When I uploaded the previous post twenty days ago, I was fully intent on posting the next one the following day. As you can see, this didn’t happen. Instead I have been telling myself every day since then that ‘You really must get around to writing That Post today’, each day finding conscious and unconscious reasons not to do so.
I’m not always good with feelings, with dealing with them, I mean. Especially pain. I have a tendency to shut down, to frantically try and get away from anything that may make me experience emotional pain. And I do this even more so if I perceive that the pain is being inflicted by someone I respect and care about. In some ways I suppose this behaviour makes perfect sense. Who wants to feel pain? Who wants to feel hurt by someone they hold important in their lives? And, yet, looking at it from another angle, it is sort of strange, particularly from someone who has spent so much time doing therapy, where much of the work centres around exploring and examining pain, past and present, often inflicted by those we find hardest to blame.
So.. this will be a hard one to write. But, I felt that I owed it to myself to be brave, to not hold back, to be honest and let it all out. After all, that is why I have this blog..
The week I had been discharged from Drayton Park I arrived for my usual Friday session with A. I had a very specific question on my mind, one which had been eating at me for a while, and I felt I really needed to pluck up the courage to ask A. about it, in light of what had been going on both with me separately and in our mutual relationship lately. I never got a chance to ask the question, because once I had sat down, A. turned to me and said ‘There is something I need to say to you.’ Alarm bells went off all around my body. Last time she started a session that way was when she told me she was pregnant, and I could tell that this time it would be something possibly even harder to deal with.
‘I can’t work with you under the threat of suicide.’
Ten words. Like bullets to my heart.
I must have sat quiet for ten minutes, my world stopping in its tracks. I felt cold, nauseous, struggling to breathe. Thoughts were spinning in my head so fast it was impossible for me to grasp any of them for what seemed like forever. For a second I contemplated just getting up and leaving, something I have never done in my life, to anyone. But, the pain was excruciating, and I felt that I couldn’t take it.
When I finally spoke, the words that came out, as I was trying to blink away tears that weren’t even there, were a mere whisper; ‘I guess that makes one more person who can’t cope with me, one more person who I’ve become too much for, who I have pushed too far’. I couldn’t look at A. as I said it, because I was too scared of the force of my own emotions.
This fear of becoming too much for people, it’s been central to my therapy from day one. It’s been a ridiculously regularly recurring theme, something many hours have been spent turning inside out. I know where it stems from: that pivotal moment when I was seven and told my mother about what my brother was making me do, when I broke her, when I discovered that there was no one who could help, no one I could tell without running the risk of breaking. And ever since then, that fear has remained, has evolved into this enormous ball of anxiety that now encompasses a million different things that I believe I do, which ultimately drive people away.
Having said that first thing, suddenly there were lots of other things I wanted to say, thoughts I wanted to share, because apart from fear and pain a plethora of other emotions were descending on me at breakneck speed. I took a minute or two to try to pick them out, to separate them. The most urgent one was the feeling that this was incredibly unfair, because in the past several months I had more than once felt unsure of whether or not A. could truly cope with what I was bringing to session, and more than once had I openly asked her if she could. And each time she had opted not to answer. So I said exactly that, adding that it felt like she was going from zero to a hundred with no steps in between. Silence, silence, silence and then ‘I can’t work with you’.
After a few more moments of silence, from both of us, I asked her how she had imagined I might respond to what she had just told me. A. said that she didn’t know how I would respond. In frustration I said that that wasn’t what I asked, I asked how she had imagined I might respond, because in my mind, she is an intelligent person, and it didn’t seem that far-fetched that she might have pictured me hearing what she said as a form of rejection and as further proof that there is no-one who can cope with me, and that it would take me down the path of ‘If even my therapist can’t cope with me, then what hope is there..?’
Later she said, in her very gentlest voice ‘I’m giving you a choice’ and because I wanted to be fair to her and to the reality of the situation, I said that I could see that, and that I can absolutely understand that it must be incredibly difficult – frightening, even – to work with me when I am suicidal. Especially in light of what had happened only a few short weeks ago. And, yet, at the same time I couldn’t help thinking ‘How is this a choice?’ She was saying that she couldn’t work with me under the threat of suicide, but how could I possibly promise to not be suicidal? It’s not something which can be switched on and off with the push of a button. It felt more like an ultimatum; ‘Either you stop being suicidal, or therapy stops’. I was going through the options in my head, thinking that I would be willing to say almost anything – even if it was a lie – if only she would carry on working with me. But, I also knew that I really didn’t want to have to go down that road, because it’s perilous in nature; one which would inevitable and seriously impact whatever work we might do in the future.
I said to A. that if I did make a promise like that, wouldn’t that by default make the whole subject of suicide and suicidal feelings taboo? Because, how could I ever trust that I wouldn’t accidentally step over the line of what A. felt was too much, now that she had shown me that such a line did exist, not only in the realm of my fears, but tangibly right there in that room? Wasn’t it exceedingly likely to have the effect that if things got to the stage where suicide felt like an option, I might not be honest with her, might not share these feelings, for fear of what the consequences might be for my therapy? To this A. said that of course I would also need to think about whether or not I could work with her. This may have been meant to make me feel that this was a two-way street, but it only left me with the feeling that perhaps she was hoping that I would come to the conclusion that I couldn’t, thereby giving her an ‘out’. So, I said exactly what I was thinking: ‘I feel like I am being pushed towards terminating this therapy. And that is not what I want.’ To which A. said that I may need to take some time to think about all of this.
I was silent for a while, trying to come up with something – anything – that may be used to bridge the gap between what I felt A. was asking of me and where I felt I was truly at, and suddenly I remembered something D. – the counsellor I worked with before I started seeing A. – and I used to do when things were very difficult. We would make an agreement that I wouldn’t act out in any way between sessions, that I would always come to the next session to talk things through with her. And, because I had a huge amount of respect for her, I knew that if I did make that promise, there was no way I would break it. It’s just how I am. And, if I felt that I couldn’t make an honest promise, it wasn’t a case of ‘Well, then I can’t work with you’ but we would instead find some sort of middle ground, acceptable to both, and which, crucially, didn’t entail making false promises. I might admit that I felt unable to promise that I wouldn’t act out, but that I could promise that before acting out I would do X, Y and Z (ie call the Samaritans, speak to three different friends, do my nails, make a painting, write a chapter on my book, contact the crisis team etc).
Having explained this set-up to A. she initially wanted to know how that had made me feel and I told her that it made me feel contained, that it was a positive thing, this process of coming to a reasonable agreement, because it made me feel that I had some control. And also, that not only did I know that I wouldn’t break a promise I had made to D., I also felt confident that she knew I wouldn’t.
After a short pause A. said that she felt she had made her position very clear and that any promise would have to be for as long as we worked together, however long that may be.
It felt like she was pulling the rug from under my feet, like she was responding to my tentative suggestion of a possible solution, by immediately raising the bar, to make it impossible for me to make the promise she was after.
So, I left that session in a daze, feeling unsure if that was it, if that was the end of the road for our work together, not at all knowing whether her earlier ‘You may need to take some time to think about this’ extended only to this particular session, if she was expecting me to show up for session the following Wednesday, or if she wanted me to do my thinking at home, so she wouldn’t have to deal with my suicidality, which clearly could not be dissolved from one session to the next.
I am not meaning to make this storyline of my life into any sort of cliff-hanger, but I am exhausted and I need a break. There is a lot more to say about what has been going on in my relationship with A. and what has happened since this session, and I hope that in the next few days, I will be able to post an update of some sort.
Be kind to your Selves,
This all sounds incredibly painful. I don’t know how you cope with it. I don’t think I could. Surely dealing with suicidal patients is part of the job as a therapist? And like you said how could you possibly promise not to become suicidal again? Not meaning to put any pressure on you, but I am looking forward (for lack of a better phrase) to reading your next update.
Thank you both for commenting and hitting the “Like” button. As always I appreciate it.
Yes, it has been incredibly painful dealing with this and in all honestly, I think I dealt with a lot of it by not writing the above post until enough time had passed for my feelings to not be quite so raw..
I am still contemplating the next update, and I think it won’t be very long until I’ve come to a decision about it.
All the very best,
PS. I borrowed your last name to use as a first name for one of the characters in my current writing project. Hope you don’t mind!
Wow! That was fast!
Sounds like a wise decision to hold off posting until you felt ready. That said, I am always looking forward to your next post. I know it’s been a while since I commented, but I have been reading!
Of course I don’t mind you using my name for a character. I’m flattered an honoured. Hope you will publish what you write! Loved the taster you posted a while back. Very promising!
Oh, I cried reading this :( poor you.
Feel totally useless but I can feel inside how much this must have hurt. If I’m honest, it is my biggest therapy fear too (and has given me the push I need to talk to my T about this).
Thinking of you x
Thanks for your very kind comment, and for showing such empathy.
Yes, it’s been very hard and painful to deal with this.. can’t really say anything else..
Will be posting an update of sorts later on today, and then a proper one in the next few days, I hope.
All the very best,
Will ‘look forward’ (wrong terminology, but…) to your updates. I do always keep an eye/ear out for your posts, and had been wondering how you were. X
Förstår inte riktigt, det är väl ingen överraskning för henne heller att du är suicidal?
Dessutom anser jag att hon borde vara utbildad i att hantera det klienterna berättar, jag tänkte när jag läste att hon “börjar” bry sig om dig även privat, inte bara yrkesmässigt. Skillnaden är stor, att bry sig privat eller yrkesmässigt och gränsen är hårfin, men det är något som vi (sjuksköterskeelever) utbildas i, det borde ju finnas på psykolog/ terapeututbildningen också.
Jag menar absolut inte att det är fel att bry sig om andra. Du förstår vad jag menar…
Hej Ninisen, min bästa bästis sen för alltid,
Jag förstår vad du menar, och jag vet att det ingår i alla terapeuters utbildning att lära sig hantera den här typen av situation. Samtidigt så är det naturligtvis en stor skillnad mellan vad man lär sig, och hur man klarar av sånt här när det verkligen händer. Terapeuter har ‘supervision’ och jag utgår ifrån att att A. talat med sin handledare om hur den här situationen känns för henne. Jag kan förstå att det är väldigt stor skillnad att under fyra års tid med jämna mellanrum höra mig tala i självmordsbanor, men att allt plötsligt blev väldigt mycket mer verkligt när jag faktiskt gjorde ett försök.
Men det är klart att allt detta kändes orättvist och som något jag inte precis hade ett behov av att försöka hantera när jag redan var mitt inne i en kris..
Hoppas du har det bra. Tänker på dig.