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

Starting Over After A Break

Posted by What It Takes To Be Me in Abandonment Issues, Anger, Attachment, Defence Mechanisms, Expressing Emotion, Inner Conflict, Psychology, Psychotherapy, Psychotherapy Breaks, Psychotherapy with P, The Therapeutic Relationship and tagged with " reasoned Little My, abandonment issues, Adult Me, anger, attachment, expressing anger, expressing emotions about psychotherapist, expressing negative emotions, fear of being abandoned, If you're angry you're angry, inner conflict, Lilla My, Little My, Little S, Moomin Valley, Mumindalen, Om man är arg så är man arg konstaterade Lilla My och skalade sin potatis med tänderna. Man ska vara arg ibland. Varenda knytt har rätt att vara ilsket, Pappan och Havet, peeling her potato with her teeth. "You're supposed to be angry from time to time. Every little creature has that right.", psychology, psychotherapy, psychotherapy breaks, starting over, starting over after a psychotherapy break, the therapeutic relationship, therapy breaks, Tove Jansson, trust, trusting the therapist, trusting your therapist, withdrawing, withdrawing from therapist Wednesday, September 3, 2014

“Lily, oh Lily – I don’t feel safe
I feel that life has blown a great big hole through me.”
And she said,
“Child, you must protect yourself,
You can protect yourself;
I’ll show you how with fire..”

I have had my first two post-summer break therapy sessions now. And it has felt, well.. strange. Both on Monday and today I found myself uncharacteristically tongue-tied at the beginning of session. [I am often silent during the first few minutes of a session, but I don’t often feel that I can’t speak]. There were plenty of thoughts and feelings buzzing around, but I just didn’t seem able to catch hold of any of them to translate into words.

In the very first session I was initially completely overwhelmed by how powerful the relief of seeing P. was. I hadn’t expected to have quite such a strong emotional response. I could almost physically feel Little S. doing backflips in sheer joy at the sight of P. in her chair. Back where she belongs.

And, at the same time, there was a real urge to withdraw and protect myself from anything and anyone who wasn’t me. To go to my island, the one that is so tiny that it only has room for me. The one where I feel safe in the knowledge that no one else can get to me.

See, that’s the funny thing about Little S.; as happy as she was to see P., – and she was very happy – she is also naturally suspicious of others. Just because P. was back and everything seemed alright, it didn’t necessarily mean that Little S. would readily take that at face value. So, she went from being absolutely delighted to have P. back to ‘You disappeared on me, so I’m not quite ready to trust you yet’ in seconds flat. You see, Little S. is – as I explained to P. in today’s session – a lot like Little My of the Moomin Valley; there is only ever enough space for one feeling at a time and she can go from one to another in no time at all. One second ‘overjoyed that P. was back’, and then – boom – ‘suspicious that she might do another disappearing act’.

- Little My - "If you're angry you're angry." Little My reasoned, peeling her potato with her teeth. "You're supposed to be angry from time to time. Every little creature has that right."

“If you’re angry you’re angry,” reasoned Little My, peeling her potato with her teeth.
“You’re supposed to be angry from time to time. Every little creature has that right.”
[From Moominpappa At Sea by Tove Jansson ©1965]

P. suggested that maybe Little S. is quite angry with her – or even really angry with her– for leaving her to fend for herself while she went on a nice long break. As soon as P. said that Little S. – sensing danger at being called on her negative feelings – had to go into hiding, and Adult Me was left to explain that Little S. wasn’t quite ready to deal with those feelings yet, [“Little S. has left the building”] even if P.’s guess was probably spot on and Adult Me would have liked to have been able to talk about it, together with Little S.

At the beginning of today’s session, while still in Unable To Speak-mode, I became aware that there was a song playing in my head. It seemed unlikely to be chance that that particular song had decided to play, so I shared a few somewhat random lines from it with P.: “Child, take what I say with a pinch of salt, and protect yourself with fire”. At the time I felt very aware that I was leaving out two lines about feeling unsafe and being afraid, but as I am writing this now, I am thinking that maybe that’s not the end of the world? I have another session tomorrow, and if I want to, I can mention making that choice – so we can look at the reasons for consciously leaving those oh-so-revealing lines out, or I can leave it as it is, because even though I missed out parts of the lyrics, we kind of managed to touch on the themes of not feeling safe anyway.

We also spoke about feeling unsure if this need to protect myself through withdrawing [from P.] is something I – or at least Little S. – genuinely needs to do in order to cope, or if it is something I now do per automatik, unquestioningly and without thinking, because it is what I have ‘always’ done.

I suppose that this is a constant battle for me; striking the right balance between being mindful of Little S.’s needs, and challenging her to take tiny steps forward.. It is also, admittedly, a struggle at times to manage Adult Me’s frustration with the amount of time Little S. needs to take any little steps at all. I often find myself having to repeat the mantra that ‘baby steps are also steps’ to Adult Me, because if she had her way, she could quite easily race ahead at a pace neither Little S. nor Adult Me is ready to cope with..

All the very best,

Lily from the album The Red Shoes. This video features in Bush's short film The Line, The cross and The Curve.
Kate Bush © 1993

Trauma Focused Counselling, Psychoanalytic Therapy & Bridging The Gap

Posted by What It Takes To Be Me in Abandonment Issues, Attachment, Counselling with Z, Expressing Emotion, Personal Growth, Psychology, Psychotherapy, Psychotherapy with A, Sef-Awareness, Sexual Abuse, Suicide, The Therapeutic Relationship and tagged with breakdown in therapy, bridging gaps, building bridges, childhood sexual abuse, corrective emotional experience, corrective experience, counselling, expressing emotions, expressing negative emotions, fear, fear of being too much, fear of breaking people, fear of breaking therapist, fear that therapist can't cope, impasse in therapy, personal growth, positive corrective emotional experience, positive corrective experience, psychoanalytic psychotherapy, psychology, psychotherapist coping with suicidal clients, psychotherapy, self-awareness, sexual abuse, short term counselling, suicide attempt, the therapeutic relationship, therapist coping with client suicide attempt, therapy, trauma focused counselling Monday, September 30, 2013

By now I have had nine sessions with Z. Only, it’s turned out very different to what I had thought it would be. Two sessions ago Z. said that she felt concerned about us doing deep trauma-focused work, said that she wasn’t sure it would ultimately be to my benefit if we started unpacking memories that would undoubtedly cause a lot of pain, when we have so very few sessions together and might not have enough time to get any closure. She also said that she was unsure if we should do all sixteen sessions as planned, or if we should perhaps instead spend a few sessions thinking about how the work we have been doing so far could be brought back into A.’s consulting room. Or, Z. added, maybe what we need to do is look at sorting out a referral to someone else, someone who specialises in trauma-treatment, but who – unlike herself – could offer long-term therapy?

All this came as a bit of a shock to me, because, after all, Z. had been handed my referral and would have known the extent of trauma I have suffered, and she also knew the premises we were working on from the outset: sixteen sessions, no more, no less, unless I decided to cut counselling short. Of course, intellectually I can appreciate the concerns voiced by Z., but it was still a tough one to take in. Also – perhaps more importantly – I know myself fairly well, and I could see right away that no matter how much intellectual sense this proposal made, it would only be a matter of time before those deep seated, fear infused questions started popping up in my head and heart: Was that really the reason why Z. wanted to cut counselling short? Maybe this was just what she was saying, because she didn’t want to tell me that I had once again become ‘too much’? What if the real reason was that the stuff I had shared already was more than she could cope with? Needless to say my internal Here-We-Go-Again alarm bells were going off like crazy.

Of course, the rational part of me knows that it is unlikely that Z. would lie to me, or that – given that working with trauma is What She Does – the bits and pieces of trauma I had let her in on would be too much to cope with, but as we have seen time and time again, intellectual understanding and emotional response rarely go neatly hand in hand in perfect harmony. As I said to Z.; in many ways it doesn’t even matter what the real reasons for not doing the full sixteen sessions actually are: ultimately it will almost certainly become cemented in my mind as further proof that I’m ‘too much’. Or, even, that I’m not really worth the hard work that is involved, because, after all – everyone else gets their sixteen sessions, and they’re all trauma clients, too. So, this must be something specific to me.

I told Z. that, although I’m nowhere near as invested in my relationship with her as I am in my relationship with A. [yet], an experienced rejection of this kind would still bring all these fears to the surface in a way that I don’t think would be particularly helpful for me, as it would only serve to reinforce the idea that no one can truly cope with me. That no one wants to hear my story.

I feel quite pleased with myself that I managed to share these thoughts with Z., that I didn’t do what I would have done a few years ago: bury all feelings as deeply as I possibly could, right at the very edge of my conscious mind, and just accept Z.’s suggestion to end counselling early – with a bright smile plastered across my face to hide the invisible tears, to boot. I’m glad that I instead decided to ‘fight back’. [Especially as Z. told me in today’s session that we have another seven to go, which means we will be doing the full course.]

The two sessions since Z. suggested stopping short we have spent, in part, at least, exploring what this proposition of Z.’s has done to me and how it has made me feel about Z. I’ve also explained that I am not looking to find a new therapist; I think it is crucial that I somehow find a way to bring the work I have started with Z. back to my sessions with A., both to allow me an opportunity to discover that I can overcome my fear of breaking people [and perhaps even of breaking myself], and for A. to rise to the challenge and earn my trust back, so that I dare once more take a chance and share some of the truly awful things that happened to me. To, in a sense, come full circle.

A.’s and my story began a little over four and a half years ago. It took me a good year of testing A. in a million different ways to make sure that she was for real before I even considered talking about anything much at all. After that another two years were spent slowly slowly building a genuine relationship. I began trusting her, tried to open up even when I was terrified to do so. And then in year five of therapy – boom – something went quite badly wrong. Both A. and I hit a wall, full speed, from opposite sides, and whatever trust there was got seriously dented as a result. And that’s where we are at now: we are both still in recovery mode.

What I would like to add to our story is a final phase where I get to experience that mutual trust can be rebuilt. Both that I can start trusting A. to ‘hold’ me again, to feel safe with her, to know that she can cope hearing about the things that happened to me, but also that she can regain her trust in me. It would be unrealistic and unfair to suggest that the breakdown and subsequent dent in trust was experienced only at my end; I can absolutely see that the act of nearly killing myself earlier this year, put a dent in A.’s trust in me, too.

This is the main reason why I don’t want to look for another long-term therapist, even if she happened to be specialised in trauma-focused work. I feel that the positive corrective emotional experience needs to happen in my relationship with A. The circle needs to be completed in a single relationship.

I do feel that the work I have been doing with Z. – both the trauma work and the work we have been doing in the last two sessions – has been helpful to me. It has made me try to, ever so gently, bring some of the feelings around the abuse into my sessions with A., to lower my guard that little bit more, and it has also helped me be a lot more direct in the way I communicate with A. about our relationship. I do a lot less tiptoeing around. I still feel that I want to complete all sixteen sessions with Z., because I think the time left could be well spent building bridges. I also think it’s been quite healthy for A. to see how I have responded to a very different type of therapist/counsellor, and I think it has made her reflect on the way she works with me, and what may or may not be useful in our work. I don’t mean that this has been a forced response to a threat of If you don’t do things MY way, I’ll find another therapist, because I don’t feel I have issued such a threat – the decision to do trauma-focused work outside of therapy was made before A. and I hit that wall, had been discussed in my sessions with A. – but that it’s happened naturally, on a genuine feeling level.

There is still a long way to go, for both of us, but I think we will get there in the end.

PS. Following my last two posts I have (a bit surprisingly) had more than one email asking if Z.’s real name is Zoe Xxxxxxx, so I thought I’d state once and for all that NO, it isn’t. Z.’s name doesn’t even begin with Z, I just randomly picked it because her letter was already in use. As I’ve said before, I do always take as much care as I possibly can to mask other people’s real identity, and this includes the identities of my counsellors and psychotherapists. :)

Where Do We Go From Here?

Posted by What It Takes To Be Me in Anger, Anxiety, Expressing Emotion, Psychology, Psychotherapy, Psychotherapy with A, Suicidal Ideation, Suicide, The Therapeutic Relationship and tagged with anger, anxiety, expressing anger, expressing negative emotions, fear of being too much, fear of breaking people, fear of breaking therapist, fear of rejection, fear that therapist can't cope, psychoanalytic psychotherapy, psychology, psychotherapist coping with suicidal clients, psychotherapy, suicidal ideation, suicide attempt, talking about suicide, the therapeutic relationship, therapist coping with suicidal client Wednesday, August 7, 2013

I have been meaning to upload this post for a few days now, have kept telling people that I was going to post an update in the next few days, but, for whatever reason, I just needed a little more time to think before writing it. As I wrote in a previous post, it hasn’t been my intention to turn this little therapy drama into any sort of cliff-hanger, I just simply wasn’t quite ready to write the update until just now, hence the delay. Nothing more to it.

A. replied very briefly to my email, acknowledging that she had received it and confirming that she was expecting me to come for session the following Wednesday. This was good; I wouldn’t have wanted her to respond to my email at length, I just wanted her to have read it and to have had some time to think about the things I was saying, so that we could talk about it in the next session.

I began that next session with a simple ‘So where do we go from here?’ thinking that that was open enough to invite some sort of mutual discussion. Instead my question was met with silence, and I felt instantly annoyed, because I had really hoped that A. would recognise the need to respond to me openly and directly, to engage in a dialogue with me, rather than to hang back and wait for me to say something for her to analyse. So, naturally, the next thing that came out of my mouth was dripping with frustration: ‘You know, it would be quite helpful if we could have an actual two-way conversation about this.’

We did have something of a conversation, eventually. Thankfully. Because, I think I would have walked out once and for all, had that not happened. My anxiety was sky high coming into that session, not knowing whether or not this would be the session where A. would tell me that she definitely couldn’t carry on working with me, regardless of whether or not I promised to not get suicidal again, because I was simply too much for her. And, also, there was tremendous fear that what I had written in the email would have a negative effect, or would be misunderstood, would have tipped things in the opposite direction of what I had hoped for. So, I really needed to be able to have a conversation with her about where we stood, what was going to happen, what the deal was going to be. I couldn’t have handled the not-knowing, the guessing, the excruciating uncertainty regarding the future of our therapeutic relationship.

A. brought something up which I had mentioned in the previous session, namely the idea that if I did go along with her request that would almost certainly mean that talking about suicidal feelings would become taboo. She told me that there were no taboos, that I was free to explore absolutely anything I wanted to in session – but – that I was not free to act.

I sat with this for a moment, because to me, this seemed quite different to what I felt she had said in the previous session. There is no way for me to know if this was what she had meant to convey in the previous session but had just expressed it in a somewhat clumsy way, resulting in me hearing something quite different, or if she had taken in what I had written in my email, and realised that what she had demanded initially was an impossible ask. All I know is that this felt different to the ultimatum-like choice she had presented me with the last time we met. So, that’s what I told her. A., of course, wanted to know in what way it felt different, and I said that this felt more doable, that while there is no way I – or anyone for that matter – can promise never to become suicidal, I can choose not to act.

I can’t say that I feel that we managed to talk it all out in that session, or even that we have in subsequent sessions. I couldn’t honestly say that this issue has been resolved. It still feels like it’s sitting there, an invisible but definite stumbling block between us. Whilst I acknowledged that I can make a choice not to act, I never made any sort of promise to A. that I won’t, nor has she pressed me for one. In some ways you could say that we have both just let it drop, allowed it to fall into that silent space between us, lost in the red pile of the Persian rug at our feet. I can’t help but feel that we are both working very hard at pretending that everything is back to normal, even though we both know that that isn’t the case at all.

As far as taboos go, do I believe what A. says, that there are no taboos? I suppose you could say that I do, or – perhaps more accurately – I believe that A. genuinely wants me to feel free to talk about absolutely anything, no matter how hard, no matter how sensitive. Have I talked about how I really feel since this happened? Have I been able to talk about suicidal feelings? About urges to act out? No. I am far too scared that I will say one thing too many and that consequently therapy will stop. In some ways I feel that all of a sudden I am doing therapy under the threat of termination.

Sharp-eared readers will have noticed that none of the discussions between A. and I have addressed the issue which felt most pressing as this whole drama unravelled; my deep-seated fear that I always end up being too much for people, and that I had pushed A. to the point where she couldn’t cope anymore. There is good reason for why I’ve not written about this; we haven’t addressed this at all. Neither my fear, nor any possible validity in my feeling that A. can’t quite cope has been talked about.

I have had a lot of comments and particularly emails about the last two posts, all of which I am grateful for, as they have offered many different angles from which to view what has been going on between A. and I. A number of readers have expressed a fair amount of anger at A.’s way of handling the situation, and as anger sadly isn’t a talent I have mastered, it has in many ways felt good to see others reacting in this way. And, at the same time, because I am a Worrier, it’s made me scrutinise what I have written, to try to ascertain if I may have unfairly painted A. in a darker shade of gray than was necessary. I would like to think that I have been reasonably fair in what I have written, yet at the same time I think it is important to remember that this blog is a stage which I share with no one, and as such only my voice gets heard, only my version of events gets told. A. has had no opportunity to put her understanding of what has been going on between us forward. Also, as I highlighted in my email to A., it is entirely possible that my assumptions about what has been going on for her are altogether incorrect.

One reader very helpfully pointed out that it may well have been that what A. was saying about not being able to work under the threat of suicide was less to do with not being able to cope with me, and more to do with the fact that a client’s suicidality can make therapeutic progress very difficult. This is something I agree with; a client’s suicidality, especially if acute, can doubtlessly make the therapeutic process suffer, may even make it impossible. I also agree that it is fair for a therapist to be clear about not finding a client’s acting out acceptable. However, I also feel that the way A. initially presented the issue to me, ie “I can’t work under the threat of suicide” suggested that it wasn’t so much that she felt that my suicidal impulses or acting out was a hindrance to the therapeutic process, as much as it was a case of her not being able to work under these circumstances, and this is what lead me to interpret her statement as indicative of her not being able to cope. She wasn’t saying that ‘The constant threat of you acting out makes it impossible for this therapy to happen, because it means your energy is focused more on the idea of being dead, than on being here with me and genuinely engaging with this process’, she was saying that she couldn’t work when things were this way.

But, of course it is very possible that I was taking her words a little too literally, maybe expecting too much of her in terms of expressing exactly what she meant in a “perfect” way, and – as I wrote in the email – there is a difference between her actual words and what I heard, and of course the things I read into those words come largely from my imagination, rather than from actual, factual knowledge or confirmation from A.

There is so much more to say about this, and I think this whole thing will take a long time to be fully resolved. But for now, this is where I will leave it.

For the time being I am still seeing A. Although, as I said earlier, there is still much left for A. and I to talk about, we have had some very good sessions lately. No, it hasn’t been addressing the stuff that is going on between the two of us, but they have still been very useful sessions.

I want to once again say thank you to everyone who has taken the time to email or comment on the last two posts. I am sorry that I haven’t been able to respond to all of you, but rest assured that I have read what you’ve written, and I very much appreciate getting your points of view. Whatever they may be.

Be kind to your Selves.

In the next episode of What It Takes To Be Me: I embark on a new journey as I dive head first into the world of intensive, short term trauma-focused counselling. Stay tuned!

By the way, we’ve just passed the 55,000 hits milestone since this blog was relaunched!
So THANKS to all!

Putting Feelings Into Words

Posted by What It Takes To Be Me in Anger, Anxiety, Attachment, Boundaries, Countertransference, Expressing Emotion, Psychology, Psychotherapy, Psychotherapy with A, Rejection, Suicidal Ideation, Suicide, The Therapeutic Relationship, Transference and tagged with An Email To My Therapist, anger, anxiety, asking client to promise not to act out, attachment, boundaries, choices, countertransference, Drayton Park, Drayton Park Crisis Centre, Drayton Park Crisis House, Drayton Park Women's Crisis Centre, expressing anger, expressing emotions, expressing negative emotions, I can't work with you under the threat of suicide, promises, promising not to kill oneself, promising to not act out, promising to not become suicidal, psychotherapist coping with suicidal clients, psychotherapy, Putting Feelings Into Words, rejection, suicidal ideation, suicide, suicide attempt, talking about suicide, talking openly about suicide, the therapeutic relationship, therapist coping with client suicide, therapist coping with suicidal client, transference, ultimatum, Where Do We Go From Here? Monday, July 29, 2013

I am not someone who commonly contacts my therapist between sessions; the resentment I always felt towards those of my father’s clients who did so has heavily enhanced my desire to not be That Client. In fact, I have only done so twice before. Once after a friend of mine killed herself right before a final session before a break, and once, earlier this year, after a session where I was simply overcome with anxiety about having broken A. and feeling sure that I had finally become too much for her, because something in session had made it seem she wasn’t really coping. But, following the session I described in my previous post, in which A. had told me that she couldn’t work with me under the threat of suicide I made a very conscious decision to write her. Below is that email.

Dear A.,

It’s late Saturday evening and I find myself feeling like my head is still spinning from trying to make sense of what happened in our last session. I decided already yesterday that I would sit down and try to write down my thoughts over the next few days and send them to you on Sunday; I felt it wouldn’t be a very wise thing to do, sending off a rash email before I have had time to sit with all of this for a little bit. Also, I figure sending it on Sunday gives you two days to think about what I’m saying, should you want me to come for session on Wednesday, so it’s fair on you too.

This is what you said on Friday: ‘I can’t work with you under the threat of suicide’. This is what I heard you saying: ‘I won’t work with you if your level of distress passes a certain point. It’s now got to that stage, and I can’t handle it.’ If I allow my mind to wander a step further it would go something like this: ‘This is too much, too scary, and I don’t want the responsibility. She has become too much for me. I’m out of my depth and I don’t know what to do. I want out, but I don’t want to be the one to end therapy, so I’ll give her a ‘choice’ which is almost impossible to go along with. ‘

I know you said in session that you didn’t know how I might react to what you had to say, but you’re an intelligent person, and it seems reasonable to assume that you must have realised both that this would have a really big impact on me, and have thought of at least one or two scenarios of how I might interpret it. Considering how fear of being ‘too much’ for people and the constant worry about breaking people have been major themes running through the last four years of therapy, it doesn’t take a particularly big leap of the imagination to see that this statement of yours would be experienced as direct proof that I have once again managed to become too much for someone..

Like I said to you in session, this does feel incredibly unfair. In the last four years I have been trying to open up, to stop holding back and to overcome this fear of breaking people – to trust that you can cope, even – and now that I have taken this step, you tell me you can’t work with me. When I have asked you ‘Are you OK? Can you cope [with what I bring to session]?’ you’ve consistently opted to not answer, and then suddenly you give me what you present as a choice, but which to me feels increasingly more and more like a black or white ultimatum. ‘Either you stop being suicidal, or therapy stops’.

I do understand that you are in a very difficult situation and I can easily imagine how very stressful it must be to work with me, especially when I’m dipping like this, I really can. However, I’m not sure exactly what prompted you to make the decision to give me this ultimatum now, because I honestly can’t recall having said anything in the previous session that I haven’t said before. I remember saying that ‘it feels like everyone knows how this is going to end’, but that is something I have said many times in the past.

Were I to venture a guess I would say that it may have been my arriving late for the first session after the break that was the trigger. The fact that you commented on it, makes me think that this was possibly (and, if so, understandably) quite frightening for you, seeing as I had previously made it clear that if I ever don’t show up for a session you’d have good reason to think I’ve taken drastic action. I’m not sure if you believed me when I said that the reason for my lateness was that I used a different route (since I was staying at Drayton Park), and I simply miscalculated how long it would take to get to your place, but that really is the truth. I wouldn’t be so cruel as to be late on purpose solely to test how you’d react, and I would never play games like that with you; I have too much respect both for you as a person and for the work that we do, to do that.

I have to admit that I feel upset about your decision to tell me this on a Friday, knowing that it’s the longest possible time before the next session. I also cannot for the life of me understand why you would wait until after I had been discharged from Drayton Park to have this discussion with me, rather than doing it while I was still there, taking advantage of the fact that I wouldn’t be going home to try to deal with this on my own, but would have people around me who could offer support. This seems especially strange, seeing as I told you that my stay at Drayton Park had been extended until Monday because I knew that the first session back might leave me feeling vulnerable and unstable, since things between you and I had seemed rocky before you went on leave.

As I said before, I can absolutely understand that it must be really hard to deal with me, and it may well have left you feeling you couldn’t cope working under those circumstances, but surely there must have been other ways of doing this? Rather than, for example, making it clear that ‘If you tell me that you are intending to kill yourself, I will have to contact your GP/crisis team/have you sectioned etc..’ (thereby taking some steam off of you), you went straight to ‘If you’re suicidal, I can’t work with you’.

I have no problem with you looking after yourself; if you feel you can’t work with me when things are like this, then – absolutely – you should raise that point. Of course a therapist both needs to and should look after herself, I take no issue with that at all. But, what I do feel has been done quite poorly is the fact that you drop this bomb in my lap without doing anything at all to ensure that I am as safe as possible with it. You could have said ‘If you don’t feel you can make a promise to not kill yourself, I’m really sorry, but I won’t be able to work with you. It would be impossible to do this work. I know this will probably feel like a rejection and I am sorry about that. It’s not my intention to leave you feeling that you have become too much for me, but I do realise that it may have this effect. I may be able to refer you to a colleague, if that is something you would want.’ Or even something so simple as to pick up the phone, call the crisis team, who you knew I was still under, to let them know that you have just had a really difficult conversation with me and you want them to be aware of this as I may need extra support over the weekend.

I really don’t want our work together to end like this, and I certainly don’t want the take away message after four years to be that I’m too much even for the professionals, and that is what it would be, should we terminate therapy at this point. I know you would soon find someone else to take my slot, you’d move on and I would eventually fade and end up being a learning experience for you. I, on the other hand, would be left with the incredibly painful knowledge that I am too much even for professionals, and, really, if even my therapist can’t cope with me, what hope is there..?

I know that some of the things I am writing in this email will inevitably come across as wholly unfair, and I recognise that my assumptions of what is going on for you may well be entirely wrong, but at the end of the day, this is how I have experienced all of this.

You mentioned that I may need some time to think about what you have said and what choice I want to make, and I feel unsure of what the timescale for this is, and whether or not you are expecting me to come to session while I work it out for myself.. I don’t even know if I’m meant to show up on Wednesday or not.

I really do hope that we can talk about this soon and find a way forward, whichever direction that path takes.

I Solemnly Swear Never To Be Suicidal Again? – An Entry About Fears, Promises & Honesty

Posted by What It Takes To Be Me in Anxiety, Attachment, Boundaries, Counselling with D, Countertransference, Depression, Expressing Emotion, Psychology, Psychotherapy, Psychotherapy with A, Rejection, Suicidal Ideation, Suicide, The Therapeutic Relationship, Transference and tagged with anxiety, asking client not to kill herself, asking client to promise not to act out, attachment, being too much, boundaries, countertransference, Depression, Drayton Park, Drayton Park Women's Crisis Centre, Drayton Park Women's Crisis House, end of the road, expressing anger, expressing emotions, expressing negative emotions, fear, fear of being too much, fear of breaking people, fear of breaking therapist, fear that therapist can't cope, honesty, I can't work with you under the threat of suicide, I solemnly swear never to be suicidal again, promises, promising not to kill oneself, promising to not act out, promising to not become suicidal, psychology, psychotherapist coping with suicidal clients, psychotherapist wanting to end therapy, psychotherapy, rejection, suicidal ideation, suicide, suicide attempt, talking about suicide, talking openly about suicide, termination, the therapeutic relationship, therapist coping with client suicide attempt, therapist coping with suicidal client, therapist wanting to terminate therapy, transference, uncertainty Sunday, July 28, 2013

When I uploaded the previous post twenty days ago, I was fully intent on posting the next one the following day. As you can see, this didn’t happen. Instead I have been telling myself every day since then that ‘You really must get around to writing That Post today’, each day finding conscious and unconscious reasons not to do so.

I’m not always good with feelings, with dealing with them, I mean. Especially pain. I have a tendency to shut down, to frantically try and get away from anything that may make me experience emotional pain. And I do this even more so if I perceive that the pain is being inflicted by someone I respect and care about. In some ways I suppose this behaviour makes perfect sense. Who wants to feel pain? Who wants to feel hurt by someone they hold important in their lives? And, yet, looking at it from another angle, it is sort of strange, particularly from someone who has spent so much time doing therapy, where much of the work centres around exploring and examining pain, past and present, often inflicted by those we find hardest to blame.

So.. this will be a hard one to write. But, I felt that I owed it to myself to be brave, to not hold back, to be honest and let it all out. After all, that is why I have this blog..

The week I had been discharged from Drayton Park I arrived for my usual Friday session with A. I had a very specific question on my mind, one which had been eating at me for a while, and I felt I really needed to pluck up the courage to ask A. about it, in light of what had been going on both with me separately and in our mutual relationship lately. I never got a chance to ask the question, because once I had sat down, A. turned to me and said ‘There is something I need to say to you.’ Alarm bells went off all around my body. Last time she started a session that way was when she told me she was pregnant, and I could tell that this time it would be something possibly even harder to deal with.

‘I can’t work with you under the threat of suicide.’

Ten words. Like bullets to my heart.

I must have sat quiet for ten minutes, my world stopping in its tracks. I felt cold, nauseous, struggling to breathe. Thoughts were spinning in my head so fast it was impossible for me to grasp any of them for what seemed like forever. For a second I contemplated just getting up and leaving, something I have never done in my life, to anyone. But, the pain was excruciating, and I felt that I couldn’t take it.

When I finally spoke, the words that came out, as I was trying to blink away tears that weren’t even there, were a mere whisper; ‘I guess that makes one more person who can’t cope with me, one more person who I’ve become too much for, who I have pushed too far’. I couldn’t look at A. as I said it, because I was too scared of the force of my own emotions.

This fear of becoming too much for people, it’s been central to my therapy from day one. It’s been a ridiculously regularly recurring theme, something many hours have been spent turning inside out. I know where it stems from: that pivotal moment when I was seven and told my mother about what my brother was making me do, when I broke her, when I discovered that there was no one who could help, no one I could tell without running the risk of breaking. And ever since then, that fear has remained, has evolved into this enormous ball of anxiety that now encompasses a million different things that I believe I do, which ultimately drive people away.

Having said that first thing, suddenly there were lots of other things I wanted to say, thoughts I wanted to share, because apart from fear and pain a plethora of other emotions were descending on me at breakneck speed. I took a minute or two to try to pick them out, to separate them. The most urgent one was the feeling that this was incredibly unfair, because in the past several months I had more than once felt unsure of whether or not A. could truly cope with what I was bringing to session, and more than once had I openly asked her if she could. And each time she had opted not to answer. So I said exactly that, adding that it felt like she was going from zero to a hundred with no steps in between. Silence, silence, silence and then ‘I can’t work with you’.

After a few more moments of silence, from both of us, I asked her how she had imagined I might respond to what she had just told me. A. said that she didn’t know how I would respond. In frustration I said that that wasn’t what I asked, I asked how she had imagined I might respond, because in my mind, she is an intelligent person, and it didn’t seem that far-fetched that she might have pictured me hearing what she said as a form of rejection and as further proof that there is no-one who can cope with me, and that it would take me down the path of ‘If even my therapist can’t cope with me, then what hope is there..?’

Later she said, in her very gentlest voice ‘I’m giving you a choice’ and because I wanted to be fair to her and to the reality of the situation, I said that I could see that, and that I can absolutely understand that it must be incredibly difficult – frightening, even – to work with me when I am suicidal. Especially in light of what had happened only a few short weeks ago. And, yet, at the same time I couldn’t help thinking ‘How is this a choice?’ She was saying that she couldn’t work with me under the threat of suicide, but how could I possibly promise to not be suicidal? It’s not something which can be switched on and off with the push of a button. It felt more like an ultimatum; ‘Either you stop being suicidal, or therapy stops’. I was going through the options in my head, thinking that I would be willing to say almost anything – even if it was a lie – if only she would carry on working with me. But, I also knew that I really didn’t want to have to go down that road, because it’s perilous in nature; one which would inevitable and seriously impact whatever work we might do in the future.

I said to A. that if I did make a promise like that, wouldn’t that by default make the whole subject of suicide and suicidal feelings taboo? Because, how could I ever trust that I wouldn’t accidentally step over the line of what A. felt was too much, now that she had shown me that such a line did exist, not only in the realm of my fears, but tangibly right there in that room? Wasn’t it exceedingly likely to have the effect that if things got to the stage where suicide felt like an option, I might not be honest with her, might not share these feelings, for fear of what the consequences might be for my therapy? To this A. said that of course I would also need to think about whether or not I could work with her. This may have been meant to make me feel that this was a two-way street, but it only left me with the feeling that perhaps she was hoping that I would come to the conclusion that I couldn’t, thereby giving her an ‘out’. So, I said exactly what I was thinking: ‘I feel like I am being pushed towards terminating this therapy. And that is not what I want.’ To which A. said that I may need to take some time to think about all of this.

I was silent for a while, trying to come up with something – anything – that may be used to bridge the gap between what I felt A. was asking of me and where I felt I was truly at, and suddenly I remembered something D. – the counsellor I worked with before I started seeing A. – and I used to do when things were very difficult. We would make an agreement that I wouldn’t act out in any way between sessions, that I would always come to the next session to talk things through with her. And, because I had a huge amount of respect for her, I knew that if I did make that promise, there was no way I would break it. It’s just how I am. And, if I felt that I couldn’t make an honest promise, it wasn’t a case of ‘Well, then I can’t work with you’ but we would instead find some sort of middle ground, acceptable to both, and which, crucially, didn’t entail making false promises. I might admit that I felt unable to promise that I wouldn’t act out, but that I could promise that before acting out I would do X, Y and Z (ie call the Samaritans, speak to three different friends, do my nails, make a painting, write a chapter on my book, contact the crisis team etc).

Having explained this set-up to A. she initially wanted to know how that had made me feel and I told her that it made me feel contained, that it was a positive thing, this process of coming to a reasonable agreement, because it made me feel that I had some control. And also, that not only did I know that I wouldn’t break a promise I had made to D., I also felt confident that she knew I wouldn’t.

After a short pause A. said that she felt she had made her position very clear and that any promise would have to be for as long as we worked together, however long that may be.

It felt like she was pulling the rug from under my feet, like she was responding to my tentative suggestion of a possible solution, by immediately raising the bar, to make it impossible for me to make the promise she was after.

So, I left that session in a daze, feeling unsure if that was it, if that was the end of the road for our work together, not at all knowing whether her earlier ‘You may need to take some time to think about this’ extended only to this particular session, if she was expecting me to show up for session the following Wednesday, or if she wanted me to do my thinking at home, so she wouldn’t have to deal with my suicidality, which clearly could not be dissolved from one session to the next.

I am not meaning to make this storyline of my life into any sort of cliff-hanger, but I am exhausted and I need a break. There is a lot more to say about what has been going on in my relationship with A. and what has happened since this session, and I hope that in the next few days, I will be able to post an update of some sort.

Until then,

Be kind to your Selves,

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

Pain, Fear & Courage – Daring To Say How You Feel

Posted by What It Takes To Be Me in Anxiety, Expressing Emotion, Psychology, Psychotherapy, Psychotherapy with A, Rejection, Sadness, The Therapeutic Relationship, Transference and tagged with anchor, anchorlessness, breaking people, courage, echoes from the past, expressing emotions, expressing emotions about psychotherapist, expressing negative emotions, fear, feeling hurt, holding on, honey-moon, honeymoon, hurt, hurting, overreacting, pain, psychology, psychotherapist, psychotherapy, real therapy, rejection, sadness, sexual abuse, telling psychotherapist how you feel about them Monday, October 1, 2012

A couple of very raw nerves were touched in my last session with A. Early in the session I made a statement to the effect that I feel un-anchored, adrift, floating with no direction. Later on A. commented on this, saying – and I’m paraphrasing here, I don’t remember the exact words – that even though I say that I feel un-anchored, it seems to her that I am perhaps a little too anchored. To the past, to old thoughts, old feelings, old memories. She then went on to saying that she can understand why that is.

I felt instantly hurt by this, because, what I heard was perhaps less of what she was actually saying and more an echo of what others around me have either said or through actions have made me feel: that I’m holding on too hard to the past, to the abuse I experienced. That I am overreacting and should just let it go. In my immediate feeling-reaction I discarded without thought the part about A. understanding why this is, and allowed the first part of the comment to hit me at full force; that I’m stubbornly refusing to let go of what happened to me as a child.

I was able to articulate this to A., to explain that what she had said left me hurting, but that I also recognised, even in the moment, that my reaction was not necessarily to what she had said, but to what other people have said, and that while I did in a physical sense hear her say that she has some understanding of why this holding on happens, the first part, the direct echo of other peoples’ views, was the part that was ringing in my ears.

Objectively I can see that she wasn’t actually repeating what others have said or made me feel, but emotionally, that is what I heard and what I responded to. In the moment, the “can understand why” didn’t feel very convincing, felt like it might have been something she just added to soften the blow while letting me know how she really feels about me and the way I live my life-.

I fell silent after my initial explanation, feeling unable to say more. Hurting too much, and trying to self-soothe, to reassure myself that A. doesn’t really think I’m overreacting or refusing to let go, that that wasn’t at all what she was saying. But it didn’t work particularly well.

During my silence A. took the opportunity to remind me that it’s OK for me to feel things about her, that she already knows I do. It was probably needed, her saying that; I am notoriously bad at expressing my feelings about A. openly and directly to her, and it was all said in the gentlest of ways; an offer for me to express freely how I felt about both what she had said and how I feel about her, but I just wasn’t ready for it right then, had too much fear inside. She went on to very honestly say that of course she couldn’t promise she wouldn’t be affected by what I might say, but that she can deal with it.

Only this shifted my focus to another sore, another deep-rooted fear; that I actually don’t feel at all certain that she can deal with it, that she can cope with me. I said as much to her, but, I feel I failed to really convey that in an odd way this isn’t something personal to her, that it’s not a case of me thinking she’s not a strong enough person, but that it stems from the simple fact that, as much as I intellectually know that this – coping with me, with what I bring to session – is her job, that it’s what all that training was there for, that she is (that dreaded word) a professional, to me, she is first and foremost a human being and no amount of training can change that fact. And my experience of human beings is that they can’t cope with me, can’t deal with me. That sooner or later I become too much, sooner or later I break people.

And that’s a hard one. Because, if this is how I feel deep down, then has my therapy got any chance of bringing about change? If I am so terrified of breaking A., then will I ever be able to truly open up? Will I ever find the courage to risk it, or will that fear forever stand in my way of letting my emotions out?

There is a part of me that wants to close the door and run as far as I can, and another that wants to be brave and carry on, beginning with exploring this immense fear. Together with A.

I still don’t know what I will do, but I know this:

My three and a half year honeymoon with A. is over.
And maybe, just maybe, this is where real therapy begins.

Starting Over After A Major Therapy Break

Posted by What It Takes To Be Me in Abandonment Issues, Anger, Attachment, Expressing Emotion, Inner Conflict, Psychology, Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, Rejection, Sef-Awareness, The Therapeutic Relationship and tagged with abandonment, abandonment issues, anger, attachment, expressing anger, expressing emotions, expressing negative emotions, fear, fear of rejection, inner conflict, maternity leave, overdose, overdosing, psychology, psychotherapist maternity leave, psychotherapist's maternity leave, psychotherapy, psychotherapy breaks, rejection, resuming psychotherapy, resuming therapy, self-awareness, the therapeutic relationship, therapist maternity leave, therapist's maternity leave, therapy breaks Sunday, July 15, 2012

A. Is back from maternity leave now. I’ve seen her twice, and it has at the same time been both a huge relief and incredibly difficult. The first time, walking up to her door, I experienced a very strong wish to cut and run, to chicken out and not knock on the door. I was that nervous. I was so worried about how I would react to seeing A. again [or rather the emotional impact it may have] that I actually felt quite sick.

As you know, over the last several months there have been a lot of thoughts and worries swimming around in my system, regarding A.’s maternity leave and her baby and how I would cope with this new situation, but, to some degree I have been able to shelter myself from it, as I’ve not been seeing her. Two weeks ago that particular way of sheltering myself came to an end, as we resumed therapy.

During that first session, I was very shaky. Not just emotionally, but physically, too. I was fidgety and struggled to settle. I had my Rubik’s cube in my hands, as a means to keep my hands steady. Speaking was difficult, and I sat in silence for a good while, trying to figure out where to start.

I can’t even remember clearly where I did start in the end. I do recall talking about the break. How hard it’s been. Even admitting to overdosing, early on; something which I hadn’t decided whether or not I wanted to talk about in that first session. A. asked some questions about that, and I remember feeling that I wasn’t at all ready to look into it properly just then, that I was still trying to get used to being back in this shared space with her, that I needed more time to test that we were OK before launching any major investigation into anything significant. I mean, I did end up trying to explain to her about that overdose, but without really connecting to what I was talking about. In contrast to the second session, where I spent quite a lot of time trying to talk about the emotional side of what really happened that night, what I was feeling before, during and after, and how I look at it now.

I managed to talk a little about my combined fears and hopes regarding resuming therapy; the hope that I will find the courage to talk openly about my feelings surrounding A.’s leave, the experience of once again being abandoned by someone who isn’t supposed to abandon you, and the anger that it triggers deep inside of me, as well as the worry that I may find that I haven’t got what it takes to face it head on. That I will yet again find a way to not have to express these feelings of anger, in order to avoid the risk of that much-feared rejection, which I have come to expect whenever I express negative emotions towards those close to me. I spoke about the knowledge that there is some potentially substantial gain in it, if I do find a way to talk about all of this, as I recognise that whatever anger I have towards A. is also an echo of what has gone unexpressed previously, in similar situation, in other relationships.

So, yes, A. is back and in theory therapy has resumed. But, although it may seem, from my summary here, that I’m well underway and going places, it still very much feels like I am only just testing the waters with A. and our relationship.

Maybe I’m not exactly back to square one, but, I also feel very aware, that I am nowhere near where I was when we left off, and that it will take time to truly open up again, to truly trust in our relationship.

But it’s a start.

Abandonment, Anger & Expressing Negative Emotions

Posted by What It Takes To Be Me in Abandonment Issues, Anger, Anxiety, Attachment, Expressing Emotion, Psychology, Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, Regression, The Therapeutic Relationship, Transference and tagged with abandonment, abandonment issues, acting out, anger, anxiety, attachment, expressing anger, expressing negative emotions, maternity leave, misplaced anger, psychology, psychotherapist maternity leave, psychotherapist's maternity leave, psychotherapy, psychotherapy breaks, regression, repression, the therapeutic relationship, therapist maternity leave, therapist's maternity leave, therapy breaks Sunday, June 17, 2012

As if by magic, following my previous post about wanting my therapist back, I received a two-line email from A. on Wednesday “to confirm that we are meeting on July Xth” and asking could I come at a slightly different time to my usual slot? Very formal and to the point, complete with a “Dear..” at the beginning and ending with “Best wishes,” in typical A. style. She does the same thing in texts, which I always find both amusing and somewhat incongruous to the kind of relationship we have and the way we communicate. It’s the text message equivalent of suddenly calling me Ms Y in session. :)

Anyway, having received said email I instantaneously found myself regressing into some sort of teenage state where my immediate reaction was I’ve spent months not knowing when my therapy will resume, weeks and weeks in limbo. If you think I’m going to reply to your stupid little email straight away, you’re wrong! You can sit there and wonder whether or not I can do the time you asked about. So THERE!

Not many points for maturity, as you can see, and of course entirely irrational; it’s not as if A. will have been anxiously awaiting our work to resume or has struggled to make it through this break. Nor is it likely that she will be particularly concerned about my holding back on replying to her email, but it still felt kind of good to allow myself to act out in this obviously infantile fashion.

Thus, it wasn’t until Friday I emailed her back. And when I did, I made sure to be decidedly less formal than she had been, writing in a way similar to how we speak, starting with a simple Hi A., and ending with a casual Shabbat Shalom for later. [Although, in hindsight, I realise that I actually don’t usually wish her Shabbat Shalom at the end of our Friday afternoon session, but more generally a good weekend. Stuff to ponder in another post, methinks.]

Clearly this need to act out stems from a place of anger at having been abandoned, and not wanting to make things easy for her. There is a part of me who wants to punish her for having put me through this separation, for having put me on hold while she carried on with her real life, and I have a feeling that it may well be a bumpy and challenging time to come once therapy starts over, while we work through this anger, which I genuinely hope I will allow myself to express.

This anger is, of course, not only about A.’s maternity leave, but also a deeply buried echo of all other times when I have felt left behind and uncared for, beginning with my birth mother giving me up for adoption and followed on by similar feelings towards my parents and other adults in my life, growing up. A person doesn’t need to be physically abandoned in order to experience the very powerful feelings associated with it..

And this – rather than just wanting to put A. through a bit of a rough time upon her return – is the reason why I say I hope I’ll be able to give myself licence to let this anger out. It has been trapped for a long time. Maybe the time has come to let it surface? Perhaps a chance for a much needed corrective emotional experience; being accepted even when expressing negative emotions?

PS. Ever wondered how your therapist really feels about you blogging about your therapy? I think my lovely fellow blogging tweetist Therapy Tales has it right. Click the link for a spot on cartoon strip!

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