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

 

 

 

Advertisements

Living With PTSD – Not Like The Movies

I managed to go to service this morning, for the first time in a long long while. Last week I couldn’t go because I had managed to give myself a concussion, before then it was down to running a temperature, and before then – for many many weeks – it has been due to simply not being up to it; too depressed, too submerged in my life/death battle. And then there’s the PTSD. Post-traumatic stress disorder. The bane of my life. A big reason for previously mentioned life/death battle.

I feel that a lot of people don’t really understand what post-traumatic stress disorder is. Or, more accurately, they may not be aware of how it affects people. I think that, at least in part, media is responsible for this. People have generally heard of flashbacks as being one of the symptoms of PTSD, and you often come across storylines in which characters suffer from this disorder, and the viewers are treated to an insight into the flashbacks that they experience in a variety of ways. Only, there’s an issue with this: having a flashback isn’t like watching something happening on a film screen. It’s about feelings. About re-experiencing the traumatic event, as if it is happening all over again, and having an emotional response to it. Again and again and again and again.

In the most recent episode of BBC’s Silent Witness, the storyline followed a former soldier suffering from PTSD. It was explained that certain sounds and situation could trigger flashbacks for him. So far so good; this is all true for many people suffering from PTSD. Later on in the program we got to ‘experience’ a flashback alongside the character: he saw a person on the street, it morphed into a flashback person – someone who wasn’t actually there – someone who had been part of the trauma. All of this is fairly accurate, I think, for a lot of people: flashbacks can very well be triggered by someone who looks like someone who was part of the traumatic event, and flashbacks can absolutely cause a person to see someone who isn’t really there. Happens to me all the time.

But then the character talked to someone about his experience of having flashbacks, and when the person listening to him said something along the lines of “That must be really horrible” the character’s reply was “No, it’s OK. It’s actually quite nice.”

And this, to me, is a huge departure from what PTSD sufferers truly deal with. I have yet to meet a single person suffering from PTSD who would describe having flashbacks as ‘nice’. Because the disorder is caused by traumatic experiences, often very extreme ones, you are not likely to have an emotional response which could in any way, shape or form be described as ‘nice’. Having a traumatic experience is not nice, thus, the emotional response will probably not include positive feelings.

Let me illustrate: say your previously wonderful and perfect partner rapes you. Very traumatic, very hard to deal with, extremely emotionally damaging. Let’s say the effects of the experience go so far as to cause you to develop PTSD. You now have flashbacks of the event. This is hardly going to trigger emotions related to the rosy honey-moon period of your relationship. Whilst you may still – in your conscious mind – remember that time when your partner brought home a dozen roses and your favourite chocolates, and the lovely feelings that gave you, those feelings will not be triggered by a flashback to the rape. They just won’t. Those lovely feelings weren’t associated with the rape, and so can’t be triggered by flashbacks to the trauma.

When you have PTSD [as I understand it, and put in layman’s terms] the memories of the trauma are stored in a different part of the brain to where other, ‘normal’, memories are stored, and the response flashbacks produce completely bypass the part of the brain that is responsible for rational thought. Thus, even though some part of you may be aware that the trauma isn’t really happening right now, and most of the time you are able to remember both positive and negative aspects of a relationship [assuming there have been both], because rational thought is taken out of the equation, your emotional response to a flashback will be as if it the trauma had only just happened, and will involve the feelings you either had at the time, or the feelings you may have had to repress at the time in order to survive. It won’t involve feelings related to an entirely different situation.

I mentioned earlier that flashbacks are often caused by triggers. But there is more to it. While a majority of people with PTSD have flashbacks caused by external triggers [sounds, smells etc – things that in one way or another remind them of the trauma], some people – myself included – have flashbacks that are caused primarily by internal triggers. Internal triggers are tricky, because they are difficult to identify. And if you can’t identify triggers, it is almost impossible to avoid them.

For me, personally, it is often a case of one flashback triggering the next, in a continuous chain, and I am just as likely to have flashbacks if I am out having an absolutely fantabulous time ice-skating with my friends, as I am sitting with someone talking about really deep and difficult things. In short, if I’m going to have a flashback, it will happen, regardless of what I am doing, where I am or who I am with.

One of the first things people [professionals in particular, actually] tend to ask is “What do you do to stop the flashbacks from happening?” to which I answer “Nothing”. They will then in one way or another convey to me that I have a very negative and defeatist attitude which isn’t helpful. Or they will suggest that I do something nice and relaxing – light candles, have a bath, listen to music, and so on. So, I tell them, oh, I do all of those things. Because they are very nice things to do. But I will still have the flashback, only I will have it in the bathtub, with the music playing and the candles all around me. I then say “You know when you go to sleep..?” adding a pause to allow the person I am talking to to nod, since this is something everyone has an experience of, before continuing “Well, you know once you are asleep, yeah?” Another nod. “At what point do you choose not to have a nightmare?”  You see, I can’t choose to not have a flashback any more than you can choose not to have a nightmare. No amount of positive thinking or relaxation is going to change it. If it’s going to happen, it’s going to happen, and it simply isn’t caused by a defeatist or negative attitude. I know a million different grounding techniques to help me come out of a flashback, all of which I employ on a daily basis, and I am working very hard at finding ways to cope with the emotions the flashbacks bring out, but there is no way I can stop the flashback from happening in the first place.

I have somewhere between 30 and 40 flashbacks on an average day. On a particularly bad day, when it seems like one flashback triggers the next, I can have over a hundred. That means re-experiencing, re-living – the abuse over a hundred times in a day. It means dealing with the emotional impact a hundred times in a day. To me, the fact that I am still here, in spite of this, is proof that I absolutely do not have a defeatist attitude.

If you would like to know what it is like [for me] to have flashbacks, there is a drawing (What Words Can’t Express – A Visual Representation Of Sexual Abuse Flashbacks) that I posted a number of years ago, trying to visually explain that sense of being in two places at once – the past and the present, simultaneously. I feel pushed to warn, though, that it is somewhat graphic, and could be potentially triggering.

I want to make it clear that I am in no way an expert on PTSD, and what I have written here is based on my own experience of living with flashbacks, and on what others with PTSD have told me. Of course, as with anything, different people react in different ways, and there may very well be PTSD sufferers out there who disagree entirely with my take on what PTSD is like. And that’s OK. I just wanted to offer my view of what it’s like.

 

All the very best,

xx

 

PS. In case you happen to know me, I’ve recently added a little section on the right, appropriately called “For People Who Know Me”. You may want to check that out. Not in any way saying that you can’t check it out even if you don’t know me, it just won’t be all that relevant to you. :)

The Beginning Of A Parallel Journey

My most beloved transitional object

My most beloved transitional object

 

You may remember that a few posts ago I wrote about deciding to go ahead and do some short term specialised trauma-focused counselling, parallel to the psychoanalytic therapy I am already doing with A.

I set out on this journey four weeks ago and it’s been quite a ride thus far, but before I begin writing about said journey, let me introduce you to a new character: Z., my counsellor. I have to admit that when I met her the first time I wasn’t entirely sure about her. My impression was mostly positive, and I absolutely felt that she was someone I could work with, but there was also a little bit of fear that she might not be quite strong enough to resist my habit of luring therapists and counsellors alike down side paths and blind alleys. What I mean by that is that, in the past, back when therapy was something I was doing because someone else wanted me to do it [parents, doctors, psychiatrists], I was very very good at finding ways of showing up for session each week, skilfully avoiding doing any actual therapy.

What I did was to go in and talk about something entirely unrelated [I spent an entire year talking about ice-hockey and the LA Lakers with my first therapist], then dazzling them by intellectually linking whatever I had decided to talk about with psychotherapeutic theory. I realise, of course, that this was something I did because I simply wasn’t ready to engage in therapy, so in one way this behaviour is hardly surprising. But, at the same time, there was always a part of me that was deeply disappointed that none of my first three therapists ever pulled me up on my fairly obvious attempts at outsmarting them, and that they were instead, session after session, drawn into complex discussions about attachment theory, projective identification etc etc. I think what I was really craving was a therapist who would step into that pseudo-parental role, different to my own parents, steering a clear path in showing me that they were more interested in me than in my ability to spin intricate and dazzling webs.

It wasn’t until many many years later in my very first session with D. that a counsellor finally told me that ‘Although your knowledge is very impressive, it’s not why we’re here.’ Felt like hitting a brick wall at a hundred miles an hour and then being told that it’s pretty silly to go running at a wall, when there was a perfectly good opportunity here to learn to use the ladder that was leaning against said wall. I’m not saying that D. was necessarily the first counsellor or therapist to see through this game I was playing, or to understand the reasons for why I was playing it, but she was the first person to properly make me feel that she understood that I was absolutely terrified and that rather than allowing me to carry on defending against this fear by using intellectualisation she cared enough about me to want to help me step onto the ladder and do something different. There was no pressure to make it to the top of the wall in the time we had, but instead there was a lot of focus on acknowledging the achievement of making it onto the first step. Any subsequent steps would be a bonus.

So, knowing that I was about to begin a completely new type of counselling with Z., one which focused solely on the sexual abuse I suffered, one where talking about my parents, or being adopted, or the million other things that are part of my life and who I am, would play very little part, I was completely and utterly petrified. Thus, meeting Z. for the first time was a big deal. Naturally, meeting a counsellor or therapist always is, but I was very aware of the need to find a counsellor who wouldn’t gobble up deliciously smoked red herrings thrown their way, and so there was a lot on the line in that first meeting.

Coming out of that meeting, my general impression of Z. was – as I said earlier – mainly positive, there was still a part of me that felt concerned that her statement that she ‘wouldn’t push me to go somewhere I didn’t want to go’, might potentially indicate that she was someone who, if I wanted to, I could easily string along in an attempt to not only avoid having to go to painful places, but to avoid challenging myself to move forward at all. Like I said to my sisters after the first session: ‘Z. is someone I would have had for lunch 10 years ago’.

But the four and a half years of doing therapy with A., along with the counselling I did with D. prior to that, has made me realise how much there is to gain from doing my utmost to stop myself from going down that route. To, in a sense, stay on that ladder and keep climbing it. So, I knew that even if I was somewhat unsure of Z., I knew that I was different, as were my reasons for going into this counselling. Of course, as much as I try to consciously stop myself from hopping off the ladder, there may still be a fair amount of unconscious [or subconscious, if you’re so inclined] motivation for leading myself astray, hence, needing to feel sure that Z. would be able to spot this when I can’t.

In my second meeting with Z., many of my initial fears were laid to rest. She came to the second session with a very clear view of what she would like us to work on and helped guide me through it. This is very new to me; I’m used to doing psychoanalytic therapy, where I’m pretty much always in the driver’s seat, and it’s a real challenge to now, suddenly, let someone else co-pilot. There were some things Z. had wanted to do in the second session, which she soon realised weren’t quite right for me, as they were things I had already worked out and implemented for myself, and she swiftly adapted to this, changing course to suit my trajectory. This lead to something I would never in a million years have thought possible: already in session three I took a plunge and showed her a drawing of one of the abuse situations and talked about it. It was scary as anything, but was much helped by discussing – prior to me handing the drawing over to Z. – what I wanted her to do with it so as to not have a repeat of that session with A. where I interpreted her immediate return of a drawing as a sign that she couldn’t quite bear looking at the reality of the abuse. Instead, this time, we made the agreement that Z. would hold on to my drawing until I indicated that I would like to have it back. Z. also showed some initiative when she felt I was getting into my normal way of racing ahead through a story, as though I’m talking about someone else, with complete emotional disconnect, by stopping me for a while and asking me to reconnect and to tell her what talking about this made me feel. This is very new to me. Naturally, A. is also very interested in what I’m feeling, and often tags a ‘Can you say more?’ [one of my absolute favourite questions] or ‘Can you unpack that?’ onto something I have said, in order to coax more out of me. But, I’m not used to being actually stopped in order to reconnect several times during a session.

I had brought my beloved Doth with me to session. Doth, for those of you who haven’t had the pleasure of meeting her, is a porcelain doll I’ve had since I was a child. She was made by my best friend’s mother and she was the only person who knew about the abuse while it was going on; I used to sit with Doth, whisper in her ear the things my brother and M. made me do. So, needless to say, she is very very precious to me, and as childish as it may seem, I thought having Doth with me in session might make it easier for me to talk about the abuse, because, in a way, she has already heard it all. I felt regressing to that childhood ritual of talking to Doth about the awful things that were happening might help me overcome my fear of talking about the abuse for fear of breaking the listener.

I think this parallel work with A. and Z. has the potential to be a very good thing. I had worried that I might be spreading myself too thin, or that it would become too confusing working with two people at the same time, but for now it seems to work quite well. Also, the work I am doing with Z. is very short term, only sixteen sessions in all, and is by its very nature a lot more intense than the therapy I’m doing with A., and I am hoping to use my sessions with A. to ensure that I remain safe while I’m doing this very painful work. I have already noticed that I am again having more flashbacks than the norm, but this is something I had expected. As I told a friend of mine: ‘Doing this was always going to be a totally rubbish time’, but I am hopeful that it will ultimately help reduce the amount of flashbacks I have, and also, that it will help me go further with A.

Sixteen sessions, even if structured, is not a lot of time, especially given that I suffered abuse from more than one person, and that the abuse went on for as long as it did, so I am hoping that doing this with Z. will open the door to carrying on talking about the abuse with A. once counselling comes to an end, much in the same way that the counselling with D. set me up for actively trying to avoid throwing red herrings at A., and subsequently, Z.

 

In other words: onwards and upwards, one rung at the time.

 

Be kind to your Selves,

xx

 

Long-Term Psychoanalytic Therapy & Short-Term Trauma Focused Counselling

I have been meaning to update my blog for a long time now, but blogging has had to take a step back in the midst of coping with what has felt like an ever-increasing onslaught of flashbacks. Still, here I am now, neatly posed in front [well, technically, behind] my computer and though I will more than likely have to make many stops to work my way out of flashbacks, I still wanted to write a little, just to keep you all in the loop as it were.

Firstly, I would like to apologise – or perhaps not so much apologise as acknowledge that my previous post was of a rather difficult-to-read nature. I know that some people found it a little too hard to cope with. And, at the same time, I have also had emails from people saying that they found it helpful in one way or another, and I suppose, at the end of the day, this blog, it is – as it states on the tin – an honesty focused blog, and does come with an explicit warning that it sometimes deals with difficult issues.

Now, moving on from that, you will be pleased to know that this post will be perhaps a little less difficult to stomach. I can’t guarantee that it will necessarily be joyful, but it won’t be leaving you with any particularly nasty mental images, I shouldn’t think.

So, what’s been going on in my life? Well, as mentioned above, there have been the flashbacks, and sometimes it really feels like that is ALL that there is, but, really, that’s not true, and I am hoping that – eventually, with plenty of hard work – I will get to a place where those will take a back seat.

As regular readers will know I am currently in twice weekly psychoanalytic therapy, and have been for nearly four years [thrice weekly, a lot of the time]. In fact, A.’s and my four year anniversary is coming up later this month. Perhaps time to crack open the champagne, or share a celebratory cigar ála Freud? But more than anything, I think, time to reflect.

People often ask me if my therapy helps, and what does A. say about all these flashbacks that I’m having, about self-harm, about feeling suicidal? And I find myself forever explaining that it’s not that type of therapy. It’s not the type of therapy in which A. and I sit and practice grounding techniques or where she advices me on what I should and shouldn’t do. It just isn’t. Psychoanalytic therapy isn’t a short term crisis action plan. But that is not the same as saying that my therapy isn’t helping. No, it doesn’t immediately offer relief from flashbacks or other psychological ills, but it helps in different ways. It helps me see things from different perspectives, it helps me develop self-awareness, it helps me understand why I sometimes react very differently to other people, it helps me see patterns in both my behaviour and in my way of thinking and relating. It helps me in a very broad way. This is not trauma focused therapy. We look at a lot more than ‘just’ the sexual abuse I experienced, we look at all different aspects of my life. It’s colour photography, as opposed to black and white, and I feel that it offers a bigger and more stable platform to stand on, when looking at all the various angles of being alive and being human. So, yes, therapy absolutely does help. It’s just that it is rather more complex than a plaster cast on a broken arm.

That said, the one thing that impacts my day-to-day life more than anything else is without a shadow of a doubt the flashbacks, the horrible experience of being made to relive the abuse again and again without warning. It’s a painful and uncontrollable mental bombardment which severely alters the way I live my life. Apart from, of course, being extremely emotionally exhausting (both the actual flashbacks and the aftermath of them – it’s simply not a case of OK, I’m out of the flashback, everything is fine now..) they also impact on a very practical level. Firstly, the unpredictability of when they [the flashbacks] are going to happen, means that it is very hard to relax. I don’t have easily identifiable triggers which give me warning that I might soon have a flashback, so, even when things are good, when I’m only having perhaps six or ten flashbacks in a day, I don’t know when they are going to happen, and so have to always be on the ready to deal with them. Secondly, when things are bad – like at the moment when I’m having anything between sixty and eighty flashbacks in a day – it leaves little time or energy to spare for doing other things. I can’t read, I can’t watch telly, because I’m constantly being interrupted by these flashbacks, and by the time I’ve come out of them and calmed down, I’ve forgotten what I was reading or what the storyline was. Also, having so many flashbacks makes venturing outside something to be avoided. It’s simply too hazardous, as I won’t notice traffic lights changing, I’ll keep walking while having them ending up getting lost, I’ll miss my stop on the tube etc etc. Even something so simple as making myself a cup of tea can become quite dangerous, as I discovered the other week; I was pouring out the water, had a flashback but kept pouring.. as a consequence the boiling water spilled onto my lap, and I got a burn on my thigh. So, even though the flashbacks are not psychotic; I do know where I am, it is like being in two places at once, it’s an altered state of awareness which affects daily life a lot more than people realise. I have to do a million different work-arounds just to get by, like being on the phone with someone whenever I’m out walking (so the person can help me notice if I have a flashback and tell me to stop walking), ask bus drivers and tube staff to make sure I get off at the right stop, meet friends in places that are easy for me to get to and generally meet at the station rather than at the cafe or restaurant we’re going to, to minimise the potential for getting lost on the way. Etc etc etc.

Because of this, I have decided that on top of my normal therapy with A. I am going to do some short-term specialised trauma-focused counselling, aimed at trying to reduce the number of flashbacks I have. I’ve talked to A. about it, and although it’s not the norm to see more than one therapist at any one time, it is something I really want to do. And I think that doing it this way, while I am still seeing A. will help me cope better with what can’t be anything but very painful trauma work. It’s one of those I don’t think it is meant to be easy, I think it’s meant to be WORTH it sort of things. Because, if it helped reduce the frequency of the flashbacks even just a little, it would improve my life enormously.

So, although there is much to discuss, not least of all the reasons why I am chosing to do this work with someone other than A. [is it to protect her? is it to protect me? maybe fear of ruining our relationship? etc etc], for now, I am waiting with some trepidation to start this new (additional) type of counselling. So do stay tuned. Updates will be forthcoming once I actually start.

All the very best,

xx