I Survived A Therapy Break

We’ve been on a break, my therapist and I. A Pesach / Easter / training combo break. Leading up to the break I was very aware of Little S. inside having a lot of feelings about P. going away. This, even though, I – or should I write we..? – were also going to be away for almost the entire break. There was an increased and very distinct need for emailing and texting P. to make sure that she was Real.

I think that what Little S. means by someone being Real is a combination of them not forgetting her when she’s not with them and for them to not abandon her when things get rough. But, at times it is also a way to express genuine fear that maybe the relationship with the other person is too good to be true, it is asking for reassurance; are you Real, or just a figment of my imagination, because it seems so unbelievable to me to have someone who is really there for me when I need them.

A break always brings out a lot of abandonment issues, especially for the Little S. part in me. From Adult Me’s vantage point this makes perfect sense, I understand why this happens; so many people in my life haven’t been there when I’ve needed them the most, so, naturally, when someone as important to me as P. declares that she’s going to be away, it is bound to trigger all manner of emotional echoes inside me. But, as much as Adult Me can see this, it doesn’t actually make it any easier for Little S. to deal with the anxiety and sadness that these separations inevitably bring to surface. To Little S. the worry that P. might be going on a break because she has been too much for her is very real, as is the fear that P. might – during the break – realise that she prefers not to have to deal with her ups and downs, her neediness, her constant need for reassurance.. Before a break the tension inside Little S. will keep building, until she is convinced that a) there is no way she can survive this break and b) that, should she through some form of miracle survive, there is no way that P. will ever choose to return.

A few years ago, back when I was still seeing A., I would never ever talk about any of this directly with her before a break. I would suffer in silence, and maybe – very maybe – mention it after the break was over, although generally in a very brief glossing over kind of fashion. Before a break, I would just feel the anxiety mounting, bring me closer and closer to breaking point, but I would not really acknowledge just how difficult breaks are for me. This, of course, lead to breaks being absolutely catastrophic in my mind, and it was extremely rare that I would not need to be working with the crisis resolution team during them.

In the first year or so of seeing P. I slowly and very gradually became better at talking around the subject of breaks, slightly dipping my toes in it, so to speak. I would talk about it in the way Adult Me sees it, intellectualising it, rather than actually feeling it. In part this was because I didn’t really know how else to approach it; intellectualising difficult feelings, analysing why they are triggered, rather than actually feeling the feelings, is how I have got through an awful lot of difficult times; it is a well beaten path. But, as I have been working more and more closely with P. to try to notice that there are feelings stirring inside, and to identify what those feelings are, I can now fairly often allow myself to stay with them.

The other part of why – back in the early days – I didn’t really talk about the feelings was that many of those feelings [particularly the ones to do with abandonment and separation, and the shame of needing someone else] belonged more to Little S. than to Adult Me, and Little S. hadn’t yet found her voice. Or rather, I hadn’t yet found a way to allow Little S. to express herself directly in our therapy. But, eventually we cracked it; first by letting Little S. email and text P. between sessions and then by Little S. speaking directly to P. in sessions [as opposed to through Adult Me]. It’s been a long journey, but I do feel that Little S. is now reasonably able to take part in therapy when she wants or needs to.

So, this time around, on top of the many emails and texts asking P. if she is Real, she was also able to not only talk about her feelings prior to the break, but she was able to experience them while she was talking about them. And that felt like a very big step forward.

The break in itself actually went quite well this time. Of course we all missed seeing P., and there were a few times when either Little S., bob, or Adult Me needed to email P., but there wasn’t quite as much anxiety to deal with as there might have been, had we not been able to experience and explore some of the feelings before the break, had P. not helped me make space for these feelings to be not only shared, but also heard. P. doesn’t ever make me talk about difficult feelings, but she does actively encourage me to try – and we set the pace together. She makes it very clear to me that it is safe to allow feelings out, that she wants to hear about them, whether it be in session or in an email, a text or in a drawing. And, possibly most importantly – especially to Little S. – she reassures her that she will be able to bear those feelings, that they won’t be too much, and they won’t result in P. no longer wanting to see her. That feeling and talking and talking about feelings is very much welcomed and valued in our relationship. Even when it’s scary. Especially when it’s scary.

Another thing that P. and I do to help Little S. manage during breaks and particularly difficult times, is to let one of P.’s ‘little friends’ – a soap stone hippo called Ringo [*not his real name, gotta protect his privacy!] – stay with me. I will also leave something of mine with P. to further strengthen the sense of connection between us during the break. As Little S. would say: “Something to help you ‘merember’ me, in case you start to forget.” It may sound like a childish thing to do, this exchanging of personal artefacts, but, Little S. inside is just that – she’s little – she may live inside the body of an adult, but she still finds comfort in having something physical to hold on to help her connect with P. So, no matter how silly it may seem to outsiders, taking Ringo with me everywhere I go, it makes all the difference in the world to Little S. And that’s worth a lot!

So, when you’re facing a break in your therapy, here is my advice to you: listen to what all of you need to make that break as bearable as possible. Don’t allow your Adult Self to stop your Little from getting what they need to manage it. To the best of your ability, talk about the fears and worries that all of the different parts of you carry about this break. Write it in a letter if it is too hard to say it out loud, if the fear of rejection gets too much. And if needed: ask if Ringo can come stay with you. And, if asking for a Ringo to stay with you feels too much; start small. I was given this tip by one of my readers many years ago, and at first, having something personal of P.’s felt way too overwhelming for me, so we started by my borrowing a random pen of hers that I could use to write in my journal with. And a little note from P. to help reassure me that she wouldn’t forget me and that she would be back.

But now that I have worked my way up to having Ringo stay with me, I wouldn’t have it any other way.
And neither would my sisters’ kids!

Be good to your Selfs.

xx

IMG_3885

A drawing Little S. made last night to show how happy bob, she and Adult Me feels that P. is finally back

 

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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

From Swan Lake to Daft Punk – A Post About Psychotherapy Breaks

Every time I upload a new post I do so with the intention of posting another update soon thereafter, but it just never seems to happen that way.. I suppose I will have to own that this happens in part because I slightly lack the discipline to stick to a set publishing schedule, but, also, it happens because – well – life happens. I’m sure you know what I mean. It is hard to write about your life at the same time as you are experiencing it. Especially when the going is tough.

So, what has been going on in my life since my last post? Quite a lot, it feels like, and at the same it is rather a lot of the same that is pretty much always going on; flashbacks, crises, therapy breaks, family stuff.
I’ve been under the care of the crisis resolution team six or seven times already this year and had one stay at Drayton Park. That’s a lot, considering we are only in the eight month of the year.. And I have a feeling that another stay at Drayton Park may be on the cards in the near future. I am actually seeing the crisis resolution team later today, and my guess is that they will suggest to start a referral for some residential care. To keep me safe from myself. Without going into too much detail, the going has been exceptionally tough this year in general, and recently in particular.

*

P. has been on annual leave for about two weeks now, with another two still to go. I know that I have written about therapy breaks many many times in the past, but it is for good reason: they really are that difficult to cope with.

And I know for a fact that I am not the only one who experiences breaks in therapy as major triggers for all manner of extreme abandonment, attachment and separation issues. A quick look at the stats for how people find this blog tells me that some of the most commonly used search terms are variations on the theme of How To Cope During Therapy Breaks. This is also a topic that people frequently email me about. [Much appreciated, and – as always – apologies if I’ve not been able to respond to your email yet]. 

So, this is clearly not something I alone struggle with.  

I think part of the reason why it is so hard to manage while one’s therapist is away is that Everyone Else [friends, workmates, family, even mental health workers] find it seemingly impossible to grasp just how important and intimate a therapeutic relationship is, and what huge emotional waves the absence of your therapy partner sets in motion. So, we are left feeling that the pain we experience because of our therapist’s absence goes unheard, thus redoubling the pain.

I have some absolutely wonderful friends, I am very very close to my sisters [by golly I love them more than I could ever express!] and I really wouldn’t describe myself as a lonely person per se [although I do perhaps crave more alone time than most] – but my relationship with P. is different to every single one of my other relationships, no matter how good, close and meaningful they are, and it takes up a huge amount of emotional spacetime in my day-to-day life. Even on the days between sessions. 

So, when P. goes away for any length of time, that is going to be hard to cope with. I am used to being able to voice thoughts I don’t share with anyone else three times a week. I have 150 solid minutes every week that are there for only me, to express whatever I want to or need to. 9,000 seconds a week to experience being heard and seen by a pseudo-parent who genuinely wants to understand and help find ways to ease the pain. And that’s not even counting the email and text contact P. is encouraging me to maintain in between sessions and over weekends. So, of course her absence is going to be massively felt.

It isn’t a case of my being needier than most, it is simply that this is a big change to the structure of my week – and I think that most anyone who had that kind of drastic change to their life [even if it is temporary], would find it quite challenging to get used to. 

And – of course – we are none of us in therapy for the sheer fun of it. Something has brought us there. There are Issues to be worked through. Usually more than one, and hardly ever the easy-to-resolve variety. [If, indeed, such a variety exists.. I have my doubts..]

During a break the therapeutic process gets put on hold. Or – perhaps more accurately – the format of the therapeutic process changes during a break. Of course we don’t go into a period of zero growth during a therapist’s absence [in fact, in my experience breaks more often than not bring growth in its wake, both for me personally and in my relationship with P.], but the rhythm is upset. There are no two ways about it. It’s like listening to Swan Lake for a solid month and then suddenly having that musical loop switched to Daft Punk. It’s not bad for us [I would never call Daft Punk bad!], but it IS vastly different. And even if we know that the switch is going to happen [having bravely attempted to talk about the upcoming break and the feelings it brings to surface], going from Swan Lake to Daft Punk is going to affect us. Different feelings will be stirred up, often difficult, deep-seated ones. And we will be on our own to cope with them. 

Or, as in my case, you’ll end up working with the crisis resolution team for the umpteenth time.. ;)
So, that’s where I am at right now.

Getting used to Daft Punk. 

xx

Progress And Pain – Parenting My Inner Child

It’s been a long time. It’s been too long, really. I suppose that I just needed a proper break from things. Or, rather, I needed to use what little energy I could muster to deal with the bare essentials, hence largely withdrawing from the world, both online and in my day-to-day interactions with family and friends.

It has been, and still is, a very rough ride. Since the beginning of the year I have had three rounds of crisis team intervention and one admission to Drayton Park, all with that burning hopeless feeling that ‘It’s pointless, it won’t make a difference’. Except, from an external point of view it has; I am still here now. I might not have been.

Therapy is the one thing that I feel is actually going well. But, as is so often the case when it comes to therapy, ‘going well’ involves a decent sized chunk of dizzying pain. The therapeutic process has never been heralded as a ‘free from unwanted side effects’ type of medication..

I continue to build my relationship with P., doing this quirky little two-steps-forward-one-step-back dance, putting my most deep seated fears and trust issues through their paces. Progress is slow, but at least we are moving. Those of you who have been in therapy will know exactly what I am talking about; one session and – almost out of nowhere – you find the courage of a lioness and take a giant leap forward, right across the abyss – the next two sessions; withdrawing and giving in to age-old fears of being let down, needing to test and re-test your therapist, to check that they really are for real, that those encouraging words won’t turn out to just be empty promises.

My need for emotional hand-holding and reassurance has known no limits in these last months and weeks, and consequently P. has had to work darn hard for the pennies.. She tells me that she knew what she was signing up for when she decided to take me on, I argue that she can’t possibly have known – because she didn’t know me – she then agrees that this is true, but reassures me that she has a very strong sense of what she can cope with, and that I really really really am not too much for her. And we take another tiny step forward.

As I have said many times before, I don’t think therapy is meant to be easy, I think it’s meant to be worth it.

Right now we are standing at the door of a two week therapy break, so – predictably – all of Little S.’s abandonment fears are awakened and hyper aroused. Adult Me works hard to try to explain that it will be OK, that we have been through – and have survived – many, many breaks before, and that we will get through this one, too, but Little S. clamps her hands firmly over her little ears, certain that this is the end of the safety and pseudo-mothering we have enjoyed from P.

What it boils down to is that my inner child, just like any other child, has no real understanding of time, and so a separation from P. is not a temporary state, but is permanent and absolute. And, again like most children, when the caregiver goes away, she assumes that this must be because of something she has done. This, in turn, makes Little S., go back and forth between putting unrealistic pressure on herself to be ‘all good’ [because, if she is very very good, maybe P. won’t leave her] and needing to self-punish [because she must have been bad, to make P. go away]. Adult Me works very hard to try to help regulate the extremes, but parenting your own inner child is not an easy task, especially when so many of Little S.’s thought patterns and beliefs still live on in Adult Me.

I still have three sessions left before the commencement of this two-week-bordering-on-eternity break, so there is time to talk this through with P., time to get another shot of reassurance injected, and hopefully that will alleviate at least some of Little S.’s [and Adult Me’s] anxiety.

We’ll see..

Anyway, take good care of your Selves, and thank you all so much for sticking with me through this hiatus, of sorts.

xx

Out Of Control – Me On Steroids

There I was, having been told that there was a good chance that my hearing loss was due to my own actions. Not an easy thing to deal with. Part of me absolutely felt angry with myself, was blaming myself; I have a natural tendency to be very hard on myself – especially when the consequences of my actions turn out to be severely negative. But, there was also another part that just felt confused, because whilst the second most recent overdose was certainly a serious one, the most recent one was one where I didn’t ingest more than about half a teaspoon of the chemical, and I couldn’t quite understand how it could have had such a drastic effect on my hearing. But, clearly it had.

The ENT specialist had prescribed a high dose of Prednisolone which I was to take for a week in the hope that it may reverse some of the recent hearing loss. The name of the medication did ring a bell at the time, but not loudly enough for me to clock why, so I went down to the hospital pharmacy and picked the medicine up. It wasn’t until I got home that I remembered that this was a medication which a previous GP had refused to prescribe when my asthma was really bad, because she felt it was too much of a risk, putting me on it. There were two reasons for this: firstly, that people with a history of serious mental health issues are particularly prone to react badly to this medicine, and, secondly, that I have in the past had extreme adverse reactions to three other medications [one of which I was reacting to when I took the second most recent overdose], so the doctors are always very cautious about prescribing any non-essential new meds to me.

But, there I was with the medication in my hand, not knowing whether or not it would really be a good idea to take it. Yes, this medication could potentially save me from needing cochlear implants down the line, but, at the same time, if I did have a really bad reaction I could end up putting myself at considerable risk. The ENT specialist wasn’t someone who knew me well [or at all, really], so when he prescribed it, he did it on the same premises he would for anyone else; ‘Worth trying, no harm done if it doesn’t work’, whereas I knew that this medication could spell real trouble for me.

There was a part of me that was genuinely scared of a bad reaction; I knew perfectly well the horrible feeling of being out of control because of a medication. I had been through it three times.. Yet, there was another part that so badly wanted to be able to do something to reverse the damage I had apparently caused.

I spent a week going back and forth, unable to decide what to do, talking it through with lots of people, knowing full well that, ultimately, it was still my decision to make. I did speak to my GP [well, technically, the receptionist spoke to her on my behalf], and she said that it would be ‘perfectly fine’ for me to take the steroids, and – after all – I had had no adverse reactions to the steroid injections I was given when treated for anaphylaxis.

In the end I decided that I would give it a go, because I knew that if I didn’t I would always be wondering ‘What if..? What if..?’.

Still, to be on the safe side, I decided to start the course early Monday morning, so that if I did have a bad reaction I would be seeing P. later that day. [With two of the three medications I had previously reacted badly to, it had happened literally within a few hours of taking the first dose]. I also had a doctor’s appointment on Tuesday, and scheduled a ‘just-in-case’ appointment with K., my synagogue social worker who I have been seeing semi-regularly, for Wednesday afternoon.

Monday came round and I took the first dose, which – as this was a high dose treatment – was a good handful of pills, making me feel as if I was actually overdosing on tablets. By the time I was due to see P. – about six hours later – I already knew something wasn’t right. I could feel things firing in my brain, rapid electric sparks in my head, and it was as if I couldn’t keep track of my own thoughts. It was a truly bizarre experience. – Anyone who has ever been seen by the mental health crisis team knows that one of the questions you will be asked during the assessment is ‘Are you having racing thoughts?’. Being prone to deep depression and suicidal ideation rather than mania I have always answered ‘No’ to that question, not really knowing what ‘racing thoughts’ actually were. I’m telling you, by noon that Monday I knew exactly what they were – and it was freaking me out, big time!

So, I had a crazy rambling session with P. that day, very unlike any other session I have ever had. I also spoke to H., my care coordinator, that same afternoon and she sorted out a referral to the crisis resolution team for Wednesday, as it was clear I was not in a good way and would likely need the extra support, particularly over the weekend.

On Tuesday morning I went to see the doctor – an absolutely lovely F2 who I hadn’t met before. By then I had taken the second dose of Prednisolone – more out of a sort of manic compulsion than anything else – and consequently the reaction was getting worse. I had also used a surgical scalpel and cut myself very badly in two places; enough to warrant stitches. The doctor’s reaction was ‘Come off these meds immediately – this is a really serious and abnormal reaction!’.

I explained to her the reason why I was on the treatment in the first place and why I was finding it hard to ‘just stop taking the meds’, and this young doctor was absolutely brilliant. She sat back and listened to me carefully and then took the time to make five or six phone calls – while I was still in the room – to get hold of an ENT registrar to find out what the implications of stopping the treatment would be for my hearing, so that we’d be able to make an informed decision. The ENT registrar told her that as treatment had been delayed by several months already [Urgent NHS referral, remember?] it was unlikely that my hearing would improve, that the specialist who prescribed the steroids probably felt it was worth a shot – even if it was a shot in the dark – because sometimes people do respond, even with delayed treatment. But, the registrar concluded, in light of the extreme reaction I was having it certainly wasn’t worth staying on the meds, as the odds of success were so small.

I felt really reassured in that moment that I wouldn’t be missing out if I ended treatment prematurely, because the odds of any improvement were so small. It made complete sense to stop taking the meds.

But, then I got home, and I was still hyper and there was so much in me saying that firstly I was already dealing with the adverse effects of this medication [the GP had explained that it would more than likely be a few days, maybe even a week, before the chemicals in my body would stop messing with my brain].. and it was only a few more days to go.. and what’s to say that I couldn’t have an equally abnormal positive reaction to these meds..? After all, my body is clearly highly sensitive to small chemical changes..

So, the next morning I took the third dose, against medical advice. This time it wasn’t manic compulsion that made me do it, but that part of me that just needed to hold on to hope, that simply couldn’t give up, even though everyone around me felt this was a very bad decision, indeed.

I spent time in my session with P. that day, exploring why it was so terribly hard for me to stop taking the tablets, even though the rational part of me knew that the chance of a positive outcome was incredibly slim – and that was really helpful, even with the chaos raging in my head.

I also had a good chat with K. that afternoon. She was characteristically open, direct and honest with me both about her anger and her disappointment that I had carried on taking the medication in spite of what the doctor had told me, and in spite of the fact that I had felt completely reassured at that point that I wasn’t missing out. I told her that I would think very carefully about handing the meds in to P. the next day, but I was also clear that I wasn’t prepared to make any definite promises, because I simply didn’t feel that I could. So much of me felt out of control and I just couldn’t say that I’d be able to do that, come morning.

Oddly, the thing that made me realise just how out of control I really was wasn’t the fact that I had cut myself so badly, but the fact that I found myself at a McDonald’s having a Big Mac.. I’ve been a vegetarian for something like twenty years, and I keep sort-of-kosher, so for me to sit down and eat something like that goes against so much of what I believe in. It is something I simply wouldn’t ever do, if I were in control of my actions..

I did end up giving P. the tablets the following day, but not before having taken a fourth dose that morning, this time – again – in a very compulsive manner. There was no reasoning whatsoever, just acting: I simply couldn’t not take them. This made me realise that I really needed to view the tablets in the same way I did my scalpels and cords [all of which I had handed in to P. two days earlier, feeling too out of control to be safe with them]; while I was still having this strange reaction I just couldn’t manage the tablets responsibly.

It took a good while after that final dose before I felt completely back to my normal in-control self, and I carried on working with the crisis resolution team through the weekend and most of the following week, just to be safe.

I am really glad that I had as much support available to me as I did during this time, because it was incredibly frightening to be so out of control. The experience was very different to other times when I have felt out of control. Whilst what came out in the midst of this whole ordeal – feelings, thoughts etc – were things that were almost certainly already brewing inside, it was – at least the way I look at it – triggered by outside factors. And that’s quite a scary thing.

All the very best,

xx

Scaffolding

I was supposed to be dead by now.

It feels kind of strange to write it, but it is true, nonetheless. A little over four weeks ago was when it was supposed to happen. I had booked the hotel room where I was going to go to, to end my life. I had everything I needed to do it. I was completely at peace with the idea of going through with it, felt satisfied that I had tried my very hardest to get onto a different path. There was only One Last Thing I needed to do before setting my plan in motion. Except chance intervened and stopped me from being able to do that One Last Thing, and there was no way I could go ahead with ending my life without that.

So, instead I ended up going another round at Drayton Park Women’s Crisis Centre. I was offered a place, having initially been turned down for it, as I was deemed too high risk to be safely contained there. Nothing had really changed between the time I was initially assessed and when I eventually took up a place, but, I banked on my good personal credit that if I made an absolute promise that I would not act to end my life as long as I was staying in the house, staff would trust me enough to let me have a place. As long-term followers of this blog will be aware, I made a very serious attempt at ending my life the very first time I stayed at Drayton many years ago, and ever since then I have developed a rather special relationship both with the staff and with the place itself. It has been a go-to place for me in times of real crisis, a place to sort out my feelings, to create space for myself without having to worry about anyone else, somewhere I feel safe enough to really stay with myself, if that makes sense.

This time was very different. Not because the above things were no longer true – they still were – but because in complete contrast to all other times I have gone there, this time I went into Drayton Park with absolutely no belief whatsoever that anything was going to change while I was staying there. The reasons for wanting to end my life were – and still are – things that could not change through short term crisis intervention. But, I decided to take up a place at Drayton Park, in spite of this. I went there in part because I wanted my loved ones to know that I hadn’t just given up without one last fight, and partly to buy myself time, because as much as I didn’t believe that anything would really change, I also accepted that I haven’t got a telescope to the future, and consequently couldn’t know for sure that I wouldn’t be proven wrong. And I desperately wanted to be proven wrong. I desperately wanted something to change.

A number of big things happened during my time at Drayton Park.
Firstly, counselling with Z. came to an end on the day I took up residence. Secondly, I made a decision that long term therapy with A. will have to come to an end after more than four and a half years of working together. A. made it very clear to me earlier in the year that she is not able to work with me under the threat of suicide, and as I am someone who simply will not make a promise I don’t know I can keep, the only fair thing to do was to set an end date to therapy. Finally, in the last few weeks I have been under assessment of the personality disorder services to see whether or not I should be offered a place with them. I have had very mixed feelings about this from day one, have very little hope that there really is anything in it for me, but again, I try to keep an open mind rather than closing doors.

With all of these things going on, and feeling completely stripped of any hope that there truly is anything out there that could change how I feel about ending my life, I decided to use my time at Drayton Park to go against what my heart was telling me – a very foreign concept to me. To hold on, rather than to let go.

I spent my three weeks at Drayton Park actively putting up scaffolding around my life, in spite of the very real and painful belief that it was utterly futile to do so.

I put scaffolding up by carrying on with the assessment process with the personality disorder services, even though I was reasonably certain that neither DBT nor MBT were really for me, that I don’t quite fit the bill. More scaffolding went up by re-arranging the end date with A.; it has now been planned so that rather than going from twice weekly therapy to nothing from one day to the next – which was the original idea, and which on reflection felt unnecessarily harsh – we will instead carry on with twice weekly sessions until A. goes on her Chrismukkah break later this week, and then go on to do one month of weekly sessions at the beginning of next year to allow for a tapered, more emotionally gentle, ending. Further scaffolding was created by contacting Z. and asking her and her supervisor to have a think about who they might be able to refer me to, for longer term trauma focused work. Someone who might be willing to work with me, knowing what the full situation is, in terms of suicidal ideation.

I also threw myself into expressing myself through writing, taking part in two creative writing workshops facilitated by the most fabulous Leah Thorn, and was able to share some of my feelings about life and death at a poetry reading during the annual Open Day, which happened to be held during my stay at Drayton Park. [Click here to read one of the poems I read that day].

I was discharged from Drayton Park a week ago today.
I don’t feel any different in terms of wanting to allow my very tired soul to rest. I wish I did, but I just don’t.

However, I am carrying on with the building work I started while at Drayton Park: I am working with the crisis resolution team to have some extra support for the first few weeks of being back home. The extended assessment with the personality disorder people has come to an end. In the only way the NHS knows how an Expert was brought in [in the shape of a clinical psychiatrist I had never met before in my life] to try figure out what the heck to do with me. It was ultimately decided that I was probably right: I don’t quite fit the bill and neither DBT nor MBT is going to be particularly suitable for me. However, although I won’t be enrolled on the personality disorder programme with all that that would have entailed, I have been given a care co-ordinator [henceforth called E.], who I will be meeting with somewhat regularly, to have someone within the blessed NHS who knows me and who I can turn to in a crisis.

Z.’s supervisor also got back to me with a name for a specific psychotherapist who she felt might be a very good match for me for long term work, and I will be having an initial consultation with her tomorrow to see if her gut feeling proves right. Although I don’t necessarily feel that even this type of work will really have the power to change anything, I am trying my best once again to at least be open to the possibility that it could have something to offer – and – for a naturally analytically minded person such as myself, at least this type of therapy [trauma work with an experienced attachment based psychoanalytic psychotherapist] makes far better sense than either DBT or MBT.

In my therapy with A. I have tried to be brave and really explore what this big change, this ending of our work together, means to me, and how it makes me feel, the deep sadness it brings out in me. It’s not easy, but I am hoping that through being as open and honest about my feelings as I can, it will make for a more manageable ending.

So, that – dear readers – is where I am at:
In the process of building something that may or may not stand the test of time.

I do hope that it will, but right now, it is simply too soon to tell.

 

Much love,

 

xx

Safety, Anxiety, Boundary Blurring & Progress

 

An Implosion of Emotion

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 5th 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 herDo 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.

xx

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

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