Things are going more and more downhill in session.  Every one over the last few weeks seems to end up brimming over with hostility and defensiveness from both sides, and last week was no different.  I think he is finding me an increasingly difficult patient.  I am certainly finding negotiation of the therapeutic relationship increasingly difficult, so I suppose in that sense we are equal, but things scream of inequity at the moment.  Where once we felt like equals, albeit in a strangely asymmetrical partnership, it now feels like the balance of power is weighed strongly in C’s favour.  He said to me once, several months ago, that he was “not my teacher”.  Well, he isn’t teaching me anything, that much is true – but I constantly feel like a naughty schoolgirl to his authoritative headteacher.  That isn’t fair.

I’m not really sure what to say about this session.  I was completely mental in it.  I tried to tell him exactly how I was feeling, but my ability with language epically failed me, and the necessary words failed to flow.  I did keep trying to convey to him that I was experiencing what I thought was akathisia – however, not at any point did I use that word.  Stupid, yes?  Why not just tell the man that I suspected I was afflicted with this phenomenon?

C is not a psychiatrist, so I cannot expect him to be an expert in the finer points of side-effects of psychotropic medication.  Nevertheless, as a mental health professional, I was expecting him to be familiar with this particular thing.  I wanted to hear him say the word ‘akathisia’ of his own accord, and he never did.  I was testing him, I suppose.  In my (rational-ish) view, this is completely preposterous; he may be an insightful psychologist, but he is not a mind-reader, and akathisia is notoriously hard to identify even by psychiatric experts.  However, C himself has defended my tendency to test him in the past.  He seemed to think it acceptable to test him for six months before finally opening up to him about some of my many issues.

And therein lies another thing that has been bugging me.  I say something I consider to be stupid.  I go into a self-hating rant about my perceived stupidity.  C listens, then eventually starts defending me.

The flip side: I say something that I believe to be perfectly reasonable.  C listens, then eventually dismisses what I have said.

Obviously this is a gross generalisation.  Not all strands of conversation result in this kind of reaction, as previous entries on my therapy sessions will attest.  But it is certainly not unknown.

Anyway.  C told me that I have to “take responsibility” for myself.  Hmm.  Does that mean that it was my irresponsibility that led to my complete doolallniess on Thursday?  Surely that is terribly unfair.  I don’t go around consciously choosing to go off my head, do I?  I talked about my desire to kill myself a lot, and said that I genuinely didn’t know if I could continue to control myself in that regard.  Obviously he thinks I can, because clearly he fucking knows what it’s like to exist in my head.

He exemplified by saying that I always turn up to therapy on time, and that when I tried to do myself in a few weeks ago, that I took myself to hospital (though he failed to acknowledge that I only did that when it became apparent that my suicide attempt was not going to be successful).  To that end, he believes that I am perfectly capable of controlling myself.  Oh yes, I may get overwhelmed “from time to time” (!), but I am still in control, or at least I can be if I take some fucking responsibility for myself.

I turn up to therapy every week on time because I am forced out of bloody bed by A or my mother each Thursday morning.  It is a struggle each week, and I can only manage it with others’ help, and I want their help because I had thought – up until recently – that this process was a vehicle full of promise of some semblance of recovery.  Being there is not about whether I am “in control” or “responsible”; it is simply something I have to do.  A bit like eating.  I don’t always want to do it, but something within me compels me regularly towards it, meaning that with help, it can be achieved.  And believe me, in the last few weeks even such simple, everyday things actually do feel like an achievement.

I admitted to C that I didn’t trust myself because I’ve done something pretty daft – bought 100 Diazepam from some dodgy online retailer (yes, it is indeed probably rat poison.  I don’t care, so don’t bother to point it out).  He kept asking me if I was intending to overdose on it.  I said that Diazepam ODs don’t kill people, but he protested that that wasn’t what he’d asked.  I said that no, I was not intending to overdose.  He asked me to guarantee that, and I said I couldn’t guarantee anything – for example, I didn’t know that I wouldn’t be blown to South Africa by a hurricane the next day, but that my perception was that on the balance of probability it wasn’t likely.

Why bother with this line of questioning?  They don’t put borderline freaks in the bin in the UK anyway, probably because they opine that we’re all going to do ourselves in eventually anyway.  I suppose he has to be seen to have asked all this wank so that if I eventually succeed in catching the bus, there will be no culpability at his door.  Oh well.  I suppose one must be grateful for small mercies; the psychiatrist basically told me it was good that my suicidal ideation was so strong.  Means I’m feeling things, apparently.  Yay.

Anyhow, C told me that “his stance” was that I should throw the Diazepam out when they arrive so that I am not tempted to take them all.  I laughed in his face.

“I spent $80 dollars on them,” I sneered.  “That’s what?  Fifty, fifty-five quid?  As if I’m going to bin something that valuable.”

“I know it’s a lot of money,” he started, “but compared to the value of your life…”

Something inside me snapped.  How dare he comment on the value of my life?  How very dare he?  He may know some of my dirty little secrets, and he may know whatever elements of my personality that are portrayed for a measly fifty minutes a week, but that doesn’t mean he knows me, not really.  He doesn’t know what I’m like socially, at home, how I was in work – none of that.  He hardly knows me at all in many ways.  Yet he thinks he can comment on how valuable or otherwise my life is?  No way, mate.

Well-intentioned?  Yes, maybe.  Indeed, probably.  But if he existed in my head, if he were around me like A is, then he would know that as a general rule my life is meaningless and empty…completely worthless.  Ergo, any supposition of its supposed worth from him was always going to serve to irritate.

I shouted at him that he knew nothing of the value of my life.  I don’t remember how exactly he responded but I think he tried to press the point, leading to more incredulity from me.

He said at one point that I had to decide “what I wanted” from this therapy, thereby implying that he feels it is meandering along with no real point, just like I do – but on top of that, the question was loaded with connotations of me failing to pull my weight in the process.  That annoyed me, because I think that despite my difficulties in motivating myself to attend every week, I have managed to do so, as he himself had noted.  Does that not suggest commitment to the therapy?  It was an exasperated question on his part, which did not have any point to my mind.  He, as a trained and, I assume, experienced, psychotherapist, ought to have the answers himself, especially as this was something we have discussed several times.  I want to be able to have as normal a life as possible and not go mental every few fucking seconds.  Does it take a brain surgeon with a secondary qualification in rocket science to understand that?

I find it really rather sad to write such a negative entry about C.  My instinct about him has always been very positive, even when the therapeutic path ahead has seemed foggy and indistinct.  Even when commentators here or people in my offline have been critical of him, I’ve been resolute in my belief that he has been and is the right psychotherapist for me.  I think I still think that, but things have been so murky in the last few weeks that part of me is beginning to question it.  Everything was fine, more or less, until about Christmas.  Is that because I’ve been really mental since Christmas?  Why can’t he deal with that?  Or is it because it was just before Christmas that he announced the end of the therapy?  Why won’t he explain that?

Maybe I do need to take responsibility for myself, but to be quite frank, my inability to do so is one of the many reasons that I’m in therapy in the first place.  So that’s an issue.  Another one is that I am not the only one that should be taking responsibility for me.  I am under NHS care for that reason, and yet none of them want to take that upon themselves, not really.  The only one that I really believe gives half of a damn is my GP, who has consistently been a tower of strength and support.

According to my psychiatrist, I am meant to be grateful that C is willing to treat me at all, because I have personality disorder.  Um…sorry, no.  C is doing what he is fucking paid to do.  I met him several months before I had received a diagnosis anyway, and if my Trust doesn’t have the specialist facilities for PDs, then that is not my problem.  They should provide treatment in line with the philosophy on which the health service was built with the resources they have, and I find it insulting that I am meant to consider myself privileged that they are only half doing so.

And as for what I want out of therapy…well, there’s the obvious general point stated above, and I suppose there must be specifics thereof, about which I’ll have to think presumably, though I’d like to do this in conjunction with him.  But I’d be grateful for your thoughts on this, readers.  What exactly is the point of psychotherapy?  What is it for, what is it meant to achieve? And does it even actually work?

Your comments, as ever, are most welcome and encouraged.  I’m sorry that I’ve been lax in replying to them on other posts of late.  I will try to change that as from this post.

Apparently I wrote this epic gem of a post on Thursday, post-C. It reminds me of a diatribe that A wrote to his friend W whilst in the early, very bleak years of his long university career:

Fuck, fuck, fuck, fuck, fuck it all,
My fucking life.
Suck, suck, suck, suck, suck it all,
My fucking dick.

Here is my apparent equivalent in prose. Hilarious.

—

Fuck my existence.

Fuck therapy.

Fuck C.

Fuck (New)VCB.

Fuck the NHS in general.

Fuck V.

Fuck Paedo.

Fuck my entire famly except my mother.

Fuck my ex.

Fuck the school bullies.

Fuck the school fucking teachers.

Fuck university.

Fuck the Troubles.

Fuck politicans.

Fuck the Social Security Agency.

Fuck the government.

Fuck religion.

Fuck secularism.

Fuck human relationships.

Fuck feeling.

Fuck heat.

Fuck cold.

Fuck the UK and Ireland.

Fuck Earth.

Fuck the solar system, galaxy, local cluster, universe and multiverse, should the latter exist.

Fuck medication.

Fuck getting washed and dressed.

Fuck getting out of bed.

Fuck prejudice and bigotry.

Fuck the beautiful people (forgive irony vis a vis last point).

Fuck this blog.

Fuck my “life”.

Fuck everything.

That is all.

This hardly even warrants an entry, but in my obsession for complete records of my psychotherapy with C, I am going to write at least a rudimentary account of it anyway.

The reason it doesn’t merit a post is not so much because it was a useless session – though in some ways it was – but more because I was dissociated through most of it, as I was stressed, agitated and strongly suicidal.  The whole session, insofar as I remember it, essentially consisted of me repeating, repeating and repeating some more that I wanted to die, that I didn’t care about anything except bringing about my own death and that I took no pleasure in anything in my existence whatsoever.  Another clichéd expression was, “I don’t have a life; I have a mere existence.”

We talked briefly about my name change, which has now taken place (w00t!), and he asked me how life as [my new name] was.  I said, “it’ll take a while to get used to being called that.  As for the life thing, well – that’s not going so well.”

I decided to be honest and just tell him that I wanted to die.  Generally I’m careful about being so direct about it, as I know he can contact a psychiatrist or my GP if he feels a suicide attempt is imminent.  But I was so desperate and miserable that I just admitted to the strength of my suicidal thinking.

I said, “at the minute it’s very much a case of when, not if, I do something.”

He came off with some blather about how some people try to conceive of things after death – a contradiction in terms to someone like me, who doesn’t believe in an afterlife.  He therefore suggested that I didn’t really want to die, because I could apparently still imagine the relief that might come from death.

This annoyed me.  Does he really think I don’t know this crap?  How stupid would you have to be to not understand the distinction between death and thinking about death?  Fuck’s sake.

“That’s exactly the point,” I protested.  “I want that nothing, that permanent unconsciousness.  I don’t want to conceive or perceive anything.  I.  Want.  To.  Not.  Exist.”

I exemplified my point by telling him about an operation a few years back when I was under general anaesthetic.  At one point I was panicking like fuck because I was petrified of being awake during the procedure — then the next thing I knew, I was crying in recovery with a nurse sitting beside me, informing me the operation had gone without incident.

“There was nothing in between,” I said to C.  “That is what I want.  Permanently.”

“But you awoke from that nothing,” he went on.

So?  The point is I want the nothing to be permanent.  Having been through that experience, I now know the nothing, or rather I don’t, because it isn’t anything.  That’s the beauty of it.  I would genuinely welcome it.

I berated myself for not having had the balls to properly attempt suicide as yet.  I reminded him that I was a frequent visitor to a pro-choice suicide newsgroup, and to that end, that I knew exactly how to complete the act.  I said I kept imagine my body flying off some of the highrise flats near where A and I live.  I even suggested I had images of me with a bag over my head, a connection to helium tank being hooked up to it.

At one point I must have gone really mental, because he kept authoritatively calling my name to try and break into my consciousness.  I remember sitting with my hands around my head, then pulling my hair to try and reorientate myself.  C asked me to join him in some breathing exercises; for the most part I think these are shit, but I didn’t have the will to protest.

He asked if I ever tried these exercises at home.  I lied and said that I did, but added – truthfully, I believe – that the scalpel was much more effective at ‘grounding’ me.  I think he responded about the usual crap – about how that was true, but that it was self-destructive – but I don’t remember clearly.

It became apparent to me at one point that he was under the impression that I wanted him to do something about my being actively suicidal.  I can’t remember what it was that he said, but he must have made some inference to this effect.  I therefore responded by yelling at him that I didn’t want anything from him, I just wanted to be dead.

C said, “but you do want something from me – you want me to help you and not to abandon you…”

“I don’t care!  I don’t care anymore!  I just want to die.  I don’t have the energy to fight that battle.”

“It’s not a battle,” he alleged.

Oh really?  Why did I have to write to two advocacy groups and your Chief Executive, then?  Why are you still telling me my psychotherapy is definitely ending in a few months?  Why is the psychiatrist going around telling me to get some perspective?  Sounds like a battle of wills to me.

Eventually, he said to me, “I can’t be with you all the time [oh really?!  After 40 odd weeks of seeing you for only 50 minutes once a week, I would never have worked that out, C.], so you have to take care of yourself between these sessions.  Do you remember we discussed ways that you can care of yourself?”

“I don’t want to take care of myself, C, I want to die.”

“No,” he said.  “Who will you contact if you feel you are in danger?”

“Not the Samaritans nor Lifeline, as you have previously encouraged.  Aside from the fact that they’re not much help, however well-intentioned they may be, I’m absolutely petrified of using the phone.”

“OK.  But you need to contact someone, or get yourself out of danger.”

“By sitting in casualty for another 12 hours?” I cried, incredulously.

“Yes!” he said, raising his voice slightly and taking an authoritative tone.

This pissed me off, and I heard myself exclaiming, “fuck that!  That’s an advertisement for suicide, if ever I saw one!”

He had no response to that.  Hahaha.

When I knew it was near the end of the session, I went into my usual self-critical mode.  I said something like, “grow up, you stupid fucking brat,” in reference to myself.

C opined that this exemplified my thinking in extremes (more splitting); either I am very “concerned” for myself [not sure about that], or I am very angry with myself.  Well done, C.  You are truly the most insightful human being I’ve ever known, my friend.  (Actually, quite often he is.  But this was not one of his most outstanding moments).

I explained to him that that wasn’t necessarily the case.  “I feel that I have to convince you that I’m not going to walk out of here and top myself,” I told him.

I realise, on reflection, that this statement was pregnant with ambiguity.  I had not intended it that way; what I meant was I wanted to convince him of something that I believed to be untrue, so as (a) he didn’t phone the bin and (b) he didn’t worry about me (as if he fucking would anyway).

However, what I now think he understood from the comment was that I genuinely wasn’t going to walk out of his office and do myself in, and that I wanted him to know this.

Obviously as you can see I haven’t topped myself, but every second of this week has been a fight against the urge.  In part I’ve managed to resist it because A had to have a minor operation on his eye this week, which has needed a lot of follow-up care from me*.  But when he is recovered I am not sure for how much longer I can fight this.  As I say, it strongly feels like when, not if.

PS.  * This has just reminded me of another conversation between C and I in this session.  I told him that I was worried about A’s operation, as if they screwed it up, then he could possibly end up completely blind.  He has no sight at all in his left eye thanks to a botched operation when he was a baby (even though this recent procedure was on his left eye also, I managed to convince myself that they could easily fuck up the right one while they were at it).

I told C this.  He said, to my considerable chagrin, “do you think this treatment [ie. my psychotherapy] is botched?”

I said that I had been commenting on one of my boyfriend’s experiences of the NHS and that I could not see how that related to my own in the least.  I defended my use of the word ‘botched’ on the grounds that that was exactly what it was; the anaesthetist had been working for something like 18 hours and, exhausted, administered an overdose of anaesthetic to A’s eye.  The only way to save any of his sight was to sever his optic nerve to his left eye.  Sounds like a botched operation to me.

C said that I had every right to be angry and concerned about this in itself, but he wondered if that didn’t actually translate to my own necessary treatment.

For fuck’s sake.  Why does everything I happen to bring up have to come back to my relationship with C?  As I said to him, I understand the principles that underpin psychodynamic therapy, and am fine with that for the most part, but honestly – surely you can have some independent thoughts that are just there for their own sake?!  Thoughts that are not connected to the relationship, or transference, or your childhood experiences?  Surely that must be at least theoretically possible?

I’ve said it before and I’ll say it again.  Fuck off, psychology

I was going to recommend a long academic paper on child trauma and dissociation, but I would have to admit that I haven’t read it all yet due to being really mental these last few days.  Nevertheless, it presents several interesting hypotheses, so if you’re interested:

Betrayal Trauma: Traumatic Amnesia as an Adaptive Response to Childhood Abuse [PDF]

The following I have read in full.  This is an article from the Suite 101 which discusses the possible meaning of dreams, as conceived by the likes of Freud and Jung.  I’m always loathe to take this kind of thing seriously, as I think it’s very unlikely that we’ll ever really know the point or meaning of dreams, but nevertheless, the article succinctly describes interpretations of some of the most common symbols in dreams.

The most pertinent for me was falling.  Like many others, it’s a dream that I experience frequently.  I always wake because I’ve acted out what I am doing in the dream – ie., I am flailing about as I ‘fall’.  According to the article, this dream could represent repressed despair or anxiety, with the subconscious using the dream to express “the threat”.

In all honesty, that probably proves that there’s nothing particularly revelatory in this piece but nevertheless, it’s worth having a quick look at.

Meaning of Dreams and Nightmares: Analysis of Symbols and Images in Dreams Can Uncover a Hidden Theme

My descent into complete madness continues, ironically – I am convinced – as a result of anti-psychotic medication.  I am fairly certain that I am experiencing, and have been experiencing, the phenomenon of akathisia.

It is so difficult – impossible, I believe – to describe this thing of complete awfulness in any coherent or accessible way, but let me try.

I can’t stay still – I am experiencing severe anatomical discomfort, from the very core of my physical being.  I keep trying to move to combat it, but it never quite seems to work; the discomfort simply moves, or wasn’t where I thought it was.  Breathing is difficult, as if perpetually on the verge of a full-blown panic attack.  I am incredibly anxious and am almost completely consumed by a sense of terrified foreboding and/or danger.  Even that feels physical, which I know doesn’t make any sense, but I don’t know how else to put it.  Concentrating on this post (and anything else) is profoundly difficult.  My mind is racing – the pressure inside it again feels physical.  It literally feels like it is going to explode and on top of that, I keep feeling ‘zaps’ in my head (and elsewhere at times), a bit like if I had missed a dose of Venlafaxine, only much worse in severity.  I want to scream and shout and run around and bang my head off the wall and stab myself and cry.  Earlier I considered going to the petrol station, with a view to purchasing flammable liquid to set myself on fire.  Extreme perhaps (well…there’s no ‘perhaps’ about it, I suppose), but in a way I cannot explain, even the indescribable agony of burning (normally one of my room-101 style fears) seems preferable to the indescribable somethingness of this.

In a sense this could be described as a mixed episode with anxiety or something.  It is a bit like that, I suppose, except that it’s more.  So much horribly more.  It effects every conceivable part of me; mentally, physically, everything.  It burns through me, every vein, every nerve – it feels like much more than a mixed episode (as if they were not unpleasant enough), but in a way that has a very elusive and unobtainable description.

The aforelinked Wikipedia article on akathisia quotes some bloke called Jack Henry Abbot, who describes this horrific state much more eloquently than I have or can:

These drugs, in this family, do not calm or sedate the nerves. They attack. They attack from so deep inside you, you cannot locate the source of the pain … The muscles of your jawbone go berserk, so that you bite the inside of your mouth and your jaw locks and the pain throbs. For hours every day this will occur. Your spinal column stiffens so that you can hardly move your head or your neck and sometimes your back bends like a bow and you cannot stand up. The pain grinds into your fiber … You ache with restlessness, so you feel you have to walk, to pace. And then as soon as you start pacing, the opposite occurs to you; you must sit and rest. Back and forth, up and down you go in pain you cannot locate, in such wretched anxiety you are overwhelmed, because you cannot get relief even in breathing.

(c) Jack Henry Abbott, In the Belly of the Beast, 1981

That about sums it up, and yet it doesn’t, because it can’t be summed up.  There are no words of magnitude great enough to describe this, or so it presently feels to me.

I could stop taking the anti-psychotics, but what if ‘They’ start being all volatile again?  What if the gnome shows up and turns out to be some sort of manifestation of the evil ‘They’, or some equally belligerent being?  I am utterly terrified of what could happen if the hallucinations are allowed to continue to develop, and to that end I am fairly sure that I will just keep taking the tablets – though I may have to raid my stockpiles of Diazepam and Zopiclone to help me from completely losing the plot (as if it wasn’t lost enough!).

It is possible that it will pass (isn’t it?) – 300mg of Quetiapine, whilst not a terribly high dose overall, is quite high for a starting dose.  Maybe my body will inure itself to the drug.  I do hope so, because this is unbearable.

I’ve been incredibly whingy on this blog of late.  I’m sorry.  I suck.  On the bright side, I might have found myself a group of suitable psychoanalytic therapists to help to try and make me sane when C condemns me to my dubious fate in a few months.  But it’s hard to think beyond right now at the minute.  I’m sorry.

Thanks, anti-psychotics.  You’re doing a fabulous job.  I’m still actively suicidal, fighting every second not to give in to my overwhelming desire to top myself, and now, as well as hearing ‘They’, I’m seeing fucking gnomes walking down the street, and strange shapes floating past my direct vision.

The gnome ignored me, like.  It just walked past, without even making eye contact.  I could have sworn it was real, but A (who was there at the time of the sighting) assures me that that is not the case.  Rational Me accepts that, I suppose, but it was so desperately convincing.  It wore a vibrantly coloured outfit consisting of a green hat (with a white bauble at the end), a red blazer and blue trousers.  A foot-high walking rainbow of sheer vibrancy.  It had a little white beard; one of those ones that sort of goes into a point underneath its chin and which was devoid of the mustache element.  It had a thin, almost gaunt, face, and walked along with its hands firmly nestled in its pockets (I resisted the urge to write “…its handses…in its pocketses” just there.  This is like something out of Lord of the fucking Rings).

The gnome didn’t look too happy, as if maybe it was having issues in its life.  I wonder to what extent its personal difficulties were compounded by its strange, etheral job of going about ‘haunting’ psychotic mentals like me.

What does it mean?  It wasn’t real, was it?  If not, why did I see it?  Why???  Previous hallucinations have, in general, had purposes – mostly nefarious, admittedly, but purposeful nevertheless.  But the gnome just walked past me.  I don’t have any particular fetish for gnomes, for Christ’s sake, and only give them any thought when the subject comes directly up, which as you might imagine is not frequently.  It is a bit of a niche interest, let’s be honest.

I saw the gnome on Thursday night.  Despite the subject matter of yesterday’s post, I hadn’t slept at all on Wednesday, stupidly having forgotten to bring my medication with me to my mother’s (where I stay the night before each Thursday morning session with C).  It could, therefore, have simply been a bizarre product of insomnia.

But I don’t think so.  I’m so completely used to insomnia lasting weeks, and it’s only after such lengthy periods of sleep deprivation in the past that I’ve become even remotely psychotic.  Irritable, lethargic and depressed yes, but not psychotic.  So surely one night alone surely couldn’t have done it.

It could be simply the change-over in anti-psychotics, I suppose, but that too seems unlikely given as, relative to the dose of Olanzapine, the dose of Quetiapine is so much higher.

Other weird stuff has been happening since the gnome was observed by me.  I keep seeing shadowy shapes slide past me, just within the range of my peripheral vision.  At first I thought it was the cats, but I ruled that out very quickly.  One or two examples of this wouldn’t remotely concern me, as there are surely a million and one everyday explanations for such nebulous sightings – but the sheer frequency of these occurrences in the last few days seems to me to be more than coincidence.

I genuinely want to cease to be.  I spent basically all the 50 minutes with C on Thursday (I’ll try and write about that tomorrow or Wednesday, not that there’s much more than “I want to die” x ad infinitum to say) yelling at him that I wanted to die, and I do; I really, really do.  And now my descent into madness seems less gradual than it previously did.  I genuinely don’t know what’s real and what’s not any more.  I fear for the future, if indeed I have one.

In the last few days the title of this blog has become something of a misnomer.  Ha – no, I’m hugely playing it down in saying that – it is a complete misnomer.  I am not anything even remotely approaching an insomniac.  I am afflicted with a severe case of hypersomnia, sleeping as I have been circa 18 hours a day.

One cannot win in this quest for a “normal” level of soporific unconsciousness.  During long, bleak nights of seemingly endless insomnia, I begged whatever higher powers may or may not exist for sleep of the magnitude that I am now experiencing.  But now I realise that this is not such a fortunate state either.  Aside from the complete and utter waste of a life that such lengthy periods of slumber represents, the unconsciousness itself is not entirely pleasant.

I crave restful, deep, peaceful sleep.  For God’s sake, I need restful, deep, peaceful sleep.  But will my mind and body play ball?  Will they fuck.

The quality of the sleep is absolutely pathetic.  Of the approximate 18 hours that I am spending in the land of nod, I would estimate that 16 or 17 are spent in that most irritating of states – the doze.  Dozing has its place, of course, but as the staple of one’s sleeping diet, it hardly allows for desired levels of daily functioning.  What’s more, because it’s not a deep sleep, it allows for dreams.

Thankfully, I have generally not been especially prone to nightmares, except as a result of medication, and indeed I could probably not say that the current dreams are nightmares as such.  But they are incredibly and grotesquely vivid and real, and I would say they even encompass more real-world awareness than one should expect when supposedly asleep.  I don’t remember them after I wake, though I recall general points of some.  All I know for certain is that they leave me disturbed, confused and in a cold sweat.

I know I shouldn’t be complaining; getting any sleep is better than none at all, especially when all my waking hours are totally consumed with the words, “I want to die” being played in a constant loop in my mind.  But it’s not fair on A that I am such non-existent company, and it’s not fair on me that I have to endure this barrage of torturous mental images daily and nightly.  Well, actually, it’s perfectly fair on me as it happens; I deserve it.  But that doesn’t mean I have to like it.

I attribute the hypersomnia to two main factors.  One is that I am in the middle of a major depression anyway, and hypersomnia is well-known in that state (though of course so is insomnia).  Secondly, and perhaps even more pertinently, this could well be a reaction to Quetiapine.  One of its key side effects when one first starts taking it is sedation.  When I was first told of that, I was of course very glad.  I thought it would behave, vis a vis sleep, just like Zopiclone or something – it would knock you out overnight, but leave you mostly OK the following day.

But sadly it was not to be.  Anti-psychotics are, of course, infamous for spacing people out, not for bringing about a restful sleep and here we are; that is what it’s done to me.  I am assured it will pass, which is something to be grateful for, but of course my concern  in that regard is that then I will simply see the reinstatement of my trademark chronic insomnia.  That would be distinctly unwelcome.

So meh.  It’s either a famine or it’s a fucking feast.

There were a number of interesting psychiatric / psychological articles upon which I happened this week, but only one really stood out, probably simply because I have a strong interest in the subject matter.  The article comes from Psychiatric Times (PT) and discusses the phenomenon of stalking.

The comprehensive article discusses a range of factors pertaining to stalking, one of the most interesting for me being the statistical profiles of offenders.  I was interested to note that PT cite a high rate of cluster B personality disorders in perpetrators.  Of course, on the surface, one might have expected a high incidence of anti-social personality disorder, but this illness is not singled out, so one has to wonder if diagnoses such as BPD are prevalent also.  Great!  (Not, obviously).

In line with generally accepted statistics, the article suggests a high rate of offenders being known to their victims.  Another interesting discussion is on classifications of stalkers; I should have assumed that such categorising was logical, but nevertheless this information was news to me.

Finally, there is a short discussion on the best way a therapist or psychiatrist can engage with the offender, including a case study.

This is a fairly long piece, and parts of it are quite heavy on statistics, but if you’re interested the area of forensic psychiatry and psychology, it’s a satisfying read.

Stalking: The Veiled Epidemic

Right. Red Bull substitute imbibed; chocolate, #jaffacakes and sweets ingested; curtains open for the first time in days. I’ve been hopelessly procrastinating in an attempt to avoid writing this – not because it’s a particularly difficult entry, just because the inertia and black dog of yesterday are very much still in evidence. I’m finding myself, even after these couple of lines, getting distracted by stupid things, but bollocks to that; I’ll try typing this crap anyway.

I had been dreading this session, being as it was the first meeting since my woefully failed suicide attempt. I had catastophised the whole thing to death, and was fully expecting to hear some shite about how trying to do myself in “broke the therapeutic contract” (not that he’s ever discussed suicide in that context) or that I was too unstable for him to treat, or some such nonsense. Luckily, I got none of that. If anything, he seemed almost understanding, if desirous of pressing some issues.

The first ten or so minutes were even more of a waste of time than they normally are. I was determined I was not going to be the one that brought up the tale of my foray to Accident and Emergency, and it seemed that C was similarly determined. I stared out the window; he stared at the floor. I knew he knew where this was going, and he knew I knew. What’s more, he knew I knew he knew, yet no one wanted to make the first move. What a silly, pointless little dance of idiosyncratic decorum.

But! Eventually he cracked. Hahaha! Hahahahahaha!!! He told me he’d received a call from Psychiatic Liasion Woman, which led to a few muttered but inconsequential words from both of us, and then he started quite firmly (but simultaneously gently, if that makes any sense) pressing me on what I had done and why I had done it. I’m not going to dwell on it too much, as it was mostly all discussed in the post where I detailed my suicide attempt.

One thing of interest was that I became slightly euphoric when asked to recall the sensation of watching the blood flowing from my wrist. I expected C to be kind of freaked out by this odd manifestation of delight, but he actually seemed to understand it. He appeared to ‘get’ the idea that I felt calmed and reassured by the temptation of death, which when I think about it I suppose makes sense, as I’ve heard of a lot of people react like this to having made the decision to die, and are they not the very people he is likely to encounter in his line of work? However, C was interested in my reaction to the blood and injury, but his main concern was for why I had done what I had done.

Although he didn’t say it explicitly, I reckoned he was trying to get me to say that the nightmare of the previous week’s session had led me to it, and in fact I ended up telling him not to “flatter himself”, a comment which I think mildly irritated him (excellent!). I tried to drive home the point that I’ve been in a downward spiral for a while (since before Christmas), and that my wrist-slitting was based on a cumulative effect of recent months’ depression. But he kept on and on about why it had happened on the Friday specifically.

Why did it? His complete wankery the previous day (get in touch if you’re interested in the password) was probably a trigger point, I will admit it – however, he really is flattering himself if he thinks it was the only factor. I just wanted to die. It all got too much, and it happened to be last Friday night. It’s as simple as that.

He said, “do you remember saying last week that you didn’t know what you had to do to make us [him, Psychiatry, other such cunts] realise how bad things were for you?”

Fuck. I had forgotten about that, but say it I did. So now I’ve been branded an attention-seeker, have I? I asked him.

Of course he refused to answer the question, instead turning it around into, “were you given the impression that you were thought to be a time-waster?”

I don’t know. Isn’t that what all the mental health professionals think of people with a diagnosis of BPD? C may go about saying it is me as opposed to BPD that comes into his office each Thursday, but does he really believe that?

The rest of the discussion ended up focusing on the previous week’s session, which sounds like it was a load of navel-gazing rubbish, but in reality I think it tackled and possibly even resolved some stuff that was festering. I was honest with him for once and told him that I had found him hostile and confrontational in the session in question, and that that was offensive to me.

To my surprise and gratification, C replied, “I can see how you could have thought that.” His tone was slightly regretful, I thought, as if he realised he’d fucked up a bit. This pseudo-admission of guilt is probably the closest I am likely to get to an apology from him.

Realising he was taking some responsibility for the preceding session’s abject failure, I ranted at him for accusing me of alienating people when I tried to assert myself. “I don’t think that’s fair at all,” I protested.

He nodded, apparently accepting this was something of a faux pas. “You think I’m guilty of a huge generalisation?” he asked.

“Yes. I don’t take well to people making unfounded blanket statements about me.”

Without missing a beat, Dr Smartarse said, “yet you’re the first one to make them about yourself.”

Bad-um-tish! 10 points to C. Quite right. I was uttery backed into a corner by this and didn’t have a half decent response, so instead of attempting to cultivate one, I ended up laughing, oddly impressed by his having caught me out.

“You’ve got me there,” I conceeded.

C said that he wasn’t trying to “outsmart” me, which I didn’t believe he was as it happens. He had simply achieved a state of outsmarting without any conscious effort to do so.

He said that I had left his room on the verge of tears the previous week, which I don’t remember particularly, but I didn’t argue with him. I said that I had been intensely frustrated by his insistence on harping on my reaction to his decision to end therapy after another 20ish weeks. I told him that I thought such repetitive discussion was largely pointless and just avoided all the issues for which I am in psychotherapy in the first place.

He insisted that the discussion in question wasn’t pointless, at which point I chimed back in saying that I accepted it was not completely without reason, but that I thought his “complete fixation” on the issue was unhelpful.

To my astonishment, C basically acknowledged that he could see why I perceived him as fixated with exploring this issue. However, he stated that he was still keen to explore it as whether I like it or not, it is an issue that has to be addressed.

I decided to make the most of the opportunity and tell him of another frustration. “I’m pissed off that you all seem convinced that my concerns surrounding the end of therapy are all about transference issues,” I sighed. “I’m not saying that’s not an issue – but it is certainly not the only one.”

“I don’t think I’ve implied that,” C replied. “I think there’s a lot more to it than that.”

“OK, well, I’m glad you do, but the psychiatrist apparently doesn’t think so,” I said, in reference to a discussion I’d had during my appointment with NewVCB the preceding day.

He tried to assure me that he does not think that. He agrees that transference is certainly something that is in play here, and that that needs to be explored, but that I had a number of completely rational reasons to be angry and frustrated. I’m glad someone fucking realises it, though of course his reticence to do anything about it is another reason to make me mad.

Noticing the time, C decided to change the subject, stating that this was an issue that we may have to come back to. He asked me how I’d gotten on with the new psychiatrist.

I responded by telling him about the medication change.

That was only part of what he was fishing for, of course. He wanted to know what I actually thought of the woman.

Rather than give him a straight answer, I said, “well, you’re obviously friends, so I could hardly slag her off if I didn’t like her, could I?”

He said, “you said you didn’t like VCB.”

As it happens, what I actually said was that I “wasn’t VCB’s biggest fan”, but I decided against splitting hairs.

“Yes,” I admitted, “but it was obvious to me that you didn’t know her especially well.” I wonder what he thinks of the fact that I have made these pathetic litte observations.

He nodded (I knew I was right), then I decided to give him what he wanted and admit that I thought my relationship with NewVCB was potentially “more workable” than that which I had shared with her predecessor. This sated him – or maybe it was the fact that the session was over and he could get rid of me for another week, as out came that old line of “we’ll have to leave things there”.

I got my bag together to leave, but he stopped me and said, “look, on this issue of ‘flogging a dead horse’ [which is what I had consistently called his fixation on the end of therapy]. I accept what you’re saying, but we can’t just ignore it you know.”

“I appreciate that,” I acknowledged. “I just don’t think it can be all we discuss for the next 20 weeks. All I’m asking is for you to meet me half-way. Please?”

He contorted his face in a gesture of acceptance, and finally nodded. And that was that for another precious, time-limited week.

Well, I’m sorry this was such a shite write-up of this session, but it’s the best I can do whilst writing from the metaphorical bottom of a pit.