The March Post

To say that this hasn’t been my favourite month ever would be a grave understatement; March has been seriously rough. But, then again, I always knew that part of this particular month would be a real challenge, as this happens to be the month in which one of my abusers’ birthdays falls, something which is always a big trigger for me. A truly awful day with masses and masses of flashbacks.

On top of that, I was sent one of those dreaded brown envelopes from the DWP that I mentioned in last month’s post, one which contained a form for me to fill out, relating to benefits. This is something that always sends me into a complete tailspin; the anxiety that these forms provoke is enormous, because they force me to have to think about all the things I can’t do, leaving me feeling like an utterly useless human being. Even at the best of times I find it hard to think myself worthy of any form of financial support (even though, in healthier times, I used to work crazy hours, and paid equally crazy amounts of income tax, earning national insurance aplenty) – but when I am already feeling low – well, those DWP forms seem to be designed to give one the experience of being kicked while already being on the ground..

I am very fortunate, I have a therapist, a care coordinator and a social worker who are all more than happy to help me with these forms and support me through the emotional turmoil they cause, but even so, my risk level increases incrementally with every page of questions on those forms. I spent a session with my care coordinator, filling out as much of it as possible, but even though – in all honesty – she did most of it, and even wrote on the form for the DWP to contact her if there were any questions – I was overcome with horrible thoughts of how the people at the DWP would rather I kill myself, than having to keep paying out money to me. Of course, the rational part of me understands that absolutely nothing about these forms is personal – that lots and lots of people are sent (read: tormented by) them every single day – they still have the power to reduce me to one giant suicidal self-harming mess. In the month and a half I needed to fill out that ruddy form, I lost count of the number of times I took it out – fully intending to manage at least a couple of questions that day – only to have to put it away again, as my urges to self-harm got too strong.

So, this, in combination with my abuser’s birthday, meant that I desperately needed the support of the crisis resolution team. I was having such strong urges to end my life – even though parts of me really wanted to live – that I was struggling to keep my Self safe from me. And, even though I was reluctant to work with them to start with, I know that the extra support that they offered this time around, is what kept me safe, kept me alive.

So, no, March 2018 hasn’t been a great one.
But, hopefully, April will treat me with the kindness I deserve.

xx

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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

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..]