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

Advertisements

Bulletpointing My Life

I had to go see a clinical psychologist for an assessment not very long ago; I needed a statement to say something about my mental health. It’s a long and rather convoluted story why I couldn’t simply get A. to write this statement, but in short: it was An NHS Thing and for whatever reason psychotherapists simply don’t rank very highly within the NHS. It doesn’t matter how long you’ve been seeing them or how well they know you, it doesn’t even matter if they are both UKCP and BACP accredited, the only letters that matter within the NHS are N, H – and you guessed it – S.

So, in the end I was given a number to call in order to book an appointment with an NHS affiliated clinical psychologist, who would clearly possess almost magical levels of insight, as she would apparently be able to conduct a full assess of my mental health in thirty minutes flat, having never met me before and knowing absolutely nothing about me, my background or my mental health history.

I had resolved to stay calm, but the second I was given the address to the place where the assessment was to happen, I realised it was where I had gone for an assessment five years earlier, where they ultimately deemed me too high risk and unsuitable to be in therapy.. [Being rejected by the NHS is the reason why I had to go private; while I agree that I was very high risk, there was no way I was going to accept that I wasn’t suited to be in therapy..]

Either way, I rolled up at the place with plenty of time to spare, giving my anxiety abundant opportunity to hit the roof and then proceed through it. This wasn’t helped by the fact that Dr NHS Clinical Psychologist was an hour [yes, an hour!] late.

But – eventually – I did get to go in for my assessment and as it turned out Dr NHS Clinical Psychologist really wasn’t too bad. It’s just that, when you meet someone for the first time and you have thirty minutes to talk about yourself, your background and your mental health history, well, what do you say? where do you start?

We covered the usual ground: I was adopted, I was sexually abused by my oldest brother for twelve years and for a year by a second person, I have a complicated relationship with my whole family, my parents are separated, my father lives with his male partner, my mother is bi-polar, etc etc etc. We then moved on to more recent times, talking about previous suicide attempts, self-harm as a coping strategy, the flashbacks, the recurrent depressions and so on. I have to give Dr NHS Clinical Psychologist some credit here, because she also allowed some space to talk about the more positive aspects of my life; my relationship with my sisters, my amazing friends, my studies, my volunteering, but, coming out of the meeting, while I felt that she had listened to all I had said, I really wasn’t sure what she would actually write in her statement.

It’s a strange thing when you are asked to summarize your whole life and your entire being in a very short space of time; it really highlights something, forces you to really think. And it’s exhausting.

So, the next session I had with A, was spent debriefing. It’s quite hard to look at the different parts of your life in this very concise way. It’s almost a bit of a shock to the system to go through it all like that. I mean, none of these aspects of my life are things I haven’t spent hours in therapy thinking and talking about, but there is something quite extraordinary when you have all these life stories mentally bullet pointed before you.

There is one part of me that thinks that considering all the things I’ve been through, all the unorthodox aspects of my life, I’ve actually done quite well to not be completely broken by it. And at the same time, there is another part that chokes and goes “It’s going to take a looooong time to make some sort of peace with all of this..”

But, thankfully, in spite of that assessment five years ago, I am in therapy and I will continue to give it my best shot to somehow make sense of it all.

xx

Because Tomorrow Might Be Good For Something

*

“..I’m not crazy, I’m just a little unwell
I know, right now you can’t tell
But stay awhile and maybe then you’ll see
A different side of me..”

*

I guess there are no easy ways to talk or write about this, but as this is supposed to be an honesty-focused blog I’ll just tell it to you straight: last week I accidentally on purpose overdosed on my medication. It really wasn’t a bid to end my life, at least I don’t think it was [although I accept that others may disagree]; I didn’t even take all the tablets I had, but it was still a significant enough dose to potentially do some damage. I know my meds pretty well, and I would like to think that I know what would and wouldn’t kill me, but, the truth is – of course – that there is no way to know for sure just how much a of a medication would be lethal for a specific individual; what’s safe for one person may well be fatal for another. In some weird and rather irrational way, it was more like I was testing if it would be possible to swallow enough tablets in one sitting to get to a lethal dose. I think that was my confused logic, anyway, [which, obviously, isn’t logic at all].

I did frighteningly well in terms of establishing that it would indeed be possible, had I wanted to take more pills than I did. But, the second I had swallowed the first lot I instantly regretted it, and I decided I should go to A&E, since the meds I’m on [Amitriptyline] are known to be very toxic. In fact, the highest therapeutic dose is not that far off a dose that would be classified as toxic, and that is the precise reason why Amitriptyline is only prescribed as a last resort, when all other types of anti-depressants have failed.

Again, entirely irrationally, I decided that rather than calling for an ambulance I would get on a night bus to my local A&E, so I got myself out, started walking to the bus stop and only just missed the bus, so I carried on walking in the general direction of the hospital. After a while I began to get really unsteady on my feet, but was still clear enough to realise that passing out on the streets of London on a Saturday night would not be a great idea, especially with a lot of drunk people out and about. So I went back home, got on my bed and blacked out before I could call for an ambulance.

When I woke up it was all dark, so I thought that it was still night, but when I looked at the time on my mobile I realised that it was in fact the next evening, and I’d been out cold for nearly 24 hours and had missed several calls and texts from worried friends. This really freaked me out, since I normally wake from even the quietest of noises.

That evening I again attempted to get to A&E, but was simply still too wobbly and I had to give up and go home again. On Thursday I had an appointment with my GP, and I told her honestly what I had done, and that since I don’t even really know why I did it, or at least, the logic in the moment really wasn’t logic at all, I really needed some extra support. She heard me and then asked whether I wanted to call the mental health crisis resolution team myself, or if I wanted her to do it. I opted for the latter, because I know I would most likely have gone home and talked myself out of ringing them.

So, at the moment I am seeing the crisis team every other day. I’m not suicidal, at least not on a conscious level, but I also think that having some extra support over the next few days is a good idea, wherever that support comes from.

The crisis team, being tied to the NHS, have, as they always do, questioned both my therapy and my therapist on the grounds that they are not NHS and must therefore automatically be harmful to me.

That really makes me angry, since I am a big believer in psychotherapy in general, and in my therapy in particular. For me, psychotherapy is the most appropriate way of disentangling my thoughts and emotions, and to ultimately get away from the intrusive flashbacks and nightmares which push me to act out in this rather extreme way.

That said, what with my therapist being on maternity leave, I do feel that as much as the crisis team and I have very different ways of understanding psychotherapy and the effect it has, I am still glad to be seen by them, because it means that, should I act out again, or miss a scheduled appointment [whatever the reason] they would send the police and ambulance round to check on me, as I am in effect an out-patient and they have a duty of care. Also, they are available to talk to 24/7, should I find myself struggling with thoughts of self-harm or suicide. I can’t promise I would definitely call them if that happened – in fact – I’m fairly certain that I wouldn’t, but at least the option is there.

Hopefully things will improve soon, so I can start looking forward rather than backward, because, who knows..

;

“..tomorrow might be good for something..”

;

xx

;

Heading, and quotes at the beginning and end of this entry are from Matchbox 20‘s track Unwell. © Rob Thomas

Remember September & Stepping Into The New Year

It’s been a while since I posted a proper update, I know. Things have been very difficult and it’s all felt too raw to put it down in black and white. To pick up where I left off: I went to the assessment at Drayton Park Women’s Crisis Centre and was offered a place the same day. It was very hard going back there, having not needed that kind of help in quite a few years. So much of my time at the therapeutic community I was staying in was designed to keep you away from the NHS mental health system, to find other ways of getting the support you need, preferably away from medication and hospital. So it was a big decision going back to Drayton Park. But needs must sometimes, and sometimes you have to swallow your pride and just accept any kind of help you can get.

The whole first week and a half at Drayton I spent virtually all of my time in my room, feeling unable to be around people other than my named support workers. I simply felt to embarrassed to be around people while I was fighting the near constant stream of flashbacks, as the things I do to ground myself can look quite odd if you don’t know what I’m doing or why I’m doing it. I did have quite a few people come visit me, which felt more OK, because they were all people who know what I’m usually like, and who I knew could handle seeing me in that very very difficult emotional place. I know it’s hard to see someone you love struggle in the way I was – constantly having to fight this torrent of intrusive flashbacks.

Flashbacks aren’t a new phenomenon to me; regular readers will know that I suffer from single flashbacks frequently, and experience periods of sequential flashbacks every so often, but this was on a scale I’ve never known before. I’ve always understood the single flashbacks as an indicator of sorts that I am ready to perhaps deal with that specific incident in my therapy, and the periods of flashbacks tend to begin either when A. is away or when I am very stressed out about other things. But this, it was just something entirely different. A whole different ball game. As I said earlier, initially I was experiencing an incessant flow of flashbacks, most of them reasonably short and all of things I already knew had happened. Though never a pleasant experience, I was able to come out of them fairly quickly. What was really wearing me down – apart from the re-experience of the abuse situations – was the fact that they were so frequent. It felt very much as if as soon as I had worked my way out of one flashback another started, like one flashback triggered the next, and it took essentially all of my energy to remain fully in the present.

Then, one day – and I still don’t quite know why – the flashbacks changed. They became less frequent and were about things I had no conscious memory of. Although the reclining frequency was a welcome break, making it possible to at least go out of my room and spend time in the art room, it was absolutely terrifying. I always knew that there were gaps in my memory, pertaining to one specific person, but some of the things that came out were things I had absolutely no recollection of at all. I know that what emerged in those flashbacks did happen, that they weren’t figments of my imagination [although at times I tried very hard to convince myself that maybe they were].. The best way I can describe it is that it felt like I was remembering things I had forgotten I knew. These flashbacks tended to be more like long sequences, and were a lot harder to come out of, I think, in part because they caught me so unawares, memorywise, but also because the content of them were cruelty on a whole new level, and I felt paralysed by fear, unable to do the things I usually do to come out of the flashbacks. And I have to say, I’m still dealing with those memories now, feeling utterly traumatised by what those flashbacks unveiled.

I ended up spending a full three weeks at Drayton Park, and throughout those weeks, being stripped of the release and relief my various means of self-harm offered, they were probably the worst three weeks in my entire life. Every day I would ask the staff – pleading with them – to please, please let me have my scalpels, just for a little while, just to get a small break from the flashbacks. And each day my support workers told me no, because although their policy is that they recognise self-harm as a genuine coping-strategy for some people, they felt that my cutting would not be safe and could end in me, accidentally or intentionally, cutting to kill myself rather than to just relieve pain. Also, owing to my previous track record at Drayton Park, downing a pint of anti-freeze in a bid to end my life, my trust/credit rating with the staff isn’t the greatest, so their decision to not allow me to use any form of self-harm to cope, is entirely understandable.

I am now back home. Things are still difficult. The flashbacks aren’t as frequent, but I still have them fairly regularly, and it seems that an underlying depression is rearing its ugly head, and I am often struggling to get out of bed at all, unless I have to. I push myself to get to therapy and to not completely disappear in my own misery, but it’s hard work.

One thing that is good is that we’re now in the middle of a period called Yamim Noraim, [lit. Days Of Awe, commonly referred to as the High Holy Days, is the period between Rosh HaShanah and Yom Kippur] – so there are a lot of things going on at shul, and so I have more things than usual that I need to get to. Also, on the days I simply haven’t been able to go to service I’ve been able to follow it online, and I’ve made a point of always making sure I am up and appropriately dressed, even if I’m only attending service via the internet.

All in all, it’s still a bit of a roller coaster; one good day, one bad and so on, but I suppose that it’s better to have some better days than none at all.

So, for a better and sweeter new year,

שנה טובה ומתוקה

~ Shanah Tova Umetukah ~

xx

OK – so this isn’t for this new year, but this Rosh HaShanah video from Michelle Citrin still makes me smile. I mean, c’mon – I named my blog after one of her songs, after all.

Long-term therapy vs. short-term crisis resolution

I’ve been thinking about how to update my blog the last few days, but I’ve not felt able to do it. Partly because all my energy has been channelled towards fighting my way out of a flashback. Again and again and again. Times a million. It really has been kind of never-ending – and the only way that has worked to give me any kind of longer break has been to either make myself black out or to cut, neither of which is particularly healthy.

To say that it’s been a difficult few weeks would be a severe understatement. It’s been pretty relentless, and at times I’ve really just wanted it all to end, because there is only so much a person can cope with. The crisis team have been quite good (well, the nurses more so than the pill pushing doctors) – but it’s also been hard to find myself back in this system. Also, I’ve felt that the crisis team has been quite critical of the therapy I’m doing with A,, and they have frequently asked me if it’s really helpful to have this kind of therapy when it’s made me have such terrible flashbacks. Also, my relationship with A. has been questioned. More than once have they asked me if I’m not a little bit too attached to my therapist. My answer throughout has been that it’s not the therapy which is causing these flashbacks, it’s a combination of going home and then returning a week before therapy resumed, in conjunction with a number of other factors.

I’ve defend both my choice of therapy and the relationship I’ve worked so hard to form with A. on numerous occasions, but it’s tricky when you’re talking to people who see medication and CBT as the cure for all ills. It’s not so easy to explain that the whole point of therapy is that you form a close relationship with your therapist, and that it allows you to look at other relationships and see how they may be played out as little echoes within the therapeutic relationship. That in my veiw CBT is a bit of a band-aid, masking deep-rooted problems, and wouldn’t be at all appropriate for the kind of issues I’m dealing with. That, yes – this is really hard work, and yes it does bring difficult things up, but that it’s my feeling that the only way for me to be able to find some sort of peace within my past is to dare look at all those difficult things and realise that I can in fact survive the pain. And that’s what the work I do with A. is all about.

Despite this difference of opinion, having the involvement of the crisis team has also been of value – I’ve felt held by the fact that I’ve been seeing them on the weekends, when I don’t see A., and that they’re available to talk to on the telephone 24/7. It does help. But, that does in no way mean that I’m any less committed to the work I’m doing with A. I see it more as a crutch between sessions – for the time being – so that I can carry on with what I do in therapy.

Following yesterday’s adventures at A&E when I had my cuts stitched and SteriStripped – with a tetanus shot thrown in for good measure – R. from the crisis team came down to have a chat with me, and she said that she felt that my self-harming behaviour was going in the wrong direction, that it was escalating rather than subsiding, and that she felt I needed more support than what the crisis team can offer, and she suggested she make a referral to Drayton Park Women’s Crisis Centre.

I’ve stayed there in the past – years ago – and it has been helpful, so I agreed to R. making the referral. I think Drayton Park could be a safe option while I’m in the middle of this crisis. To me it seems like a happy medium – I’ll still be able to see A., but rather than going home to a lonely room battling flashbacks and urges to self-harm, I’d be going back to Drayton Park, where I’d be able to talk to someone about my urges to self-harm. Also, I know that they will be a lot more encouraging in terms of doing the type of work I do with A. han the crisis team has been.
Fair enough, I’ve never actually been at Drayton Park when I’ve been in therapy, but I have several friends who’ve stayed there and have felt that the Drayton Park staff have been very much in favour of them carrying on seeing their therapists while they’re staying at Drayton Park. Essentially what they say is that your therapist is your long-term support and who will help you with long-term goals, and Drayton Park is a place to feel safe while being in the middle of a crisis. It’s a short-term add-on support system, not a replacement for your long-term aims and goals.

Anyway, I’m meeting with one of the workers at Drayton Park tomorrow for an assessment, and it still remains to be seen if they’ll deem it appropriate to offer me a place for the week.

Think it’s time to hit the hay now – hopefully I’ll be able to sleep a little more than I have been in the last few nights..

Be kind to yourselves.

xx

Little S At Six Months

Little S At Six Months

Cuts, Stitches & Psychotherapy

Things are still fairly touch and go. Really struggling at the moment. I’m having a lot of flashbacks, and it feels like everything in my life revolves around that. I don’t go out unless I have to, because I worry about having flashbacks in public. Not only is it embarrassing, but it could also potentially be quite dangerous as I don’t always feel completely aware of what is going on around me. I could quite easily not notice a traffic light going from red to green. And that’s just the “practical” side of flashbacks. Naturally there is also an emotional side to them, which is even more difficult to cope with..

Have been seeing the crisis team nearly daily since last Wednesday and have called them several times in between, and yet I can’t seem to find a way out of this darkness. Still can’t fight my urge to self-harm, and thoughts of suicide come easily to me at the moment. I fight it as best I can, but this is a mighty frightening place to exist within.

Went to see Dr H. today. She had asked me to check in with her in a week’s time when I saw her last week, because she wanted to be kept in the loop of how I’m faring, not just via the crisis team, but from me directly. Didn’t have much good stuff to share, I’m afraid, but I still think it was good to see her. Makes me feel a bit less anxious about when the crisis team decide to discharge me. Also she actually asked to see my cuts – which was a little embarrassing, but also made me feel more confident in her as she wasn’t shying away from the reality of self-harm. Have to admit that she looked quite shocked when she saw my handiwork, and she quickly decided that the cuts are quite a bit too deep and gaping to just be left on their own, so she ordered me to make an appointment to see the practice nurse, for her to clean them properly and either put in some stitches or Steri-Strip™ them. She said that ideally they should be stitched, but as my cuts are fairly close together that might not be possible.

I know this is going to sound really odd, but in some ways I don’t think I had really considered my cutting a real problem until Dr H. told me I might actually need stitches. I tend to just think of it as one of those things I do. A coping mechanism of sorts. I mean, I do know that cutting isn’t a good thing, but considering that I always use individually packaged sterile scalpels and antiseptic wipes to clean up, I kind of figured I had it under control. Clearly this is not the case; hadn’t at all realised how deep the cuts were – it wasn’t until I got home and had a look in the mirror that I could see that they were quite a lot more severe than I had thought. A seriously sobering discovery.

Saw A. today, and it was a good but quite difficult session. The last few sessions have been a lot about the here and now, about the impulse to cut and to play the choking game and fantasising about suicide and so on, but not very much about what’s triggered this downward spiral. So that’s what A. asked me to talk about today. An unusual step for her, as she is usually not particularly directive in her approach. Anyway, I gave it my best shot, starting with the obvious: the trip back to the scenes of the crimes. Talked about what it was I had wanted to be able to do on this trip, and how I feel I’ve let myself down by not being able to do it. And also what the reactions were to the little bits I did try to share. There’s plenty more to explore on this theme, and I think that the sooner I can start verbalising what’s happening inside of me, the sooner I’ll be able to step away from this very dark place I find myself in. I really appreciate that A. has been able to make time for extra sessions for me this week and last, even though that clearly means her working day becomes a lot longer. It makes me feel like I’m not fighting this beast on my own.
Also, she spoke to the crisis team on Monday, because they wanted to discharge me, and she felt it was too soon, that I’m still in the middle of this crisis, and need extra support from them for a bit longer. I’m really glad that she said that, because I feel I lose my voice when it comes to asking for things for myself, even when I desperately want to.

It’s really hard being back here again. It’s difficult to fight the feeling that no matter how hard I work, how hard I try, I will always mess it up, and find myself back where I started. That this is one of those life lessons that I seem incapable of learning.

But tomorrow is another day, and who knows, it might be marginally better than today.

And that’s better than nothing.

xx

Survival – Knowing When You Need Help

Things aren’t going so well.
Downward spiral at breakneck speed, I feel frightened at how quickly I’ve gone from doing really well to finding myself stuck in a pattern of inward turned anger and self-harm. A few weeks and I’ve managed to undo all the hard work I’ve put in these last four years.

Realising that I’ve lost control of things I have been forced to accept that I need someone to help me, and so on Monday I called my GP to make an appointment. Couldn’t get one until Wednesday, and let me tell you, that felt like a very long way away.

These last few days have really have been rollercoaster like, oscillating between trying to stem flashbacks by using cords and scalpels and later on feeling very very angry with myself for not having been able to stop myself from going back to this very destructive behaviour. And it’s becoming increasingly erratic. This morning I woke up and immediately reached for a fresh scalpel to punish myself for having, the previous night, used a cord coiled around my neck to make myself pass out. – There’s no logic to it, and I can see that. Yet, I don’t seem able to stop myself from acting out in this way.

I’ve been trying to do things in the last few days to try to prove to myself that I’m not quite such a bad person as I sometimes think I am. To show myself that I’m not a waste of space, that I am of some sort of value to the community. But it’s hard to hold on to those thoughts when it has to come through external actions rather than from some internal place..

Saw my GP this morning. I say my GP, but really, I saw a GP. I saw Dr H., a newbie doctor, in her own words. This turned out to be a pretty good thing; she listened to me and seemed to really take in what I was telling her, in contrast to some GPs who’ll whack out the ever-so-patronising “How Depressed Are You?” multiple choice questionnaire at the earliest possible opportunity in a bid to avoid having to actually listen to the patient. Given this opportunity to be heard I tried to be as honest as I could with Dr H. It’s hard, when you’re a bit of a people-pleaser like me, and you don’t want to make the other person feel bad, but I think I did OK.

Dr H. made the decision that she didn’t just want to start me on some meds, but that I needed to be seen by the mental health crisis team. She asked me to wait in the waiting room while she sorted it all out, as she didn’t want me to leave the clinic before she knew for sure that I’d definitely be seen by the crisis team. A reassuring touch, I have to say. I’ve certainly come across doctors who say they’re going to make a referral and send you off with a “Don’t call us, we’ll call you” style parting phrase.

As it turned out the crisis team wanted to see me at noon, so I essentially ended up going straight from the GP practice to the Highgate Mental Health Hospital. Felt quite anxious about going there, as I was still experiencing flashbacks and I was worried that I’d become too confused and disoriented on my way there. Also, I didn’t know what to expect. It’s been several years since I’ve been in touch with any form of NHS run mental health service. A lot of my work has been aimed at getting away from this system.

Then I was thinking of the advice I would give – and have given – friends who have found themselves struggling in the way I am right now: accept any help you can get, whatever that may be. This is not a time for pride, it’s a time for survival.

Talking to two members of the crisis team I did feel a lot better. They reassured me that their aim is to support people struggling with self-harm and suicidal ideation in their homes, rather than pushing people into wards, which may not at all be the best for a person. They did – of course – make it clear that if they felt I became more destructive and posed a serious danger to myself they would have to put me on a section order, but that their aim was to find alternative ways of supporting me. They made the decision – based on my previous history – that they’ll want to see me every day for now, and also asked if I would give them permission to liaise with A. regarding what would be the best way to go about things. Initially I didn’t feel comfortable with that, but in the end I decided that maybe it could be helpful to not try to keep different parts of my life separate. As I was a little unsure of A.’s number I told them I would ask A. to call them instead.

My session with A. today was quite difficult. I was just feeling so low, so defeated at finding myself back in this very dark place. I’m finding it very hard to motivate myself to not give up, keep falling into thinking that no matter how hard I try, no matter how hard I work, I will always come crashing down..

A. said a few things that made me feel a bit better, made me feel like I’m not entirely on my own. But it’s still very very hard. She also added an extra session for me this week – first thing tomorrow morning – which felt comforting. Also I have been given the number for the crisis team, which is a 24 hour care service, so I can call and talk to someone on the crisis team at any time between seeing them in person.

I hope this will help stop me falling any further. Because last time I felt the way I feel right now I drank half a litre of anti-freeze and ended up in ICU..

So, if you have any to spare, thoughts and prayers are much appreciated.

xx