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.

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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

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Cuts, Stitches & Psychotherapy

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.

xx

Survival – Knowing When You Need Help

Things aren’t going so well.
Downward spiral at breakneck speed, I feel frightened at how quickly I’ve gone from doing really well to finding myself stuck in a pattern of inward turned anger and self-harm. A few weeks and I’ve managed to undo all the hard work I’ve put in these last four years.

Realising that I’ve lost control of things I have been forced to accept that I need someone to help me, and so on Monday I called my GP to make an appointment. Couldn’t get one until Wednesday, and let me tell you, that felt like a very long way away.

These last few days have really have been rollercoaster like, oscillating between trying to stem flashbacks by using cords and scalpels and later on feeling very very angry with myself for not having been able to stop myself from going back to this very destructive behaviour. And it’s becoming increasingly erratic. This morning I woke up and immediately reached for a fresh scalpel to punish myself for having, the previous night, used a cord coiled around my neck to make myself pass out. – There’s no logic to it, and I can see that. Yet, I don’t seem able to stop myself from acting out in this way.

I’ve been trying to do things in the last few days to try to prove to myself that I’m not quite such a bad person as I sometimes think I am. To show myself that I’m not a waste of space, that I am of some sort of value to the community. But it’s hard to hold on to those thoughts when it has to come through external actions rather than from some internal place..

Saw my GP this morning. I say my GP, but really, I saw a GP. I saw Dr H., a newbie doctor, in her own words. This turned out to be a pretty good thing; she listened to me and seemed to really take in what I was telling her, in contrast to some GPs who’ll whack out the ever-so-patronising “How Depressed Are You?” multiple choice questionnaire at the earliest possible opportunity in a bid to avoid having to actually listen to the patient. Given this opportunity to be heard I tried to be as honest as I could with Dr H. It’s hard, when you’re a bit of a people-pleaser like me, and you don’t want to make the other person feel bad, but I think I did OK.

Dr H. made the decision that she didn’t just want to start me on some meds, but that I needed to be seen by the mental health crisis team. She asked me to wait in the waiting room while she sorted it all out, as she didn’t want me to leave the clinic before she knew for sure that I’d definitely be seen by the crisis team. A reassuring touch, I have to say. I’ve certainly come across doctors who say they’re going to make a referral and send you off with a “Don’t call us, we’ll call you” style parting phrase.

As it turned out the crisis team wanted to see me at noon, so I essentially ended up going straight from the GP practice to the Highgate Mental Health Hospital. Felt quite anxious about going there, as I was still experiencing flashbacks and I was worried that I’d become too confused and disoriented on my way there. Also, I didn’t know what to expect. It’s been several years since I’ve been in touch with any form of NHS run mental health service. A lot of my work has been aimed at getting away from this system.

Then I was thinking of the advice I would give – and have given – friends who have found themselves struggling in the way I am right now: accept any help you can get, whatever that may be. This is not a time for pride, it’s a time for survival.

Talking to two members of the crisis team I did feel a lot better. They reassured me that their aim is to support people struggling with self-harm and suicidal ideation in their homes, rather than pushing people into wards, which may not at all be the best for a person. They did – of course – make it clear that if they felt I became more destructive and posed a serious danger to myself they would have to put me on a section order, but that their aim was to find alternative ways of supporting me. They made the decision – based on my previous history – that they’ll want to see me every day for now, and also asked if I would give them permission to liaise with A. regarding what would be the best way to go about things. Initially I didn’t feel comfortable with that, but in the end I decided that maybe it could be helpful to not try to keep different parts of my life separate. As I was a little unsure of A.’s number I told them I would ask A. to call them instead.

My session with A. today was quite difficult. I was just feeling so low, so defeated at finding myself back in this very dark place. I’m finding it very hard to motivate myself to not give up, keep falling into thinking that no matter how hard I try, no matter how hard I work, I will always come crashing down..

A. said a few things that made me feel a bit better, made me feel like I’m not entirely on my own. But it’s still very very hard. She also added an extra session for me this week – first thing tomorrow morning – which felt comforting. Also I have been given the number for the crisis team, which is a 24 hour care service, so I can call and talk to someone on the crisis team at any time between seeing them in person.

I hope this will help stop me falling any further. Because last time I felt the way I feel right now I drank half a litre of anti-freeze and ended up in ICU..

So, if you have any to spare, thoughts and prayers are much appreciated.

xx

This Little Voice In My Head – An Entry About Human Courage

I really genuinely think I’m going crazy. Losing it.
And at the same time I don’t think I’ve ever been more in touch with myself and how I’m doing. It’s hard to explain. Sometimes I think it’s really just the fact that I’m so unused to feeling things that it knocks me for ten, and other times I think Oh my God, how the flippin’ BEEEEP am I gonna get through this? And still, somewhere at the back of my head, even when I’m feeling really low, there’s this little voice that tells me that Ok, so maybe you don’t know how to deal with this, but that doesn’t matter, because you’re just gonna have to. That’s just how it is, girl.

And I think that’s a clear indication that I am getting better; that I am in fact dealing with things, even if I have no idea how. Because that voice is new. It hasn’t been there before. Or maybe it has, but if that’s the case I must have been utterly deaf to it, because I can honestly say I haven’t heard it before.

I think it’s to do with spending those weeks at Drayton Park Women’s Crisis Centre earlier this year, working so desperately hard at putting in motion a change in myself. Not just on the surface, but through and through. Also, seeing D. every week, well, I guess it reinforces that idea. That, actually, the only real option here is to get myself through this, by any means necessary. And, I suppose that the reason why I’m struggling so much right now is that for the past few weeks I haven’t had that weekly dose of encouragement.

The last thing D. said to me before we parted after my last session in the second week of August was “S, I don’t want to come back and find that you are dead.” And I remember very clearly thinking that Why in the world would I be dead?, that it was a remarkably ridiculous thing to suggest, and so I went on to make a jokey comment.

I get it now. I do. Although I always knew that I liked my counselling sessions with D. I didn’t at all realise how incredibly important they really are. How being told something and then going home to think about it actually gets me through the week, and strengthens that survival instinct within me, ups the volume of that voice, if you wish.

Yesterday after work I was feeling a bit fragile. So, I went to see my friend P. and her little girl. That worked a treat at lifting my mood. I also spoke to two of my friends on the phone and spent some time just reflecting over all the difficulties in my life I have had, and marvel at the fact that I’m still around. I don’t mean to brag, but when I think about all the things in my life I’ve been through – how unconventional my life has been in many ways – well, I do feel proud to still be alive. And I think I have a right to be.

Now, on to something else that inspired me the other day. I was having one of those days where I really couldn’t think of any good reason to smile. One of those Yes, I’m alive, but so what?-days. You know what I mean. So I spent most of my day in bed, trying to, but not managing to sleep. In the end I gave up and reached for my iPod and started surfing the web and I came across this story about a little girl called Danielle. I read it, and what struck me the most was not how cruel a place the world can be, but an enormous sense of gratitude for the fact that there are people around – like Dani’s new family – who are willing to not just talk about it, but act to change that. So, please, visit the Lierow’s website. I suggest you also read the wonderful article by Lane DeGregory, sharing Dani’s story with the world. It is in parts pretty grim reading, but, I do like the way it’s been written and how it actually also offers Dani’s natural mother to give her side, indefensible as it is.

Having read Dani’s story I felt compelled to contact the Lierows to tell them how their courage has touched me, and to ask if it would be ok for me to link to their site in my blog, and yesterday I got an email back from Bernie, Dani’s new dad, to say that it was.

So, again, take a deep breath and read the story about this family. I am sure, that you, like me – will feel a bit better about the human race after. And feel that, after all – there are things worth smiling about.

Real love,

xx