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

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Starting Over After A Break

               *

“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..”

                           [from ‘Lily’ by Kate Bush ©1993]

 

 

 

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,

xx

 

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

Hearing the Littles – A Therapy Break Update

Våga Lita - Dare Trust A reminder written on my arm before going into a therapy session shortly before The Break

Våga Lita – Dare Trust
A reminder written on my arm before going into a therapy session shortly before The Break

It is far too early on a Sunday morning for me, or indeed anyone, to be awake. But, I am. Anxiety is stretching my nerves to the point of breaking, and I have been unable to sleep for about forty hours. Insomnia isn’t out of the norm for me; it is part of my pattern. But the anxiety is. Or, at least, the level of anxiety. I can feel the extreme imbalance of the chemicals surging through my system, splashing around, crashing into each other and the rocky shores of my insides that have until now been unknown to me. The inner landscape of my body is soaked, drenched, in acidic anxiety, and I can’t think of how to rid myself of it, how to alkalise.

I know that I can and will get through this. I have survived it before, and I will again. It is just that the strength of emotions have taken me by surprise. Yes, I was nervous about this upcoming break in therapy for weeks before it started, but I thought that perhaps this time might be different, because, in contrast to many other breaks, I – we – P. and I, had spent so much time talking about it, preparing for it, putting in place things to make it more manageable. And I, foolishly it seems now, thought that that in itself might dull the sharpness of my feelings. But it doesn’t.

I miss P. terribly, and even though I have talked to my friends about it, and many of them have responded with empathy – more so than in the past, it seems – I am still left feeling that no one really understands the depth of my emotions. Or maybe it is a sense that others expect Adult Me – the intellectualising, reasoning, part of me – to handle this, to take charge and make it all OK, for all of the different parts inside of me. Truth be told, I think that even I expect her to.

But, what happens during a therapy break – a break from my pseudo parent – is that Little S. – not Adult Me – is the one who is reacting to this separation. Adult Me can watch, but can do nothing about that, because Adult Me wasn’t there when the fear of separation and abandonment, was born. Adult Me hadn’t yet been formed when Little S. – or even before then – tiny Baby S. were dealing with life in a world where there simply was no stability, where her parents gave her up and left her to fend for herself, completely void of tools with which to do so. Because of this, the reassurance Adult Me is continually trying to offer rings hollow to Baby S., in exactly the same way reassurance from anybody else does. Adult Me may be one of many parts that forms the whole of me, but she wasn’t there when it happened, and as far as the Littles are concerned, she doesn’t get it any more than my incredibly kind and well-meaning friends do. Not emotionally. And Little and Baby feel just as nakedly defenceless as they did back then.

Of course Adult Me has acquired lots of tools over the years to deal with situations like these. And during normal, daytime, hours, she makes the most of those tools and is often successful in temporarily alleviating much of the fear and anxiety. But when the rest of the world goes to sleep, and Adult Me is exhausted from a day of constantly trying to soothe those Little parts, when she needs a break to stock up on supplies, that’s when the primal scream of Baby S. sounds the loudest, deafening all intellectualisation and reasoning.

Baby S. was about six months old when she was adopted, when she came to live with her new parents in Sweden. No one knows, and Baby S. can’t remember, what happened in the six months before then. But the emotional echoes of the feelings born in those months still bounce between the walls of her outer shell, and when something like this – a separation, a perceived abandonment from a care giver – happens, those echoes amplify and drown out everything else. The echoes are always there, even in peacetime, noticeable in the fear of forming attachments with others and the difficulty in trusting, but when an actual separation happens something explodes in her, because just as Baby S. couldn’t know at the time that that abandonment would be temporary, she is now – still – blind to this fact. Baby S. only knows the here and now, isn’t able to look to the future, so when Adult Me, in sheer exhaustion, takes a break from reassuring Baby S., Baby S. thinks that this will last forever.

I wrote an email to P. a few weeks prior to her going on her summer break, about the whole How to cope with your therapist abandoning you for a minor eternity-issue, and as I am writing this now, it strikes me that that is exactly what I am dealing with: a minor eternity. It is minor in the eyes of the world, even in Adult Me’s eyes, but to Baby S. and Little S. – both of them too young to understand the concept of weeks or days or even minutes – it is an Eternity. And eternities have no foreseeable end.

As I wrote at the beginning, I will get through this separation, just as I have got through separations in the past. But in order to help Baby S. and Little S. I need to remind Adult Me to deal with them gently and patiently in the understanding that they have not yet got as far in the healing process as she has. They will get there eventually, but it will take more than the survival of a few therapy breaks for them to feel safe enough to integrate fully, to get to a place where The Whole can begin to work as a single entity, rather than as a multitude of frightened independent parts.

So, I say to myself, as much as I do to you:
be kind to your Selves.

 

Much love,

xx

 

The Beginning Of A Break

Had my final pre-therapy break session yesterday, and it was hard. Or, maybe hard isn’t the right word? It was emotional. Not emotional as in floods-of-tears-streaming-down-my-face-fifty-minutes-straight, but it certainly stirred things up inside of me in a big way.

So, P. and I spent most of the session talking about all the different feelings this break is bringing up for me. How it makes me feel like the abandoned, forgotten baby I once was, the distant echoes from when I was tiny and was given up by my birthmother, and how – even though I have no conscious memory of it – that must have had a profound effect on me. I also retold the story that my mother [technically adoptive mother, but it’s not a term I ever use; she’s just my mother] has told me so many times: that about two or three weeks after I was adopted my mother was downstairs doing something with my brothers, and she completely forgot about me. Not as in ‘she forgot that I was upstairs in the baby swing’, but as in ‘she utterly and completely forgot that I even existed’. My mother tells this story as a bit of an amusing anecdote, but of course, there isn’t really anything very much fun about it at all: I had already been given up once and then only a few weeks later my new mother also forgot that she had a baby to care for..

We also talked about how I simultaneously fear it will be an incredibly difficult break and that it won’t be difficult at all. That it, paradoxically, is easier to deal with the idea of finding this break an immense struggle, than to cope with the idea that it mightn’t affect me much at all. Because, if it isn’t difficult, if it doesn’t affect me, what does that say about P.’s and my relationship? Of course, it could just mean that I have simply developed better ways of self-soothing than during previous therapy breaks, but, knowing myself, I am far more likely to jump with instant certainty to the conclusion that it must be because P.’s and my relationship isn’t really all that special after all etc etc etc.

Last week P. gave me a few suggestions of things we could do to make me feel less abandoned during this break, to allow me to hold on to her even when I’m not actually seeing her. One of her suggestions was to give me a recording of her voice for me to listen to, if she started feeling too distant in my mind. I rejected that idea right away, stating that it wouldn’t be all that useful, considering how poor my hearing is, all the while knowing that that wasn’t the reason at all, but rather that something about having a voice recording felt too close and too scary for me to cope with. Another suggestion, in a similar vein, was that perhaps it would be helpful if she were to give me a photograph of herself to look at. This led to me coming clean and admitting that I already have a picture of her, and that – yes – I do find it very helpful to look at it. P. said that this photo would be different, though, because this would be a photo she had given me, which I agreed it would be, but that I needed to think about it.

What I failed to explain to her at the time, and which later came back to haunt me in the form of a number of sleepless nights, was that I said nothing about why [how?] I had a picture of her. Eventually, it got to me so much that I had to write her an email to explain that it wasn’t quite as creepy-stalkerlike as it may seem: because of the prosopagnosia I have taken to doing a quick search engine/social media scan for a pic to add to any new contact I put in my address book, including the guy who comes to fix the boiler. Just for clarity: I don’t think there is anything inherently wrong in having your therapist’s photo; most clients have a very natural, healthy curiosity about their therapist, and googling someone is hardly the crime of the century – it was more the fact that I hadn’t said anything about it to P. that was bothering me, because it filled me with anxiety that she might think I was exhibiting creepy stalkerlike behaviour. Unfortunately, the very sweet email she wrote back to reassure me that this wasn’t the case, that she didn’t feel it was either creepy or stalkerlike, for some reason didn’t make it through to my inbox, and consequently my anxiety was quadrupled over the next two days. But, we managed to talk all of that through later.

In the end I did accept P.’s offer of giving me a photograph. The actual photo is one that my prosopagnostic brain has trouble deciphering as being of her – there is something about the fact that she isn’t smiling with her eyes – as she so often does in session – that makes it hard for me to understand that it is really her in the photo, but it still means a lot to me having it. I treasure it in the same way that I might treasure a handwritten note from her, precisely because it is from her. I also showed P. the picture I already had of her, and I think she understood why that is a picture I find much easier to connect emotionally with – because in that photo she seems very relaxed and is indeed ‘smiling with her eyes.’

The final idea of how to cope with this separation was one I came up with. I had been thinking about what exactly all of those fears inside of me really are, and what different ways we had worked out to deal with each one of them, and I realised that one of my biggest fears – the one about being forgotten and left behind – could also be dealt with, with a photo. This time, I suggested to P. that maybe I could send her a photo, of me, because even though Adult Me intellectually knows that I won’t disappear from P.’s memory the second I am out of sight, her having something of me with her would make Little S. feel a lot better. [For long term followers, this idea was a modified version of the rubber duck I gave A. in our very last session together.]

So, all in all, that last pre-break session was a good one. I felt quite overwhelmed by P. saying so many kind things to me, particularly when she said that her having my photo meant that she could take me with her on her leave.. But, as I also explained to her, it was good overwhelming, not bad..

Right at the very end of the session P. asked one last time if there was anything else she could do for me, to which I said: “Just make sure that you DO come back”.

To which she replied that she wanted the exact same thing from me.

 

xx

Reconnecting

I’ve been writing this update in my head for about a month, only I’ve not got down to typing it up. I am struggling to remember where I was at, emotionally, when I posted my last update, but I know that it wasn’t a very nice place.

Things sort of spun out of control for a bit. I went into the worst period of constant flashbacks I have ever experienced and ended up, once again, at Drayton Park. The whole first two weeks of staying there I more or less only ventured outside of my room to see P. for therapy. I didn’t eat, didn’t sleep and didn’t socialise with any of the other women who were staying there, so this stay was very different to many of my previous stays at Drayton Park. I simply found it too much to be around others when I was being thrust back into the past again and again and again, in an endless waking nightmare of relentless flashbacks.

Something very serious happened while I was at the crisis house, something I still don’t feel I have properly processed or understood, and I may come back to that another time, but for the time being I won’t go into it. I need more time to think about it.

In my third and final week at Drayton Park the frequency of flashbacks began to decrease and I was able to be my usual self a bit more. I had a few really good conversations with some of the other women staying at the project, feeling privileged to be allowed hear their stories and to get to know them a little. It is always a very special thing when someone decides to trust you enough to share of themselves.

I saw D., my ex-counsellor, in passing a few times during my stay [since she is based at Drayton Park one day a week] and we had some good, honest banter over lunch one day. In fact, it must have been really good, even to others listening in, because after D. left one of the residents asked me if D. was my mother, because we had such a ‘natural and easy way with one another’. How anyone could associate ‘natural and easy’ with a mother-daughter relationship is beyond me, it certainly doesn’t fit with any experience of a mother-daughter relationship I’ve ever had, but it was a very nice thing to hear, nonetheless.

Good banter aside, as D. and I were ending one of our little mini-conversations she told me to take good care of myself. Force of habit I shot a semi-automatic “I always do” coupled with a bright smile in her direction. Only, this being D. on the receiving end, she didn’t just let that statement slide, but immediately lobbed a “No, you don’t” back at me. She then paused, looked me right in the eye and slowly repeated “No. You don’t.” And there was so much feeling in those words. There was an unspoken – but clearly received – message of ‘I so wish that you did take good care of yourself. Because you really, really matter.’  And that meant a lot to me.

 

*

 

It has now been four weeks since I left Drayton Park, and there have been both ups and downs. The frequency of flashbacks seems to be back to normal, more or less. It is in no way easy to deal with the flashbacks, regardless of the less intense frequency, but it is a lot better than what it was. As I explained to a friend of mine; it’s a bit like my breathing. While my breathing is never really all that good, immediately after a bad asthma attack the ‘not so good’ still feels like a relief, by comparison.

Therapy with P. is going well and we are continuing to build our relationship, making sure to take plenty of time to do so, so that all of the different parts of me – especially Little S., who is so terribly afraid of anything that resembles trust and care and attachment – feels both seen and heard. Little S. gets scared, because she learned very early on that all of those things will inevitably lead to pain and hurt, and as much as Adult Me wants to challenge that fear, wants to show her that this relationship with P. can be safe and won’t necessarily lead to pain, it takes time and patience to get there. It takes a lot of work to truly alleviate fears that are that deeply rooted.

We are coming up to our first therapy summer break by the end of this week and as a consequence anxiety has been running high both for Little S. and for Adult Me. Regular readers of this blog will know that psychotherapy breaks is a topic I have written about a lot over the years, because it brings to the fore all of my fears about being abandoned and forgotten. It is also one of those things that people who haven’t been in therapy never seem to fully understand or appreciate. And, to me, that is also part of what makes breaks in therapy difficult; the sense that others don’t understand how hard they really are. Whenever I mention to ‘non-therapy’ friends that I feel really anxious about an upcoming break, I always get the feeling that they are thinking that I am worrying over nothing. And if I, during the actual break, say something along the lines of finding it hard that my therapist is away, the immediate response is invariably ‘When will she be back?’ followed by an equally predictable ‘Well, it’s only X weeks left’. This, of course, feels terribly invalidating, since a therapy break isn’t really about length of time at all, but about strength of emotions and how to cope with them in the absence of a safe place to explore them.

P. and I have been talking about this upcoming break and how I will be able to manage while she is away. P. had a few different suggestions of things we could do and I felt incredibly touched by them. I know that it probably seems a little silly, but it had never even entered my mind that she would have spent time thinking of ways to make this easier. I am so used to doing all my thinking and coping on my own, and I feel simultaneously grateful and overwhelmed by the care she has shown me leading up to this break.

 

I think I will end this update here.
Hopefully it won’t be quite so long before I post another one.
[I always seem to be saying that, these days].

Just before I leave you for this time: Thank you all so very much for the many moving and kind words posted in the form of comments and emails during this past blog hiatus. I am sorry that I haven’t been able to respond to all of you, but please know that I do read every single email and comment, and they really do mean a huge deal to me.

Namaste.

 

xx