Endings: Standing On The Brink Of The Unknown

Being in therapy is being in a relationship. Therefore it follows that ending therapy is an as complex and complicated – and sometimes painful – process as ending any other relationship. There are loose ends and jagged edges to deal with, memories – good and bad – to look back at, and a struggle to not panic and in desperation seek to go back to something that just isn’t there anymore.

I have always said that things that are familiar are often also comforting to us, even when The Familiar isn’t necessarily a good thing in itself. The Familiar is comforting because it keeps The Unknown at bay. And nothing is more frightening than The Unknown.

I have four more sessions left with A.
Four more sessions, after more than four and a half years of working together. In short: it is nothing. I am standing only millimetres away from The Unknown, and I have to find the courage to not turn and run, but rather to allow myself step in to and somehow tolerate existing within it.

I have been spending a lot of time over the Chrismukkah therapy break thinking about what exactly it is that makes this ending feel so difficult, because, intellectually I can see that ending work with A. has more or less become a necessity, both because I am unable to give her the reassurance that she needs that I won’t end my life, and – perhaps more importantly – because we have simply come as far as we can, working together. The conclusions I have reached, as to why the ending is difficult is summed up in the first paragraph of this post; this is the end of a very special relationship, so how could it not be difficult? But, on top of that ‘normal’ difficulty, apart from the anxiety and sadness and sense of loss that any ending brings with it, I think that there is something I need to take from this relationship, which I fear A. might deny me, and this is what makes it so much more painful.

In November, when I finished counselling with Z. – that, too, was a difficult ending. But, I do feel that in the last few sessions – and especially in the very last one – Z. managed to provide me with that one thing I needed: the reassurance that it mattered to her too, that we would not be working together anymore. That I had made an impact on her. That she would actually miss seeing me. What I am talking about here is not a need to be told that I am her favourite person ever to work with, but something far more simple; an open acknowledgement of the fact that working with me is special, because I am special: there is only one of me. So even though my slot would soon be filled by someone else, someone just as engaging, it is still different, because the relationship between Z. and I could only happen because of who we are as individuals, and what we accomplished in those sessions was specific to our relationship, to what we jointly brought to the table.

I talked with A. about this ending at the time, explaining that those things Z. said to me meant a lot, and significantly helped make that ending, if not less difficult, at least not painful, and left me with something positive to carry forward. The fact that Z. actually told me these things, actually said them out loud, rather than simply assume that the way we had been working together and the way we relate would automatically lead me to know it, I think is important. People who have been abused tend not to take things like that for granted, because actions and the meanings of those actions have been so terribly mixed up and confused in the past.

So, I suppose, what I would like from A. is something similar. I’m not talking about any earth shatteringly emotional revelations or dramatic proclamations, but just something said, in clear plain direct speech, about the work we have been doing and about what this ending means.

I asked A. earlier in the year if I matter to her, and she decided to not answer my question, and I am sure she has her reasons for that, but, I think what I need – especially now – is for her to step away from those reasons, whatever they are, and just meet me openly and honestly. The lack of this direct communication in the last few months, is part of why therapy is now coming to an end, and seeing as there will be no Next Session in which to analyse why I asked the question, an answer would be good, would provide me with that Something that I need.

But, as I wrote earlier, my fear is that A. will not opt to go down this route of openness and honesty, and this is where I feel the pain is created. To need to hear that working with me has mattered to her, that getting to know me, hearing my thoughts, means something, is important, and to leave, having been denied it, would be excruciatingly painful.

Of course, I don’t know that this will be how things end, and I really hope that A. will have taken onboard the things I said about ending with Z., and what made that a more positive ending. But, the fear is still there, looming like a dark cloud over my head.. I am seeing A. for the first time after the break tomorrow, and I will carry on talking about all of these things with her, as I had been before the break. I just hope that her response will be different.

*

Before concluding this post, I just wanted to say thank you to all who have emailed me following my last post. I am sorry that I haven’t been able to reply to all of you, but, hopefully, in time, I will. I know that this post hasn’t really been a direct follow-up on the previous one, and it isn’t because I am trying to shy away from the seriousness of the situation, which remains sadly unchanged, but because I feel that – for now – I need to try to deal with things in slightly smaller chunks, and if that means navigating by auto-pilot for a little while, well, so be it. As my sister said We much prefer Auto-Pilot to No Pilot..

But, once again, thank you all for your very kind emails and comments. They have been read, heard and appreciated.

Much love,

xx

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Where Do We Go From Here?

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.

xx

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!

Being The Perfect Therapy Client

I know this is a bit like the London double-deckers; for a long time there’s not a single bus, and then there are five all at once. The Heinz Ketchup effect.. But, you see, one of my readers commented on the post I uploaded last night, and in responding to his comment I realised that it could well be turned into a blog post in its own right, so here I am again, updating my blog merely hours after my last offering. You’ve got to strike while the iron is hot and all that.. I hope you don’t mind.

Anyhow..
The comment was in reference to my mentioning that five years ago, following an initial psychological assessment, I was deemed to be too high risk and unsuitable for psychotherapy, and the commenter said that “From the posts I’ve read by you, you certainly seem like the sort of patient that therapists are delighted to have.” My initial reaction was to feel flattered by this comment, and I instantly thought that I rather agree, biased as I am; I do think I make a good client. I have a bit of a chequered past, quite a few things in my baggage – obvious material to work with so to speak – and I am also reasonably self-aware, rather analytically minded and fairly articulate. Not a bad prospect for a psychotherapist.

Then again, I am no different to any other psychotherapy client; I think we all want to see ourselves as good clients – interesting, intelligent people – who therapists are happy to work with. And we all wish to be the favourite client, the one our therapist is really looking forward to seeing, because we challenge them just the right amount without being burdensome or draining. [If you’re in therapy yourself, I’m sure you will know what I mean.]

Yet, having been turned down by the NHS for therapy I really struggled to find someone who was willing to take me on. Naturally I had to give up on the idea of getting free therapy on the NHS, but I figured that outside of The Service there had to be plenty of privately practicing therapists who would want to work with me.

In reality it took me quite a few months to find a therapist. I had to go to many ‘first appointments’ and found myself being repeatedly rejected. Many of the therapists I saw, said exactly what the NHS assessor had said; that I was simply too high risk, what with my recent serious suicide attempt and my habit of using self-harm as a coping strategy. And I can understand that. I imagine it can be quite challenging – scary even – to work with, and in a sense – be responsible for – a client who may well choose to down a litre of anti-freeze rather than turn up to session. Naturally, not everyone will be up for that. But, at the same time, the way I always saw it – and I would always make this clear at assessments – I’ve always seen therapy as the way forward for me, the thing which will eventually help me manage my past in a more positive way, and also – while I have many times become depressed while in therapy, I’ve never made an attempt to end my life when I’ve been in therapy or had counselling. That has only ever happened when I’ve not had a place to take my thoughts and emotions, when I’ve felt I’ve not been able to share what’s going on for me.

The other reason given to me, when therapists declined taking me on, was that they felt they simply didn’t have the experience they needed to be able to work with someone with such a complex background. There are quite a few aspects – issues, if you will – to work on; I was adopted, so a high potential for major attachment and abandonment issues and possible identity crises. I was sexually abused and suffer from intense flashbacks of this, and so more than one therapist said that I should probably look for someone who specialised in this area, perhaps a therapist trained in EMDR or TF-CBT. I have one parent who is gay, I have another parent who has struggled a lot with the rollercoaster that is bi-polar disorder. So lots of different things to work on in therapy, perhaps too many, for some.

I also suspect, although I don’t know this for sure, that I probably came across as someone who might be a bit of a handful to manage in session, because I happen to be ridiculously well read on the theory of psychotherapy, particularly psychoanalytic and psychodynamic therapy, which was also what I wanted to do. I am not someone who will hold back on commenting if I feel that the therapist is ‘text booking’ me. And also, there is a definite barrier to get through; the fact that I often, knowingly or unknowingly, intellectualise and theorise in order to not have to deal with actual emotions. Hiding behind my theoretic understanding of things, so as to not really have to deal with anything. I don’t do it so much anymore – in fact, these days I tell myself off if I notice that I am slipping back into this pattern – but five years ago, that was certainly something I did a lot.

In the end, having tried for a good few months to find myself a therapist and failed, I asked the house therapists in the therapeutic community I had recently moved in to, to set me up with one of their trainees, because I felt I would never be able to get anyone to take me on on my own.

Long-term readers of this blog with remember that this turned out to not have been a great idea, as the person who was ‘assigned to me’ wasn’t a particularly good match for me and the chemistry just wasn’t there. Having thought it through, I ultimately decided to terminate with her, as I felt that I could probably carry on seeing her for years and still never get what I wanted from our work together. It wasn’t a decision I took lightly, but, I always felt it was the right decision for me. I’m sure B. – my previous therapist – is a great therapist; she just wasn’t the right one for me.

As it turned out, I actually managed to find a therapist that seemed a good fit for me before I had even let B. know for sure that I was going to move on. Almost as if by magic, I had completely by chance contacted two different therapy organisations, both of which A. happened to be affiliated with, and already the first time I spoke to her on the phone, I felt she could be the right person for me to be doing this very important work with. Going for my first initial appointment with her I was nervous, but also felt decidedly positive. I had a good feeling about it.

I have since asked A. how come she decided to take me on – thinking about the many people who had turned me down – and, although she slightly dodged the question in her funny little way, she did say that she never considered not taking me on. I am still not entirely sure why that was, but maybe she saw it somewhat similarly to how I saw it; I seemed like someone she could work well enough with me to give me a chance.

We’ve certainly had our moments over the years, A. and I, and I know that I can definitely be more than just a little challenging at times, and not always in a nice way, but I do think that we speak similar enough languages to be able to communicate well and to work things through. I also know that A. can stand up to me, and that she won’t be cornered or pushed around by my intellectualisations or red herrings, something I really appreciate. In fact, only the other session, she was challenging me and I commented that she’s asking very difficult questions, to which she responded Good! and we exchanged a quick smile across the room.
And I think that illustrates our relationship quite well.

I don’t know if I really am that magic Favourite Client, and by now that doesn’t even seem all that important anymore, but I do feel that we have a decent enough relationship that I could be.

And that’s enough.

xx

Starting Over After A Major Therapy Break

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.

xx