A Time of Not Being Suicidal?

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

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

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

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

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

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

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

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

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

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

Until It Sleeps

The iPod has been acting as a mindreader again.

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

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

Until It Sleeps

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

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

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

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

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

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

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

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

I don’t want it, I don’t want it…

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

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

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

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

Remonstrations with C – Week 29

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Then yes, exactly.”

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

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

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

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

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

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

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

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

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

But it could all change tomorrow…

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?!

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Things are Bad

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

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

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

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

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

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

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

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

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

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

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

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

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

Sorry for whinging.

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

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

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Tuesday: The Psychiatrist

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Handbags at dawn, dearest readers!

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

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

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

Wednesday: The General Practitioner

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

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

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

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

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

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

Thursday: The Clinical Psychologist

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“If I can,” he responded.

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

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

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

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

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

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

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

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

In general, that is.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Friday: The Flight

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

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

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

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

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

Meh

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

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

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

Today’s Psychiatric Appointment

Saw a new Senior House Officer, Dr A, who listened to how things had been and asked me to explain various specifics. After 20 minutes, she summarised things – missing a lot of points in my view, but I couldn’t be arsed arguing – then went to see Dr C. Dr A said either she or Dr C would come back. Whilst in the waiting room, I saw Dr C calling someone else. As I am scared of her, I was in part pleased she wasn’t going to see me – but I was also outraged that she was abdicating responsibility again.

However, the people she’d be seeing left before anyone came to get me again, so it looked like she might get involved. Alas, Dr A turned up again. After I’d been waiting another half hour.

She said that there had been a “secretarial error” and that Dr C would need to see me, but couldn’t today, how unfortunate, she’d send me out an appointment as soon as possible, things must remain as they are for now, Dr A isn’t experienced enough to deal with a case like mine, Dr C needs to speak to C (um, didn’t you have three months to do that, luv?), must away now SI, we’ll be in touch soon. Byeeeee!

I could go into detail about my response to Dr A, and I will, but for now I think how I feel about the whole thing and how I think they feel about me and indeed how I feel about me is best expressed by a graphic rather than words. It ‘speaks’ louder.

My mother had to phone the GP’s office to get me Valium, as my main ‘stash’ is at A’s. Hey ho, ho fucking hum.

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…

Martyrdom in the Key of C: Week 21

So, yesterday saw C’s much anticipated return from his fortnight’s leave. As described here on Wednesday, I was pretty mental over the weekend period, but other than that, my madness was, by its own standards, fairly low-level during C’s absence. I had been surprised by this, thinking I’d completely lose the plot without him, but although I spent most of the time feeling really low, with (up until Thursday) occasional mood swings, things generally weren’t as bad as they could have been.

To this end, I was actually incredibly anxious about seeing C again. As stated in Wednesday’s post, I became irrationally convinced that he’d want nothing to do with me due to BPD, but besides that, I was just generally scared of seeing him. I am not sure why; I think it’s because I’ve found psychotherapy so difficult hitherto that a break from it was more welcome than I had anticipated, even though on previous breaks I’ve gone utterly doolally. Maybe it’s simply the fact that he had prepared me well in advance for it. I don’t know. Whatever the case, I was very nervous yesterday morning.

Anyway, I arrived laughably early (I was coming from A’s rather than Mum’s, and overestimated the traffic I’d encounter); in fact, before I suspect C even arrived. I started worrying that he’d see me sitting in the car park like some pathetic little girl hoping to catch a glimpse of him. So I left and went and hid in the car park of a shop local to the hospital, amusing myself with Twitter and a text message to CVM.

Anyway, I went back, and eventually he came out and got me. I asked how his break had been. He screwed up his face in uncertainty, and said, “it was alright.” I was still coughing and spluttering from my flu-ish illness and when I explained that I had been ill to C, he said that it made two of us, and that he was just recovering himself.

This is absolutely horrible, but I was actually inwardly satisfied that he hadn’t really enjoyed his break, and indeed that he’d been sick for part of it. I did state towards the end of this post that I hoped he’d have non-serious swine flu. Bad SI. Bad bad bad. I see it as his commupence for going and abandoning me for three weeks, just at the time I needed him most (in light, at the time of his leaving, of Dr C’s assholery).

Do I really think this? Horrifically, part of me does, yes. Rationally, of course C is entitled to his leave, and if he is abandoning me, then I am hardly the only one, bring as psychotherapy is his 40-hour-a-week profession, not 50-minutes-a-week-devoted-to-SI. Of course, I make a point of never acknowledging to myself that he has other clients, as I would find the idea of that hard to cope with. Meh. Transference and reliance suck.

Anyway, he asked me where I wanted to start the proper discussion, and I shrugged and looked blankly into space. He presented the perennial question, “how do you feel now in this moment?” and I told him that I was anxious about being there. To my surprise, he didn’t for once ask why this was, but just nodded thoughtfully for a minute. Then he asked how I had felt about the discussion we had regarding the fabulously fool-proof definitely-guaranteed-to-prevent-suicide-super-D plan we had supposedly formulated together when I’d last seen him.

I had told him at the time, and I repeated it yesterday, that the problem I had with this was that by the time I’d become distressed enough to need to do these things, I was too distressed to actually be able to actually do them. I said, “we did end up in Casualty, as it happens.”

I admit that the statement was deliberately provocative, but it was true, wasn’t it? (See Wednesday’s post – in fact, all events I will refer to here, unless otherwise linked, probably relate back to Wednesday’s post). We did end up in Casualty. C shifted in his chair in a disconcerted fashio and I relented and explained that we were not there because of me, but A.

I related the incident to him. In fact, I quoted from this blog when describing A’s injury, telling C that it was like “…a gaping mouth vomiting up blood.” C laughed, and told me that that was “very descriptive”. I said that I’d missed out on a career as a lyricist, and he laughed again.

Anyhow, I told him about my resourcefulness that night, but that I then had what A had called a “mini-PTSD” afterwards. I told him how I didn’t remember it clearly, as if I was outside myself, like seeing it take place through one of those two way mirrors one sees on cop dramas, and how I had believed until the next day that it was a dream. I was reluctant to use the word “disassociation” as C has pulled me up on using psychiatric language in the past. I can’t see what the problem is personally; surely it’s good to educate yourself about your conditions? But anyway.

I went on to tell him about the metaphorical vice, as I had with A. (In fact, I referred him to a song by Morrissey, called Something is Squeezing My Skull). C probed me – gently, to be fair – on this, seeking a more specific explanation, but I ended up saying I couldn’t articulate it any better, and that I was sorry. He said that it was OK, and pointed out that here I was apologising to him again, as is often my unnecessary (in his view) wont.

I moved on to the social security saga, and this was when the session became somewhat confrontational.

I told him I wanted to appeal the decision made by the SSA wankers, but that I was concerned that I didn’t have the mental capacity to fight a battle with them. However, I complained, they get away with wank like this because they rely on people like me backing down over issues like this.

C was confused, which is unsurprising as the social security system in the UK is a convoluted, murky quagmire. He kept asking me what “work related activity” meant, and I kept telling him that I was as clueless as he was about it as the SSA told me fuck all. My rant about them was vicious, possibly even more so than the invective published here on Wednesday, though what I told him essentially consisted of the same material I wrote here.

At no point did he say this, but I got the impression he felt I was being unfair, both about the SSA themselves and towards those people who claim benefits to which they (in my admittedly subjective view) are not entitled.

I said that as I didn’t know what “work related activity” meant, I was concerned that it would involve a group of people, and that I would crack up. I said, “if they ask me to do something like that, I will do something…something bad.”

I ranted on for a while longer, though I don’t recall the specific content. Eventually he pulled me up on the above statement, asking what I meant.

For Christ’s sake, C. You and I both know you know exactly what I mean, so why ask stupid questions? Why is it necessary for me to articulate the actual words?

But in any case I did; I told him, as I had told Mum, that the SSA would be sorry when they were standing over my grave.

“But,” C said, “a lot of people get anxious going into a room with a group of people they don’t know.” He did not verbalise this, but the inference was very strongly “just go and fucking do it.”

Let me be diplomatic: I did not think at this point that I was getting a sympathetic hearing from C. Let me abandon diplomacy: I wanted to reach across the table, grab his glasses, and shove them down his fucking throat. I protested against his position, stating that whilst he was indubitably correct, most people did not seriously contemplate self-harm or even suicide over such a thing. Surely that is correct?

This is where he really enraged me. He said – he actually fucking said – “you idealise suicidal gestures here, seeing them as an act of revenge, seeing yourself as a figure of martyrdom for all oppressed by the social security system.”

Martyrdom! FUCKING MARTYRDOM! He actually accused me of having a martyrdom complex!!!

I was utterly astonished by this statement. So much so, that for once in my life, I was stunned into silence. He was still babbling on about something or other, but I couldn’t even hear him, never mind listen. Martyrdom! That was all I could here.

Eventually, when I was able to fucking speak again, I interrupted him and told him that I did not see myself as a martyr. I think I might have laughed incredulously at him.

I went on, stating that yes, there was a principle involved, but that I was no fucking martyr. Yes, it would be partly about revenge, I admitted, but it was mostly about desperation. No one ever listens, no one ever cares. There is no guarantee that topping myself, or trying to, would make anyone sit up and take notice, but one thing seems to be guaranteed – nothing else does.

Then I asked him what he knew about suicide anyway. He went to think about it but I didn’t let him answer and launched into a defence of the act of suicide (I have a post in the pipeline that will explore my position on this in more detail later).

“People like you assume that suicidal behaviour is the act of irrational and/or selfish people. Many people I’ve spoken to who are serious about it are perfectly rational, seeing it as the only viable option to put an end to an unpleasant situation, when other options have been exhausted. I didn’t ask to be born, just like you didn’t. If I didn’t like living in Northern Ireland, I would leave, and I wouldn’t be stopped. So why am I told I can’t leave another place I don’t want to be?”

I think he said something along the lines of me idealising the act of suicide again.

“No,” I spat, with measured but nonetheless evident contempt, “I am merely sick of society vilifying the act and those who engage in it when most of society will never understand the phenomenon properly.”

He looked at me for a few minutes, then averted his eyes to the floor. I have no idea what he was thinking, but I sensed, rightly or wrongly, deflation.

I felt a bit bad then. I had not at any point raised my voice to him or got up and paced, head-banged etc like I had felt almost compelled to do, but I did rant at him quite personally, about quite a controversial subject.

The thing is, I spend half of my time on this blog ranting about C. I make it sound like I hate him sometimes, and that all he ever does is frustrate me. Transference issues completely aside, the reality is I actually like him. He is intelligent and personable, and although he is a traditional blank canvas, he nevertheless conveys enough of his character, if not his personal life, that I do get a very strong sense of his personhood. I like him as a person, insofar as I know him, not just as my psychotherapist.

His role as my psychotherapist puts the poor sod in a different light for me though, and as such this is where transference comes in. There are days when I long to be with him and just sit with him, or even have him comfort me by putting his arm round me (and for all of you who still think I want to fuck him, can I just say that I do not mean it in that way). There are other days I hope to never see him again. There are days I am indifferent to him. There are days I detest him. There are days he frustrates me. There are days I am totally blown away by his ability to analyse me. There are days I wish I could just have a normal conversation and a bit of a laugh with him. Etc etc etc ad infinitum.

So poor C. He takes a lot from me, and one day I do hope to lose it properly so he can fully understand, or at least observe, my anger, my desperation, my complete and utter distress. And yet simultaneously I don’t want to thus lose it, as I have a burning need to protect him from it and, more selfishly, I would be mortified in the aftermath of such a breakdown.

In any case, I digress. To diffuse the atmosphere of tension, I told him about my mania – depression – mania – depression over the weekend, in particular that I was especially disturbed by the amnesia when I found myself curled up in the corner on Saturday night, not knowing how or why I got there.

I also said that I was horrified about more arguments with A, and although I don’t remember the causes, that I assumed I had started them.

“There’s a book,” I started, “I Hate You, Don’t Leave Me. Have you heard of it?”

“Yes,” he said, “though I haven’t read it. What’s it like?”

I briefly outlined my take on the book, but stated that the title was the only reason brought it up. “I don’t hate A, of course,” I told him, “but I sometimes behave like I do, then I freak out when I feel he is on the verge of abandoning me. I hate you. Don’t leave me.”

C nodded, and said that that was maybe why I had ended up as an amnesic lump curled up in a dark, lonely corner (my words). As A had walked off on me, I withdrew into myself, seeking comfort by rocking back and forth in the foetal position in a protective corner.

He was trying to explain what he thought of this, but got toungue-tied. He said, “I’m looking for the words here, but you’re looking at me in a way…” he trailed off.

I realised I was probably staring at him in a fixated, piercing fashion. As stated above, sometimes his analysis stuns me. Sometimes it’s like he’s a mind reader. In short, when he gets into the actual psychology of my situation, my intellectual interest is piqued, and my interest is focused solely on him and his subject, not me and my problems. This is something C has sought to avoid with me, as I stated here before (his words were, at out third meeting back in March, that we had to “be careful not to intellectualise matters, which would be an attractive situation for both of us”. For what it’s worth, I actually think I’d get a lot out of intellectualising things, but maybe not in the right way – he is keen to explore emotional bullshit, whereas of course I am not).

Anyhow, I apologised to C and turned my head markedly away from him. He then went to great pains to reassure me that it was OK to look at him, but I could only glance at him thereafter, as I feared unsettling him again.

But that was really it anyway. It wasn’t a productive session, but neither was it a complete waste of time; we’d had a gap of three weeks, and this meeting served to bring us back up to speed with each other.

And regarding martyrdom? On reflection, I think I took such utter and complete offence as he probably hit the nail right on the bloody head.

The Parting of the Ways – C: Week 20

For a variety of reasons I simply haven’t had the opportunity to blog about my most recent session with C to date, so, with it now being the septiversary of our last meeting, it seems appropriate to try and do it now before my memory of the meeting dwindles further.

Last week was weird, because for once he actually opened the conversation, rather than just fucking staring at me for 140,618 years, waiting with futility for me to express my thoughts. He wanted to know how I had coped the previous week without him, and what plans we were going to put in place in case (or rather when) I go batshit mad during his annual leave which will be ongoing until 20 August (might as well be 2079 to me right now for all the closer it seems).

I was encouraged by this: I thought he was going to explain the procedures that the CMHTs have in place to deal with attached-to-shrink mentals in the absence of said shrink.  Which of his colleagues should I contact in an emergency, who should I get it touch with should I need general advice, blah blah.

Was he fuck!  The exercise, and frankly most of the session, was a load of naval-gazing, useless dross.

“We need to formulate a plan,” he declared.  It seems his idea of a plan has four progressively mental points in the key of D:

1. Mental: DBT Distraction Plan
2. Quite mental:  Discussion About Being Mental
3. Very mental:  Doctor – Either LGP or Out of Hours
4. Suicidally mental:  Death Avoidance – Casualty

He didn’t use this stupid ‘D’ thing; that’s of my doing, because it’s equally fucking patronising to the whole bloody ‘plan’.  I actually laughed in his face about the discussion bit.

“Who the fuck am I going to discuss this with?” I asked.  He reminded me that the first time he’d been unavailable for a session I called D, my best mate, to expunge myself.  I don’t think I was keeping this blog then.  Not sure.  It was a while back anyway.

This is true, but whilst D is mostly aware of the issues that have given rise to my mental health issues, I really don’t want to discuss them in detail with him.  He reads this blog from time to time, but I’m quite analytical here, not off-my-head mental, so even though the material here may well be disturbing to normals, they don’t get to hear or actually witness what it’s really like. I need to protect people from it.

I said so to C, who by virtue of his chosen career has de facto committed himself to hearing about and witnessing disturbing behaviour.

He asked could I not speak to A, then.

Yes, I can, as it happens; he bears witness to many of the worst moments and is certainly aware of the others.  In fact, of late, I’ve noticed many of our conversations have been about my being mental – I think I’m trying to forge some sense of identity by being obsessed with my madness, but that’s an entire other post.  The point is talking to A doesn’t always alleviate the problems; not that it’s specific to A though, talking to anyone doesn’t make a difference, at least depending on the type of episode anyway.

Yet still C wanked on about it.  The Samaritans then.  Lifeline.  Some such 24 hour crisis line.

This was winding me up to fuck, so at this point I expressed my annoyance yet again through a cynical laugh.  This didn’t go down too well – not that he criticised me, but just because he’s the one trained to be perceptive doesn’t mean that he is the only one that actually is perceptive.  I could sense an annoyance, or at least a confusion, at my reaction to his suggestion.

I explained that whilst I had every admiration for the volunteers operating these services, recognised their well-meaningness, and in principle fully supported them, that I had not found them helpful in the past.  To be fair, I was overplaying my use of them, letting C believe I’d called them a number of times when in actuality it was only once or twice.  But when you know something isn’t helpful (or indeed is), then you do.

He hides it well, you know, but I sensed exasperation.  I said the point was that I cannot talk to anyone other than him, and to a lesser extent LGP and Dr C, about the darkest things.  Even then the discussions are abstracted, formalised or structured by me so that I can avoid talking about those things that I wish not to discuss (or at least discuss them in a ‘safe’ way).  In front of them, I don’t behave in the angry, frenzied, self-destructive way that I often do otherwise, and that I frankly long to do in front of them at times.  I try not to express emotion, and when I do I either force myself to desist from it or end up apologising for half an hour for my failure to control myself.

Simply put – it’s hard to talk to anyone.

Anyway, C said this was about my inability to ‘do’ empathy.  I asked what the hell ’empathy’ had to do with it.

He said, “you despise the emotional side of yourself so much that you don’t allow yourself, or feel unable, to empathise with others, would you agree?”

“Not entirely,” I replied, “but in the main, I suppose the answer would be affirmative.  Why?”

“You can’t empathise with others because you can’t empathise with yourself.  I think that has to be one of our goals here, to allow you to gain, or regain, that sense of empathy.”

I protested that I didn’t want it, I don’t do emotions, I like to be rational, this arse shouldn’t come into my life, thank you very much, the end.

C wanked on and on about emotions for a while.  I do do them, of course, he contended.  He didn’t say this, because labels are so evil and unhelpful, don’t you know, but of course the cornerstone of a diagnosis of BPD is an inability to regulate emotions properly, thus you go mental.

So, he concluded, my emotions are clearly very strong, and my lack of empathy for myself is profound.  “For example,” he said, “you carved ‘hate’ into your body.  Don’t you think this is a way of expressing a strong emotion, without expressing it in a ‘normal’ fashion?”

Once more I laughed in his face.  “You think ‘hate’ is bad?” I sneered.  “You want to see some of the stuff that’s been added since!”

He raised his eyebrow and said, “you say that with almost a sense of glee.”

“Yeah.  So?”

“Well, I’m getting the sense that you delight in self-harm – it’s a further, and outer, manifestation of your self-hatred.  You mask ithe hatred well outwardly, for the most part, but you need to confront it eventually, in ways that aren’t self-destructive, in order to get over it.  Thus, you need to be able to empathise with yourself.” He also stated that carving things such as ‘hate’ into myself was a form of punishment for feeling emotions. He seems to think that’s at least partly why my mood improves after self-harm; I am sated because I am punished and have got what I deserve. Probably fair, admittedly.

“Yeah, whatever,” I said, “but the point is, cutting is quick, and it works.”

“Maybe so, but it is self-destructive.”

I shrugged.  I mean, he’s probably right in the sense that it is an outer manifestation of something I don’t generally express in other outward ways, such as through talking.  It certainly is self-destructive, though I don’t really see how that matters, but still, how could I argue?  I simply told him that I genuinely cannot foresee him being able to get me to ’empathise properly’ – not in the manner that he means, anyhow.

An interesting side-note is that I’ve observed from re-reading parts of this blog that I’ve (unconsciously) stopped putting words like ’emotion’ and ‘feelings’ in quote marks (except in circumstances like the immeadiate foregoing where they are necessary to denote they’re not active nouns in the sentence). I told C this, laughing that he must have made some progress with me in this particular area. Interestingly, he did seem mildly encouraged by this.

Anyway. We discussed suicide ideation for a bit, in relation to the stupid plan of action for when I go doolally in his absence.  He said something like, “…if you start thinking about suicide…” at which point I interrupted him, yet again with a sneering laugh, stating that I thought about suicide every hour of every day.

He asked why.

I said because I want to not exist.

He replied, in my view rather confrontationally, “so why have you not done it then?”

“Cowardice,” I responded instantly, without a mere second’s hesitation.  I’m fairly sure he was expecting some humming-and-ha-ing, but I’m already well aware of the answer.  I’m too fucking pathetically scared.

I did concede that not all shreds of altruism are lost amongst my endless waves of narcissism; in part, I haven’t topped myself because I know it would annoy A, Mum and my friends (plus – in my view, oddly – the family, but who cares about them).  But the main reason, selfish or otherwise, is simple cowardice.

He didn’t quite seem to know how to respond.  I think this was one of many points where he irritated me intensely by silently staring at the floor for what seemed like eons, with his index finger ensconsced thoughtfully over his mouth.  Eventually, this pissed me off so much that I said, “you do realise, don’t you, that I’m trying to work out what you’re thinking?  Isn’t that a role reversal?”

“Do you mean,” he enquired, “that you think you feel like the therapist?”

“That’s patently ridiculous,” I said, but in quite a nice way.  “I suppose I’m asking if you think I play mind games with you.”

“Do you?” he asked.

“I think so, yes.”  I told him I felt there were times when I challenged him, whether overt- or covertly, to work me out, or answer difficult questions, or respond to deliberately provocative statements.

“‘Mind games’ isn’t the terminology I’d use,” he said, “but if you want to call it that, fair enough.  I think you’re testing me, is all.  You want or need me to prove my competence, understanding, whatever – basically that I’m worthy of your trust or time.”

I agreed with this.  I told him that he would, of course, have worked out by now that I had very strong defences built up and thus have big problems trusting people until they’d proven themselves trust-worthy.

“Consider yourself lucky,” I smiled.  “I do trust you – yet I don’t know you at all.”

He asked how I felt about not knowing him; I responded by stating that “this relationship is asymmetrical of necessity.”

“Perhaps,” C said, “but that doesn’t mean you don’t find it strange.”

“Of course it’s strange,” I replied, waving my hand dismissively.  “But I can deal with strange.  I’m strange.  My life is strange.  Strange is normal to me.”  Fair is foul, and foul is fair, hover through fog and filthy air… [Macbeth, Act I, Scene I, if memory serves].

I don’t remember really what that led to, so the next few issues I remember raising were my ongoing problems with my cunt office, although that rant was brief, though I then launched into a major invective regarding the situation with Dr C.  Well, I say it was ‘major’ – it was, but it was also very measured.  I did say to C that I was extremely angry but I couldn’t go on about it too much as I risked behaving in a “psychotic pacing ranting fashion” and that I didn’t want to do that “in front of him.”  I did say that I was sick of the pillar-to-posting I’d experienced under the care of the NHS for over a decade, and that it was particularly frustrating that when things actually looked like they might be moving forwards, I was yet again rejected.  I whinged that when I needed Dr C most, due to the problems with my medication causing serious and frequent mixed episodes, it was the time she chose to abandon me the most.

[Alas.  It is now Friday 7th, thus I didn’t get this published on Thursday 6th, the septiversary of my last meeting with C, as I had planned.  Apologies.]

The truth is, I was hoping C would contact Psychiatry and tell them that my self-harm is getting worse and my suicide ideation is out of control, which I think it is, given that most people don’t seem to think about suicide and death all day, even if they are rather batty.  I mean, he had most of Thursday and all day on Friday to contact them before he went off on his stupid fucking leave.  But he made no such offer, and a week has now passed without my having heard from them, so it’s evident he made no such contact.

What do you have to do?  What the fuck do you have to do?  Do I need to run into a busy shopping area pointing a shotgun at my head or climb, very publicly, to the top of a tall building with the threat of jumping, to convince them that this is fucking serious and that I need help?  Nobody gives a fuck.  No one.  I’m sure most of C’s silences during this session were him fantasising about 5pm on the Friday when he’d be free for over two weeks.

Anyway, before the end of the meeting, he returned to the wanky Four-D Perfect FoolProof Anti-Suicide Plan.

“Look,” I said.  “I promise not to be dead in three weeks, OK?!”

He looked over his glasses at me in that strange enigmatic way he sometimes does.  “But you’re promising me, not yourself,” he mused.

“So what?  The effect is the same, isn’t it?”

Essentially this relates back to my lack of self-empathy or some such bollocks.  Whatever, who cares.  He asked me to definitively agree a plan of action with him before I left.  I should have tried a new mind-game and pretended (or, more accurately, admitted) that I didn’t agree with anything he was saying so as I could have made the session overrun, just to see what he did or said.

I did say, and in fact although I didn’t mention it above I had said it earlier, that the problem with any of this stuff is that by the time you’ve gone mad enough to need it, you’re far too mad to do it.  Fairly simple concept, yes?

“In advance,” C said, “write it down.  You’ll then have something tangible to which to refer.”

“It doesn’t matter,” I protested.  “The entire house could be wallpapered with plans for what I should do when I go mental, but when I am mental none of it matters.”

I tried, with absolutely no success whatsoever, to describe what it’s like when I’m psychotic, or panicking, or experiencing a mixed episode.  I couldn’t put it into words, but the point was that even though I may maintain some small awareness of rational issues that exist outside my head, that I did not have the cognitive functions to actually put any such things into practice.

“What do you think the answer is then?” he asked, again in what I felt was a confrontational manner (though I could just have been paranoid – who fucking knows).

“Valium and sleeping pills,” I declared.

His concern was instantly piqued and he went to protest, but I pre-empted it by saying I wasn’t talking about overdosing on them (I know from the suicide newsgroup that there’s practically no chance it would fucking work even if I tried), but rather about knocking myself out for a few hours in the hope that by the time I woke I’d have returned to my default state of quasi-sanity,or at least vague rationality.

He seemed cynical of this.  I don’t remember what if anything he actually said, but I got the distinct message from him that drugs were only part of the answer, if even that.

We were running out of time, and he kept pressing me to work with him to formulate the stupid plan.  In exasperation and to just fucking pacify him I finally said, “right – distraction, discussion, GP and casualty, OK?”

“Yes,” C replied – relieved, I think – “but you may want to add layers in between.  Remember the breathing exercises as well, for example, or specific distractions of your own.”

Well, as it happens I don’t fucking want to add ‘layers in between’, because I don’t think the bloody thing is of any adequate use anyway, unless someone is acting on my behalf (in stages three and four anyway).  But fuck it, I just nodded.

He said, “our next appointment is 20 August.  Do you want an appointment card?”

I said yes, as I would be wont to forget that, as each day runs into another when one is a dolescum.  He wrote it out and handed it to me.  I was irritated in the extreme to observe that he’d written “Dr C. J.” on the front of it.

I have been seeing you for twenty weeks, C.  That’s about five months.  I FUCKING KNOW YOUR FUCKING NAME.

I got up and wished him a pleasant holiday (though part of me was secretly hoping he spent it in mild misery with ((non-fatal)) swine flu or something – but only part of me ;-)), and he thanked me.  As I left, I said, “take care.”  I was offended by the fact he merely said, “bye” and didn’t reciprocate.  Funny how silly, meaningless little things take on such importance in the therapeutic setting.

This post has made it sound like I am absolutely raging with C and that our last session was a confrontational battle of wills.  Neither of these are really true; it comes across differently on ‘paper’ than it really was, and of course I use this blog as a sort of secondary therapy where I can rant and rave all I like with (mostly) anonymous impunity.  I can castigate C to the high heavens here; even though my annoyance at him can be real, it’s also somewhat tongue-in-cheek and in any case my feelings towards him vary from day to day, maybe even more frequently than that.  Stupid transference.

I’ve managed relatively well without him thus far.  I’ve not been in good form by any means, but when am I (except when hypomanic)?  My only real major episodes were last night and part of today, but there were precipitating causes – the McFs, perhaps unsurprisingly – and that’s a story for another day, for it is now 1.40am in the UK and I must draw myself away from the computer.  It’s my first night of the tri-weekly sleeper-fast and I need to try and relax somehow in a perhaps futile attempt to get some rest.  Due to the almost certain insomnia of the next week, I have a horrible feeling that the coming seven days will not be much fun, but we’ll see.

I Hate my Colleagues II & Occupational Health Shenanigans II

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I Hate Psychiatrists

So, after my grovelling apology and new-found respect for Dr C back in June, the current behaviour of her and her team has reinforced to me why I thought they were shit in the first place.

I was supposed to be seeing Dr C next Tuesday, so as she could review how the change to Venlafaxine was affecting me.  Regular readers will know that I’ve gone completely fucking mental since I changed to them, as demonstrated in just about all my posts in the last few weeks, but especially here and here.  Dr C, or perhaps more accurately her bint secretary, had already changed my appointment time several times.  This was irritating, but meh; as long as they were to see me, I could live with it.

Well, a letter arrived on Friday from their office stating that whilst they “apologised for the inconvenience”, the outpatient clinic had been cancelled and that an appointment had been rearranged for 8 September.  September.  What the fucking fuck?

I went to ring them but instead of being able to type their number into my phone I just ended up panicking and ultimately throwing it across the room.  Eventually I got my mother to phone the bint secretary for me.

The bint told her that the clinic wouldn’t have even been with Dr C in the first place.  My mother didn’t get the name, but it sounded like it was Dr N, the SHO I met the first time I went to psychiatric outpatients.  That wouldn’t have been ideal, but I could have lived with it.  But anyway, Dr N has cancelled her clinic.  Just like that, apparently, and no more reason was given.

Alright, my ma went on.  But SI is climbing the walls and would really need to speak to Dr C.

But that isn’t possible, apparently, since Dr C is on holiday.  For “quite a while”.

And in the meantime?

September is literally the first appointment available, so that’s too bad really, oh how regrettable, but that’s the way it is.  If there are any cancellations, they’ll apparently phone me.  Yeah, right.

FUCK FUCK FUCK FUCK FUCK FUCK FUCK FUCK FUCK

Go fuck yourselves, one and all in psychiatry on the NHS.  Fucking bastarding cuntflapped bollockheads.

No wonder I don’t want to be hospitalised, if this is the standard of care one can expect.  Mental health professionals don’t care about mentals, clearly.

I got off the phone with my ma and threw my head at the wall with such force that I literally fell backwards, and very nearly knocked myself out.  I sat down again, got back up, sat down, got up, paced, sat down, paced some more and eventually ended up in the kitchen looking for the knife.  I then went and re-carved the word ‘HATE’ across my tummy, about which I wrote here.

That action having been completed, I sat on the sofa with the knife for a while wailing and sobbing in utter desolation.  (For what it’s worth, after a fairly short while I felt a lot better, proving that self-harm does indeed work).

It’s like the conversation I had with C on Thursday.  I don’t think I’m being taken seriously by the NHS.  I really don’t.  I would love to have the nerve to make a suicidal gesture and that would fucking show them.  Even better, I’d love to actually be successful in catching the bus and then the cunts would face a potential lawsuit and be forced to apologise to my family and friends and shit.  But as of right now, obviously, I don’t have the nerve.

Everyone is commenting that these tablets don’t seem to be good for me.  As I detailed here, if they are creating mixed episodes (which they are), then the apparent way of treating this is to add mood stabilisers to the medication cocktail.

How the fuck am I meant to get these if the psychiatrist refuses to fucking see me for months?  My GP can, theoretically, prescribe them, but of course he’s not the expert that Dr C supposedly is.  She would know if the mixed episodes are caused directly by the Venlafaxine, or whether it’s something else.  She would know whether she should change me to another anti-depressant, or whether adding mood stabilisers on top of Venlafaxine would be the best answer.  I am not sure that Lovely GP has this in-depth knowledge.  As CVM (a registered nurse) said to me, he went to university for five years and then trained as a GP thereafter, so he damn well should be able to know – but, simply, he doesn’t have the same knowledge and specialist experience than Dr C and her ilk are reputed to have.  Still, I may go and see him anyway.

I am convinced that C could get them to take notice (it turned out that it was him rather than Lovely GP that did in the first place), but of course there is no C this week 😦  I will have to rant about it to him next week before he then goes away for two weeks 😦 😦

Additional worries:

• GA is on this landmass.  In fact, she is – until her departure next week – never more than about 40 miles away.  I feel violated.  I wonder, despite my request for her not to, how much back-chat she has engaged in about me?
• Fucking occupational health tomorrow 😦  Panic panic panic panic panic panic
• Because of the shrinks wanking about, it is almost certain that I will lose my job now.  If they’d see me as planned next week then I might have been able to get a solution to my present situation fairly quickly.  Given that I am now likely to continue feeling this fucked up until at least September, about the time work are expecting me back, I really cannot see how the situation can be resolved.  I didn’t realistically think it could have been anyway, but it was possible, and now the chances of not getting dismissed are low to infinitesimal.
• The effects of my mentalism on poor A (I went mental again on Saturday, though it was remarkably less severe than the previous couple of weeks).
• The fact that some people are still unwilling to try and understand that this is not something that I can help, that I could end being mental by “changing my thoughts” (ha!), and decide to tell me what I should and shouldn’t do about it and how I should count my blessings.  Never thought of that or anything, thanks.

I’m not totally losing it today, but things do seem pointless and bleak.  Nevertheless, that’s a fairly default position for me, so I suppose it’s progress from going totally off my head.

Well, I will report back on the occupational health tomorrow.  Can’t wait…!

Not Getting Sectioned Just Yet – C: Week 19

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

How. Does. He. Know.

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

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

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

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

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

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

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

“How do you feel…?” he began

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

“How so?”

“How do you feel about it?”

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

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

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

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

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

“OK,” I responded.

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

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

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

“Frightened?” he remarked, surprised.

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

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

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

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

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

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

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

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

“Then you take yourself to casualty.”

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

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

“OK,” I agreed.

And then, once again, it was over.

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

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

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

Self-Harm

WARNING: SOME OF THIS MATERIAL MAY BE TRIGGERING.  PLEASE DON’T READ ON IF YOU THINK THAT MAY APPLY TO YOU: I DON’T WANT TO CAUSE ANYONE ANY HARM OR PAIN.

I’ve written about my self-harm before but I engaged in an especially…er…interesting version of it this week.  I’ll come back to that shortly.  One thing I’ve been thinking about recently is that there was a gap of something like eight or nine years between my most prolific cutting phase and my more recent return forays into cutting, head-banging etc.

I didn’t harm myself at all in these intervening years.  Or did I?

I’ve been doing tiny little things to myself for so long I would never ever have regarded them as self-harm, but some material I’ve read recently led me to believe that, unconsciously, maybe they have been.

I compulsively pick scabs.  I pick the cuticles and skin around my nails.  I am obsessive about squeezing spots and go out of my way to find new ones to burst.  I pull hairs out of my head or my eyebrows.  Picking the eczema induced dead skin out of my ears is an uncontrollable compulsion.  Indeed, I peel dead skin off other parts of my body.  I scratch at myself when I am not itchy, pinch myself for no reason and gawk in delight at blood when I accidentally cut myself.  Indeed, I am notoriously clumsy and careless.  Even drinking is considered a form of deliberate self-injury.  I rarely drink during the week, but I suppose I would be a heavy drinker at weekends or on holidays (my hilarious bruises from this weekend show how dangerous that can be!  This one, one of many incurred over the last few days, is on my right thigh).  I’m sure I could think of more of these ‘little things’ if I bothered to probe my mind in detail.

None of this shit seems like a big deal in and of itself, and as I say, I would never for a second have considered it anything approaching self-harm.  But apparently it can be; that’s what some of the so-called experts think at times, anyway.

Of late, all of these behaviours have continued, but additional ones have surfaced (and the hair-pulling has become more severe; it’s not just a hair or two here and there, but entire tufts at times)  Some of them, such as cutting, are simply a renewal of old behaviours, but others are new – the head-banging for instance.  Actually, that’s not entirely true, now that I think about it.  I have been known to head-bang when extremely agitated or, particularly, whilst in great physical pain (eg. migraines, which is kind of stupidly ironic) for basically as long as I can remember, but it would have been very intermittent, whereas in the last few months it’s almost become the norm when the madness comes (though less so for physical ailments).

One thing I did quite a bit as a teenager than I no longer do is burn myself.  The main reason I’m not doing that now is because I no longer smoke.  If I did, however, I’m sure I’d be sticking fag ends into myself as well as the rest.  On one mental health related website I’ve read, they actually advise you to smoke as a distraction from self-harm.  I found this amusing when I read it, as it would only encourage it in me.

People wonder why my more serious self-harming behaviour have been anewed in the recent past.  It would be easy to blame C, which I have been doing and which I think A does.  After all, it all started again since meeting him and certainly, I think an already dodgy situation has been exacerbated by therapy, because it forces me to confront shit I really do not want to confront.

But I am fairly sure I have no recollection of C asking had I considered self-harming recently, because it was such a fabulous solution to all life’s problems.  This bullshit was all bubbling under the surface, and if therapy has brought it out, then it has – but it was merely uncovering it, not creating it.  Indeed, C’s attempt at employment of DBT was deliberately to give me another focus when I feel these urges.

And that’s what they are: urges.  People who don’t do it don’t seem to understand that – why should they I suppose?  But it’s compulsive.  It’s like an instinct that becomes progressively overwhelming if you don’t act upon it.  It’s all-consuming, visceral, a caveman-esque reaction.  For me, unlike some others, it’s selective in when it comes.  It don’t feel the urge every time I am mental, depressed or otherwise not in what most people would describe as a normal mood.  But when it does come, it is profoundly intense and driven.  It feels as natural to act upon it as it does to breathe.

I had been having some self-harm ideation prior to actually going mental this night, but hadn’t actually done it.  However, as I stated later in this post, seeing a knife that night was like an epiphany.  Using it to slash my body seemed like the perfect solution to the mentalism I was experiencing.  The thing is, for the most part, it worked.

My memory is slightly skewed, but I do remember that the frenzy of racing thoughts largely desisted.  Instead a calm thoughtfulness and, dare I say, fascination, descended upon me.  The pain of the cuts refocused me and the slow oozing and flow of the blood captivated my psyche.  I’m sorry if this upsets anyone, but it was beautiful.

I didn’t entirely agree with that assessment the next day, but it’s funny how it grasps you again at a later stage.

The truth is I’ve been making small cuts more often than I’ve detailed here since the above incident, and there’s been quite a lot of head-banging too.  I think I only talked about them again here, but it’s been happening more often than that.  Not with tremendous frequency, though, and essentially most of the self-inflicted injuries have been superficial.

On Monday I decided to be more elaborate.  I mentioned on the last link that I’d been toying for some time with the idea of carving the word ‘hate’ into my abdomen.

On Monday, I did it.

Monday was a public holiday in Northern Ireland, thanks to the annual 12th July celebrations (held on Monday 13th, because it would apparently be a sin to have it on Sunday).  I’m indifferent to the politics of the situation, but since A and I live almost exactly on a marching route I usually go and watch the parades.  My mother and A’s family were all about too.

The morning was great fun as it happens.  Everyone was in good form and there was no political or sectarian bullshit, just a kind of carnival atmosphere, something both the Orange Order and the various Northern Irish councils had been hoping to create.  So I was in a pretty good mood, but – mainly but not entirely at the will of the in-laws – we went to the pub afterwards.  My mood just changed.  I was exhausted and just felt really depressed and not at all part of the group-belonging feeling that seemed to permeate the pub.  My mother and I decided to go home after only one drink, and A joined us.

I can’t have been just exhausted and depressed, and I don’t know why my mood took a nosedive.  Sometimes it just does; that’s the nature of some of the illnesses with which I am afflicted, I suppose, and it happens to everyone from time to time anyway.

When we got back to the house, we discovered that one of the PCs was mostly fucked, and I became convinced that it was my fault, and my already-poor mood became worse.  I wouldn’t say I was overly agitated, but I was upset and full of self-disgust.

When my mother went upstairs to the toilet, and A was focused on working at the computer, I went into the kitchen and quite deliberately picked up a knife.  I successfully carved the ‘H’ into my stomach, facing upwards so I could read it, and felt an instant release.  However, it was not enough.  I had to do more.  I had to complete the word.  As I said above, it was visceral, a complete compulsion.  But I heard my mother coming down the stairs at that point so I hid the knife and to cut a long story short smuggled it to the bathroom, under the pretence that I was going to the toilet.  I carved the rest of the word, then sat on the toilet and looked at it.

I must have been in some sort of trance.  I kept muttering to myself, “it’s beautiful, it’s beautiful, it’s beautiful,” as I watched the gorgeous blood flow from the wounds.  The words just sort of ‘came out’ of me.

Two things are worthy of note.  Firstly, I didn’t really feel particular pain in slicing my stomach.  According to I Hate You, Don’t Leave Me – an outdated but by far the best-selling book on borderline – endorphins rush to the cut site to act as one’s body’s natural painkillers.  In fact, the book argues, one can become hooked on the endorphin rush.  It also says that for many of those afflicted by BPD self-harm becomes a ritual.  Now I’m no expert, but I would imagine that carving ‘HATE’ into your abdomen then staring at it in a child-like wonder could, just perhaps, be classified as ritualistic.  It certainly wasn’t just random slashing.

A is terrified that I will enter the ritualistic stage of self-harm as a more permanent state.  I did the above whilst 100% sober, in a relatively stable state of mind (very, very down – but not going totally mental), and it was more elaborate than recent cuts have tended to be (though it still doesn’t rival some of my teenage creations).  Perhaps I have already reached the stage.

The second issue is that it almost instantly improved my mood.  I met A on the stairs afterwards and he asked me if was OK, because it had been evident earlier to him that I was not.  I said, truthfully and cheerfully, that I was, and he was convinced – indeed, suspicious – enough to actually ask had I taken Valium (which I hadn’t).  The point is, for me, cutting works.  It improves my mood.  I can’t say I always feel happy or contented afterwards like I did on Monday, but there is always some mood improvement.

So, I was in fairly good form for the rest of the day.  We went back out, saw the return leg of the parade, went for a lovely dinner and for a few quiet drinks, came home and went to bed.  Apart from my mother unwittingly causing a delusion in me (which she then ever-so-helpfully pronounced ‘silly’ on my part), I was in good humour up until and including going to bed on Monday night.

I know I shouldn’t do it, and part of me regretted it on Tuesday (when I was essentially depressed all day, though this was mainly due to sheer exhaustion and the bullshit with GA).  It was what I was referring to in yesterday’s post when I said I wasn’t at liberty to discuss something.  The reason for that is that I had successfully managed to hide it from A, and he reads this blog.

Mostly I am happy for him, and indeed for a few select others that I know in ‘real life’, to do so, as I articulate myself, in general, better here than I do in person.  If I want them to know what my madness is like or how I am feeling, the best way to do so is to direct them here.  Words will never entirely grasp it, I don’t think, but a written analysis over which I can take my time and plan is always likely to be more descriptive and accurate than any shite I can ever tell people verbally.  Witnessing the mentalism, as poor A often does, can certainly show someone how mad one can be; however, almost by definition, I am unable in that state to articulate how it feels for me, or what goes through my mind.  Hence allowing him and others access to this, which is otherwise anonymous.

But I didn’t want A to know about this incident as he is disturbed enough by my madness and especially issues of self-harm as it is.  It is one thing for him to learn of random slashing, but to actually plan then execute the act in this rational, calculated manner is probably quite another.

He did work out after reading yesterday’s post that the missing information must have been related to cutting.  He is going to see the wounds sooner or later I suppose – I mean, we do live together – so I thought I would just go ahead and write about it.  But I do fear for his poor sanity too.  I am causing everyone in my life so much pain, and I (quite appropriately) hate myself for it.

I am also scared to tell C in the morning.  Between this and the hanging incident, I am convinced he is going to do something I don’t want him to do.  I guess I’ll just play it by ear.  The funny thing is, at present I actually trust Dr C more than C, even though I feel much closer to and understood by the latter, in general.  Perhaps that is because I feel betrayed by his fucking about last week, but perhaps it is because I have some sort of perception that C does actually care about me and will section me if he feels it is in my best interests.  Dr C is so much more formal – which is good in its own way I think – that I kind of feel she sees me as just another patient.  This is probably irrational thinking; I am probably that to C too, but he (generally) doesn’t make me feel that way.

A thinks there is no point in going to psychotherapy if I am not entirely honest with C.  He is obviously right, objectively speaking.  But it’s just so fucking hard.  Part of me is actually seriously considering just telling C that we should stick it.  Our most recent contracted sessions are due to end either tomorrow or the next week I see him.  I am finding talking to him hard and at times futile.

But then, aside from the logistical issue of having to wait for months to get therapy again if I later decided it would be in my best interests to have it, I would miss him and grieve for my loss of him.  I do rely on him and am horribly attached, regardless of whether my transference becomes negative at times or whether therapy seems pointless.  In short, I’m not sure I want to continue, but at this stage I really think I need to.  In some way, part of me does want to continue as well.  I don’t know.  It’s hard to explain.  I’ll talk to him about the future; we have to tomorrow anyway as, as I say, the contracted sessions are due to finish shortly (which is actually frightening to think about, thus apparently proving I do not want to be parted from C).

Anyway, for those interested, a link to a picture of the body-art can be viewed at the end of this post.  Please don’t click it if you think it would disturb or trigger you.

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