Archive for transference

Protected: Pointlessly Stupid Navel-Gazing Repetitive Nonsense – C: Week 37

Posted in C, Moods, Psychotherapy, Triggers with tags , , , , , , , , , , , , , , , on Thursday, 14 January, 2010 by Pandora

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Article of the Week: Week Two

Posted in Article of the Week with tags , , , , , , , , , , , , on Wednesday, 13 January, 2010 by Pandora

The Main Course

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

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

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

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

10 Myths About Schizophrenia

For Afters

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

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

The Americaisation of Mental Illness

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

Intelligence and the Idle Mind

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

Abuse in Childhood Linked to Migraine and Other Pain Disorders

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

Transference is Not Transferable

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

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

*SI walks away, whistling innocently*

Anything Else?

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

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Vulnerability and Self-Disgust with C – Week 36

Posted in C, Moods, Psychotherapy, Triggers with tags , , , , , , , , , , , , , , , , , , , , , , , , on Tuesday, 12 January, 2010 by Pandora

Thursday was the first day back to therapy after C’s Christmas break.  It was a successful session in a long-term sort of way, but was nevertheless very traumatic for me, tackling as it did a lot of hurt and vulnerabilities that I don’t want to face nor admit to.  There was nothing specific that was so stressful about it, but as I said to C towards the end, I felt very “battered and bruised”.

I was glad to see C again, having missed him and craved his protection over the three weeks since I last saw him.  However, he has committed a cardinal sin.  He has grown a beard.  Not like the goatee, Derren Brown-esque beard he had when we first met, but a full-on, proper beard.  I’ve nothing especially against beards, but honestly – he looks like something out of a children’s illustrated Bible.  When he came to the waiting room to get me, I was aghast to be greeted by Jesus (or Judas if you prefer, he could be either).  It took me a quite a while to stop fixating on this newly arrived hirsute feature.

As has been the case since C has been back in VCB’s stomping ground (as there is building work going on in his office), we opened by taking a few moments to compose ourselves.  The waiting room in the place is usually full of people, unlike that for C’s proper office which is always empty.  The people unsettle me, and C has realised now that he has to give me a few minutes for this anthropophobic anxiety to abate somewhat.

Of course, I had C anxiety as well.  I always feel nervous before I see him, and it was especially strong on Thursday given that I had not seen him for three weeks.  To that end, initially I was stubbornly refusing to speak in anything other than one word answers to questions.

Eventually, he asked me how Christmas had been.

“I’m not going to discuss that,” I brattishly declared.  I knew, of course, that he would follow that up with a question as to why I was not going to discuss that, so before he got the chance to do so, I changed the subject and told him about the latest troubles with the health service.

The first thing was the whole bullshit about the GP talking down to me, just after I’d last seen C.  I told him all about it, going so far as to re-enact some of the mannerisms that Dr Arsehole had employed during his irritable rant towards me.  This was before the reply to my complaint had arrived.

“How dare someone earning as much as a GP does behave in that fashion?” I raged.  “How dare the jumped-up twat speak to me like that?”

“How were you in the room with him?” asked C.

“Pathetic,” I admitted.  “I just sat there and took it.  I did try to argue with him at one point, but he just kept on and on, and I backed down.  As I was leaving, I even thanked him!  A reckons I need to discuss my remarkable ability to be so horribly passive with you.”

The second NHS issue, which I’ve only mentioned in passing here, is that apparently VCB is no longer my consultant psychiatrist.  When I last saw her in November, she said she’d see me again in a month, which she didn’t (surprise surprise).  Then, when I finally did get a letter inviting me for an appointment with Psychiatry, it merely said that I had an appointment on 20 January with Dr M, not VCB.  It made no reference as to the change of individual whatsoever.

C said, “as far as I know there’s been a shake-up in Psychiatry in terms of geographical location.  They’ve changed the boundaries that each consultant operates in.  Is that what happened?”

“No one told me anything, so I wouldn’t know,” I spat, disgusted.

“I’m not going to lie to you,” I continued, “I’m not VCB’s biggest fan.  But at least I had some sort of relationship with her – I knew her, and she was at least in some ways familiar with my case, so this is incredibly frustrating.  It strikes me that Psychiatry is possibly the worst branch of medicine in which such nonchalance and disruption should be in evidence, what with issues of trust and attachment being so much a part of certain illnesses.

“But what do I know,” I added bitterly.  “I’m just the mental that sits opposite you people.”

“Is that how you see yourself?” C jumped in.

The truthful answer to this is that I don’t know.  The comment had been intended as a slight on the Psychiatric “service” and indeed on mental health services on the NHS in general, but of course I exist in a perpetual state of self-loathing and self-disgust, whether im- or explicit, so yes, it probably is – to some extent – how I see myself.

I told him so, adding that I have no right to be mental because what has happened to me is so considerably less serious than that to which many others have been subjected.  This came up a couple of times in the session – basically I feel guilty for being a mental when other people who’ve endured worse aren’t or, if they are, then they have more right to be than I.

C mulled it over for a minute or two, then said, “one thing about you is that you’re defined by contradictions.  You mentioned earlier about being passive – there is that side, yet there’s another side that can be extremely assertive in the right circumstances.  It’s the same with your belief that you are somehow not entitled to be a mentalist [interesting use of that word, I thought].  You hate yourself for being this way, you think you have no right – yet you will fight to the death to get the treatment to which you feel you are entitled.”

“It’s hardly rocket science, though,” I responded.  “In some ways, whether or not I’m entitled to be mad is irrelevant; the fact is, I am.  Regardless of the reasons for that, I should be entitled to treatment, under the foundations on which this health service was based.  If I kicked that wall over there and broke my toe, the stupid manner in which I broke my toe would be irrelvant to those treating me; I would still be entitled to their medical attention.  I don’t see why it should be different for one’s mental health.”

“It shouldn’t,” he agreed.

Oh really?  OK then, why are you cutting short my fucking therapy?  Not that I brought up that issue specifically, because I didn’t want to engage in the pointless navel-gazing that had been the previous session.  If our time is limited, it must be used effectively.

Anyhow, I don’t remember how he phrased it, but basically he said that a person’s history and indeed how they respond to it is completely relative.  He said that we can only develop from our own experiences and, essentially, that I really shouldn’t beat myself up for being mental.  Later on in the session, he almost went so far as to say that I have every right to be, but I’ll come to that later.

Of course, I can rationally accept a lot of this, and indeed I know that certain mental illnesses with which I have been diagnosed are thought to exist in individuals who are biologically predisposed to having them, the symptoms manifesting after some sort of psychosocial trigger.  So of course I am not to be blamed for being mental…says Rational Me.  In-Control-Irrational-and-Ironically-Mental Me does not agree.

We also discussed how the anger I feel is sometimes misplaced.  I contend absolutely that my anger towards the health service is completely just, so that’s not one such example, but I will fly into a genuinely murderous rage at either myself or, say, my mother (particularly my mother) for something ridiculously stupid like dropping a pen – yet I am not angry at my uncle.  I am angry at my father, but that miserable sod had the audacity to die, so I’m hardly likely to be able to direct that towards him.

Of course, mention of my uncle in the context of anger was A Very Bad Move.  C said, “so, are you going to tell me what happened at Christmas?”

I glared at him.  “Did I not already say that I don’t want to talk about that?” I sneered, eventually.

“You did, yes.”  He looked at me enigmatically.

Oh, but you can read my mind, can’t you C?  Saying that I didn’t want to talk about it is some sort of conspiratorial Newspeak for, “I want to discuss that with you in intimate and excruciating detail”, isn’t it?!

“You don’t want to tell me about your Christmas, do you?  No – you don’t.  So why should I tell you about mine?” I challenged.

It was meant mainly as a sarcastic and rhetorical question, but he answered anyway.  “If we met in other circumstances, that’s probably exactly the conversation we’d be having,” he mused.  “But I know that you know that this circumstance has to be one-sided.”

As it happens, I do know, thanks very much – and I don’t like it and it isn’t fair.  And yet it protects me from the probable sheer ordinariness of this man that I so pathetically look up to.  But that’s another matter.  I told him, truthfully, that if we met socially, I would still not be telling him the specifics of what happened at Christmas.

Actually, if I’m 100% honest, of course I wanted to discuss it with him (in his capacity as my psychotherapist) – aspects of it anyway.  I was horribly mortified (as well as disturbed) by what ‘They’ wanted me to do on Christmas Night, and didn’t especially want to outline that in specific terms, but I did want to tell him of the fear and anguish that took me to that point.  Yet I felt absolutely unable to give myself permission to do so.

We sat in silence for a bit.  I knew he would break me sooner or later, but I decided to fight him anyway.  I was thinking about the psychoses, which led me to question how I had described them here on WordPress.  In doing so, I was reminded that I won an award for this blog on New Year’s Day from the fabulous Mental Nurse blog.

“My blog won an award,” I randomly blurted out at him, with thinly-disguised pride.

C seemed quite excited by this news and congratulated me, then paused.  “I really want to ask you more about this,” he began, “But I’m wondering if we shouldn’t leave it until later – I don’t want to avoid the issue of Christmas.”

I wanted to avoid the issue of Christmas.  It’s my fucking therapy, can’t I talk about what I like?

But I gave up the fight, and gave the man what he wanted.  “There were issues with the voices,” I admitted finally, tapping my head (as if he didn’t know what voices I damn well meant).

“OK,” he started.  “What sort of ‘issues’?”

“No, no, no, we’re not going down that road.  It’s enough that you know that the day was stressful and I went doolally in the evening, though mercifully not in front of the 3,820,691 people with whom I was forced to spend the whole sorry day.”

“But how could it not have been traumatic?” C asked.  “I really fail to see how it could not have been, what with you having to see and interact with your uncle.”

“You’ve built it to be all about him,” I replied.  “It’s not – not entirely.  To say my family is a freakshow is to insult freakshows.  I just cannot put into words how fucked up and weird they all are, and how much I have nothing in common with them.”

“I remember you saying before that their ‘weirdness’ was difficult to convey, but I do have some sense of that.”

“They’re worse in a collective,” I continued.  “As individuals – well, I can’t pretend I’m their biggest fans, but they’re more tolerable.  But their group dynamic is seriously – epically [not that that’s a word] – bizarre.”

Moving away from this slightly, C went back to the voices.  I told him that I had already said I was not going into that and requested that he left it be.

“I’m not really so concerned about what they actually said,” he told me.  “At present I’m more interested in why you don’t want to tell me about it.”

I should have been expecting such a question, but I hadn’t been.  I thought about it for a moment.

“I’m very aware that we’re sitting in Psychiatric Outpatients and that the bin’s over there,” I said, leaving him to infer the rest.  “I can’t get away quickly here.  At least in your normal office I have time to flee before you all catch me.”

I got the usual spiel of crap about how he would only call a psychiatrist or my GP if I was at a serious and imminent risk of harming myself.  Or others, he added, almost as an afterthought.  I laughed bitterly.

I don’t remember the exact discussion that followed, but he seemed to have established that on Christmas Night it was ‘others’ that ‘They’ were trying to get me to hurt.  He never said it straight out, and I never confirmed it, but there seemed to be a shared, implicit understanding that this was what had occurred.  He sought to reassure me in as strong terms as he’s allowed to that he would not call anyone to have me sectioned unless he thought that such harm was absolutely imminent.

“I don’t believe you,” I told him.

Ouch.  I think that one cut him a little (no pun intended, not that I’ve been too bad vis-a-vis self-harm of late).  He asked why I doubted him.

In part, it is because I feel that some of the trust has been broken between us, owing to the whole uncertainty over the continuation of treatment – though in fairness, he was good in this session and I feel it might have been built up a little again.  Other reasons are just how terrible the episode was – I mean, I was told to kill a fucking not-quite-two year old, how much worse does it get? – and the fact that I’m preposterously paranoid.  Probably the simplest reason is that I often genuinely feel that I should be fucking sectioned, though I really, really don’t want to be.

In any case, I do believe that C wouldn’t section me unless he felt it absolutely imperative, yet I don’t believe it at the same time.  I believe two absolutely polar opposite things simultaneously – not an unknown state for me.  I told him so, and he seemed to understand that.

For some reason, presumably relating to all the discussion about Paedo and the multitudinous weirdness of the McF dynasty, C and I ended up discussing how my mother didn’t believe me about the sexual abuse, and about how she seems to go out of her way sometimes to put me down, or to compare me (negatively) to others (particularly SL, who she seems to fucking idolise).

C said, “it seems to me that your mother has been severely traumatised by her relationship with your father.”  Now, I genuinely don’t recall what he said next, but I think it was something along the lines that she therefore seeks solace in the McFs and, despite what she may say, finds it hard to believe that they are capable of fault – even when it’s rape of her daughter.  I don’t want to put words in C’s mouth, though, so don’t take that as gospel.  Of course, whilst I cannot disagree with the aforesaid conjecture, my own take on things is that she will always remember that I am my father’s daughter (she will even say it from time to time when she wants to hurt me).  In any case, I am certainly not the daughter that she would have wanted.

I agree with C that she is completely traumatised (not that she’d admit it herself), but was surprised by him coming out and telling me that was his view in such forthright terms.  In any event, this tangent didn’t especially add much to the session, except to exacerbate the rawness of the hurt I was already feeling.

So that was his next tactic – the perennial, “how are you feeling?”

I couldn’t verbalise it at first.  I just felt so something, so indefinably sad and upset and low.  He quietly encouraged me to try harder to express it more exactly.

Eventually, through gritted teeth, I seethed, “I feel hurt and sorry for myself and vulnerable, are you happy now?”

Unfortunately he thought this comment was sarcastic, intended as a snide take on what he wanted to hear.  Admittedly, the manner in which I had said it could easily have been taken that way, though it was meant to have come across as a dramatic, “there!  I’m finally admitting the truth!  I’m deflated but this is progress, isn’t that fantabulous?” kind of gesture (fail!).  I apologised, and advised him that the content of my comment was serious.

Yes, I admitted to being vulnerable.  What I didn’t admit, of course, is that I want C to protect me from all that which makes me vulnerable.  I want him to put his arms around me, stroke my hair, tell me in his gentle voice I will be OK, and protect me from all the bad that exists in the world.  Of course I didn’t tell him that, but admitting to this hideous vulnerability that I’ve been repressing for I don’t-know-how-long was a start.

“Unwillingness to feel or express feeling of these things is very common in people who’ve been brought up in abusive and traumatic backgrounds,” he told he, tilting his head to gauge my reaction.

“‘Abused’,” I repeated wistfully, looking away.  The branches of the trees outside were blowing back and forth in the wind, stripped bare of their leaves.  I felt as emotionally naked in front of C as they looked.

“You don’t think you’ve been abused?” he checked, apparently confused.

“No,” I replied quietly.

“You were sexually abused by your uncle!” C said, determinedly.

“And I responded to that and other things by dissociating and emotionally numbing myself.  Fat lot of good it’s done me.”

“It probably did at the time, though.  It was a means of self-preservation during those times.”

There was a pause, then I randomly spat out, “I disgust myself.  My vulnerability disgusts me.  I disgust me.  Fucking schizo bitch!”

“You’re one of the most self-critical people I’ve ever known,” C told me, taking a very slight tone of authority.  “My worry is that this is a major stumbling block.  I really think if we can develop some self-compassion in you, it will help a lot.”

“You said a moment ago that dissociation etc was a means of self-preservation.  It ties in with the psychology discussed in a book I’ve been reading.  It is, shock horror, a self-help book, one designed to teach you strategies to soothe yourself when you go mental.”

C was delighted by this.  He asked me if it was any good, my response being that a lot of it (as with any such text) was “wank”, but that despite this, there were some good, and vaguely intelligently written, parts to it.

The thing is, I’m not always as critical of myself as I seem to be in psychotherapy.  I can only surmise that that is when the truth really comes out.  The raw, visceral nature of everything that’s gone or is wrong with my life is so palpable and explicit in those 50 minutes, and the true depth of my self-hate is exposed.  Eugh.

He went on to say that it was not desirable to rid me of my “sarcasm and [my] wit” (he said I was witty!!!  Smiley me!), but that he thought aspects of that fed into my lack of self-compassion, and that we needed to strike a balance.

“And I’m encouraged by the fact that you’re trying,” he concluded.

I left feeling psychologically battered and bruised, even so much as allowing myself a tear as I drove home (how self-compassionate), but I was also quietly encouraged and reassured.

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Flogging a Dead Horse with C – Week 35

Posted in C, Everyday Life, Psychotherapy with tags , , , , , , , , , , , , , , , , , , , , , , , , on Wednesday, 6 January, 2010 by Pandora

Christmas and the arrival of 2010 have seen some disruption to your usual service from SI. It seemed impossible to get a chance to write on the latest C session, given as these post seem to be the most ridiculously detailed.

This post shouldn’t be overly detailed, as a lot of it was repetitive bullshit regarding the annoyances of the previous week. Nevertheless, here we go.

Upon leaving C’s company the previous week, we had agreed that we would use week 35, the last week before a break of three weeks owing to Christmas, as a session to discuss how I would manage the so-called festive season.  In reality, that bit ended up taking approximately five minutes at the end, and although it was ever so slightly more helpful than some of the nonsense he’s come off with at other breaks (“breathe!”), it was still not entirely helpful.  But then again, he’s not my guardian, is he?  Much as I would like it that way.

I say we were flogging a dead horse because the majority of the discussion centred around the same crap we had discussed over the previous week (leave a comment or get in touch if you need the password) and the week before that, ie. my anger and distress about his decision to cut short my treatment, and my general disgust about the NHS’s abject failure to adequately treat me since I first sought help for my mental health problems.  I do understand that in some ways maybe C sees exploring my reactions to this as a form of projection or transference, and maybe in some ways it is: perhaps I feel so rejected and aggrieved because that’s how I was meant to feel about my father, uncle, ex, etc etc.

However, it endlessly frustrates me that I cannot just simply be angry because I have been so horribly fucked about by the health service.  Again, in this session, C reiterated that the 24 week limit (starting from tomorrow) was his decision; he said he was “not a robot” controlled by the NHS.

It completely contradicts all the stuff he says about my right to be annoyed and about how BPD should really be treated, and we went round and round in circles on how I could not reconcile his two contrasting views, and about how he either couldn’t or wouldn’t explain it properly.

I also, having decided as a result of the preceding week that he hated me, went to find out whether or not this was indeed the case.

I said, “if I ask you a question, will you promise not to answer with a question?”

He shifted uncomfortably, then admitted that he was unsure as to whether or not this was achievable.

I asked him anyway, on the proviso that if I thought he was “blagging” his way through his answer I would pull him up on it.

He did come off with the form bullshit such as, “why is it important for you to know that?” and whatnot, but I was pleased when he finally admitted that he too had found the preceding week “frustrating”.  So he is a human after all!

He said that I had been “very angry” with him, which I thought was unfair.  I told him that I genuinely hadn’t been angry with him, merely the system, until he confessed to having been the one that decided on the time limit.

“But you were angry with me then,” he pointed out.

“Yes,” I said.  “You had seemed so supportive of me prior to that; you agreed that my situation was wholly unfair.  Then you completely contradicted that by admitting to this arbitrary limit crap.”

And so back we went to flagellating that deceased equine.  More questioning demands from me, more bullet-dodging from him, no progress from either of us.

He had asked me in week 34 to seriously consider whether or not to continue with therapy, as I “had” to agree to the time limit as part of the contract (which strikes me as being quite unreasonable, as contracts are meant to be negotiated rather than forced in this type of setting).  Apparently if I don’t accept the limit, I cannot continue treatment.

“On that note,” I told him, “I am prepared to accept it, but only if you accept – because this works both ways – that I am going to fight it.”

He asked what I meant by ‘fighting’ it, prompting me to withdraw a copy of the letter to the advocacy groups out of my pocket.

“It’s only fair that you read that, given that you’re going to be involved,” I told him, handing the document over.  He took it and began reading.

I sat there and watched him reading it for a minute or two, then stood up and walked to the window, knowing perfectly well that he would almost certainly comment on this, as he had done two weeks previously.  Indeed, he didn’t disappoint.

“I’m wondering why you got up, SI…” he pondered, as he continued reading the letter.

“It’s not reflective of anything,” I spat cynically.  “I’m not denying my hurt or failing to face up to my problems.  I’m simply looking out the window whilst you are occupied with reading that.  Am I not allowed to get up, C?”

He shrugged and muttered something along the lines of that I was, in fact, allowed to get up, then continued reading in silence.

He eventually looked up and said, encouragingly, “it’s a good letter.  Who all are you going to send it to?”

I told him about the advocacy groups, Mindwise and the NI Association for Mental Health.

I was astonished – and delighted – when he then proceeded to actively encourage me to also send it to both the Chief Executive of my Trust, and the head of the mental health directorate of same.  In the end, he forgot to give me the person’s name, but as it turns out it’s been passed to him anyway (more details on how the letter has progressed in a future post).

C said, “you’ve also made reference there to people I think are in England – perhaps it would also be worth adding information about provision for personality disorders in other Northern Ireland Trusts.”

I asked him what such provision existed, knowing that people with the most serious PDs are in fact sent to specialist units in England as there are no facilities to treat them here at all.

C said a self-harm team exists in one of the other Trusts here.  “Although not everyone who self-harms has BPD, and not everyone with BPD self-harms, they would probably see a disproportionately high rate of people with your diagnosis,” he said.  “No such team exists in this Trust at the minute.  There’s discussion ongoing about making the existing team a regional, cross-Trust one, but it hasn’t yet come to anything.”

He talked on for a few minutes about plans our Trust has for action on personality disorders, and how they don’t seem to much be coming to fruition.  But the best part of the session was when he asked me if he could have a copy of the letter.

“I think it would be good for my line managers to know how you feel about all this,” he said.  He went on to say something (I don’t recall what) indicating that there might be some benefit to me in this, but was very quick to point out that it was my choice as to whether or not he did take a copy for them.  I readily agreed, of course, delighting in his apparent desire to act as my advocate to the bureaucrats above him.

Now, of course, I am convinced that he took the letter so he and his twatfaced bosses of evil can formulate some plan of self-defence in advance of hearing from the advocacy groups.  It was not in my interest at all – merely their own.  No doubt over the next few weeks we’ll see which way it actually is.

Eventually – I don’t remember how – I said that he must get sick of his job, what with all the whinging he would have to listen to.  “I accused you of being a sadist a few weeks back,” I said.  “Now I think you’re a mashochist.”

He accused me (sympathetically, to be fair to him) of splitting, which on reflection makes me slightly irritated, but at the time I agreed and called myself all the names of the day for employing this “silly psychological process.”

C leapt to my defence.  He said he knew that I had long since known I was guilty of splitting, but that it’s now “emotional for [me]”, not just something I recognise intellectually.  And it is OK, I do not need to berate myself for it, because I have suffered serious traumas, apparently, that have caused this defence mechanism (which is not silly, he contends) to develop.

On that note, as I recall it anyhow, we moved on to the discussion about the dreaded Christmas.

C’s advice was basically to get the fuck out if I felt anxious or overwhelmed.  I said that was easy to say, but he didn’t have to listen to my mother’s wrath if I did so.

He advised me to talk to her in advance, but I protested against this as well.  “When I told her about what happened with my uncle, she said I made it up to avoid going to his house,” I reminded C.  “So how can I justify my anxiety?”

“Blame your crowd phobia,” C said.  “She can’t be critical of that, can she?  There will be a crowd there, won’t there?

“Yes,” I replied.  “And they’re all part of the problem – it’s not all about my history with my uncle.  I have nothing in common with them and it’s a weird matriarchal set-up, where about 18 different generations all live under the same roof.  They’re freaks.”

He said, “are there children living there?”

I was horrified.  He was obviously wondering if anyone else is presently at risk from Paedo.

“Now you’re angry with me for putting the baby and all the other generations in danger.  I’m sorry,” I raced, in a bizarre panic.

C looked at me, his eyes wide-open.  “Where did that come from?” he enquired, surprised.

“Oh, you’re not angry with me?  Then I’m using you as a board for my anger at myself, am I?”

“OK, you’ve lost me,” he admitted.  “Just…just remember – get out.  Talk to your mother in advance, blame your crowd phobia if you have to, but if you feel yourself becoming tense, get out of there, even if only for a few minutes.  Allow yourself to be anxious about this.  How could you not be?”

And that, folks, was really that.  Of course, you know how ridiculously awful Christmas turned out to be, but I did remove myself from the others when I went so horribly mental, so I suppose I did at least follow the advice given.

As I was leaving, I wished him a Merry Christmas.  He said, admittedly cautiously, “you too,” causing me to laugh bitterly.  I think he knew that it was inevitable that the season would be utterly shite.

So, the three week gap is due to be over tomorrow.  Of course, I am convinced that C is dead again; either that or therapy will be cancelled due to the stupid, horrible, pointless fucking snow, and I need him so desperately at the minute.  Though I have not heard anything about a cancellation today, and I suppose I would have expected an advanced notification were the snow to fuck everything up on the monumental scale that it has in Britain.

The last time he was on holiday, in August, I didn’t miss him that much.  But this time I have, and I need him to help me pick up the pieces of the last few weeks.

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Reflections on 2009

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

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

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

THE BAD

Being Mental

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

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

Specific Issues on Mentalism

–> Psychoses

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

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

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

–> Dissociation

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

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

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

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

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

–>  Self-Harm

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

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

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

Losing My Job

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

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

Trouble with the NHS

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

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

Christmas

It was fucking God-awful dreadful.  Enough said.

C

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

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

THE GOOD

C

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

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

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

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

Diagnoses

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

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

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

Turkey

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

This Blog

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

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

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

Twitter

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

–>  Thank Yous – Twitter

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

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

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

–> Thank Yous – Blogging Buddies

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

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

Again this is not an exhaustive list.

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

Friends

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

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

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

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

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

A

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

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

AND FINALLY…

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

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

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

Yours ever

SI x

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

Posted in C, Moods, Psychotherapy, Triggers with tags , , , , , , , , on Sunday, 13 December, 2009 by Pandora

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Countdown to Abandonment – C: Week 33

Posted in C, Moods, Psychotherapy, Triggers with tags , , , , , , , , , , , , , , , , , , , , , , , , , , , , , on Wednesday, 9 December, 2009 by Pandora

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“I’m curious.”

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

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

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

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

I nodded non-committally and waited for the backlash.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“But…” he went on.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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