I Survived A Therapy Break

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

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

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

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

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

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

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

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

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

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

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

Be good to your Selfs.

xx

IMG_3885

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

 

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When Your Therapist Goes Away

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

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

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

So, let’s talk about it.

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

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

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


                                                                                                              *


To P.

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

From your Little S

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


                                                                                                              *


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

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

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

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

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

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

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

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

All the very best,

xx

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

But here’s a good one:

http://youtu.be/UVDg8fVC4EQ

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

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

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

*

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

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

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

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

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

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

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

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

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

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

Getting used to Daft Punk. 

xx

Progress And Pain – Parenting My Inner Child

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

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

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

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

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

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

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

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

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

We’ll see..

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

xx