Out Of Control – Me On Steroids

There I was, having been told that there was a good chance that my hearing loss was due to my own actions. Not an easy thing to deal with. Part of me absolutely felt angry with myself, was blaming myself; I have a natural tendency to be very hard on myself – especially when the consequences of my actions turn out to be severely negative. But, there was also another part that just felt confused, because whilst the second most recent overdose was certainly a serious one, the most recent one was one where I didn’t ingest more than about half a teaspoon of the chemical, and I couldn’t quite understand how it could have had such a drastic effect on my hearing. But, clearly it had.

The ENT specialist had prescribed a high dose of Prednisolone which I was to take for a week in the hope that it may reverse some of the recent hearing loss. The name of the medication did ring a bell at the time, but not loudly enough for me to clock why, so I went down to the hospital pharmacy and picked the medicine up. It wasn’t until I got home that I remembered that this was a medication which a previous GP had refused to prescribe when my asthma was really bad, because she felt it was too much of a risk, putting me on it. There were two reasons for this: firstly, that people with a history of serious mental health issues are particularly prone to react badly to this medicine, and, secondly, that I have in the past had extreme adverse reactions to three other medications [one of which I was reacting to when I took the second most recent overdose], so the doctors are always very cautious about prescribing any non-essential new meds to me.

But, there I was with the medication in my hand, not knowing whether or not it would really be a good idea to take it. Yes, this medication could potentially save me from needing cochlear implants down the line, but, at the same time, if I did have a really bad reaction I could end up putting myself at considerable risk. The ENT specialist wasn’t someone who knew me well [or at all, really], so when he prescribed it, he did it on the same premises he would for anyone else; ‘Worth trying, no harm done if it doesn’t work’, whereas I knew that this medication could spell real trouble for me.

There was a part of me that was genuinely scared of a bad reaction; I knew perfectly well the horrible feeling of being out of control because of a medication. I had been through it three times.. Yet, there was another part that so badly wanted to be able to do something to reverse the damage I had apparently caused.

I spent a week going back and forth, unable to decide what to do, talking it through with lots of people, knowing full well that, ultimately, it was still my decision to make. I did speak to my GP [well, technically, the receptionist spoke to her on my behalf], and she said that it would be ‘perfectly fine’ for me to take the steroids, and – after all – I had had no adverse reactions to the steroid injections I was given when treated for anaphylaxis.

In the end I decided that I would give it a go, because I knew that if I didn’t I would always be wondering ‘What if..? What if..?’.

Still, to be on the safe side, I decided to start the course early Monday morning, so that if I did have a bad reaction I would be seeing P. later that day. [With two of the three medications I had previously reacted badly to, it had happened literally within a few hours of taking the first dose]. I also had a doctor’s appointment on Tuesday, and scheduled a ‘just-in-case’ appointment with K., my synagogue social worker who I have been seeing semi-regularly, for Wednesday afternoon.

Monday came round and I took the first dose, which – as this was a high dose treatment – was a good handful of pills, making me feel as if I was actually overdosing on tablets. By the time I was due to see P. – about six hours later – I already knew something wasn’t right. I could feel things firing in my brain, rapid electric sparks in my head, and it was as if I couldn’t keep track of my own thoughts. It was a truly bizarre experience. – Anyone who has ever been seen by the mental health crisis team knows that one of the questions you will be asked during the assessment is ‘Are you having racing thoughts?’. Being prone to deep depression and suicidal ideation rather than mania I have always answered ‘No’ to that question, not really knowing what ‘racing thoughts’ actually were. I’m telling you, by noon that Monday I knew exactly what they were – and it was freaking me out, big time!

So, I had a crazy rambling session with P. that day, very unlike any other session I have ever had. I also spoke to H., my care coordinator, that same afternoon and she sorted out a referral to the crisis resolution team for Wednesday, as it was clear I was not in a good way and would likely need the extra support, particularly over the weekend.

On Tuesday morning I went to see the doctor – an absolutely lovely F2 who I hadn’t met before. By then I had taken the second dose of Prednisolone – more out of a sort of manic compulsion than anything else – and consequently the reaction was getting worse. I had also used a surgical scalpel and cut myself very badly in two places; enough to warrant stitches. The doctor’s reaction was ‘Come off these meds immediately – this is a really serious and abnormal reaction!’.

I explained to her the reason why I was on the treatment in the first place and why I was finding it hard to ‘just stop taking the meds’, and this young doctor was absolutely brilliant. She sat back and listened to me carefully and then took the time to make five or six phone calls – while I was still in the room – to get hold of an ENT registrar to find out what the implications of stopping the treatment would be for my hearing, so that we’d be able to make an informed decision. The ENT registrar told her that as treatment had been delayed by several months already [Urgent NHS referral, remember?] it was unlikely that my hearing would improve, that the specialist who prescribed the steroids probably felt it was worth a shot – even if it was a shot in the dark – because sometimes people do respond, even with delayed treatment. But, the registrar concluded, in light of the extreme reaction I was having it certainly wasn’t worth staying on the meds, as the odds of success were so small.

I felt really reassured in that moment that I wouldn’t be missing out if I ended treatment prematurely, because the odds of any improvement were so small. It made complete sense to stop taking the meds.

But, then I got home, and I was still hyper and there was so much in me saying that firstly I was already dealing with the adverse effects of this medication [the GP had explained that it would more than likely be a few days, maybe even a week, before the chemicals in my body would stop messing with my brain].. and it was only a few more days to go.. and what’s to say that I couldn’t have an equally abnormal positive reaction to these meds..? After all, my body is clearly highly sensitive to small chemical changes..

So, the next morning I took the third dose, against medical advice. This time it wasn’t manic compulsion that made me do it, but that part of me that just needed to hold on to hope, that simply couldn’t give up, even though everyone around me felt this was a very bad decision, indeed.

I spent time in my session with P. that day, exploring why it was so terribly hard for me to stop taking the tablets, even though the rational part of me knew that the chance of a positive outcome was incredibly slim – and that was really helpful, even with the chaos raging in my head.

I also had a good chat with K. that afternoon. She was characteristically open, direct and honest with me both about her anger and her disappointment that I had carried on taking the medication in spite of what the doctor had told me, and in spite of the fact that I had felt completely reassured at that point that I wasn’t missing out. I told her that I would think very carefully about handing the meds in to P. the next day, but I was also clear that I wasn’t prepared to make any definite promises, because I simply didn’t feel that I could. So much of me felt out of control and I just couldn’t say that I’d be able to do that, come morning.

Oddly, the thing that made me realise just how out of control I really was wasn’t the fact that I had cut myself so badly, but the fact that I found myself at a McDonald’s having a Big Mac.. I’ve been a vegetarian for something like twenty years, and I keep sort-of-kosher, so for me to sit down and eat something like that goes against so much of what I believe in. It is something I simply wouldn’t ever do, if I were in control of my actions..

I did end up giving P. the tablets the following day, but not before having taken a fourth dose that morning, this time – again – in a very compulsive manner. There was no reasoning whatsoever, just acting: I simply couldn’t not take them. This made me realise that I really needed to view the tablets in the same way I did my scalpels and cords [all of which I had handed in to P. two days earlier, feeling too out of control to be safe with them]; while I was still having this strange reaction I just couldn’t manage the tablets responsibly.

It took a good while after that final dose before I felt completely back to my normal in-control self, and I carried on working with the crisis resolution team through the weekend and most of the following week, just to be safe.

I am really glad that I had as much support available to me as I did during this time, because it was incredibly frightening to be so out of control. The experience was very different to other times when I have felt out of control. Whilst what came out in the midst of this whole ordeal – feelings, thoughts etc – were things that were almost certainly already brewing inside, it was – at least the way I look at it – triggered by outside factors. And that’s quite a scary thing.

All the very best,

xx

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A Fork In The Road – Choosing A Path

A. has been away since the Friday before last, and it feels like it has been our longest break ever. There is just something about this particular break that has felt sort of endless. Of course, this hasn’t really been the longest one, seeing as she was off on maternity leave last year, but it has felt incredibly long.

I think one part of it is the fact that I have been living in a heightened state of fear ever since I ran into M., and not having A. there to talk it through with has been hard. Yes, I’ve still had Z., but since that’s the place where I’ve seen M., I haven’t been able to relax at all, and that – naturally – has had a direct impact on my ability to open up and talk about things; it is very hard to allow yourself to be vulnerable in a place where you don’t feel safe. That isn’t to say that I haven’t tried to do just that. But, still, it’s in my sessions with A. I usually feel most safe, more sheltered from both external and internal storms. In fact, this is where I am least likely to experience flashbacks. Sure, I do still have the occasional flashback when I’m with A., but it happens a whole heap less there than anywhere else.

A. is back tomorrow, and that’s a good thing, for sure. I feel that there is a lot that has happened in the eleven days since I last saw her, and there is a lot of catching up to do. Prior to A. going on leave I had a session where I tried to be brave and share my concerns regarding not feeling sure about where our therapeutic relationship and work is headed, or even where I would like it to go.

There is one part of me who is listening closely – perhaps even a little too closely – to other people, who all seem to be suggesting that perhaps I am overly attached to A., and that I have really come as far as I can, working with A. That I may have outgrown her, in a sense, and the time has come to start over with someone else. And at the same time there is the intense pull in the opposite direction: that while there are many things that are less than ideal in our relationship and the way we have been working together, there is a golden opportunity here to work things through, to have a different experience to what I have had in many previous therapies.

I think what troubles me most is the fact that I feel so completely in the dark about my own motives for wishing to go in either of these directions. Is thinking about terminating my work with A. really a result of outgrowing something, or is it a case of the exact polar opposite? That, actually, having spent years only dipping my toes I am now dangerously close to allowing myself to dive in head first? Perhaps terminating is a way for me to avoid having to do that? It certainly wouldn’t be the first time that happened. In at least three previous therapies I’ve managed to find an ‘out’, when things have got a little too hot. Maybe I am really just repeating a pattern here? To cut and run, rather than stay and face my fears?

And, at the same time, is my wish to stay with A. purely about this opportunity to go deeper than I have done before, or is it rooted in fear of letting go of the emotional safety blanket A. has been providing for me in the last four and a half years? Change can be a pretty scary thing, and sometimes we all need a little push in the right direction to dare take that final step off the beaten path.

I definitely feel that working with Z., alongside A., in the last few months has been a very positive experience, has made me reflect on the work I have been doing with A. It has helped clarify in my mind what I feel has sometimes been lacking. But, equally, it has highlighted the things I really appreciate in my relationship with A., the things I find a little overbearing in my work with Z.

In many ways, therapy with A. is a very independent endeavour; I am most definitely in the driver’s seat, choosing which roads to go down, which ones to avoid, and what speed we should be travelling at. Counselling with Z. is a lot more directed, something which became very clear when she expressed concern that we may be dipping too deep into things. And, at the same time, Z. is a lot more head on than A. She often asks very direct questions about what’s going on for me, what I am feeling, and, particularly – what I feel about our relationship, pushing me to go to a place where it is a little scary to be. And, this is an area where A. and I don’t really manage to communicate all that well. I am not sure if this is down to me and my fears, or if it is a situation A. and I have created jointly, but I do know that it is absolutely one of the things I would like to change.

A. made a comment when I talked about this, among many other things, in one of the last sessions before this break, which I feel is both valid and makes me worry. She said that all these questions I have about our work together, the uncertainty of where we are going, the not knowing where I would like to go, echoes very loudly in the rest of my life: there is a lack of clear direction and a strong feeling of being pulled in two opposite directions [the wish to live and work through things, and a darker pull towards giving up and ending my life].

As I wrote earlier, this comment does have some validity: I can see the echo, and I get what A. was trying to tell me. And at the same time, there is some frustration on my part about the way A. tends to see most everything I say about our relationship as a direct echo of something bigger in the world outside of her consulting room, the way she sometimes seems reluctant to allow me [us] to fully explore what’s there inside those four walls. My general view is that, yes – there are often echoes of the outside world being reenacted in A.’s and my relationship, but, that this doesn’t mean that what is going on between the two of us isn’t equally real and in need of being worked through. One doesn’t negate the other, and sometimes a rubber duck is just a rubber duck.

As you can see there are a whole lot of questions bouncing around inside of me at the moment, and very few solid answers to counter them, but I hope that in the next few weeks I will be able to use my sessions with both A. and Z. to look at them closer.

xx

Self-Harm Distraction Techniques: "Draw, Don't Cut"  [..the slightly more creative version..]

Self-Harm Distraction Techniques: “Draw, Don’t Cut”
[..the slightly more creative version..]

Self-Awareness & Self-Doubt

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PLEASE NOTE THAT THIS PARTICULAR POST DEALS WITH CHILDHOOD SEXUAL ABUSE AND MAY THEREFORE BE UPSETTING AND/OR TRIGGERING
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During the last two weeks the frequency of flashbacks I’ve been having has been steadily on the increase. This is never a nice thing and inevitably makes me very anxious that I might be heading for one of those truly horrendous periods where the flashbacks become relentless and I get no respite from them at all. Thankfully, things are not at that stage, but the fear is still there, and I am having significantly more flashbacks than I usually have in a day. So it has been hard. Especially since A. has been away, and I’ve not had my usual space to process things. [A. being off isn’t the reason for the increase in flashbacks; the escalation had started before she went away, but lacking a place to talk things through doesn’t help].

Now, having flashbacks is something which I live with all the time [to a greater or lesser degree], but there is one thing which has been very different about this particular increase of flashbacks: normally, my flashbacks tend to be very random in terms of which abuse situation they are about. There might be one from when I was four and a half, then one from when I was seventeen, then one from when I was twelve. Some will be of things my brother did to me, others of things that the foster child who lived with us made me do. In short, it tends to be a completely random mix, with no specific order to them.

But this time, nearly all of them have been about a very specific situation, something which happened over the space of about twenty hours when I was nine. The flashbacks haven’t been sequential, it has been bits here and there, and it has all been absolutely sickening. What happened over that period of time are some of the most traumatic things I have ever experienced, and so it follows that the flashbacks are equally horrendous.

A few days ago I tried to desensitise myself a little by saying out loud [to myself] what happened, but I simply couldn’t do it. It felt too frightening and the words were too charged. Instead I turned to another form of expressing myself: drawing. I drew the whole situation, and I drew it in a very specific way, I drew it from his point of view. In other words, I drew what he would have seen: me, tiny, naked, frightened, tied to the radiator [which he had cranked, just because he thought it was funny when I was in pain], the various objects he was using [when he wasn’t using “his body”] – the whole situation. I won’t go into any more detail than that, because, writing about it – like talking about it – is a bit too much for me [and may also be a bit too much for you, the reader]. I did think about posting the picture I drew, but in the end decided that it is simply too graphic for general view. [Also – although the intention with the drawing is very different – legally, in some places, it would be considered child pornography, as it clearly depicts a young child being sexually abused.]

I really don’t know why so many flashbacks have been centring around this particular situation. I mean, yes, the things that happened were incredibly traumatic and cruel, but that has always been the case and it doesn’t explain why this kind of ‘zooming in’ of flashbacks is happening, or why this change is taking place now. I am still trying to work that out.

The idea to draw it, to really focus on it – allowing the emotions – was something I did in the hope that it would decrease the frequency of flashbacks, but that’s not really worked; it hasn’t at all influenced the number of flashbacks I’ve been having. [For the better or for the worse].

What it has done, is allow me to see that I really was a very young child. I don’t remember ever feeling that I was a child, I always felt like an adult, but I think it is important to recognise that although I didn’t feel like a child, that doesn’t mean that I wasn’t a child. The other thing that it has done, is that it has made it possible for me to see the whole situation, meaning that I could see for myself how truly awful it was. And that helps, because it makes me feel that maybe it isn’t so strange that I am still struggling with what happened; it tells me that I am not over-reacting.

Sadly, in contrast to all of this positive recognition, all this self-awareness, there has been another change inside of me. A very different one. One which isn’t nice at all, and is almost the polar opposite of what I just described..

Up until now, if anyone has ever suggested to me that maybe I carry some sort of guilt feelings about what happened inside of me, I have always vehemently denied this. I’ve always maintained that this is not the case; that I am not a typical abuse victim who blames herself for what happened. I am perfectly able to see the abuse for what it was.

But in the last two days, I’ve been completely overwhelmed with self-doubt. Doubt about whether or not maybe, just maybe, there was something I did to make this happen. A sense that, because there were two different people who abused me – separate from one another – there might be something wrong with me, that maybe I was sending out some sort of unconscious signal. That I didn’t do enough to make the abuse stop. Etc etc etc.

I can honestly say, that I have never felt this way before – certainly not on a conscious level; when I have protested to any suggestions like those mentioned above, it has never been in order to purposely mask my true feelings, or to make myself clever or anything like that. I have simply never felt this way before.

This isn’t a case of suddenly feeling 100% sure that I must somehow be to blame for what happened, rather it is an ambivalence about it, an uncertainty about who is to blame, which is now coming into the open. It is more than likely a fear that has always resided deep down inside of me, but it isn’t until these last two days that it has been allowed to enter the realm of the conscious. What I am trying to illustrate here is that all of a sudden there is a very tangible discrepancy between what I can intellectually understand [that being a child I couldn’t possibly be to blame for the abuse, that I was powerless to stop it etc], and what my inner child emotions are telling me. And it makes me feel awful. It makes me feel like I am not as far along the road to recovery as I had thought.

Of course, I can see that having my true feelings surface is probably a good thing, that this could be viewed as “a step back in order to ultimately move forward” [you can only work through things that are in the open]. In the short term, however.. well.. it has me on my knees. Completely. And, as much as I hate to admit it, on three occasions, I have resorted to escaping these very painful feelings through self-harm. This worries me, since my favoured form of self-harm is coiling a cord round my neck and pulling until I pass out, a variant which is undeniably dangerous, as there is no way of knowing that the cord will release once I have lost consciousness.

I am trying to not be too hard on myself about the self-harm. Firstly, being disappointed and angry with myself doesn’t help the situation, it only serves to make me feel even worse. And secondly, in some ways it makes perfect sense to act out like this; for as long you are unconscious you can’t feel anything. You could even go so far as to say that this particular form of self-harm is a desperate attempt at putting these now conscious feelings back into the unconscious.

But, of course, it would be much better if I didn’t feel a need to do this to myself, and I am hoping that when A. is back, being able to talk all of these different things through will be enough to help me cope with these new emotions without putting myself at risk.

I just need to somehow hold on until then.

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

Self-Harm & Self-Piercing

Not very long until A. is back now.

Looking back at this break I can honestly say that there were definitely times when I didn’t think I would be around to see her return to work. I had some very very low points, where it felt entirely impossible to think that I could make it through. As you know, early on during this break, I did accidentally on purpose overdose, and even though this may sound weird, that wasn’t even the lowest point I got to. In fact it wasn’t even near to being the lowest point.

Then I had a bit of a breather, where I went to spend time with my sisters, where I reconnected with my faith, where I felt a little less frightened. Went back to only having the normal amount of flashbacks. And that was nice. And much needed. I count my blessings that I do have those times when things are a little easier. I try to take notice of the good in life, I really do. I know that reading this blog, it may seem that I only focus on the hard times, but I really do try to balance it out, to see the bigger picture.

I have to admit, however, that these last few weeks it has felt a little as if I am starting to slip again. I’m not sure if that is perhaps because, knowing that this therapy break is nearing its end, I am allowing myself to feel a little bit more than I have during the majority of this time. It’s possible. People keen to criticise my choice of therapy and therapist will, I’m sure, draw the conclusion that going back to therapy is what is making me worse; that therapy is itself the culprit. Needless to say, I disagree. Strongly.

Still, I do have to take these dips seriously; I am very well aware of my tendency to sink hard and fast, and to try to waive it off as nothing would be decidedly unwise. So, I’ve reached out. I’ve talked to my sisters, my friends, the Samaritans, just to make sure that I don’t plummet.

I did have a night last week which was particularly bad, where I felt very very tempted to get the scalpels out again, to release the tension, to get away from the bad feelings surging through my whole system. I resisted. Sort of. I had them out. I looked at them. Held them in my hand. Then I put them down. Put them away. Decided it was a bad option. Thought some more, and decided that there was something else I could do, which was a little less destructive, a little more spiritually meaningful. Something which I had been thinking about doing for some time.

The end result is a freshly pierced nose.

I know, to some, this seems little better than cutting myself, but to me, there is a big difference. Self-harming through cutting is a way of making my body look worse, it’s almost like physically punishing myself, not just through the pain inflicted while cutting, but also in the way the scars will always be there [and, trust me, I have plenty]. They only serve to make me feel bad, because they make me think of how I was unable to control my impulse to cut. Make me feel weak. And I don’t like feeling weak.

A piercing to me is different.

Whilst people may have varying views on the aesthetics of body piercings, or religious reasons for opposing them, to me, they are pretty – plain and simple: I like them – and my interpretation of religious text does not cause me to see them as forbidden. And so, in my mind, choosing not to slash my skin in destructive desperation, but deciding to do something different [albeit similar]; it makes me feel that I can control my impulses, I can convert destructive energy to something much more positive:

A sparkling reminder, right in front of my nose, that even bad nights do pass.

I feel I need to write a little something here about self-piercing: I am not an advocate of it, despite having done it more than once myself. Each time I’ve done it, it has been done as responsibly as possible. No dirty safety pins, no pound shop jewellery. Always clean hands and/or using gloves, always clean work surfaces, always proper after-care. Never without thinking it through, and never without, in my opinion, a genuinely valid reason for doing it myself.

You can read a detailed piece I wrote about my first self-piercing and my reasons for doing it myself here. Some of the things I say there are not quite how I see things now; it’s been four years. But the key is that it was a thought-through and reasoned decision. Not an in-the-moment act. In contrast to self-harming.

Even this latest piercing wasn’t something I did lightly. The reason I had the appropriate equipment in the first place was that I had been thinking about doing it for some time. And by thinking about it I don’t mean in the middle of the night in a moment of feeling very low, but during the day, consciously weighing the pros and cons. I made the decision to do it that night, because I wanted to – perhaps even needed to – prove to myself that I could do something other than cut, something which for me had meaning, something which wasn’t a destructive and impulsive form of self-punishment.

If you do choose to DIY pierce; do the research. Then think again. Think about why you are wanting to self-pierce and the risks involved. Also, think about where you want your piercing. Not all places are ideal for self-piercing. In fact, most aren’t. [In hindsight, I would have to admit that the nose definitely isn’t particularly ideal for self-piercing. And it was darn painful!] Also, just because something can be done, doesn’t mean it should be.

If the reason you’re considering not going to a studio to have it done is that you’re underage, get your parents to come with you to give their consent. Or wait until you are legally able to give consent. If you want it that badly, you’ll still want it in a year or two. From a religious point of view, getting your parents’ consent also matters in terms of honouring your mother and father through not choosing to do something your parents directly oppose. I’m not meaning to be preachy, I’m merely pointing this aspect out. [For me this was always a non-issue, as my mother sports a sparkling lip piercing of her own.]

For most people, people who just want a piercing because it looks good, my advice will always be: Go to a professional piercer! You won’t end up accidentally mis-aiming and come out with a wonky piercing in a place you hadn’t meant to have one. Seriously. Going to a professional piercer will generally be a much better experience; quicker, more than likely less painful and much much simpler all round.

First and foremost;

remember to be kind to yourselves.

xx

PS. I do realise I am displaying an astonishing amount of double-standards when it comes to self-piercing, but in my defence: I am an adult, I had a valid reason to do it myself and it was a thought through decision. And, as I wrote earlier, looking through a rear view mirror: I wouldn’t recommend piercing your own nose to anyone. Anyone. That includes my future self.

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

Three Key Rules For Surviving The Present

*

“..when all I really want, I said to myself, is to survive the present..”

*

Sitting here, alone. Trying to somehow keep it together. And failing miserably. I feel like I’m a prisoner in my own life, and while there may well be a key to the lock, it seems impossible to find. Or maybe I’m just looking in all the wrong places?

I haven’t been able to attend service for weeks, owing to flashbacks. Haven’t even had enough head space to follow them online. Still, as my therapy is on now on hold, I know that it will be important to find other, non-destructive, ways to cope, so this morning I decided to brave it and just push myself that little bit extra to get there. Which I did.

I now regret that bitterly. As lovely as the service was, I was struggling throughout it, trying to stave off the flashbacks that insisted on popping up, and it took all I had to somehow stay in my seat and not just rush out. I tried to focus on the music, on the words, the prayers, and to a degree I suppose you could say that I succeeded, but what is normally something that feels naturally easy and enjoyable, today took a lot of hard work. By the time service was over and it was time to exchange the customary Shabbat shaloms [“have a peaceful day of rest”] I was exhausted, and I only barely scraped by during kiddush. Feel very bad about it, because I know I probably came across as a bit off to others, but it was the best I could do. Having greeted the people I know, I made my excuses and left as quickly as possible. The second I got on the bus home I just broke down in tears.

Of course, tears are not the enemy, if anything they are an entirely appropriate response to the difficulties I’m facing, and they’ve been waiting to fall since I left my final session with A. But it’s not nice when it happens in public. It just isn’t.

It was hard saying goodbye to A. The session in itself was reasonably OK. I managed to talk about the extreme separation anxiety I was [and still am] experiencing, and I think that was important. To be able to say how hard and frightening this long break feels, to be honest about how uncertain I feel about whether or not I have what it takes to make it through to the other side of it. To talk openly about why it’s so hard, this effective re-experiencing of every other time I have felt abandoned, neglected, second-best and left behind, with no one to care for me. To feel that there is no one I can truly trust to see me through.

Of course – and I said that, too – in my final session, I know that I’m not really all alone. I know that there are lots of people in my life who care about me and who want to see me make it through, people who are more than willing to offer me support. But, at the same time, as I’ve described many times in the past, a therapist is in many ways a pseudo-parent, and so, having a break – especially a big one like this – is bound to cut pretty deep. And when you cut deep, you bleed, and it inevitably leaves a scar. It’s impossible to just pick up where we left off, as if nothing’s happened. So there is a fear of that, too. Of what it will be like once A. is back. Will I ever feel able to trust her in the way I was? Because, unlike other breaks, at the end of this one her whole world will have changed. That moment when she goes from being a pseudo-parent to her clients, to being an actual parent will be unlike anything else. And even if we manage to reach that Winnicottian good enough place together again, the fear of another abandonment will linger, as it’s likely that in due time she will want to have another child. In fact, whether or not she does, the fear will be there, regardless.

So things are distinctly uphill right now. I keep thinking Oh, I’ll talk about this in my next session, and then I crash with the realisation that that next session is so desperately far away.

I told A. that I would do my very best to stick to my usual 3-rule therapy break survival plan:

1: No matter what; keep breathing in and out
2: Try to find ways of coping other that resorting to self-harm
3: Even if I fail on number two, stick to number one!

That made A. smile, and I will try to keep that in my mind and in my heart, because I do want to make it through.
I just don’t entirely trust it that I will.

xx

The quote at the top is from the book Are You Somebody? © Nuala O'Faolain

Whitney Houston, Eating Disorders & The Greatest Love Of All

“Everybody searching for a hero
People need someone to look up to
I never found anyone to fulfil my needs
A lonely place to be
So I learned to depend on me

I decided long ago
Never to walk in anyone’s shadows
If I fail, if I succeed
At least I live as I believe

No matter what they take from me
They can’t take away my dignity..”

The words above seem more poignant than ever today, as news of the death of one of our generation’s greatest voices spread around the world, via texts, tweets and status updates. My own reaction was not, I imagine, dissimilar to that of many other people who, like me, grew up listening to her music. A sense of sadness and loss, not only of a fine singer, whose life was cut short, but a loss of the era she represented. For all the fanciful make-up and hair spray [not to mention those horrendous shoulder pads], the 1980s were also the time when I discovered the joy of music for real. It was a time when music sounded like it had a life not only through the melodies or the words, but through the very record, with their unique individual kinks and scratches. Back in the day when such imperfections could not easily be remedied in a computer program, and listening to my father’s copy of Whitney Houston’s now iconic 1987 album was a completely different experience to listening to the same record at a friend’s place, since their copy had different scratches and kinks. I was only 11, but I remember the feeling as if it were yesterday..

The picture of Whitney Houston on that album cover trigger other, very different, memories, too. It reminds me of one of my cousins who had a large poster with that picture on the wall in her room. I only ever visited her once in her home, as she and her family would normally travel up north to see us [and the rest of our family] for Christmas and Midsummer, and I didn’t even know her that well, because she was almost ten years older than me, and would usually hang out with my other older cousins. And yet, she left a big impression on me, and I think of her often.

My cousin died young.
For much of her life she vacillated between battling anorexia and bulimia, and in the end, even though she had got to a stage where she was ready to accept the help she so desperately needed and had begun the twisting road to recovery, it was too late; her heart was literally broken and it gave out.

I don’t often talk about her. I may mention her, but I rarely say much more than what I just wrote. That she died young, of an eating disorder. But, she’s often in my thoughts.

I haven’t got the best of relationship to food myself; I tend to comfort eat when I feel down, or to not eat at all – and being a survivor of sexual abuse I am automatically at higher risk of being caught in the claws of an eating disorder.

Physical abuse [sexual or other] has been shown to have a huge effect on the way we view ourselves, not only in terms of our personality traits, but also in terms of body image, and I know that my own need to be in control of things could easily encompass my eating habits. So I have good reason to be extra aware of thoughts of this nature. The memory of my cousin helps with that, helps me to not just brush it off and think of it as not a big deal, but to recognise that anorexia and bulimia are real illnesses, illnesses which people die from.

I remember my cousin and honour her memory by making myself at least try to improve the way I relate to food [and by extension, my body]. It doesn’t often last very long, this improvement, but long enough for me to catch myself before getting stuck in that very unhealthy pattern where you feel you have to be in absolute control over what you eat..

Of course there are no guarantees, I – like anyone else – could slip, could forget; if it was easy to avoid the trap of eating disorders then no one would suffer from them.. But, I really feel that the memory of my cousin, and the way she struggled, gives me that extra kick to keep my alarm bells powered up.

So I guess, in a backwards kind of way my cousin has been a role model to me, and even in death she has left a legacy.

As has Whitney.

‎”..I believe that children are our future
Teach them well and let them lead the way
Show them all the beauty they possess inside
Give them a sense of pride to make it easier
Let the children’s laughter remind us how we used to be..

Learning to love yourself
It is the greatest love of all ..”

xx

Extracts from The Greatest Love Of All © Michael Masser & Linda Creed

One Step Closer To The Edge [..And I’m About To Break..?]

Four sessions to go until A. goes on maternity leave. At the most. These last few weeks since our Christmukah break I’ve been living with the worry of suddenly having a message that A. has gone into premature labour and thus leaving me to fend for myself without even getting to have the Final Session. Very stressful, indeed.

I am feeling on edge, wondering how in the world I will be able to get through these coming months without therapy. Feels like there is no way I’ll be able to cope. I am scared that I’ll go into another of those never-ending periods of flashbacks, because if that happens, I don’t think it will end well.. I am, of course, trying my very best to hold it together, to look ahead, to not assume my worst case scenario will come true. But it’s hard. Especially as over the last few weeks I have been having more flashbacks and nightmares than the norm. The other day I once again found myself looking like Harry Potter. Also, on one occasion, I tripped up and used a white hot screw head to creatively burn myself with. And this is before A.’s leave has even started.. Not great.

The last few weeks have been very intense, therapywise, almost as if my psyche has kicked into overdrive in anticipation of A.’s leave. The sense of running out of time is immense. In some ways I guess you could say that this therapy break has pushed me to delve into things I may otherwise have found a way to not get into. I’m not sure if that’s a good or a bad thing.

My GP, who is the best GP in the world [possibly the universe], has been really good, and has taken my freak-outs very seriously, sorting out various referrals etc etc etc, trying to make sure that I have as much stability as possible during what promises to be a bumpy ride. And I really appreciate that.

People keep asking me what my therapist has put in place for me during her absence, and it’s hard to explain to someone who has never been in therapy that, actually, she’s not put anything in place, that there is no one covering for her. What I’m doing with A. is long-term psychoanalytic therapy, meaning that immediate symptom relief isn’t necessarily the goal, and that, also, it would make little sense for me to be referred to someone else while she is off, as that would in essence mean starting again, attaching to another person, only to have to break that up when A. is back. As a case study that could be quite an interesting little experiment, but in reality, it would involve unnecessary complication, and even if that was an option, I doubt it I would be up for it. It took me a really long time to let A. in; we’re talking years rather than months, and although people sometimes find it shocking that I’ve been seeing A. for nearly three years, to me, it feels like we’re only now getting below the surface. Like I said to A. in a recent session; while I may be a fast learner intellectually, emotionally I am exceedingly slow. And trust, well, that’s a big’un. There has been a lot of testing both A. and of the strength of our therapeutic relationship to get to the place we are now, where I am slowly, slowly allowing myself to let my guard down a little.

Which, of course, makes this break all the harder..

xx

Below are two videos; one which has nothing at all to do with what I’ve just written about.. and one from which I nicked the title for this post. Both are well worth checking out!

Maternity Leave, Eternity Leave & Lessons From A Goldfish

Some of you will know that I recently moved. I did a straight room swap with someone, and when this someone else moved, she – let’s call her K. – left behind a great big goldfish bowl with accompanying goldfish. Now, I told her straight off that I didn’t want it; I could never keep fish like that, in an un-oxygenated bowl with no black-out sides and nothing inside the bowl for the poor fish to hide behind. She told me she was going to get a smaller tank to fit in her room and come back for her fish. Being the friendly [if somewhat horrified] person that I am, I told her fine, just put it in the hallway for now, but make sure to come get it as soon as possible. No worries, K. replied and went on her way.

A week passed. Nothing. I started googling to find out what the heck to feed my un-invited flat mate [finely chopped spinach and orange, apparently] as I couldn’t just let it starve. I texted K. Nothing. I put a tea mug in the tank so the fish would have somewhere to hide from the world. Another week went by. Another text. Met by even more silence. And then, yesterday morning, a text from K. saying “Sorry about the late reply, I was busy with exams until Friday and now I’ve gone abroad. Won’t be back until January”. What the flying BEEEP..!?

Needless to say, I wasn’t much pleased with this development, so I texted her back saying that I understand she’s been busy, but really, sending a text takes seconds – anyone can fit that in no matter how busy – and wouldn’t it have been a good idea to check that someone was actually going to be in the flat over Chrismukah & New Year to look after her fish? Apologised in case I sounded harsh, but honestly I wasn’t very impressed.

Now, I’m not someone who habitually sends out even remotely angry sounding texts, so having sent off the text I sat down to reflect, realising that this was probably about something bigger than just the poor goldfish. I mean, I’m not actually going away, and feeding a fish isn’t exactly hard labour. So what was it about all of this that was really upsetting me?

Seems pretty obvious from a distance, right? What was really bugging me was – of course – the fact that she could so easily leave this living being behind without a thought, without making sure someone was going to be there to make sure that it was OK.

Fast forward to later in the day, still thinking about the fish, feeling genuinely upset by it being abandoned like that, I realised that I was very much identifying with this poor fish, and that my anger with K. was probably more accurately a misplaced expression of anger with A. leaving me behind, with no one to look after me.

So that’s what yesterday’s session – the final one before a two week Chrismukah break – was spent on. Trying to explore the feelings I have, not only around this break, but also about A.’s maternity leave – which I feel, ought really be re-named eternity leave. How I feel, much like this little fish, left to my own device in this not-great-but-won’t-kill-me place, where all I can do is to swim round and round in circles.

I feel that being in therapy gives me a sense of direction, like – although progress is often excruciatingly slow – I’m going somewhere, I’m moving. But with this massive break coming up, well, I’m not sure what to do with it, what to do in that huge expanse of time. Do I retreat into the tea cup of my mind? Do I try to move forward on my own, risking getting myself into territory I’m not at all ready to cope with outside of the safety of the therapeutic setting? Or do I just stand still? I genuinely don’t know, and that makes me feel lost and frightened.

A. gave me the breakdown of her plan for her maternity leave on Tuesday. She’s planning to keep working until the fourth week of February [but, naturally, there is no guarantee that that will happen] and then she’ll be off until some time in July when she will go back on a part time basis, meaning I will have only one session a week, in contrast to the three I’m currently having. And, of course that makes perfect sense, from her point of view, to start over slowly. But for me, I’m not really so sure. Going from thrice weekly therapy to weekly sessions, it’s one heck of a drop, even if it is temporary.

I’ve been in weekly therapy before [albeit not with A.], and it is incredibly different to having more sessions in a week. My experience of weekly therapy is that, although it is helpful – and certainly better than nothing – it’s very.. hm.. choppy. Because so much can happen in the week between sessions, there is both a sense of wanting to cram as much as possible into that one session, and also there is very little flow between sessions. What you started talking about last week can easily be pushed to the side, in favour of new exciting events and thoughts, and deeper exploration often suffer as a consequence. And if you are, as I am, prone towards avoiding digging too deep, this can be used as a way to get away with not looking below the surface of things. So, that worries me.

Towards the end of last session I was really finding it difficult to speak, feeling very emotional and tearful. I just felt utterly overwhelmed by this feeling of being left completely on my own, and feeling that I really haven’t got the tools to stay above water. Like I said to A.: Forget about that nice sturdy IKEA bag I was hoping to find, right now I’d settle for the flimsiest of Morrisons carrier bags to help somehow contain my emotions. I feel really worried that, lacking a time and place to express what’s going on inside of me, those horrendous flashbacks will start coming back again, in the way they did earlier this year. I just don’t feel I’d be able to cope with that. Not without resorting to self-harm again.

A. pointed out that despite things being difficult, I was still managing to look after that goldfish and taking steps to make things as comfortable as I can for it, given the situation, to which I had to admit that I had, in all honesty, thought that I really ought to put that poor fish out of its misery, as I can’t bear watching it live out its life in this depressing little tank. I realised then that this could easily be interpreted as my expressing thoughts of wanting to end my own life, because it just feels too miserable and closed in, and so I felt I had to reassure A. that this wasn’t my plan, that I simply wouldn’t have been able to kill the fish, or myself. I’m not entirely sure if this is true, but metaphoric suicide didn’t feel like a very good note to end the session on, and after all, the woman is pregnant, so I felt I needed to smooth things over.

Don’t worry, I’m not saying I’m suicidal, only that it’s kind of hard to know with me. Even for me.

At points in this final session I felt very strongly that I needed A. to reassure me, to play the good, nurturing therapy mother, and tell me that things would be OK, but, for whatever reason A. didn’t seem to pick up on that, and said very little when I felt I needed it most. [Yes, I do recognise that this is the child in me being angry at not getting instant gratification]. But then, at the very end of session, as we said our goodbyes, she gave me this very warm smile [which, for all I know she may have been giving me all through session, but since I rarely look at A. during session I wouldn’t know] which made me feel so much better, and I wished her a good break. And I meant it.

All the very best and more,

xx

PS. Once again, thanks to all of you who have voted for my blog in the TWIM Awards. The polling station is still open, so if you haven’t but would like to register your vote there’s still a little bit of time left.  Just click here. :) Voting closes at mid-day on December 31st.