, no, you can’t ‘adhered to’, you stupid bitch.  Your contention that the organisation wishes to make ‘reasonable adjustments’ to accommodate my illness is frankly amusing given your continuous refutations of my comments.

Her constant use of my name at the beginning of sentences (if you could even call them that) is infuriating.  How dare she patronise me in this fashion?  How dare she?  I can almost guarantee that my intellect is about double hers.  I am also willing to bet substantially that my qualifications are more significant than hers.  Even if not, I think the pathetic construction of her correspondence just proves that she is a dumb, fuckwitted moron.  I would have thought that it was key in a Personnel job to be able to communicate effectively.  Apparently not in my organisation.  It doesn’t matter that my dismissal is imminent anymore, as I was wasted on the cockheads anyway, it seems.

She also demanded written evidence regarding Dr C.  She failed to specify the nature of the written evidence she requires.  I am now of the belief that they don’t believe I have seen her or that I have been diagnosed as I have.  A says this is paranoia and that it is standard practice to ask for written evidence for everything.  Maybe so, but they have not asked for anything of this nature previously.  In A’s view, this exemplifies the incompetence of the Personnel function in the organisation.  Which is probably fair in relation to some of its members, most notably the Horse.

Anyway, this email arrived on Monday, which was 20th July.  As per the Horse’s previous email a few weeks ago, I understood that I was due to attend Occupational Health the following day, ie. Tuesday 21st.  The Horse then said in the email referenced above that the appointment was on Thursday 23rd.  Great work, Horse.  You’re obviously competent enough to keep track of your own emails.  It turned out it was Tuesday, but I had to call OHS themselves to determine this.

I emailed her back and was frankly just on the borderline of civil.  Well, that’s not true; I am always very careful in my correspondence with them not to be a cunt, as they would indubitably use it against me, so it was still polite and professional.  However, there was a sneering, cynical tone to it that adequately if subtlety conveyed just how fucked off I am with the whole bloody thing.  AC told me it was a bit “cheeky” (but justifiably so); Mum and A said it wasn’t cheeky exactly, but it did make clear that I was sick of the way they were treating me.  Good.  That is what was intended.

It is the tip of the iceberg, anyway.  A and I are going to work on an email to the Horse outlining exactly why her shite contentions fail, and why what she perceives as “reasonable” is in actual fact not at all reasonable.  We are going to do this before she contacts me again to eliminate the risk of a knee-jerk emotional response to her inevitable imbecility, and it’s going to be fucking brilliant.

Anyhow, despite my anger, Monday evening / night was relatively OK.  Without the sleeping pill (it was my week off them until last night), I didn’t sleep, as ever, but I didn’t go mental either.

This was not the case on Tuesday afternoon.  I worked myself into a major panic regarding the impending OHS appointment, which culminated in some fun with a knife.  There are at least 10 random slashes across my arms, legs, breasts and stomach, not to mention the delightful words of “vile”, “fail” and “die” across my lower abdomen.  In keeping with previous incidences of self-harm, I then calmed down.  For a while anyway.

I was laughably early for the appointment, so sat in my car playing games on my phone for a while.  I was fine until I actually got into the building and then I just lost it.  I took a Valium, but to be honest by the time it started having any effect, I was out of there – not that one Valium tends to make any difference anyway.

I was, fairly quickly, approached by a tall, fairly good-looking middle-aged bloke with grey hair.  This exacerbated my panic as I was expecting the woman that I’d seen the last time I was at occupational health; at least I was familiar with her.

He introduced himself as the doctor I was to be seeing.  I could barely speak and when he held out his hand I could barely shake it.  I was shaking, stuttering, rocking back and forth and generally behaving like a loon.  I even burst into tears at one point, for which I then found myself apologising.

It was telling that the only notes the bloke actually took were regarding my current medications.  He literally wrote nothing else, as I recall – why would he bother?  It was self-evident that I am mad, why bother noting that information?  I don’t really remember a great deal of the conversation, but I do recall telling him that work didn’t believe me about the BPD / bipolar diagnosis and that they were out to get me.  I also recall him asking if I had been to university, and my telling him that I ended up having to leave my Masters degree with a post-graduate diploma because I had a previous breakdown at that point.  He said quietly, and with evident sincerity, that he was “sorry to hear that”.  In fact, he seemed so genuine and sympathetic in saying so, that I thought he was going to come around the desk and put his arms around me.  I also admitted to the self-harm, some of which I even showed him,and the recent hilarious mini-suicide attempt. I told him about the trouble with the shrinks that is causing such extreme fuckuppery at present.

I have to say he was lovely.  I felt that not only did he understand the nature of the diagnoses and the symptoms thereof, he actually seemed genuinely sorry that I was experiencing them and, reading between the lines (although he didn’t actually say so), I did get the impression that he wasn’t overly impressed with the behaviour office.

Although he was nice, the meeting was essentially a waste of my petrol.  I was there less than 10 minutes, with his view being very clear; there is no way I am well enough to return at the minute.  He didn’t put a timeframe on it the way his colleague had done the last time I was there, but did say he would probably see me again.

It’ll be interesting to see what Horse and friends make of what he says.

I was fine on Tuesday evening, but after going to bed I became progressively mental.  Well, I say ‘mental’, but that’s probably not true; it was more real, hard-core depression (is it the same thing?).

I admitted defeat.  Work had won.  GA had won.  V had won.  MMcF’s husband had won.  The school bullies had won.  My ex had won.  I had failed, epically.

I ceased to care.  Let C section me.  Let him not section me.  Let the shrinks abandon me.  Let them not abandon me.  Let me die, let me live, I don’t care.  I just didn’t care.  Whatever became of me, I didn’t give a fuck.  My life is over; all I can look forward to is existence.  If that’s my future, then it doesn’t matter what form it specifically takes.

A started babbling at me in his sleep, which is not something he can help, but it annoyed me and I started crying and came downstairs.  I lay on the sofa and curled up with the cats, rocking back and forth, and remaining there, awake, for the rest of the night.  I thought about adding to the body art, but to be honest I simply didn’t have the energy or motivation.  Interestingly, I have read in several places that depressed people are at the most risk of suicide and/or self-harm when they start to make small improvements, for instance when anti-depressants or psychotherapy first start to be successful; when they are in the depths of despair, they simply cannot get motivated to undertake the acts, but when they are still depressed, just a little less so, they begin to get back enough energy to go ahead and do it.

Wednesday was alright, if boring.  However, after I went to bed on Wednesday night, A found some of the cuts from Tuesday afternoon and was upset by them (I had been successful in hiding them until then).  I freaked out at him at one point then started crying and apologising to him.  I kept wailing that he was angry with me, and he would either not answer or he would say that he was not angry with “my rational mind”, which means he is angry with me because my irrational mind is in control of me so much of the time.

But he ended up being nice to me and so I got over it and, although I was fairly depressed yesterday during the day, I improved last night have been in fairly good form since.  Strange how the moods swing.

So, this is kind of a pointless post, but then they all are, except for my own reference, and of course that is the main point of this blog.  So I suppose in that sense it does have some point.

Not Getting Sectioned Just Yet – C: Week 19

I told him everything. Everything I could think of. I told him about the hanging attempt, and the self-harm of the same weekend. I told him about the carving of ‘HATE’ onto my stomach. I told him about the delusions I’ve experienced lately. I told him how I almost obsessively read pro-suicide newsgroups on the internet which provide advice on how to do yourself in in the most fool-proof manners possible.

It was about as easy to talk about as discovering that the person you love used to fuck baby seals during hate-filled orgies would be to experience, but I did it.

After apologising to him for wasting his time last week, and the usual grilling that induced (“why do you feel you wasted my time? What was it you should have said or done that you didn’t? Why did you feel unable to express that?” blah blah), I told him that if I was honest and open with this stuff that he would section me.

“To clarify,” C began, “I can’t myself section you.”

Oh, really? I do know nothing about the Mental Health Act, after all. I haven’t clearly researched it or anything, C. I had no idea!

“I know, I know,” I interjected. “But as a mental health professional you can easily find two doctors that will do it for you.”

“If I believed that you were in imminent danger of harming or killing yourself, or others, I’d have to contact either your GP or psychiatrist, yes.”

I fidgeted relentlessly, eventually stating that whilst I would not say any danger was imminent, I could not guarantee that it wasn’t.

I don’t remember what he must have said, but I just went ahead and just told him the bloody lot. Not all at once, but one way or another, I did.

There isn’t a great deal of point in detailing the bits where I told him what happened, as it would be repeating a lot of the material about which I’ve already written and to which I have linked above. The only thing I think I haven’t expressly detailed here is my perusal of the pro-suicide newsgroups, but there’s not much to say on that. I read them. It’s interesting. I know how to kill myself should I want to. I find morbid fascination in the pursuit. The end.

He did ask what I felt the causes of the mentalisms were. I blamed Venlafaxine, stating that I understood that if it was taken in many people experiencing any bipolar symptoms, it could increase mixed episodes, and that although my main diagnosis is BPD, Dr C does believe I have bipolar II as well.

C asked me when I was seeing her again and advised that I would have to tell her about all of this (no shit, Sherlock), but said that that wasn’t really what he was getting at. Apparently he wanted to know were there any emotionally stressful events that brought the madness on.

Aside from my belief that I had bollocked A’s computer on Monday – after which I carved the ‘HATE’ into myself – there was none. I just went mad. I apologised to C for this.

C laughed, but in a nice way, and said that it was OK; I didn’t need to have a reason. He had just been keen to know if there was one.

He probed me on how I felt there and then as I sat in his office about the various episodes, and how I’d felt in their aftermaths. I thought carefully about this, then responded that in a way I was regretful of them, because A had to bear witness to them, or at least live in knowledge of them, and that I was unhappy about that.

“OK,” he said, “but how do you feel about it yourself?”

I responded that I was mostly indifferent because I deserve it all.

“You deserve it?!” he exclaimed. “Why?”

“What’s my point in this world? Whose lives do I enrich? What do I do? Everything I touch, everything with which I come into contact, turns to shit.”

“Do you think I’ve turned to shit?” he asked.

“Do you think I have contaminated your mind with mine?” I queried.

“Do you think I cannot cope with you?” he returned.

It was like a game of verbal tennis, and I don’t remember who the game-set-match went to. Probably him, to be honest. But it doesn’t matter because at this point some fuckwit knocked on his door. C apologised and got up to answer it.

Fuck. I was furious with him, briefly. I don’t care if your fucking children (if he has any) have had their throats slit and their eyes gouged out and shoved up their arses, C, this is my time with you. Anyhow, to be fair to him he tried to fob the person off, was apparently unsuccessful, and turned back to me saying he’d be back momentarily.

During his absence, which seemed like 10 minutes but was probably about 30 seconds in reality, I imagined all the bile-filled rants I was going to post about him both here and on Twitter. However, when he returned he explained that it was some old broad who got lost looking for the hearing clinic down the corridor, and needed help to locate it. C did her the courtesy of showing her to the place so, even though the interruption was annoying, I did think it was nice of him to help the old woman. So I softened and forgave him.

He returned to the verbal tennis subject, but I don’t really remember any more about it to be honest.

My next recollection is that he asked me what was so terrifying about the possibility of being sectioned.

“Oh God,” I cried, “that means you’re going to do it! You’re going to phone them! I won’t do it again, I promise!”

“I just want to know what you fear about it, that’s all,” he replied calmly. It was an interesting answer; he wasn’t saying that he was or he wasn’t going to do it (though he was evidently trying to infer the latter) – it was presumably deliberately ambiguous as some sort of get-out clause if he later did feel sectioning me was necessary.

In any event, I was reluctant to tell him that the reason I don’t want to be sectioned is because I would miss him. That’s about the only secret I kept from him today, because that’s just too pathetic to even articulate verbally. Instead, I told him that I knew the kind of shite that went on in psychiatric institutions and that I didn’t “fancy it.”

This is true. A and I ran into G, our intellectual philosophising friend about whom I wrote here (interestingly, my most popular post to date) the other day, and he was telling us that his ex, a bipolar sufferer, spent a while in a psychiatric unit and that if she was fucked up already, she left in a worse condition. Apparently they all but force you to engage in group therapy, and the differing types of transference bouncing about the room turn the whole thing into a complete fucking nightmare. This correlates with stuff I’ve read and accounts I’ve heard elsewhere. I could perhaps cope with hospitalisation if I didn’t have to engage in this way with the other mentals, I think, but if I did have to do any of this arse, I am convinced I would be even more fucking crazy than when I was admitted.

The crux of this discussion was that whilst he accepts that I am largely terrified of being sectioned, he thinks a part of me would actually welcome a recommendation of hospitalisation, because that would be a recognition of just how indescribably fucking awful I am feeling at times. This was interesting, as it basically echoes a view that A holds. He continued that whilst I obviously didn’t want him to instigate any Mental Health Act shite, and would be very angry with him if he did, part of me would also feel that he cared about me if he did so. He then went on to say that perhaps in some ways the self-harm is about proving how terrible I feel, regardless of how much I try and hide it, as I don’t have adequate words for a description of the mentalism. He said that he believed that part of me didn’t feel the enormity of my psychological condition was being taken seriously.

It’s all true. It’s all fucking true. How does he know? How? How?! He fucking is Derren Brown, even if he looks less like him since shaving off his goatee beard (I’m sure at this juncture someone may think, “ah yes – Derren Brown. He’s a mentalist in the true sense of the word and you’re not, SI.” Well – I know this. But nevertheless, I think ‘mentalism’ works for us nutjobs too. So fuck that shit.).

Anyway, there is more to self-harming than just what he said, but it’s probably part of it. The rest of it is absolutely spot-on. I don’t like admitting it, but it’s true.

How. Does. He. Know.

He’d picked up on the fact that I’d said, “I won’t do it again,” which was apparently just said in panic and didn’t come across as remotely sincere. He postulated the position that part of me saw him as some sort of authority figure; in fact, he said, it was as if I was a child trying to satisfy her parent(s).

This resonated with me. I concluded towards the end of this post, reluctantly, that perhaps I do parentify C. I asked him if he felt that I did that.

He sort of shook his head, then told me that the therapeutic dynamic can be reflective of many of my outside relationships, not just those with parents. I don’t remember exactly what he said, but essentially the idea was that my transference towards him reflects, or at least can reflect, all my interpersonal relationships, whether current or past. He did, however, state something to the effect that perhaps my childhood had a stronger bearing on the transference than the here and now does, though again I don’t remember how it was phrased exactly.

He asked how I felt about people in general. I said I wished that they’d all go away and leave me alone. C nodded, though I saw his eyebrow quiver slightly cynically. I added, “but of course I don’t want them to leave me alone.”

He laughed slightly, and nodded more convincingly this time. “You hate the world but you fear it, in your words, abandoning you,” he said. Basically, yes.

I believe it was at this point that the silence returned. I turned round and looked at the clock and saw, to my surprise, that 10 minutes remained of the session. Once more I apologised for wasting his time and said that I hated sitting in silence, as it was a waste of his time and not helpful to me either. C went to challenge this, I think, but then I butted in and said, “where do we go from here?”

He asked what I meant, and I explained that I was aware that our contracted sessions were due to end. What happened next, therefore?

“How do you feel…?” he began

“No,” I said. “I’m going to bat that back at you.”

“How so?”

“How do you feel about it?”

To my amazement, he actually answered the question; in fact, he monologued for some time in response. The essence of what he was saying is that any termination of therapy has to be conducted over time and be mutually agreed; it will never just come to an end some week. Was that OK with me?

“Of course,” I said flatly. “But I am ever conscious of you telling me once that as this therapy is on the NHS, it will be finite. Just how finite is finite?”

He laughed. “It’s a good question,” he said.

I pointed out that I was aware that a borderline personality can be difficult and time-consuming to treat, but I accepted that what was right for Person A was not necessarily right for Person B.

“Exactly,” he said. “It’s difficult to say, I’m afraid – I’m sorry I can’t be more definite than that.” He said that we will discuss in the next session the exact time-frame for which we want the next contract to last, though the next contract isn’t necessarily the last anyway, presumably. Or at least hopefully.

“OK,” I responded.

“But how do you feel about that?” he pressed. He should get that printed on his fucking business cards.

It was at this point that I turned into a gibbering wreck, and I fought against it…but he knew. Eventually I gave in and just blubbed like a fucking baby in front of him.

Through my tears I explained that I was, naturally, reassured by the fact that the therapy was to continue, as I was perpetually terrified of him abandoning me. He nodded in acceptance, but recognised there was some sort of ‘but’ coming. The ‘but’ is that I am simultaneously frightened of the therapy continuing.

“Frightened?” he remarked, surprised.

“Yes,” I wailed. “This is so hard. So hard. I always expected I’d have to get worse before I got better, cos I have to confront stuff I’ve been repressing for years, but I didn’t expect that it would be this difficult. It’s so intense.”

He paused for a minute or two, then asked if I had gotten worse since I met him. I tried to bullshit about the medication having an adverse effect on me and not him, but the reality is that yes, my condition has been aggravated quite demonstrably by psychotherapy. I think I apologised to him and said that it was not him – it was nothing personal – it was me and my reaction and repression and defences.

When I finally raised my head I could see that he was upset. He wasn’t crying or anything, but there was something about his facial expression that was horribly sad and dismayed. I don’t think he felt that I was insulting him or anything; I think he was just kind of taken aback by my unusual candour and concerned that I felt everything was so utterly bleak at present that part of me didn’t want to see a future for myself, either in or outside therapy.

He said, “I want this to be a safe place for you to talk about everything. I don’t want you to feel you have to repress anything because you think I am going to panic and get straight on the phone to your GP…” At this point, he acted out making a phone call to LGP, and I accused him of over-dramatising.

“OK, I am a bit,” he admitted, apologetically. “But I don’t want you to think I’m going to panic and do that, I’m not…”

“Thank you,” I interrupted in a pathetically grateful whisper.

“…however,” he continued, “I don’t want you to think I don’t care. If you are feeling suicidal, please phone your GP at once.”

“What if it happens at night?” I asked. “My GP is married with three young children.”

“Then you take yourself to casualty.”

“But what if I don’t have the mental faculties to be able to do that?”

“That’s my advice to you,” he said authoritatively. “Take. Yourself. To. Casualty. OK?”

“OK,” I agreed.

And then, once again, it was over.

It is two weeks until I see him again; after that next session, he will then be on leave for a fortnight. Part of me welcomes the break, for the process is exhausting, demanding, hurtful and intense as fuck. But overall I am dreading it. I rely on him so much. He is the only person I can begin to openly talk to, and I mean that in no offensive way to anyone. It just is.

I had asked him before about what would happen if I go mental whilst he is off, and he said we could discuss that. I’ll be sure to bring it up in a fortnight’s time, because nothing is surer to cause me to go batshit mad again than being parted from him for three weeks.

It’s feeble and lamentable beyond measure that he and his imminent absences elicit this reaction in me, but I will try and end on a more positive note by remembering that this is temporary in nature. So is the therapy itself, but it is in no imminent danger of drawing to a close, and I still find myself a free, non-sectioned woman tonight, and this morning I really wondered if that would be the case. Ho hum.

He May be Attacking but my Shrink is Not Resigning! C: Week 17

Or at least if he is, he did not tell me so, and he is still having supervision sessions with his boss so it doesn’t look like he’s going any time soon!  To be honest I didn’t mention my irrational fear to him about him leaving (that I expressed yesterday), but I am fairly sure now that if he were going he would have told me.  So I am sated…for now.  I wonder will his new job offer come in the next few weeks and then I will have to worry about this again?

We spent the first while talking about work..  I only mentioned briefly here on Friday that I had heard from the office, but basically it ran thus: I had not responded to the email about which this rant was…um…ranted, I have to attend another OH assessment (not panicking, not panicking…oh fuck oh fuck oh fuck…OK, am panicking), that they want a therapy progress report, that they wanted to know had I yet seen a “specialist” and basically what more “aggravating factors” there were in the workplace.  Since I had previously provided them with a comprehensive but diplomatic list of “aggravating factors” which they then completely refuted, this seem a stupid question to me, but hey, that’s management shit, right?  Also, given the previous OH report, they are hoping I will be back in September / October.  If not, or if they cannot make reasonable adjustments for my madness, they will have to enter the “incapacity process”.

I wrote back to Horse with a therapy progress report, telling her about Dr C and the diagnoses/tablet changes, agreeing to attend the stupid, hateful OH shite, and stating politely that since she had already merely refuted my discussion of “aggravating factors” that my going into further detail would be nonconstructive.  I simply detailed a few supervisory-esque matters that would need to be addressed in the relative short-term after a hopeful return to work.

Anyway, I gave C brief details then started ranting about work and how I think my colleagues are all “bastards”.  Then I castigated myself saying that they are not all bastards, but in my mind right now they are in fact all bastards, so let’s just go with the idea that they are all bastards even though in the real world only one or two of them are actually bastards.

C pointed out that this was a very black and white generalisation.  Really, C?  I didn’t know that, thanks mate.  I was tempted to ask him if I was splitting, but after last week I was feeling submissive and didn’t want to antagonise by making it look like I know more than him, so I didn’t.

He did accept in fairness that I both believe they are all evil and don’t at the same time, and asked what it was that terrified me so utterly about returning to work (in light of the fact work are hoping to have me back by October).

I told him that A had suggested I just leave my present job (or at least let them to dismiss me, so as I can continue to claim whatever dolescum money I can) and take a very protracted period off work until I was confident enough to cope.  C tactfully disagreed, at least to an extent anyway, stating that the more one promised oneself to return to public life when one was more confident, the less likely they seemed to be able to do it.

I panicked and asked if that meant he thought I should just go back to work.  The answer was not right now, but yes, relatively soon,not after a very protracted period.  We obviously have to work on some confidence-building/fear-elimination, just not use it as an indefinite excuse for me to remain off.  However, he said, he did not necessarily think that ‘work’ had to be my present job.  That was reassuring, because starting a new job whilst terrifying is actually less so than returning to my present one.  The problem is that when I have been offered interviews in the past year or so I just go mental.

I said that I didn’t actually want to go back to work at all, but I did want to want to go back.  I said I didn’t fancy wallowing off social security for the rest of my life and letting my mind atrophy.

Apparently I said the words ‘social security’ with a certain tone.  C searched for the word, but I butted in and said, “contemptuous”.

“Yes,” he agreed.  “Contemptuous.  Why so?”

I offered the view that although there were certainly genuine claimants within the social security system, that I did not want to be associated with benefit fraudsters and layabouts.

“Hmm,” he said.  “Black and white thinking again.  There’s no middle ground in this for you.  It’s either/or.”

At this point as I recall it he moved the discussion back to my actual present job.  The change of direction seems confusing, but will makes sense as my little story progresses.  So, what was it then that worried me so much about my present job?

Essentially, I said, no one listens to legitimate concerns (true), nothing ever changes despite promises that it will (true), they are so pedantically anal that nothing is ever good enough (mostly true) and that basically they all know what’s wrong with me and despite the nature of their business (voluntary sector social care) that they don’t believe I am ill or at the very least they are stigmatically judging me for my mental fuckuppery (probably not true but still my perception).

(C found the term ‘fuckuppery’ amusing.  I was glad to give him a couple of opportunities to smirk in this session).

I told C that if I have to walk somewhere during office hours that would, if I was taking a straight route, take me past the office that I walked ridiculously convoluted routes to avoid it.  My best attempt at walking right past it was on the other side of the road with my face covered with a scarf, which still resulted in a panic.  In fact, when he asked me to relive that day, I refused as I began to become incredibly jumpy and agitated.  Thankfully C didn’t need to probe me any further as he could see how the fear of the office was manifested.

I said to C that even though I had reasons to be angry, or at least irritated, with work, that I couldn’t explain my abject terror about something as apparently inoffensive about simply walking past it.

C’s conclusion is that the fear is not about the fact that things never change in the place, or indeed any specific work related issue, but more about my perception of others’ perceptions of me.  He said that I fear scrutiny, feel that I need validation and am petrified of being judged in a negative way by almost anyone.  This ties in with my self-contempt at being part of the social security system.  Much to my regret, his analysis is correct.

He said this led on appropriately enough to how I’d reacted to my shouting at him last week and indeed how I had responded to our first in-depth discussion of this blog.  He suggested that I ended up apologetically submitting to him in both cases because I feared he was scrutinising me and coming to negative conclusions about me.

I felt this was a fair comment, and indeed timely given the similar patterns of behaviour with A, about which I then told him, discussing the incidents at the weekend in some detail (though I neglected to include the information that one of the arguments that I started was about him).

To my surprise he suggested drawing a diagram of my behaviour on his whiteboard.  “It’ll give us some visual reference for this,” he stated.  “You may feel that this is a bit caricatured at the moment, but over time we’ll make it more specific to you.”

When he had finished the chart I made the unusual request to take a photo of it (so I could remember it all).  He was slightly taken aback by this, but agreed.  In return for his kind acquiescence, I stated that I would not put the picture on the internet.  I didn’t, however, state that I wouldn’t describe it *evil grin* so here goes.

Self versus Other

Self feels attacked by Other, causes feelings of being threatened or afraid.  Self is attackee, Other is attacker.  To mitigate effects of perceived attack on Self, Self must defend Self.  In defending Self, attacking role is reversed.  Self attacks Other.  Other is attackee, Self is attacker.

Self also attacks Other to induce potential abandonment as at least control is then had over said abandonment, rather than abandonment being in the control of Other.  Self perceives attack from Other as being evidence that abandonment is imminent.  Self must attack so as to justify imminent abandonment, therefore making Other (not Self) being the abandoned one, at least by proxy.  Abandonment justified because Self wants to abandon Other rather than have Other abandon Self.

Self then reflects on being attacker/abandoner-by-proxy, causing Self feelings of guilt.  Self submits to Other, partly in an effort to avoid abandonment that was previously considered imminent (as abandonment by-proxy is not ideal for Self either), but also partly because Self feels that Other is damaged by Self and Self is sorry for that.

Etc.  I am having to explain it linguistically here, so it seems more complex than his little diagram with connecting arrows and lines actually did.

We both sat and looked at it for quite a while, before C turned the whiteboard round because he didn’t want either of us to overthink the material thereon.  He did, however, ask me what I thought of it.

It was like most of my interpersonal relationships, whether current, at some point in the past or in the projected future, being laid out before me.  I felt it was a very succinct way of putting it all.

He said that as well as submission then there was my tendency to self-castigate when I later believe that the perceived attack from ‘Other’ (that brings on the attack-defend-submit behaviour) was not worthy of response, or at least not worthy of getting riled at.  “For example,” he said, “you may believe now that my having emphasised last week that your blog should be anonymous was nothing more than my emphasising that fact.  At the time you believed that I was attacking both your intelligence and your continued writing of the blog.”  (As it happens I am not sure what I do think of that now, but in any case he was just exemplifying).

He continued by stating that regardless of what I think later, it is important to remember that my perception of attack at the time said perceived attack is taking place is very, very real.  As such, I should go easy on the subsequent self-flagellation.

“But I need to criticise myself,” I protested.  “If I don’t, I run the risk of believing all my warped perceptions are real, and then will fall into deep, permanent madness.”  This was a reference to believing that the sun could see me and wished death on me.

C reiterated that my ‘warped perceptions’ were fundamentally real at the time.

I screwed up my face a bit and became (even more) fidgety.  He asked what was wrong.  I said there was something I felt I ought to tell him, but I didn’t want to.

He asked what I felt was going to happen if I did tell him about whatever it was.  I said I feared that he would have me sectioned because I was presenting episodes of genuine psychosis.

He said the only circumstances under which he would start using the Mental Health Act were if he felt I was seriously about to kill myself (or, although he didn’t say this – presumably for fear of offending me – if I was seriously about to hurt someone else).  My response to that was that in that circumstance sectioning would certainly be preferable to him calling the stupid crisis response team, a response which probably didn’t go down too well, but I didn’t stop long enough to observe his reaction in detail.

I went ahead and told him about the sun, and about how A had tried to rationally convince me that my delusion was just that (ie. a delusion) but that I apparently argued that A could not know that the sun was not sentient and malevolent.

C listened intently, then said, “this will maybe sound like leap of logic, but if we can relate this back to your colleagues for a minute, would you accept that both feelings are related to being, in your eyes, overly scrutinised?”

I hadn’t thought of that, perhaps unsurprisingly, but it seemed to make sense in a warped sort of way.

He continued by opining that if I had enjoyed being out of the sun that we experienced this week (remember I described yesterday about how much happier I was in the dark, underground pub than out on the street?) that perhaps this delusion lasted longer than just the period for which I initially felt it.  Ultimately, he felt that the delusion came back to this idea of being scared of having my persona attacked.

Curiously, I felt, he then stated that another comparison, tenuous as it may have sounded, was that my perception over the previous two weeks had been that he was, at times, attacking me.

I frowned.  “Do you think I see you as a being of harm and malevolence?” I queried.  “For the record, I don’t.”

“No,” he ventured, “but I do think you have fleeting moments where you might think I want to hurt you or wish harm on you.  Thus you defend yourself.  So, what do you feel now that you have told me this?”

“That you hate me because I’m psychotic and that now you’re going to abandon me,” I sighed.  “You see, this is why I have to berate myself at every turn for my irrational perceptions and thoughts.  If I don’t I will end up completely believing that you despise me and that the sun is out to murder me.  I’m clinging to a few threads of sanity here.  To just let this wash over me would be to break them or to let go of them.”

C nodded understandingly and sympathetically, but then uttered the immortal words, “look, I’m sorry, but we’ll have to leave it there.”  He indicated interest in picking this theme up again next week.

Before I actually left, though, two things of interest occurred.  The first was that he reported that, as mentioned, he will soon have a supervision session – unfortunately this conflicts with my appointment with him in three weeks.  The last time such a conflict occurred, C simply allowed us to miss a session.  This time, he has suggested that we rearrange the appointment.  I am certainly glad of that, because I crack up when he’s not there, but it does seem to me that he thinks I’m really mental at preset, if he is going to have a change of heart like that.

The next thing was, as I was about to go out the door, he stopped me and asked when I was next due to see Dr C, the psychiatrist.  Perhaps, given the sun episode, this question was entirely unsurprising.  I told him I had an appointment for the end of July and laughed that I would be interested to see what she thought of this.

Then I left.  An intriguing session.  I am not entirely sure what to make of it at this point, but it was certainly interesting.