I Survived A Therapy Break

We’ve been on a break, my therapist and I. A Pesach / Easter / training combo break. Leading up to the break I was very aware of Little S. inside having a lot of feelings about P. going away. This, even though, I – or should I write we..? – were also going to be away for almost the entire break. There was an increased and very distinct need for emailing and texting P. to make sure that she was Real.

I think that what Little S. means by someone being Real is a combination of them not forgetting her when she’s not with them and for them to not abandon her when things get rough. But, at times it is also a way to express genuine fear that maybe the relationship with the other person is too good to be true, it is asking for reassurance; are you Real, or just a figment of my imagination, because it seems so unbelievable to me to have someone who is really there for me when I need them.

A break always brings out a lot of abandonment issues, especially for the Little S. part in me. From Adult Me’s vantage point this makes perfect sense, I understand why this happens; so many people in my life haven’t been there when I’ve needed them the most, so, naturally, when someone as important to me as P. declares that she’s going to be away, it is bound to trigger all manner of emotional echoes inside me. But, as much as Adult Me can see this, it doesn’t actually make it any easier for Little S. to deal with the anxiety and sadness that these separations inevitably bring to surface. To Little S. the worry that P. might be going on a break because she has been too much for her is very real, as is the fear that P. might – during the break – realise that she prefers not to have to deal with her ups and downs, her neediness, her constant need for reassurance.. Before a break the tension inside Little S. will keep building, until she is convinced that a) there is no way she can survive this break and b) that, should she through some form of miracle survive, there is no way that P. will ever choose to return.

A few years ago, back when I was still seeing A., I would never ever talk about any of this directly with her before a break. I would suffer in silence, and maybe – very maybe – mention it after the break was over, although generally in a very brief glossing over kind of fashion. Before a break, I would just feel the anxiety mounting, bring me closer and closer to breaking point, but I would not really acknowledge just how difficult breaks are for me. This, of course, lead to breaks being absolutely catastrophic in my mind, and it was extremely rare that I would not need to be working with the crisis resolution team during them.

In the first year or so of seeing P. I slowly and very gradually became better at talking around the subject of breaks, slightly dipping my toes in it, so to speak. I would talk about it in the way Adult Me sees it, intellectualising it, rather than actually feeling it. In part this was because I didn’t really know how else to approach it; intellectualising difficult feelings, analysing why they are triggered, rather than actually feeling the feelings, is how I have got through an awful lot of difficult times; it is a well beaten path. But, as I have been working more and more closely with P. to try to notice that there are feelings stirring inside, and to identify what those feelings are, I can now fairly often allow myself to stay with them.

The other part of why – back in the early days – I didn’t really talk about the feelings was that many of those feelings [particularly the ones to do with abandonment and separation, and the shame of needing someone else] belonged more to Little S. than to Adult Me, and Little S. hadn’t yet found her voice. Or rather, I hadn’t yet found a way to allow Little S. to express herself directly in our therapy. But, eventually we cracked it; first by letting Little S. email and text P. between sessions and then by Little S. speaking directly to P. in sessions [as opposed to through Adult Me]. It’s been a long journey, but I do feel that Little S. is now reasonably able to take part in therapy when she wants or needs to.

So, this time around, on top of the many emails and texts asking P. if she is Real, she was also able to not only talk about her feelings prior to the break, but she was able to experience them while she was talking about them. And that felt like a very big step forward.

The break in itself actually went quite well this time. Of course we all missed seeing P., and there were a few times when either Little S., bob, or Adult Me needed to email P., but there wasn’t quite as much anxiety to deal with as there might have been, had we not been able to experience and explore some of the feelings before the break, had P. not helped me make space for these feelings to be not only shared, but also heard. P. doesn’t ever make me talk about difficult feelings, but she does actively encourage me to try – and we set the pace together. She makes it very clear to me that it is safe to allow feelings out, that she wants to hear about them, whether it be in session or in an email, a text or in a drawing. And, possibly most importantly – especially to Little S. – she reassures her that she will be able to bear those feelings, that they won’t be too much, and they won’t result in P. no longer wanting to see her. That feeling and talking and talking about feelings is very much welcomed and valued in our relationship. Even when it’s scary. Especially when it’s scary.

Another thing that P. and I do to help Little S. manage during breaks and particularly difficult times, is to let one of P.’s ‘little friends’ – a soap stone hippo called Ringo [*not his real name, gotta protect his privacy!] – stay with me. I will also leave something of mine with P. to further strengthen the sense of connection between us during the break. As Little S. would say: “Something to help you ‘merember’ me, in case you start to forget.” It may sound like a childish thing to do, this exchanging of personal artefacts, but, Little S. inside is just that – she’s little – she may live inside the body of an adult, but she still finds comfort in having something physical to hold on to help her connect with P. So, no matter how silly it may seem to outsiders, taking Ringo with me everywhere I go, it makes all the difference in the world to Little S. And that’s worth a lot!

So, when you’re facing a break in your therapy, here is my advice to you: listen to what all of you need to make that break as bearable as possible. Don’t allow your Adult Self to stop your Little from getting what they need to manage it. To the best of your ability, talk about the fears and worries that all of the different parts of you carry about this break. Write it in a letter if it is too hard to say it out loud, if the fear of rejection gets too much. And if needed: ask if Ringo can come stay with you. And, if asking for a Ringo to stay with you feels too much; start small. I was given this tip by one of my readers many years ago, and at first, having something personal of P.’s felt way too overwhelming for me, so we started by my borrowing a random pen of hers that I could use to write in my journal with. And a little note from P. to help reassure me that she wouldn’t forget me and that she would be back.

But now that I have worked my way up to having Ringo stay with me, I wouldn’t have it any other way.
And neither would my sisters’ kids!

Be good to your Selfs.

xx

IMG_3885

A drawing Little S. made last night to show how happy bob, she and Adult Me feels that P. is finally back

 

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From Swan Lake to Daft Punk – A Post About Psychotherapy Breaks

Every time I upload a new post I do so with the intention of posting another update soon thereafter, but it just never seems to happen that way.. I suppose I will have to own that this happens in part because I slightly lack the discipline to stick to a set publishing schedule, but, also, it happens because – well – life happens. I’m sure you know what I mean. It is hard to write about your life at the same time as you are experiencing it. Especially when the going is tough.

So, what has been going on in my life since my last post? Quite a lot, it feels like, and at the same it is rather a lot of the same that is pretty much always going on; flashbacks, crises, therapy breaks, family stuff.
I’ve been under the care of the crisis resolution team six or seven times already this year and had one stay at Drayton Park. That’s a lot, considering we are only in the eight month of the year.. And I have a feeling that another stay at Drayton Park may be on the cards in the near future. I am actually seeing the crisis resolution team later today, and my guess is that they will suggest to start a referral for some residential care. To keep me safe from myself. Without going into too much detail, the going has been exceptionally tough this year in general, and recently in particular.

*

P. has been on annual leave for about two weeks now, with another two still to go. I know that I have written about therapy breaks many many times in the past, but it is for good reason: they really are that difficult to cope with.

And I know for a fact that I am not the only one who experiences breaks in therapy as major triggers for all manner of extreme abandonment, attachment and separation issues. A quick look at the stats for how people find this blog tells me that some of the most commonly used search terms are variations on the theme of How To Cope During Therapy Breaks. This is also a topic that people frequently email me about. [Much appreciated, and – as always – apologies if I’ve not been able to respond to your email yet]. 

So, this is clearly not something I alone struggle with.  

I think part of the reason why it is so hard to manage while one’s therapist is away is that Everyone Else [friends, workmates, family, even mental health workers] find it seemingly impossible to grasp just how important and intimate a therapeutic relationship is, and what huge emotional waves the absence of your therapy partner sets in motion. So, we are left feeling that the pain we experience because of our therapist’s absence goes unheard, thus redoubling the pain.

I have some absolutely wonderful friends, I am very very close to my sisters [by golly I love them more than I could ever express!] and I really wouldn’t describe myself as a lonely person per se [although I do perhaps crave more alone time than most] – but my relationship with P. is different to every single one of my other relationships, no matter how good, close and meaningful they are, and it takes up a huge amount of emotional spacetime in my day-to-day life. Even on the days between sessions. 

So, when P. goes away for any length of time, that is going to be hard to cope with. I am used to being able to voice thoughts I don’t share with anyone else three times a week. I have 150 solid minutes every week that are there for only me, to express whatever I want to or need to. 9,000 seconds a week to experience being heard and seen by a pseudo-parent who genuinely wants to understand and help find ways to ease the pain. And that’s not even counting the email and text contact P. is encouraging me to maintain in between sessions and over weekends. So, of course her absence is going to be massively felt.

It isn’t a case of my being needier than most, it is simply that this is a big change to the structure of my week – and I think that most anyone who had that kind of drastic change to their life [even if it is temporary], would find it quite challenging to get used to. 

And – of course – we are none of us in therapy for the sheer fun of it. Something has brought us there. There are Issues to be worked through. Usually more than one, and hardly ever the easy-to-resolve variety. [If, indeed, such a variety exists.. I have my doubts..]

During a break the therapeutic process gets put on hold. Or – perhaps more accurately – the format of the therapeutic process changes during a break. Of course we don’t go into a period of zero growth during a therapist’s absence [in fact, in my experience breaks more often than not bring growth in its wake, both for me personally and in my relationship with P.], but the rhythm is upset. There are no two ways about it. It’s like listening to Swan Lake for a solid month and then suddenly having that musical loop switched to Daft Punk. It’s not bad for us [I would never call Daft Punk bad!], but it IS vastly different. And even if we know that the switch is going to happen [having bravely attempted to talk about the upcoming break and the feelings it brings to surface], going from Swan Lake to Daft Punk is going to affect us. Different feelings will be stirred up, often difficult, deep-seated ones. And we will be on our own to cope with them. 

Or, as in my case, you’ll end up working with the crisis resolution team for the umpteenth time.. ;)
So, that’s where I am at right now.

Getting used to Daft Punk. 

xx

Hearing the Littles – A Therapy Break Update

Våga Lita - Dare Trust A reminder written on my arm before going into a therapy session shortly before The Break

Våga Lita – Dare Trust
A reminder written on my arm before going into a therapy session shortly before The Break

It is far too early on a Sunday morning for me, or indeed anyone, to be awake. But, I am. Anxiety is stretching my nerves to the point of breaking, and I have been unable to sleep for about forty hours. Insomnia isn’t out of the norm for me; it is part of my pattern. But the anxiety is. Or, at least, the level of anxiety. I can feel the extreme imbalance of the chemicals surging through my system, splashing around, crashing into each other and the rocky shores of my insides that have until now been unknown to me. The inner landscape of my body is soaked, drenched, in acidic anxiety, and I can’t think of how to rid myself of it, how to alkalise.

I know that I can and will get through this. I have survived it before, and I will again. It is just that the strength of emotions have taken me by surprise. Yes, I was nervous about this upcoming break in therapy for weeks before it started, but I thought that perhaps this time might be different, because, in contrast to many other breaks, I – we – P. and I, had spent so much time talking about it, preparing for it, putting in place things to make it more manageable. And I, foolishly it seems now, thought that that in itself might dull the sharpness of my feelings. But it doesn’t.

I miss P. terribly, and even though I have talked to my friends about it, and many of them have responded with empathy – more so than in the past, it seems – I am still left feeling that no one really understands the depth of my emotions. Or maybe it is a sense that others expect Adult Me – the intellectualising, reasoning, part of me – to handle this, to take charge and make it all OK, for all of the different parts inside of me. Truth be told, I think that even I expect her to.

But, what happens during a therapy break – a break from my pseudo parent – is that Little S. – not Adult Me – is the one who is reacting to this separation. Adult Me can watch, but can do nothing about that, because Adult Me wasn’t there when the fear of separation and abandonment, was born. Adult Me hadn’t yet been formed when Little S. – or even before then – tiny Baby S. were dealing with life in a world where there simply was no stability, where her parents gave her up and left her to fend for herself, completely void of tools with which to do so. Because of this, the reassurance Adult Me is continually trying to offer rings hollow to Baby S., in exactly the same way reassurance from anybody else does. Adult Me may be one of many parts that forms the whole of me, but she wasn’t there when it happened, and as far as the Littles are concerned, she doesn’t get it any more than my incredibly kind and well-meaning friends do. Not emotionally. And Little and Baby feel just as nakedly defenceless as they did back then.

Of course Adult Me has acquired lots of tools over the years to deal with situations like these. And during normal, daytime, hours, she makes the most of those tools and is often successful in temporarily alleviating much of the fear and anxiety. But when the rest of the world goes to sleep, and Adult Me is exhausted from a day of constantly trying to soothe those Little parts, when she needs a break to stock up on supplies, that’s when the primal scream of Baby S. sounds the loudest, deafening all intellectualisation and reasoning.

Baby S. was about six months old when she was adopted, when she came to live with her new parents in Sweden. No one knows, and Baby S. can’t remember, what happened in the six months before then. But the emotional echoes of the feelings born in those months still bounce between the walls of her outer shell, and when something like this – a separation, a perceived abandonment from a care giver – happens, those echoes amplify and drown out everything else. The echoes are always there, even in peacetime, noticeable in the fear of forming attachments with others and the difficulty in trusting, but when an actual separation happens something explodes in her, because just as Baby S. couldn’t know at the time that that abandonment would be temporary, she is now – still – blind to this fact. Baby S. only knows the here and now, isn’t able to look to the future, so when Adult Me, in sheer exhaustion, takes a break from reassuring Baby S., Baby S. thinks that this will last forever.

I wrote an email to P. a few weeks prior to her going on her summer break, about the whole How to cope with your therapist abandoning you for a minor eternity-issue, and as I am writing this now, it strikes me that that is exactly what I am dealing with: a minor eternity. It is minor in the eyes of the world, even in Adult Me’s eyes, but to Baby S. and Little S. – both of them too young to understand the concept of weeks or days or even minutes – it is an Eternity. And eternities have no foreseeable end.

As I wrote at the beginning, I will get through this separation, just as I have got through separations in the past. But in order to help Baby S. and Little S. I need to remind Adult Me to deal with them gently and patiently in the understanding that they have not yet got as far in the healing process as she has. They will get there eventually, but it will take more than the survival of a few therapy breaks for them to feel safe enough to integrate fully, to get to a place where The Whole can begin to work as a single entity, rather than as a multitude of frightened independent parts.

So, I say to myself, as much as I do to you:
be kind to your Selves.

 

Much love,

xx

 

The Beginning Of A Break

Had my final pre-therapy break session yesterday, and it was hard. Or, maybe hard isn’t the right word? It was emotional. Not emotional as in floods-of-tears-streaming-down-my-face-fifty-minutes-straight, but it certainly stirred things up inside of me in a big way.

So, P. and I spent most of the session talking about all the different feelings this break is bringing up for me. How it makes me feel like the abandoned, forgotten baby I once was, the distant echoes from when I was tiny and was given up by my birthmother, and how – even though I have no conscious memory of it – that must have had a profound effect on me. I also retold the story that my mother [technically adoptive mother, but it’s not a term I ever use; she’s just my mother] has told me so many times: that about two or three weeks after I was adopted my mother was downstairs doing something with my brothers, and she completely forgot about me. Not as in ‘she forgot that I was upstairs in the baby swing’, but as in ‘she utterly and completely forgot that I even existed’. My mother tells this story as a bit of an amusing anecdote, but of course, there isn’t really anything very much fun about it at all: I had already been given up once and then only a few weeks later my new mother also forgot that she had a baby to care for..

We also talked about how I simultaneously fear it will be an incredibly difficult break and that it won’t be difficult at all. That it, paradoxically, is easier to deal with the idea of finding this break an immense struggle, than to cope with the idea that it mightn’t affect me much at all. Because, if it isn’t difficult, if it doesn’t affect me, what does that say about P.’s and my relationship? Of course, it could just mean that I have simply developed better ways of self-soothing than during previous therapy breaks, but, knowing myself, I am far more likely to jump with instant certainty to the conclusion that it must be because P.’s and my relationship isn’t really all that special after all etc etc etc.

Last week P. gave me a few suggestions of things we could do to make me feel less abandoned during this break, to allow me to hold on to her even when I’m not actually seeing her. One of her suggestions was to give me a recording of her voice for me to listen to, if she started feeling too distant in my mind. I rejected that idea right away, stating that it wouldn’t be all that useful, considering how poor my hearing is, all the while knowing that that wasn’t the reason at all, but rather that something about having a voice recording felt too close and too scary for me to cope with. Another suggestion, in a similar vein, was that perhaps it would be helpful if she were to give me a photograph of herself to look at. This led to me coming clean and admitting that I already have a picture of her, and that – yes – I do find it very helpful to look at it. P. said that this photo would be different, though, because this would be a photo she had given me, which I agreed it would be, but that I needed to think about it.

What I failed to explain to her at the time, and which later came back to haunt me in the form of a number of sleepless nights, was that I said nothing about why [how?] I had a picture of her. Eventually, it got to me so much that I had to write her an email to explain that it wasn’t quite as creepy-stalkerlike as it may seem: because of the prosopagnosia I have taken to doing a quick search engine/social media scan for a pic to add to any new contact I put in my address book, including the guy who comes to fix the boiler. Just for clarity: I don’t think there is anything inherently wrong in having your therapist’s photo; most clients have a very natural, healthy curiosity about their therapist, and googling someone is hardly the crime of the century – it was more the fact that I hadn’t said anything about it to P. that was bothering me, because it filled me with anxiety that she might think I was exhibiting creepy stalkerlike behaviour. Unfortunately, the very sweet email she wrote back to reassure me that this wasn’t the case, that she didn’t feel it was either creepy or stalkerlike, for some reason didn’t make it through to my inbox, and consequently my anxiety was quadrupled over the next two days. But, we managed to talk all of that through later.

In the end I did accept P.’s offer of giving me a photograph. The actual photo is one that my prosopagnostic brain has trouble deciphering as being of her – there is something about the fact that she isn’t smiling with her eyes – as she so often does in session – that makes it hard for me to understand that it is really her in the photo, but it still means a lot to me having it. I treasure it in the same way that I might treasure a handwritten note from her, precisely because it is from her. I also showed P. the picture I already had of her, and I think she understood why that is a picture I find much easier to connect emotionally with – because in that photo she seems very relaxed and is indeed ‘smiling with her eyes.’

The final idea of how to cope with this separation was one I came up with. I had been thinking about what exactly all of those fears inside of me really are, and what different ways we had worked out to deal with each one of them, and I realised that one of my biggest fears – the one about being forgotten and left behind – could also be dealt with, with a photo. This time, I suggested to P. that maybe I could send her a photo, of me, because even though Adult Me intellectually knows that I won’t disappear from P.’s memory the second I am out of sight, her having something of me with her would make Little S. feel a lot better. [For long term followers, this idea was a modified version of the rubber duck I gave A. in our very last session together.]

So, all in all, that last pre-break session was a good one. I felt quite overwhelmed by P. saying so many kind things to me, particularly when she said that her having my photo meant that she could take me with her on her leave.. But, as I also explained to her, it was good overwhelming, not bad..

Right at the very end of the session P. asked one last time if there was anything else she could do for me, to which I said: “Just make sure that you DO come back”.

To which she replied that she wanted the exact same thing from me.

 

xx

Reconnecting

I’ve been writing this update in my head for about a month, only I’ve not got down to typing it up. I am struggling to remember where I was at, emotionally, when I posted my last update, but I know that it wasn’t a very nice place.

Things sort of spun out of control for a bit. I went into the worst period of constant flashbacks I have ever experienced and ended up, once again, at Drayton Park. The whole first two weeks of staying there I more or less only ventured outside of my room to see P. for therapy. I didn’t eat, didn’t sleep and didn’t socialise with any of the other women who were staying there, so this stay was very different to many of my previous stays at Drayton Park. I simply found it too much to be around others when I was being thrust back into the past again and again and again, in an endless waking nightmare of relentless flashbacks.

Something very serious happened while I was at the crisis house, something I still don’t feel I have properly processed or understood, and I may come back to that another time, but for the time being I won’t go into it. I need more time to think about it.

In my third and final week at Drayton Park the frequency of flashbacks began to decrease and I was able to be my usual self a bit more. I had a few really good conversations with some of the other women staying at the project, feeling privileged to be allowed hear their stories and to get to know them a little. It is always a very special thing when someone decides to trust you enough to share of themselves.

I saw D., my ex-counsellor, in passing a few times during my stay [since she is based at Drayton Park one day a week] and we had some good, honest banter over lunch one day. In fact, it must have been really good, even to others listening in, because after D. left one of the residents asked me if D. was my mother, because we had such a ‘natural and easy way with one another’. How anyone could associate ‘natural and easy’ with a mother-daughter relationship is beyond me, it certainly doesn’t fit with any experience of a mother-daughter relationship I’ve ever had, but it was a very nice thing to hear, nonetheless.

Good banter aside, as D. and I were ending one of our little mini-conversations she told me to take good care of myself. Force of habit I shot a semi-automatic “I always do” coupled with a bright smile in her direction. Only, this being D. on the receiving end, she didn’t just let that statement slide, but immediately lobbed a “No, you don’t” back at me. She then paused, looked me right in the eye and slowly repeated “No. You don’t.” And there was so much feeling in those words. There was an unspoken – but clearly received – message of ‘I so wish that you did take good care of yourself. Because you really, really matter.’  And that meant a lot to me.

 

*

 

It has now been four weeks since I left Drayton Park, and there have been both ups and downs. The frequency of flashbacks seems to be back to normal, more or less. It is in no way easy to deal with the flashbacks, regardless of the less intense frequency, but it is a lot better than what it was. As I explained to a friend of mine; it’s a bit like my breathing. While my breathing is never really all that good, immediately after a bad asthma attack the ‘not so good’ still feels like a relief, by comparison.

Therapy with P. is going well and we are continuing to build our relationship, making sure to take plenty of time to do so, so that all of the different parts of me – especially Little S., who is so terribly afraid of anything that resembles trust and care and attachment – feels both seen and heard. Little S. gets scared, because she learned very early on that all of those things will inevitably lead to pain and hurt, and as much as Adult Me wants to challenge that fear, wants to show her that this relationship with P. can be safe and won’t necessarily lead to pain, it takes time and patience to get there. It takes a lot of work to truly alleviate fears that are that deeply rooted.

We are coming up to our first therapy summer break by the end of this week and as a consequence anxiety has been running high both for Little S. and for Adult Me. Regular readers of this blog will know that psychotherapy breaks is a topic I have written about a lot over the years, because it brings to the fore all of my fears about being abandoned and forgotten. It is also one of those things that people who haven’t been in therapy never seem to fully understand or appreciate. And, to me, that is also part of what makes breaks in therapy difficult; the sense that others don’t understand how hard they really are. Whenever I mention to ‘non-therapy’ friends that I feel really anxious about an upcoming break, I always get the feeling that they are thinking that I am worrying over nothing. And if I, during the actual break, say something along the lines of finding it hard that my therapist is away, the immediate response is invariably ‘When will she be back?’ followed by an equally predictable ‘Well, it’s only X weeks left’. This, of course, feels terribly invalidating, since a therapy break isn’t really about length of time at all, but about strength of emotions and how to cope with them in the absence of a safe place to explore them.

P. and I have been talking about this upcoming break and how I will be able to manage while she is away. P. had a few different suggestions of things we could do and I felt incredibly touched by them. I know that it probably seems a little silly, but it had never even entered my mind that she would have spent time thinking of ways to make this easier. I am so used to doing all my thinking and coping on my own, and I feel simultaneously grateful and overwhelmed by the care she has shown me leading up to this break.

 

I think I will end this update here.
Hopefully it won’t be quite so long before I post another one.
[I always seem to be saying that, these days].

Just before I leave you for this time: Thank you all so very much for the many moving and kind words posted in the form of comments and emails during this past blog hiatus. I am sorry that I haven’t been able to respond to all of you, but please know that I do read every single email and comment, and they really do mean a huge deal to me.

Namaste.

 

xx

 

 

 

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

Endings: Standing On The Brink Of The Unknown

Being in therapy is being in a relationship. Therefore it follows that ending therapy is an as complex and complicated – and sometimes painful – process as ending any other relationship. There are loose ends and jagged edges to deal with, memories – good and bad – to look back at, and a struggle to not panic and in desperation seek to go back to something that just isn’t there anymore.

I have always said that things that are familiar are often also comforting to us, even when The Familiar isn’t necessarily a good thing in itself. The Familiar is comforting because it keeps The Unknown at bay. And nothing is more frightening than The Unknown.

I have four more sessions left with A.
Four more sessions, after more than four and a half years of working together. In short: it is nothing. I am standing only millimetres away from The Unknown, and I have to find the courage to not turn and run, but rather to allow myself step in to and somehow tolerate existing within it.

I have been spending a lot of time over the Chrismukkah therapy break thinking about what exactly it is that makes this ending feel so difficult, because, intellectually I can see that ending work with A. has more or less become a necessity, both because I am unable to give her the reassurance that she needs that I won’t end my life, and – perhaps more importantly – because we have simply come as far as we can, working together. The conclusions I have reached, as to why the ending is difficult is summed up in the first paragraph of this post; this is the end of a very special relationship, so how could it not be difficult? But, on top of that ‘normal’ difficulty, apart from the anxiety and sadness and sense of loss that any ending brings with it, I think that there is something I need to take from this relationship, which I fear A. might deny me, and this is what makes it so much more painful.

In November, when I finished counselling with Z. – that, too, was a difficult ending. But, I do feel that in the last few sessions – and especially in the very last one – Z. managed to provide me with that one thing I needed: the reassurance that it mattered to her too, that we would not be working together anymore. That I had made an impact on her. That she would actually miss seeing me. What I am talking about here is not a need to be told that I am her favourite person ever to work with, but something far more simple; an open acknowledgement of the fact that working with me is special, because I am special: there is only one of me. So even though my slot would soon be filled by someone else, someone just as engaging, it is still different, because the relationship between Z. and I could only happen because of who we are as individuals, and what we accomplished in those sessions was specific to our relationship, to what we jointly brought to the table.

I talked with A. about this ending at the time, explaining that those things Z. said to me meant a lot, and significantly helped make that ending, if not less difficult, at least not painful, and left me with something positive to carry forward. The fact that Z. actually told me these things, actually said them out loud, rather than simply assume that the way we had been working together and the way we relate would automatically lead me to know it, I think is important. People who have been abused tend not to take things like that for granted, because actions and the meanings of those actions have been so terribly mixed up and confused in the past.

So, I suppose, what I would like from A. is something similar. I’m not talking about any earth shatteringly emotional revelations or dramatic proclamations, but just something said, in clear plain direct speech, about the work we have been doing and about what this ending means.

I asked A. earlier in the year if I matter to her, and she decided to not answer my question, and I am sure she has her reasons for that, but, I think what I need – especially now – is for her to step away from those reasons, whatever they are, and just meet me openly and honestly. The lack of this direct communication in the last few months, is part of why therapy is now coming to an end, and seeing as there will be no Next Session in which to analyse why I asked the question, an answer would be good, would provide me with that Something that I need.

But, as I wrote earlier, my fear is that A. will not opt to go down this route of openness and honesty, and this is where I feel the pain is created. To need to hear that working with me has mattered to her, that getting to know me, hearing my thoughts, means something, is important, and to leave, having been denied it, would be excruciatingly painful.

Of course, I don’t know that this will be how things end, and I really hope that A. will have taken onboard the things I said about ending with Z., and what made that a more positive ending. But, the fear is still there, looming like a dark cloud over my head.. I am seeing A. for the first time after the break tomorrow, and I will carry on talking about all of these things with her, as I had been before the break. I just hope that her response will be different.

*

Before concluding this post, I just wanted to say thank you to all who have emailed me following my last post. I am sorry that I haven’t been able to reply to all of you, but, hopefully, in time, I will. I know that this post hasn’t really been a direct follow-up on the previous one, and it isn’t because I am trying to shy away from the seriousness of the situation, which remains sadly unchanged, but because I feel that – for now – I need to try to deal with things in slightly smaller chunks, and if that means navigating by auto-pilot for a little while, well, so be it. As my sister said We much prefer Auto-Pilot to No Pilot..

But, once again, thank you all for your very kind emails and comments. They have been read, heard and appreciated.

Much love,

xx

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