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.

Christmas…

…has been fucking awful. I had a complete psychotic break on Christmas Night after the stress of engaging with the MMcFs (and in particular Paedo) all day and heard ‘They’ telling me to kill MW. Obvioulsly I didn’t. I also told A, apparently believing completely, that ScumFan was a drug-dealer (he’s not) and that A was actually his sister in disguise (!).

Boxing Day has been a fucking nightmare too, though on a lesser scale. But the psychoses of last night are what matters. It is time to be hospitalised.

‘They’ told me that smothering MW would be “a mercy”. Maybe or maybe not, the very thought of harming him is beyond contempt.

Enough is enough.

The Questions I Never Wanted to Face – C: Week 30

I’ve been avoiding writing this entry, in part due to a continuing malaise with being arsed to do anything, never mind soul-searching and expunging myself across the internet. But it’s not just been that. There’s nothing that I am going to say that is unknown amongst the circles that read this blog, but talking about this shite in therapy and then making it a concrete black-and-white reality in a journal make it real, and it is not allowed to be real, not by me at any rate. So I have been avoiding it. You should note that I am deliberately going to refrain from putting some details here, due to their personal nature, but I am sure you can forgive me.

Thursday’s session with C was one of the most frank and revelatory that I’ve experienced to date. It was a strange meeting, because initially I thought it was going to be one of those useless, ‘let’s both stare at the floor’ encounters, but if anything it ended up becoming one of the more useful (if difficult) sessions I’ve had in psychotherapy, because we finally began to face some of the stuff I’ve been so strategically avoiding in the last six months (and, frankly, for much of my life).

I was greeted with that usual opening gambit of, “so where would you like to start?” I know why he does this (“the dyad is a co-construction but you have to help inform it by raising issues of concern” or some such, no doubt) but seriously, is it really so much to ask for him to just ask me a question about something he thinks is worth discussing? Although I wasn’t in the same agitated mood that I was last week, I sort of shrugged off the question and we looked at each other.

Two points of interest arise for me here. One – why do I have such trouble just telling him where I would like to begin? Let me try to articulate how I feel in the moments immediately subsequent to his opening question. I suppose the closest I can really get to it is to say that it just feels inappropriate. Is this a boundaries thing? Is it something to do with a possible perception on my part that he is an authority figure? It just feels like I’d be breaking a rule, that it is something of inherent embarrassment to me, like I’d be showing myself up like a child humiliated by her teacher or parent.

Two, regular readers will know that C has directly confronted me – if I may use artistic licence with the term ‘confront’, for want of a better one – about the fact that I hide from him. I mean that I literally hide, not (just) metaphorically: I have fairly long hair, and I either wear it loose in his office and hide behind it, or I take it down from a ponytail in his office, and hide behind it. I also put my hands over my face to avoid him. How, then, is it that I can stare him out at other times (note that above I stated that we stared at each other for a bit)? In fact, I do the stare with such intensity at times that I think I unsettle him – whether or not that’s correct, at the very least I usually win ‘stare-outs’ with him. I stare and stare and stare, confrontationally, challengingly, defiantly even, all in a strange dance of intellectual seduction, no doubt designed to avoid actual exploratory psychotherapeutic work, which is no doubt exactly what this o’er weighty prose is also designed to do, so I shall forthwith desist from it. To try and answer the question, though, my suspicion is that the ‘hiding’ occurs when I am vulnerable or open with C, and the staring when I feel confident or (probably erroneously) believe myself to have the upper hand in the dyad. I am a walking Freudian stereotype.

The beginning of the discussion – and in fact the first 30 or so minutes – were really pretty innocuous. One thing that completed cracked me up was that he made enquiries as to the nature of my finger injury. Initially I was slightly taken aback by this – why the fuck would he show friendly concern over a cut finger? That is at most a medical problem, surely? However, I explained the circumstances in deliberately pedantic detail.

He nodded and smiled slightly in that irritating ‘oh-right-that’s-nice way’ that he does when I have said something that he deems irrelevant (which was most frustrating in this case, as he instigated the discussion), seeming apparently satisfied with my response. I wasn’t going to let him off with it though (more avoidance?) and said, “you thought I did it deliberately, didn’t you?”

He hesitated; I think he was reluctant to answer that, but for once he did give me a straight response, stating that, “that had been [his] thinking.”

For some reason I found this preposterously hilarious, and laughed and laughed. Although he tried to humour me, C was clearly puzzled by this amused lunacy, and retrospectively speaking, so am I. OK, so trying to severe my finger hasn’t exactly been my self-harm MO to date, but then this is the girl that recently bought, for the purposes of cutting herself, a surgical scalpel from eBay, and as a young child tried to amputate her foot. His supposition was not that terribly unreasonable when you think about it.

By whatever means of progression, we ended up engaging in a fairly length discussion about ‘They’ and the VCB’s prescription for an anti-psychotic to combat ‘They’. C, correctly, kept calling ‘They’ ‘them’ when ‘They’ were the objects of his sentences. He then went about correcting himself and apologising to me, apparently believing his ‘incorrect’ term was some sort of invalidation of me (because throwing a whole ream of hard work back in my face isn’t, but whatever), but I honestly couldn’t care less. It doesn’t matter what C calls ‘They’ – it’s not exactly going to rid me of their malice, is it? And his ‘mistake’ isn’t a mistake – he’s correct. Allow me to honour Dr Freud again; does my refusal to name ‘They’ in correct grammatical terms hark back to childhood trauma, when such niceties of the English language were only beginning to be understood? No, it probably doesn’t, so let’s move on.

The discussion of ‘They’ led on to further perusal of my recent psychoses (as detailed in the ‘They’ post and in this tweet); namely, the knocking, whimpering and music. I told C how I sinister I found them all, in particular the heinous music, but that in some odd, vaguely altruistic way, the whimpering was the worst. My desire has been to help the whimpering creature, to rid it of its obvious pain, but of course I cannot do that as, oddly enough, it isn’t fucking there because it doesn’t fucking exist. On the other hand, I explained, even if I could find the source of the whimpering, my pathological fear is that it is a trap laid by ‘They’ to somehow torture my mind further…or indeed worse (if you can euphemistically call taking me out ‘worse’, and I am not convinced that you can).

Anyhow, so far so tame. Well, not so for a normal, but yeah – let’s stick with ‘tame’ anyway. Unfortunately I walked into a trap at this juncture. Well, that’s unfair; C didn’t mean to dig into something right at this point (or at least I don’t think he did), and even if it had been a probing question, it would not be fair to consider that entrapment. He merely asked how I experience these sounds.

I won’t go into my answer nor the next 10 minutes of conversation, as this is the personal information to which I alluded in the opening paragraph. This remains private, between C and me, and no one else; all I’m willing to say is that it relates to me protecting myself. I’ll make only two other points about it. Firstly, this particular subject could have been horribly uncomfortable and awkward – and with the wrong person, it indubitably would have been. But I felt at ease with C, relatively speaking, and thought he dealt with it with tact and sensitivity. Secondly, this part of the session ultimately led to one of the topics I have been dreading to face in detail.

“You’re opening a Pandora’s Box here,” I cautioned at this point.

“Do you want to tell me what’s in the box?” C responded on cue.

I very deliberately turned round to look at the clock, noting only 10 minutes remained of the session.

“What a shame we don’t have time for that,” I smiled, probably patronisingly.

He took another route. “Can you even tell me the name of the box then, or give some details as to its contents?”

I took a deep breath. “You are aware of what happened with my uncle.”

He nodded, and what followed was some slightly circular discussion about my continuing worries about MW and his soon-to-be sibling (my cousins twice removed, or third cousins if you prefer the more common, yet inaccurate, assessment), and how that’s diminished a little of late*. Another point was regarding MMcF’s husband’s exact relationship with me – ie. that he is my uncle by marriage. There was subtle reference as to what extent the incident (lovely word) has consciously impacted upon my life in the last 16-ish years.

Finally he said it. I don’t remember his exact words, but it was something like, “you haven’t told me it all, have you?”

That sounds like he phrased it in a sort of blaming fashion, but honestly, he didn’t. I just remember that it wasn’t something like, “there’s more to this”, because I’d have said ‘yes’ to that, whereas the correct answer to the question above was ‘no’.

I didn’t feel like a child, or at least I don’t think I did. I did, however, bow my head, look up at C from this submissive position and shake my head slowly, sadly and in a horribly resigned sort of manner – just like a child does when faced with a similarly awkward position. Submit submit submit. You lied to him, you little bitch, you lied.

I would reiterate that this is my thinking and that I got no sense of blame or recrimination whatsoever from him. Still, I hate the fact that I actually outright lied to C about this matter in our early discussions. I hate it. I hate it almost as much as confronting this bollocks itself.

We didn’t talk about the whole shame issue I mentioned in the sex abuse post, simply as there wasn’t time. We did spend the few minutes that were left exploring who else was privy to the information – A is one of only two ‘real life’ person to whom I’ve actually spoken the word ‘rape’ in this context, though a few others will have now found out thanks to reading the material I’ve written on the blog.

The other person who heard me use the word was my mother. Her reaction to the whole thing is a subject for several sessions with C as, to be honest, her way of handling it wasn’t exactly in my best interests. I gave C the brief version, which is what follows, though of course it will be revisited I’m sure. When I first confessed to my mother that anything happened, she said that I had misinterpreted McMF’s husband’s actions, as “he loves children” and would touch them in innocent, companionable sorts of ways – that must have been what happened, SI, you silly girl! Mum still holds to that position, on the very rare occasion that there is some sort of reference to the INCIDENT. When I told her, on a separate occasion, the full extent of the INCIDENT, she – knowing I am not a fan of the McF dynasty – said I made it up to avoid going to their house. Cheers mother.

Of course it was not just the INCIDENT that permeated this period in my ‘relationship’ with McMF’s husband, though that was always the worst bit – well, obviously, I suppose. The fact that I mainly have flashback-like recollections of the worst part – ie. my wriggling under him as he pushed me down and did what he wanted – is presumably suggestive of dissociation from there onwards, for which I am both grateful and resentful. There was more to it than just than one day too, and God forgive me, I played up to it. I did. I played up to it. I would wear short skirts in front of him and make suggestive comments to him – not because I wanted him to touch me ever again, but because I wanted him to suffer (the rationale being, “oh, you want me, do you fuckhead? Well, you can’t have me!”). When he did later touch me again (once in a room full of other children – thanks for that memory, mind), I would seize up and eliminate myself from the situation with as much speed as possible. It makes my skin crawl to think of this.

Yes, it makes my skin crawl, and my reaction to it makes my skin crawl. I know I was a child, and I know flirtatious and sexualised behaviour is a common response to child sex abuse, but I feel like a grotesque little slut nevertheless.

Readers, I cannot do this. I cannot face the enormity of not just this hideous link to the past, but also that of the first boyfriend saga, and that of the desolation of grammar school, amongst others. How can I face this all with C? How? I can’t even face it with me! I am not strong enough. I am weak. The word flows through my blood and inhabits every cell and fibre of my being. Weak, so, so horribly, pathetically weak.

OK, I have totally digressed. This post was about a session with C, and I have turned it into a mini discussion on child sex abuse and my failure as a human being. Sorry. To return to the point, C and I had to finish the session after the talk about my Mum not believing what I had told her about her brother-in-law. A Pandora’s Box indeed. I should have kept my mouth shut – the next few weeks are, I suspect, going to be tough.

And yet I should not have kept my mouth shut because it needs to be confronted, and in this way I am heartened too. Even though I don’t think I can do it, it is a real development. It’s only taken six months, but what’s half a year between therapist and client! 😉

The session ended with C advising me that both offices on either side of him are being renovated shortly and that as “we can’t do work of this nature with such noise”, we’ll have to have an office change. It will be the second, which is a completely cuntified state of affairs – but there is an upside to it. The building work, which is starting in two or three weeks or so, is due to last for 12 weeks. Our current therapy contract is due to end on 26 November which would mean only two more sessions, which from my point of view simply cannot happen or I’ll be straight into the bin (or the ground – who’s discriminating). But C said something like, “so we’ll have to move out during that time…”, which is an excellent statement, as it strongly infers a continuation of treatment for the foreseeable future. Certainly, he once told me before that there would be a minimum of a four-week preparation period prior to any cessation of therapy, and very clearly that has not come to pass, but whatever way he phrased his words it sounded like he still expects to see me back in the current office when the work is over, so that’s a decent extension to the current timeframe.

What I expected to be a reasonably short post has turned into my usual 2,800 word bullshit. I see, reading back, a lot of pontificating about words and language. More avoidance?! Anyway, I’m going to bed. Goodnight, dearest readers.

* I’ll blog on this in a future post. Suffice to say, I saw MMcF’s husband the other week and he really is a pathetic shadow of his former self which, for the benefit of his great-grandchildren at least, is a most beneficial state of affairs.

Remonstrations with C – Week 29

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Then yes, exactly.”

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

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

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

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

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

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

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

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

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

But it could all change tomorrow…

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?!

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.

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…

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.

Attack, Defend, Submit – The Behaviour of a Lunatic

I have noticed a pattern of behaviour in myself of late that follows the rules of attacking someone (verbally), defending myself for said attack and/or against their perceived attack on me and then becoming submissive to said person in the form of apology or begging them not to desert me.  This was evident to some extent in my session last week with C, but it became increasingly evident over the weekend with A.

Indeed, although I would not have considered it especially indicative of my mentalism in the past, I do have a history of doing this with him.  Not with tremendous frequency, I hope, but probably enough to be unsettling.  Sometimes an argument is justified, but oftentimes I am just enacting my viciousness.

The weekend’s example of it was the first time that I’ve wondered was this a manifestation of being mad, because (a) it is consistent with my transferential behaviour last week towards C and (b) it seems to be quite typical stylistically of a borderline individual, which as you know was a recent diagnosis applied to me.

I’d be lying if I told you I could remember what happened.  The fight took place after a heavy night in the pub, so I’m hoping that’s the reason for my forgetting it, but the next morning when A told me what had happened I worked myself into a frenzied panic and really don’t remember that either, and that can’t have been alcohol induced.

So apparently, on Saturday night, I launched into a vituperation against A on the way back from the pub to our hotel (we were in Dublin for a gig on Sunday night) because it is my perception that he hates C.  I have tried to defend C to A in the past as A feels he has not done anything useful at all in four months of being my therapist.  I have tried to explain that in psychotherapeutic terms this really isn’t a long time, but A responds by saying that C doesn’t even really have a clear plan.  The thing is, I think in some ways C actually does (insofar as my rambling will let him implement it), but I think he won’t share it with me in case I try and analyse it, which is exactly what would happen.  This is just conjecture though; I may be completely wrong.

Whatever the case, the issues in my head are so long-term and deep-seated that I cannot imagine therapy in the short-term (which hitherto this is) would work.  C needs to dig deep, and has to fight my defences, because it’s not as simple as just telling your mind you need to start talking about a, b or c.  I don’t want to think about what he wants me to think about, so he will have to press me over time.

So anyway, I have tried to explain this to A, but he seems dubious.  This must’ve been in the back of my mind somewhere as it all came out in this rant.  A doesn’t remember the specifics either, but basically I started slagging him for his apparent misunderstanding of psychotherapy, then went on to bitterly defend both C and myself.  Apparently then I suggested going to the hotel bar but A had enough sense to make me go to bed.  Epic fail.

Sunday was a really weird day.  I woke up and joked to A about not being able to remember coming home.  He seemed slightly uncomfortable so I probed him on what had happened and he told me.  I don’t remember much about the next hour or so, but I did apologise over and over again, accuse myself of being a failure, I blubbed and blubbed and blubbed, apologised some more, wept some more, panicked, paced and had the usual breathing issues.  A kept telling me it was OK, that he accepted my apologies and that I should forget it (well, I had forgotten it – but you know what I mean).  He kept trying to hug me and tried to calm down but there was no consoling me.

The only thing of which I have a clear memory was eventually taking two Valium before leaving the hotel.  Walking down the road, I felt some of the really unpleasant and hardcore-extreme depersonalisation and derealisation that many people have reported with Valium, but which has never been the case for me when I have taken it in the past (my depersonalisation and derealisation are not caused by Valium ((I take it very rarely, yet they are fairly frequent)) and while certainly ‘unpleasant’ in their own way they are normally not of the malevolent nature that this was).  I felt so far out of my own body and out of this world that wasn’t in any control of my physical or mental self, and as such could quite easily have fallen under a tram or a car.  Frankly I would have welcomed that outcome at the time.

Anyhow, in this weird daze I still somehow managed to make it to the pub – yes, more booze, but in fairness it was a rock bar and we were going to a rock gig.  It’s dark and underground, and was fairly quiet at the time with good music by AC/DC (the band of that evening), and my mood instantly improved.  In fact, for the rest of the afternoon I would say I was in a state of mild mania.  At this point A banned me from using the word ‘fail’ for the rest of the day, as he believes my constant use of the word in relation to myself perpetuates my negative self-image.  I was surprised by how difficult this proved to be.  Even in a good mood, at every turn I wanted to self-deprecate, and that is my current term of choice to do so.  This proved his point, I think.

We then got the bus to the concert which was at a venue about 25 miles south of Dublin.  Initially the bus journey was fine, but it became increasingly evident that the vehicle was full of knobs.  Being a veteran of rock gigs in Dublin (and elsewhere), this came as a surprise to me.  You don’t normally get spidey types going to them, but there was a high proportion of them evidently going to this one.  This was annoying, but the expected journey time was only 45 minutes, so it could be lived with.

But then we hit traffic – a massive, impenetrable backlog, caused by the gig – and without bothering to get into unnecessarily details, after an hour we had maybe moved 40 feet or so.  Gradually, people got more and more concerned that we’d miss the gig and eventually there was a mass exodus of gig-goers from all the buses in front, so we too ended up following them on foot up the hard shoulder of the motorway, onto the relevant slip road, and onwards.  It was approximated by our bus driver that the journey would take about an hour (ha!).  Better than waiting on the bus, we thought.

At first there was a real air of camaraderie.  The spides were less evident and I was beginning to think that maybe our bus had just been anomalous in that regard.  People were all in good humour, and it was kind of infectious.  The sheer absurdity of the situation gave it a novel atmosphere.

After the first couple of miles, though, the comicality began to dwindle a little.  More drunken spides and millbags were beginning to surface, openly pissing on the streets but even worse than that throwing their litter (booze cans, mostly) into peoples’ gardens or into hedges.  Even worse again, from my selfish perspective, was that they were behind me, in front of me, and closing in on me – and making a fuck of a lot of noise.

I began to lose it after about an hour and a half, and the racing thoughts and disjointed comments of an agitated depression and panic set in.  I remember begging A to make the people go away or at least to protect me from them.  But there was nothing he could do, so on we struggled.

After about two hours of walking, it started to rain.  At that point, I was grateful for it, as I was so warm and dirty from the long walk.  Eventually we were picked up by another bus (our own never passed us, so must have still been well behind us) and got, eventually, to the venue, two and a half hours after leaving our bus and well over three since leaving Dublin.

But it was now very cold and very wet, and I was suicidally depressed.  I went to the first stall I saw selling water, bought some and downed another two Valium.  A insisted on finding the bar, though all I wanted to do was go home.  I’d have happily paid a fortune for a taxi, but I was conscious that A had spent a lot of money on taking me to the gig so I held back and went in search of the bar with him (he is partially sighted – completely blind in one eye, in fact – so wouldn’t have easily found it alone, and in any case I could not have been left alone or I would probably have either panicked or killed myself somehow).

Anyhow, the bar – fuck me.  I have never seen a crowd like it. I was hemmed in on all sides and movement was impossible.  It was horrible.  I turned round (insofar as was possible) and asked A if this was really necessary, but he didn’t hear me.  The odd thing was, though, I didn’t have a complete panic attack, I was “just” extremely disconcerted.  That might partly have been a (paradoxical) self-preservation thing, because if I’d panicked there and then I might well have died as there would have been no way for first aiders to even know what was going on, never mind get access to me.  But in reality, it was probably simply the lovely Valium, which in this case hadn’t caused any significant depersonalisation or derealisation.

To cut a long story short (or as short as my verbosity allows), we eventually got to the bar and after much trouble got a place to stand near a random steel wall which was used as a make-shift pisser by a row of men.  I observed the wall with interest (not in the pissing blokes, honest!), asking – aloud at one point – if I banged my head off it enough times, would I be able to kill myself.  A said that I probably would, but wouldn’t let me try.  Eventually I suggested we go and look at band T-shirts.  I was so wet and utterly fucking freezing that I could hardly hold anything, so I was hoping to buy something to warm myself up and protect my body from further rain and cold.

And at that point, my mood suddenly changed from one of suicidal desolation to a return of the good humour, hypomanic state of earlier.  For no reason that I could discern.  None at all.  The most bizarre thing of all was that A’s pretty poor mood changed simultaneously with mine.

He blamed beer.  I blamed Diazepam.  Who cares?  Whatever it was, it meant we at least enjoyed it when AC/DC came on.

Back on the attack-defend-submit theme, on Thursday after C my ma made me visit Aunt of Boredom with her (MMcC, not GA ((Aunt of Evil)) or MMcF ((Aunt of Oppression))).  MMcC was oh-so reassuring and helpful about my being insane by openly asking me what traumatic events had occurred to make me the way I am?  How was I meant to reply to that?  “Well, aside from the fact that your brother-in-law raped me, which I’ve been trying to hide, there was the hardcore effects of how V treated your sister, the effects of which I’ve been trying to hide, but even though she’s sitting right here, that’s OK, I’ll just tell you.”

Needless to say, I eventually responded by saying, “I don’t feel at liberty to say.”  She then effectively denied the very existence of BPD and bipolar II.

Are all my extended family complete cunts?

Anyhow, that’s all an aside.  As we were driving home, the sun was shining in front of the car and I suddenly became convinced that it was watching me and wanting me to die and was out to get me.  Hmm.  Rational.  Not psychotic or anything, SI.

Anyhow, I was telling A about this over the weekend, and although at first he didn’t believe me, when he realised I was serious, he kept trying to rationalise the situation by explaining how this was scientifically impossible etc.  Yet again, I don’t remember arguing him with him over this, but apparently I did.  I argued that it was, in fact, entirely possible that the sun could see me and why couldn’t he just understand that?  Why not?!  It was a perfectly rational belief, so where did he get off trying to convince me otherwise?!  Attack-defend.

When he told me what I had said later, I did of course apologise and submit.

My latest irrational belief, less irrational than the sun thing admittedly but still not based on any evidence, is that C will tell me in the morning that he is resigning from his present position and will be leaving me in a few weeks.  If that proves to be the case no doubt I’ll attack him, defend myself for attacking him, then submit to him and beg him not to leave me.  If the irrational belief that C is leaving is in fact realised I will have to kill myself.  I cannot see any other viable another option of not collapsing into permanent madness.  I so hope I am wrong.

Have the threads of sanity to which I was so frailly but desperately clinging finally snapped?

Work Jerks, Shrinks and Iffy Psychotherapy

One of Dr C‘s minions phoned yesterday to report that an appointment has been made for me this Friday at 9.30am.

Aside from being frightened of nasty Dr C and the possibility of yet another panel interview-esque meeting with her and Dr N, I am kind of angry.  I was referred to a psychiatrist in January and didn’t finally see one until the end of May, and of course regular readers will remember that they fucked up my entire referral until C got involved.  Why, then, do they think it’s reasonable for them to click their fingers and expect me to come running?

Meh.  I suppose I ought to be grateful that they are seeing me again relatively soon after the last appointment.  C stated to me last week that he thought that Dr C was going to experiment with new medications for me, so hopefully that will come on Friday.  The thing is, due to the set-up of the first meeting with Dr C and Dr N, I didn’t get to talk to either of them in the detail I’d have liked.  In fact, after 14 weeks of psychotherapy, I haven’t even discussed everything I’d like to have done with C.

Given that circumstance, I am not sure how Dr C can accurately diagnose my condition on Friday and as such I am not sure how she can adequately prescribe appropriate medication.  Perhaps she just wants to talk to me in more detail about my symptoms?  Or maybe she feels her conversation with C has been adequate.  I don’t know; I’ll try not to pre-empt it I suppose.  Regardless of the fact I don’t like the woman, she is the consultant psychiatrist and for now I’ll try and assume that as such she knows what she’s doing.  Like it’s that simple.

And of course this is Wednesday evening, meaning that it is C tomorrow morning.  I forgot to mention last week that at one point I broke down in tears in front of him as I thought I had offended him (it was paranoia – logically speaking I very much doubt I did offend him, but hey, logic loves to fail me).  I thought I’d offended him because of something very minor., so minor that I don’t even remember what it was  Now I have to go in tomorrow and tell him what a complete pile of bovine manure I believe this DBT nonsense to be.  It’s not completely invalid I guess, but most of it is.  My worry is that when he first introduced me to it, C was so enthusiastic about it.  I’m concerned about raining on his parade.  He is, after all, only trying to help.

Am I just a cynical wankstain who needs to get over herself?  I want to want to give this a try, but just reading the stuff makes me angry.  I want to go to Marsha Linehan‘s house and firebomb it (Disclaimer to the thought police / government: this is deliberate hyperbole again.  I am not actually desirious of firebombing Linehan’s house; if nothing else there is the logistical problem that she is based in, I think, Seattle and I am in Northern Ireland).

Seriously, I have no idea what to say to C.  I am paranoid about upsetting him and having him abandon me.  Then there is the issue of his leave in July – I wouldn’t possibly be panicking already about that, now would I?  Oh wait, affirmative to that, I am.  I am fucking shitting myself.

What has become of me?  Why am I so intensely reliant on one individual that I don’t even really know?  How have I become a dolescum and how have I let my mind atrophy for the best part of a year by sitting about the house all day wallowing in my self-indulgent and pointless despair?

Speaking of dolescum status, today I have written to the office of much evil and malevolence asking for a copy of my contract of employment.  I revisited the CAB last week after my success in my application for DLA and lamented the fact that I was probably about to be fired.  Now, I have two very close contacts that are intimately familiar with employment law (one writes the laws in question themselves, another writes about them), and it is agreed that eventually evil work will probably be well within their rights to dismiss me.  The woman at the CAB, however, stated that in “some” cases unless they have a clause about dismissal on the grounds of absence written into the contract, they cannot dismiss you.

I have therefore written to nice personnel woman, not Horse, to ask for said contract.  Of course, like everything in my life, this is not as simple as it sounds.  I was initially employed on a part-time basis in what is now my assistant’s role.  I signed a contract for this.  When I was successful in my application to the current position, I did not receive a new contract.  There is not likely to have been a great deal of differences in the two, I suppose, and in any case I am advised that a contract for the more recent job would have been implicit between the organisation and me given that I was, for some time, undertaking the duties of the post and that they were letting me.  Nevertheless, I do wonder if this leaves room for a loophole?

Anyhow, I’ve written to nice personnel woman asking for the document and being overly sweet and friendly to her.  The reason for my uncharacteristic charm is twofold: one, she is a genuinely lovely woman and deserves people to be nice to her and two, I am fairly certain the letter will be passed to Horsey anyway, who will notice the significant disparity between how I communicate with her and how I communicate with the nice woman.  I want her to know, without my being unprofessional, or overtly nasty, that I dislike her.  Is that really bitchy?  Well, of course I already know the answer – of course it is.  But that’s kind of the point 😉

After the Horse asking me to get straight back to her regarding the occupational health report, I note with interest that she is not getting straight back to me.  I made subtle (but obviously achingly polite) reference to this in the letter to nice woman.

A is of the view that I probably will lose my job and that thereafter I should remain off work for about a year.  He thinks that I should wait not just until I have made an adequate recovery from my current episode, but right until I am capable of completely coping with everything life throws at me.  The rationale is sound, but the problem is that, even with psychotherapy and medication, I am not sure his dream of me being able to completely cope with life will ever be entirely realised.

On another note, thank you all for the many responses to Monday’s post.  In two days it has become one of the most popular on this blog.  Perhaps I should be a full-time psycho-philosopher?  Is there a career ladder in that?!

Back tomorrow with C post-mortem.  I will force myself to do it tomorrow not next week this time!

Mindful or Mindless? DBT and C: Week 14

I started writing the below on Thursday straight after C, but completely lost momentum at the bit where I was talking about telling C about my iPhone mood tracking from Tuesday.  I intended to write more on Friday, but that most horrible and frightening of things, real life, interfered.

On Thursday night, I received word that a good friend of mine, CVM, was seriously ill.  She had been in hospital for a few weeks but as I understand it her illness was not considered serious to the point where she was felt to be in significant danger.  Horrifyingly, though, on Thursday her condition deteriorated significantly; she was critically ill and in ITU.  Her family genuinely feared for her life.  I will not go into details as I was asked not to, and even though this is for the most part an anonymous blog, I still have no desire to betray confidences.

Mercifully, she has pulled through.  The last few days have been really hideous for me cos of this, so I cannot imagine how hard it must have been for her poor, lovely family.  I feel privileged that they kept me in the loop throughout CVM’s most serious illness, and am so very thankful that she is going to be OK.  She reads this blog fairly avidly (or at least did when she was not imprisoned in hospital) so I will not disappoint her by failing to put up the latest entry, so here we go…

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Thursday has come to equal only one thing for me. *Drum Roll* — It’s the Cult of C! Yay!

Actually I am not that happy with Thursday’s session.  As you will know I wasn’t that happy with last week’s, but that was my fault.  On Thursday past I was annoyed with C, kind of, but of course then that lends itself to my being annoyed with myself because I am too cynical and should give what he is trying to do a chance.

I was busy on Thursday and of course more time has now elapsed so I am not sure that I will remember the meeting in as much detail as I would like, but it seemed to go on for an inordinately long time.  It’s the first time I’ve felt that; usually the 50 minutes seems to go by so quickly.

As usual he wanted me to commence but I couldn’t think of anything to say to the man so I let him guide me.  He started by discussing the DBT material.  Although I find some of this useful in some ways I am still struggling to come to terms with it as an adequate method of psychotherapy.  In fairness, C is keen not to abandon our psychodynamic-esque discussions, but he feels – rightly – that I need practical help too.  I am just questioning whether or not this is the most appropriate form of practical assistance for me.

In any case, he said he thought the ‘distraction plan’ I had written was “very good” and that I had obviously put a lot of work into it.  I felt validated by this and couldn’t help a slightly flattered smile, though I hope he didn’t see it.  This is absolutely pathetic; regardless of my reliance on C, I do not want to be in the position where I need his vindication for everything I do, especially not some cack that I could have quite easily have come up with myself had I bothered to take the time.  Anyway, though, apparently that is the next thing.  I want C’s endorsement.  Brilliant.

We discussed some of the points briefly, then he asked me if I felt I could actually put them into practice when I need distraction or when I go completely mental.

I postulated the belief that it was all well and good to sit in a rational and comparatively mellow frame of mind and write the stuff out, but that it perhaps wasn’t so easy when one actually went nuts.  I told him about Tuesday night, about how depressed and angry I’d been watching the European election results (in particular the horrific news about the evil BNP‘s relative success) and how pathetically hyper and manic I’d become watching the Great Britain council election coverage, something that does not even affect me directly at all.

C didn’t seem overly concerned about my histrionics regarding the political matters.  In fact he seemed surprised when I berated myself for becoming (positively) manic after watching the council elections.  Perhaps he is a politics junkie-nerd too.

He did ask me to elaborate on Tuesday night, however; oddly, some part of me was reluctant to discuss this with him.  Is this yet more protection or was I simply embarrassed?  Whatever the case, I forced myself to read out to him the same stuff I wrote here on Wednesday (the edited version that didn’t mention him or Dr C) that was garnered from the mood tracker on my phone.  A long discussion ensued, much of which I don’t remember.

C said it was as if I was talking about someone else.  I was initially confused as to whether he meant the terminology I had employed when I wrote about my mania on the phone, or whether he was referring to my tone of voice when reading it back to him.  When I asked for clarification, I found his answer ambiguous, so simply said that when I read the stuff back to myself I had found it unpleasant.

“Definitely!” exclaimed C, very emphatically.  I was pleased at the time that he was taking an interest, but now I am worried by the passion he put into the statement.  Have I contaminated his mind with mine?

I don’t really remember what happened next (I am writing this on Sunday) but I do remember him asking me how I felt about not sleeping.  I said I was used to it, that unless I had sleepers I almost never slept.  I told him that before I went off sick from work, I would have been awake all night, then got up and quite adequately fulfilled the duties of my job.  I said, in passing, “It’s not a big issue.  I’m used to it; I’m a serial insomniac.”

I don’t think it was my imagination; I am pretty certain that his eyebrow quivered ever so slightly at the use of he term ‘serial insomniac’.  Does he read this blog?  *WAVES MANIACALLY* HI C!  WELCOME!!!!! Seriously, it was almost certainly a coincidence.  But it’s not impossible; he does have a list of my mental fuckupperies that he knows was basically copied straight from this website – all he’d need to do is Google some of the specific terms therein.  However, this is paranoia on my part, as ever.  C has better things to do with his time.  I am his client (Or am I his ‘patient’?  Or, most annoyingly, ‘service user’?  I fucking hate that one), not his life.

Obviously he did quiz me on what had caused my going completely doolally.  If I wasn’t upset about the insomnia, what was annoying me?  The answer was simply nothing.  I just went mental.  There was no reason, or at least there wasn’t consciously.  I think I need to ask Dr C, my psychiatrist (more on her in a minute), for some anti-psychotics (if the old bag will give them to me that is) – it’s bad enough to end up in this state for a clear reason, but to experience it with no evident rationale whatsoever is very disturbing.  Though I suppose I should be used to it by now.

I’m finding this really hard to write.  I don’t remember what happened next with C.  I do remember we talked about the Tuesday night episode for some time, but I don’t recall any of the content.  I really should force myself to write up my psychotherapy sessions straight after they take place, but I just couldn’t do it for some reason on Thursday morning.  I think it was probably simply exhaustion from yet another week of insomnia.

So, given that I can’t remember any of that crap, let’s move on.  The next things I do remember were what made me angry.

He asked was I able to ground myself in the moment when I go mad and I laughed in his face as, self-evidently, I am not.  I said that often when I go mental I pace back and forth and bang my head off the wall, although I didn’t on Tuesday night as I didn’t get out of bed (I’m such a lazy fuck that even going nuts can’t make me rise from my pit).  I said that whilst the banging of my head on stuff was partly about causing myself deliberate pain, it was in many ways to achieve reorientation in the ‘here and now’.

C started into a monologue about ways to reorientate oneself (or “ground” oneself, as he put it) in a non-destructive way.  I have already spoken about stuff like using ice cubes instead of cutting as a way to feel pain, but this stuff was less tangible and much more airy-fairy.

He made me focus on the sounds I could hear – the clock, cars and birds outside, the fan on his PC.  He asked me to focus on the sound of his voice too.  I interjected at this point by asking if he was trying to hypnotise me.

He took this remark as evidence of my cynicism about what he was doing, but asked me to go along with it anyway.  I did as I was told.  I don’t know…I had mixed views.  On the one hand, focusing on his soft, gentle voice was rather hypnotic.  But focusing on stuff like the clock / car is all I can do when I’m on my own, and I really wonder if that is enough to abate the madness when it comes.

C asked what I had thought of the excercise.  I said that although his voice had a hypnotic quality, I largely thought the entire thing was “terribly silly”.  He accepted that but asked me to bear with him.  I heard myself acquiescing to this.

The second thing he wanted to show me was even worse.  It was a breathing exercise.  What a pile of patronising wank!  I already know that you are supposed to try and control your breathing when you are in a panic!  Sweet Jesus jumping Christ!

C went on demonstrate the technique.  I watched and listened in horror as he closed his eyes and exhaled heavily.  It seemed kind of indecent to me, and I almost felt slightly violated.  (I know, I know.  Only a diseased mind like mine could turn a simple breathing exercise into something dirty).

He asked me then to try it with him.  Quite clearly he detected my reluctance to do so.  He said, “you might feel a bit daft doing this.”

“Indeed,” I replied.  “I feel like a twat just thinking about it.”

He muttered something about understanding that, but asked me to indulge him.  I rolled my eyes and followed his lead.

It amazes me that some apparently well-established and regarded professor of psychology, Marsha Linehan, came up with this utter nonsense.  I could have come up with this horsebollocks whilst decomposed, dead and chained to a fucking crane.  It is as simplistic as taking a fucking piss in a fucking nappy.

To be fair, I can appreciate that advanced meditative techniques can be hard to master and potentially helpful for some people and for some problems, but really.  Breathing in through my nose and out through my mouth is hardly a fucking revelation in psychotherapeutic treatment, is it?

I was completely mortified throughout the entire ‘exercise’ and even if the bloody thing did have any value in it, I wouldn’t have been able to realise it as my discomfort was so strong and palpable.

With this shite completed, thankfully, C said that he recognised I was very sceptical about it (no shit, Sherlock).  However, intriguingly, he also stated that he felt part of me was interested in engaging with DBT and its inherent mindfulness.

Is this true?  I agree that I need practical help as well as therapy that uncovers the roots of my problems.  I am just not sure that this is the type of practical therapy into which I can buy.

A and I have a friend, G, who has a degree in psychology (though unfortunately he did not pursue the discipline professionally, which is a shame as he would have been a fabulous psychotherapist) and he is probably the most intelligent person I have ever met (and I am lucky enough to have met a number of brainiacs in the course of my life).  G is extraordinarily knowledgeable of Eastern philosophies and religions, and when combined with his knowlege of psychology, he is the obvious candidate to speak to about all this.  A asked him what he thought of DBT and mindfulness, and G responded saying that it was a very effective tool for some, but certainly not others.  We are meeting him next Saturday night to analyse these matters.  G is the most skilled debater I have ever known, and is remarkably persuasive.  If he thinks DBT actually has value, then there is a chance he might be able to make me see that.  At present, I have to admit that, with regret, C is not doing so.

In any event, C gave me the photocopies of the next chapter of the DBT book, which summarised the stupid exercises we’d been doing.  I read it when I got home on Thursday morning and fuck me.  If the session with C was irritating at times, this was infuriating.

Aside from its patronising tone and its espousal of the aforementioned breathing/grounding exercises, there is this pile of shit called Radical Acceptance.  Now, in fairness, what I was reading is a very introductory discussion of this concept, but I felt that my intelligence had been insulted by it.  Apparently, you have to tell yourself that “you can’t change the past” or “everything leads up to now” or “it’s a waste of time to fight what’s already occurred” or, my personal non-favourite, “the present moment is perfect, even if I don’t like what’s happening.”

The latter excepted, I already tell myself these things.  I know I cannot change the past.  I don’t fucking want to change the past.  I do not have an IQ of -1,000,000.   THIS STUFF IS FUCKING SHIT.

It goes on to ask you to formulate a radical acceptance plan.  For example, read a controversial news story without being judgemental, or wait in traffic jams without becoming irate.  Yes, cos it’s that easy, fuckstains.

It then asks you to come up with your own ideas of non-judgemental acceptance.  I have written the following:

• Try to re-read this chapter without getting annoyed
• Try not to self-criticise re: being irate about this chapter

This sounds like sarcasm, but I mean it in all sincerity.  If I can manage to read the chapter again without wanting to scream, the ideas may have some very small chance of having validity.

As well as this, the doctrine of radical acceptance as I understood it suggests that you have to lose part of your personality by deliberately choosing not to have opinions.  If you stop being judgmental, don’t you cease to opine?  If you cease to opine, do you not lose part of the very essence of your humanity?

Am I to sit here and say, “no problem that the economy is fucked.  I shall not make a judgment on that.  It’s OK that Ahmadinejad rigged the Iranian election and treats his ‘subjects’ as he does.  I shall not judge that.  Eastenders is not a programme that I despise.  It exists and that’s all.  I do not judge it.  So Hitler killed millions of Jews, gay, disabled and non-Aryan people.  I’m not going to judge him for that.  I accept it all.  I can do nothing about it and therefore it is all fine.”

Fucking complete toss!  Sorry, but I’m raging that our economy is cunted!  Ahmadinejad is a fucking twat.  Eastenders defines manure.  Hitler was murderous fucking maniac.  This is what I think and I don’t give a flying fuck if Linehan, or McKay, Wood or Brantley (authors of the workbook in question) think I am being cynical, snide or otherwise cuntish for it (but of course they don’t, do they?  Oh nooooooo!  They are all perfect and non-fucking-judgmental, so they have no opinion on my opinions).

Aside from all the annoying concepts, the actual terminology and tone of the fucking book is as condescending as nursery school – in fact, nursery school probably assumes its “consumers” have more fucking wit than this book does.  I think it thinks it is talking to fucking goldfish.  I have written infuriated annotations all over it.

I don’t want to offend C, but I have to be honest with him.  There may be some stuff that is useful in DBT, but one thing I cannot abide is being patronised, and as such at present this book is merely serving to create negativity rather than resolve it.  Perhaps as it becomes more advanced, it assumes more intellectual prowess, so I suppose I will allow him to continue with it for now.  But it would seriously need to improve its tone and writing-style for me to significantly re-evaluate my opinion of it.

C does know that I have considerable reservations, and was keen to remind me that this is still only a small part of our therapy.  He does strongly feel that we need to continue with the more freeform psychodynamic-ish stuff, but recognises that this will not solve my acute problems right here and right now.  As such some practical therapy is necessary.  I do agree, but I am dubious about the form that that is presently taking.

In any event, before I left we discussed the psychiatrist, Dr C.  C thinks that she is indeed willing to explore alternative medications with me, which is good as my time on a lower dosage of Citalopram (as instructed by her) has proven that it was no use whatsoever.  C also seemed to think that perhaps she will actually give a diagnosis (or diagnoses), which had previously been in doubt.  I told him how glad I was about this, as I really, really want to know what this/these illness(es) is/are.

Before he had the chance to butt in, I pre-empted his commentary and tried to enunciate why a diagnosis is important to me.  I said I was unlikely to become fixated with a name for my mentalism as I don’t want to engage in labelling theory, nor did I wish to be defined by a nice shiny tag.  Nevertheless, I said, I felt that I already am defined as an individual by being mental, and that a name for it would help me come to terms with that.

“In the absence of an official diagnosis, I am making them myself,” I told him.  “I don’t think that’s healthy, do you?”

“No,” he conceded.  “I actually think you have quite a sensible approach to this; being fixated with a label is obviously a negative thing, so your belief that you would not be consumed by that is encouraging.”

He went on to remind me that as a clinical psychologist, he was unqualified to diagnose (I fucking know, C!), but said that his department did have some questionaires which can indicate what your illness might be.  Initially my interest was piqued by this, but then he stated that if I wanted to explore this, I would need to do so with one of his colleagues.  This put me off.  I have never met any of C’s collegues but I hate and fear them anyway.  He is the only one I trust.  Though thinking about it, would they be about when C is skiving off work in July?  If so, they might be better than nothing, because I will collapse in a mess without him.

Ho-hum.  I suppose my next move is just to try some of this mindful wank and see where we end up.  I do look forward to G’s take on it.

Sorry this has been such a shite post.  My memory is skewed.  I willhave to force myself to write up the C sessions immeadiately after they take place in the future.