When Your Therapist Goes Away

Here we interrupt the regular scheduled programme for a Holiday Special: “When Your Therapist Abandons You”

“Big Kids DO Cry” – a little illustration I made while sitting at the library pondering what childrens books REALLY teach our children.

Yes, it’s here once again – that darkest time of the year when your therapist has almost certainly gone off and left you. My guess is that you’re just about half way through it by now, and at this point things will either have got a lot easier – because you’ve got used to having the rhythm of your week disrupted – or, got rather a lot worse – because you’ve been trying desperately to hold it together, but now you’re running out of whatever it is that has kept you going until now. Or, you may be – like me – dealing with both of those scenarios, simultaneously; things getting both easier and much much harder at the same time. [Really playing the odds with my guesses here, aren’t I?]

So, let’s talk about it.

I realise that I have written about breaks a lot, and I am likely to be covering similar grounds once again, but there is one slight difference; this post is written from inside a break, not in anticipation of it. It is quite possible that I am remembering this incorrectly, but my feeling is that I generally tend to write quite a lot more prior to the beginning of a break to then go fairly quiet and disappear almost entirely during it.

Either way, this is where I’m at: I last saw P. on December 21st. Prior to previous breaks I had got increasingly better at, sort of – very sort of – broaching the subject of The Break before it actually happened, rather than just ostriching [that’s the technical term, look it up!], which is how I dealt with pre-break anxiety pretty much all the way through the five years I was working with A.

With P. I had begun to at least mention that I was aware – very aware [I’m sure you know the feeling!] – that a break was coming up, and that there were in fact feelings connected to it. I may not have been quite brave enough to really explore those feelings, the desire to go back to ostriching being too strong, but I would at least acknowledge the fact that there were a lot of feelings floating about, messing with my head, heart and soul. This time I took it a few steps further. A few weeks before the actual break – all the way back in early December – Little S. wrote an email to P. that I thought I might share with you:


                                                                                                              *


To P.

I am feeling very extremely sad that soon you are going to go away from me again. That is because I don’t like it when you are away, because then I can’t see you anymore ever again for a very long time. And I will miss you too too too much. And maybe I won’t even remember what your voice sounds like. Also I think that maybe you will forget everything about me, because I know that usually I can be very easy to forget. And also maybe I will forget all the things you have said about feeling bad and being bad. And that makes me very especially worried in my soul. Because then sometimes I do Very Bad Things. And then I will know that I am bad, because of doing those Very Bad Things. When you are away no one can remind me about feeling bad and being bad, and I can’t tell the difference all on my own. I can only remember it when you tell me. So that makes me feel very extremely worried.

From your Little S

PS. Maybe before you go away you can think of a song that I can listen to, like you did one time before, because I really really liked that. Because then I can listen to it and I can think about you and my soul can remember your soul. Or maybe you can write a little letter to me before you go. But you don’t have to do anything if it is too much trouble. I understand.


                                                                                                              *


As you can see this is an email written by Little S. completely on her own, without Adult Me stepping in or editing away the most embarrassing bits. This is not an easy thing to do, allowing your inner child to voice their fears – in their own way – in spite of your adult self’s embarrassment and self-consciousness, but it is such a valuable tool, because when it comes to therapists [read: pseudo-parents] going away, it is often that very young part of you that takes the biggest hit. All those fears of being abandoned, forgotten, and left behind shoot straight through Adult Me’s far tougher shell, and allowing those feelings to be exposed can really make a difference.

So, we took time to look at those feelings, with P. working very hard at getting us [all the different parts] to acknowledge our true feelings, both about the actual break and about P. herself. – Yes, we are talking about acknowledging anger and disappointment and feeling let down here. Can’t honestly say that I quite managed to go all the way this time round, either, but it certainly wasn’t for lack of trying, and especially Little S. did a great job of using a few sessions to speak directly to P. So, yes, I’m really rather proud of us all.

Knowing that things might get more than just a little bit rough during P.’s absence I sorted out a referral appointment with the crisis resolution team for the day of my last session with P. This, too, was new: me reaching out to ensure that a bit of extra support would be on hand prior to actually hitting rock bottom.

This has worked out really well, especially since the person I saw for the assessment told me right away that they would be working with me all the way through until P. is back, rather than doing the usual little dance of “We’ll see you x times, to begin, and review your needs as we go”. That has been incredibly helpful, because as much as I always say that how difficult a break is going to be is completely independent of how long it is, it is far easier to cope with little chunks of a day or two at a time, than trying to deal with an overwhelming fourteen day break in one go.

Knowing that I’d be working with the CRT throughout meant that we were able to schedule regular appointments, and also to ensure that on top of in-between appointments I would definitely be seen on all significant dates during this period: Christmas Eve [that’s when we celebrate Christmas back home, and I reserve the right to call people who insist on celebrating on the 25th Stragglers!], New Years Eve, my mother’s birthday and the anniversary of my first suicide attempt [when the abuse I was being subjected to came out]. So, that has really has been very useful.

In our final session before the break, Little S. gave P. a letter which she read in session, so that we could talk about it, and P. gave us a card on which she had – among other things – written a special bit for Little S., to remind her that feeling bad is not the same as being bad, and that she won’t forget me, because she ‘carries me in her heart, just as I carry her inside when we’re not together’. Also, as she has done over the last few breaks [and some particularly difficult weekends] P. leant me her little soap stone hippo – let’s call him Ringo – who fits perfectly in my hand, to keep me company. Needless to say [but I think I’ll say it anyway], both Ringo and the card have been invaluable to me.

It’s not been a bump free ride, but I do feel very proud of how I was able to prepare for this break, and for accessing help during it, rather than making it harder than it needed to be.

Do be kind to your Selves.
And your elves.
They are not just for Christmas, you know!

All the very best,

xx

 
What song did P. leave me with? For me to know, and you to guess.

But here’s a good one:

http://youtu.be/UVDg8fVC4EQ

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Because Tomorrow Might Be Good For Something

*

“..I’m not crazy, I’m just a little unwell
I know, right now you can’t tell
But stay awhile and maybe then you’ll see
A different side of me..”

*

I guess there are no easy ways to talk or write about this, but as this is supposed to be an honesty-focused blog I’ll just tell it to you straight: last week I accidentally on purpose overdosed on my medication. It really wasn’t a bid to end my life, at least I don’t think it was [although I accept that others may disagree]; I didn’t even take all the tablets I had, but it was still a significant enough dose to potentially do some damage. I know my meds pretty well, and I would like to think that I know what would and wouldn’t kill me, but, the truth is – of course – that there is no way to know for sure just how much a of a medication would be lethal for a specific individual; what’s safe for one person may well be fatal for another. In some weird and rather irrational way, it was more like I was testing if it would be possible to swallow enough tablets in one sitting to get to a lethal dose. I think that was my confused logic, anyway, [which, obviously, isn’t logic at all].

I did frighteningly well in terms of establishing that it would indeed be possible, had I wanted to take more pills than I did. But, the second I had swallowed the first lot I instantly regretted it, and I decided I should go to A&E, since the meds I’m on [Amitriptyline] are known to be very toxic. In fact, the highest therapeutic dose is not that far off a dose that would be classified as toxic, and that is the precise reason why Amitriptyline is only prescribed as a last resort, when all other types of anti-depressants have failed.

Again, entirely irrationally, I decided that rather than calling for an ambulance I would get on a night bus to my local A&E, so I got myself out, started walking to the bus stop and only just missed the bus, so I carried on walking in the general direction of the hospital. After a while I began to get really unsteady on my feet, but was still clear enough to realise that passing out on the streets of London on a Saturday night would not be a great idea, especially with a lot of drunk people out and about. So I went back home, got on my bed and blacked out before I could call for an ambulance.

When I woke up it was all dark, so I thought that it was still night, but when I looked at the time on my mobile I realised that it was in fact the next evening, and I’d been out cold for nearly 24 hours and had missed several calls and texts from worried friends. This really freaked me out, since I normally wake from even the quietest of noises.

That evening I again attempted to get to A&E, but was simply still too wobbly and I had to give up and go home again. On Thursday I had an appointment with my GP, and I told her honestly what I had done, and that since I don’t even really know why I did it, or at least, the logic in the moment really wasn’t logic at all, I really needed some extra support. She heard me and then asked whether I wanted to call the mental health crisis resolution team myself, or if I wanted her to do it. I opted for the latter, because I know I would most likely have gone home and talked myself out of ringing them.

So, at the moment I am seeing the crisis team every other day. I’m not suicidal, at least not on a conscious level, but I also think that having some extra support over the next few days is a good idea, wherever that support comes from.

The crisis team, being tied to the NHS, have, as they always do, questioned both my therapy and my therapist on the grounds that they are not NHS and must therefore automatically be harmful to me.

That really makes me angry, since I am a big believer in psychotherapy in general, and in my therapy in particular. For me, psychotherapy is the most appropriate way of disentangling my thoughts and emotions, and to ultimately get away from the intrusive flashbacks and nightmares which push me to act out in this rather extreme way.

That said, what with my therapist being on maternity leave, I do feel that as much as the crisis team and I have very different ways of understanding psychotherapy and the effect it has, I am still glad to be seen by them, because it means that, should I act out again, or miss a scheduled appointment [whatever the reason] they would send the police and ambulance round to check on me, as I am in effect an out-patient and they have a duty of care. Also, they are available to talk to 24/7, should I find myself struggling with thoughts of self-harm or suicide. I can’t promise I would definitely call them if that happened – in fact – I’m fairly certain that I wouldn’t, but at least the option is there.

Hopefully things will improve soon, so I can start looking forward rather than backward, because, who knows..

;

“..tomorrow might be good for something..”

;

xx

;

Heading, and quotes at the beginning and end of this entry are from Matchbox 20‘s track Unwell. © Rob Thomas