BPD » Confessions of a Serial Insomniac

Ending Therapy: How To (Mostly But Not Entirely) Do It Properly – Paul: Week 25, Part II

Nexus, Paul, Psychotherapy, Recovery, Sexual Abuse, Traumatic Stuff 3 Responses »

Oct 282011

This post is continued from here. What follows will not make a great deal of sense unless you’ve read that first; however, it mostly likely won’t make a great deal of sense if you have. I disclaim any culpability for the boredom, confusion and irritation at the mammoth self-indulgence that you will find in the forthcoming. If you want to ruin 20 minutes of your day by continuing to tolerate this complete and utter nonsense, then you do so at YOUR OWN RISK. Now, rather than bother with this bullshit, why don’t you have yourself a nice pint instead?

—

After a contemplative silence, Paul moved back to discussing my writing projects; he wanted to know what they were about. I was forced to admit that everything I have been doing in this sphere has been about mentalism. Even my proposed novel is going to be about mental health issues.

I defended the piece for Rethink on the grounds that it is about my recovery from borderline personality disorder. As I stated to Paul, there is a false perception that BPD is incurable and that, furthermore, there are a billion myths out there about how people with the disorder can’t have loving relationships, or that they’re abusive, etc etc, ad infinitum (Zarathustra noted that I’d debunked some of this bullwank in my writing of this blog, which I hope is true). In that way, I think that article was a very important one to write, because these fallacies need to be corrected, and people afflicted with BPD deserve to have some genuine hope of recovery.

However, as I’m sure many of you will agree, living a life narrative entirely dictated by one’s mental illness is a potentially dangerous idea. I should, at least sometimes, write about normal stuff (insofar as anything is ‘normal’). I told him that I was considering resurrecting the Not as Smart as Pandora Braithwaite blog, which had once been my haven to bang on about telly, the arseholery of Facebook, gaming – normal things in which I take an interest, rather than being devoted to the exclusive domain of mental health or the lack thereof.

Indeed, at about the time of this session, when I was feeling so much better, my prolific posting here on Confessions went notably down. This was because I was living in that fabled place called real life and, y’know…doing stuff.

“Well,” he said, looking piercingly over his glasses at me, “I take what you’re saying, and mostly agree. But you don’t want to be too sane in your writing. That would see you suppressing that pained part of yourself yet again.”

Ha. Would it really. I don’t often use this blog to ‘let loose’ with feeling and emotion, and I am certainly not going to do that with any published pieces. That is just not me.

Rather than labour the point, though, I returned to my old favourite Freudian dictum about the transition from “hysteria” to “ordinary unhappiness.”

To my considerable consternation, Paul started quoting that arsehole R.D. Laing whose tolchock, were he still alive, I would take pleasure in punching. Paul claims that, as per Laing’s advice, he suspends his concept of normality when working with clients. At some point or another, he also alluded to Adam Philips and his book Going Sane. In short, he was blathering about how we are all mad in our own way. Laing-hatred notwithstanding, I did have to concede that point to him.

“The problem I face,” I sighed, “is that I have been out of work for so long now that all I know is mentalness and the pertinent issues surrounding it. It has entirely become my life, yet people in the real world don’t care. They don’t spend their days talking about psychosis or manic depression or borderline personality disorder. They talk about the weather, last night’s shit TV, politics and salary cuts. They don’t care.” I briefly (and anonymously) alluded to a post that Seaneen had written on this subject (a second excellent article she wrote on the issue for One in Four can be found here).

Seaneen is still highly involved with organisations like Rethink, but her own mental health is not the sole kaleidoscope through which she sees life these days; her life is about her boyfriend, her family and friends, and her mental health nursing course, which is an amazing thing, and something to which to aspire. Could it ever be that way for me, though? I have no idea, but one thing I do know is that I have a right gob on me, and whether normals care or not, I will end up talking about mentalism. I mean, I just won’t walk into a room and go, “hi, my name’s Pandora. Yours? … Nice name, I like that. Anyway, I’m mental. … No, I mean really mental. I had borderline personality disorder and still have manic depression and complex PTSD with psychotic and dissociative features. … Hey! Where are you going? … What did I say?!” No, obviously not like that. But if someone says, “where did you get that scar from?” or “so, what were you doing before I met you?” I am going to tell them the truth (see my posts on speaking up here and here).

Having babbled all that out, I concluded my monologue to Paul by saying that although I’m not sure about the accuracy of the perennial ‘one in four’ statistic, that at least it serves as a sort of motif to highlight the prevalence of mental health difficulties in society. “So why not speak up?” I pondered. “Fuck stigma. Fighting it is my cause célèbre.”

He said, “I work five days a week, and I’m off for two – so I get a break from the intensity that inevitably comes with my job. You, however, never get a break from your mind.”

I nodded pointlessly.

He went on, “so wouldn’t it be nice if you could not be mental for, say, two days a week?”

I nodded pointlessly again.

“So…could you take a break from your cause célèbre for a couple of days a week?”

Of course I can. I already do. I don’t spend every single sodding day trying to play some sort of omnipotent mental health ~~warrior~~ advocate. However, that does not mean that I can somehow turn off my mind during those non-advocacy periods, as his penultimate comment had insinuated. If it were that simple, I would have no mental health problems at all, would I?!

Nevertheless, he asked me in what activities I could engage that did not pertain to madness. I monotoned out the usual list you might expect to see on the ‘what are your interests’ section of a social network or dating profile. For some reason, that led to a short discussion around my frequent disconnections from the world at large – how I push this laptop away, religiously ignore my phone, and hide alone in my living room, pretending that no one else exists.

I shrugged. “That’s not healthy, is it?”

“There’s a fine line there,” Paul replied, cocking his head in muse. “Overall I think that whether or not it’s healthy, it’s more normal than not – but I suppose it depends on the extent of it.”

“You see, I struggle with this a lot,” I complained. “If you will permit my use of psychiatric parlance for once, where does pathology end and idiosyncrasy begin? Or, indeed, vice versa.”

As you know, most darling readers, I’ve been grateful for my diagnoses, and have found having a name for the various aspects of my insanity to be helpful in several ways. However, I still think this issue is a very valid criticism of the practice and more general discipline of psychiatry. I suppose the line is where the ‘idiosyncrasy’ becomes distressing to the ‘idiosyncrasist’ (indeed, for this reason, there is an ongoing debate about the validity of schizoid personality disorder as a discrete condition), but even that line can be blurred.

“My wife has a great-uncle that the family frequently describe as ‘eccentric’,” Paul told me. “When they mentioned it in front of me, I responded by saying that that simply meant that he was mad, but with money.”

I laughed. A fair enough assessment – most people I’ve heard described as ‘eccentric’ would broadly fit within that bracket.

Anyway, he had reminded me of a conversation I’d once had with Mike, my erstwhile teacher. For some reason Mike and I had been talking about how well (or indeed badly) we fitted in with social norms, and I characterised myself as, indeed, “eccentric.”

“No, Pandora,” he’d responded. “Not ‘eccentric’. You’re individual.”

Paul liked this little anecdote. Apparently Mike’s “eloquent” distinction had touched upon Paul’s perceived truth that psychiatry involves a certain amount of repression of one’s individuality. He banged on that sanity and insanity are concepts created by times and places.

He’s right – to a point. Psychiatry is an imperfect science, if indeed it can be said to be a science at all, and if we consider the inclusion of homosexuality as a mental illness as recently as the DSM-III, I can agree that some supposed diagnoses are societally constructed. Despite my general support for this field, I do accept those criticisms of it, and have never denied them. But, as I said, there’s a point, surely, when that can no longer be true. I’m told, reliably so, that hallucinating gnomes and being so severely depressed that all you can think about is killing yourself on a chronic basis are not normal states in which to exist…and I would believe that that, at least, transcends times and places.

Not that I had the balls to say any of that to Paul. I sat there, nodding pathetically compliantly. What the fuck, Pandora? Am I afraid of him unwitting me or something? Of looking less intelligent than him (which, frankly, I probably am)? Why can I debate my points intelligently and coherently online or even in the fucking pub, but not do it with Paul? What a stupid bitch.

As I allowed his anti-psychiatry rhetoric to progress, I found myself becoming vaguely irritated with him again. Not because of his opposition to that field per se, but because of how he related it back to me. One thing that had apparently been “big” in his engagement with me had been “peeling back the layers” that were “enforced upon” me: diagnoses, medical examinations, medication.

“It’s like it’s been forgotten,” he intoned with an infuriating earnestness, “that somewhere in there is an abused little girl.” [Emphasis mine. I am SO unutterably fucking sick of that fucking fucking fucking term. Jesus hot jumping Christ sliding down a shit-stick. Just. Fucking. Stop. Fucking. Calling. Her. Fucking. That. GAH!]

(Hypocritical) Ranting about terminology aside, this assessment of my situation was not fair. NewVCB has been really good about the abuse bullshit; she usually asks me at some point during each appointment how things are in my head in relation to that subject. She doesn’t just wank endlessly on about my current symptoms, blindly throwing medication at me as a result. OK, so she doesn’t go into intimate, cringe-worthy detail about the whole sordid mess when I’m with her – but guess what, Paul? She isn’t fucking meant to. That’s your job. You’re the therapist, she’s the the psychiatrist. Simple.

More irritably than I’d intended, I retorted that I had not been a “nice little girl,” as he appeared to opine. As I said, “I was precocious, and because of that I was haughty and arrogant at times. In that way my current predilections toward so-called intellectualising are entirely in keeping with my child self.” My point in saying so had been to infer to him that this constant bollocking on about me v my repressed self was not as clear-cut as he might like to think.

He hammered on for a bit with a story he’d told me before. Little boy falls in the playground, maintains a stiff upper lip all day long, eventually sees his mother and then bursts into tears. Containment, blah de blah, yadda yadda.

“It’s a harsh judgement to describe yourself as precocious. You had to be precocious to survive,” he declared.

Oh really? I mean, seriously?

This particular elucidation implicitly suggests that being precocious is an inherently bad thing. Why the fuck should that be the case? Surely being an intelligent child is something to be welcomed, something that both that child and those around it should find gratifying?
I can’t prove anything, but I’d be stunned if precociousness and abuse are directly correlated. I’m all but certain that not every smart child has been/is being abused, and I’m equally sure that not every abused child is demonstrably highly intelligent.
On a related note, why does everything have to come back to abuse and spurious psychodynamic interpretation? Can’t some things just fucking be?

Palpably uncomfortable with the direction in which this conversation was headed, I tried to shift the subject – but I did it subtly, so that it was still ostensibly related to what he’d said. I said that, in a non-literal sense, from what I could remember I had been a Jekyll and Hyde type of kid. The weird, insular one that despite her then-popularity couldn’t relate to her peers – and then the ordinary, outgoing person that most of the world saw.

“I don’t recall having any distressing examples of mental illness until at least my late childhood,” I told him, though now that I think about it, that can’t be true. I tried to strangle myself when I was nine, and I had that constant, horrid somatic feature of itchy feet with such sickening frequency – so evidently some shit was definitely hitting some fans there. But then, I have so many anamnestic gaps when it comes to my brathood that I can’t easily tell you what the conditions generally were.

“In retrospect,” I continued, “obviously I was a bit barmy – I mean, I lived nightly with pseudo-hallucinations and a delusion that a terrorist was right outside my door, every single night. But I don’t recall being chronically unhappy.”

Paul jumped on the terrorist comment with a force that could turn this metaphor literal. He said, “‘terrorised’ is a pretty good word to describe what you must have felt about the abuse, isn’t it?”

It depends whether you subscribe to the etymological or legal definition of the word ‘terrorism’, I suppose. Me, I tend to view terrorism as a macro phenomenon, ostensibly carried out for political or religious reasons (but really carried out simply because you’re a fucking cunt). It’s all very well for Paul to draw parallels between Paedo and my horrified dread each night that I was about to be murdered, but perhaps he forgets my age and my origin. I grew up in Northern Ireland in the ’80s and early ’90s. Terrorism was a very real issue here and then. Could there not be some connection to that, rather than everything always being about being a paedophile’s plaything?

“I’m reminded of a client I used to work with,” he said, as I sat there wondering silently when he might realise that not everything should be narrowed down to Freudian analysis. “When he first properly started communicating with me, he said, ‘I’ve put a bomb under your car’.”

I regarded Paul with an expression of complete revulsion. What a vile thing to say – especially to someone who’s meant to be helping you!

“It was his way of saying, ‘how would you feel if your life were threatened?’” Paul explained. “He had to find some way of expressing how his deepest fears affected him, and that was it.”

Maybe so; I can understand the context of the remark, I suppose, but it feels re-abusive to me – and much as I sympathise and empathise with any abuse victim, re-enacting what happened to you by abusing another is not on in my book (there’s a lot I could say on that, but this post ((and its predecessor)) is ((are)) already stupidly long and way too introspective vis a vis what it’s ((they’re)) meant to actually be discussing).

“In the same way, your most buried terror was expressed – perfectly appropriately – as fear of a terrorist,” Paul was continuing. “Do you remember when we first commenced this therapy that I told you that all clients are geniuses? Well, there’s a perfect example of it. That was a genius thing to do.”

Whilst there can be no doubt that the human mind is capable of great things, I’ve always been slightly uncomfortable with the assertion that it simply doing its unconscious job is something worthy of being considered ‘genius’. Surely genius involves intellect, which involves thinking, which surely involves conscious consideration? Still, I’m not a psychologist. A widely-read layperson, maybe, but by no means an expert.

“I firmly believe,” Paul continued, “that all delusional stuff is based in reason.”

I can see what he’s saying, to be fair, and I acknowledged that. The connection he was making in my case is at least arguable. However, what about the cases where a person believes that he or she is Jesus Christ or something? That’s not me rejecting Paul’s claims outright, by the way. It’s a genuine query; in all seriousness, where does that come from, and in what way would it be functional?

In any case, I went on to tell him that I’d gone through very little psychotic experiences in the couple of months that had led up to this session – a few whispers from fringe facets of the odious ‘They‘, but nothing more than that. Rather than simply be glad of it, though, he irked me a little by stating that he was sure that NewVCB would “chalk that up to the wonders of Seroquel.”

Again, this was unfair. As she had openly stated to me once, she only cares about ‘what works’ – and for me, that seems to have been a combination of therapy and psychopharmacology. Moreover, I would chalk my lack of psychosis up to Seroquel myself in many ways – but I’m willing to acknowledge that therapy has also played its part. What’s so terrible about a dual approach?!

He ranted a bit about how Seroquel in particular was being “handed out like sweeties” these days (first I’ve heard of it), but when I actually went to defend both it and psychiatric diagnoses – as useful adjuncts and guidance in the treatment of mentalness respectively – he curiously backed down.

And this is why he’s not a dick. We may disagree, and I may rant here about issues over which there could have been minor conflicts, but he’s not a dick. Ultimately, despite some of his more sarky reactions to my defence of psychiatry in the past, he is willing to respect me as an individual, with individual views. And while, in another time and place, the disagreements we have may have merited longer discussion, that was not possible here, and it was of the upmost importance to him – and me – that we parted on a convivial note.

And suddenly, that note of departure was finally realised. Paul said, his voice deep with regret,”we’ve come to the end.”

As I stood, he told me that it had “really been a pleasure” working with me, and that he would “truly miss” our sessions. I advised him that the feeling was entirely mutual, and went on to tell him that I intended to re-refer myself to the organisation come September or October (as I now have done). I asked if that was too soon, but he said that it wasn’t – as long as I was comfortable with that timeframe, then he was too.

“I look forward to working with you again,” he assured me, as he opened and held the door for me for the final time.

The last bits of these things are always the most awkward. How do you say ‘goodbye’ in a professional but affectionate manner? Rarely have I felt so horribly exposed as the socially awkward knob that I am. After handing him his pound of flesh, I suddenly grabbed his hand, shook it and said that it had “been a pleasure” working with him. Almost before he could respond, I smiled idiotically at him and told him to take care.

“You too,” he said unsurely, but with palpable warmth.

We said our goodbyes, and I left hurriedly. My car was close, and as I had done when things ended with C, I sat in the driver’s seat for quite a while ruminating on the ramifications of the (thankfully temporary) cessation of the relationship. Rather than bawl my eyes out though, I allowed myself to shed one single tear of mourning, then wiped my eyes, shot myself a reassuring grin in the rear-view mirror, and drove away.

Change of Diagnosis

Christine, CPN, Mental Health Diagnoses, Psychiatry 5 Responses »

Oct 042011

I finally saw my CPN, Christine, this morning. I say ‘finally’ as I had been meant to see her about – what? A month ago? Three weeks past? Something like that. I turned up on that occasion, early as usual, and reported to the CMHT/outpatients reception in the normal fashion. The bloke seemed a bit unsettled to see me, which should have been a warning sign that things were afoot, but then he told me to have a seat, as normal, in the waiting room. I dutifully did so.

And thus began the wait for which the term ‘waiting room’ was invented. To be honest, as soon as the allocated appointment time had been and gone, I somehow knew that she wasn’t coming – but rather than approach the reception bloke again and enquire as to Christine’s status on this plane, I just sat there rocking back and forth like the oversized bodybag of insanity that I am. Someone sat opposite me, curled up in her seat in a ball. Someone else sat to my right, shuddering and ‘ticcing’ with a remarkable frequency, as if afflicted by tardive dyskinesia (not such an improbable scenario in this realm, of course). I was struck by the obvious mental illnesses of all three of us: you might think that comes as no surprise in a psychiatric outpatients waiting room, but you’d be wrong.

In my two-plus years of attending the outbin, I’ve always been a little taken aback by how completely sane and normal most of the people looked – and then this makes me feel like a right stigmatising bitch. Mental health problems really aren’t that abnormal, and societal stereotypes on how people with such issues should look (foaming at the mouth, constantly existing in states of 1,000 yard-staring catatonia, running around wielding knives) are dated, inaccurate and sickeningly discriminatory. Madness can affect anyone – any age, any race, any gender, any religion, any sexuality, any class. It does not discriminate, and it can be well disguised. So why would I, someone who should have known better, have assumed that there must be a certain ‘look’ a mental must have, or particular behaviours he or she must present? Why does the the complete ordinariness of most mental health outpatients surprise me so? Because I’m a bigoted bitch, no better than the majority of the supposedly sane community who generally live in a similar ignorance – that’s why.

But I digress, as I am often wont to do. I knew Christine wasn’t going to turn up on this occasion because of the confluence of events in which (a) reception bloke had regarded me with an odd disposition; and (b) there had been a missed call from an unknown number on my phone earlier that day. No one had left a fucking message, though, so I did not consider it important.

Of course, it turned out that it had been the outbin calling me to alert me to the fact that some shit was hitting some fans in Shite Town, one of poor Christine’s unfortunate ‘community’-based stomping grounds, as poor reception bloke was forced to eventually admit to me. Not that I displayed it to him, but I was fucking irritated. Not with Christine – I fully recognise and accept that shit hits fans sometimes (especially in Shite Town…God, I hate that bastardhole with a passion) – but with her colleagues back at the bin for letting me drive all the way there when a simple fucking message could have saved me the petrol.

A secondary issue, of course, was that I was right in the midst of a major depression at the time, but meh. I was completely pissed about by (Old)VCB, but NewVCB and Christine have generally been very good in terms of seeing me, and have even afforded me the opportunity to contact them if I am in a non-crisis-team crisis – which, in de facto terms, means any serious (but sub-A&E) crisis, because it will be over my dead body when I ever deal with the bloody crisis team again.

Anyway, so it came to pass that this morning’s appointment was organised, and subsequently attended by both Christine and me. I was with her for about half an hour, which is relatively short by previous standards, but there wasn’t a huge amount of things to discuss. The poor cat had died since I last saw her, which was obviously rather a rather shit stabbing of fate, and it had come at a time when I was very mentally fragile anyway. Christine expressed what appeared to be sincere apologies for our loss, which I appreciated. Some folks say the words alright, but you can almost see them thinking, “but it’s just an animal..!” Others, of whom I’m guessing she must be one, realise that pets become your friends and family.

The odd thing is, apart from the first weekend after Ms Cat’s death, I think things have been stabilising ever so slightly. Obviously, one might reasonably assume that if one had atypical (AKA reactive) depressive symptoms, that such a horrible and untimely occurrence would have paved the way straight back into the depths of the abyss – yet in my case, it did not. It’s not because I’m cold or some sort of unfeeling droid – truly, I miss Ms Cat horribly and am horrified when I think about her being hit by that fucking car, her dying all alone in the middle of the road – but overall, putting a quite normal reaction to bereavement aside (and if viewed from an entirely pathological perspective), things seem to be ever so slightly moving upwards. This makes me feel smug. Why? Because I’ve been trying to tell the quacks for ages now that my moods are not reactive, and that my major depressions are clearly melancholic. What has happened in the wake of Ms Cat’s death exemplifies that well, to my mind.

Lack of a reactive mood suggests a lack of borderline personality disorder. I’ve discussed the fact that I don’t feel the diagnosis is relevant to me any more both here and here, in the latter case having made brief allusion to the issue with Christine herself. Today, I just came out and asked her: what the fuck actually is my current diagnosis?

The question was borne out of a discussion about mood stabilisers. As I had asked you lovely lot here, I so asked her about the pros and cons of Depakote and Lithium, both of which she actually seemed quite positive about. She must have seen some scepticism in my expression, because she asked me to articulate what it was that I didn’t like about them. I presented a redacted version of some of your responses to the aforelinked post.

“I know that’s a tiny amount of people compared to all of those that take these drugs, but still, I’m dubious,” I admitted. “What about Lamotrigine? I heard from various sources that it’s particularly good for depression.”

“Lithium and Depakote are the ones we most frequently use here,” she told me, “but yeah, Lamotrigine and [some other anti-convulsant-cum-mood-stabiliser whose name I have forgotten] are also used, and yes – Lamotrigine does tend to be good for depression. I know that [NewVCB] does recognise the severity of your depressive features. Would you say that they’re the most troublesome part of your illness?”

I thought about it for a moment, and then said they were certainly the most pervasive, which is undoubtedly correct. I kind of screwed up my face, though, because – although depression is a hell beyond the comprehension of those who have never truly experienced it – other symptoms I’ve experienced have been pretty ghastly too. ‘They‘ (especially on a bad day). The particular anti-delight that is the psychiatric mixed state. Insomnia. Fake Paedo and night-time peccaries. Dissociation. They all suck donkey balls that are bigger than I know how to quantify, but despite it all, I think that depression probably is still the worst of the whole sorry lot. It’s inutterably abominable.

For some reason, though, we ended up talking in some detail about my psychotic symptoms; Christine noted that whilst the psychosis had actually been pretty serious at times, that on most occasions it hadn’t been particularly prolonged (save for my ongoing GCHQ obsession, but then I don’t think that that is delusional. Those ~~nosy pricks~~ honourable men and women watch all of us: it’s simply a fact). This is true – in the past I’ve even suggested that my psychotic symptoms were perhaps transient and/or stress-induced, though as I continue walking this darkened path of lunacy and reflect on times gone by, I’m less and less convinced that any of it was (is) as simple as that. Either way, though, it has been uncommon for me to be verbally persecuted or delusional or whatever for long periods of time, as is traditional in the likes of schizophrenia.

One thing I told her, that I haven’t mentioned here for a long time, was that I missed Tom. Not all hallucinatory voices are malicious, y’know. Christine empathised; she says she has one particular patient that has an extremely settled and successful life now (hope, perchance?), but who really misses her voices which (like Tom) were killed by the anti-psychotics that, all things considered, the woman had little choice but to take.

Anyhow, that’s by the by, apart from my worry about reducing the Seroquel to 300mg and adding a mood stabiliser. This concern, as I observed in the appointment, was that even with a slow titration back down to the half-dose of the stuff, I would become psychotic again. Christine reminded me that when I had tried a self-inflicted hand at living on 300mg, that I had only had one day of psychotic mentalness – that the rest of those few weeks, whilst they appeared to have fucked with my mood, had not rekindled voices, paranoia, thought disorder and so forth. True enough, to be fair to her.

“So, maybe 300mg can work to prevent psychosis for you,” she said. “But yeah – I think the introduction of a mood stabiliser is a good idea to make up for the loss of such properties if you lower your dose of Seroquel.”

I nodded, also expressing my willingness to “just deal with the weight gain” if indeed it turned out, after all, that 600mg of the stuff was what I needed. She said that it was good that I had such a philosophical attitude to the whole thing.

“I suppose so,” I adventured, “but I’m going to be taking 300mg of Venlafaxine, 300mg of Seroquel and God knows what dose of a mood stabiliser. That’s a bit…well, mad.”

She shrugged, but not in a dismissive fashion. “If you had a broken leg you you’d put it in as big a cast as it required…”

“Oh don’t get me wrong,” I said, “I agree. I’m not at all one of those anti-medication apologists; the stuff has saved my life many times. It’s just a lot of medicine to be taking when…well, when supposedly dealing with a disorder for which NICE don’t recommend medication…”

Christine made some remark that seemed derisive of NICE, which left me feeling all warm and fuzzy inside. Then she continued by saying that, if I was referring to BPD, then NewVCB was seriously doubtful about my having it.

Good! (Though let’s be clear: I do believe that I did have borderline personality disorder, though I never met the stereotypes so nefariously associated with same – but then, very few people actually do. So here I am – proof that it can be recovered from). But if BPD is no longer applicable, what are we all dealing with, then?

“[NewVCB] doesn’t like to discuss diagnoses with me,” I complained forlornly. “But I’d like to know.”

Christine nodded and said, “I’d say she’s about 90% going with – predominantly depressive, bear in mind – bipolar affective disorder with psychotic features.”

Of course, bipolar type II was always my differential diagnosis, but it now seems that they’re looking at type I. In a way, it’s curious as I’m pretty sure I’ve never intimately danced with a euphoric mania – indeed, (Old)VCB (who met me about four times and was therefore the consummate expert on the idiosyncratic nature of my personal psycho-neurology) stated that I definitely didn’t have bipolar I. However, if I have had mixed episodes – and I certainly have – then clearly, by very definition under the current editions of the ICD and the DSM, it must be bipolar I. I’d always shrugged that reality off: these things exist on a spectrum. I haven’t changed my view on that, but an elevation from II to I is not exactly a non-issue for me, partly because specific diagnoses may (or may not) affect one’s treatment. In that regard – and it’s as unfair as fuck, because the popular, sensationalised images of it are not accurate – not being seen as having BPD any more is a positive development, even though it’ll obviously never leave my files entirely.

Anyhow, there is a window of doubt in this apparent bipolar diagnosis. It is, to no surprise of mine whatsoever, potentially filled with schizoaffective disorder. Essentially, the difference between it and psychotic bipolar disorder is that the psychosis can occur outside mood episodes in schizoaffective disorder, whereas in bipolar (or psychotic depression), such symptoms are exclusive to either depressed or “manic” states (I use the scare quotes* here ((which I normally loathe loathe LOATHE)) because I feel the term denotes euphoria, whereas clearly in my case – if I do have this – then my “mania” is of the dysphoric variety). Given my inability to properly rise from bed in the mornings, it will come as no surprise to you to learn that trying to keep track of my exact state of mood relative to other symptomatology isn’t entirely easy. My sense is that I have hallucinated when fairly euthymic, but then euthymic by my standards could be a mild to moderate depression by those of another, and thus I feel unqualified to judge this objectively.

Oh yeah, and let’s not forget that I still have a number of elements of C-PTSD, regardless of whichever one of the other two conditions is predominant.

I rattle when I walk sometimes, what with all the tablets I have to carry about with me. And that’s going to get even worse! And lo, my poor brain must rattle now, with all these diagnoses in place to form description of it. But, although I know the terms aren’t important and that the actual treatment is, I still see value in diagnoses. I read recently – I can’t remember where, sorry – that the point of diagnostic psychiatry is communication. Without at least some guidance – to be taken with a pinch of salt certainly, but which can act as something of a sign post – surely all branches of medicine, even those in which spectra and classification-overlaps predominate, would end up jargonistic free-for-alls.

Diagnoses may not help diagnosees, but I still can’t see how not having them does either.

* On the point of scare quotes, actually. The verb ‘to label’ and its nominal, adjectival and qualifying derivatives are unlikely to be used synonymously with ‘to diagnose’ on this blog – but if they are, they are the only terms I will always put in scare quotes. I cannot express how much I completely abhor this usage of the word ‘label’. I hate it. I despise it. I feel repugnance and disdain and derision and other derogatory d words towards it (though, it must be noted, not those that use it!).

It’s not a rational objection, but please don’t kick me – we all have foibles, do we not, and this, sweet readers, is one of mine

—

Random real life aside – in the wake of Ms Cat’s death, we decided to get a new kitty quite quickly. This was a pragmatic decision based on Mr Cat’s future wellbeing. It became quickly apparent that he really missed Ms Cat; so did we, obviously, but human mourning takes time – does the same apply to felids? We know not. Had it been about us, we’d have waited at least a few months before getting another ~~female~~ cat, but on balance, we reckoned it would be better for Mr Cat if a new adoptive si~~ster~~bling came sooner rather than later.

So here she is! ShHe shall henceforth be known as Señoritao (Srtao) Gatao on this blog [EDIT: As you can perhaps deduce from all the strikethroughs, we thought the bloody cat was a female when we got it, but alas it's a bloke. We never intended to get another male; the possibility of territorial disputes was too unsavoury. But although Srto Gato annoys Mr Cat with his kitten ways, they actually seem to get on reasonably well. Thank Christ.]

Writing for the Rockstar CPN

Christine, CPN, Moods, Recovery 5 Responses »

Aug 022011

Sorry for yesterday’s pathetic rant. I’d initially made it a private post, but then decided to go ahead and publish it; what’s the point of a blog but for people to read it? That said, despite its moderate success (and as I am always harping on), Confessions is still written primarily for my own benefit, so I do still occasionally write private material, if I want to keep track of particularly personal issues. But by and large I like to have things available for others to read and comment on, as it’s a huge source of support and insight. Anyway, thank you for having the kind diplomacy not to tell me what a silly bitch I was being

I’m feeling a good bit better today. The Everythinger is still here and the house is still a tip of epic proportions, but I’m a bit more rested than I was. I’m not sure if I’ve mentioned it here before, but I suffer from relatively frequent migraines, and when I got up this morning I felt one coming on. I’m relatively fortunate compared to some thus maligned in that if I act quickly, I can sometimes prevent it developing into a full-blown, lie-in-a-darkened-room-for-three-days attack, so I threw 2,000mg of paracetamol down my throat (yeah, I know, I know) and told the Everythinger that I was going back to bed for a few hours. This I did, and though I still felt rough when I did get up, another dose of paracetamol (yeah, I know, I know x2) and a few minutes to myself seemed to curb the problem. Now the sun is shining, the cats are not being their usual indifferent, offhand selves and the Everythinger is working outside, so I’m feeling relatively OK.

Anyway, this was going to be about Christine, was it not? I saw her a few weeks ago, the day after I went completely doolally thinking that there were secret, governmental cameras all over the house etc etc. Frankly I was petrified of seeing Christine because I know she remains surprised that I’ve never been hospitalised for my psychotic difficulties. To be honest, to be sectioned in Northern Ireland it seems to me that you have to run at a psychiatrist with an axe and 13 AK47s (which is odd because so many of you in the rest of the UK and, indeed, other jurisdictions have written about how a mere idle mention of, say, suicidal ideation can see the quacks telling you to accept an informal admission or be forced into the bin), and since I am hopefully unlikely to ever do such a thing (I have no idea where to get an axe or even one AK47 anyway), I’m hopefully safe. Yet it was still a passing concern because Christine has mentioned it a few times in the past.

Anyway, as you can see from my continued bilging here, on Twitter, etc, I was not put away. In fact, I was very surprised by her reaction to my episode; yes, it was disturbing, she felt, and yes, it must have been very unpleasant for me (no shit), but given all that had been happening (the burglary, Aunt of Evil, not seeing my mother because of the presence of Aunt of Evil, etc), she felt that I was still doing remarkably well. She was of the opinion that because I had managed to retain some insight, however small that had actually been, and because the whole thing had been fairly short-lived, that it was probably a response to the stress I had been under, rather than a mentalist episode per se.

She did ask if I felt it was the start of something more, but I found myself rather inclined to agree with the sentiments she’d already expressed. Nevertheless, when she said that I was to contact her urgently should it develop into anything – even the following week, when she was on leave! – I was most reassured. I laughed lightly and said, “it’s nice to know there’s someone professional I can talk to if this all goes tits up.”

Christine cocked her head, and asked me if that had not always been the case. I wryly recounted a redacted version of a conversation I once had with C, my ex-psychologist (I’ve made reference to it here, though I can’t find the specific post on the session in question):

Pandora: Who am I supposed to contact in a crisis? I mean, no one has given me the number of the crisis team, no one has referred me to a CPN or social worker, my psychiatrist [OldVCB at the time; her successor is completely different] doesn’t want to know. So what am I meant to do when I can’t cope? Who do I contact?

C: The Samaritans.

Someone commenting in the afore-linked post aptly stated that “…The Samaritans comment was particularly wank.”

Christine laughed when I told her about this, as I did in memory of it. I don’t recall what she actually said (I don’t keep the in depth notes on appointments with her and NewVCB the way I do with therapy sessions), but there was a derisive (of C) quality to it which made me feel both dryly amused and smugly vindicated. Since I’ve been discharged from Psychology and have a proper, decent psychiatric team looking out for me, I’ve been surprised and pleased by how many times they’ve either directly criticised NHS mental health services, or delivered loaded, highly implicative statements about same with coy but suggestively raised eyebrows. It delights me no end.

Anyhow, that was the last appointment, and I didn’t go completely batshit in its wake, so didn’t need to contact her urgently. Perhaps this is a case of the stick in the drawer is the biggest stick of all, in the same way that having a stash of Zopiclone and Diazepam is. In other words, having the option there is reassurance in itself; with that very reassurance, one does not need to access the option. So instead of having to arrange an emergency appointment, I instead saw her as normal yesterday.

Those of you that read the nonsense I wrote yesterday will know that I was absolutely fed up, so I just went into the appointment and told her so.

Stress and Routine

“It’s ordinary fed up, having said that,” I added. “About normal life, and the challenges it brings.” Yet again I find myself reminded of Sigmund Freud’s dictum that recovery from “hysterical misery” means an advancement into mere “common unhappiness”. I am finding the vicissitudes of “common unhappiness” more and more starkly present in my life as I find myself to be relatively symptom-free. There’s a small part of me that rejoices in that – she’d rejoice even more if I could be symptom-free (thanks, overpowering anxiety) enough to go back to work, mind you – it’s ordinary, it’s real, it’s a part of a proper life. The larger part of me sneers at this saccharine idealist, and laughs a bitter “fuck away off” in her general direction.

In any event, I moaned and moaned about my stress pertaining to the Everythinger and the state of the house in much the same way as I did here yesterday and in the post before that, citing the unmitigated exhaustion I was feeling pursuant to my defiance of the instructions of my demanding custodian, Seroquel. I left a very important detail out until the end of the appointment, however, which I will leave out until of the end of the review of this appointment, however. However, however, however. It’s a nice word.

We also discussed how I have hardly seen my mother at all over the last few weeks, initially due to the presence of Aunt of Evil and secondarily thanks to my having to be about A’s house so frequently to accommodate the Everythinger. She asked me how I felt about that, and I felt guilty saying that it was a probably a good thing – but, all things considered, it is.

Christine asked if my levels of irritability had gone up, and I admitted that they were at an all-time high. The thing is, little things my Mum does – perhaps unfairly – wind me up to the point where my entire body seizes up in a red-blooded, silent scream. By the same token, she loses it with me quite a bit (and doesn’t try to hide it) for reasons that are rarely clear to me – a tone of voice she has (in my view) misinterpreted, or something inane like that. And at present, I’m not the only one that is stressed and irritable as a result of circumstance; my mother pretty much hated every second of Aunt of Evil’s visit, and is only beginning to recover from the stress of it.

Aunt of Evil Visitations

One of the few times I have seen her in the last few weeks was when Aunt of Evil was still in the country. I met my mother one Friday afternoon and spent about three hours listening to her ranting about what a cunt AoE is (which was a bit of a failed conversion really; she was already preaching to the choir on that one). To cut a very long story short, AoE lashed out at everyone except her offspring, his bitch, and their young offspring. Everything was someone else’s fault; she demanded service and opportunities that should only be available to someone staying in a five star hotel with spa facilities; she complained when something wasn’t up to her perfect USian standards; she patronised anyone that she perceived as being less intelligent or interesting than her and her twats; etc blah yadda. Even her husband, of whom I’m not the biggest fan but whom I also don’t utterly loathe, was apparently not exempt from her fuckery – I was interested to learn that he was even heard to complain about his wife to my mother.

They all fucked off again back to America last Tuesday, to my mother’s, the McFauls’ and even Aunt and Uncle of Boredoms’ evident and expressed relief.

(Aside: in one of her less ranting moments, Mum advised me that despite all the Amazonian-scale water under the biggest bridge in the multiverse between AoE and me, AoE considers me “the daughter she never had.” I responded cruelly: “her attachment to me makes my hatred of her all the more amusing,” or some such. I mentioned this conversation briefly on Twitter, to which @bourach expertly replied, “next time she says that say, ‘well, she’s the aunt I never wanted’.” PLUS ONE, Ms bourach ).

So in short what I’m saying is that, thanks to my aunt’s pavonine exploits, my mother is stressed too. Putting her and I together in such a potentially double-charged situation could lead to a few sparks flying in the heat of an ill-thought-out moment. I don’t like arguing with anyone, and least of all her, so it’s for the best.

Even so, Christine argued, I have an established routine of seeing her regularly, and that’s being broken. I do feel regretful of this, but more from my mother’s point of view than my own; she is getting on in years now, and lives alone. Yes, she has the golf club and the family to visit, but of course it’s not the same as living with someone and having the comfort of coming home to them. So I feel guilty about not seeing more of her, but there’s not a hell of a lot I can reasonably do about it when I have to keep to the schedule of the Everythinger.

Depression?

I must have seemed down to Christine, because she seemed concerned that my mood had dropped (overall, in her estimation, since the burglary). I think it has, in her defence – not like the body of the condemned dropping suddenly and sharply from the gallows (sounds like fun!), but slowly and insidiously trickling and meandering its way down a mountain. I’d say I’m only a little bit down that particular hill as of yet, but the fact that this is a concern to Christine in turn concerns me. I thought I was Almost Proper Well, Like.

So I responded to her apparent worry by insisting that even if things were slipping, that that was all they were doing. No avalanche, no impending disaster. “Indeed,” I continued, “I think today’s particular frustrations relate to being so overwhelmingly exhausted. I think it’s normal – or at least normal on 600mgs of Seroquel – to feel this bad as a result of this exhaustion and stress.”

“OK,” she said cautiously. “But I want you to call me if this gets any worse, OK?”

I casually nodded my apparent assent whilst averting my eyes from her cross-examining gaze. Despite my witterings earlier about knowing she’s there for me being a reassurance, realistically I have no intention of calling anybody. I don’t do phones. Why the fuck can’t they give out email addresses?! I would, happily, contact her then.

She later commented that she didn’t notice any other deteriorations, and I assume she was referring to hallucinations and delusions. Barring what I’d told her at the previous meeting, there have been none for a long time. This is undoubtedly positive, but it was never psychosis that put me in danger. Well, it was, but not in the chronic, soul-crushing fashion that the true black treacle of depression was, can do and – let’s fucking face it – probably will (though hopefully not any time soon..?). So, if my ‘mood is slipping’, I see that as a greater problem right now than the odd voice or delusion-induced panic, cruel and heavy as those of course are.

Non-Confessions Writing Projects

Bah. This is turning into an introspective examination of my mental health problems, rather than a report of yesterday’s meeting with Christine. What followed the above was a discussion about writing, and I told her that I had completed and submitted my piece on recovery from BPD to Rethink. For those interested, by the way, I’m not sure when it will be appearing in the members’ magazine, Your Voice, but it won’t be the Autumn edition because the editorial committee had something already lined up for that. The Editor – a lovely, helpful and supportive lady called Natasha (Tash) – will advise me of its publication date, and so I’ll keep you apprised. Tash was even nice enough to tell me to keep in touch with her and send her other interesting (as if anything I write could be termed ‘interesting’!) articles, which I thought was a really delightful parting gift

Christine was all smiles about this. In a moment of madness – that, thank God(s)/Nagi/Vishnu/Allah/Morrigun/Xuan Wu/some pantheon combination of the lot of them/common sense, I managed to keep silent – I wondered should I take her in a copy of the magazine so that she can see her little writing protégée in action. This would be what is known in the trade as A Very Bad Idea. The article links to this blog…do I want the professionals reading it? Nope; no matter how much they help me, no matter how much I feel I owe them (and I do have a strong sense of recompense towards her and NewVCB ((and, of course, Paul)), despite the many previous vacillations of the Health Service when it came to my care), I don’t think it a particularly wise idea for them to come across this nonsense.

Anyhow, what Christine didn’t know about – because it had all happened very quickly, and took place after I’d last seen her – was about how it wasn’t just Rethink that contacted me. The evening after I’d previously seen her, I was checking Twitter and found a direct message from @MindCharity, which is the account of that other big UK mental health charity, Mind (incidentally, they and Rethink co-run the Time to Change programme – if you haven’t already done so, you should follow the link and sign their pledge to end discrimination against mental illnesses). The tweet asked me if I’d be interested in reviewing one of the books Mind have short-listed for their 2011 Book of the Year Award. Um…yeah?!!

I wrote back and expressed enthusiasm, which was rewarded with an offer to send out an advance review copy of my choice of one of four (out of a full eight) titles. After a bit of dithering, I elected my tome, and it arrived the following Tuesday. I finished it on Wednesday last week, and sent the review off back to Mind, who will later publish it on their blog. I’m not giving any details away until then, however

This impressed Christine greatly – she seemed genuinely thrilled that I had been contacted in a completely unsolicited fashion by a major organisation about a fairly major event in their calendar. I have to say that I was similarly pleased – not to mention rather stunned. Why do you like this blog? What have I done to garner (potentially influential) people’s respect with my blatherings here? I don’t get it, but it’s flattering, humbling and exhilarating in equal measure. Thank you. ‘Thank you’ doesn’t seem enough, but it’s all I have.

On a roll of positivity, I then told her something that I’ve not really mentioned to anyone but A yet. I’ve actually decided to pull my finger out and look into a voluntary placement somewhere. I have a position in mind, but I haven’t applied for it yet, so won’t give out any details, suffice to say that it’s in this same general arena – writing about and awareness raising of mental health issues. I’ve no idea at all if I’ll get it, but the two projects detailed above must surely stand me in good stead, as must my current editorship of TWIM (yeah, I don’t know how that happened either!).

Clouds

However, all those silver linings belong to clouds. They don’t just shiver and shimmer around a perfect blue sky by themselves, much as that would be desirable. The following issue pertains to a friend of mine, so I don’t want to discuss the details here, but I will state that her difficulty is directly affecting me too – and could, in a peripheral but still intrusive sort of way, be contributing to any whisperings of depression on the wind that is my life. However, Christine was extremely supportive and reassuring in relation to this matter, so I mostly feel assured that I can cope with my friend’s problem.

So, all in all, it was (as usual) a good appointment. “But!” I hear the eagle-eyed amongst you mutter. “You said there was a very important detail to share, Pan! Do tell, or we’ll spam your inbox from here to eternity.” I’m very wary of any so-called meat put into cans – a feeling surely shared by anyone else who played GTA III – so I shall, indeed, oblige.

As things were drawing to a close, she said, “so, is there anything else we need to discuss?”

I shrugged ambivalently, and looked away.

#lyingfail

Unfortunately for me, I must have looked away in the wrong manner, because she picked up on some sort of vibe of dissent. Examine the following scene from L A Noire:

LIAR!!!

Observe how our suspects angularly holds his jaw and avoids the gaze of the interrogator. Moreover, observe how he directs his eyes upwards. (This is actually a bad example, because he’s looking up and to the left, whereas I understand that looking up and to the right is more indicative of falsifying statements). Do you press Truth, Doubt or Lie?

I do have a vague recollection of looking up, to the right, whilst sort of biting my upper lip, at which point Christine had licence to hit the figurative ‘Doubt‘ option. (She can’t press ‘Lie‘ unless she has clear and present evidence to back it up, mwhahahaha! Oh, how I wish life were as simple as gaming).

I am absolutely disgusted with myself. I used to be a fucking excellent liar – what the shit has happened to me?! OK, so that’s an admission not to be proud of, but let’s be (ironically?) honest for a minute here: lying does come in useful when dealing with certain individuals and certain circumstances. How many times have you lied to a mental health professional? How many times have you told a so-called white lie to avoid hurting someone? How many times have you lied by default? Yes, just like that time your boss came in and said, “here’s 50,000 pages of turgid fuckwittery to proof-read and edit. Can you do that by yesterday, please?” and you merely smiled in response, leading him or her to believe that that was absolutely hunky-dory.

Seroquel Manipulation

Right, right, OK, I’ll get to the point. Christine realised that my shrug meant that there was something else I had to bring to the fore, even though I didn’t want to. I screwed up my face in an expression of embarrassed expectation and said, “I’ve decided I’m a consultant. I’ve cut back on the Seroquel.”

I waited for her to wince, or to bollock me, but instead she said, “by how much?”

I bowed my head and looked up at her meekly. “By half,” I admitted.

Then she winced.

In the end, she had mixed feelings about it. She said that it’s not always the worst thing to decrease a dose of something, particularly something that so potently affects one’s ability to do anything, but by the same token she did (reasonably enough) opine that to cut a dose of an anti-psychotic in half is potentially conducting playgroup in an incinerator.

She instructed me to call her “the second anything happens”. In this case, assuming I’m not …told… not to, then I actually will. I asked her should I just start taking the higher dose again if anything happens. Curiously, she said no – again, I was to call her first. I reluctantly agreed to this (reluctantly because it’s the cunting, fucking, shitting, bastarding phone), and also agreed to discuss it in full with NewVCB next month. I’ll see Christine before that though, on 22nd August.

And that was really that. I have to admit that, generally speaking, things have so far been fine since I cut my dose of Seroquel. No voices, paranoia, no significant mood drops other than that which has been already discussed and accounted for. What I’ve noticed, though, is that whilst I’m still stuffing my fat face, I’m slightly less out-of-control on that front than I was, and I’m slightly less lethargic than I was, say, last week. It’s not a huge difference, but (a) it’s a start and (b) it’s very early days.

Bye

Anyway, well done to anyone who got this far. It’s after 11.30pm now and I’ve been writing this on and off since about 4pm – in between bouts of reading, examining the crimes of H H Holmes and random mysterious disappearances, plus other silly, mostly self-inflicted intrusions. But I’m still in relatively good form, all things considered, so I’ll depart on that hopefully-non-shit-for-you note. Goodnight x

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Shiny Things

Blog News 7 Responses »

Jul 192011

Not to blow my own trumpet, because the relative popularity of Confessions continues to mystify and astonish me, but I’ve picked up a couple of awards since I started writing the bilge a few years ago. Sometimes I mention them, more often I don’t – but if you really care, if you’re fixated with the idea of self-flagellation by means of Pandorian self-aggrandising and narcissism, then be my guest and take a look at them.

Initially, pleased as I was when the lovely Little Miss Sunshine afforded me a ‘Liebster Blog Award‘, I wasn’t going to go with the meme and write this post – but then I thought, ‘what the hell?’

Liebster Blog Award

Firstly, thanks very much to Little Miss Sunshine for bestowing this upon me. As noted, I still find myself genuinely stunned that the crap I write is worthy of simply reading, never mind awarding – and since I really respect LMS’s writing, intelligence and determination, it’s really flattering coming from her. So this put a smile on my face. Thank you, lovely lady

Secondly, I have the pleasure of passing the award on to blogs that I enjoy. There are of course many such writings, but here are a few that stand out, for various reasons.

Conversations With My Head – bourach. Always bourach, one of my oldest online friends! Not because of some sort of Twitter-based nepotism, but because she is a great and evocative writer. Often, sadly, the reading is tragic and heart-wrenching – but it’s always intelligent, engaging, eloquent and even, when the tone is right, witty and entertaining. One of these days I’m going to Kent to meet her A year ago, we’d probably have been planning to head the White Cliffs for a wee bit of a fall together – now, hark! We are both moderately sane. I have to hand it to bourach – my relative recovery has been, at least in part, down to medication. Her’s has been down to the very opposite – coming off medication! Not to mention therapy and working fucking hard to free herself of mentalism.
Living with Bipolar Disorder, DID and the Consequences of Childhood Abuse – this blog is articulately authored by tai0316. I’ve only fairly recently discovered this journal (as in, this year), but I am sooooo glad I did. I can empathise with so much of what tai writes about, and find her style – although she also frequently discusses tragic and painful issues – to be strong and smart. There are times when I wish I could give her a big hug – but as I said, she’s strong, and there equally as many times when I find a smile creep across my lips in delighted congratulations of her determination to fight her demons. tai also posts quite a lot of artistic collages, which are as expressive as they are insightful. She’s a gentle, intelligent, remarkable lady, and I’ve been so glad to make her acquaintance.
Living Life on the Borderline – the online home of outwardlyintrovert. I don’t want to sound patronising here, but I suppose I probably will, so I’ll just get on with it. Outwardly is in her late teens, yet writes with a cleverness and insight not always seen in people three or four times her age. There’s a theme emerging here – there’s trauma in outwardly’s history too. I hate that any of that happened (as I obviously do for all concerned), but I’m glad that she writes. I know that mentalism is a fucking inconvenient thing to have when you’re trying to study, to make something of your life – it sort-of destroyed my attempt at a Masters degree – but as you’ll see from her blog, outwardly has an excellent intellect, and an important characteristic that I’ve always lacked: wisdom.
Whisper on the Wind – written by Me. Not me me, but Me. OK? OK. I’m new to this blog (the blog itself isn’t that old, though), but again I’m very glad I came across it. I always hesitate to use the word ‘beautiful’ when it comes to writing, as it’s so often little more than self-referential or arse-licking hyperbole. In this case though, the word is, I feel, quite accurate. Yes, Me rants and raves like the rest of us, and such posts are always excellently expressed, but there are times when she becomes more introspective and philosophical, and on these occasions her prose and poetry is beguiling.
At Least My Cat Loves Me – Autumn Delusions. Another young blogger, whose prose I often read thinking, “fuck me, I wish I could write like that.” Engaging, entertaining, smart and often funny; though I don’t think AD realises that she has the capacity to amuse, let me assure you that she does. Now, unlike some of the others mentioned here, AD has some…what’s the diplomatic term?…sod it, mentalist issues that I haven’t been through (others that I have), and of course can’t ‘get’ from an insider’s perspective. AD, however, has a great capacity to promote understanding, and whilst her posts are often long – though I think I’ll be keeping the crown for the bloody longest, thanks very much – they never meander, and always keep you interested.

As well as being fab in their own rights, all of the above have been enormously supportive of me over the months/years, and I’d like to publicly thank them for that. It’s not whyI picked their blogs for this award, but it is hugely important to me, so thank you all.

Right, enough of the love-in gushing. I’m going back to being a bitch now. To echo Charlie Brooker’s immortal Newswipe parting gambit, go away.

I do love you people though. Not just the five above, though of course that includes them, but all of you.

Right, really. Enough of that. GO AWAY!!!

Night x

(Can’t be arsed proof-reading this, but I hope you don’t care because this isn’t about me; rather, it’s about bourach, tai, outwardly, Me and AD. Yeah!).

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Blog Carnival of Mental Health, June 2011: Hope and Despair

Random Mental Health Related Philosophising, Recovery 18 Responses »

Jun 302011

Welcome to this month’s Blog Carnival of Mental Health, on the topic of hope and despair. They are, ostensibly, a simple couple of concepts – but within each, there is a lot to be said across the Madosphere.

So let’s see what our entrants made of it. Please be aware of potential triggers in the following, particularly in relation to suicide. Thank you to everyone that has taken part, and to all that tweeted, Facebooked or otherwise promoted the Carnival; it was much appreciated. In no particular order:

Turquoise, author of theurbanworrier, discusses the liberating feeling of travel…and how, sadly, her senses of wonder and triumph have been replaced by her descent into depression:

…it’s like a journey of life: how on this 300/800/more kilometre walk on pilgrimmage routes that have been travelled by thousands of people over hundreds of years, you just have to take each step as it comes, and meet each challenge as it presents itself, live with just the stuff you can carry (ie, literally in your backpack as well as mentally). That although there is reasonably good signage *you* will get lost sometimes. You will have problems, sometimes the worst ones you as a person could cope with. But you will learn to deal with these, and learn that you *can* cope. How you have to trust that your needs will be met; that you’ll find water, and food, and somewhere to sleep. That language is no barrier; that we are all people with a common ultimate goal, with the same needs, hopes, and desires. That you can only walk at your own pace; sometimes that means your journey is solo, but at the end of the day, you are never alone, and your camino family is like all the relationships you will ever have.

…

But that was then. As anyone who has had the misfortune to be traipsing around in my blogland recently, the optimism of hope just hasn’t applied. That whilst I’ve *been* in great places, and was hopeful I’d get back there, it really ain’t gonna happen. This month has seen little cause for hope, and much much more for despair. I seem to be pretty stuck in a downward spiral with the madness really taking over, but the really sucky thing is that it’s been contrasted by some things and people which are so damn rock you wouldn’t believe it. But you don’t want to read about despair, mine, or anyone else’s. It’s shit.

Ash, a commenter here, has emailed the following contribution, which has left me sad but encouraged in equal measure:

‘D’ is for despair and also depression. In my case I naively thought it was a one off event; post-natal depression after the birth of my child. How could this be happening to me? We had wanted this for so long and yet when it finally happened it came along with a side order of depression. I struggled to admit to it. I refused at first to take any medication but then I had to surrender to the truth and -take time off work!

A few years ago my husband suffered a stroke at the age of 37 which left him registered blind. Immediately my symptoms returned.

Here entereth despair. For me now it seems that when something traumatic or stressful at all occurs, depression tightens its grip and I hate it. I was a confident, outgoing person who ok, worried a little about “stuff” but was very positive. Now my head is constantly filled with negative thoughts. I can’t look on the bright side anymore and the rage within me is unbearable. I have lost myself and hate what I’ve become…but hold on…

…Hope – it is out there. Over the past eighteen months I’ve been going to a therapist who has been guiding me along this difficult path. I have the support of my family and close friends. I have my faith. Most of all I have realised that I am not alone. As I trawled the internet I read similar stories. Depression I have found is something that people find difficult to understand if they’ve never experienced themselves, but by reading other sufferers’ blogs and accounts it has given me hope.

I’m so glad the Madosphere (amongst other things) has restored some of your hope, Ash

sanabituranima, author of <a href="Sanabitur Anima Mea, takes an insightful and fascinating look at mental illness within the context of her religion of Catholicism:

Depression is not a sin. It has never been considered a sin. It is an illness (and usually a treatable one.) When my Church tells me despair is a sin, it does not mean depression, extreme sadness, or a lack of joy and enthusiasm are morally wrong. These things may be, and often are, things that make me tempted to despair, but they are not despair in the theological sense of the word. If you are a Catholic, despair means that you allow your emotions to stop you trusting in God. I may not feel like God is on my side and that I might as well give up and die but as long as I let my faith and my reason to overpower that feeling, I still have the virtue of hope. It is important to understand that, because I have come across Catholics and other Christians who believed they were sinning by experiencing a mental illness. This is like believing that coughing is sinful.

…

I have faith that Jesus will pull me out of this. Not that He will magically make it go away. In the early days, I hoped for an instant, miraculous cure – but I really wanted a miraculous escape. I believe God has a purpose I cannot yet perceive in testing me in this way. As Saint Paul said ”We glory also in tribulations, knowing that tribulation worketh patience; And patience trial; and trial hope; And hope confoundeth not: because the charity of God is poured forth in our hearts, by the Holy Ghost, who is given to us.”

Astrid, on her DID-focused blog A Multitude of Musings, discusses her fears surrounding death, and how she now has hope for the future despite them:

Three years ago, I was convinced I would not make it to the end of the year 2008. Everyone kept telling me that I’d find a good place to live in the long run, and yet I believed I was going to die before then. So the hope that people tried to give me, turned to false hope and despair.

Now, I’ve made it three years since then. I still feel sometimes that I’m having a foreshortened future, but I realize this is probably a PTSD trait coupled with despair from it having taken so long for me to find a suitable living place.

Now in September I’ll be moving to a new place that is hopefully suited for my needs. It took years for me and my staff to find this place, but I think it will finally be somewhat safe there. I will also get married this September. Finally, it seems there is hope for the future. Now if only I could overcome my fear that I’m going to die as soon as I finally feel better again.

Jonathan Alter, who chronicles his story of life with mental illness and after trauma here, thoughtfully describes the development of the tumour he thought he had on his brain:

Not long after my son’s birth, around the age of 47, I started to get sick. I was a pastor of a small church in the Blue Ridge Mountains of Virginia where I could be hiking on the Appalachian Trail in a matter of minutes. It was an absolutely beautiful place to live! This small country church where I served was filled with the greatest people on the earth. I loved them. We grew close together through suffering; like a family that comes together at the death of a parent or a child. Once I arrived at my new church, it seemed that everyone had waited just long enough, so that they could die and have a pastor there to care for them and bury them properly. The old started dying one after the other. There were suicides. There were strange diseases brought about through environmental pollution. Cancer was everywhere. And we held each other, cried together, and relished the beauty of joy when it came to us amidst so many dark days.

…

Finally [after experiencing a range of somatic as well as psychological symptoms], I came up with the only solution that made sense to me. I was dying of a brain tumor, and it was growing at a pretty good pace. My father was a surgeon and I had heard of some of the symptoms before… The headaches were increasing. I couldn’t read. I couldn’t concentrate. My ability to write was deteriating. I was having trouble walking and standing. I couldn’t sleep. At times it was hard to understand what others were saying to me, and my environment started to take on a kind of surreal nature.

…

He asked me a couple of strange questions such as, “Do you find that you cry all of sudden? Have you been thinking about death more than usual? What has your mood been like?” And incredibly, about five minutes into the exam, instead of being sent immediately to get an MRI, I was being diagnosed with Depression. I was stunned! “How could that be? What about all the physical aspects of my symptoms? What about my headaches? Are you absolutely sure!” The doctor was confident of his rendering and looked concerned. My wife joined in with the doctor and pronounced, “John, can’t you see that this church is killing you?”

Ten minutes into the examination I was being prescribed my first antidepressant famously named Prozac. Twelve minutes into this mind bending revelation I was ordered to take some time off. Fourteen minutes into this, I was still an unbeliever, but regardless of my personal disbelief, the doctor referred me to a therapist. After fifteen minutes I walked out of the doctor’s office numb, confused at what had just taken place. In one hand I carried a piece of paper to give to the pharmacist. In the other hand I held a card with the name of my first therapist. Fifteen minutes ago I had this picture of dying from a brain tumor with grace and dignity, now, I had to continue to live in my messy life battling some unknown force named depression.

Mike, from the Unhappy Happiness blog, talks about a recent depressive episode and how structure can help him retain (and regain) stability:

Up until that point I thought I had everything under control–that is, I had developed a set of routines that I thought were impenetrable. However, I went from only going to school online and being subject to few real social situations to having a full-time job and an internship. It was too much. They broke down my structures so much I couldn’t recover. And so I gave up.

I let myself be taken by chaos. I let myself fall further and further down. Granted, I started planning for suicide, which ironically in itself brought structure. But for the most part, I let all structure go.

…

I am learning that there is a balance between structure and chaos; it’s not an either/or situation. There will always be hope and despair in my life, sometimes at the same time–and I’m learning that that’s okay.

Lis, writing at Seesaws and Roundabouts, has found that recovery is a double-edged sword (something I remember writing about a long time ago too):

I’ve been ill for more than ten years, this is part of me now. It’s who I am. My illness, by it’s nature, gives me moments of sheer bliss and moments of total sorrow. It’s easy to forget the despair when I feel amazing, it’s easy to dismiss it when driven with manic energy. I can live life at times so full of hope and expectation. It feels like a gift. That’s why there are times when I am well and yet I’ll be craving an episode, a relapse into mania. I want the thrill, the joy, the hope it gives for something better than just mere life.

…[W]hy would I say recovery causes me despair? Well, as I said, this is now part of me. It’s shaped me. It’s who I am, or at least so strongly tangled with who I am I don’t know how to separate the two. What if I lose part of myself?

Despair is then discovering I’m not naturally confident or articulate. I’m quiet and shy. Despair is losing so called friends as you’re not the person you had appeared to be. Monotony. Routine. Feeling tired. Trying to pick up all the broken pieces of your life and rebuild. That one is the hardest. Starting life from the beginning, picking up on life before sickness, being so far behind.

Steve has a harrowing post on his journal, Is There a Future?, about the day he fled in despair from a psychiatric ward:

Police baton hits windscreen hard. Hands up. Feet off pedals. People screaming at me. Engine off. Keys in passenger footwell. Reaching for door. Bang of baton on side window, hands around head. Baton through window. Baton hits my head hard. Other window goes in. Glass flying. Door open. Not resisting. Punched twice in face. Being pulled hard by arm. Seatbelt gets done. On floor. On glass. Cuffed. Police screaming at me. Still not resisting. Pulled onto feet. See damage done to car. Absolute pit of despair opens like a trapdoor.

I don’t know how hard that is to read but even after all this time it’s so very very painful to think about. I can’t help but cry as I remember it.

But where’s the hope?

A shred of hope was given that day when a different doctor changed my meds off SSRIs to something totally different. Which got me out of hospital. Which got me back from the abyss.

I despair that I didn’t die every time I remember that time. I just… it… I was ripped apart over several months from that day on.

I hope that others won’t have to go through any of what I went through. From the bad care to the lies of the police. The hell of bad meds choices. Everything.

I despair because I know that’s exactly what will happen.

La-reve, over at My Head Noise, poignantly discusses the relevance of today’s theme in her life:

So I guess all I can do is define what it means. Despair for me is the crash that follows the euphoria. It could be Digging lithium and paracetamol out of the ash in your car’s ash tray where you had to stash them momentarily as someone walked by and still chewing them longingly along with the soot.. Despair is standing with a ready tied noose looking into icy waters, at 3am. Despair is sitting in a crowded AnE department with a security guard within arms reach because you pose that high a risk. despair is being locked away in a cold 6 foot square box for 11 hours while people outside organise one of the 12 mental health act assesments you have had in just a couple of years. But despair really is realising you are treading that final line that your death is inevitable, having your consultant a specialist in your mood disorder, agree with you, hearing him say ‘when you die’ not ‘if you die’. Despair is knowing there is no cure nor may there ever be.

And yet here I am and things did get better. I wont say that things don’t get bad, I recently had another 8 related slip, but I don’t recall any moments of True despair in the last couple of months. I may not always feel so good, but I know there is another path, that with careful monitoring, some meds etc, I can live my life, I can have a family, see my boy grow and hopefully one day soonish I will be back in full time work. Now that is hope- a shy and cautious one but hope none the less and yes it is scary but nothing ventured nothing gained, and there is another world, beyond mental illness, blogging, appointments etc.. and I have lingered too long on its sidelines I want to get back in the game, and live my life as me, not a diagnosis thats all I want from hope, thats enough.

One of a number of people in the Madosphere who is both a patient and professional, Lothlorien addresses this week’s big mental health news story: Marsha Linehan, the creator of (my favourite! ) therapy DBT, suffered from borderline personality disorder herself:

I have spoken to my own therapist about my becoming a therapist and the fact that I would be a therapist who has had DID. I worry about people finding out. What would they think? Would they think I was less competent? My therapist views me as MORE competent, and she says I have so much to offer, not only to clients but to clinicians as well.

…

The article talks about how Marsha Linehan felt incredibly suicidal and engaged in various forms of self-injury for which she still carries the scars.

…

My favorite part of the article, which I can identify the most with and is exactly why I am persuing my MSW in Clinical Social Work is below:

….referring to her suffering, suicidality, and cycling hospitalizations which yeilded not much help for her, she says, “I was in hell, and I made a vow: when I get out, I’m going to come back and get others out of here.” (Marsha Linehan)

And she did exactly that.

What an amazing story.

Regular readers will of course know that I am not Marsha Linehan’s biggest fan, because of my lack of tolerance for DBT. However, the article in question did inspire in me a newfound respect for Linehan; just because I don’t like DBT doesn’t mean that it doesn’t work for others, and in any case – Linehan used her own experiences to help others struggling as she did. So I’m with Lothlorien on this

Lothlorian also submitted a revealing and fascinating series for this Carnival entitled Welcome to the World of Inpatient Care. It begins here.

Writing at trichquestions, the author shows us how important writing poetry is to her, and how she is hopeful that, through therapy, some of her muse will return:

The last time I went to see my therapist, I was talking about how I’ve stopped writing poetry, and how much I miss it. I’ve been climbing walls with how much I miss it, actually. It’s not that I’ve run out of ideas or gotten bored. It’s just nothing’s coming out with the same energy it used to. Most days I feel like I’ve got nothing to say (or nothing worth saying, anyway), and when I write anything down it sounds contrived and dull. I’m reading absolutely loads of it still, and I don’t think I’ll ever be able to get rid of it completely. But something vital is missing at the moment and I have no idea what. It’s been over a year since I finished a poem, and about that long since I wanted to.

…

She [the therapist] mentioned last time I saw her that I may have been relating to myself back when I wrote the last poems in a way that I won’t be able to do now. I’ve moved on since then, in many respects things have gotten better, although more confusing in equal measure. I’m not the same person, so trying to get back something that I believe has been lost might not be the best way to go about this. It’s true that I have little idea how to relate to myself at the moment. A lot of things have happened very fast recently and I’m still struggling a lot. So trying to recreate a time that is essentially past is not going to bring back my work. The trouble is… I don’t know what will.

I’m going to keep talking about my writing in therapy, and I’m going to keep continuing to feel hopeful that it’ll come back. There’s just large amounts of frustration and despair in the meantime while I work on this. One thing I had an idea of more recently was that I do need to allow myself some space and time to write every day, even if it’s just for half an hour. I gave up on doing that when I thought nothing was coming of it, but I’m starting to see how important it is to allow yourself that space.

CBTish reports to the Carnival via his blog that he has encountered some cockroaches – and they’re not all very NICE:

NICE (the National Institute for Health and Clinical Excellence) is consulting on a draft guideline on Improving the experience of care for people using adult NHS mental health services. Much of the guideline is based on other guidelines for specific conditions. The consultation is not public even though the documents are — only registered stakeholders can submit comments.

…

There is little or no mention of discharge from the system altogether. Even the small section on discharge from community care (10.3) emphasizes continuing support and the availability of top-up appointments and re-referral.

It’s as if the entire mental health system has become an asylum in the community, a grim institution that no one ever really leaves, with the hospital ward taking on the role of padded cell for those patients who become too troublesome. This ties in with the widespread belief, a false belief, that mental illness indicates a fundamental weakness in you as a person from which you will never recover, and that the best you can ever hope for is life-long struggle in the care of others.

…

Lest anyone despair at the bureaucratic numbskullery of the NHS, it should be said that this NICE consultation is hopefully one of the last to get away with a tick-box approach that sidesteps the question of whether people are actually getting better.

Although it may take years to arrive, hopeful new thinking is on the way — the thinking that the outcomes people experience are more important than the NHS’s internal procedures. NICE might have to change or be abolished to make way for the new thinking, but whatever it takes there is at last hope.

a_wry writes on her blog about the “glasses” she needed for an “astigmatism” she didn’t even believe she had:

I’ve been having “headaches” for a long, long time, and haven’t been able to “see” things nearly as well as most people I know.

My family doesn’t believe in “astigmatism”, and so I didn’t either, really, for many years. (I mean, sure, I bought that it happened to other folks, but my own life hadn’t been hard enough to give me cataracts. Yet. Right?) All of us squint constantly, for what it’s worth.

In the meantime, I tried doing eye-exercises religiously. I did all sorts of complicated things with the contrast and text-size settings on my computer at work. I switched to a diet high in vitamin A, and gave up reading in situations with less than ideal lighting. I wore polarized sunglasses, hypoallergenic mascara, and I did my damnedest to get enough sleep.

But the headaches and the encroaching blindness just got worse.

And then someone jammed a toothpick through one of my eyes, and I finally felt justified in going to the doctor.

…

I am equal parts hopeful that these glasses that so many people sing the praises of will help me, too, and fearful that the doctor will look at my eyes and say, “Your problem is that you just don’t do enough eye exercises.”

Yeah, I know that feeling I really loved this analogy, though.

BtF from Behind the Facade looks at the issue of raising suicide prevention awareness using the media:

Breaking down the barriers and creating change is hard. But it can be done, and it has been done in the past. As said by John Brogden, “Forty years ago I’m sure that people would have been aghast if you suggested that we should suggest to women to get their breasts tested. How could you use that word in public? Now cricketers play cricket in pink once a year or whatever it is to promote that you know – how could you talk to men about testicular cancer or prostate cancer – oh my god – we are big enough and smart enough to deal with this now rather than find excuses and I don’t want us to find excuses to telling people who feel this way – there is a way to deal with it. That’s the message.”

The closing message I’d like to quote was also made by John Brogden. “One thing I want to make sure that people watching this show understand and I don’t think there is a person here who would disagree with one message from tonight… it’s that you’re better off talking about suicide than not.. I’ve met parents who say I wouldn’t know how to talk to my kid…. You’re better to talk about it than not talk about it as that will open them up… you’re not going to put the idea in their head and that’s a great worry that too many people have and I’d like to think that people will turn off the TV after this and think about talking to friends and family and this very important issue.” I couldn’t agree more. The time is now to talk about suicide.

I couldn’t agree more either. Perfectly put.

Over at the blog My Crazy Bipolar Life, the author is also writing about suicide, but has an interesting take on the subject (and, indeed, the Carnival’s theme): does the perfect suicide note exist, she asks?

I have tried visualizing how I would feel if it was I who was reading a suicide note of someone I loved and it was through this that I realized that no matter what they wrote it wouldn’t make me feel any better about their death. I think it would be impossible to leave a nice suicide note because no matter how you choose to write it, the recipient is going to be just heart broken. If it were me sitting reading a suicide note from a family member my head would be spinning at a hundred miles an hour. I would have so many questions – why couldn’t they talk to me? did they try and get any help? if they did why did no one help them? why couldn’t they see that this mood would pass and wasn’t permanent? why did I not know something was wrong when I last saw them?

Then that brings the reader to the next point. When did I last see the person? They seemed OK. I’m sure they seemed OK. They weren’t overly happy but joined in with conversation here and there. They stayed a decent amount of time and didn’t seem uncomfortable. Why the fuck have they done this to their self? Confusion. Anger. Heart broken again. Maybe they would even blame themselves. How could I let my Mum or Dad ever think they didn’t do enough or could have done more?

The answer is I can’t. I can’t write the perfect suicide note. I can’t even write a nice one no matter how many times I tell them I love them in it. And ‘I’m sorry’ just seems so trivial, it almost seems rude that I didn’t give an explanation.

…[I]f I can’t write the perfect suicide note, then what hope is there for me having the perfect suicide?

Hopefully (from my point of view) none! Your life is worth an awful lot, you know

Finally, some odd woman called Pandora, writing at Confessions of a Serial Insomniac, has been driving on the wrong side of the road:

Remember how I was in February? I was such a mess, so enthralled with the idea of ending my life, that NewVCB considered putting me in the day bin…My point is, I was in no fit state to do anything. Lifting my head off the pillow was a genuine and concerted effort; getting downstairs was a fucking good achievement.

I wouldn’t even have been able to go on holiday in the first place, never mind committing to driving in a strange land, in a fashion diametrically opposed to that to which I am used.

And if I had got to that point, I’d have had a complete, full-blown panic attack at the first sign of trouble with the car. Having the various mishaps we did have would have probably sent me jumping into the nearby quarry. Having been told that I’d marked the vehicle and was liable to pay for it would have seen me collapse in the street, begging the bloke to forgive me for my (non-existent) carelessness.

I wouldn’t have dared speak anything other than the occasional “hola” or “gracías” in Spanish, and even that would have been delivered with a head-bowed meekness.

Instead, I behaved methodically, calmly and generally confidently throughout.

…

So I’ll continue to hope – hope for the best, be prepared for the worst, and take what comes.

And that’s all folks!

(I don’t think I’ve forgotten anyone, but I ended up with far more submissions than I expected, so if I have omitted your entry, leave a comment here and I’ll add it straight-away. Please accept my apologies if this is the case!).

The next Blog Carnival of Mental Health will be hosted by Behind the Facade, and the theme will be stigma and discrimination. If you are interested in hosting a Carnival on your own blog, please contact Astrid van Woerkom, who is the facilitator of the project. I believe that she has monthly slots available from August onwards.

In the meantime, I hope you enjoyed reading the blogs here! Toodle-oo

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Psychology vs Therapy, and Being Burgled (AGAIN)

C, Life, Paul, Psychotherapy, Recovery, Traumatic Stuff, Triggers 24 Responses »

Jun 292011

It seems I have ignited a mini-debate (very, very mini) in the comments thread of my last post for apparently having been less than complimentary about C in the post pertaining to same (I wasn’t particularly nice about him, granted, but I didn’t think I’d said anything incendiary either). Anyway, this was intended to be a comment, but unsurprisingly it became rather long, and anyway, I have NEWS. So here is a post instead. Lucky you!

Right, it’s like this. I do not hate C (A does; I don’t). When compared to the woeful CBT that I went through, or my experiences of a couple of dreadful assessors and nurses and twatbags I saw prior to him, he was a therapeutic fucking genius. Even A acknowledged on a couple of occasions (most notably this. Perhaps this to some extent too?) that he (C) was obviously intelligent, and even dared to wonder briefly if “he actually [did] know what he [was] talking about”. Believe me, coming from A in relation to C, this is a compliment.

However, if you’ve read this blog for a long time, you’ll know that it wasn’t as simple as that.

Surely the contemptuous tone in which I frequently wrote about him cannot have gone unnoticed? I used to have this pathetic worry in terms of this blog than the only phrase I ever used in my session reviews was “I laughed in his face,” because really, I seemed to write it every other week. When C and I had a good session, I admitted that and indubitably felt smug and self-satisfied about it, which I’m sure came across in the narrative (check out this gushing, for example). When we had a bad one, most of the time I would vituperate against him – but simultaneously I acknowledged the role the transference was playing in my ire.

And this is the crux of everything really; not only did C allow the development of a very strong parental/fraternal transference, he encouraged and fostered it. OK, it was psychodynamic therapy; transference is an issue therein, and that is fine. I understand the process, and I’m OK with the reality that that one has to deal with these feelings. What C abjectly failed to do was do, though, and what is a fundamental imperative in analysis-derived therapy, was to deal with the phenomenon. Therapeutic literature is pretty clear on this issue: a lot can be learned from transferential feelings and behaviour, but the work cannot be considered completed until the issues resultant from this type of work are resolved.

You must surely also recall all the goings-round in circles, the sitting pointlessly looking at each other, saying nothing (which happened with Paul too, to be fair, but those silences seemed to have more ‘contained’ ((in the non-analytical sense)) in them), the constant repetitive remarks from both parties. Feel free to reread the posts if you think I’m mis-representing any of this.

What I only occasionally detailed was how I’d often spend Thursdays (a) in tears – not because of the content of a session, but because of what C had said or how he behaved; (b) waking up from a mini-dissociative fugue as a result of that morning’s therapy; (c) having a bitching session about C with A over coffee; or, most commonly, (d) some combination of all (a) to (c) inclusive.

I’m not going to sit here and tell you that Paul is a worshipful therapeutic guru to whom you need to bow or I’ll shoot you in the face, but I will tell you that none of that ever happened when he was treating me. Well, that’s a lie – there were occasional tears (this awfulness springs mind), but the disparity between him and C is ably demonstrated by the fact that those tears were almost exclusively because of the content that the appointment had brought up, not because of Paul doing something to hurt me or otherwise fuck me off.

I remember some of the comments I got from my readers when I wrote certain sessions. “Sorry, but ‘C’ stands for ‘cunt’,” stands out. “Just change his name to ‘Fucker’,” was also quite nice. I also had another therapist challenge his competence a couple of times (though in fairness, the said person and I disagree on the various models of therapy). Often I disagreed with everything that was said against him, and in many of the cases I still do. The point I’m making, though, is that my weariness of the man has not been something that new, not something sculpted by my relationship with Paul; there were always concerns there, and I wasn’t the only one to notice them either.

Of course, I was always encouraged by my interactions with him, even where they were negative ones. In a perverse sort of fashion, my willingness to scream abuse into his face was a sort of backhanded compliment; it meant I was comfortable showing my entire self with him (something I’ve still not done with Paul, though I have rarely felt the desire to). However, my optimism was based on my expectation that my treatment with C would last until it had yielded tangible results (and C’s lie in my discharge letter to NewVCB that “mindful breathing ha[d] had some impact” does most assuredly not count as a “tangible result”). And so that optimism was justifiably destroyed.

Someone said on the aforementioned mini-debate that my relationship with C only became toxic when the end of therapy was announced. This I agree with, despite my acknowledgement that the relationship was never properly ideal, and indeed herein lies my point about the hope that I’d formerly held vis a vis my relationship with him. The thing is, although I obviously never expected my time with him to be permanent (surely the point of therapy is to eventually not need therapy any more?!), I was given to believe that I would be treated until I was better – better, as far as I’m concerned, being defined as being functional in the real world (ie. with work, strangers, phones, leaving the house alone, yadda). The literature and even the relevant guidelines from the odious NICE are, again, clear on this. Given that I was at the time diagnosed with borderline personality disorder, the Northern Ireland PD Strategy (essentially a rip-off of NICE’s PD recommendations) also applied. None of this was adhered to.

Partly it wasn’t his fault. Indeed, mainly it wasn’t his fault. It’s the pathetic bureaucracy and evil postcode lottery that is seen so disgustingly frequently across NHS mental health services, piles of shite that they are. C, however, kept alternating between saying “I support your complaint” and then whinging that it actually was he, not Mr Director-Person nor any of his minions, that had decided on the ending point. Granted, C had to take a decision within a certain framework and context, but his position on that decision and on my indignant response to it alternated wildly between Point A and Point Z.

Another issue is that he never seemed to take serious my (in my view entirely legitimate) concerns about how the end of therapy was likely to affect me, psychologically speaking. Reading through my notes has been particularly insightful in this particular regard; for example, each time I used the word re-traumatisation in session, he put the term in scare quotes, as if to suggest that the premature cessation of the therapy could not possibly really result in further trauma. But believe me – it did.

On the point of trauma, when I told him that NewVCB agreed that I had Complex PTSD, C was highly critical of the diagnosis, proclaiming that it was “controversial” (see?! I can do scare quotes too!). Possibly so – it’s not included in either the ICD nor the DSM, after all. However, it is used by the Royal College of Psychiatrists, and anyway – Zen Buddhist crusader C had already stated that he was not a slave to “labels”, so surely a less “label”-ly, more personally appropriate diagnosis is superior to that of “a high functioning borderline personality”. Oh, wait a minute. It was…!dun dun dun!…C that described me as having “a high functioning borderline personality”. (Incidentally, he was incorrect. Because I was incapable of functioning in society, my intellect should not have come into his judgement; in reality, I was pretty low functioning at the time. So there).

So. Am I guilty of revisionism? Am I wearing the opposite of rose-tinted glasses (shit-stained glasses, perhaps?)? I don’t particularly think so, though one thing I accept is that now having had the services of a truly excellent therapist, I might be more open to seeing where C was at fault. However, well before I met Paul, I noted on this blog that I was, in fact, “better off without” C. I think what the key difference in my transgression to “meh, screw you” has been is simply not being in a complete thrall to the man any more. I can clearly see where he made dubious judgements, but by the same token I can also acknowledge that he did do some good things for me.

Perhaps I’m being pedantic, but the long and the short of things is simply this. We did some good work, some times. The work with C did, in fairness, gave me some sort of meaningful foundation on which I could later build with a proper trauma therapist like Paul. C is an extremely insightful man, and he’s actually a wonderful psychologist. I’m just not overly convinced that he is a wonderful clinical psychologist [sponsored link] (ie. therapist). I’m not saying that he wasn’t better in that capacity than those I’d seen before, or that he isn’t better than many therapists who dine on a menu of tiresome, generic behavioural techniques. He was, and he is. But then, being hit in the face with a tennis ball would be better for me than any of that.

He’s a nice enough man. I believe that he generally wanted the best for me, and we certainly ‘gelled’ together; there were times of humour and there was usually some rapport. But, other than allow me to trust ~~(and then distrust)~~ him, thus giving me scope for further psychotherapeutic exploration, he didn’t actually do much. He didn’t do much other than hurt me, that is, surely the last thing that should be one’s enduring memory of a competent therapist.

—

OK, news. Yes. I was sitting minding my own business on Friday afternoon, when the menagerie in the kitchen starting behaving oddly. Mr Cat was so scared of something that he stopped eating his food. This is the domestic-tale equivalent of a super-massive blackhole sucking an entire universe into itself. It simply doesn’t happen more than once in a lifetime.

Ms Cat followed suit. This means that the super-massive blackhole had just sucked in a second entire universe (I’m a proponent of M Theory).

In genuine shock, I staggered to the kitchen. Nothing was out of the ordinary, though there were some weird noises in the back alleyway – something I thought nothing of, really, because there are a few things out the back that someone could have been working on. I went back to the living room and tried to coax the cowardly felines back to their dinner.

They refused to co-operate, which is much more in keeping with their general behaviour. I shrugged, and sat down to read something or other.

Something must have caught my attention out of the corner of my eye because I looked up without thinking, and there – looking in my fucking living room window – was some hoodied spide. Looking in. Talking on his fucking mobile, as if to relay the details of what he could see in my fucking house. He fled as soon as he saw me.

Rather than go after the cunt, I stared out the window in a sort of stupefied apprehension for a minute, then sent a message to A and asked him to come home. Then I went out the back, wondering perhaps if the cacophony that had scared the cats was perhaps connected. Our gate-door into the alley was open, so yeah. A correlation looked likely.

Fucking cunts. We were burgled in 2005 and lost quite a bit of stuff; as a result, and as a pre-requisite of a renewed insurance claim, we installed an expensive but sophisticated alarm system. These cheeky bastards were not only trying to break in despite this, they had the temerity not to check whether or not anyone was in!

Long story short (well, -ish), A came home, we secured things as best we could and eventually went out anyway. You can’t be a prisoner in your own home; we’d have to have gone out sooner or later, so why not make it sooner?

We went out for a bit on Saturday too. All was fine, and I wondered had I perhaps misinterpreted Friday’s events.

Cut to Sunday. A third universe was then destroyed by our friendly super-massive black hole because A and I decided to leave the house. This is almost unprecedented. A and I loathe Sundays so much that we almost always lock ourselves away in the house, trying to pretend that the rest of the world does not exist. This week, though, we decided to go out for a couple of pints and a meal. I think A was even more overwhelmed by Sunday-itis than normal, so yearned to ‘shake things up’ a bit. We left the house about 4.30pm.

At about 6.30pm, my mother called me on my mobile. Had I been in the house, I would almost certainly have ignored her, but something must have compelled me to answer on this occasion. She asked where I was; I told her, and asked why she cared.

“The alarm people called me,” she said. “They’ve been trying to get hold of you. I’m sorry to have to tell you this, but there’s a confirmed intruder.”

We got a taxi straight back, and found the cops awaiting our arrival. They were pleasant but useless. A SOC officer came out a bit later, and although he took prints, apparently the quality of them was utter shite. Not that I’d have expected to see the wee shites brought to justice, anyway.

The following was stolen:

A’s Mac Mini
My iPod
Several video games

Mercifully, the cunts had spotted neither the Kindle nor the satnav, and Friday’s occurences had scared me enough into hiding the two laptops. I will always be grateful for that, at least.

Of course, the theft is only a secondary issue. What sucks most about burglary is the breaking and entering element of it. Knowing that someone you didn’t invite has been in your private property. That they have, sometimes intimately, examined your things and made judgements on their material worth without a thought towards sentimental value. Simply that someone stood there, in your home, your safe place, looking.

And this is particularly exacerbated in this case because they had been watching us. They knew I normally left the house on Friday afternoons to meet A (I was running late the other day). Then they knew that we’d uncharacteristically gone out on Sunday. They were watching us.

It almost makes my ongoing sort-of delusion ~~(legitimate belief)~~ that GCHQ read this blog look tame. At least they’re not looking in my window at me (or maybe they are? Perhaps the spide was one of them. He donned a superlative disguise, if so).

Our living room door and the alley door-gate-thing need to be replaced, and frankly – since this is the second time in little over half-a-decade – we intend to move now. That, of course, will incur massive expenses, both in terms of doing our present house up to the extent where it won’t completely require potential buyers/renters to be fumigated afterwards and, of course, as regards getting and furnishing a new place.

All this when I am £950 overdrawn. Our plan had always been to move, but the plan was that this would take place when I was back at work. Now, we’re hoping to make it by the end of this year. I will help A with a new mortgage in whatever way I can, but it won’t be particularly significant until I have substantially more money coming in than I currently do. Still, I’m just grateful that this happened now, when at least I see working again as feasible in the medium-term, rather than, say, six months ago where it was distinctly a future-aspiration.

Practicalities aside, I have obviously been affected by this incident. On Sunday itself, A and I were both…I don’t know, numb with shock? Too confused and fed up to feel? For a while, it even seemed that it had hit A worse than me. My mood has been slowly dipping for about a week now, so I didn’t really notice any reactive change in it after the burglary…until, that is, last night.

A’s step-mother is a friend of a man who’s a very competent DIY maestro. A spoke to him yesterday evening about the replacement of the two doors, as well as improvements to the general look and maintenance of the house, and he is coming round on Friday morning.

A reports him to be “a lovely fella”, but as soon as I heard that I was to be his host, my body went mental at me. Shaking, breathlessness, nausea – you know the drill. Psychologically, my mind went into a spin of utter terror. This is entirely and completely ridiculous. I have met this man before, albeit briefly, and there is nothing to fear. Indeed, after greeting him, I can in all probability loll about upstairs reading A Song of Fire and Ice. But my bloody head won’t listen to its own rationalisations.

However, the worse was to come. In preparation for the DIY bloke, A started tidying the house. Long-term readers may recall how I reacted to similar before. Well, I reacted in the same fashion again. Poor A; as he rightly said, this needed to be done, but here I was – this stupid, childish, pathetic ball of quivering madness. Who in the name of all that is holy has a phobia of fucking tidying up, for fuck’s sake? Furthermore, who has a phobia of tidying up in the wake of a legitimate fear, namely burglary? I shock even myself.

But there’s something there. There are faint, peripheral stabs of familiarity in the fear. As with the last time this happened, I haven’t worked out exactly what they allude to as yet, and perhaps I never will. But it’s a ridiculous, completely impractical disability; I can’t go on living with it.

Every cloud, though. Although I took Zopiclone last night (as both of us had done in the immediate wake of the break-in on Sunday), otherwise I survived the panic attack without drugs. This, I think, is A Good Thing. Moreover, had the burglary happened in February or March when I was completely off my rocker, this set-back – and it is a set-back; I’m just not sure to what extent yet – would almost certainly have seen an express delivery of helium arriving at our door.

But for now, we’re OK. Both of us. We got through the last break-in, in which much more was stolen (though was, in a sense, less disturbing; we didn’t have the ‘protection’ of the alarm then), and we’ll get through this one too. If we do move as planned, the next six months will be some of the most stressful of my life, but I have the support of NewVCB and Christine, Paul again at some point, and – more importantly – my mother, our friends and of course the lovely A himself. I think my prognosis over the aforementioned timeframe is dubious to say the least, but it could certainly be a lot worse.

Christine tomorrow, though unless there’s anything outstandingly amazing about it, I shan’t write about it until another time (if at all). At least she can help deal with the fall-out of the burglary in some fashion…or such is my hope, anyhow.

Also, if you’re about tomorrow, don’t forget that I’m hosting this month’s Blog Carnival of Mental Health. See you there

Anyway. That was my news. You can go to bed now.

PS. Thank you so much to Counselor Careers for awarding Confessions, in common with several of my favourite mental health journals, a Top 50 Most Inspiring Mental Health Blog award! I still don’t get why this blog is deemed worthy of awards and recognitions, but I do sincerely appreciate that it is. So thank you, very much indeed.

Now, off to bed with you!

—

EDIT (Thursday 30 June): I corrected all the mistakes above, then the computer crashed on me and WordPress apparently failed to take an autosave. I cannot be arsed to go through this tripe again, so you’ll just have to live with the multitude of errors. Sorry.

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To BPD or Not to BPD?

Christine, CPN, Mental Health Diagnoses, NewVCB, Psychiatry, Recovery 11 Responses »

Jun 242011

Last night I was reading this post by GoldenPsych, and was reminded of a recent, and potentially significant, development in the saga that is my mental (ill) health – something that I had hitherto forgotten to record here.

I saw Christine, my CPN, last week, who was full of earnest apologies for having had to cancel a previously scheduled appointment with me. A year ago this particular confluence of events might have annoyed me; as it was, I didn’t mind in the slightest – particularly because she’d been ill. People don’t choose to be sick, for God’s sake. I kept telling her that I didn’t mind, but she kept apologising nonetheless. Again, this steadfast sorriness might once have irked me. Instead, I felt rather touched that she gave enough of a shit to say it first of all, and then that she wanted to press home the point that she actually meant it. I can’t say that everyone I’ve dealt with in mental health services has shown such concern.

Anyhow, the long and the short of it is that she’s “delighted” with how I’m doing. I told her about the writing I’ve been doing independently of this blog, and she couldn’t stop smiling. I went on to say that I’ve been reading pretty voraciously for a while now – and that, whilst it’s not at the lofty levels of studying the texts of Dostoyevsky or some other such ~~self-referential literary fuck~~ highly acclaimed author, it’s still vaguely challenging material that requires much more concentration than that to which I’ve been used since I had this breakdown almost three years ago. Christine continued to not stop smiling.

Can it be that she actually gives a rat’s arse about her patients? I mean, this is an employee of my Trust we’re talking about, not one of a properly run nor remotely respectable organisation. But hark! It seems to be true, of both her and NewVCB. Maybe I shouldn’t have allowed my hopeless experience with Psychology and wholly tiresome engagement with the responsibly bankrupt Mr Director-Person to bias me quite so much as it did. At a corporate level, the Trust is a fuckhole – but that doesn’t mean it doesn’t have some good people within its ranks.

I complained about the weight I’ve gained since I started taking 600 daily milligrams of Seroquel (I had no such issues at all at 400mg and below) and we had a conversation around that (“take it up with [NewVCB], but remember the command hallucinations were often still there at 400mg, so you have to be careful…I have a patient who was seriously ill who was prescribed Seroquel; he’s really well, mentally, now but has gone from a fit, athletic man to being over 20 stone,” apparently), the upshot of which is that I’ll raise it – without much hope of a reduction, however – at my next psychiatric consultation.

We also discussed how I live less here, on this blog, in this created online world that was my more vivid life for so long. I’d also had this chat with NewVCB the last time I saw her (which I didn’t write about because nothing happened), and they both agree that it’s a good thing. I assured them both, though, that whilst I’m living as ‘me’ – out here in the ‘real world’ of air and trees and streets and clearly embodied human beings – that I will not abandon this side of my life, at least not for a good while yet. Being ‘real’ is a good thing, but I’m not better yet, and even if I was, the support I gain from all of you would still be invaluable. Christine seemed to feel that I am striking a fair and reasonable balance.

Anyway, I was with her for ages, babbling on in the spoken word in the verbose way I veer towards on this blog with the written word, but other than the above, most of the appointment consisted of her asking y, me answering z, and her smiling in recognition of the supposed progress that z represented. One thing of particular note did occur, though.

I told her at one point that I’m writing an article for <a href="can be recovered from.”

This led to a discussion of the diagnosis. You may recall that I protested to NewVCB several months ago about its applicability or otherwise to me – my view at that stage had been that I had major depressive disorder and some unspecified psychotic condition, with the occasional fugue thrown in for good measure (schizoaffective disorder? Psychotic depression? Psychotic depression plus ((C-))PTSD?). NewVCB whined a bit about how she wasn’t interested in diagnosing me; she just wanted to treat my symptoms.

Of course, this is sensible. I don’t know why I’m fixated on diagnoses, but I always have been, even for physical illnesses. I like terms that help me to understand my conditions, even if they’re not wholly definitive and are in need of some elasticity around the edges (as I believe most mental health, and many physical health, conditions are). I loathe the terminology “label” in this context, probably because I see the validity of a diagnosis; to me, it’s not necessarily a nasty, sticky thing that follows you everywhere.

Except…in the case of BPD, it actually sort of is. Although I fully agree that I had the illness when I first received the diagnosis, I truly feel that I do not now (and indeed that I didn’t when I raised the matter with NewVCB). However, borderline is notoriously difficult to get rid of, officially speaking. Once you get it slapped on your file, whether or not it’s accurate, you can’t get it off your fucking file. So then some idiot that still views the disorder in the outdated, pejorative way that it’s traditionally been considered peruses one’s notes and whines, “oh for fuck’s sake, not a bloody borderline!”

It’s not fair, but it seems to be true. You. Cannot. Get. Rid. Of. It.

Unless, apparently, you’re me.

Christine tells me that when NewVCB first referred me to her, the latter said that she was “seriously questioning” my supposed status as a person with BPD. Christine said, “have you asked her again about it?”

I told her that I hadn’t, alluding to the aforementioned comments of the consultant on treating symptoms. I pointed out that I agree with the approach, to an extent, but that knowing what’s ‘wrong’ is still important to me.

Christine nodded empathetically. “Do ask her about it again,” she urged. “She was genuinely reconsidering the diagnosis.” Then, and I don’t recall exactly how she phrased it, she somehow insinuated that she agrees with me; whether or not I ever had BPD, I don’t now.

I will truly be amazed if there is ever a definitive statement ascribed to my medical notes observing that I am no longer diagnosable with borderline personality disorder, but the fact that the two of them are even considering the issue is hugely significant to me. It’s a measure of their competence and understanding, and (perhaps more importantly) it’s also a measure of how different things are for me these days.

I’d stress at this point (a) that I’m not completely banking on getting BPD ‘removed’ from my file; and (b) that just because things are reasonably OK at the minute, that I’m under some sort of illusion that I’m cured and will never experience fucked-up-ness again. I’m not the wisest person on the planet, but I’m not a complete fool either. Still, I’m cautiously encouraged. All of this represents a good sign.

In the absence of Paul (more session reviews to come), I’m seeing Christine at two-week intervals for the time being, meaning that our next appointment is next week. I’m due to see NewVCB the week after that as well. I shall explore this further with them both on these occasions.

(Aside one: Christine mentioned a patient whom she’d referred to Nexus. The woman had been very mental prior to going to them, but after completing her course of therapy, was “a different person”. That’s a great thing in itself, but Christine continued by saying, “I was so happy for her, I just gave her the biggest hug!” I thought this was rather lovely. She does genuinely seem to care

Aside two: Remember C? C of NHS-Psychology-I’m-Dumping-You fame? When I used to see him, he worked at the hospital in which I see Christine and NewVCB on Mondays, Thursdays and Fridays. My consultations with Christine have previously been on a Tuesday or Wednesday, but the appointment to which I’m referring in this post took place on a Thursday. Do you see where we’re going with this?

I didn’t go into his building, of course; it’s too small, and he could easily have spotted me. I did drive round to it though, to see if his car was there. It was. I stared blankly at for a minute or two, then turned round and left.

I don’t know what I was hoping to achieve, but the silly endeavour only succeeded in evoking a stale taste in my mouth, a vague mental conjecture as to what he might have been doing right then, at that very moment – and, ultimately, an involuntary utterance of “meh”.

A was somewhat less ambivalent. “Did you throw a fucking fire bomb at it?” he seethed when I told him, bouncing around in a fit of pique. It seems odd, really, but I think A has even more contempt for C than I do.

((For the record, in case the police/GCHQ/MI5/any similar organisations are reading this, I didn’t firebomb that or any other car and, furthermore, A was employing verbal hyperbole to emphasise his frustration and his comments are therefore not to be taken literally in the least. Sorry lovers, but one apparently now has to add these sorry disclaimers to such comments – after the Twitter joke trial farce, you can’t be too careful, can you?)).

So yeah. I don’t know if I still compartmentalise everything about C ((quite possible)) or whether I really don’t care at all anymore ((not inconceivable either)). Either way, it wasn’t him that helped me get to the stage I’m at, was it?).

Alas. I’ve had enough of composing this dull post; I just thought the above merited reporting. See you next time, darlings.

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Nadine Dorries: “Abstinence Only Education Will Help Prevent Child Sex Abuse”

Random Mental Health Related Philosophising, Sexual Abuse, Traumatic Stuff, Triggers 45 Responses »

May 172011

EDIT TO ADD: A petition has been created calling for Nadine Dorries’ resignation in light of the comments below. Please don’t allow her to get away with this unscathed - add your name to the list of signatories right here. Thank you.

—

How many times do the political and mental health blogospheres have to highlight and respond to this bloody woman’s insidious, dangerous views? First she whinges that genuinely disabled people are incapable of using social media (“get back to work, you layabouts!”). Next, she uses deliberately loaded and offensive language to slur an individual she has decided she doesn’t like because he had the bare-faced audacity to take her to task on something (“nutter nutter nutter nutter nutter!!!”). Now she is saying that we, ie. the victims of childhood sexual abuse, asked for it. Yep, you read that correctly: if young females, in the face of potentially unimaginable terror and bewilderment, had just said “sorry, not today, thank you”, all would have been well! Those poor ~~paedophiles~~ misunderstood gentlemen, being led astray by these slatternly young sirens!

Her quote:

If a stronger ‘just say no’ message was given to children in school then there might be an impact on sex abuse…if we imbued this message in school we’d probably have less sex abuse…when sex abuse takes place [girls] don’t realise that that was a wrong thing to do. (Source I, Source II)

This in light of her ridiculous Parliamentary bill to teach girls – and girls only – ‘abstinence only’ sex education.

I could go and dig out statistics on this whole abstinence debate if I could be arsed, but I’m sure there’s dozens of other bloggers that have already done so, so I won’t (leave me links in the comments if you wish, and I’ll add them to the post). I will instead respond to this in light of personal experience.

As far as I can remember, I was first raped at the age of five. It could have been slightly earlier, or slightly later, but it was at about that age, because I have a conscious recall of, during the assault, my agonised fat face lying wide-eyed on the ground with my long, light-brown hair cascading around my enforcedly-horizontal body (in a perfect rape-victim stereotype, I had the majority of my lovely mane’s length hacked off shortly afterwards).

I had a playground knowledge of sex, I suppose. It was a taboo thing in which adults engaged – if you did it before you were married, it might even result in a baby coming! My childhood naivety – my belief that sex wasn’t required after a marriage to ensure procreation; one’s offspring just sort of arrived in one’s arms – makes me laugh a little now, yet also disturbs me in that such anti-sex-before-marriage-rhetoric probably harked back to the horrible Presbyterianism that was forced upon me around such matters. Dorries would, presumably, be pleased by this sort of dogma.

Anyway, a playground knowledge of sex does not equate to a fundamental (or even rudimentary) understanding of the mechanics of the act of sexual relations, nor does it suggest an understanding of the physical sensations nor psychological impact of engaging in said activity. I knew it was something to do with genitalia, but no more than that.

So that first time, during that first rape, not even knowing I had an orifice in that location, I thought that my uncle was stabbing me. The pain, mental as well as physical, is almost impossible to describe.

Fast forward six years or so. We had sex education in school, much to the sniggering amusement of all the boys and a majority of the girls. I had already worked out what was happening to me by this juncture, but had assumed that my younger self’s belief that sex was the exclusive domain of adults had been an unsophisticated child’s mistake. To me as an 11 year old, childhood sex was a normal practice in which to engage.

It was only as a teenager that I began to properly realise that this was not the case, and to some extent I still struggle with the idea.

Anyhow, despite the apparent evils of standard sexual education both at primary and at secondary school, I did not willingly have sex until I was 18. I was an adult – albeit a traumatised, disturbed one – and the action was desired, considered and undertaken with considerable precaution. My partner did not abuse me; I consented to having sex with him. I consented because I wanted to, not because I was unaware that I could say ‘no’ to the man. I knew that I could say ‘no’, and what’s more – I knew that if I said ‘no’, but he made me sleep with him, that that would be rape. He would be forcing himself upon me; he would not somehow be encouraged nor spurred on by my not having some requisite words of objection as taught from some crap sexual education class. If I had not wanted to have sex, and he had continued, the fault – as with any situation of this nature – would lie entirely with him.

Such knowledge is not available to a child. You don’t know that you can say ‘no’ – not just because the situation may have a gruesome normalcy to it, nor conversely (if it is the first time) because you are utterly mystified as to what’s happening to you – but because, simply put, you cannot say ‘no’. You are option-less in this scenario: in the terror of a fully grown man forcing himself upon your tiny body, you have little choice but to lie still, grabbing whatever laboured breaths you can, in order to remain merely alive. Saying ‘no’ is likely to only provoke further determination and violence from the perpetrator. At the risk of being repetitive, you cannot say ‘no’. Your very life may depend on you not doing so.

Sexual abuse is deeply traumatic and has the power to considerably affect its victims long after it itself has ceased. I have lived with a life time of mental illness, much of it trauma-related, and am still wading through the murky waters of therapy in an attempt to gain something that approximates an ordinary life, as understood by society at large at least. The notion that I brought this on myself by not ‘standing up’ to my rapist(s) is so incredibly offensive that it nauseates me to my core. Righteous anger pulsates through every vein, artery and capillary of my being. I know there’s a dichotomy here – regular readers will know that I often say, “yeah, but it was my fault” or “I should have stopped him” – but those are the words of a petrified, traumatised child. The echoes of such ideas by an elected MP on a national television programme merely serve to re-enforce a victim’s (misguided but natural) sense of shame and self-castigation, to add to the stigma of sexual trauma and any mental illnesses resultant therefrom. And that’s not to mention a word of the blithe assent to misogyny inherent in Ms Dorries’ insulting remarks.

If we have an abstinence-only message in schools, there will be no miraculous drop in the statistics of child sex abuse. As alluded to briefly above, I would contend that the perceived “defiance” of a child saying ‘no’ to an abuser four or five times her/his size could actually be dangerous.

Does Ms Dorries really think that a perpetrator, hearing a young kid saying, “please don’t!” is going to cock his head and scratch his chin in a moment of stark realisation? Oh right, she doesn’t want to have sex, so I’d better not go on. Augh well, some other time maybe. The idea that this is somehow easily obtainable is ludicrous.

Why? Because, as has been consistently shown time and time and time again, rape and sexual abuse are only secondarily (if at all) about sex. They are primarily about power, about control, about the twisted, megalomaniac thrill of seeing another person made vulnerable and degraded by one’s own dominance. In other words, if a sexual criminal has the will and the opportunity to rape or molest, (s)he will take it – no matter what his/her victim may say.

Oh yeah, and another thing, Nadine. Plenty of people did say ‘no’ and were raped anyway. I suppose they mustn’t have protested fervently enough, eh?

Dorries will no doubt claim that her comments have been taken out of context. I don’t care, and I don’t care what context they were meant in. What she said is still fallacious, victim-blaming and reductive in the rightful apportion of blame to a rapist and/or abuser. Her mens rea is irrelevant; her comments are still grossly offensive and morally (not to mention factually) wrong.

Links

Facebook – Stop Dorries’ Abstinence for Girls Sex Education Bill
iPetition – Petition to Call for the Resignation of Nadine Dorries
The Guardian: Comment is Free – Nadine Dorries’ Dangerous Message
Dawn Willis – Tory MP Proposes Controversial ‘No! Test’ for Alleged Victims of Sexual Abuse
The Madosphere – Nadine Dorries, It’s Not About You
Political Scrapbook – Nadine Dorries Says Child Sex Abuse Victims Should “Just Say No”
Nightmares and Boners – Nadine Dorries Thinks I Was Asking for It
Niklas Smith – Why Nadine Dorries is So Wrong About Sexual Abuse and “Saying No”
Too Much to Say for Myself – Girls: It’s All Their Fault!
Milena Popova – Open Letter to Nadine Dorries
Fierce as Fuck – Nadine Dorries Says Child Sex Abuse Victims Should Just Say No
Crazy Elmont – Sexually Abused? It Was Probably Your Fault
The F Word – Adding My Voice to Those Revictimised by Nadine Dorries
The Nadine Dorries Project – Teens, Sex and Nadine Dorries

Disclaimer: As discussed in the comments, Ms Dorries is unlikely to be saying, straight-up, that sex abuse survivors were directly to blame for their traumas and rapes. It is indeed probable that the woman has used a poor turn of phrase for what she was trying to imply. However, that does not make her nonetheless distasteful remarks any less controversial or offensive; she should think before she speaks and make her points thoroughly unambiguous. As I noted above, her intent matters little amongst the offensive terminology and implications, deliberate or otherwise, that her comments were laced with.

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It’s My Birthday, and I’ll Die if I Want Two

Blog News, Life 25 Responses »

May 042011

Fortunately (or unfortunately) for the not entirely insignificant number of readers this blog has, I don’t ‘want to’. Or even ‘want two’. Even if my posting here has dried up markedly of late, my little corner of cyberspace intends to remain alive and well for the foreseeable. The picture above amused me, and made me think back to some of my most suicidal days earlier this year, and thus I thought it was apt that I bring it to you along with my news…

…which is the announcement that it’s fuckin’ party time. Confessions is two years old today!

This time last year, I wrote quite a long post with a sort of “where I’m up to at this point” theme, plus some stats. I’ll do the stats bit again – renewed for the blog’s second birthday – because that’s always kind of entertaining, but in terms of the ‘my life in the last year’, I’m not going to bother detailing everything that’s happened; instead, I’ll just note a few major events and hat-tip a few significant people.

Life and Times as a Mentalist

There were four major developments in my life of madness in the last year:

Therapy with C ended, pretty much destroying my life.
Therapy with Paul started, pretty much making my life better.
I started taking 300mg of Venlafaxine and 600mg of Quetiapine, and the prescribing NewVCB proved herself to be thoroughly on my side.
I was allocated a CPN.

2 – 4 inclusive have had the surprising but highly gratifying effect of improving my life, to the extent, indeed, that last month I realised I could no longer be diagnosed with borderline personality disorder. Whilst I still struggle with issues relating to complex PTSD, am frequently afflicted with (sometimes very debilitating) anxiety and know severe depression will once more return, I am, right now, doing fairly well, and getting rid of borderline (even if it’s unofficial) feels like a big deal. Life is OK.

In these ways, it feels like I’ve come on a long way in the space of a year (particularly in the space of the last few months), and I feel ever so slightly proud of this. However, it could not have been done alone: Paul, NewVCB and (to a lesser extent, but only because she’s new) Christine have been invaluable in the relative success of this process. In personal terms, A, my mother, my regular blog readers and Twitter friends have all been worth their weight in gold too. Thank you all for your continued support.

Blogging as a Mentalist

In terms of stats, the blog at the time of writing has 243,724 hits. Just short of the magical 250,000 that I’d hoped (though not really expected) to get, bah!!! I know that, in terms of blogging overall, this isn’t a huge amount – but in terms of a personal blog about a personal subject by a personal, provincial non-entity, it’s not bad. It’s certainly exceeded by expectations by…well, by about 243,273 hits, I suppose. I don’t think I’ll ever understand what it is that you like about this blog, but whatever it is, I’m humbled by it and very grateful for it.

I don’t think it would be a huge exaggeration for me to say that blogging has saved my life. At the very least, a combination of this and Twitter has; without the support that I have been almost unconditionally offered through these ventures, I strongly suspect that I would have caught the bus sometime in the last two years. I’ll never be entirely grateful that I’m alive, I suppose – I still can’t understand how some people aren’t suicidal. How the fuck does that work?! How the fuck can that even be?! But still, as of right now, I’d probably rather I have my life than I didn’t – and a large part of that can be attributed to the never-ending friendship and encouragement that you lot have shown me.

I got more blog awards over the past 12 months – see here and here for the main ones, and here for others that I somehow managed to rack up along the way.

The most popular posts this year were:

Thoughts on the DLA Changes in the Budget – 6,501 hits
BPD vs C-PTSD – 1,841 hits
Self-Harm: A Warning – 1,012 hits
Suicide – 950 hits
Suicide Attempt Epic Fail – 832

The most popular static pages have been:

About the Author – 2,811 hits
NEW? Start Here! – 987 hits
The Alter Ego – 953 hits
A Mentalist’s Glossary – 719 hits
BPD & PTSD – 592 hits

Over the last 12 months, I’ve had an average of 16,330 hits per month, and with the data available (only about six months’ worth), I see that, at a rough average, I’ve had between 3,000 and 4,000 hits a week and about 500 daily visits. Even when I haven’t posted for a while, for whatever reason there still seem to be about 200 – 250 hits daily, but this goes up notably when I do write more regularly.

The top three traffic providers have been StumbleUpon, Twitter and BlogSurfer. The top three other blogs sending visitors here were Bippidee (her old blog, and for the second year running), Mental Nurse (RIP) and My 13th Sad Day.

The top search terms arriving here are:

(Confessions of a) Serial Insomniac (and analogous terms) – 2,474 hits
DLA Changes (and analogous terms) – 2,229
C-PTSD – 274 (bit of a gap there)
Peccary – 248 (yes, I know – how odd. It’s because the picture on this post ranks highly on Google Images).
Mental Nurse Blog – 238 (lots of people missing it, then)

Mentalist Acknowledgments

This is always difficult, but let’s give it a whirl. Mega thanks to bourach, Phil Groom, UselessCPN, Narky, Maria, Maybe Borderline, Sanabituranima, Seaneen, Little Feet, Autumn Delusions, Zarathustra from the erstwhile Mental Nurse, Kate (all three Kates!), Tit Flasher, MCBL, Splint, tai, Clarissa, Ali, Nick, Null and Mental Spaghetti. Thanks also to all of those on Twitter that I regularly chat with, and indeed those on Facebook (Please, please do not be offended if you’re not mentioned here – it’s me that’s shit, not you. I’m sure I’ll come back here to add people as Venlafaxine memory-lapses allow me!).

Many thanks as always to A, Mum (not that she’ll see this), Daniel, Brian (not that he’ll see this either), Aaron (not that he likes to be called that), CVM, K and everyone from the Mad Up.

Meh

Things have changed around here lately; because I’ve been keeping relatively well, my writing on Confessions has gone down proportionately. But make no mistake – my recovery is far from complete. It’s started well, but there’s a fuck of a long way to go. This blog will continue until, at least, I am able to return to normal, paid employment. I’ve no idea if I’ll have achieved that by May next year – probably not, I’d guess, for even if I feel ready for it, the economic climate is still pretty shit. Even if it does happen by next May, I do have to keep you updated here and there, don’t I? And also, I’ll probably still be under Paul’s care then, in our second run of therapy. And who am I to deny you your vicarious therapeutic pleasures?! (Before someone says it, I know you’re owed three session reviews. Soon. Really. Yes. Honestly, soon. I promise. Yes! I really do!).

So I think Confessions will see its third birthday, at least. Whatever the case, thank you all for all your comments, emails, tweets, FB messages, RTs and so on. Thank you for the never-ending support and encouragement. And thank you for making this venture the modest but important success that it has become.

Much love

Pandora <3 xxx

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Mentalist Appointments and Other Boring Faff

Christine, CPN, Life, Meh 18 Responses »

Apr 152011

I’ve been very sick this week. I was throwing my guts up and, to be euphemistic, losing matter at the other end almost continuously from Monday morning to sometime yesterday. Well, not quite; what happened on Monday was that I was sick (as in throwing up) from about 9.30am to 2.30pm straight, meaning that I had to cancel my session with Paul and a subsequent arrangement for lunch with a friend. Then, suddenly, I stopped hurling everywhere, and seemed temporarily fine. Even though there was almost no risk of it, I convinced myself that I was up the duff and drove round to Boots to buy a pregnancy test. It was negative, of course, as I knew it would be. But knowing something is or isn’t true and actually being convinced of it is, when you’re me, not at all the same thing.

Shortly after I got back from Boots, the diarrhoea started, and on Tuesday the vomiting came back – though this time not confined to the morning. So I’ve been feeling sorry for myself, but I’ll live.

Had I seen Paul on Monday, today (or yesterday, if you must be pedantic) would have been the fourth consecutive day of appointments. I’ve said it before, but I’ll say it yet again; being mental is a full time job.

On Tuesday I went to see Christine, my CPN. I ate nothing beforehand, other than to stuff Immodium down my throat, as I didn’t want to cancel what was only our second appointment. I actually managed to talk to her reasonably well, all things considered.

As I mentioned, in my last psychiatric appointment NewVCB had said to me that she wanted Christine to focus on ‘practical’ stuff in her interactions with me. As you might imagine, this caused me a certain amount of anxiety given my general disdain for the supposedly therapeutic properties of basket weaving, ‘changing’ your thinking, flicking a fucking rubber band on your wrist or ringing the Samaritans (with no disrespect meant to said organisation).

It turns out that Christine’s approach is considerably less shit than the above. I had told her about this blog the last time I saw her, and mentioned that it had been moderately successful over its almost-two years of existence (I mean, compared to the big blogs, this site is nothing. But compared to what I expected, it’s considerably more than nothing). On Tuesday, she brought this issue up – basically she said that if I had an audience, that if people bothered to read the shit I splurge here, that if people interact with me because of it – then I must have some sort of ability to write (personally I don’t think this is the case, although some of you have been kind enough to make contrary assertions in the past. Thank you).

I shrugged at her, and asked her what her point was.

Not a bad one, actually, as it goes. She was wondering if I had considered submitting some of what I write to some of the local mental health charities – Charity A, Charity C, Aware Defeat Depression, Charity B etc etc. She said that these organisations often produce newsletters, and in her opinion they would be “crying out for” a patient with an ability to articulate him/herself to produce a few pieces for such publications. I have to say that I would never in a million years have considered something like this. It simply would not have occurred to me.

I have noticed in the waiting room at Nexus that the organisation compiles and advertises writings from some of their (former?) clients (or clients of related organisations). One lady to whom they frequently allude wrote a book, published by the small, socially-run house of Chipmunka (who are mental health specialists). The verse of others features in the originally-titled Nexus Poetry Book. I remember finding these publications interesting, but I wasn’t somehow inspired into submitting anything of my own.

So, I told Christine that I hadn’t thought of it, but that it seemed like a plausible idea. She said, “have you considered writing professionally?”

Who hasn’t? Seriously, doesn’t everyone grow up wanting to be best-selling novelist? It was something that certainly crossed my mind many times. (Aside from the fact that I haven’t written any fiction since…God, probably since my GCSEs). In real terms, though, I did apply for a few freelance contracts some months ago, and based on samples from both this blog and Not as Smart as Pandora Braithwaite, was successful in securing all of them. The problem was that they, reasonably enough, wanted exclusivity on all submissions.

So what? Well, my writing for me comes first. This blog comes first. Writing here, especially in the highly verbose manner in which I do, can be energy-zapping at times, meaning I don’t have any va va voom left to write elsewhere. If one of the magazines who offered me freelance contracts had been willing to budge on the exclusivity matter, I could have simply sent modified versions of posts from here – but I understand why they won’t do that. By the same token, I have my terms. I am not going to prioritise money-making articles over the therapeutic concern that is this blog.

I told this to Christine, but she reckoned that the local charities wouldn’t really give a shit. She repeated the term “crying out for”, suggesting to me that in their apparent desperation, exclusivity on articles would be the least of their worries. In which case – fine by me. Though as I said on Twitter, if indeed this comes to pass, I will have to edit out the multifarious instances of the words ‘fuck’, ‘cunt’, ‘dickshaft’, ‘tossface’ etc. Null has offered to help me. He is going to be my editor, bitches, yeah! Null advises that I must henceforth use the words ‘fudge’ and ‘cumberbund’ in place of my more typical parlance. For fudge’s sake.

What else? We talked about my ability to get out of the house, and I said that although it was still reasonably poor, it was improving. I told her that I had developed a small but fairly active interest in geocaching (though this was a difficult conversation, because anyone who engages in this practice sounds…well, mad to non-cachers. “It’s a high-tech treasure hunt!” I enthused. She raised her eyebrow, scribbled something down and gently moved the subject on) that was taking me out a little. I discussed how A and I would often go out at weekends.

“But can you go out alone?” she queried.

I laughed in her face. “Of course not!” I said, incredulous.

“Why?”

I thought about it for a minute. I had arrived at the CMHT alone, after all. Why not elsewhere? But the very idea of going almost anywhere else by myself made me anxious, and I started blathering idiotically at her.

She saw my distress, and duly steered the conversation away slightly. “OK,” she said, “but how are you when you’re out?”

“Alright if someone’s there, usually – unless there’s a crowd, or someone sitting close to me or something.”

“And then what happens?”

“I go mental and simply have to get out of the situation.” I thought back to a recent trip to fucking Tesco and shuddered.

“Have you ever been prescribed Diazepam?” she queried. I told her that I had a stash of it at home.

“Not to throw down my throat in a moment of existentialism, you understand,” I assured her. “Just…for emergencies. For when the GPs stop being willing to give it to me.”

“Like a comfort blanket,” Christine said.

“Exactly.”

The long and the short of this discussion was that she believes that taking a Diazepam, using Diazepam when needed, is better than not going into what I perceive as difficult situations. She told me to take some with me in my pill box and to just take one (or two, whatever), as needed.

She opined that most GPs, if satisfied that you’re not addicted to the things, will be willing to give them to most people. I thought back to Dickhead GP‘s abject refusal to give me anything other than that which the consultant prescribed, but kept my mouth shut.

Christine then talked about volunteering for a while. She agrees with me that I’m not ready to go back to work any time soon, but does think that a few hours a week of this would be a good thing. I explained that volunteering was certainly on my long-term agenda; from an entirely selfish angle, it’s a good way back into work, both in terms of the CV experience and as an ‘ease in’ to a more demanding position. However, for once in my sorry life, my greater priority in planning to volunteer is the altruism involved. If they would be willing, I’d love to do some admin or something in Nexus, given the difference their service has made to my life. Failing that, I’d like to work with Aware or one of the other charities listed above, because their work is so vital to people with mental health problems. For some, maybe those who are not considered worthy of seeing CMHT members or something, such charities are their only lifeline.

Ultimately in terms of volunteering, I’d love to join the CAB, as they have been truly excellent when I’ve seen them regarding benefit issues. That’s a serious commitment, however, as (a) you have to be willing to give them at least 16 hours a week and (b) you have to do (at least?) a year’s worth of training (an NVQ in Advice Work, I believe). Of course, they accept applications for admin and so on as well, but these tend to be quite oversubscribed and anyway, I think that ultimately the proper training would be an excellent opportunity both in terms of my career and vis a vis ‘giving something back’.

Anyhow, Christine was essentially suggesting I apply for some sort of volunteering position now. She agreed that the CAB one should be much further down the line, but went on to say that in the case of the other charities, they may only want a few hours a week from me, and in any case, that the application processes were notoriously long (probably because of a dearth of resources). I said that I took her point, but I wanted to be certain that I was ready to move into this domain, and that right now I’m not. She accepted that, but told me to keep thinking about it. I will. In the meantime, I will see if the aforementioned charities are indeed interested in any of my written ramblings as she suggested.

I told her that I was having an ECG the following day to see if NewVCB could increase my dose of Venlafaxine to 375mg daily. Christine said that she thought that would be great; she said that she knows that that dosage is pretty hardcore, but given the chronic and severe nature of my depression, and especially given that 300mg has made such a difference so far, that she agreed with NewVCB that it could be a productive way to proceed.

This led to a brief discussion on NewVCB. Christine loves her. She told me that NewVCB does home visits to the most ill in the community – apparently this is exceptionally rare for consultant psychiatrists (I’m sure it is, though I was reminded that when Paedo first started going really mental, a consultant was at his house within 24 hours. The McFauls seem to get everything they want from the NHS, which is odd in itself; it is made all the odder by the fact that they are under the same Trust as me!). She went on to proffer the view that NewVCB is the best consultant in the area – she meant in terms of her personality and devotion to her patients, I think, but there was also a suggestion that she meant medically too. Based on my admittedly limited experience of psychiatrists, I would agree with this assessment. One thing that continually sticks in my head is the time that NewVCB said to me, “you do know that you can ring me if you need to, don’t you?” I didn’t – not before she said that. I thought that, unless I was crisis-team mental (does that kind of state even exist? I loathe the crisis team beyond words), that I was completely alone out here on the outside.

Finally, we had a discussion about Paul, and about how things are coming to an end with him in the next six weeks or so. I told her that NewVCB had intended to discuss my care with her in relation to the immediate aftermath of that, but Christine didn’t take the bait on that, and instead started wanking on about whether or not I felt “abandoned” or something.

I told her that I didn’t feel abandoned in the least. In part, that’s because Paul himself thinks that the time limit is a crock of shit and is enforcing it only because he has to. In part, it’s because whilst I’m very fond of him, I’m not reliant on him the way I was with C. In part, it’s because I am stronger and less borderline now.

What my problem with the discharge is, I said, is that very productive work had been going on with Paul – but that it is far from finished (by his admission as well as mine). I was abused, badly, for years. Not to mention all the other crap that came with life – Hideous Ex, V, bullying, grandfather’s death, yadda yadda. I’ve read the literature. I’ve spoken to others in similar positions. I’ve even asked the fucking professionals. And the consensus is the same: trauma therapy cannot be adequately conducted in a matter of weeks. It can take years. I told her so, and she accepted that.

And that was that really. I’ll see her again in three weeks, at which point – particularly if I haven’t seen NewVCB in between – I’ll ask her if we can increase the frequency of our meetings whilst Paul is out of the picture. I have no idea if she’ll agree – though I think NewVCB would be happy for her to, so there’s no reason why not that I can detect – but we’ll see.

I like her. I feel able to talk fairly openly to her, which is not normally an easy thing to do. I can’t necessarily see myself getting close to her as such, but I can see her being helpful and supportive, and right now I think that’s all I really need her to be. As you know, I was cynical about the role of CPNs when the idea was first mooted to me about a year ago, but I am happy to have been proven wrong in this instance.

The next day I turned up at the same hospital for the ECG. I was 20 minutes early, but went into the “waiting room” (a few broken plastic chairs strewn over the corridor of the crap mobile building) anyway. Immediately, a young girl stuck her head around the door, into where I stood (I was too scared to sit). The poor cow is obviously marked for NHS redundancy, because she actually didn’t keep me waiting and didn’t fuck about. Despite my o’er-timeliness, she brought me into the crap room straight away, cheerfully gabbled out the usual small-talk (traffic, weather, her fiancé), hooked me up to the machine, waited 10 seconds, glanced at a print-out, then advised me that I was “all done”.

She was obviously not a doctor, because she couldn’t read the results of the test herself. She said that she’d sent it to NewVCB for analysis but – and this is hilarious – it needs to go, firstly, to Big Bastard Hospital That Everybody Hates to be lodged on the computer as “[they] don’t have a computer [there]“. Once lodged, it then goes back to this hospital (the same one in which I see NewVCB and Christine and, formerly, C).

I arrived back at my mother’s house before my allocated appointment time. I couldn’t have been in the room for more than five minutes.

Finally, to today (or rather yesterday, but meh). At 8.30am, I had an appointment with Lovely GP. I cursed myself for booking such an early slot when my alarm went off this morning, as I do each and every time I see him. The reason for doing so is that, as his first patient, I won’t have to wait for my predecessor to take up more than 10 minutes of his time like I normally do.

I had essentially made the appointment to discuss the usefulness or otherwise of Orlistat, which he had prescribed me the last time I saw him to try to help combat the weight issues resultant of taking Seroquel. Knowing, however, that I had stuffed my face with more chocolate in one day than can be found in an entire Cadbury’s factory in a decade, I chose not to bring the subject up.

Instead I told him how much better I was feeling, and we had the same discussion around Venlafaxine that I had had with Christine on Tuesday. He said almost exactly what she had: that yeah, 300/375mg is a fuckload to be taking, but that my issues are severe and chronic and if that’s what it takes to mitigate them, then that’s what it takes to mitigate them.

I don’t remember a lot of what was said, as I was still under the influence of Zopiclone. I do remember that he commented, as many people have, that he could see the positive difference in me – to use his term, I seemed a lot more “responsive” (an interesting way of putting it, I thought). I told him about being allocated a CPN and that how, in light of Bye Bye Paul, this was A Good Thing.

Then, cautiously, I decided to ask The Question.

“She [Christine] said…hmm…well, she said I need to keep getting out but…well, crowds still kill me. She said…um…I should maybe…well, you know…”

He looked at me with bemused enquiry etched across his face.

“…God, I feel like I ask you this every time I see you…she said…’get out, take a Diazepam if that helps you get out. It’s better than not doing so’. So I know I must seem like an addict…but could you maybe prescribe me some? Please?”

He sat back in his chair and laughed. I looked at him in irritation and asked what I had done to arouse such amusement in him.

“‘I know I must seem like an addict’,” he repeated. “I last prescribed you Diazepam months ago. And it was only 14 of them even then. No, Pandora, you are certainly not an addict. You are clearly not abusing these pills in any way.”

True – after all, I haven’t taken any of them. They’re all sitting there in my stash box taking up space. Not that I told him that though, because he wouldn’t prescribe any more if he knew that, or at least so I assume. (And at this juncture you might validly ask why I need more of them despite already having loads. The simple answer is that I have no idea. I just know that when I give myself permission to even take a couple of the things, I feel like I have to make up for their ‘loss’ by gaining three-, four- or five-fold more. As Christine said, they function as a security blanket).

LGP said that he “completely agree[d] with the CPN” that it is better to get out and about and pop a Valium than it is to sit terrified in the house and not pop a Valium. He talked about my need for confidence building, the need for me to develop some sense of routine and ‘normality’, and so on and suchlike – though not in the irritatingly patronising fashion normally employed by GPs. The long and the short of it is that he too is pleased with my progress. Result.

I was trying to grab my scripts and scurry away when he asked me about the Orlistat. I had a moment of guilt-ridden desolation in which I considered making a run for it without saying anything, but I decided to be ‘brave’ (!) and admit that my cravings have been completely out of control.

“Let’s weigh you anyway,” he said – to my utter horror.

In a fluster, I went to frantic pains to remove my boots, belt, mobile phone and other encumbering objects from my person in order to fool the scales into saying that I was lighter than I am. I would have fucking stripped naked and picked off each scab on my body if I had thought I could get away with it. Again, LGP seemed to find amusement in my behaviour. I glared at him, and he apologised – but then added, to my utter astonishment, “you do have great capacity to entertain, you know.”

I asked him what he meant. Apparently, I am “charismatic and articulate” and that will “stand [me] in good stead.”

Initially I thought he was joking, but when he said, “really!” and followed it up with an appropriately reassuring smile, I knew that he was being sincere (or, at least, that he thought he was). I could happily have hugged him – how sweet! There are a lot of cunts in the NHS, but I seem to be becoming increasingly lucky in terms of avoiding them.

Anyhow, my efforts to unladen myself worked. My weight is a pound less than when I last saw LGP. A reduction of a pound is fucking crap, I know, but I was genuinely expecting to have gained a fair bit. The Orlistat mustn’t be completely useless, then. He asked me a lot of questions about its (notorious) gastrointestinal effects, and I admitted that whilst they were frustrating and embarrassing at times, that they weren’t that much in excess of my pre-existing IBS. Furthermore, they’ve reduced in severity over time. (Interestingly ((or not if you’re a vaguely normal human being)), the drug’s manufactures, GlaxoSmithKline, admit to indulging in a bit of the ol’ A Clockwork Orange in terms of said side effects. The worse the side effects, they feel, the more likely you are to stick to a healthy diet in order to avoid them).

LGP said he’d give me another script for the stuff, and see me about it again in six weeks. After 12 weeks on it, if you haven’t lost weight you’re supposed to discontinue it, though I suspect LGP may be flexible on that exact timeframe. Either way, I’m glad he was willing to give me more at this juncture – even if the stuff doesn’t work a fuck, I feel less guilty eating when I know I can take it afterwards.

Finally, I asked him if he could prescribe my Venlafaxine on a two-monthly basis, in the same way as the Seroquel is currently issued. After last week’s disaster, I wanted to make sure that I have a decent stock of the horrible stuff at all times – and besides which, Fat Pharmacist is still proving himself to be an incompetent fuck and thus needs about six years’ notice to allow him to practice pharmacy in his pharmacy. I was somewhat surprised when LGP agreed to this request, in the same way that I have always been surprised by Seroquel being issued in this way. I’m a mental. Is it really sensible to give me two months’ worth of both drugs at any one time? (Which is to say nothing of the Zopiclone and Diazepam stashes). As it happens, if I ever do decide to do myself in, it’ll not be by overdosing, as I know that only certain cocktails work reliably, and that if anything else does kill you, it’ll be slowly and horribly. But the GPs don’t know that I know that.

Still, I don’t care, because this will save me an awful lot of hassle in future.

And that was about it. He asked me to come back in six weeks, said he was glad that things were on the up, and told me to take care. I reciprocated, left, hung around the car park for ages waiting for the pharmacy to open, got my prescriptions, drove back to my mother’s, had a few slices of bacon (plus Orlistat, mais oui) and went back to bed.

And now I am back at A’s and about to go back to bed again. Which is a good thing because this nonsense is waaaaaay too fucking long even by my standards. I don’t think Christine had this length of article in mind when she suggested I sow my blogging seed across Northern Ireland’s mental health outreaches.

Goodnight, lovers.

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