The March Post

Posted by What It Takes To Be Me in Being Alive, Diagnosis, Psychology, PTSD/Extreme Emotional Stress Disorder, Self-Harm, Sexual Abuse, Suicidal Ideation and tagged with crisis resolution team, crisis team, CRT, flashback, managing self-harm, self-harm, self-injury, sexual abuse flashbacks, suicidal ideation Saturday, March 31, 2018

To say that this hasn’t been my favourite month ever would be a grave understatement; March has been seriously rough. But, then again, I always knew that part of this particular month would be a real challenge, as this happens to be the month in which one of my abusers’ birthdays falls, something which is always a big trigger for me. A truly awful day with masses and masses of flashbacks.

On top of that, I was sent one of those dreaded brown envelopes from the DWP that I mentioned in last month’s post, one which contained a form for me to fill out, relating to benefits. This is something that always sends me into a complete tailspin; the anxiety that these forms provoke is enormous, because they force me to have to think about all the things I can’t do, leaving me feeling like an utterly useless human being. Even at the best of times I find it hard to think myself worthy of any form of financial support (even though, in healthier times, I used to work crazy hours, and paid equally crazy amounts of income tax, earning national insurance aplenty) – but when I am already feeling low – well, those DWP forms seem to be designed to give one the experience of being kicked while already being on the ground..

I am very fortunate, I have a therapist, a care coordinator and a social worker who are all more than happy to help me with these forms and support me through the emotional turmoil they cause, but even so, my risk level increases incrementally with every page of questions on those forms. I spent a session with my care coordinator, filling out as much of it as possible, but even though – in all honesty – she did most of it, and even wrote on the form for the DWP to contact her if there were any questions – I was overcome with horrible thoughts of how the people at the DWP would rather I kill myself, than having to keep paying out money to me. Of course, the rational part of me understands that absolutely nothing about these forms is personal – that lots and lots of people are sent (read: tormented by) them every single day – they still have the power to reduce me to one giant suicidal self-harming mess. In the month and a half I needed to fill out that ruddy form, I lost count of the number of times I took it out – fully intending to manage at least a couple of questions that day – only to have to put it away again, as my urges to self-harm got too strong.

So, this, in combination with my abuser’s birthday, meant that I desperately needed the support of the crisis resolution team. I was having such strong urges to end my life – even though parts of me really wanted to live – that I was struggling to keep my Self safe from me. And, even though I was reluctant to work with them to start with, I know that the extra support that they offered this time around, is what kept me safe, kept me alive.

So, no, March 2018 hasn’t been a great one.
But, hopefully, April will treat me with the kindness I deserve.

I Survived A Therapy Break

Posted by What It Takes To Be Me in Abandonment Issues, Anxiety, Attachment, Being Alive, Communication, Drawing, Expressing Emotion, Expression Through Art, Personal Growth, Psychology, Psychotherapy, Psychotherapy with P, Separation-Anxiety, The Therapeutic Relationship, Writing and tagged with Adult Me, allowing all of yourself in therapy, anxiety, attachment based psychoanalytic psychotherapy, attachment issues, attachment-based therapy, Community, crisis resolution team, crisis team, CRT, drawing, experiencing emotions, expressing emotions, expressing through art, Little S, psychology, psychotherapy, psychotherapy breaks, separation anxiety, separation-anxiety, surviving a therapy break, the therapeutic relationship, therapy breaks, transitional objects in therapy Friday, April 21, 2017

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.

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

A Much Delayed Update

Posted by What It Takes To Be Me in Being Alive, Coping Strategies, Defence Mechanisms, Depression, Dissociation, Expressing Emotion, Family, Illness, Personal Growth, Psychology, Psychotherapy, Psychotherapy Breaks, Psychotherapy with P, PTSD/Extreme Emotional Stress Disorder, Sef-Awareness, Self-Harm, Sexual Abuse, Suicidal Ideation, Suicide and tagged with consequences of failed suicide attempts, crisis team, Depression, Drayton Park, Drayton Park Crisis Centre, Drayton Park Crisis House, Drayton Park Women's Crisis Centre, Drayton Park Women's Crisis House, effects of childhood sexual abuse, ethylene glycol, expressing emotions, psychotherapy, psychotherapy breaks, recovery, suicidal ideation, suicide attempt, talking about suicide, talking openly about suicide Monday, April 25, 2016

It has been such a very long time since I last posted anything on here, it feels all but impossible to try to catch you all up. And maybe it’s not really the most important thing in the world that I do? If you’ve been following this blog for a little while, you’ll probably already have some idea of what sorts of ups and downs you might have missed in the last few months. After all, there is nothing new under the sun. And if you have only just arrived on my site, well, feel free to hop on board as you are.

So, I’ll just begin with where I am at now. Literally.

I am at home, very slowly trying to allow my body to recover from the hell I have recently put it through. I suppose you could say that I had been on a slippery slope to nowhere for a long time, and a number of weeks ago, my therapist started a referral for me to go to Drayton Park. I was already with the crisis resolution team at this point, struggling enormously with trying to keep myself safe. Being at a very low point, the only way I could really manage was by taking sleeping tablets. Paradoxically not to kill myself, but to stop myself from doing so. Perhaps not the best way to manage, but it was all I could do at the time. The referral to Drayton Park took longer than usual for a number of reasons that I won’t bore you with, and being asleep most of the time while I was waiting was the only way I could think of to stay safe. After all, if I was knocked out there was no way I could actually act on my suicidal impulses. Right?

A little over a week later I was finally given a place at Drayton Park, and that felt like such a relief. But it wasn’t all smooth and simple. The depression and the suicidal ideation, the flashbacks and the urges to self-harm came with me. And, although I have stayed at Drayton Park about a million times [OK, maybe not a million, but certainly enough times to feel at home there] this time felt like a distinct travel back in time. You see, the only room available was the one room I have always dreaded being put back in; the room I stayed in during my very first time at Drayton Park. Yes, I have stayed in other rooms there more than once with no problem, but this one holds some particularly bad memories for me; this is the room I died in. And this time it isn’t an exaggeration – I was found lifeless in that room, and while I have no actual memory of it, I was told by the doctors in ICU that I had been clinically dead for a number of minutes by the time the managed to bring me back.

The reason I was found lifeless in that room all those years ago was my own. I had brought a substance into the place that I shouldn’t have, and being the kind of person who – owing to deep seated psychological issues – is far more afraid of being found to have broken The Rules than to tell staff that I was afraid of what I might do, and that I needed help, proceeded to ingest said substance. So, this time around, being back in that room, I was overcome by memories of standing in front of the mirror in the bathroom swigging pure poison from a bottle, quickly followed by a handful of Smarties to mask the bitter taste, looking at myself, hoping to die.

This time around I used my one-to-one sessions at Drayton to talk about these memories, about the sense of being thrust back in time and the feelings evoked, and I was immediately and repeatedly offered to switch rooms. But, me being me, I thought there might be some therapeutic value in being able to stay in the same room, look at myself in the same mirror, but having a different outcome. I thought that the feelings brought out by staying in this particular room might be used for healing, for psychological growth, even. Sadly, I seem to have completely forgotten that the reason I was back at Drayton in the first place, was that magnetic lure of release from life – and that I wasn’t strong or stable enough to do this kind of work at this particular time. And it proved to be a costly miscalculation on my part.

Prior to admission to Drayton Park I had purchased another bottle of a similar but far more lethal poison, and it was still sitting at home, waiting for me. Thus, part of the objective of my stay this time was to get me to a place where I would be stable enough to be able to safely go back to my flat and pick up the bottle to hand it in to staff, without having the urge to down its contents on the way back. I was working very closely with both P. and staff at Drayton to get to this place, we talked about my feelings, about the reasons for those feelings and how best to keep me safe – we really were doing everything possible to get me out of this perilous place I had been perched at when I first arrived.

Admittedly, at first there was a fair bit of pressure for me to bring the bottle back at the earliest possible opportunity, but this plan was thankfully changed, when I – with the help of P. and staff who have known me for a long time – were able to to explain that bringing back the Bottle before I was ready to do so wouldn’t necessarily make me any safer; I’d just order another one online, or I’d feel pushed to act out in some other equally dangerous way. [Having a severe nut allergy means that I am never further than a chocolate bar away from having the means to end my life]. Instead we planned trial runs to my flat where I would go into my flat but not into my bedroom [where the bottle of Poison was kept]. I’d pick up post or a change of clothes, but there was no expectation that I bring the poison back. This worked. Twice. In fact, during one of my visits home I managed to – relieved of any pressure to perform, so to speak – bring back the anti-sickness tablets that were also part of my suicide plan. It was hard going back to the flat; in spite of our best efforts to have strong safety plans in place and in spite of never staying longer than ten minutes, I never quite felt safe.

Partway through my stay P. went on leave, as did K. This meant that most of my usual safety net was no longer available to me. And that, too, was hard. Destabilising, is the word that comes to mind. I knew that I would not be able to stay at Drayton until they were back from their respective leaves, and that didn’t feel good at all. So, fear of going home – having still not been able to hand in the Bottle – intensified. Towards the end of week two I was asked to make a Week Plan, to add structure to my stay, which I did. Knowing how hard it had been the two previous times going back to the flat, I only planned visits home for every other day, so as to not overwhelm myself.

But on the very first day of following my Week Plan I knew I wasn’t stable enough to be able to go home, even for a short visit. It was one of those very bad days with lots of flashbacks and thoughts of how much better things would be if I were dead, so, I switched days on my planner, did my Tuesday plan on the Monday. And it would have worked out fine, except the next day was just as iffy as the previous one, safety-wise. I wanted so badly to be able to stick to the plan, though, since otherwise there would be fewer opportunities to go home before actually being discharged. And I knew discharge would be coming, whether or not I had brought the Bottle back.

I want to pause here to make something perfectly clear: there was absolutely no pressure from staff for me to go home that day – none, zero, ziltch – and that is really important to understand – they were all working hard to keep me safe. All pressure to go home that day came from me, and me alone. But, in the end I did decide to push on through. And that turned out to be a near fatal mistake.

When I first got to the flat on that third trial run I felt anxious, but sort of within the realm of what I could manage. So, before entering I rang Drayton to say that. All was good, I sat in the kitchen for a bit, I even wrote an angry note to my flatmates about the washing machine not having been fixed during my two week absence. Everything felt normal.

And then suddenly it didn’t.

I know that I went and took a sleeping tablet in desperation. At the time I really thought it was just the one, so, that is what I told staff when I called them in panic. They stayed on the phone with me until I was out of the flat and I got a taxi back to Drayton. I saw my main worker when I got back, and prepared to go to bed [after all it was a sleeping pill I’d taken]. We agreed that they would check on me every hour, just to make sure I could be woken up, since I have a history of taking overdoses in a state of dissociation, and I couldn’t say with 100 per cent certainty that I hadn’t done so this time, too. [Entering a dissociated state is actually far more common than you might think, especially for people who have suffered severe abuse and have used dissociation as a coping mechanism all their lives]. About quarter of an hour later I knew that I must have done more than just taking a single pill, because I was feeling nauseas and drunk and was losing control over speech and movement. So, I went straight to the staff office and knocked on the door. [This is, incidentally, the exact opposite of what I did that very first time at Drayton]. The last thing I remember is lying on the sofa in The Quiet Room with a member of staff next to me, being told that an ambulance was on its way.

I woke up in hospital. I knew immediately that I was in hospital, because nowhere else on earth are you met with those cold harsh lights, and those ugly tiles in the ceiling. That is my first memory. My second one isn’t so much a memory as a feeling, a feeling of immense relief that I was alive, that I had in fact woken up. And I knew that was a big deal. Every other time I’ve woken up in hospital I have felt nothing but sheer anger that I hadn’t died, wondering what I had done wrong, thinking about when I could do it again.

I spent a number of days in hospital being given antidote every twelve hours. And that was one of the most scary experiences ever. The relief of being alive soon wore off, and the fear of not knowing whether or not I would actually live – and what that life might be – took over. I knew that things were bad, really bad – not just from the vast number of tubes coming out of my body or the urgent frequency with which blood tests were taken day and night – but by the fact that when I tried to ask doctors and nurses would I be OK, they avoided eye contact and would generally mumble something along the lines of Let’s not worry about that right now, sweetie.

It wasn’t until the very last day, the day I was due for discharge, that I finally found out the truth of just how close it had got. I didn’t ask the doctors or nurses this time because I didn’t trust that I could deal with what they might have to tell me, instead I reached for the journal folder at the foot of my bed. And there it was in black and white. Multiple organ failure. Prognosis: poor.

Of course, by the time I read those journal notes, I was out of immediate danger, but it was still a shock to see it. This was what I had done to myself.. I had put kidneys, heart and respiration at serious risk. When the first tox screen came in they didn’t think I’d live, and if I did I’d likely have reduced function of at least some of those organs.

I have now been at home for about two and a half weeks. I am extremely fatigued and am sleeping most of the time. Any little thing exhausts me. I have had follow up tests and the results are not great. They aren’t anywhere near as bad as they could so easily have been, but I am also not recovering at the rate the doctors would have hoped. So there will be more tests to come. In short, I still don’t know the full extent of the damage I have done to myself.

But, I am alive.

And I have a lot of feelings about that.

I hope that I will be able to write more about those feelings soon. –ish.

PS. I want to make a special mention that I have chosen not to share what has happened with my immediate family, in an effort to spare them pain and worry. At least until I know for sure what I am dealing with. So, should you be someone who knows me in person – and knows my family – please make sure to keep this information to yourself. This blog is semi-anonymous, not for my sake, but for the sake of those close to me. It is also a place where I can safely share my feelings, and that means a lot to me.

When Your Therapist Goes Away

Posted by What It Takes To Be Me in Abandonment Issues, Anxiety, Attachment, Coping Strategies, Drawing, Expressing Emotion, Expression Through Art, Music, Personal Growth, Psychology, Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, Psychotherapy with P, Sadness, Separation-Anxiety, The Therapeutic Relationship, Video and tagged with abandonment, asking for help, attachment based psychoanalytic psychotherapy, big kids do cry, bridge over troubled water, card from therapist, coping during breaks, crisis resolution team, crisis team, CRT, drawing, email to therapist, expressing emotions, expressing negative emotions, fear of being abandoned, garfunkel, getting help, holidays, letter to therapist, preparing for a break, psychotherapy breaks, simon, the therapeutic relationship, when your therapist abandons you, when your therapist goes away, when your therapist is away Tuesday, December 29, 2015

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,

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

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

I’m Alive, I’m A Mess

Posted by What It Takes To Be Me in Being Alive, Depression, Dissociation, Friends, Illness, Inner Conflict, Medication, Music, Psychology, PTSD/Extreme Emotional Stress Disorder, Suicidal Ideation, Video and tagged with crisis team, dissociation, Drayton Park Crisis Centre, Drayton Park Crisis House, Drayton Park Women's Crisis Centre, ethanol, ethylene glycol, ethylene glycol overdose, ethylene glycol poisoning, friends, Heather Nova, I'm a mess, I'm alive, mental health crisis resolution team, music, music video, overdose, overdosing, suicidal ideation, suicide, suicide attempt Tuesday, June 4, 2013

It’s been a physically and emotionally exhausting few days and I really ought to be asleep right now. It’s 4.30am at the time of writing, yet, inspite of being tired in the extreme sleep evades me.

Things have been shaky in the last few weeks, to say the least. A lot of flashbacks, and on top of that I’m on a hormone triggering treatment which makes me even less stable than normal. We are talking an emotional rollercoaster of going from blue skies to pitch dark in seconds flat, up and down, round and round. Not an enjoyable ride in any way, shape or form.

And at some point in the midst of all that my poor impulse control won over the utilisation of coping strategies; I decided that having a bit of ethylene glycol would be a good idea. I think it was only a tiny amount to start with, certainly less than a mouthful. I knew that was a really bad idea, and the following night when I felt the urge I rang the mental health crisis resolution team under whose care I’ve been the last three weeks (with a break in the middle, where I went to stay with my sisters). It was about 1am when I rang and talking seemed to help; by the end of the call I had agreed with K., (the person who was working the night shift), that I would come in to see them at ten that morning and bring the bottle of ethylene glycol for safe disposal. That felt both scary and good. It’s kind of hard to explain, but there is something about having the means to kill myself readily available that feels like a safety net of sorts, something that gives me a feeling of being in control. Twisted logic, for sure, but there you have it. But, it also felt good, the idea that someone would relieve me of this deadly stuff,would, in a sense, save me from myself.

Two hours later I once again felt myself plummeting into darkness and I picked up the phone again, since I had found it helpful the last time, and talked again to K. for some time. I may have come across somewhat incoherent because she asked me if I had ‘tasted’ any more of ‘that toxic chemical’. I said I hadn’t but in the same instance shot a glance at the plastic bottle and it was immediately clear that there was a whole lot more than ‘less than a mouthful’ missing. Alarmingly, I genuinely have no recollection of downing a large amount of this sickly-sweet substance. In fact, and I said as much to K., I wasn’t even sure if I had actually drunk it or maybe just spilled it. Or when this had happened. Still, as there was certainly more than a lethal amount missing from the bottle I agreed to let K. call for an ambulance – but, not before saying ‘Can you wait half an hour to call so I can have a shower first?’, to which she calmly explained that having a shower at three in the morning when you have potentially consumed enough poison to kill yourself was hardly a priority. So instead I started stuffing things into bags: iPad, iPod, mobile, chargers, clean underwear, toothbrush, EpiPen, my journal, a random bunch of puzzle cubes and even my prayer book. I have no idea where this sudden organisational skill came from, I normally have to write lists to make sure I don’t forget things when I pack a bag, but there I was, five minutes later, fully equipped to spend a long time in hospital, should it come to that. Then I told K., who was still on the line with me, that I was going to go outside to wait for the ambulance, promptly grabbed my bags and made it down two flights of stairs and out onto the pavement outside my house.. where I laid down to sleep while I was waiting for the ambulance to arrive. K. kept talking to me, trying to convince me that while it was OK to lay down, if I was too dizzy to stand up, I really needed to stay awake.

The paramedics arrived and got me into the ambulance with some difficulty as my legs refused to carry me properly. They asked a tonne of questions, all of which I answered in something of a drunken stupor. K. had already told them what I had taken, which was probably a good thing as they would more than likely otherwise have assumed I was just another overly refreshed Saturday night party-goer, and might not have realised that time was pretty darn critical. Also, I had brought the bottle with me so they could see exactly what I had drunk and how much was missing. I mainly just remember babbling like crazy in the ambulance before passing out, and the paramedic pinching at the nerves on my shoulders over and over to get me to stay awake.

In A&E I was first put on a drip of pure ethanol, which is one of two antidotes to ethylene glycol poisoning, followed by a number of rounds of Fomepizol. Hurt crazybad, I can tell you that much for nothing. (Imagine the sting of cleaning a wound with rubbing alcohol, and then imagine that kind of stuff going straight into your bloodstream, and you’ll get a fair idea).

The side effect of this, having bare spirit pumped into me was that I got drunker than I have ever been in my life. I’m not someone who drinks particularly often, so I have a very low tolerance to alcohol, and here they were giving me as much as they could based on my weight. Suddenly absolutely everything was hilarious beyond comprehension. I was giggling and rambling and apologising left right and centre, trying to explain that They were making me drunk. In the midst of that I decided that sending a text to let people know I was in hospital was a good idea, only – I discovered later – the text made very little sense, and I managed to send it to a whole bunch of people I wouldn’t knowingly have sent them to.

At one point a friend of mine, having seen my text, rang me (this was as I was being wheeled into a ward, still apologising profusely for my drunkenness) and all she got was me laughing, unable to explain what had happened. Later, when she came to visit me, she said that it wasn’t exactly what she had expected when she called to hear if I was still alive..

Whilst being drunk was not all that bad, it did mean that I was sick a lot. I have a sneaking suspicion that there was a miscalculation as to how much ethanol they were giving me, because last time I was rushed to hospital for having done something very similar (that time, completely on purpose), I remember screaming in pain as the ethanol went in my arm, but I don’t remember being drunk, nor being repeatedly and violently sick.

I had to stay in hospital for a day and a half, on constant drip, most of the time in both arms. It’s still too early to say if I have done any permanent damage to my kidneys and if so, what the extent is, all I know is that I my vision is extremely blurry and I have been sick a number of times even this morning.

I am out of hospital now, back under the care of the crisis resolution team, but as neither I, nor they, think it’s a good idea for me to be on my own just now, an assessment has been set up for later today at Drayton Park Women’s Mental Health Crisis House. As regular readers will know, I have stayed there in times of acute crisis before, and have found it helpful in turning a negative trend, so I really hope that following the assessment they will offer me a place.

Sorry for making this a somewhat long-winded entry, but I think I just really needed to get it all out.
I think I am still a very long way away from truly absorbing how close I got to dying, and writing is often the best way for me to process things.

Do be kinder to your Selves than I have been to my Self.

Much love,

PS. If you are one of my many wonderful friends who received my drunken text and who tried to get in touch with me later, but couldn’t get through and didn’t hear from me: something went wrong with my mobile and I could only send texts, not receive them, and incoming calls only worked sporadically. So, please don’t think I was ignoring you, I simply didn’t get your messages and consequently didn’t know to respond to them.

For some reason this song is playing in my mind. (Although the title of this post is actually from another Heather Nova song).

Because Tomorrow Might Be Good For Something

Posted by What It Takes To Be Me in Depression, Flashbacks, Inner Conflict, Medication, Music, Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, Self-Harm, Suicidal Ideation, Video and tagged with 112, 999, A & E, a different side of me, A&E, accepting help, Accidents & Emergencies, acting irrationally, acting out, ambulance service, Amitriptyline, Amitriptyline Hydrochloride, anti-depressants, asking for help, crisis team, criticising psychotherapy, I know right now you can't tell, I'm just a little unwell, I'm not crazy, inner conflict, irrational, lyrics, Matchbox 20, MB20, medication, mental health crisis resolution team, music, music video, NHS, NHS Mental Health, OD, overdose, overdosing, pregnant psychotherapist, pregnant therapist, psychotherapist's maternity leave, psychotherapy, psychotherapy breaks, psychotherapy with A, Rob Thomas, self-harm, stay awhile and maybe then you'll see, suicidal ideation, suicide attempt, therapist's maternity leave, therapy breaks, tomorrow might be good for something, tricyclic anti-depressants, Unwell Monday, March 12, 2012

*

“..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..”

;

Boxes, Bin Liners & A Pregnant Therapist – An Entry About Preparing For A Major Therapy Break

Posted by What It Takes To Be Me in Abandonment Issues, Attachment, Being Alive, Coping Strategies, Expressing Emotion, Inner Conflict, Panic, Psychology, Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, PTSD/Extreme Emotional Stress Disorder, Separation-Anxiety and tagged with abandonment issues, Adult Me, attachment, bin liners, containing emotions, coping strategies, crisis team, Drayton Park Crisis Centre, Drayton Park Crisis House, Drayton Park Women's Crisis Centre, emergency, escape, expressing emotions, Extreme Emotional Stress Disorder, family, fear, feeling safe, fight or flight, friends, help my therapist is pregnant, IKEA, inner child, inner conflict, Little S, maternity leave, my therapist is pregnant, panic, Post-Traumatic Stress Disorder, pregnancy, pregnant psychotherapist, pregnant therapist, psychotherapist maternity leave, psychotherapist's maternity leave, psychotherapy, psychotherapy breaks, PTSD, reassurance, retreating, Samaritans, separation-anxiety, shul, shutting down, the therapeutic relationship, therapist maternity leave, therapist's maternity leave, This Week In Mentalist, TWIM 2011, TWIM Awards Sunday, December 11, 2011

Last week was a big week, therapywise.

Started a bit shakey on Tuesday, feeling very anxious, and stepping into a mode of not wanting to engage, not wanting to connect and deliberately steering clear of potentially explosive material. There was a definite wish to keep it simple, to not touch on anything that could be even remotely emotionally triggering.

Then, on Wednesday, my second session of the week, the second I sat down I was overcome by this very intense need to retreat into myself, to shut everyone and everything out, to protect myself from making myself vulnerable. To, in essence, stop all processes and just deep-freeze everything. A. responded to this information by stating that that’s quite alarming, and I went on to spend the rest of the session trying to explain this reaction, to dress in words what this fear looks like. Did a bit of waltzing around, but eventually, in my own unique roundabout way, I arrived at the fairly obvious conclusion that a lot of this wish to cut and run comes from the worry about what will happen once A. goes on maternity leave.

I used the analogy of unpacking my moving boxes to try to illustrate what the worry is; how, as long as all my things are still in the boxes there is a certain order to things. I know exactly what’s in each of the boxes, and although the contents may not be immediately accessible, I can get to them, with a little work. On the other hand, were I to empty all the boxes, even if I arranged the contents neatly on my bookshelves and in my wardrobe, well – the contents wouldn’t change, but in an emergency situation, it’d be that much harder to grab everything and run for cover. That, yes, in day-to-day life it’s easier to have things within reach and in the line of vision, but, having spent so much of my life in survival mode, it’s really hard to trust that a fight or flight inducing situation isn’t forever lurking just around the nearest corner. I keep hearing the voice of Little S desperately urging me to not lower my guard, to make sure that I have a clear escape route at all times. And although Adult Me is trying hard to keep hold of Little S’s hand, to steady her and to show her that things are different now, it’s hard. It’s a fine balance to allow Little S’s voice to be heard, to exist, without giving into it – because, after all, she speaks from years of experience and from a place of almost unimaginable pain, and her voice is in no way trying to halter progress, but simply wanting to make sure that I don’t get hurt again. It’s a kind of poorly calibrated and somewhat mis-directed self-protective impulse.

Now, Adult Me knows that in order to move forward I have to somehow find the courage to keep at it, to keep sharing, to keep expressing, keep unpacking those boxes – even now when things feel so very fragile – knowing that, should things come crashing down around me, I can always grab a couple of bin liners and chuck my stuff into them to make possible my escape. It won’t be as neat, precise or efficient as if all of my things were still boxed up, but it would still work as a temporary measure. The only problem is that, as I explained to A., unlike with my actual, material possessions, when it comes to my emotional property, I don’t feel that I have that bin liner to hand; the fear is that I lack that quick-fix temporary container to make things manageable. I can have things out, look at my emotions, experience them, especially in the safe environment that therapy offers, or I can keep them in the box for now, until I feel ready to un-box, but, once they’re out – it’s not very easy to re-package. That, although I do have some practical outside tools, should things get really bad in A.’s absence; Drayton Park, the crisis team, shul, Samaritans, my friends and family, I just don’t trust it that I have the inner means to keep myself safe without shutting down. And that leaves me feeling very frightened and vulnerable.

With this in mind, it makes perfect sense that Little S pipes up, reacting strongly to thinly veiled abandonment issues popping up in the face of A.’s impending leave, pushing for me to keep on the well-beaten path of trusting no-one but me, to rely on myself and myself alone, to let no-one in and let nothing out.

History shows that I often find myself struggling to keep things together during therapy breaks, that flashbacks and nightmares tend to increase at a maddening rate when I haven’t got that safe space to unload my emotions in, that the risk of self-harming behaviour sky-rockets, and so, with a break of this proportion on the horizon, well, it’s bound to drive my fears to boiling point. In some ways it would be more worrying if they didn’t.

A. reassured me that she has no interest in making this break any harder than it needs to be, and although it felt really good to hear her say that and I genuinely appreciate her wanting me to know this, it’s still incredibly daunting to know that I have such a big break ahead of me. And finding that courage, well, it’s something only I can do.

This week’s final session – Friday – was spent doing some further exploration into the constant internal struggle between Little S and Adult Me. We looked at how Adult Me very much wants to do everything in her power to ensure that I don’t start going back on the progress I’ve made thus far in my therapy, while – at the same time – Little S is deeply invested in that tried and tested path, pulling in the opposite direction, wanting to go for what is known and what feels safe.

The conclusion is, of course, that what we need to focus on in the next few months, is to find not only a bin liner, but preferably a nice sturdy IKEA bag, to ensure I have what I need get me through once A. does go on her leave. To find that something which will allow me to resist listening too much to Little S – without completely ignoring or silencing her – and to not give in to the temptation of going down that comfortably familiar path of keeping myself safe through shutting down.

So, I’ve definitely got my work cut out for me. But – hopefully – I’ll find that I have what it takes.

To carry on.
Being me.

All the very best and more,

IN OTHER NEWS

I was utterly surprised to find out, earlier in the week, that my blog has been nominated in two categories of the TWIM Awards this year. The TWIM Awards is an annual award given to blogs focusing on mental health issues. My blog is nominated in the categories “Best PTSD/Extreme Emotional Stress Disorder Blog”, and “Best Therapy Blog”. Feel honoured to have been nominated (especially considering how incredible some of the other nominees are) and would like to send out an absolutely massive thank you to those of you who have voted for me. I’m chuffed beyond words! Truly.

If you would like to support me, or any other blog, you can do so by casting your vote here.

Winners will be announced on January 1st, 2012.

Long-term therapy vs. short-term crisis resolution

Posted by What It Takes To Be Me in Attachment, Creativity, Depression, Drawing, Expressing Emotion, Expression Through Art, Flashbacks, Illness, Medication, Psychotherapy with A, PTSD/Extreme Emotional Stress Disorder, Self-Harm, The Therapeutic Relationship and tagged with art, attachment, crisis team, Depression, drawing, Drayton Park Crisis Centre, Drayton Park Crisis House, Drayton Park Women's Crisis Centre, expressing emotions, expressing through art, Extreme Emotional Stress Disorder, flashbacks, managing self-harm, medication, NHS Mental Health, Post-Traumatic Stress Disorder, psychoanalytic psychotherapy, PTSD, self-harm, the therapeutic relationship Wednesday, August 24, 2011

I’ve been thinking about how to update my blog the last few days, but I’ve not felt able to do it. Partly because all my energy has been channelled towards fighting my way out of a flashback. Again and again and again. Times a million. It really has been kind of never-ending – and the only way that has worked to give me any kind of longer break has been to either make myself black out or to cut, neither of which is particularly healthy.

To say that it’s been a difficult few weeks would be a severe understatement. It’s been pretty relentless, and at times I’ve really just wanted it all to end, because there is only so much a person can cope with. The crisis team have been quite good (well, the nurses more so than the pill pushing doctors) – but it’s also been hard to find myself back in this system. Also, I’ve felt that the crisis team has been quite critical of the therapy I’m doing with A,, and they have frequently asked me if it’s really helpful to have this kind of therapy when it’s made me have such terrible flashbacks. Also, my relationship with A. has been questioned. More than once have they asked me if I’m not a little bit too attached to my therapist. My answer throughout has been that it’s not the therapy which is causing these flashbacks, it’s a combination of going home and then returning a week before therapy resumed, in conjunction with a number of other factors.

I’ve defend both my choice of therapy and the relationship I’ve worked so hard to form with A. on numerous occasions, but it’s tricky when you’re talking to people who see medication and CBT as the cure for all ills. It’s not so easy to explain that the whole point of therapy is that you form a close relationship with your therapist, and that it allows you to look at other relationships and see how they may be played out as little echoes within the therapeutic relationship. That in my veiw CBT is a bit of a band-aid, masking deep-rooted problems, and wouldn’t be at all appropriate for the kind of issues I’m dealing with. That, yes – this is really hard work, and yes it does bring difficult things up, but that it’s my feeling that the only way for me to be able to find some sort of peace within my past is to dare look at all those difficult things and realise that I can in fact survive the pain. And that’s what the work I do with A. is all about.

Despite this difference of opinion, having the involvement of the crisis team has also been of value – I’ve felt held by the fact that I’ve been seeing them on the weekends, when I don’t see A., and that they’re available to talk to on the telephone 24/7. It does help. But, that does in no way mean that I’m any less committed to the work I’m doing with A. I see it more as a crutch between sessions – for the time being – so that I can carry on with what I do in therapy.

Following yesterday’s adventures at A&E when I had my cuts stitched and SteriStripped – with a tetanus shot thrown in for good measure – R. from the crisis team came down to have a chat with me, and she said that she felt that my self-harming behaviour was going in the wrong direction, that it was escalating rather than subsiding, and that she felt I needed more support than what the crisis team can offer, and she suggested she make a referral to Drayton Park Women’s Crisis Centre.

I’ve stayed there in the past – years ago – and it has been helpful, so I agreed to R. making the referral. I think Drayton Park could be a safe option while I’m in the middle of this crisis. To me it seems like a happy medium – I’ll still be able to see A., but rather than going home to a lonely room battling flashbacks and urges to self-harm, I’d be going back to Drayton Park, where I’d be able to talk to someone about my urges to self-harm. Also, I know that they will be a lot more encouraging in terms of doing the type of work I do with A. han the crisis team has been.
Fair enough, I’ve never actually been at Drayton Park when I’ve been in therapy, but I have several friends who’ve stayed there and have felt that the Drayton Park staff have been very much in favour of them carrying on seeing their therapists while they’re staying at Drayton Park. Essentially what they say is that your therapist is your long-term support and who will help you with long-term goals, and Drayton Park is a place to feel safe while being in the middle of a crisis. It’s a short-term add-on support system, not a replacement for your long-term aims and goals.

Anyway, I’m meeting with one of the workers at Drayton Park tomorrow for an assessment, and it still remains to be seen if they’ll deem it appropriate to offer me a place for the week.

Think it’s time to hit the hay now – hopefully I’ll be able to sleep a little more than I have been in the last few nights..

Be kind to yourselves.

Little S At Six Months

Cuts, Stitches & Psychotherapy

Posted by What It Takes To Be Me in Expressing Emotion, Flashbacks, Illness, Psychotherapy, Psychotherapy with A, PTSD/Extreme Emotional Stress Disorder, Self-Harm, Suicidal Ideation and tagged with crisis, crisis team, expressing emotions, Extreme Emotional Stress Disorder, flashbacks, GP, NHS Mental Health, Post-Traumatic Stress Disorder, psychotherapy, PTSD, self-harm, suicidal ideation Wednesday, August 17, 2011

Things are still fairly touch and go. Really struggling at the moment. I’m having a lot of flashbacks, and it feels like everything in my life revolves around that. I don’t go out unless I have to, because I worry about having flashbacks in public. Not only is it embarrassing, but it could also potentially be quite dangerous as I don’t always feel completely aware of what is going on around me. I could quite easily not notice a traffic light going from red to green. And that’s just the “practical” side of flashbacks. Naturally there is also an emotional side to them, which is even more difficult to cope with..

Have been seeing the crisis team nearly daily since last Wednesday and have called them several times in between, and yet I can’t seem to find a way out of this darkness. Still can’t fight my urge to self-harm, and thoughts of suicide come easily to me at the moment. I fight it as best I can, but this is a mighty frightening place to exist within.

Went to see Dr H. today. She had asked me to check in with her in a week’s time when I saw her last week, because she wanted to be kept in the loop of how I’m faring, not just via the crisis team, but from me directly. Didn’t have much good stuff to share, I’m afraid, but I still think it was good to see her. Makes me feel a bit less anxious about when the crisis team decide to discharge me. Also she actually asked to see my cuts – which was a little embarrassing, but also made me feel more confident in her as she wasn’t shying away from the reality of self-harm. Have to admit that she looked quite shocked when she saw my handiwork, and she quickly decided that the cuts are quite a bit too deep and gaping to just be left on their own, so she ordered me to make an appointment to see the practice nurse, for her to clean them properly and either put in some stitches or Steri-Strip™ them. She said that ideally they should be stitched, but as my cuts are fairly close together that might not be possible.

I know this is going to sound really odd, but in some ways I don’t think I had really considered my cutting a real problem until Dr H. told me I might actually need stitches. I tend to just think of it as one of those things I do. A coping mechanism of sorts. I mean, I do know that cutting isn’t a good thing, but considering that I always use individually packaged sterile scalpels and antiseptic wipes to clean up, I kind of figured I had it under control. Clearly this is not the case; hadn’t at all realised how deep the cuts were – it wasn’t until I got home and had a look in the mirror that I could see that they were quite a lot more severe than I had thought. A seriously sobering discovery.

Saw A. today, and it was a good but quite difficult session. The last few sessions have been a lot about the here and now, about the impulse to cut and to play the choking game and fantasising about suicide and so on, but not very much about what’s triggered this downward spiral. So that’s what A. asked me to talk about today. An unusual step for her, as she is usually not particularly directive in her approach. Anyway, I gave it my best shot, starting with the obvious: the trip back to the scenes of the crimes. Talked about what it was I had wanted to be able to do on this trip, and how I feel I’ve let myself down by not being able to do it. And also what the reactions were to the little bits I did try to share. There’s plenty more to explore on this theme, and I think that the sooner I can start verbalising what’s happening inside of me, the sooner I’ll be able to step away from this very dark place I find myself in. I really appreciate that A. has been able to make time for extra sessions for me this week and last, even though that clearly means her working day becomes a lot longer. It makes me feel like I’m not fighting this beast on my own.
Also, she spoke to the crisis team on Monday, because they wanted to discharge me, and she felt it was too soon, that I’m still in the middle of this crisis, and need extra support from them for a bit longer. I’m really glad that she said that, because I feel I lose my voice when it comes to asking for things for myself, even when I desperately want to.

It’s really hard being back here again. It’s difficult to fight the feeling that no matter how hard I work, how hard I try, I will always mess it up, and find myself back where I started. That this is one of those life lessons that I seem incapable of learning.

But tomorrow is another day, and who knows, it might be marginally better than today.

And that’s better than nothing.

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