The End Of A Relationship

Sometimes A Rubber Duck Really IS Just A Rubber Duck ..these ones, of course, aren't..

Sometimes A Rubber Duck Really IS Just A Rubber Duck
..these ones, of course, aren’t..

 

I feel so desperately sad.

Had my final session with A. earlier today. And I just want to cry. In fact I have been crying. A lot. It just feels awful. I hate the way things have ended, it doesn’t feel good at all; there are so many loose ends that we were just never able to tie up and we will now never get the opportunity to do so. I feel we came to an impasse at some point last year, and no matter how hard I’ve tried, it’s just not been possible to break it. And that is what is making me feel so terribly sad, what I mourn. I knew that I would have to end therapy with A., that there really was no other path left to take, but, I would have liked to have been able to rebuild at least some of the things I felt got broken in the midst of this therapeutic breakdown of sorts.

I knowingly opted not to write about the last four sessions as they happened, because I wanted to use these few weeks to deal with therapy coming to an end on my own and in my sessions with A., without discussing and analysing it to bits elsewhere beforehand. I just felt that if I spend a lot of time between sessions writing about them, especially about all the things I didn’t say in session, it would somehow dilute something, would make it easier to remain emotionally remote in session, because I would have already felt the initial force of impact when dissecting it in black-on-white writing. And with this very important final phase of my work with A. I wanted to try to avoid that. Especially knowing how good I can be at switching off emotions, even when I’m actively trying not to.

But, now that it is over, I would like to share some of the things that have been going on. I’m not sure that I will be able to write about it all tonight, it all feels so terribly raw still, so there may have to be a few posts on the subject over the next few weeks, but I’ll make a start today, to the best of my ability.

There is this broken record that’s been playing in my head on repeat this whole time: How am I supposed to say goodbye at the end of the final session, walk through the door and never come back..? It’s a thought I have been wanting to share with A. throughout, but I wasn’t able to give voice to it until today, in the very last session.

The idea of never feels so terribly painful and inescapable that I’ve not quite known what to do with it. In the last few weeks, I’ve often found myself suddenly struck with sheer panic about the fact that I would soon not be seeing A. anymore. That she will no longer be my therapist. And – even more painfully – the realisation that, not only will A. not be my therapist anymore, but I won’t be her client. The link will be completely severed. Forever.

And it hurts like hell.

So, I had to come up with a solution to help me deal with that. Something. Anything. And in the end it happened in the shape of two rubber ducks.. I spent some time thinking about whether or not I wanted to make a card for A. for the final session, or even give her a little something. It’s something I’ve never done in all of our years together. You see, my father – The World’s Greatest Psychotherapist – used to get Christmas cards and Easter cards and Happy Midsummer cards and other bits and pieces from his clients, and I always deeply resented this intrusion of his work in our family home. Feeling that he was already so much more involved with his clients than he was with his family, I really didn’t want reminders of his clients dotted around the house.. As a consequence of this, I’ve always felt I can’t quite cope with being That Client, and as a consequence A. has never been sent a card or left a gift or anything like that.

In the end I decided that actually, doing a little project of some sort, while dealing with the ever nearing ending, might be useful. In essence, to put my own needs before any thoughts about what impact this may have on anything or anyone. So, I came up with the rubber duck idea. It seemed fitting, because I have told A. many times that “sometimes a rubber duck really IS just a rubber duck”, meaning that not everything said in session is an echo of the world outside, and even if there is a bigger duck in the outside world, sometimes dealing with the smaller duck inside the therapy room, will be just as effective at resolving something..

Anyway, I bought two ducks to decorate with my trademark nail varnish flowers. [Having never used nail varnish on this material before, I wanted to have a back-up duck should I need to have another go, using different paints.] As it turns out, nail varnish works really well on rubber ducks, and I didn’t need the back-up, spending an hour and a half painting the duck and thinking about my journey with A., allowing the emotions it brought out to just exist. The idea with giving A. the duck – apart from serving as a reminder of what I used to tell her – was that it might make it a little easier to walk out and never come back, if I knew that there would be something of me left behind. No, I don’t really feel that nothing of me would have been left behind, without the duck, but leaving something physically behind, made it less abstract. Then, last night, I decided to paint the second duck as well, because I thought that if I have the twin to A.’s duck still with me, there wouldn’t be such a definite severing of the link between A. and I. A very comforting thought. So, that’s what I did. When I was done, I named A.’s duck Graduation Day Duck [End of Therapy Duck, was a little too negative] and mine Separation Anxiety Duck. [I think we’ll save analysing that for another time..]

I’ve previously written about the things I’ve felt I’ve needed from A., in order to make this parting of ways more manageable. I can’t say that I’ve really had any of those things, at least not packaged the way I had imagined. But, at the same time, some things have been said – tiny little things here and there that have seeped through when A. has been talking about other things, which have made me think you’re really talking about us here, aren’t you? I think therapists sometimes underestimate the amount of time their clients spend analysing them, and the fact that interpreting what is being said is not a magic skill bestowed on their profession alone. Just as they hear echoes of other things in what we say, so do we see shadows and other dimensions in the pictures they paint for us.

In one session A. said something along the lines of how it is really important for me to hear her say that I am special. I can’t remember if I replied directly to that, at the time, but I remember thinking that, actually, it isn’t so much about being special to her, as it is about feeling validated in the fact that I am unique, that even if she sees a million other clients, every single one with a similar background, our work is unique, because our relationship is unique –  that our relationship can’t be replicated or duplicated, because of who we each are as individuals, and the unique combination that creates.

At times, the refusal to allow me to have this validation has felt very harsh and has been experienced as exceptionally rejecting, regardless of the intellectual understanding that this was not the intention. In the midst of therapy, I can to some degree see the value in not always providing automatic gratification, to instead look at what this need is really about. But, at the end of nearer to five years, when there soon would be no next session in which to analyse things, I don’t really understand this withholding of validation. In fact, even if it really was just about needing to be told that you’re special, what is the cost in doing that? When there is no further analysis to be done within that particular relationship? I have talked to A. about how the fact that both D. and Z. in their final sessions with me made sure I could really feel that the work we had been doing had meant something to them, too, has been really helpful. To be told that I – simply through being the unique person that I am – have had an impact on them, has had a definite positive effect on me. That is not to say that I am unable to feel good about myself without someone else reassuring me of my value, BUT –  a little positive reinforcement from someone you respect can go a long way and create rings on the water that reach very far, indeed. Just look at children who grow up with parents who validate them, and then at children whose parents actively invalidate them, and the benefit of the former becomes obvious. It is human nature to continue to grow in a healthier way as a person, if we feel valued for simply being ourselves.

*

Today the dreaded final session finally came. At the beginning of it I used the duck to talk about the ending, and the process the duck had been part of [and – yes – I did a little analysing of the names I’d given them], and that part of it felt good. But then I sort of side-tracked myself and talked about something entirely different – something which, had this been a normal mid-therapy session, would have been very useful – but, which in the context of this being the final session felt very much like something that wouldn’t really be nearly as helpful as talking about the fact that after 429 sessions and 21,450 minutes spent together, A.’s and my relationship was about to end. At one point I tried to get back to talking about the ending by stopping myself mid-sentence and stating that ‘No, I don’t actually want to talk about that’, but as A. encouraged me to carry on, and not feeling particularly brave, I ended up using all of the precious remaining time on this side-track.

And all of a sudden, without any warning at all, A. announced that “Our time has come to an end”. Not ten minutes before actual end of session, in order to leave time and space for a proper goodbye, but at the actual end of session, with no time to spare. It’s a bad habit of A.’s, this lack of signalling that time is nearly up, and it was particularly deeply felt today.

So, I left feeling somewhat robbed of the chance to say a proper goodbye, because, really, this session was ended much like any other session, with me putting my shoes on and quickly gathering my things, ready to vacate the room for The Next Client.

Yes, I was able to look A. in the eye and say “Thank you”, and  A., in turn, said that she wished me all the best, but, even though she more than likely genuinely does wish me all the best, it sounded awkwardly formal. She tacked a “Thank you for my duck” on after that, with a little more feeling, and that helped some, but I could without a shadow of a doubt have done with another five minutes spent truly acknowledging that what has been an incredibly important relationship for me was coming to an end.

Instead, I said goodbye and walked through the door.
Knowing that I would never be coming back.

And that’s when the tears began falling.

xx

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Putting Feelings Into Words

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

 

*

Dear A.,

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

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

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

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

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

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

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

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

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

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

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

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

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

xx

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

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

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

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

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

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

Ten words. Like bullets to my heart.

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

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

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

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

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

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

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

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

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

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

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

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

*

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

Until then,

Be kind to your Selves,

xx

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Disappointment & Rejection – An Entry About Coping With Negative Experiences

I didn’t have counselling last week as D. was away. It’s been ok, anyway, but it is nice to know that you have that set time that is there just for you to vent whatever you need to vent.

Not only was there no counselling last week, but Dev has been away, also, and is not returning until late on Friday.

So, I’ve been on my own. Which is always a bit of a worry. Not so much because I don’t like being on my own, I actually do, but, well, leaving me on my own with my thoughts for too long can sometimes lead to me getting stuck in a thought pattern which isn’t necessarily healthy for me. I’d say that I have been able to take quite a big step away from becoming directly destructive, but I still, on occasion, end up allowing my thoughts to roam a little too freely. While I was at the women’s crisis centre earlier this year I learned various different distraction techniques, and have become pretty good at using them as my coping strategy when I feel myself slipping. And yet, being on my own – I think it’s a good idea to be aware that I am still recovering from a very severe depression.

The week has actually gone quite well. I’m back to working, which is incredibly exciting, and at the same time very very tiring. It’s amazing how unfit you become, workwise, from being off work for six months. I get home from work and I’m absolutely knackered. Usually I’ll just make myself something nice and easy to eat and stumble into bed, somtimes being able to read for about an hour before falling asleep, but more often not. In fact, yesterday, when I started doing a load of laundry after work, I found myself struggling to stay awake until the cycle had finished. Luckily my friend Bobbi gave me a ring, so she kept me awake, and then I managed to squeeze in another quick call with a friend from back home before dozing off.

Now, I said that the week has gone well, and in general that’s pretty accurate. Having said that, I did have a pretty big downer on Monday. As I’ve told you I had my assessment for psychotherapy a couple of weeks ago. Well, on Monday I was asked to come down to my local community care centre, to meet with S., my care co-ordinator, and Dr J., who I did the assessment with.

Said and done. Come eleven o’clock I rushed from work to make it in time to the meeting at eleven thirty. S. greeted me in the waiting area and lead me to a tiny and very hot room. Dr J. was already there as was some psychiatrist or other from the community care centre. Unlike the last time we met, Dr. J was the one who first spoke. She made a bit of waltzing around before telling me that they had – after careful consideration – reached the conclusion that at this point in time psychotherapy would not be right for me. That, looking at my history, I’m simply too high risk to be put through it. Basically, they felt that therapy might stir up emotions in me that I haven’t got the means to handle.

So, I said exactly what I felt – that it was a huge disappointment and that it felt incredibly unfair that I was being denied the help that I genuinely feel is right for me, and that I can’t prove to them that I am able to handle it, since I won’t be given that opportunity. I also pointed out that I have completely stopped self-harming and that I’m only on a very low dose of anti-depressants, compared to earlier in the year when I was impulsively hurting myself and was taking a very high dose of an SSRI.

Naturally I knew that this would by no means sway the decision that had been made, but I felt it was important to make it clear that I disagreed with it, and that I feel that psychotherapy would be more helpful than harmful to me.

In the meeting it also emerged that Dr J. had not actually talked to D. before making her decision. This feels especially unfair since S. has only been my care co-ordinator for a very short time and we’ve only met three times, and D. actually knows me a lot better, and has also seen for herself how I manage both my counselling and the week between the sessions.

Needless to say I left the meeting feeling pretty downbeat.
I was meant to return to work, but decided in the end that I was too upset and needed time to take this all in.

I went home feeling very tearful and bundled myself into bed, where I reached for the phone and called up the Samaritans’ helpline. I got to talk to this really lovely woman who encouraged me to keep calling back throughout the day and evening to make sure I didn’t lapse too far into my thoughts.

Next I called S. They had said, as the meeting ended, that they’d want to keep in close contact with me to make sure I was able to cope with the disappointment. She told me to come on over to the community care centre again so we could talk face to face.

So, I did. And it was pretty good. I still felt rather low, but it helped to at least be able to talk about how I felt.

I should probably point out here that all of this in itself is pretty solid proof that I’m moving in the right direction. Had this happened earlier in my life, I would without a doubt have felt suicidal, and instead of calling the Samaritans I’d likely have got my razorblades out. And there is absolutely no way that I’d have picked up the phone to S.

Also, I would have shut down emotionally. I would not have allowed myself to stay in the moment for long enough to even identify all the things I was feeling, whereas now I was able to tell S. exactly how I was feeling and pinpoint that it was without doubt the feeling of being rejected that I struggled the most with.

I made it through the rest of the day and evening by calling a number of different helplines and talking to my sister. I never felt that I was in any real danger of becoming physically or mentally destructive, but I did make a conscious decision to not hold back on the way I was feeling, but explore it and express it as best I could and to be aware of any drastic changes in the intensity of my emotions.

And when morning came round I was ready to go to work.

This is not to say that I’m not still very disappointed – I most definitely am – but at the same time I want to make sure that I properly acknowledge the fact that I found a way to manage this let down that was positive and will hopefully eventually prove to the powers that be that I am capable of controlling my negative impulses.

I’m not sure what will happen next, and that does worry me. A lot. A few of my friends have suggested that I go to a private therapist, but in all fairness, I think that looking at my papers they would also make the decision that I’m too high-risk and would likely be unwilling to take me on.

Unless you actually know me you probably wouldn’t be able to see how far I’ve come and how radically my view on life has changed. Looking at the papers it will probably look like We’ve been here before – she says she’s better and then she crashes.I guess I can’t really blame them for thinking that, but it’s enormously frustrating to feel so ready to start working on my issues and at the same time be denied a safe place to do it.

I think that is the main problem for me at the moment; I feel ready to talk about my experiences – I can feel it wanting to bubble out of me – but I have nowhere to put it all..

Still, at least I have learned something from all of this:
I’ve come damn far from where I started out!

xx

Too Depressed For Psychotherapy?

Another Friday, another counselling session with D.
But, what have I been doing with myself in between sessions?

Well, I’ve had a pretty big week for someone who doesn’t normally venture outside if it can be avoided, and there is one specific event I want to tell you about.

As I mentioned in a previous blog entry I’m on the waiting list for psychotherapy through the NHS. And Monday was The Big Day – my initial assessment with Dr J. It took place at Hill House in North London, a very tall building semi-hidden behind the Archway tube station; frighteningly unfamiliar territory to me.

Nervous as I was I had given myself plenty of time to get there and as a consequence arrived ridiculously early. I had planned on bringing a book and my journal with me; they had both been neatly laid out on the coffee table at home the previous evening, but I had still managed to somehow leave them behind.

Not wanting to sit in the waiting room with just myself and my jittery nerves I found the nearest Woolworth and bought a hideous turquoise notebook in which I started scribbling frantically once back in the waiting area.

While waiting I was also asked to fill out one of those standard forms that is meant to give an indication of just how depressed you really are. If you’re not familiar with these questionnaires, basically you’re given about thirty statements which you should rate the validity of based on how you have been feeling in the last week. It includes statements like ” I have felt it would be better if I were dead” and “I have felt too overwhelmed to talk about my problems”, and you get to choose between “Never”, “Only occasionally”, “Sometimes”, “Often” and “Most of the time”.

Needless to say, it’s pretty obvious how to score high versus low on the depression scale – so it really is key to be honest. At least if your aim is – like mine – to get the right kind of help.

I’ve taken this test probably about fifteen or twenty times in the last six months, and I have to say that this time round I could really see a marked difference in how I am managing my depression. A significant positive improvement.

Dead on the hour Dr J., a long-haired woman in her early forties, who I had not met before arrived. She led me to her tiny-bordering-on-claustrophobic little office in complete silence and gestured for me to sit down on one of the chairs, still not talking. I’ve been in therapy a number of times before, so this – the absence of a proper greeting – didn’t come as a surprise to me, but I think had I not been familiar with this particular approach, I would have been somewhat taken aback by it.

Knowing that the good doctor would not be the first to break radio silence I said the first things that came to mind: “Let me just put these things away (meaning my iPod and the notebook). I always write when I’m nervous,” immediately wondering what she would make of that, slightly beating myself up over being so utterly un-original.

Thus began The Assessment.

I was asked to tell The Doctor about myself, (“Wow, that’s a big question – I wonder if I have a big answer to it.”) so I did, starting out by verbally bullet pointing the basics; That I have been living in the UK for about five years, but grew up in a small town in the north of Sweden. That I was adopted from India at the age of six months, but feel Swedish through and through since I don’t remember anything of my time at the orphanages where I stayed. I also stated, almost casually, that I was sexually abused from when I was about four and a half years old until I was seventeen and that the abuse came to light having overdosed on a random cocktail of my
mother’s sleeping pills and anti-depressants. I admitted that I have been and still am struggling a lot with the way my family have dealt with the knowledge of the abuse and mentioned that I was still expected to see my abuser, a member of my family (not my father), whenever I go home. I then went on to talk about growing up caring for my bipolar mother, with all of her ups and downs, but that neither she nor the rest of my family are likely to acknowledge this (the sense that my role was to be her carer) as being either valid or true. I ended my life-story recap by describing how I drank half a litre of anti-freeze liquid over a period of three days in March of this year, in an attempt to kill myself.

At this point Dr J. stepped in and commented that I seemed very emotionally detached from the things I was talking about, and I explained that this is one of the reasons why I feel I would benefit from psychotherapy; that I want to learn to connect to my feelings surrounding my childhood and my family, and find ways to deal with them that don’t include resorting to occasional self-harm or other drastic action. In short, I want to feel real. I want to learn how to respond to things without immediately putting up a three-foot thick wall to shield me from any potentially painful feelings.

The assessment lasted for a bit over an hour and at the end of it Dr J. said that she didn’t really question my intellectual suitability for this sort of treatment, as I am clearly very articulate and perfectly able to express myself verbally, but that she had some serious concerns regarding my safety, as therapy often brings out a lot of very difficult things and you are bound to experience an abundance of complicated feelings which may be very difficult to manage.

Since my history points towards an acutely self-destructive pattern she simply couldn’t overlook the fact that my risk-factor is high. I pointed out the things I have done to keep myself safe; not keeping razors at home, using distraction techniques to control my impulsiveness, calling help-lines for support if needed and the fact that I have been able to manage the week between my counselling sessions in a positive way. So, she responded that she would still need to talk to D. and to my care co-ordinator, and also to the women’s crisis centre where I had been staying when I made my last suicide attempt, before making any decision, and that once she’s talked to them she would ask me back for another session to discuss the outcome.

I feel quite happy about this, because if she hadn’t felt the need to talk to others who have been working with me I’d have thought her rather irresponsible, taking on someone who on paper is very high risk without any consideration. I mean, there is no two ways about it; in the eyes of any professional I amhigh risk, and taking my word for it that I’ve changed would be very reckless, indeed. Having said that, I hope that once she has talked to D. and my care-coordinator, she will feel that I am capable of coping with psychotherapy and give me the opportunity to prove it.

In my session with D. today we talked about the assessment and also the fact that I have come a long way since I first started counselling with her. And that I have worked very very hard at finding alternative ways to deal with destructive impulses. She also said that she definitely feels confident enough regarding my risk-factor to recommend me for psychotherapy, but that she fully appreciates Dr J.’s concerns.

Hopefully what D. says about me will weigh heavily enough to sway Dr J. ‘my’ way, because I think I could benefit hugely from therapy.

Anyway, I am going to end this entry here. Dev is forever teasing me that blog entries are meant to be short and concise, and that this is a writing style I have yet to master.

All I have to say to that is; I could write that way if I wanted to, I just don’t want to . So there! :þ

xx