Safety, Anxiety, Boundary Blurring & Progress

Posted by What It Takes To Be Me in Anxiety, Being Alive, Boundaries, Creativity, Expressing Emotion, Expression Through Art, Inner Conflict, Psychology, Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, Sef-Awareness, Self-Disclosure, Sexual Abuse, Suicide, The Therapeutic Relationship, Transference and tagged with anxiety, boundaries, Boundary Blurring & Progress, boundary-blurring, breaking people, childhood sexual abuse, crisis resolution team, crisis team, Drayton Park Crisis Centre, Drayton Park Crisis House, Drayton Park Women's Crisis Centre, expressing emotions, expressing negative emotions, expressing through art, inner conflict, mental health crisis resolution team, professional self-disclosure, psychotherapy, psychotherapy breaks, safety, self-awareness, self-disclosure, sexual abuse, sexual violence, sibling sexual abuse, suicide, suicide attempt, the therapeutic relationship, therapy, therapy breaks, transference Monday, July 8, 2013

An Implosion of Emotion

I know this update is long overdue – in fact, there may well be enough in my head for two separate posts – but, let’s begin where my last post ended, and we’ll see where it takes us.

Following my near lethal excess intake of ethylene glycol and subsequent hospitalisation I was finally discharged a few days later. Sort of. I was discharged back into the care of the crisis resolution team, pending an assessment at the Drayton Park Women’s Crisis Centre.

The assessment was conducted a few days later, by two members of staff who I knew from previous stays there. This was probably a good thing, not only because they were already aware of my background, but also because they knew that I have found stays there in the past very helpful by way of turning a negative trend. In other words, they knew that if offered a place I was reasonably likely to make good use of my time there. So, having asked me if I wanted to come there, I was told they would offer me a one-to-two-week stay, with a review at the end to see whether or not the stay should be extended.

So, on Wednesday 5^th of June I took up residence at the crisis house. I have to admit that it felt a little like taking a trip back in time. The last time I stayed there was in 2011 and before then it was in 2008, if memory serves, but in many ways the place hasn’t changed at all. My artwork and poetry was still on the walls in various places around the house, in fact, even a little note I’d written and stuck on one of the doors during my first stay, asking people to please not slam the door, was still there. Other things that very soon clicked into place was the very special rhythm of life that exists in this place: house meeting, one-to-one, lunch, massage/therapy/art/going out, one-to-one, dinner. Also, just as during all of my other stays there, save the first one, I had to agree to allow staff to look through my bags each time I entered the house. This is not a general rule for everyone who stays there, but something specific to me, because during my very first stay there, back in 2008, I brought a bottle of anti-freeze in and then proceeded to drink from it at carefully planned intervals in a bid to end my life. Thus, as a result any subsequent stay at Drayton Park has been conditional upon my agreeing to have my bags searched. And, ever since then, I have always gone along with this, as I genuinely want to use my stay there in a positive way. Also, in fairness, there is quite a lot of give and take, even with this condition; some staff would definitely ask to have a look in my bags, but some would be happy to just ask me to tell them what I had brought back, and others still simply asked ‘Have you brought anything back that you shouldn’t’?

I ended up staying at Drayton Park for three weeks. It was extended by a few days past the original leaving date, because of something which happened between A. and myself in my final therapy session before she was due to go on leave and which created a bit of a crisis on top of the original crisis. Having spent the session talking about how near I got to dying, and the fear that it’s not quite enough to nearly die, but that I would have to actually die for it to make a difference to my parents, and battling it out with myself whether or not they truly care about me, I finally turned to A. and asked her ‘Do you care?’

At this point A., rather than to answer my question, opted to abruptly end session. Yes, we were out of time [although I didn’t know that when I asked the question], but the way she ended it felt very different to how she normally ends sessions, and it is also not unheard of for her to allow a session to overrun by a minute or two, to ensure a better ending to a session.

I left session feeling very upset and unstable with a single thought pounding in my head; that it was more important to A. to stick to the rule of not answering a direct question than to ensure I was in an as safe as possible place, going into a break which she knew would likely be very difficult, given what had been happening in the last few weeks, coupled with the fact that I had in that session expressed that I was feeling very anxious about how I would manage during the upcoming break. Needless to say, it was an incredibly painful thought to be stuck with..

In my one-to-one back at Drayton Park I managed to voice some of my thoughts about the way the session had ended, how I had interpreted it and alternative ways as to how A. might have responded to me which would have felt better [without her being unfairly pushed to give an extensive answer right then and there, at the end of the session]. All this made me question my and A.’s relationship and also made me realise that there was a lot of disappointment stuck inside of me about the fact that she hadn’t contacted me while I was in hospital to find out how I was doing [or if I was even still alive].

Because of this, my keyworker at Drayton Park and I, made the decision that rather than me going home on the day before therapy was due to resume, my stay would be extended until the Monday after, so as to give me some time to stabilise, should the first session back go very badly.

There was another incident while I was staying at Drayton Park, which had quite a big impact on me: in one of my one-to-ones a member of staff disclosed to me that she, too, had suffered abuse. This may seem quite an alarming thing to disclose, given that she was staff and I was staying there to deal with a crisis, but in the context, I can definitely understand why it was made and I have absolutely no doubt whatsoever that the intentions were good, that it was meant to be helpful. But, as I said, it did have an impact on me. Not so much what I was actually told – I have heard stories like that before, have even done some volunteering on a sexual abuse helpline and I can deal with it – but it was more my own reaction to the boundary blurring that caused a lot of anxiety. It made me second-guess myself, in much the same way I used to do during the abuse I suffered: was this OK or not? Was I overreacting? Ought I tell someone? What would happen if I did? Would I even be believed? What if I had just misunderstood what had been said? All of these questions were bouncing around inside of me, as I struggled to decide what – if anything – to do with it all.

Just by chance the social worker from my shul happened to ring as I came out of the one-to-one, and I told her what had just happened. She wasn’t particularly impressed by the self-disclosure, and immediately got it that, while in many ways not that difficult to handle, it had triggered a lot of other feelings and fears, among them the very acute sense that no one can really cope with hearing my story. She said that of course it was up to me to make the decision, but she thought it might be a good idea to talk to the manager at Drayton Park about this incident.

I thought about it for a while, had another one-to-one with the person during this time, but just felt entirely unable to act; the echo of fears from the past and the wish to not get anyone into trouble were simply too strong. So, at first I said nothing, in spite of ever growing anxiety and also feeling worried that this person might end up making similar disclosures to other women coming to the project, some of whom might not be able to handle it.

A few days later, someone from the CRT came to meet with me and the person who was assigned to work with me that day. It was just a normal review, as the plan was that – unlike other times I have stayed at Drayton Park – rather than to just go home and have no formal support in place, I would be discharged back into the care of the crisis team. At the very end of the meeting the person from the crisis team asked if there was anything else I wanted to talk about, and I made the decision then and there that this was a good chance to get to talk it over. I asked the person from Drayton Park could I please have a word alone with the crisis team, and once she had left the room, I explained what had been disclosed to me and the anxiety it had evoked. I made a point of not telling her who the person was, as it seemed irrelevant at that point; I mainly just wanted to get it off my chest and perhaps get some insight into what self-disclosure policies were generally at work within the NHS. She said – in that oh-so-typical-NHS-way – that she would need to bring this up with her own supervisor and that she would get back to me about it, but also encouraged me to have a word with the manager of Drayton Park, who I know reasonably well and have decent rapport with.

A few more days passed and I heard nothing from the CRT. The anxiety was still very present and I began worrying about having to work with this person again, because, even though I didn’t feel burdened by the factual things she had disclosed, I knew I would always feel aware of the risk of triggering things for her etc etc. I still didn’t feel sure about going to the manager, but in the end brought it up – still without mentioning the name of the member of staff in question or when this had happened – with the worker at Drayton Park I felt most comfortable with.

Two days later there was a knock on my door. It was the manager wanting to talk to me, so we went into a meeting room. She explained that the CRT had been in touch with her, as well as the person I had talked to two days earlier, and she just wanted to talk it all through with me and see how we could best resolve this. I asked her if she knew the specifics of what had been disclosed, and she said that she had assumed that it was to do with a staff member’s own experience of sexual abuse, so I confirmed that that was it and also told her who the person was. I then went on to explain that I really didn’t want anyone getting into trouble over this, that I could cope with the actual disclosure and that I could absolutely see that it had been well-meaning, but also that it had set in motion a lot of left-over feelings about ‘telling on someone’ stemming from my childhood and feeling unsure whether or not I could trust my own ability to judge what was and wasn’t a boundary crossing. She reassured me that this type of self-disclosure should not be made, that even if it was done with the very best intentions at heart, staff members should know not to cross that line. She then suggested that the three of us have a meeting to make it possible to move forward. I agreed to this, thinking in secret that I wasn’t at all sure if I would be able to do it.

By the time we were due for our meeting my anxiety about it was through the roof, feeling intensely worried that the person would for whatever reason deny having told me what she had, or say that I had completely misunderstood, that it hadn’t happened the way I said etc etc. Of course, I can easily see that this wasn’t in any way congruent with the knowledge I have of this person – she’s someone who I have always found to be exceptionally straight and fair, but that this was really more of a transferential re-experiencing of what I went through when the abuse I was subjected to came to light and social services made the decision to press charges against my brother whether or not I wanted them to.

The meeting in itself was.. well, truth be told, awkward and uncomfortable for all present, but – ultimately – a good thing. And, as much as I would rather not have had this experience, one very positive thing did emerge: the knowledge that I acted differently to how I did as a child. In spite of not feeling entirely sure that what had happened was wrong, the fact that it didn’t feel quite right was enough for me to speak up.

And,THAT, I think, is very very valuable.

I am aware that quite a few readers arrive at this blog having googled ‘Drayton Park Women’s Crisis Centre’, and so I want to once again re-iterate that in the interest of protecting other people’s identity I use creative licence. Thus, if you for whatever reason feel you know who this member of staff is, I can assure you that you are more than likely going to be wrong, as enough details have been changed or omitted to protect that person’s identity.

Always end up doing a lot of art when staying at Drayton Park

Psychotherapy, Facebook & Minor Boundary Blurring

Posted by What It Takes To Be Me in Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, Self-Disclosure, The Therapeutic Relationship and tagged with boundaries, boundary-blurring, facebook, Facebook connections, Facebook privacy, online presence, openness, privacy, psychotherapist maternity leave, psychotherapist online presence, psychotherapy, psychotherapy breaks, self-disclosure, social media, social media networks, taking charge of online presence, the therapeutic relationship, therapist online presence Thursday, August 16, 2012

It’s been a long time since my last post. A number of very sweet people appear to have noticed this, and I feel genuinely touched by that. So, today I sat down to write an update. It ended up being about six (yes, six!) pages long, and when I read through it, I didn’t like most of what I had written. So, below is an extract of what I wrote, taken “as is” and just pasted into this post. I know there will be some lose ends, both at the beginning and at the end. But loose ends are not our enemy, they are simply the places where we can start our explorations..

But, we live in a fast-moving world where things are not always so clear-cut. I know I’ve written before about googling our therapists, that there is a natural curiousity about who they are, a curiousity which I believe most clients have, and it is borne out of the fact that they know so much about us, yet we are let in on so very little when it comes to them. Some things we can gather from being with them, like their rough age, maybe something about their sense of humour, or how they react when something we say is a bit close to the bone, [A. has a very definite “tell” when it comes to this!] – other things may be discerned from the way their counselling room has been decked out. Although many therapists favour reasonably neutral rooms, few would choose to hang a picture they really dislike in the room they spend most of their days, there may be a book shelf or little figurines that tell you something, or at least gets your fantasies going. But all in all, the fact is that your therapist will always know more about you than you do about them.

In my case – and I didn’t know this when I first started seeing A. – there is some minor overlap in our semi-social circles. To my knowledge we don’t have any close friends in common, but, as it turns out we do move in similar secondary circles on occasion. I only realised this a few months into seeing A. when her name began popping up a here and there. It was almost by chance that I connected the dots, and when I did it turned into a bit of a crisis for me, because I didn’t feel ready to talk about this discovery, because I worried that she might feel I was stepping onto her turf, and even though there really wasn’t anything I could do about it, the longer I didn’t talk about it, the more I felt that my motives for not doing so might be called into question. It took me a very long time to open up and talk about this with A. Once I did A. very helpfully pointed out that although I may think of it as her turf, it could also be seen as her standing in the way of what is just as much my turf. And still, despite having had this conversation, I feel that we both more often than not steer clear of things that could bring these over-laps up. Not sure A. would agree, or admit it, but I definitely feel that this doesn’t just come from me.

When A. went on maternity leave, I felt very aware that even though I would not be seeing her, I would likely hear about her baby being born through these over-lapping circles. I didn’t talk to A. about it, partly because I still have that sense of it being her turf, and I shouldn’t really be there and I find it hard to talk about these feelings, and partly because there was some sort of acceptance that there really is nothing I can do about this over-lap, anyway.

When the baby was born I did eventually hear about it, but not through the route which I might have expected – and had slightly prepared for – but through a much more personal link.

The culprit? Modern technology by the name of Facebook. My Facebook account is completely private, can’t be found in a search unless you have my personal email address, which most people haven’t, and even if you do have it, you wouldn’t have any form of access to photos, status updates or info until I have accepted the friendship request. (This is, incidentally, not because of extreme social paranoia – although I do think it is important to take charge of and be careful with your online presence – but because the place where I occasionally work happens to be one of those place where you simply cannot allow any of your personal details to be disclosed, and any contact outside of that place is strictly prohibited in any way shape or form.)

However, Facebook being Facebook, it does its darndest to connect people whether you want it to or not, and one morning a picture of a very vaguely familiar man holding a tiny black-haired baby popped up on my screen as a “person you might know”.

A.’s husband.
Presumably a combination of having a number of mutual friends and us both having A.’s email address in our address books had caused him to appear on my screen. I felt quite shaken by this. Didn’t know what to do with it. Had a whole host of feelings about it. Still do.

But have I talked to A. about it? No. And I feel I am now repeating the exact same cycle of avoidance that I did when I first realised A. and I have some common turf outside of therapy. It’s not good, because it is becoming something of a barrier for me, this holding back. I know I need to overcome it, somehow, but I don’t feel brave enough to deal with it just yet..

Help! My Therapist Is Pregnant

Posted by What It Takes To Be Me in Abandonment Issues, Attachment, Boundaries, Family, Inner Conflict, Music, Panic, Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, Sadness, Sef-Awareness, Self-Disclosure, Separation-Anxiety, The Therapeutic Relationship, Video and tagged with abandonment issues, attachment, boundaries, boundary-blurring, children, happiness, help my therapist is pregnant, inner conflict, Massive Attack, maternity leave, music, music video, my therapist is pregnant, panic, pregnancy, pregnant psychotherapist, pregnant therapist, psychotherapist maternity leave, psychotherapist's maternity leave, psychotherapy, sadness, self-awareness, self-disclosure, separation-anxiety, teardrop, the therapeutic relationship, therapist maternity leave, therapist's maternity leave, therapy breaks Saturday, November 19, 2011

Ever since I began seeing A. about two and a half years ago the fact that she is very obviously of child bearing age and would thus in all likelihood at some point want to have children has been brewing at the back of my mind. It’s one of those worries that has been there from the get go, and on more than one occasion I have actually talked myself into believing A. was pregnant when she wasn’t. Rather unsurprisingly, this has usually been at times when I myself have been particularly worried about the possibility that I may never get to experience motherhood.

The one thing I’ve always said is that when it does happens, well, I won’t deal well with it. I will hate it.

Now that it has happened, it feels very different to how I imagined it would. I can’t really say whether I’m dealing with it in a good or a bad way, I’m simply dealing with it on a day-to-day, session-to-session basis. Some days it all feels very OK, and on other days not at all. Sometimes the way I feel about A.’s pregnancy will even shift within a single session! And whether my feelings are positive or negative is definitely more random than cyclic.

As I mentioned in my previous post, prior to A. actually telling me she’s pregnant, I had already somehow worked it out, but decided to push it aside. Even though I on almost all levels knew this wasn’t the case, I tried very hard to convince myself that it was just another one of those false alarms, that it was all in my head, all to do with me, nothing to do with reality. I was working very hard at pushing myself into denial, until A. burst the bubble.

The way she broke it to me was something along the lines of “There’s something I need to talk to you about. I think you may already know..” at the very beginning of a session. She then told me she wasn’t exactly sure how it was going to work, in terms of her having time off, but that she thought she’d have three months off. My instant reaction to that was “That’s not very long” failing to explain that by that I meant that it wasn’t very long for the baby. For me, any break longer than a week is an absolute eternity, and fills me with out-of this-world anxiety.

Child-related themes have always been fairly frequent in my therapy, as having children has been my number one dream since I was a kid myself, so it’s hard to say if A. being pregnant has pushed those issues more to the forefront or not – it’s never particularly far off my mind – but I can say one thing for sure: having someone sitting across from you looking very pregnant will inevitably be a bit in your face; it’s not exactly something which can be readily ignored. [Although I have read case studies of clients apparently doing just that right up until the baby was born].

There are so many different aspects to all of this. There’s the outrageously jealous she’s having what I want most of all aspect, there’s the classic but I want to be your baby aspect, the I don’t want to share you with anyone sibling-rivalry perspective and – of course – the I really don’t want to think about it but you’ve been having sex borderline Oedipal side to it. There is also feelings of wow I’m so unbelievably happy for you and the somewhat odd I feel really sad that I won’t get to know this child I see growing before me.

There are moments when I really wish A. wasn’t pregnant, and other times I’m genuinely panicking at the thought of anything going wrong with the pregnancy.

I guess in a way you could say that A.’s being pregnant is one of those boundary blurrings that can’t really be avoided, and as I have said to A. more than once, I have a feeling that the next few months will be a bit of a roller coaster in terms of how I’ll respond to it all. Some days I feel completely freaked out by the huge unknowable factor which comes naturally with something like this: there is no way of knowing exactly from when A. will need to be off, there is no way of knowing when she’ll be back [in my mind I am mentally preparing for a much longer break than three months], there is also no knowing where I’ll be at when the break does happen, and there is no knowing where I’ll be at the end of it. What if things just plummet? What do I do? And, oddly just as frightening; what if I deal really well with the break, cope in a way I hadn’t expected? What would that say about the work we have been doing? About our relationship?

Scary stuff, all of it, let me tell you.

So.. watch this space and brace yourself for more than one serious freak-out.

All the very best and more,

Massive Attack – Teardrop

In Treatment, Richard Long & Fear of Real Emotion

Posted by What It Takes To Be Me in Boundaries, Psychology, Psychotherapy, Self-Disclosure, Television, The Therapeutic Relationship and tagged with accessing emotions, boundaries, boundary-blurring, change, fear, feeling, In Treatment, Richard Long, the therapeutic relationship Friday, March 12, 2010

It’s reasonably early morning. And once again anxiety has me up and about. Well, about is a bit of a stretch, but up, at the very least.

Been spending a lot of time writing in my journal this past week. It seems the best way to control this rising anxiety, this fear of all the emotions that are bouncing around inside of me. That and distracting.

I know I wrote in a post not long ago about trying to stay with the emotions, to allow them to break through my defences. And I was. But now, suddenly, it feels too much. So I distract. But, since a big part of me wants to feel, I do it through watching In Treatment, this American version of an Israeli show which rarely fails to get me to respond emotionally. It follows a therapist and his clients through the weeks, and also the therapist’s own therapy/supervision/marriage counselling sessions. The last part is, well, a bit unclear, really. As the therapist/supervisor/friend/colleague Gina frequently says:“Some lines have been blurred”. Understatement of the century! Anyway, I’m getting sidetracked.

Those who know me and my family background will probably understand why this show really gets to me, why it’s the show of choice for conjuring up a controlled emotional response. Anyway, maybe the reason for my choosing this particular show over other shows is of lesser importance than the fact that I choose to watch a show at all. Instead of allowing my real feelings room to roam I distract, so that I can – not switch off entirely – but can experience emotions once removed, if that makes sense. It reminds me of going to see the Richard Long exhibition at the Tate last year. How I felt that looking at photographs – beautiful as they were – were still merely watered down versions of these amazing works of arts, which he had created on a large scale in nature. In that particular case, it felt like it was lacking in flavour, left me wanting something stronger – but in the case of In Treatment, well, I think it provides me with just about the amount of emotion I can handle right now.

That said, I do hope – and also believe – that sometime soon, I’ll feel able to return to experiencing the real feelings in the moment, rather than half-way-but-not-quite retreating to something which feels safer.

I stand firm in the belief that true emotion is what brings about change. But, for now – maybe this way of feeling is an adequate apéritif? A taster of what is to come.

Enjoy your day.

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