Three Key Rules For Surviving The Present

Posted by What It Takes To Be Me in Abandonment Issues, Attachment, Being Alive, Coping Strategies, Depression, Expressing Emotion, Faith, Flashbacks, Judaism, Loss & Mourning, Psychology, Psychotherapy, Psychotherapy Breaks, Psychotherapy with A, PTSD/Extreme Emotional Stress Disorder, Self-Harm, Separation-Anxiety, The Therapeutic Relationship and tagged with abandonment issues, attachment, books, British Reform Judaism, coping, coping strategies, crying, eternity leave, expressing emotions, Extreme Emotional Stress Disorder, Faith, flashback, flashbacks, help my therapist is pregnant, Judaism, kiddush, managing self-harm, maternity leave, Movement for Reform Judaism, MRJ, my therapist is pregnant, Nuala O'Faolain, Post-Traumatic Stress Disorder, pregnant psychotherapist, psychology, psychotherapist maternity leave, psychotherapist's maternity leave, psychotherapy, psychotherapy breaks, PTSD, Reform Judaism, self-harm, separation anxiety, separation-anxiety, service, sexual abuse flashback, sexual abuse flashbacks, Shabbat, Shabbat Shalom, support, survival, survival plan, Surviving The Present, synagogue, tears, The Movement For Reform Judaism, therapist maternity leave, therapist's maternity leave, therapy breaks Saturday, February 25, 2012

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

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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.

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

Survival – Knowing When You Need Help

Posted by What It Takes To Be Me in Acceptance, Depression, Flashbacks, Illness, Inner Conflict, Medication, Psychotherapy with A, PTSD/Extreme Emotional Stress Disorder, Self-Harm, Suicidal Ideation, The Therapeutic Relationship and tagged with accepting help, crisis, crisis team, Depression, Extreme Emotional Stress Disorder, flashbacks, getting help, inner conflict, knowing when you need help, medication, mental health system, NHS, NHS Mental Health, Post-Traumatic Stress Disorder, pride, psychotherapy, PTSD, self-harm, suicidal ideation, survival, the therapeutic relationship Wednesday, August 10, 2011

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

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

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

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

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

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

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

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

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

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

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

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

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

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