Too Depressed For Psychotherapy?

Another Friday, another counselling session with D.
But, what have I been doing with myself in between sessions?

Well, I’ve had a pretty big week for someone who doesn’t normally venture outside if it can be avoided, and there is one specific event I want to tell you about.

As I mentioned in a previous blog entry I’m on the waiting list for psychotherapy through the NHS. And Monday was The Big Day – my initial assessment with Dr J. It took place at Hill House in North London, a very tall building semi-hidden behind the Archway tube station; frighteningly unfamiliar territory to me.

Nervous as I was I had given myself plenty of time to get there and as a consequence arrived ridiculously early. I had planned on bringing a book and my journal with me; they had both been neatly laid out on the coffee table at home the previous evening, but I had still managed to somehow leave them behind.

Not wanting to sit in the waiting room with just myself and my jittery nerves I found the nearest Woolworth and bought a hideous turquoise notebook in which I started scribbling frantically once back in the waiting area.

While waiting I was also asked to fill out one of those standard forms that is meant to give an indication of just how depressed you really are. If you’re not familiar with these questionnaires, basically you’re given about thirty statements which you should rate the validity of based on how you have been feeling in the last week. It includes statements like ” I have felt it would be better if I were dead” and “I have felt too overwhelmed to talk about my problems”, and you get to choose between “Never”, “Only occasionally”, “Sometimes”, “Often” and “Most of the time”.

Needless to say, it’s pretty obvious how to score high versus low on the depression scale – so it really is key to be honest. At least if your aim is – like mine – to get the right kind of help.

I’ve taken this test probably about fifteen or twenty times in the last six months, and I have to say that this time round I could really see a marked difference in how I am managing my depression. A significant positive improvement.

Dead on the hour Dr J., a long-haired woman in her early forties, who I had not met before arrived. She led me to her tiny-bordering-on-claustrophobic little office in complete silence and gestured for me to sit down on one of the chairs, still not talking. I’ve been in therapy a number of times before, so this – the absence of a proper greeting – didn’t come as a surprise to me, but I think had I not been familiar with this particular approach, I would have been somewhat taken aback by it.

Knowing that the good doctor would not be the first to break radio silence I said the first things that came to mind: “Let me just put these things away (meaning my iPod and the notebook). I always write when I’m nervous,” immediately wondering what she would make of that, slightly beating myself up over being so utterly un-original.

Thus began The Assessment.

I was asked to tell The Doctor about myself, (“Wow, that’s a big question – I wonder if I have a big answer to it.”) so I did, starting out by verbally bullet pointing the basics; That I have been living in the UK for about five years, but grew up in a small town in the north of Sweden. That I was adopted from India at the age of six months, but feel Swedish through and through since I don’t remember anything of my time at the orphanages where I stayed. I also stated, almost casually, that I was sexually abused from when I was about four and a half years old until I was seventeen and that the abuse came to light having overdosed on a random cocktail of my
mother’s sleeping pills and anti-depressants. I admitted that I have been and still am struggling a lot with the way my family have dealt with the knowledge of the abuse and mentioned that I was still expected to see my abuser, a member of my family (not my father), whenever I go home. I then went on to talk about growing up caring for my bipolar mother, with all of her ups and downs, but that neither she nor the rest of my family are likely to acknowledge this (the sense that my role was to be her carer) as being either valid or true. I ended my life-story recap by describing how I drank half a litre of anti-freeze liquid over a period of three days in March of this year, in an attempt to kill myself.

At this point Dr J. stepped in and commented that I seemed very emotionally detached from the things I was talking about, and I explained that this is one of the reasons why I feel I would benefit from psychotherapy; that I want to learn to connect to my feelings surrounding my childhood and my family, and find ways to deal with them that don’t include resorting to occasional self-harm or other drastic action. In short, I want to feel real. I want to learn how to respond to things without immediately putting up a three-foot thick wall to shield me from any potentially painful feelings.

The assessment lasted for a bit over an hour and at the end of it Dr J. said that she didn’t really question my intellectual suitability for this sort of treatment, as I am clearly very articulate and perfectly able to express myself verbally, but that she had some serious concerns regarding my safety, as therapy often brings out a lot of very difficult things and you are bound to experience an abundance of complicated feelings which may be very difficult to manage.

Since my history points towards an acutely self-destructive pattern she simply couldn’t overlook the fact that my risk-factor is high. I pointed out the things I have done to keep myself safe; not keeping razors at home, using distraction techniques to control my impulsiveness, calling help-lines for support if needed and the fact that I have been able to manage the week between my counselling sessions in a positive way. So, she responded that she would still need to talk to D. and to my care co-ordinator, and also to the women’s crisis centre where I had been staying when I made my last suicide attempt, before making any decision, and that once she’s talked to them she would ask me back for another session to discuss the outcome.

I feel quite happy about this, because if she hadn’t felt the need to talk to others who have been working with me I’d have thought her rather irresponsible, taking on someone who on paper is very high risk without any consideration. I mean, there is no two ways about it; in the eyes of any professional I amhigh risk, and taking my word for it that I’ve changed would be very reckless, indeed. Having said that, I hope that once she has talked to D. and my care-coordinator, she will feel that I am capable of coping with psychotherapy and give me the opportunity to prove it.

In my session with D. today we talked about the assessment and also the fact that I have come a long way since I first started counselling with her. And that I have worked very very hard at finding alternative ways to deal with destructive impulses. She also said that she definitely feels confident enough regarding my risk-factor to recommend me for psychotherapy, but that she fully appreciates Dr J.’s concerns.

Hopefully what D. says about me will weigh heavily enough to sway Dr J. ‘my’ way, because I think I could benefit hugely from therapy.

Anyway, I am going to end this entry here. Dev is forever teasing me that blog entries are meant to be short and concise, and that this is a writing style I have yet to master.

All I have to say to that is; I could write that way if I wanted to, I just don’t want to . So there! :þ

xx

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One response

  1. Pingback: Bulletpointing My Life | What It Takes To Be Me

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