What triggered it?  It’s stupid, really.  All that happened was that A decided he would clear out two big boxes in which I throw things – either for hoarding purposes, or because I can’t be arsed dealing with them.  What a preposterous, utterly ridiculous thing to induce a panic attack.

I feel dreadful.  I feel better than I did 10 minutes ago, but I still feel dreadful.  My head is fuzzy; nothing seems real – not me, not the world.  Ah, depersonalisation and derealisation, my old friends.  Welcome back.  Not.  You have not been missed.  (NB. These states are not induced by the Diazepam; I felt this way before I took it).

My chest is still heavily constricted, and I find myself forced to take long, slow breaths in order to obtain any at all.

I have a vile, flat, metallic-y sort of taste in my mouth.  Slightly salty, a little watery.  Tingly.  It wasn’t there before this attack, but it is a sensation I know intimately from other occasions.  There’s something at the back of my throat; it’s as if something is trapped, like I want to gag.*

The hypervigilance that characterises some of my C-PTSD symptoms is here in droves that are comparable to armies.  The TV, my medication alarm, even the distant sound of one of the cats stirring quietly in its sleep is sending me into cosmic levels of freak-out.

I feel a repugnant nausea to my core and my nerve endings are alert to the point where my skin is actually sore to the touch.  It’s compounded by a sense of inner restlessness that is essentially and atrociously unquantifiable (although I suppose it slightly reminds me of akathisia).

I’m horribly irritable, shrieking mindlessly at things for no reason and banging around the place like some sort of bloody barbarian.

Oh yeah, and there’s the whirlwind that my thoughts and cognitive processes presently are.  I am trying to work out what has triggered this batshitiness.  Paedo and his depravity keep entering my mind, but that makes no sense.  Something as inane as this has nothing to do with Paedo.  A spring clean [I cut off here mid-sentence when that phrase suddenly resonated in my head.  I was going to write 'a spring clean has nothing to do with any of what he did to me'.]

No, wait!  ’A spring clean’.  A spring clean.  That rings a bell; that most ordinary of phrases for this most ordinary of acts rings a bell about something deeper, something darker.  I can’t work it out completely, but there are hazy images somewhere in here of my aunt talking about ‘spring cleaning’ and of her husband’s wrinkled, grey, perhaps even expectant face hovering about at the edge of my peripheral vision.  I don’t remember anymore.  But there’s something there, oh yes.  Something.

Fuck.  FUCK THIS!  FUCK IT TO THE ENDS OF THE EARTH AND FUCKING BACK AGAIN AND THEN FUCK IT SOME MORE.

I hate that I still don’t remember all of this stuff, I hate that I dissociated so much of it away.  I feel like I have no control of triggers, of life events – fuck, of life itself - if I have no conscious recall.

The attack also acutely reminded me that this is far from the first time I have reacted in a similar fashion to simple, everyday clear-outs and clean-ups.  I recoil in horror when my mother asks me to examine my remaining possessions at her house.  I have vague memories from when I was growing up of being constrained by overwhelming and indescribable disquiets every time she asked me to clear out my wardrobes, under the bed, the toy cupboards or whatever.

Indeed, the two boxes that A was clearing out tonight have sat in the kitchen looking at me and demanding my attention for the past week, and I have quite deliberately avoided dealing with them.  As I always do.  Always.

I had never realised before this day, this hour, how much of a pattern this avoidant behaviour is.  Even if I had, I suppose that I probably would have thought little of it beyond my self-confessed laziness.

But…can this really be about child abuse?  Seriously?!  I mean, that’s…well, it’s insane.  Hazy memories or otherwise of some afternoon in Hotel California** aside, I can’t see the connection.  It’s silly.  Occasionally clearing things out of one’s abode is a normal part of life, unless you are some sort of minimalist (which I most certainly am not).  Why do I make everything about my being mental?

I remember the mixed states I used to have before I started taking Seroquel (which, perhaps ironically, were similar to the akathisia that Seroquel ((mercifully temporarily)) induced!).  They were similar to this.  God.  Eugh.  How awful.  I had forgotten just how utterly unbearable these sort of sensations are.  If I never experience a mixed state or anxiety attack again it’ll be far too soon.

Things from the boxes adorned the seat to both my left and right.  I gathered them up and put them in a bag and hid them, which is exactly what I was meant not to do.  But I just couldn’t look at them.

Fuck it, I’m too away with it to continue this post.  Now I want to cry and hide under the bed and be away from everything – not exactly pleasant ways to be, but it’s better than the restless, overpowering anxiety of before.  I apologise for rambling and whinging and probably making damn all sense, but at least the composition of this post seems to have given me some sense of perspective on why this unpleasantness occurred, daft and all as that reason may have been.

* Based on this description, perhaps my eventual conclusions about this being sexual abuse-related are hardly surprising.  Hmm.
** Hotel California is what I call Maisie and Paedo’s house, if you don’t already know.  This is because you can check out but you can never leave.  Google it if you’re too young to get the reference

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.

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.