Archive for delusions

Reflections on 2009

Posted in C, Everyday Life, Moods, psychiatry, Psychotherapy, Random, Random Mental Health Related Philosophising with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Thursday, 31 December, 2009 by Pandora

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

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Christmas…Revisited

Posted in Context, Everyday Life, Moods, Triggers with tags , , , , , , , , , , , , , , , , , , , , , on Wednesday, 30 December, 2009 by Pandora

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.

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The Fantasy World

Posted in Context with tags , , , , , , , , , , , , on Wednesday, 16 December, 2009 by Pandora

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.

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The Malice of the Voices of ‘They’

Posted in Everyday Life, Medications, Moods, psychiatry with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Tuesday, 10 November, 2009 by Pandora

Owing to the pain of this –

Ouchies

– 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?!
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An Impasse – C: Week 26

Posted in C, Psychotherapy with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Thursday, 15 October, 2009 by Pandora

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Apparently that is “not helpful”.

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

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

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

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

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

“I don’t know,” he admitted.

“Well, that’s great, thanks.”

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

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

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

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

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

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

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

I agreed.

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

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

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

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

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

“Well-intentioned,” I responded.

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

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

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

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

“OK,” he said, encouragingly.

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

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

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

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

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


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Reflecting on Being a Psychotic Bitch

Posted in Moods, Triggers with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Wednesday, 14 October, 2009 by Pandora

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.


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I Hate the Therapeutic Relationship – C: Week 25

Posted in C, Moods, Psychotherapy with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Friday, 9 October, 2009 by Pandora

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.


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