Things were so much improved on Thursday from what they had been the week before.  I think C’s mood and / or attitude was better than it had been, and I was feeling considerably more sane than I have of late, so between the two of us, the whole session felt a lot more productive.  I, in fact, felt respected and – dare I say it – I felt a lot of the warmth from him that I had felt to be characteristic of him before all the bollocks about the cessation of therapy began.

The discussion commenced, perhaps unsurprisingly, with C picking up where we’d left off the previous week with reference to the dodgy Diazepam that I’ve (hopefully) purchased.  Under the caveat that he of course doesn’t approve of the purchase at all, he wanted to talk about ways that I could protect myself from taking the whole dose if I go mental some time, whilst at the same time taking responsibility for their ownership and the fact that I made the decision to buy them.

Writing it back now, it sounds very DBT-ish, but at the time it didn’t seem particularly condescending; if anything, I felt that he gave enough of a toss that he didn’t want me to do myself in (that it wasn’t just about covering his arse), but that simultaneously he didn’t want to patronise me by telling me I had to bin them all or give them all away.

A discussion ensued about putting a few of them in my care, and giving guardianship of the rest of them to A.  As long as I have access to some of them at any given time, I honestly don’t give a toss about someone else having them, but C didn’t seem to really think that all of me was content with it.  I admitted that because I was in a relatively stable frame of mind that I couldn’t see what other ‘parts’ of me might think, but I did concede that I have a rebellious streak that may manifest at some point and take offence at not being allowed to have all of the tablets in my possession.

C said, “what would you say to that side to persuade her that this is a sensible course of action?”

“Nothing,” I replied.  “I’d just tell her to fuck off.”

He laughed, and said that he didn’t think the rebellious streak would feel particularly validated or disciplined by that.  I nodded, accepting that such a confrontational stance may only wind ‘her’ up further, and make her more determined to claim ownership of the Valium.

The conversation advanced in an unexpected way.  C said, “Imagine I’m you and you’re the therapist, trying to persuade me that putting the Dizaepam in someone else’s temporary care is a good idea.  What would you say?”

“Well, I’d probably say something like…”

“No no no,” he interrupted.  “I don’t want you to just tell me what you’d say…I want you to actually say it, as if you’re me.”

“Like a role-play?” I checked, aghast.

He nodded.

I didn’t really fancy this idea, but I took a deep breath and decided to play along.

I don’t remember what I said, but I got to the point where C – as ‘me’ – was about to reply, when I bottled it.

“OK, C, sorry – this is just too weird,” I interjected, waving my hands embarrassedly.

He smiled and said that he had no wish to make me uncomfortable, but after dithering a bit he asked if I would be willing to try the exercise again.  I heard myself agreeing to this.

He started.

C:  They’re my tablets, I’ll do what I want with them.

SI: But I’m not proposing that you get rid of them entirely, just that you take some of them out of your hands for a bit.

C:  [waving hand dismissively] Nah.  Why should I?

SI:  Because it’s for your own good.  [wincing] Think of it like this – it’s kind of like the tablets are under lock and key, as they would be in a pharmacy or something.  You don’t have immeadiate access to the key, but access becomes yours as your own small stash depletes.

C:  [pauses, apparently ruminating on what I said]  OK, so what you’re saying is this stuff is still mine, but access to it can only be granted in bursts.

SI: [incredulous] Obviously, yes…

C:  But why shouldn’t I just take them all anyway?  I hate my life.

SI: I can’t let you do that…it would be unprofessional…

C:  Why can’t you?  You don’t care about me!

SI: No, but I have a professional responsibility to stop you.

He laughed at my “no, I don’t care about you,” and signaled that we could desist from continuing in this vein.  He said, “I really liked your lock and key analogy, that was very good.”

I was astonished.  “That was patronising bollocks,” I declared.

“I don’t think it was.  Parts of you may think so, but I also think it’s a simple but effective way of communicating to those ‘rebellious’ parts that they are being protected whilst at the same time being afforded some responsibility.”

He paused for a moment, then continued by saying, “I know you have that book on schema therapy in BPD.  Do you recall that, according to it, there’s a detached protector, and several child parts?”

I nodded.

“Perhaps the detached protector, the healthy adult even – they may find something like what you’ve just said ‘patronising’ – but don’t you think it’s really the angry or frightened children that most need to be protected?  And if so, then this is clear, effective language that they can understand.”

I fought the urge to protest that I had been a precocious child.  I had been, and these ‘child parts’ still are, but even I wouldn’t have been able to come up with a decent immediate comeback to my stupid ‘lock and key’ analogy.

I finally said that I would keep 25 of the tablets and give the remaining lot to A, to act as my dispensing pharmacist as and when the 25 were depleted.  C furrowed his brow.

“What strength are the tablets?” he asked.

“10mg each.”

He winced, causing me to protest that 25 of the things couldn’t kill you.  “One gram, the whole lot, wouldn’t kill you unless you were very (un)lucky.  I’ve researched this.”  (My research consists of reading a pro-choice suicide newsgroup, a seemingly dubious source, but actually, the members thereof are very well informed.)

He continued to look concerned.  “I know you’re well informed about this, but do these types of medications not slow the heart rate?  Surely ‘even’ 250mg could induce heart failure?”

I don’t think so, but I was not against the idea of meeting him half way, so I advised that if it would ease his mind, I would retain ownership of only ten tablets.

He was unhappy with that too, of course, believing that I believed that he had invalidated my sense of responsibility and coerced me into retaining the lower amount.

“Look, C, it’s fine.  Honestly.  I am not displeased with the idea of only keeping 10 of them.  I don’t use them frequently anyway, and even as I do, I have no doubt that A will give me the next ten when necessary.  I don’t feel treated like a kid or anything like that.  Really.”

The entire discussion may be moot anyway, since the bastarding things have not arrived yet.  C did acknowledge the possibility, as do I, that the whole transaction might be a scam.  I hope not though, because my GP’s surgery is being difficult regarding the prescription of Valium, which is the only thing that calms me down in certain circumstances.

This led C to talk about his silly breathing exercises.  I told him that I didn’t think they were totally useless, but stole a quote from W, and said that they were akin to throwing a bottle of water on a massive Australian bush fire – ie, something that may help in a minuscule way which is totally inadquate.

To my surprise, C’s first reaction was to say that he saw my point; however, he then went on that even if that bottle of water is totally inadequate at putting out the entire fire, it might enable a little bit of the fire to dissapate, in turn enabling further work to be done to put out the rest of the fire.

I hadn’t thought of it like that, although I’m smart enough that I probably should have done.  I do genuinely think that the breathing exercises in and of themselves are mostly wank, especially when one is going really mental.  Nevertheless, for mild anxiety attacks, I suppose they have something of a place before taking actual, tangible measures of self-protection, such as removing yourself from the anxious situation.

There was a lull in the discussion then, a contemplative silence which I eventually broke by admitting to C that I had found the last few weeks in therapy really challenging and frustrating.  I told him that I had found him defensive and un-empathetic, though I acknowledged openly that I hadn’t been much use myself.

I don’t recall his phraseology, but he admitted to his defensiveness, though carefully suggested that it was a mutual thing.  I agreed and said things in my world had been really difficult since Christmas / New Year, so he had gotten to see me at my most mental.

I lamented this further by saying that I wished I had been referred to the psychiatrist before seeing him, as I felt that becoming more stable thanks to medication could have helped me to use therapy in a more productive manner.

He reflected on this, and for the first time in the whole year or so that I’ve known him made (an admittedly oblique) reference to the fact that he sees more people in his line of work than just me.  “I think you’ve made an important point,” he told me, “and in future I’ll consider that, maybe telling GPs that in some cases psychiatric referrals would be better in the first instance than referrals to me.  However, here we are – I hope we have nevertheless been and will be able to do something valuable together.”

I nodded, and told him that just because I felt the referrals were the wrong way round did not mean that I believed our relationship had been valueless.

“And if you’re thinking of the frustrations of last week,” he continued, “I think our discussion hitherto has followed on from that – to that end I don’t think it was actually a wasted session at all.”

I suppose, horrible as it had been, that it had indeed provided some impetus for this session.  Furthermore, as I told him, it is probably a good thing that he sees me in all my moods, even the most mental thereof.

Another brief lull ensued.  Eventually C reminded me that we had, a few weeks ago, discussed the fact that I was reading a self-help book.  He asked how I was getting on with it.

I said that I hadn’t finished it (read: haven’t read any more), but gave him a brief overview of it.  “There’s plenty of wank in it, but the parts that it does well, it does very well.”

He asked again what it was called and I said that its name was Getting Through the Day: Strategies for Adults Hurt as Children.

“Obviously it’s designed for victims of real abuse,” I mused, “but I can make it apply to myself in some ways.”

I regretted these thoughtless words as soon as they were out of my mouth.  At least, I did at a visceral level; I didn’t want him to defend me on the grounds that my ‘abuse’ was real.  Not only would that mean facing that stuff, it would mean having to confront my default position that it was of my own doing.  Intellectually, of course, I know this needs to be addressed.

C said, “you don’t think your abuse was real?  But there was sexual abuse by…”

This was the first and only thing that annoyed me in this session.  He said, “…there was sexual abuse by your…grandfather?  Uncle?”

So you remember that I have the book on fucking schema therapy but you don’t remember the identity of my rapist?  Thanks C.  Thanks very fucking much.

I confirmed that it was the latter.

He asked me how I felt about going into greater detail about this subject over future weeks.  I told him that to say I wanted to do so would be absolutely untrue, but I did say that I believed it was a possible necessity.

He said that it isn’t always necessary to explore such matters down to their very minutiae, the implication being that the memories in some people’s minds are not always unprocessed and unresolved.  “But,” he went on, “I think your instinct is that this is something important, and to that end we probably should look at it more.”

I winced.  I don’t want to do that.  The images haunt my consciousness on a fairly frequent basis as it is.  Detailing it with him, actually going into specifics, is bound to make that worse, even though the idea is to make the memories less vivid and cumbersome in the long-term.  But I’m not stupid; I know I shoudn’t avoid it, much as the temptation to do so is strong.  I told C that I wanted to go ahead with it.

So that is something that will presumably come up tomorrow, especially in light of my little outburst of self-blaming sluttery at the weekend.

I’m not sure to what extent I have conveyed it by detailing the dialogue, but I did get a sense of respect and care from C in this session, something that I had desperately needed from him in the last few weeks.  On the other side of the coin, I did not, for once, enter the session in a confrontational frame of mind, but instead was also extending an olive branch of respect and, insofar as it is possible in the therapeutic sense, friendship.  Our mutual stances paid dividends, I think, and I can only hope that that will continue.

I drove back to my mother’s, as I usually do after seeing C, to find a cross-generational gaggle of McFs (MMcF, Sarah, Suzanne and Marcus) inhabiting the living room.  Occasionally they come to see my mother during the week, as Suzanne (the only driver amongst the females of that dynasty) only works three days a week, and in any case is now on maternity leave as her second kid’s birth is due to take place in the next few weeks.  I am never glad to see them, of course, but I prefer these occasions much more than having to end up in their house, bored out of my fucking skull and having to rely on Paedo of all people for some slightly-better-than-completely-desultory conversation.

Anyway, the interaction went as non-shitly as these things tend to do – for a while.  Eventually one of the McFs brought up the fact that their neighbour is regularly leaving his insolent five year old daughter at the McF’s house, whilst he fucks off to the pub or the gym or something.  Apparently Paedo keeps acquiescing to this, then dumps the kid on Sarah, MrsCMcF or whatever human of the female persuasion happens to be about that day.  Which I suppose is a good thing because it means he’s not fucking raping the child.

Apparently on one day that this happened the wee girl had disobeyed the McFs and went to one of the bedrooms and started jumping on the bed.  S was concerned not just for the child’s welfare had she fallen, but for that of the McFs.  She claims that social services have been involved in the child’s life at times, and was worried that if the girl had fallen and sustained injuries, that the McFs would be assumed to be beating her up or something and get done.

It was my mother that said it.  My mother, who knows – or has chosen not to know – about my history with Paedo.  Fucking bitch.  She said, “you’ll have to stop this practice [the girl coming round to be babysat] altogether.  As well as her hurting herself, what if she starts making stories up about Paedo…you know…?”  I am convinced she shot a sideways glance at me as she said this.  She did not need to complete her sentence to be understood.

Suzanne nodded.  “And mud sticks,” she sighed.

Oh fucking does it really.  Apparently not with my mother.  I told her he raped me.  I told her he regularly touched me in inappropriate ways.  I told her, and she refused to believe me.  So actually yeah, maybe the mud does stick – but it sticks in the sense that she still believes I’m a malicious fucking liar.

Who lies about being sexually abused as a child?!  Who does that?  How fucking dare she not only not believe me and accuse me of lying, but then make unsubtle digs showing me that she hasn’t forgotten my alleged ‘lies’?  How.  Dare.  She?!!!

Yesterday she dragged me to the other aunt still residing in Northern Ireland, the Aunt of Boredom, Maureen.  I was zombified by anti-psychotics, and even if I hadn’t been, the conversation centred around whether or not you should have a fence or a hedge at the perimeter of your property, and thus was insurmountably boring.  After lunch, Maureen was heard to say to my mother than I was being very quiet.  Well, I wonder why that might be, Auntie Dearest.  It is because I couldn’t give a sideways fuck about fences or hedges.  However, my mother was then heard to respond not by saying that I was bored, but instead that she was “very worried” about me.  The two old biddies subsequently closed the kitchen door and started discussing my mentalism in hushed tones.  And then Maureen was allowed to cross-examine me on the finer points of my madness.  I felt like somebody’s lab rat.

Can I just say that my mother’s behaviour of late has been un-fucking-acceptable.  Since before my BPD diagnosis in June, I’ve done a lot of reading on the possible causes of the illness.  I now believe that it was not just the abandonment of me by my father nor the sex abuse that brought the hibernating insanity out in me.  It was, surely, my mother’s frequent invalidation of me too, not to mention some of the borderline-abusive behaviour to which she subjected me during my teens.  She too has obviously been traumatised, in her case by her relationship with my father (as C has recognised).  It seems to me that that has led to difficulty in her interactions with me.  Or so says SI the armchair psychologist.

No parents are perfect, and we are probably all mental in our own idiosyncratic ways.  My mother is a good and decent woman who has had a horrible life.  But I still deserve better than this from her.

First Signs are a UK-based charitable organisation devoted to the prevention, or at least the minimisation of, self-harm.  Whilst as regular readers of this blog will know, I don’t really see the big issue with (controlled) self-harm, I can and do admire the work that FS are undertaking.  If nothing else, at least they’re raising awareness on the issue – why people self-harm, that most people who do it aren’t dangerous to normals and so on.

However, as you can see from the title this isn’t a post espousing the worthwhile cause of this user-led charity.  I am writing in response to this supposed distraction technique.  Yes, folks, they are arguing that bringing yourself off is a viable alternative to cutting or burning yourself.  Riiiiight.

I read a lot of articles on psychiatry and psychology, much to the detriment of my Twitter followers (not so much on the account allied to this blog), but I rarely feel the need to respond to them.  However, I just find this article so ridiculous that in this case I felt compelled to do so.

The first thing that struck me about the piece was that FS had devoted the entire thing to masturbation.  I mean, even if you do accept that wanking is a credible alternative to self-harm, it’s not the only distraction technique that exists out there.  When C and I first discussed the stupid DBT bullshit way back in week 12 of our therapy, some of the stuff in the material he gave me was devoted to distracting oneself – and, as it happens, masturbation was mentioned (to which I responded with an ‘LOL’ which I know is really rather puerile)…but the difference was, it was only mentioned in passing, as one technique amongst dozens available.  No 1,300 word article on this topic per se was deemed to be required.

Personally, I think distraction techniques are all bollocks, but that’s not really the point.  The point is, to what extent is masturbation really a viable alternative to self-injury?

FS pose this question:

When you’re urging to hurt yourself, aren’t you looking for a release, and some relief from the emotional distress you’re having trouble coping with?

This basically forms the central tenet of their entire argument as far as I can see.  In fact, looking again at the article, it seems to be their only tenet.  What a convincing argument they must have if they only have one major thread to their point.

That said, OK – successfully orgasming undoubtedly does relieve tension, and no doubt endorphins are released upon climax just as they are in cutting.  But for goodness sake, how obvious is it that it is an entirely different type of release?!

I wrote about the satisfaction, if that’s the correct term, that I get from self-harm in this post a few weeks ago.  I suppose my main point was that bloodletting is beautiful because one feels, temporarily, that they are watching their own evil flow away along with their blood.

Which, to be objective, is the only point I really made – but it feeds into the idea that many people will injure themselves as some sort of ritualistic punishment for their perceived inherent evil, or for the self-disgust they feel.  I know I have been known to cut for this reason.

Why, then, would I allow myself the satisfaction of a pleasurable activity?  If I am a bad person, I need some obvious form of punishment, not a reward, whether that’s sexual or otherwise.  Now, satisfaction is undoubtedly garnered from the ‘punishment’ of cutting – but it’s not a premeditated satisfaction (masturbation is in my view, even if a sexual urge comes on one quickly, because it usually has a clear objective that one is trying to meet).  And in any case, the satisfaction is, primarily, mental, not physical (which is all masturbation, unless conducted mutually with a partner, can ever be).  You are satisfied because you have done what needed to be done to this bad individual; you have hurt them.

Of course, that’s only one aspect of self-harm.  One other major function of it is to reorientate oneself when going doolally or, as FS admit, to release some psychic pain in the same circumstances.

Now let me get this straight.  When I am going off my head in a mixed state or panic attack, am I seriously going to sit down and analyse distraction techniques (this is why I think they are all complete arse, as discussed here, for example, or there’s always this epic rant specifically about methods of distraction)?!  In particular, am I going to think, “Christ, life is so fucking terrible right now…an orgasm would make it better”?  Well, maybe it would actually, in an ephemeral sort of way, but would that really be forefront in my mind?  The idea, as any one who’s experienced such a state will appreciate, is ludicrous.

All one can think about when going mental is the mentalism.  The ‘decision’ to harm, if it can be termed that as it is not always conscious, is almost innate.  OK, so sexuality is innate too, but there the comparisons end.  Perhaps the reason for the visceral nature of self-harm in these circumstances is simply that its effects are instantaneous (my mantra to C: “it’s quick and it works”).  Even if we (erroneously) were to agree that an orgasm can have exactly the same physiological effects as self-harm, time (for most women but I reckon to some extent blokes too) is required.  One does not feel like they have time when one is going mental.

Another issue that escapes them, and my aforementioned post on blood being beautiful ties in with this, is that cutting isn’t always about pain or distraction; sometimes it’s about blood.  Personally speaking, I love watching the blood.  Occasionally I cut only to watch the blood and how it flows.  Again, if we make the false assumption that orgasm release = cutting release, where is anything tactile or tangible from that?  FS do state that “…masturbation doesn’t cause any physical problems..,” and in doing so of course acknowledge that cutting can and does of course have physical consequences – but, as I said, they miss the point that that can be exactly why it is done in the first place.

Above all, what antagonises me most about this article is how it trivialises the issue of self-injury.  Now, I don’t think it’s a big deal if done under controlled circumstances, but neither do I think it can simply be equated as having similar physical and mental properties as something that most people have done in their lives and that is seen, rightly or wrongly, as something to be sniggered about at the back of a classroom.

FS state several times in the article that they fully recognise that self-harm is a serious issue, and to be fair they wouldn’t exist in the first place if they didn’t think so.  Nevertheless, singling out masturbation as a distraction technique in this fashion strikes me as counting it as some sort of panacea in a path to recovery from self-harm.  That probably wasn’t their aim, and what they have written was clearly with the best of intentions, but it has sadly worked out as over-simplified and utterly ineffective.

It may seem like I’m saying, “fuck distraction techniques, self-harm for the win!” in this and other posts – I am not.  This may be what I think for myself, but I would not advocate such for anyone else.  One thing FS got right in this article was to remember that everyone is different, and so other cutters / burners / whateverers may find a range of distractions, including this one, effective.  To that end may I reiterate that I admire the work that First Signs do; I applaud their very existence.

But wanking is never going to be a viable alternative to the scalpel for me.  Sorry folks.

It’s funny how really small things in therapy catch your attention sometimes. Today, he called me by my name at one point, which he never does except to call me in from the waiting room. I also noticed him bring out a bottle of still water from his briefcase at one point, which struck me as odd as he normally has sparkling water. Neither of these things matter. It’s just strange how such tiny things take on some significance in some settings.

This post should be interesting, given that the crux of the conversation between C and I today was Friday night’s happenings, which I am (stubbornly?) refusing to discuss here. How many words can I turn not-very-much into this time? [EDIT FROM LATER: Over 2,000 apparently!).

For contextual sense, let me tell you the following. I am utterly convinced that what happened on Friday night was a complete psychotic breakdown. I was totally disconnected from reality, I had a complete persecutory complex a la paranoid schizophrenia and I was having conversations with myself (though I note with contempt that bloody Tom didn't turn up to help, the fucking self-serving, non-existent twat).

On the surface the session would appear thoroughly unhelpful. When C himself asked me how I was finding it, I was honest and admitted that it was "frustrating". Essentially, in discussion with him regarding what I shall now term The Incident, we ended up fundamentally disagreeing with each other as to how future incidences of same could be dealt with.

I had asked right at the beginning of the session who I was meant to contact if things were as serious as they, especially on occasions where I was not due to see him for a good while. He said that whilst he was more than glad to discuss this with me, that he wanted us - together, he insisted - to find 'a balance' between getting other people involved, and finding ways that I could manage my mentalism.

At one point he wanked on and on about 'strong emotions', and I quite irritably interrupted him and said it had fuck all to do with 'emotions'. I said, "I know I have used the term 'psychosis' out of context here before, but I assure you I am using it in its most accurate sense now. I was completely disconnected from reality."

I goaded him on how I was meant to predict psychoses. He said I couldn't. I asked how, then, was I meant to prevent it happening. Apparently I am meant to deal with triggers as they arise regardless of where I think they might go.

He said, "you spoke about being irritable at other points last week, prior to The Incident - maybe we can think about what you might do in that circumstance so that it doesn't escalate into something like this."

"I'm permanently irritable," I sneered. "I don't normally turn into that, however, so I fail to see your point." To be fair to C, I had made reference to something that annoyed me, and he seemed to think that The Incident was a direct result of that. It wasn't; it was, at most, tangentially linked. I told him so.

I sighed, and advised him that he was seeing the situation entirely differently from the way I did, and to his credit he admitted this (without stating that one or other of us was correct). He agreed that by the time I got to this stage of madness that there was very little I could do to combat it (I had shown him the scars on my arm that were caused by flicking rubber band on my arm, as espoused by accursed DBT, to demonstrate that this had at least been tried, and had failed) and that in these circumstances, it was reasonable to get someone else involved.

So, C had his view, I had mine, and never were the twain going to meet. I was keen to reassure him that I didn't necessarily disagree with him in general, just about this, and he was keen to reassure me that I wasn't to think he was lecturing me or threatening to 'sack' me (a term used because I told him work are coming round on Tuesday to do just that - or so I think anyway - but I'll talk about that at another point).

By this point I was relentlessly pulling at and playing with my hair, hiding behind it because I didn't want him to see my face. I plaited it, wound it round my finger, straightened it out in front of my face, pulled it forcibly, pushed it away only then to drag it back. From behind it I said, in a tiny voice, "yes, well - you do know I have an abandonment complex."

I don't remember his exact response, but he did say he wasn't abandoning me. But is he really not? If we're not on the same level, how can we work together?

I was acutely aware of how childlike my hair-fiddling, voice and general sense of failed object relations all were. Fucking child. Fucking huffy immature little brat. Hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate hate. It's classic borderline bullshit, isn't it? The psychiatric establishment still thinks of those with BPD as immature and manipulative, doesn't it? I don't think that's generally true, but it certainly is of me.

I kept wanting to ask C if he thought I was immature and childish but for some reason I never did. Perhaps I realised subconsciously that if he did think that, I would be hurt if he said so - or hurt, more likely, when he implied that was his view by failing to answer the question. Perhaps also I thought if he said that he didn't think so that I wouldn't believe him.

Immature or not, of course I dissolved into berating myself.

"I hate myself, I hate myself so fucking much," I whinged.

Apparently that is "not helpful".

This really pissed me off. "So what?" I raged at him. "It just is. Have you ever [done what I did on Friday night]?”

To my utter astonishment, he tilted his head and thought about this. “I don’t think so,” he eventually concluded. “I might have [done a version of it]…I don’t think so, but I’m not sure.”

A tactic? He couldn’t possibly have done it. I know you don’t know what it is that I’m on about, but really – it is completely inconceivable that he would ever have done this. And how can he not know? Unless you were suffering from the most severe type of amnesic psychosis, I am genuinely at a loss as to how you wouldn’t fucking know whether you had done this or not. It wasn’t something like forgetting to turn the lights off before you went to bloody bed.

Anyhow, he went on that OK, I can’t just decide not to hate myself, but that I should just “let it be there” and make no judgement on it, or something. More mindful wank.

“Alright,” I challenged. “How do I do that?”

“I don’t know,” he admitted.

“Well, that’s great, thanks.”

“I mean, I can’t give you an answer like that right now. It’s something we have to work on over time – we have to work out your triggers, how you’re feeling and whatnot, and develop strategies from there.”

Of course this means that because I hold back on just about everything, we haven’t been able to do the aforesaid in six entire months of therapy. I freely admit it. I dodge everything I don’t like or feel potentially upset by like it’s a fucking bullet. He knows, I know, you, dearest readers, know. It’s not that C is unskilled in getting stuff out of me; I have admitted much more to him than to any other therapist I’ve ever seen (or many people outside psychotherapy, for that matter). It’s just that I’ve become remarkably skilled myself in spotting exploratory techniques, however subtle, on the part of the questioner. Freud himself would find me an incredibly difficult patient.

Yet I regret it, because I know it misses the entire point of therapy. It’s just so damn difficult to ‘let it all out’, as it were. I simply cannot just make myself do it. But still…

“Fucking mental freak,” I intoned, darkly and angrily. “Wasting an hour of your time every week. Fucking useless mental, psychotic piece of shit. I have failed. I have failed me, and I have failed you.”

“Ah,” he said, sort of knowingly, as if a penny had dropped. Then, firmly and with (apparent) absolute sincerity, “I don’t think you’ve failed at all.”

That was reassuring, and I tried to smile, but by that point I had been overcome with a range of extreme perturbations and melancholia, and it was difficult. I managed a pathetic and incredibly small, “thank you.”

After a while – I don’t remember the exact context, but it was the characteristic disagreement of this session in some way – he said, “we’ve kind of reached an impasse, haven’t we?”

I agreed.

But he continued, shrugging slightly, “you know, that’s alright. We’re allowed to disagree. It happens in any social interaction.” He paused, waiting for me to look at him (I’d avoided eye contact with him for most of this session). When I finally returned my gaze to him, he made some sort of positive facial gesture, designed (I think) to reassure me.

We spent some time talking about who to contact when I go mental again. As I know, there’s the fuckwitted Crisis Team. I can call them (so I can be advised that a nice cup of tea and some rest and some meditation will profoundly change my life and stop me losing contact with reality). If I am seriously contemplating suicide, I have to go to casualty. Hmm, yes C, because if I’m trying to kill myself on impulse then that will be forefront in my mind.

When I went to protest this, he clearly knew that I was going to make the foregoing argument, and he pre-empted it by saying, “you have to; it’s your responsibility to do that,” echoing what he’d said when I begged him not to get LGP or VCB to section me in this session.

Then he asked me if I had had experience of Lifeline and/or the Samaritans. I responded in the affirmative.

“And how did you find them?” he queried.

“Well-intentioned,” I responded.

He smiled at that, which initially perplexed me, but it turned out that he was apparently pleased that I hadn’t just said that they were “useless” or “crap” or something.

“It’s simply my version of diplomacy,” I retorted. “It doesn’t mean I don’t think that they’re useless; it just means that they are well-intentioned. Well-intentioned does not equal effective.”

He went to his briefcase and took out a list of numbers, and looked at it for a few minutes. He asked if he wanted a photocopy of it. Thinking it might actually be useful, I agreed to this.

Of course, it was the end of the fucking session at this point. In a moment of uncharacteristic and surprisingly urgent self-concern, I suddenly came out with, “you know, there is so much more stuff that I need to have out with you. It’ll have to wait, of course, but I do.”

“OK,” he said, encouragingly.

I will regret having said this later, because I won’t want to discuss ‘more stuff’. I really don’t want to as it is, but at the minute I’m glad I made the remark, as it’s essentially unavoidable to have at least some of these uncomfortable discussions now that I’ve admitted I need to do so.

When I got to the car, I looked at the list of numbers. It was a pile of crap. Lifeline, SANE, The Samaritans. I could have found it all out for myself within about 10 seconds. To my incredible amusement, one of the ‘resources’ given was my soon-to-be-ex employers. Oh, the beautiful, dark irony. I laughed out loud, sitting alone in the driver’s seat, when I read that. One thing that was of some interest was the fact that the CMHT are apparently accessible via a referral from one’s GP. Therefore, I shall try and make an appointment with LGP before I am due one to see if I can get him to get me a social worker or CPN or something. Not that I think they’ll be much good, but anything’s better than nothing when C’s not available.

My final thoughts on this morning are more positive than you might think. One thing that maybe hasn’t come across in this post especially well is that, although the actual content of the discussion was somewhat fraught and to use C’s term, something of an impasse, I was fairly expressive with C, in a non-verbal way at least. I fought against tears throughout the meeting – and I won – but I did squirm, put my head in my hands, roll down the chair, throw my head back, play with my hair (as mentioned), and various other little things.

It doesn’t really sound like much, but it’s actually something of a turning point for me. I am almost always calm and measured with C, and today I really wasn’t. It’s not that it’s good to be upset or uncomfortable, but if I am going to be, then the best place to exhibit that is in psychotherapy. It might be dead on the six months mark of the process, but regardless, in a way I feel that it’s a minor breakthrough.

My next goal is to allow myself to be completely honest with him about everything, something that I have deliberately avoided to date. He knows many things that he ought to, but not all. Maybe eventually I’ll even be able to allow myself to cry and scream and rant as I often feel compelled to do, but always manage to resist. Maybe that’s optimistic, I don’t know. But I hope today was a start.

As you know, I’ve been on holiday, and as you also know, I promised I would go into more detail about the three mental health appointments I had in the days that preceded my departure. I had started this post well before going to Turkey, but despite my claim that I’d finish it on the plane, of course I didn’t; even flight-safe phones such as the iPhone were not allowed to be used onboard. Obviously in Turkey I was trying to enjoy myself, though as you will see in a later post that did indeed involve some forays into psychiatry. Anyway, I’ve finally got round to the post in question, so here it is.

—

Tuesday: The Psychiatrist

I said I’d go into more detail about how I responded to the psychiatric SHO on Tuesday 8th. Basically, I said I couldn’t deal things any more (I’m sick of my up-down moods and am worried about the effect some of my psychoses are having not just on me but the others around me). I said I’d been pushed from pillar to post by Dr C’s department – due to the ridiculous saga to be seen by them in the first place, then their cancelling an important appointment in July – and that I thought it was unacceptable.

The thing was, I was in a complete state and it sounded more than I was pleading with her than that I was angry with her. I was begging, effectively. My first reaction to her refusal to do anything was one of panicked desperation, and I half broke down, but she merely apologised and said she was too inexperienced to deal with a case like mine. She blamed the department’s failure to have me sitting there with Dr C on a “secretarial error”.

She said, “if you need help in the meantime, you can always get the Crisis Team to…”

Regular readers will know what I think of the CRT. See about three-quarters of the way down here, for example. So you can imagine my response.

“No,” I shrieked. “No, I can’t – they’re useless, they’re crap!”

“Well, they’re always there for you,” she started, but she seemed to realise the futility of continuing in this vein, so she changed tactics and continued by saying, “or your GP.”

She said, “Dr C will talk to your psychologist right away and see you as soon as possible – unfortunately she’s just doesn’t have a window today.”

Seems to be her curtains are always fucking pulled, but anyway – I told Dr A I would be on holiday until 21st September inclusive, so she agreed to organise a new appointment for sometime after the 22nd. I got up then, mumbled some sort of goodbye, and almost literally stumbled out of the building. Some other (male) mental sitting near the door tried to grope me on my way out (the “appointment” was in the psychiatric day hospital, rather than the usual outpatients clinic, so obviously he was ((erroneously?)) recently released from the actual bin).

As I was telling C the following Thursday, another thing of note was the physical environment of the “appointment”. As stated it was in the day hospital, which has much smaller one-to-one consultation rooms than outpatients. This was a problem as there was a window in the door, and I could see the other mentals looking in from time to time. Even worse than this was the fact that the room was near the entrance, meaning that all the others waiting for their cunty day therapy and other patronising OT-esque wank were directly outside the room smoking. Not a problem in itself – except that Dr A neglected to close the window, meaning that everyone else could hear the conversation.

I could have (reluctantly) lived with all of this imbecility if they had done something, but obviously they didn’t.

So anyhow, I went and sat in my car. Recognising that I was unfit to drive, I decided to ring A for cathartic discussion. I cried down the phone to him for about 20 minutes. He was absolutely livid with Dr C and her people. He authoritatively told me not to drive until I’d calmed down considerably, but said when I got back to my mother’s house that I should get her to phone them and kick up a fuss and demand answers – not to mention an actual definite date to see Dr C.

After a while I thought I’d calmed down and left, but I remember bawling my eyes out at times on the way home and practically fell through the door to my mother’s. Initially I was incapable of even rudimentary speech, but eventually I managed to convey a basic version of Dr C’s neglect to my mother.

My mother tried to calm me and I suppose she partially succeeded, because she managed to eventually tear herself away from me for long enough to phone Dr C’s admin department (a suggestion unsolicited by me), who emphatically denied a “secretarial error” but did say they would try and find out what had happened. Apparently the girl Mum spoke to was very nice and she said she would phone back with information later.

Then Mum contacted the GP; the one on call was the (only) one I hate in the ‘surgery’ (I’m indifferent to the others, mostly), because on more than one occasion she has blamed my mental health issues on being overweight. Sure, luv; wouldn’t be anything to do with personal pathology, rape, abandonment, bullying, lies or bereavement. Obviously not. As it happens, I think a lot of my excess weight is caused by depression rather than the other way about; partly because of comfort eating, partly as an annoying side effect of antidepressants. But that’s another issue.

Anyway, let’s call this woman Horrible GP, in contrast to her colleague, Lovely GP, with whom I was due to have a review appointment the next day. My ma outlined the issues involved and Horrible GP asked to speak to me. I refused, but she pushed my mother to get me to talk and thus I started to go mental, screaming that there was no way in hell that I was going to pick up the phone.

Mum said to HGP, “she’s panicking now.”

Query: is “going mental” the same as having a panic attack? I’ve certainly had the latter; for me, a panic attack is much more of a physical problem. Not that that doesn’t affect one mentally, of course, but going mental is almost a reverse course of action. It’s the shit in my mind, racing around in a whirlpool splitting my skull, that causes physical distress, rather than the other way about.

Whatever the case, the long and the short of it was that HGP agreed to provide emergency Valium, as I had left my main stash from my last meeting with LGP at A’s house, on the other side of town.

This agreed, Mum sat down with me again and ranted about Dr C and her negligent behaviour and about how she was thinking of going to the media. About this time, A sent me a text message saying that he was “so angry with these abject cunts” and also suggesting contacting a popular local consumer affairs programme.

Handbags at dawn, dearest readers!

Mum eventually went to get the Diazepam from the pharmacy, at which point I inflicted the self-harm that I posted a photo of, perhaps irresponsibly, here. It’s no big deal, self-mutilation is not uncommon for me as many of you know. It helps. I did it as I perceived the situation as Dr C hating me. Therefore, I was a hateful person. Therefore, that had to be acknowledged somewhere. That’s a logical(-ish) train of thought that wasn’t exactly present at the time, but it was at least the sense of my reasoning.

I bled and bled and bled and then worried that I wouldn’t be able to try and hide the injury from Mum, who has been mostly unaware of my cutting. I managed to bandage myself up, though, and the bleeding was adequately hidden just in time for her return.

I took the Diazepam, and the rest of the day was mostly uneventful. A was good enough to go back to our house, feed the cats and get my tablets, then come and stay with me at Mum’s (I wasn’t allowed to drive due to the Valium). He and Mum spent some time scathing about the morning’s occurrence, and the words “criminal negligence” were used. My mother queried what would actually happen if someone were seriously suicidal, little knowing of course that a few weeks ago, I tried to hang myself. Mind you, I hadn’t told Dr A that either. To be perfectly honest, I didn’t tell her because I had forgotten that I’d tried to hang myself. Who forgets trying to hang themselves?! It’s a good thing I did, though, as there’s always the possibility they’d have sectioned me. I am, after all, a danger to myself at times.

Wednesday: The General Practitioner

The next day I had a very long discussion with LGP (his colleague having related the previous day’s fun and games to him). Appointments are meant to be 10 minutes long, so if you’re the poor sod that was waiting at least 15 minutes after your appointment time, then I apologise. At least it shows LGP cares about his patients, unlike others I can fucking think of.

LGP asked to see the self-harm of the previous day, so I showed him, and in fact gave him the guided tour of the words and slashes that litter the flabby rolls of my abdomen. He appeared to be genuinely affected by this; not freaking out like normals do over this sort of thing, nor angry, but sorry that I was in the position where cutting seemed my best course of action (which I maintain it often is, to be honest). He wasn’t judgemental nor overly worried – he’s obviously aware this is quite normal in mental illness, certainly in BPD and very definitely for me on and off over the years – but just fucking caring. Just nice, supportive and caring.

He showed me the letter Dr C had sent him re: my diagnoses and medication change. I was interested to observe that whilst she wanked on and on about BPD, she had then said that “a differential diagnosis” was bipolar II. I thought a “differential diagnosis” was a diagnosis based on the elimination of most other illnesses based on symptoms presented? If correct, that would suggest to me that bipolar is considered my primary diagnosis, but contextually the letter presented it – as Dr C had done to me in June – as if BPD was my primary pathology. Her whinging about NICE’s mood stabilisers and anti-psychotics in BPD to both LGP and me would seem to confirm that. Can anyone, therefore, clarify the meaning of “differential diagnosis”?

One thing it did say that was moderately encouraging was that she was not totally against the use of mood stabilisers in future. She didn’t make further mention of anti-psychotics, but with regret I am beginning to wonder if I really should have them. (Incidentally, Maisie’s husband was put on an anti-psychotic a few years ago to combat his very severe paranoia. It changed his life for the better almost instantly. You can take a guess as to what I think about that).

LGP wasn’t happy with Dr C as well he might not be. He believes that additional medication (though he didn’t say which) seems appropriate, and furthermore that the dose of Venlafaxine is very low, despite its dodgy side effects. However, he said that he was in an awkward position. He certainly has knowledge of psychiatric illnesses, but he’s no expert, whereas Dr C (supposedly) is. He virtually said that in an ideal world after her lax approach he’d refer me to an alternative specialist, but after all the trouble we had had getting me to one in the first place, he didn’t really see that as a viable option.

That’s fair enough I suppose, although it didn’t help me much. Regardless, LGP has been the only one out of the three main health professionals with which I deal that has been a constant source of support, rather than frustration, so I’ll forgive his reluctance to interfere with the psychiatrist’s domain. We discussed sleeping pills and he suggested I return to Zopiclone over the holiday at least, as it worked for me before and I wouldn’t have to drive on the holiday (prolonged use of it has affected my vision in the past, though not on every occasion on which I’ve taken it). I remembered that he’d given me an inhaler when I was about 14 to help with panic attacks and asked if, in conjunction with the Valium, this would help me when I start to go mental. LGP agreed to provide this inhaler and as I left, after wishing me an enjoyable holiday, he said that if I hadn’t heard from Dr Cunt within the next few weeks, to phone him and he’d get slabbering.

Thursday: The Clinical Psychologist

So the next day’s measure of insanity was with twatting C. We had agreed to spend most of that day’s session discussing coping methods of mentalism on the holiday, and he reiterated that point at the start of the session.

However, he firstly wanted to discuss a few housekeeping issues. The selfish prick chose to take leave the week I came back from Turkey (ie. what would have been today’s session), rather than taking it the same bloody week that I was away.

Is this annoyance on my part unreasonable? Probably, but sometimes I really wonder if mental health professionals, including C, realise the positions of responsibility, authority and trust in which they are placed by their patients. Anyway, at least he’d given me notice of this unfortunate absence before; I sat seething in silent rage as he then explained that the week after that, he’d be on a training course. This means three missed sessions, as opposed to the original expected one.

Fuck. Fuck. FUUUUUCCCKKK!!! Fuck you, C!!! [As it happens, so far I have hardly missed him at all, but (a) there's still two weeks until the next session so Christ knows what'll happen between now and then, (b) I'm trying to replicate my frustrations from then rather than my feelings now and (c) whether or not I miss him is not the point. The fact that I am essentially entirely devoid of mental health support for nearly an entire month is the fucking point].

So anyway, C asked was there anything I wanted to bring to the table before we discussed preventing and coping with madness whilst on holiday. I decided to refrain from coming right out and asking him directly if he had spoken to Dr C, and instead enigmatically replied, “has anyone spoken to you about me?”

He furrowed his brow a little and said, “not since I spoke to your psychiatrist, Dr…Dr..,” he searched for her name.

I reminded him, and asked when the conversation to which he was referring took place. It was clear he couldn’t remember exactly, and he eventually replied with something vague like, “a few months ago.”

Great work, Dr C. You and your SHO claim you want to speak to C and see me as soon as possible thereafter. Clearly it was right the fuck up there in your list of priorities.

I nodded at C, feigning casual indifference, eventually cracking under the pressure of his piercing stare of curiosity a few minutes later.

“You won’t be aware of the events of Tuesday, then?”

“It was Tuesday you saw her, wasn’t it?” he asked in all sincerity.

I laughed bitterly and made some vicious snipe about how useful “seeing” her was.

I went on to detail the circumstances in full. Those have all already been reported here so I can omit that part of the discussion from this summary of the meeting. Basically, two issues arose.

Firstly and of foremost interest was that C seemed utterly perplexed by the fact that I had cut myself in the wake of his colleague’s fuck up. Well, aside from the fact that’s a fucking hallmark trait of my illness, you twat, I was going totally up the walls and self-harm – as I have told about 496,960 times – is a quick, simple and effective tool to suppress such spiralling insanity.

OK, SI. Why the need for something so elaborate, then. Perception at time: Dr C hates me. I am hateful. That needs to be acknowledged.

Entirely predictably, C droned on for about 40 years on methods of “distraction” and “grounding myself in the moment”, all this bollocks we visit in a circular motion time and time again. I don’t remember my response to him. I just remember my metaphorical eye-rolling and desire that he’d move the fuck on from this DBT nonsense, because in its simplest form anyway, it doesn’t fucking work.

Anyhow, the second issue arising from the Dr C conversation was what he thought of the treatment meted out to me by Psychiatry. He seemed surprised by the strength of the reactions of A, Mum and (obviously) me, and his expressions and body language suggested, to me, something akin to nonchalance about the situation. Well – maybe ‘nonchalance’ is an unfair word. But I certainly did not get a vibe of overt concern like I had from LGP.

So, I set him a challenge. “If I ask you a straight question,” I began, “will you please give me a straight answer?”

This, of course, garnered a slight non-verbal reaction, because it was a strong inference that he often doesn’t answer straight questions. Well, he doesn’t. If he doesn’t like my directness about that on this occasion, that’s just too bloody bad.

“If I can,” he responded.

Ha! What you mean, C, is if you’re willing. Do you think I’m stupid? Can’t you even plan the answer in a straight fashion?!

I asked him if he thought I was being unreasonable in expecting better from the Health Service. I reminded him that I had been fucked about by Psychiatry from January to May, then fucked about again in July after a serious medication change to a seemingly effective but nonetheless insidious, potentially mind-altering, drug, then fucked about again in September. Was that fair? Was it fair, also, that such carelessness was exhibited vis a vis my privacy in my meeting with Dr A? Whilst acknowledging that to some extent the NHS is ‘free’ to use, was it fair that I had worked since I was 16 (insofar as my illnesses permitted) and will hopefully return to and continue to work until my 60s, thus facilitating the salaries of Dr C and her team via national insurance – only to be treated in this fashion? Was any of that actually fair? Was I being unreasonable?

When he didn’t immediately respond, I pointed out that my enquiry was serious. I genuinely wanted to know if something about my fury, and that of Mum and A, was somehow unjustified.

He eventually started wittering on about it being fair to expect certain standards from a service, regardless of what that service is, and certain frustrations were bound to be evident were those standards – or, more accurately, the expectations of standards (my distinction, based however on what I inferred from what he said) – were not met.

Exasperated, I said, “yes or no – do you think my anger is unreasonable?”

He sort of sighed, then said, “you talked about your main GP as being a good doctor, but the on-call one on Tuesday as being someone you strongly dislike. Dr C is, presently, in your mind, a second ‘bad’ doctor. If I answer ‘no’, I am just another ‘good’ doctor, affirming your present mindset. If I say ‘yes’, then I become a ‘bad’ doctor.”

He was obviously accusing me of black and white thinking, which is generally not a particularly unreasonable view for him to take, but nonetheless I resented every syllable of this fuck. Is what he said not profoundly black and white? Can’t he understand that if he can coherently and reasonably defend his position on the matter that I might have some insight, that if he disagrees with me that I might be able to derive some perspective from that? Oh no. Even in someone with an IQ of 148, it’s apparently as simple as a childlike concept of good v bad, with no room for relativism at all. I might have BPD, but I’m not completely colour-blind to shades of grey.

Rather than lose it with him, I tried to rationally explain my reasoning for my views on the GPs, the subject of his comments that had especially irritated me. My views on both have been developed over years. I first met LGP over 12 years ago. I first met HGP maybe six or seven years ago. I just didn’t meet either of them once or twice and form a view of them. My views on them, and on all other GPs and health professionals I’ve met, are based over time. They can change dramatically or quickly, I’ll admit, but not without very good reason.

In general, that is.

He conceded that perhaps there was more to it than good-doctor-bad-doctor, but pressed, “why self-harm though?”

This was irritating, as I’d already outlined my reasons. I sighed and said something like I wasn’t sure we’d ever see eye to eye on this.

He said, “I wouldn’t be sitting here with you if I didn’t believe you had other coping methods.”

Seeing my eyebrows raise, he added, “…or at least if I didn’t believe that you could develop them. What would be the point in that?”

I don’t recall my thinking now, but I looked him straight in the eye with what I think was some sort of oddly demanding expression and asked in a dark monotone, “are you going to leave me then? You’re going to abandon me?”

Poor C. The man was genuinely stunned. Reflecting on it now, so am I. Talk about adding two and two and getting half a million. There was absolutely no tangible link between expressing that he had hope for me and a suggestion he was going to desist from seeing me. None.

“Where did that come from?!” he exclaimed, mystified.

I honestly don’t remember my answer; I am writing this a fortnight later. I must have said one of two things; either I tried to justify my ridiculous belief that C had suggested he was going to ‘dump’ me, or I immediately apologised and submitted to him. Either way, we ended up in the submissive position, with me predictably following my Attack-Defend-Submit pattern. I said that my comments were clearly bullshit, that I was being daft and he should forget it.

“But it’s obviously something you’re bringing to this room,” C pointed out. “Why is that?”

As can be my won’t at times, I began playing psychologist. Interesting that I refuted any suggestion above that I was childlike, because I remember telling C that that’s exactly what I was. When he asked me why I thought this, I sardonically replied that I wasn’t allowed to intellectualise matters so I couldn’t answer his question.

He laughed and said, with a kind of amused defeatism, “go on then.”

Of course, I couldn’t. This was a PhD qualified clinical psychologist I was talking to. I’m a Wikipedia qualified psychologist. (Actually, I’m underselling myself, as I do have some knowledge of the subject, but it is from some time ago and was not even half as in-depth as a full undergraduate degree, nevermind a doctoral one). For the record, I was thinking of attachment and object relations theories and their roles in transference.

Anyway, my paranoid whining led to a monologue from C about ending therapy. Obviously I’m aware it’s not indefinite, it’s not a permanent fixture in neither his nor my life, aren’t I? But he’d like to assure me – again – that it will never just abruptly end. He envisions a minimum of four sessions of preparation before discharge, probably more, blah de blah.

I just sat there and looked at the floor, struggling to not burst into tears like a bloody newborn, struggling not to get down on my knees and beg him not to leave me to try and make some sense of insanity, my past, my future – my entire damn life – alone. I know I sit here and spout bile about the man and slag him off and call him names – but I do like him despite it all, and I need him and see hope with him and I can’t do it without him – not yet anyhow.

I was utterly overwhelmed by how much I don’t want him to abandon me and how inadequate and feeble I felt because of that. How sad and ridiculous that an intelligent woman of 26 wants a man she doesn’t even know to take the place of her missing father, grandfather and, frankly, friends, given that she only has a few close ones. How pathetic that she is vulnerable like a girl 20+ years her junior, and that she wants this unknown figure to scoop her up and take care of her. It’s so wretched that it’s almost kind of darkly amusing.

He interrupted this self-indulgent and piteous stream of consciousness by asking, “how are you feeling now, in this moment?”

I can return to ranting now. I swear to fucking God that I am sick to death of that phrase. He must surely use it as his meditation mantra. Is there some cadence in it that I’ve missed that makes it an attractive thing to say all the time?

I cleared my throat and said I was fine. He looked at my cynically, but decided against pressing the issue, presumably as there was very little time remaining in the session.

“When Dr C contacts me,” he began, “I can tell her nothing if you want. What we discuss here is confidential. Some people might not be at all comfortable with the idea of a discussion about them behind their back. Others may find it helpful. What’s your take on that? What do you want me to tell her?”

“It is weird to think of the two of you discussing me whilst I’m in absentia,” I admitted. “However, I don’t think that makes it unhelpful.”

I shrugged. “Use your discretion, I suppose. Answer her questions, give her any information you feel is relevant.”

He nodded, and I saw him look at the clock, which to my annoyance he’s moved to behind ‘my’ chair so (I presume) that it’s less obvious to the patient when he checks the time. Which it’s not as you can see his eyes shift above your head. And in any case it was pointless to hide it on this occasion, as he said, “we’ve left very little time to talk about your holiday.”

Oh really, I had no idea, I thought we had six hours. To be honest, I was glad. The preceding minutes had been pretty intense for me and I was tired.

We did conduct a quick and fairly basic discussion on coping if I were to go mental in Turkey, but beyond talking about getting A involved in the techniques, there was nothing new in what was discussed. I did talk about the inhaler from LGP and the Valium, but C kept whinging that these were external sources (oh really? I thought I had them sewn into my oesophagus) and that I needed to develop internal responses. To be honest, I just sat there and nodded, not really agreeing, not really even thinking about what he said, because I just wanted to leave. Not a good thing probably, but there you have it.

As I left, he said, “I hope the holiday goes OK.”

I ranted to A about this later. OK? You hope it is OK?! No “have a nice break” or “I hope you have a great time”?

To my surprise, A defended C. A contends that C had to be careful; had he said he hoped it was “great” or whatever, I would have been too cynical to really believe that he meant it, or that I expected it was possible that the trip could be great. I actually don’t agree that that would have been my view, but in fairness I can see why C might have thought that. So I can forgive his lack of enthusiasm to some extent. I suppose.

Friday: The Flight

OK, the title says ‘three’ days and this is a fourth day, but it doesn’t involve professionals attending to my madness, and in any case I’m not going into too much detail. You can probably tell from the style of writing here and here that I was (hypo)manic on Thursday night. This carried on right into Friday.

I suppose there is an argument that I could simply have been excited about going on holiday, but I don’t think that is the case. Forms of mania are, to me (and as far as I know to diagnostic manuals), different from contentment or excitement, in subtle ways at least. I understand that bipolar II in particular often goes undiagnosed because the hypomania therein often presents simply as an especially good mood. Maybe I seemed in an especially good mood on the Friday of that week, and I probably was, but I was also behaving oddly and saying really stupid shit.

I don’t have the best recollection of it, I’ll admit. I do remember sitting at the departure gate at the airport, delayed, babbling incoherently and in a racing fashion to A. I remember dropping my bag and having some sort of hysterical fit of laughter and more racing speech about this ludicrously uninteresting event. People around me were looking at me as if I was mad (which clearly I was). A found it amusing, and I can understand why it might have been to some – but it is also not ‘normal’; certainly, it was not appropriate behaviour for a public place.

And it very certainly, profoundly and completely wasn’t appropriate for a plane, and luckily I had enough cognisance to realise this. So, for the first and to my credit (?) only time from then to now, I took Valium to space me out and slow me down. It worked, to A’s self-proclaimed disappointment, but obviously it is not a long-term solution to episodes of mania.

Thus began our holiday. I will write in more detail about that shortly; it’s a separate issue from most of this post’s material. However, don’t worry; I’m not going to bore you to death by telling you what we did, what we ate etc etc etc – even if you actually know who I am, such things become dull very quickly. Of course, I keep this diary primarily for my own reasons – but more in relation to my mental health, not ‘normal’ stuff, if there even is any of that presently in my life. No, I want to think about how I felt on the holiday, how I behaved – whether there was an overt exhibition of madness thereon, or whether I actually managed to acquit myself well. I hope to write this tomorrow, but if not hopefully early next week.

Meh

When A and I were waiting for the plane, I received a message from my mother stating that a letter had arrived from Psychiatry offering an appointment on Tuesday 15th. LOLOLOLOL. Can’t they get anything right? I clearly told Dr A I would be away until the 21st. Mum rang them for me and whinged some more, pointing out they had not explained the situation as promised to her on the phone on Tuesday. They promptly and without question rearranged the meeting for Tuesday 29th. I am now terrified of it. It’s not great timing either as I have another bloody OH appointment on Thursday 1st October as well, but there’s not much I can do.

So, finally, you’re probably wondering what the reference to ‘genital vinegar’ in the title of this post relates to. It relates to Dr C. In ranting on Twitter, someone responded to me that Dr C was a “vinegar cunted bitch” – or so I thought. It turned out he was actually referring to some bint spreading more “Obama is a Nazi” bollocks in the US, but never mind – the title as one for my psychiatrist stuck.

Obviously there are a lot of ‘C’s in my life anyway. The actual C, CVM, Dr C…I’m sure there are more. Therefore, to avoid confusion and to reflect my current position on Dr C, I shall henceforth refer to her as the Vinegar Cunted Bitch, or VCB. I know I have a terrible penchant for acronyms, and when combined with usage of terms such as ‘BPD’ etc it is bound to get confusing – but I’m not going to start calling C ‘John’ or VCB ‘Dr Alfonso-Smythe-Hetherington VI’ just to anonymise them, so you’ll just have to bear with me. I have to bear with myself, after all.

C didn’t believe me when I told him this, but prior to Thursday’s session, I had had no more than about five hours’ sleep in the preceding three weeks. I believe that for a while I’ve been in something of a hypomanic state; my experiences have included racing thoughts, restlessness, insomnia even whilst on sleeping tablets, being over-talkative, creative but paradoxically easily bored, impulsive and reckless. The one thing I haven’t felt to any great extent is an elevated mood – fucking typical.

To this end, I’m not sure I was much use to either C nor myself the other day. I rambled and rambled and rambled, fiddled with my hair, got up, sat down, stared into space, laughed randomly and was just like a total crackhead or something. He would start talking about something and I would stare at him in apparent deep concentration, but in reality my mind might as well have been floating in the gases of Jupiter, because I didn’t really hear much of what he said.

Given these circumstances, perhaps it’ll be unsurprising to learn that I remember little of the session, which annoys me as of course I seek to record everything in detail here. Bollocks.  Well.  Here goes with what I do recollect.

One thing worthy of mention is that I am going on holiday on Friday, 11 September for 10 nights. A and I had both agreed that 10 nights was perfect, and given the day it fell on, it also had the beneficial side effect on only missing one session with C.

Imagine how irritated I was, therefore, when C announced he’d be off himself for the session immediately after I come back. Why didn’t he arrange whatever stupid, meaningless real-life activity for the week I was away?! I sat there calm, measured, controlled as he told me this – but I wanted to reach across the table and smite him.

I know how irrational and unreasonable this is. He is a person, with his own friends, his own family, his own life. But it winds me up to fuck whenever that impinges upon my time with him. For 50 minutes on a Thursday morning, C belongs to me. Me!!! In my line of work, I was always expected to take holidays at the convenience of the department and our clients. Surely it should be the shame for shrinks having to deal with their pathetically attached mentals? [/stupidrant]

Anyway. I had ended up buying a copy of the book he’d recommended to me last week, and presented it to him. I hadn’t read any of it, but based on a cursory flick-through, it didn’t seem to be as patronising as self-help books generally have been in my experience. In fact, the first half seems to be a more theoretical discussion of the issues the author has explored during his academic studies of compassion, which could be potentially interesting. The second half is more self-helpy. Later in the session C gave me homework; I am to read the first chapter of the second half for next week, and we’ll discuss it then. More wank on mindfulness, I see, based on flicking through it.  Hurrah.  Still, at least it’s likely to be better than the crap he had me read on same before!

I was telling him about my restlessness and exemplified it by telling him how I’d written over 8,000 words on this blog the day before seeing him. “I couldn’t have done that when depressed,” I contended, “as I wouldn’t have had the motivation.  I hate to use the term ‘hypomanic’, as that has connotations of being in a good mood, and I’m not particularly. But if Dr C thinks I have bipolar elements, and she does, well then, this is consistent with that.”

He nodded, then asked me if it was indeed next week I was seeing her again?

“Tuesday,” I confirmed. “If she fucking shows up this time.”

He ignored the insult and instigated a discussion regarding the Venlafaxine. “Are you going to discuss the medication with her?” he asked.

No, C. I’m going to go there and tell her that it’s a beautiful / shite day. I’m going to ask her what I should buy my mother for her birthday. I was thinking of asking her what “season” she thinks I am best represented by in Colour-Me-fucking-Beautiful (NB. Please don’t think for a second that I use this ridiculous ‘service’.  I have provided the link only for context and have heard of it only through work colleagues.  It’s probably a good thing, therefore, that I am off).

Rather than give such a response, though, I said that I was scared of the meeting in case Dr C tried to take the Venlafaxine away (not to mention the fact that I’m actually scared of Dr C, full stop). I said that it had certainly aggravated my bipolar symptoms, and as such I felt I needed something to counteract that, but that my ‘base’ mood seemed to have improved slightly, and as such I didn’t want her to remove the anti-depressant instead of giving me something to deal with the manic shit.

He looked thoughtful for a minute, then said, “if your base mood is improved…do you think that’s as a result of the medication?”

I said, almost (unfairly) sneeringly, “why? Do you think it’s you?!”

I think he misheard me and believed that I’d said, “No, I think it’s you,” because he smiled a big wide smile, and actually seemed to blush slightly.

Blank canvas, C! Blank canvas. No blushing. Bad C!

This led to a weird discussion of our relationship and what we hoped to achieve through it. I’m not going to sit here and detail it, because I’d be making it up; I don’t remember it well at all. I do remember rambling on for quite a while about how he was the first therapist I’ve seen that ‘gets’ me and that was because he was good at employing intellect and empathy and understanding in the right balance.

At some point during this I confessed to the content of Wednesday’s post and stated that C was the ninth psychotherapist I’d seen.

He was stunned. “I thought you saw a CBT therapist!” he exclaimed.

“I did,” I replied, “but she was one of eight others. I thought you knew this.” I thought this information had been included in the questionnaire I’d completed prior to first meeting C. I’m pretty sure it was. Why else would I sit and whinge each week about the NHS letting me down for 12 years?

He quizzed me in particular on Ian, the psychoanalyst. He seemed really taken aback that such therapy is still available at all, even if on a private basis.

For what it’s worth, I don’t put much faith in pure psychoanalysis, based on what I know of it (not a great deal, admittedly) – mainly because it takes too bloody long to have any demonstrable results.  Having said that, I think there’s a lot we can learn from the approach and the teachings of Freud, and presumably so does the NHS otherwise they wouldn’t have clinical psychologists like C practicing psychodynamic techniques (given as they are ultimately derived from psychoanalysis). So his perplexity confused me a bit.

In the end we briefly discussed my upcoming holiday to Turkey. I said that whilst I was looking forward to it, I felt slight trepidation too. For one, I’ve never been there; the last two holidays I’ve been on, I have been to the places before. Secondly, I don’t speak Turkish at all (I know in tourist resorts they speak English, but I still feel irresponsible for not speaking at least some of their language); previous holidays have been in North America, where they obviously speak English, or various parts of Spain, which is OK as I speak a little Spanish (I’ve been to Germany too, but A speaks German. I’ve been to Czech, but was motivated to learn enough of that language before I went there. When I was in Portugal, I was too young too give a damn). Mainly the issue is that this is the first time I’ve been on any sort of foreign trip whilst really mental.

“So you see,” I said to C, “I feel like I’m going a little out of my comfort zone.”

“Maybe,” he agreed, “but you can also see it as an opportunity.” He paused, and then laughed. “Plus don’t forget it’s a holiday!”

“Indeed,” I smiled. I did point out that I am looking forward to it, I just wondered what would happen if I lose it whilst there.

“Aside from the fact I don’t fancy a spell in a Turkish asylum, it’s not covered for in the fucking travel insurance,” I pointed out.

He suggested that we spend most of next week’s session discussing ways to manage being mental on the holiday, a proposition to which I agreed.  We also plan to look at the chapter from Paul Gilbert’s book that I mentioned earlier.

But that’s really all I remember of it, which is frankly appalling.   If anything more comes back to me, I’ll add it – this journal is still, primarily, for my own reference after all. For the rest of you, whilst this entry has been pointless and boring, at least it isn’t 8,000 words of verbose, narcissistic nonsense!

On Tuesday I see Dr C, on Wednesday I see Lovely GP and on Thursday it is back to C.  I will try my best to report on these meetings, last-minute traveling arrangements permitting. At least an entire week of stressful madness will be rewarded with 10 days in, I hope, the Turkish sunshine.

As any of you who have read this blog since I began it in May will know, it has long since been my intention to write about each of the different therapists of one description or another that I’ve seen over the years. The idea was inspired by the same type of post by Introspective at Conversations with my Head, so hat-tip and thanks to you my dear.

It’s now September, so you can see how successful I’ve been to date in getting around to this. But here I am, finally, with all the fascinating (!) details.

Be warned; this is very, very long. I’d suggest you don’t even bother reading it if you wish to remain awake (possibly alive). If you really want to, try it in two parts or be prepared to be sitting at your screen for a while.

—

I was about 12 or 13 when I began to think that I had mental health problems. With the benefit of that wonderful thing called hindsight, I can see that I might have been a bit batty even as a child – I was a complete narcissist even then, and once tried to amputate my foot. I was an insomniac and experienced nightly hallucinations. I thought it was normal at the time.

But with the onset of adolescence (though not puberty, for I experienced that mostly in its entirety a bit earlier than most), I began to feel increasingly depressed. I felt hopeless, like my life was worthless, that the future was bleak and dark, that everything was utterly futile. Even I had the sense to recognise this as a bit unusual.

The realisation that I was depressed came one day when we were visiting my grandfather in hospital. In the corridor, there was a sign detailing the diagnostic criteria for a depressive episode. I hadn’t had five of the criteria for a few weeks; I’d had them all for several months.

I remember going back and looking at the poster over and over again, in the hope that my mother would notice that there was something on it that was piquing my interest. I never succeeded in that endeavour, but sooner or later she did, somehow, realise that my marked change in behaviour was quite long term, and off she marched me to the GP. Thus commenced about 12 years, to date, of on-off psychotherapy.

The GPs

Not therapists obviously, but it was of course one of my GPs that initially made the diagnosis of clinical depression; I was aged 14 at the time. To be honest, I think they just gave me a diagnosis and medication just to get rid of me. I am still of the view that I was initially seen as an angsty adolescent that they wanted off their hands. Best to give me Prozac, then say toodle-oo. Except it wasn’t so simple. Mum had me up at the practice more times than enough and eventually they sought the involvement of…

The Counselling Bloke

In all honesty, I remember very little of this guy. I don’t remember his name, and I don’t remember the precise point at which I saw him. I remember that he was a counsellor, of course, but I can’t recall whether he felt I needed more specialist help than he could give me, or whether we just closed the meeting and mutually agreed there was no point in continuing the brief alliance. Whatever the case, I’m fairly sure that I only saw him once, and I found the meeting utterly fruitless.

I do remember what he looked like; he was a short, thin, dark haired bloke, and actually reminds me a bit of C. It’s not beyond the realms of possibility that he in fact was C; although I’m not sure of C’s age, I’m guessing he’s in his mid-thirties. That would make this meeting just on the side of possible; he could have been an undergraduate or new graduate gaining some work experience. Perhaps I am creating a phantom memory, but it doesn’t really matter either way. The meeting was still useless.

The Trainee Child Psychiatrist – Anna

I’m not sure how I ended up with Anna, but it could have been one of two ways. Either the Counselling Bloke referred me, realising I needed more help than he could give, or Mum and I went back whining to the GPs and they eventually referred me. I don’t remember, but it doesn’t matter.

According to Anna herself, so my mother says anyhow, people under the age of 18 aren’t allowed to see psychiatrists. This seems ridiculous and unlikely to me, especially given that Anna – by her own admission – was a “medical doctor” (Mum asked her one day if she had a PhD in psychology), so surely the only mental health specialism of medicine is psychiatry?

Anyway. Whatever the case, she was based at a Child and Adolescent Mental Health Unit and I saw her for quite a few months. I liked her, and despite the bizarre situation and the fact that we never really made any headway, she liked me too (more on that in a minute).

I remember few of the specifics of the psychotherapy. I do remember her giving me stupid, patronising little sheets to fill in. You had to complete the end of the sentence, eg. “I secretly…” or “I really hate…” or whatever. Though in thinking about it, this maybe only happened a couple of times.

I think she was trying some sort of cognitive behavioural approach with me, because I remember thinking at the time that whilst she was well intentioned, her methods were unintentionally condescending (even though she herself wasn’t) and I just knew they were never going to work. I did apply myself to the therapy, though, and tried to work with her, but I never let my guard down and was always very careful in what I said to her. She knew I was bright and I think she actually found me quite entertaining; I remember one incident where I had the woman doubled-over laughing (thanks to some scathing remark I’d made about someone that was intended to be amusing, but I hadn’t predicted just how funny she’d find it).

I don’t remember the exact reason that my sessions with Anna came to a close. We must have agreed to have a break, though I don’t remember that happening exactly. All I do remember is that, whilst I hadn’t seen her for a week or two, I was expecting to see her again, when a little card arrived in the post from her, explaining that she’d been offered a new job on the other side of Northern Ireland and would not be able to see me again. The letter was kind, stating that she’d enjoyed working with me and wished me all the best for the future.

I wished her well and fully understood her reasons for moving on. Our therapy hadn’t much worked anyway, but nevertheless here I was left high and dry again.

The Education and Welfare Officer – Elaine

Actually, I’m not sure whether it was Elaine or Lorraine, but I’m going to go with Elaine as it’s quicker to type.

Elaine wasn’t a traditional psychotherapist; she was actually a social worker attached to the local education board, and was involved in my situation as – owing to my mental health problems – I missed a lot of school. Nevertheless, our relationship became one that more closely resembled a therapeutic one; she was more like a counsellor than someone involved to keep tabs on me. I would meet her each week on a Thursday – it was during GCSE Maths which of course was especially gratifying

As is the wont of social workers, especially (though not limited to) those not directly trained in managing mental health issues (or so I’d imagine), Elaine’s discussions with me would centre around practical measures I could take to help myself, rather than an psychoanalytical exploration.

Although she wasn’t much like Anna in her actual therapeutic approach, she was to some extent in her reaction to me: I distinctly got the impression she recognised that I was not being deliberately awkward as some of my teachers believed, and that she believed that I was a bright, not unpleasant kid, with some genuine difficulties. She liked me. I would take her in photographs of events I’d been at the odd time and she’d always compliment me on how well I looked in them. She took me out to lunch a couple of times as well. She was the only one (other than my best friend D) to whom I would show my prolific self-inflicted injuries (which were more than just silly little cuts, but long, occasionally complex words all over my body). I don’t remember whether Anna ever asked to see them or whether I just avoided it with her, but I’m pretty sure she never saw any of it.

I don’t remember, again, the exact reason why this relationship came to a close. I don’t think Elaine left her position; I think it must’ve been something to do with me taking my GCSEs and therefore potentially leaving school, and ergo, her remit. As it happens, despite my previous intentions, in the end I elected to return to school for sixth form, but by the time I got to that stage, things were more (not entirely, but more) settled anyway.

It was during my time with Elaine that I seriously tried to kill myself (the first attempt, a gesture in retrospect, had been about a year beforehand, catalysed by a break-up with a boyfriend). On this occasion, although I decided upon doing it on a whim, it was something I had been thinking about for a long time and I really intended to die. I took a massive overdose of everything I could find in the house – paracetamol, ibroprufen, various prescription medicines of my mother’s, my Prozac etc etc – thinking it would be enough to off me (I know better now, but I genuinely believed it would kill me then).

I am reminded that my time with Anna and Elaine must’ve overlapped, because I now recall Anna coming to see me the next day in hospital, after I’d had my stomach pumped. When I went back to school the next week, Elaine took me out for lunch. I remember asking her why she was rewarding my behaviour; she responded that she didn’t feel that she was ‘rewarding’ it, but she was upset that I had felt so desperate that I’d seriously tried to kill myself, and she wanted to do something to cheer me up. Well, as anyone who’s been there knows, it takes more than skiving off school for lunch – but I appreciated the gesture, as well as the rest of her tenure as my EWO.

It actually pains me to write about Elaine, because it reminds me very acutely of what was probably the bleakest period to date in my life. It was only through thinking about what I was going to write about on this post that so much came flooding back to me; clearly I had compartmentalised much of it (I was whinging about this to bourach here recently). In a way, one could argue that this past year of my life (ie. 2008 – 2009) has been even worse in the sense that I have experienced a lot more than ‘just’ depression, and that would most assuredly be true. But now, at least, I have a support network, and a network that understands this whole mess is not something of my choosing. I very distinctly didn’t have such support when I was 15/16. I had a few friends, yes, but with the best will in the world it was hard for them, not having been there, to understand a disease so often (and often unfairly) solely associated with adults (I’m not even sure they’d understand it then, but anyway). Although she recognised that I was mentally ill, my mother couldn’t fully grasp the enormity of my despair either, and reacted aggressively to my illness at times, although in fairness she did champion me a lot with the GPs/counsellors etc. I was picked on by a couple of teachers too, though in fairness there were a few good ones. All in all, it was a horribly dark period in my life, and rather than discuss the specifics thereof, I think I’ll just leave it be. Maybe another day.

—

After doing my GCSEs I existed in a relatively sane frame of mind for a while. My dosage of Prozac had been upped, and a lot of the wankers that had made my life so miserable at school had either left or had grown up a bit. Additionally, I was only having to do subjects I liked and was good at for A Level, so things were a lot more settled for a while. Things were far from perfect; I continued to miss a lot of school, and didn’t do as well in my A Levels as I could have done – but things were certainly better in those two years than they had been in the previous five. In fact, it is only through writing the above about Elaine that I am shown how much I wear rose-tinted glasses regarding school. I tend to be quite defensive of the place should anyone slag it off, and when I think back upon my time there in an abstract sense, I am sometimes overcome with fond nostalgia – this is based almost entirely on not absolutely hating those two years of sixth form. Clearly at least part of me blocks out the unbearable misery that were the preceding five years.

But anyway, that obviously didn’t spell the end to the madness…

—

The First Assessment Woman

I’m not sure when this was. After sitting my GCSEs, the next time I really remember losing it big style was when I was doing my postgraduate course, but I’m fairly sure the First Assessment Woman was earlier than that. Perhaps I had been feeling low for a while in sixth form (or whilst I was an undergraduate) and had yet again been at the GPs’ ‘surgery’; given my history, they might have referred me to the Psychological Therapies people. Who knows. Whatever the case, I went to see this woman at the same hospital in which I now see C and Dr C.

I believe the meeting was intended to assess what the most appropriate psychological treatment would be for me given my history. It was, short of the Crisis Response Team (see below), the most useless and frustrating mental health-related meeting I have ever had. The woman quite openly sneered at me as I tried to relate some very difficult information to her. I think it was because I expressed everything with a distinct absence of emotion and she therefore didn’t think there was actually much wrong with me (or such was my impression, anyway).

When I related a very abstruse outline of the sexual abuse, she decided that that alone must be the entire cause of my problems and gave me the number of the local Nexus Institute. I remember protesting that I didn’t want to phone someone (so clearly the phone phobia has been ongoing for a good while then) but she dismissively said it could be in confidence “if I wished” (thus totally missing the point) or that I could see them in person, if I preferred, and that that was all, I was to run along now. I didn’t have the energy to argue with her and that was that.

—

I had a major breakdown whilst undertaking my postgraduate degree. I had, at this point, only the dissertation left to write and had finished the taught part of the Masters programme, so took a full-time job which looked to be like a very good opportunity, and which was, unlike my previous and subsequent jobs, directly related to my academic background.

Unfortunately, I had been in a slow, but with hindsight obvious, downward spiral, largely thanks to my own doing. I had been feeling pretty good during my postgraduate year, so cut back on my Prozac without medical approval. DO NOT EVER DO THIS!!! By the time I realised I needed to remain on the dose I’d been at, the spiral had already taken its grip and the return to the full dose didn’t make a difference.

In fairness to myself, it would probably have happened sooner or later anyway, because at no point had I seriously tackled the underlying causes of my mental health difficulties – surely a recipe for disaster. It’s one thing to be aware of what they are, but it’s different to fully face them and be aware of all the subtleties therein. To mitigate their effects, or at least begin to reverse them, in my view I need to do this. Of course it had been my choice to never get into this detail, as I’d already seen a number of different ‘therapists’ by this point and had failed to utilise the opportunities presented. On the other hand, until you’ve been there, it’s impossible to understand how difficult this is, and how skilled a therapist needs to be to get it out of someone with so many defensive walls built around them, like me.

Anyhow, as ever, I digress. The breakdown meant I lasted a sum total of one week in my new job, and eventually had to leave my course with a postgraduate diploma rather than a Masters degree.

I returned to my GP. LGP had joined the practice by this point, but I didn’t see him consistently until more recently; it’s dog eat dog in our practice, and you take who you get unless you’ve planned the appointment for weeks. So I went to another one, who simply told me to “fight against it”. Unsatisfied with this, I went to the practice’s Nurse Practitioner, who prescribed me a new anti-depressant – Mirtazapine (in part because it’s good for insomnia) – and referred me for wanky CBT. I saw ‘wanky’ now, but I was hopeful at the time.

—

The Second Assessment Woman

She was a CBT Nurse at the main bin in Northern Ireland, Holywell. She was certainly better than the first bint of her ilk (see above), although I disagreed with her ultimate conclusion. I remember that she asked me the one question that every single one of them has consistently asked me: “don’t you have any female friends?”

I said that I didn’t like other women, adding, remembering her gender, that I meant “no offence” to her. (To qualify this a bit, I generally don’t get on well with other women in real life, though I felt more harsh about this at the time than I now do. Online, this isn’t the case at all – most of my online friends are women. I do have one real life female friend at the minute, so maybe I’m making progress! It all goes back to a terrible case of black and white thinking; because many women express emotion, want children and dream of white weddings, stuff I hate, I behave like I think they all do. Rationally of course I don’t think that at all, but then rationality and I are not always the best of friends, regardless of my desires to the contrary).

Anyway, Assessment Woman Two listened to me and, in fairness, seemed non-judgemental and accepting of the fact that there was something wrong. She did seem puzzled by my customary lack of emotion and even apparent amusement at some stuff, but she let it pass. Her conclusion was to refer me for group CBT. I protested vehemently against this – I was terrified of the group thing. The woman said, though, that she felt it would be beneficial in two ways: (1) the waiting list was shorter for group therapy than individual therapy and (2) it would help me confront my fear of group situations face-on. I reluctantly agreed.

The Psychoanalyst – Ian

As the waiting list for even the group CBT was six months, I went back to my GP’s ‘surgery’ and asked for a recommendation for a private therapist in the meantime. The physician I saw that day suggested Ian.

Ian was a very well regarded psychologist who’d even practiced as a forensic psychologist. Without detailing my academic background too much, this appealed to me strongly at an intellectual level and although he charged £70 per hour, I was happy to ‘try’ him.

I liked Ian. In a way, he reminds of me of C, the psychologist I now see; he was qualified to PhD level in his discipline, was clearly intelligent and astute, and seemed to be able to read my mind.

It was he who first suggested to me that my narcissism was an elaborate defence mechanism, built up over the years to disguise inherent and strong self-dislike. I remember arguing, “but I genuinely do think I’m better than some people,” and him responding by saying, “you genuinely think that you think you do, yes.”

We did discuss some of the stuff that effected me as a youngster, but although this was closer to psychoanalysis than any other therapeutic situation in which I’ve been, he was still primarily interested in here-and-now of my psychology. I believe that this was not because he wasn’t intending to explore everything else in more depth, but because if he had an understanding of what was now the case, it would allow him to work backwards. C did something similar, but has a more structured approach.

Again, though, my whole ‘lack of emotion’ thing was pronounced and perhaps he therefore didn’t realise how serious the situation was, or at least was becoming. Furthermore, if I am entirely honest the whole thing was kind of like an extended intellectual discussion between two parties interested in the way people’s minds work. To this end, I don’t feel that it was necessarily a particularly helpful relationship, even if it was an interesting one.

I think Ian could perhaps have helped me had I allowed him to break down more barriers, but then again, just because we liked each other at an intellectual level doesn’t mean that we ‘clicked’ especially; I don’t think we did, and there is increasing evidence suggesting that the dynamic of the therapeutic relationship is what allows the most useful and effective type of work to be done (see here or here, for example).

I went maybe five or six times, approximately every fortnight, though it became progressively less frequent as time went on. Aware that I wasn’t working, Ian suggested that I do some reading and practical things, and suggested I came back in a couple of months to save myself some money. In fairness, he did genuinely seem to want to provide me with a value for money service.

I didn’t go back, but not because I just gave up.

The Hypnotherapist – Edith

Having heard that I was paying out £70 per hour, the McF dynasty decided to get involved, recommending a hypnotherapist that S and her daughter Suzanne had both gone to, finding her effective and more reasonably priced than Ian at £70 for two hours. I must confess that I was cynical, but my mother offered to pay for the treatment so I thought, “what the hell?” My intention was to have it compliment the work with Ian, rather than replace it, and for a short while nearing the end of my contact with Ian, the two did overlap.

Edith was the sweetest, most gentle woman you’re ever likely to meet. She oozed empathy and sympathy and absolutely tried her level best.

For my part, I did open up to her, but still in a pretty detached sort of way. For instance, I remember one discussion in which I was supposedly hypnotised where she was “regressing” me to my childhood. She asked if I could see the little SI in my mind’s eye, and I said that I could. There was a conversation about the kid’s actions, behaviours – I don’t remember it fully, but in any case, despite outward appearances, it became apparent that Child Me was probably not very happy. Big SI was very bad and said that she didn’t care that her mini-me was somehow unhappy. Edith said, “doesn’t she need to play? Shouldn’t she be enjoying these years of her life?”

I can’t remember my exact response, but it was certainly a definitive no. She kept pressing the issue – “but can’t you empathise with that little girl, that innocent child” blah blah blah – but no matter what way she tweaked it, or however she phrased it, I didn’t like Child Me and did not empathise with her. Edith kept trying and trying to instill empathy in my unconscious, but it never worked.

I’ve always wondered if I was completely hypnotised anyway. Whilst I obviously recognise that hypnosis is generally not like you see on the Paul McKenna show or whatever, but that it is rather just a heightened state of relaxation, my experience in Edith’s was distinctly different to both that of S and Suzanne. S in particular had found that her body took on the characteristics of her abusive ex-husband – she spoke in his voice, she lashed out a couple of times and emulated his stature. Suzanne hadn’t quite such an intense experience, but more so than I had, and neither remember much of it, whereas I remember a lot of it quite clearly (and anything I don’t recall is more to do with the passing of time rather than the hypnosis bit, I think).

I’m not faulting Edith; if I wasn’t hypnotised, then it is probably because I resisted it. I don’t know about the accuracy of the claim that some people can’t be hypnotised – maybe that’s part of it? But still, once more, I wasn’t fully willing to confront everything in detail. Again, yes, this is arguably stupid, but I still utterly despised the notion of expressing emotions (I still do) and was incredibly defensive.

One issue of difficulty was that I had to point blank lie about McMF-paedo-fuck to Edith. This is because she lives close to the McFs, and of course she treated Maisie’s husband’s daughter and granddaughter. Although I have more than one uncle that is still alive (and did then too), it would just have been too awkward to admit that it was an uncle. She did directly ask me who was responsible, so had I said, “my uncle,” there was nothing to stop her from asking which one. I therefore had to lie and say it was the husband of a friend of my Mum’s. This meant having to remain on guard about this issue a lot, which no doubt didn’t help the hypnotherapuetic process.

Having said all that, Edith must have done me some good. One thing she did do was set anchors, though as far as I know this is as much about neurolinguistic programming (NLP) as hypnosis. Occasionally I’ll still grab my wrist in a certain way to try and calm myself – that was one of the anchors.

Whether it was partly this, or partly expunging myself each week to her in general, even if still in a detached way, something must have helped in some way, because it was after seeing Edith for a few months that I started looking for work again.

—

(For the record – when I got a job, thinking I was back on track, I didn’t return to Ian. I did eventually receive a notification to attend a CBT session back at Holywell, but it was in the mornings, and that clashed with work, though as I was part-time back then, afternoons were ‘do-able’. I let Holywell know this, but was told that the group sessions only took place in the mornings and that therefore I’d have to wait another while for individual therapy. I never heard from them again).

A initially advised me against going to the four interviews I got at this point, as I would totally lose it each morning before the interview of that day. But I somehow forced myself to go to them all, and in the end was offered two of the four positions (I had temped briefly at the full-time one, and had other experience in the area, so no doubt that helped). Ultimately, I took the part-time one, because (a) I felt really encouraged by the staff I’d met at my interview, (b) it was in part working with animals and (c) I felt that a part-time position would be a better way to ease myself back into work.

Unfortunately, it didn’t entirely work out well, as despite appearances some of the staff weren’t quite so nice – but that’s another story. I did keep in touch with two of my colleagues from there (AC and DL), and thus am still grateful for the experience. Anyhow, I applied for another part-time job, got it, then a few months later got promoted to a more senior and full-time job. This is my ‘current’ job.

Things were fine for about a year, though the year had many stresses – V’s death and the will fiasco, a change of manager, a lot of stresses in the job itself that really shouldn’t have happened. Eventually, I was becoming increasingly agitated and depressed, and even dreading going to meetings as I knew I would only have a pile of extra work laid at my door, when it wasn’t possible to do any more. I was becoming increasingly neurotic and disillusioned with life in general, and one day I cracked and rang my mother in tears, begging her to put an appointment on with the bloody GPs the next day.

This she did, and that was the last day I was in work.

—

The Crisis Response Team (CRT)

I initially saw the Nurse Practitioner that day but when she heard I wanted to die and I couldn’t see a future for myself (amongst other things), she said, “you know, you’re really ill,” and decided to involve one of the partners in the practice.

He, in turn, decided that I needed to urgently see specialist mental health professionals and arranged for someone to come out to my house that day.

I am not sure that I have enough pejorative terms for the two women that turned up. Whilst the first one was friendly enough, when the other (apparently the more senior) one took over, she was incredibly passive and didn’t stand up for me, so I hold her as well as her colleague culpable for my annoyance.

Despite outlining how unbearably bad I felt, despite trying to tell them why, despite all the efforts I made to convey the longevity and seriousness of my condition to them, the more senior woman said I should “perhaps try meditation”. I actually laughed, thinking this was some sort of twisted piss-take, but her facial expression conveyed the information adequately that she was not joking. For the record, I have no problem with meditation, but don’t believe it’s a substitute for proven medical intervention.

She continued by asking me to analyse a scenario. Bloke A is in the park with his six brats running around screaming and doing my head in. What’s my reaction? “That Bloke A should die.”

“Alright,” she said, “now assume you approach Bloke A and tell him to shut his children up, and he apologises to you and says it’s just that his wife died that morning. What’s your reaction now?”

“My reaction is that while I am sorry for his loss, Bloke A should die.”

She looked puzzled and said, “but don’t you see that there are different ways of looking at things?”

“Yes,” I said, “I’m not stupid. What is your point?”

Apparently I was not recognising that there was an alternative viewpoint to the behaviour of Bloke A’s children and his inability (or unwillingness) to discipline them.

“That is incorrect,” I protested. “I do accept that there’s an alternative viewpoint. I still think he should die as his grief isn’t my problem. In fact, I’m offended on behalf of his wife. Shouldn’t he be taking his kids to see her parents or something? Or, in an alternative viewpoint, let’s assume the wife’s parents are dead – surely she has some family? Shouldn’t he be engaging with them and sharing grief? Or if he needed to be alone, why isn’t he alone? I appreciate that it’s possible that neither he nor his wife have any friends, family nor colleagues, but I think even you’d agree that that’s unlikely.”

But apparently I still missed the point.

After a long and protracted argument, about the above scenario, meditation and other issues, I admitted defeat and told the two of them that I was disgusted that my national insurance went towards their salaries.

This comment was ignored and they agreed to refer me to a…take a guess…wow-ee, a CBT therapist! Deja vu, anyone?

As they left, they told me it was “lovely” to have met me (so they’re liars as well as morons). Perhaps needless to say, I didn’t return the ‘compliment’.

The Cognitive Behavioural Therapist – Margaret

Given my previous experience of CBT therapists twatting about, I knew if the dumb bints from the CRT even did refer me (which it turned out they hadn’t), that I’d be waiting a while for it, so back I went to one of the GPs, and again asked for advice on a private therapist, though this time I specified that I wanted to try CBT rather than psychoanalysis.

Enter Margaret, at £90 an hour.

Although I liked her as a person, it was Margaret that gave me my intensely negative view of CBT. Initially, I was cautiously optimistic, but it didn’t last. As is apparently typical in CBT, now that I’ve read about the process more in-depth, she would have me analyse the likelihood of a perceived negative event. As a very rudimentary example, someone I know walks past me in the street without speaking to me. I can (a) assume (s)he hates me or (b) rationalise it – maybe (s)he didn’t have her glasses on, maybe (s)he was on his/her mobile, maybe they’re depressed.

Um…so? I know there are a million other explanations and I know that it is almost certainly not about me unless there has been a very clear reason for that, such as an argument. I already fucking know all that, I don’t need anyone to patronise me about it. The question is how does one really believe it? When I asked Margaret that, she said you just have to have an evidential base for the belief, which tallies with the literature on the subject, but that’s bullshit in my view as it’s already been recognised as utterly irrational by me; I already see and recognise that evidential base, but it’s doesn’t stop me from believing that the worst case scenario is the case, even if I don’t rationally believe it. If that makes any sense.

Another technique would be to directly face that which is most feared. As an example of this, I told her that I was freaking out about an interview for a job for which I’d applied, and she said I must go, as exposure to the event would be helpful.

I ended up in LGP’s office having gone totally batshit, and he gave me Diazepam for the first time.

In fact, I actually did go to this interview, and of course it didn’t go badly (in the sense that the panel weren’t Satan Incarnate; it did go badly in the sense that they were looking for someone much more qualified than me). But I already knew it would never be as bad as my panic was making it out to be. This happened another few times – I would utterly and completely lose it, even though I knew it could almost certainly not be as bad as my losing it would suggest. It doesn’t matter than I’m rationally aware of probable realities. It doesn’t matter that I know the worst that can happen is that the interview panel don’t like me or that I don’t get the job, and it doesn’t matter that neither of these things are likely to matter in the grand scheme of things.

I still fucking go mental when I’m under stress, or sometimes (mostly, actually) ‘just because’. Furthermore, in the case of the latter, I am not losing it because of any specific reason – as such, how can I rationalise what I fear? I mean, I don’t (consciously) know what the fear is in those moments. Even if I did, I already know anything a CBT-like approach could teach me.

Although I liked Margaret, I became increasingly disillusioned with the CBT approach, not to mention the fact that I was beginning to get into horrific debt – meaning that her employer’s ludicrously high charges were too much for me to pay. So that was the end of that.

—

My mother happened to be seeing the Nurse Practitioner at the GPs’ ‘surgery’ on an unrelated matter. The Nurse asked how I was getting on, and my mother said that things were not good. Upon a brief glance at my records, the Nurse saw that no referral had been made for me by the CRT for psychotherapy (I knew they were incompetent).

The Nurse therefore took it upon herself to make a referral. Fortunately for me, though, she cocked it up and didn’t make it specifically for CBT, like it was meant to have been when the bitches from CRT decided upon it.

I was really struggling during this period, and at my behest, had my medication changed to 40mg of Citalopram daily, which is the highest dose they were prepared to give me. It was at this juncture that the GP I saw decided to refer me to a psychiatrist, on top of the Nurse Practitioner’s referal to a psychologist. I finally saw her about five months later, despite the fact the waiting list was less than three months at the time. Contextual links follow later.

It was somewhere after my CBT with Margaret than I began to believe I probably had more than ‘just’ clinical depression and anxiety. I didn’t really investigate anything further at the time, but I recognised that for a while I’d been experiencing a wider set of symptoms. I assumed, rightly as it turned out, that seeing a psychiatrist would shed some light on this.

A relatively short period after my mother’s appointment with the Nurse Practitioner, I received a questionnaire through the post asking me to outline my psychological difficulties to help cut waiting times for a psychologist. I was prompt and, I hope, thorough in my completion of this document.

Some weeks later, I received a letter from the same hospital in which I’d seen the first assessment woman, asking me to attend an assessment with Dr C J, a clinical psychologist. Mum and I were both raging, as we wondered how many more fucking assessments it would take before they actually offered treatment? In both of my previous assessments, I then was simply moved to a waiting list for whatever the treatment deemed appropriate was. Still, I went along, because one has to do things the way the NHS wants.

—

The Multi-Disciplinary Psychologist – C

I’m not giving his first name. I’ve already told him I’ll keep all references to him here anonymous, and even though his first name wouldn’t give away his identity exactly, there’s always the chance that someone who doesn’t already know may find out who I am and work it out from there.

The ‘assessment’ session with C ended up turning into three assessment sessions, because he actually took the fucking time to discuss each of the points raised in the aforementioned questionnaire in detail with me. Surely he must have been breaking NHS protocol by actually taking his time over it?

I didn’t know what to make of him at first. His intellect was obvious, and I respected that, but there was something indefinable about him that I found quite irritating. Nonetheless, when I told him I thought CBT was a load of crap, even though I wasn’t a psychological expert, he accepted that and said that I was certainly the expert in myself, and that if that didn’t work for me, then it didn’t.

By the end of the three sessions, whatever it was that irritated me about the man was beginning to abate, and when he said that he would continue to treat me, rather than someone else, I was glad. We initially agreed to six weeks (his optimistic suggestion), shockingly commencing the following week! Progress at last. He did warn that although it might be mutually attractive, we couldn’t let our sessions become some sort of intellectual endeavour (as had been the case with Ian, though C is not entirely familiar with all that). I did stress that I couldn’t abide being talked down to, nor could I bear to not communicate comfortably because I had to ‘dumb down’ what I was saying. C accepted that and stated that he would be glad to have an intelligent dialogue with me, but it wasn’t to become a discussion of my issues as a psychological abstract; it still had to be directly about me. Given my narcissism, I was happy enough to acquiesce to this.

During those first six weeks, I began to grow from being pretty indifferent to him, to becoming really rather fond of him. He seemed to have got the mix right between employing intelligence and empathy in his approach – this is a position I still maintain about him. At the end of those first six weeks, I burst into tears in his office and begged him not to abandon me, as he was the first therapist to really ‘get’ me out of the many I’ve seen. We agreed to another 10 weeks at that stage, and when those came to an end, another 12 (of which we have presently had two sessions, with the third tomorrow). I see him once a week, first thing on Thursday mornings.

Perhaps because of his balance between intellect and empathy, rather than just one of them being in evidence, I have opened up considerably to him and have even shown the dreaded emotion, though I still curb it to some extent a lot of the time. I’ve told him stuff I’ve told no other living being.

In essence the therapy is mainly psychodynamic, though he has tried – usually to my annoyance – to bring stuff like DBT into the mix. His rationale is fair; psychodynamnic exploration is important, but when I lose it I need practical help too. I’m still dubious about DBT, but at least it has an ancient philosophical background which CBT doesn’t.

The main thing I’d say about my relationship with C is that there is a bond between us now. I am horribly attached to him, and whilst I won’t delude myself into pretending that he returns that attachment, I do think he likes and gives a damn about me. He is the first of all of these people that I have actually experienced transference towards, which is demonstrative of the fact that my psychotherapy with him just might be the vehicle I need to a recovery of sorts, as of course the phenomenon is generally expected to manifest if the therapy is to have any hope. Transference does cause me to get annoyed with him over very little at times. He causes me to get annoyed with him at times; the way he’ll avoid a question infuriates me, but this is him trying to avoid getting into a intellectual discourse with me, for the most part.

But all this transference, bonding etc is not to say that the process is fun; quite the opposite. It’s intense, overwhelmingly so at times. It often (ironically) depresses or angers me, saddens me, has made me lose it a couple of times. Even though I’ve opened up to him on many issues, I am still incredibly defensive and tend to (figuratively) run away if he hits a nerve. Yet somehow he manages to get most of it out of me eventually, showing his subtle but evident skill. I always crack up though. But then I always expected that things would get worse before they got better, because I have not faced any of my ‘baggage’ in any real depth before.

Overall, it’s possibly the most difficult sustained experience I have ever been through, but nonetheless, I think the relationship is a very good one, and despite the regression in my condition since I met him, in conjunction with his colleagues in Psychiatry, I have a glimmer of hope that, over time, C may be able to help me get some control back over my life.

The Psychiatrist – Dr C

Again, no names. In this case I don’t even know their first names anyway.

Obviously she’s not a psychotherapist and exists mainly to monitor my illnesses from a medical point of view. But I want to hat-tip her anyway, for providing my diagnoses back in June. Dr C also changed my medication to Venlafaxine on that occasion, but was open to the possibility of adding further medication to the cocktail should it prove necessary.

Unfortunately it took a hell of a lot of trouble to finally get to see her (it was only in discussing self-harm and suicide ideation with C that I was ever seen by them) and now that I have met her, it apparently takes a lot to continue to be seen on a regular basis. Basically, I feel fucked over by her, just like I have been by the NHS on several occasions, but meh. I ought to be used to it.

At least, though, when she does bother to show up, she seems to be willing to tackle my case in a straight-up fashion and to do something that might actually have something like a positive effect, so in conjunction with C, I have my fingers cautiously crossed.

—

So there you have it. The life of the Serial Insomniac through therapy. I realise that I have whinged an awful lot in the early part of this post that people kept attributing my madness to teenage angst. For what it’s worth, I do understand why this was thought to be the case, for the laypeople anyway, and I am working towards letting go of my anger in that regard, though it’s not easy.

It is only now, about 14 years after first really feeling that there was something psychologically wrong with me and about 13 after seeing someone about it, that I feel I might actually be finally moving in the right direction.

I expect it to be a slow process, but I’d rather have that than have no hope of regaining control at all.

Apparently BPD has a decent prognosis in the right circumstances, though I certainly won’t hold my breath. Bipolar disorder has no known cure. Either way, I’m not asking for ‘cures’. I accepted years ago that I will probably be on medication for the rest of my life; I am fine with that, and I am not against some sort of semi-regular ‘top-up’ psychotherapy after completing my main course, if that is what is required. Cures are not what I seek, as discussed in more detail here and here.

But I do want to be able to at least be functional, and I do hope that with C’s help, maybe – just maybe – I might be able to regain enough control to achieve that. I don’t know. The journey will continue to play out on this blog.

Lucky you, dear reader. If you’re still reading this post, then I’m amazed and don’t understand how you’ve not passed out or even died of boredom. Even by my verbose standards, this is fucking long. So, until ‘C: Week 23′, so long.

I had what I felt was a really good session with C on Thursday.  That, to me, seems like an odd thing to say, as the best I’ve had to say upon departure in the past is that it ‘wasn’t bad’ or some such, but I actually left the other day feeling very positive about the whole thing.

I’m not entirely sure why; I felt reassured and taken seriously, and felt the dynamic between the two of us was good. Not that it isn’t normally, but it seemed to ‘flow’ particularly well and naturally on Thursday morning.

Apart from the very start, that is; he always wants me to start the session, and I almost never know where to begin unless something has been very definitely playing on my mind.  Plus I hadn’t slept all night and had missed a dose of the dreaded Venlafaxine, so I was kind of two seconds behind him intellectually.

Eventually, with my inability to articulate myself, C decided he would draw attention to my starting arguments with A over nothing (see here, and latter part of here), as we had discussed to some extent last week.  I didn’t really have much to add to that, to be honest, mainly as I don’t remember the circumstances on many of the occasions.

So began a discussion regarding disassociation.  He thinks that I have amnesia as regards the stupid arguments because then I completely freak out that I am going to be abandoned, so in order to cope with the enormity of that in my mind, I have to disassociate from myself and the world.  He went on to lead a dconversation on what can be done to “ground myself in the moment” when I first start to notice negative feelings that could cause me to lose it and ultimately disassociate.

He asked me what I thought I could do in such a situation.

I laughed and said, “you don’t honestly want me to answer that with sincerity, do you?”

C pretended to be perplexed by this apparently cryptic comment but he knew as well as I did that it was a reference to self-harm.  I said, “what I think I can do in such a situation is carry a knife about with me.”

He muddled his face, but laughed when I admitted this was probably not the best idea in light of the police crackdown on knives thanks to so much knife crime doing the rounds in the UK and Ireland of late.

But I continued, asking him what the problem with self-harm was – he made some comment to the effect that it was potentially dangerous, but I waved my hands dismissively at him and pointed out that any cuts I made were superficial.

“Look at me,” I challenged.  “Apart from where I’ve picked the spots on my face, can you see any scars?”

He looked me up and down, and eventually concluded that he couldn’t.

Excellent.  “In that case, what’s the problem?” I asked.

He thought about it for a minute or two, then said something like, “don’t you think it can have negative consequences?”

I complained that because my entire abdomen is covered in stuff like ‘hate’, ‘death’, ‘vile’ etc, that it would certainly make it difficult to get a cut-price* full-body massage from A’s sister, a beautician, but beyond that minor disability, I didn’t really see any negative consequences.  As stated a million times here, cutting is quick, and it works.

(* Perhaps a poor choice of term given the subject matter?!).

“Other people vilify self-harm,” I whinged.  “I don’t get it.  What’s the big deal?  It’s effective, and if it’s superficial – ie. not life threatening, and none of these scars would have been – then I really fail to see the problem.  What is it?”

“If I define a problem, you’ll see me as someone who wants to defy or contradict you,” he replied.  “If I don’t, then you’ll take that as carte blanche to inflict self-harm on yourself, as the perceived need arises.”

I don’t consciously think that would have been the case, personally.  I was asking him to explain what, objectively, the problem with self-inflicted injury is, given that it’s a speedy and effective antidote to severe agitation.  But to be fair to him, I can’t tell you what my unconscious might have thought if he’d answered the question directly, and knowing this, I let it pass.

I noticed that he was trying to avoid making me aware of any judgement he may have had on self-harm, but predictably he did reiterate that there are other methods I can use to “ground myself” rather than merely grabbing the nearest sharp object and slashing myself.  We discussed briefly the DBT methods such as breathing techniques, using rubber bands and/or ice cubes to hurt myself.

He said that he thinks I can appreciate that there are times when they can be effective distractions, but that maybe I do not garner the same satisfaction from them.

I affirmed this.  I told him that even the simple cuts I’d inflicted to my arm this night didn’t have anything like the satisfaction of a big, angry ‘HATE‘, which I kept going back to and looking at in awe.  If that is the case, how can breathing or whatever possibly offer an appropriate level of satisfaction?

However, I continued by telling him that whilst I certainly didn’t necessarily dismiss these techniques completely, I saw this whole coping method as being on a “sliding scale”.  I can’t remember how I expressed it, but I think I was suggesting to C that if I try these DBT methods and they don’t work to calm me, I can then give myself permission to cut myself, if it is the only thing remaining that will ease my distress.  I mean, it’s better than taking myself out, right?  …Right?!

I was astonished when C didn’t argue with this.  He didn’t agree with it, but he didn’t argue.  It reminds me a little of a recent documentary I saw on self-harm, hosted by author and comedian Meera Syal.  It told of a controversial treatment employed in some psychiatric hospitals (the featured one was Bethlam – still Bedlam to me – in London) in which the staff allow the patients to self-harm, as long as they document the incident in detail afterwards.  The young woman interviewed said that when she had been stopped from cutting, she simply found more inventive ways to harm – eating lightbulbs, throwing herself at the wall etc.  Obviously my example is considerably less extreme, but rightly or wrongly I felt that C was meeting me half way; if I was willing to try his methods, and they failed, he would reluctantly tolerate my methods, as long as they were implemented in a controlled and non-dangerous fashion.  Perhaps I read too much into this though – perhaps his decision not to argue was based around the aforementioned notion of my feeling (in his mind) that he was judging me, whatever way he responded.

He went on to state that he was “concerned that there’s two sides of you in conflict with each other – during a previous self-harm incident, you spoke of being in a trance-like state, saying, ‘it’s beautiful, it’s beautiful’ [this incident is discussed here] and finding that your mood dramatically improved after inflicting the cuts.  One side ‘hates’ the other and whenever she feels that side is getting out – for example, when she’s feeling depressed or lonely or anything that she perceives as weak, she has to be punished.  This then affirms her position as strong, and makes her feel better.  In suppressing the other her, though, she is ultimately repressing stuff and in the long-term is going to feel worse because of it.”

Two things strike me about this.  The first was that he spoke in the third rather than second person for so much of this particular part of the session.  I didn’t think about it at the time, but now I wonder if he thinks I have Disassociative Identity Disorder?  For what it’s worth, I don’t really actually think he thinks that, as it’s certainly not uncommon for a myriad of mental health issues to feature disassociative symptoms in some way.  But his choice of phraseology was interesting.

Secondly, I became completely fixated with the fact that he’d said he was “concerned”.  The word ‘concerned’!!!  He actually used it!  Any reference to him giving anything that vaguely resembles a shit about me in the past has been along the lines of, “…but if I do x, you’ll think I don’t care about you,” or whatever.  In this session, unsolicited, he actually outright stated that he was concerned for me.  I literally had to bite my bottom lip for some time to prevent a delighted smile.  This is a pathetic over-reaction and I think I need to die.  (Sorry, not allowed to say that.  Bad Side is suppressing Nice Side again.  Bad Girl.  I am not empathising with nor showing compassion to myself.  More on this later).

C said that I need to start recognising triggers for negative experiences.  He didn’t phrase it like that, but that’s what he meant I think.  He then went into a monologue about how humans do so many things on autopilot – cycling (“you’d probably fall off the bike if you started thinking about how you do it, actually”), opening doors, driving, breathing, whatever.  Such revelations nearly floored me, of course, who would ever have thought it, eh? [/sarcasm]  But his point was, if we do that for these innocuous processes, sometimes we can let an autopilot take over for more important matters.  In my case, he is of the view that I ‘automatically’ respond in an inappropriate (not that he used that word) fashion to (relatively) minor things.

He said, “imagine someone or something pisses you off, whether or not it was intended.  Stop a second.  Try breathing before you respond.  I know your reaction is an impulse but try and control it by remembering this discussion.  Then think about what’s going through your mind – identify the thoughts, emotions you experience, how you want to respond in light of that.”

Although that sounded way too easy to be true, the latter part of the instruction was interesting, as I had read very recently somewhere that it was important for individuals diagnosed with BPD to try and recognise the exact nature of their emotion; for example, rather than feeling ‘miserable’ or ‘low’, you’re ‘sad’, or you’re ‘depressed’, or you’re ‘scared’ or whatever.  I have to say that by and large I think I can identify these different experiences, though not necessarily when I’m in the middle of them, which is the issue I think C was driving at.

Back-referencing a little, he said the side that inflicts harm on herself experiences triumphalism in its wake, because she has won.  He said that in learning what’s going through my head and what I am actually experiencing, I could begin to develop some sort of sense of empathy for myself (or Bad Side could do so for Nice Side, whatever).

You can imagine my reaction to that, of course.  “We’ve been here before, C – I can’t imagine ever wanting to or being able to experience this empathy thing.”

“What’s the worst that can happen if you empathise with yourself?” he queried.

That took me aback somewhat, and I had to think about it.  Eventually, I said, “OK, I’m in the middle of an abject depression, feeling sorry for myself, so I stuff my face with chocolate and red wine (or maybe red wine isn’t the best idea when you’re already depressed, but you know what I mean).  How does that look?  ‘Oh, look at that lazy bitch, lounging around in her self-indulgence whilst nothing is wrong with her’.”

I paused then, my words reminding me of an earlier discussion with C in which he concluded that I was pathologically terrified of being scrutinised (negatively, at least) by others.  “What I’ve just said relates back to that, doesn’t it?” I mused, as an aside, and mostly rhetorically.

“Whatever the case,” he said, “what is clear is that you aren’t allowing any room for middle ground.  You can only be intensely self-critical or self-indulgent.  Is there any potential to reach a half-way point?”

I babbled on a bit incoherently about this for a minute.  C summed my position up better than I had by saying that whilst I could objectively appreciate there may be more of a grey area than my previous comments suggested, I didn’t really feel it.  Indeed.

“But what’s the point of empathy anyway?” I asked cynically.  “How is it going to make me feel less shit?”

I don’t remember exactly how he put it, but his response was something along the lines of if you fail to empathise with yourself, you fail to empathise with others, that can alienate others, thus making the self feel worse, etc etc.  (I knew altruism was about selfishness, really).

I said to C, “are you saying I’m a sociopath?”

“No!” he exclaimed instantaneously.  “No, no, no!”  He shook his head vigourosly and sort of put his hands out as if to stop me saying stuff like that.

“I’m sorry,” I said, “I was joking – I just did so much about psychopathy at university that I found it funny how closely what you just said matched the description of that condition.”

He sort of laughed, and yet again he insisted emphatically that no, he does not think I am a sociopath.  Well, that’s one less thing to worry about, then.

As if to prove his point, he went on to say that in fact I am more than capable of expressing empathy; the thing is I tend to express it towards inanimate objects, such as Disraeli, my car.  (Case in point: on Thursday night I ended up in tears thinking that I had ‘offended’ a lamp.  Yes, folks; a lamp.  Repeat after me: SI is not a loon, SI is not a loon – keep repeating it and we might CBT ourselves into believing it, right?).

Having read over parts of this blog for something to do during the particularly painful bout of insomnia the night before this meeting with C, I remembered another set of ‘objects’ (in the psychological and philosophical, not physical, sense) for whom I do feel empathy: my online friends.

C’s assertion on that occasion was that, perhaps, online relationships are, for me, ‘safe’, just like inanimate objects.  I had dismissed it at the time as even though I’ve not met any of my current online friends in person, I still do see them as very real.  However, I thought about it on Wednesday night / Thursday morning and concluded that he might have a point, as long as he accepted that the personnel concerned were still ‘real’ to me.

I raised it with him.  Did he still think that?

He sort of shrugged without shrugging, if that makes any sense; whatever the gesture was, the implication was that it was something to which he was open, without necessarily feeling that it is fact.  Indeed, he said, “it’s an idea.”

I told him that I now thought he had a point, and he went on to voluntarily tell me that if we accepted that this was possibly indeed the case, that I was definitely not to think that it diminished the importance of my internet friends in my life, nor was the implication that I – nor he, for that matter – saw them as ‘unreal’ figures.  (Though what is real anyway?  Sometimes I wonder about the validity of solipsism.  An aside – in Googling ‘solipsism’ to double check the spelling, I came across Solipsism Syndrome – what a cool psychiatric diagnosis to have!  I wonder if I can try and get it.  I would probably have to fulfill my childhood dream of becoming a professional space-based cosmologist, however, and that’s not fucking likely).

Anyway.  What was I saying?  Right, so C said t’folks on t’internet are still very real and important friends.  “But,” he continued, “online relationships are…” – he searched for appropriate words – “…less complex than ‘real life’ ones.”

I accepted this, but did want to make it clear to C that I wasn’t engaging in the “less complex” relationships to avoid dealing with the “more complex” ones.  “My real life friendships are stable,” I said, “even if there are fairly few of them.  I haven’t sought out new ones for a very long time, but I’m not sure that’s related.  I’m socially inept, I’m a misanthrope, I just can’t deal with people.”  Certainly, I admitted, I don’t trust people and fear being hurt, but there are other factors.  They’re probably related via some electron cunt thing in my brain somewhere, but they aren’t consciously so.

“But then,” I continued, “it’s funny being me.  If I’m in some sort of hyper or manic mood then I tend to be exceptionally good with people, if over-talkative and arrogant at times.”  As a relevant example, I related having met A’s parents the other weekend, when I was pretty manic and apparently good craic (for those uninitiated to Northern Ireland Speak, ‘craic’ is pronounced ‘crack’, though does not denote drugs ((well, beyond dopamine and/or serotonin, I suppose)).  It means ‘fun’, ‘entertaining’, ‘a laugh’, etc).  And about how A’s mother had cross-examined him on the phone afterwards wondering (in not so many words, to be fair to her) how I could possibly be mentally ill in any way when that was the behaviour I exhibited in front of her.  I can see her point.

“This annoys me,” I continued.  “I cannot stand ambiguity or unpredictability.  I used to work with a woman who was terribly moody.  One day you’d go in and she’d call you all the names of the day.  The next she’d throw her arms round you and practically declare undying love.  It infuriated me.  Either always be nice, or always be a bitch; don’t fuck about.  I don’t know how to deal with you if you fuck about.  Point being, I don’t know how to deal with me if I fuck about.  I want certainty.”

I paused, and asked C if I was rambling.

“If I say that you are, you will perceive me as being critical, but if I say that you aren’t, you’ll feel I didn’t really take an interest in what you said.”

I tilted my head and stared at him enigmatically.

“What?” he asked.  “What do you think?”

“I think if you answered the question you’d be someone who answered a question.”

He smiled in an odd sort of way, almost as if he was embarrassed.  I’m not sure what his exact response but he was basically asking if he thought I thought he avoided answering questions a lot.

Well, dear readers, you will know that this is indeed the case.  His ability to bullshit around a question is akin, at times, to that of a politician.  I know that there are probably fair reasons for this – “NHS Guideline 1,090,073.233.642 – Thou must patronise the stupid mental to avoid said stupid mental having a clear or definitive idea of the service thou hast provided or that thou willst provide, thus ensuring the NHS is not taken under the ludicrous claim culture of the 21st Century” – but it still winds me the fuck up.  I actually feel bad even writing something remotely critical, because me likes C today.  And thus was the case at the time too; in fact, it was almost a reversal of previous situations, as I became the one who avoided the question.  I can’t remember exactly what I told him but it was something like my conscious mind at least would not pass judgement on him answering the question honestly.  I deliberately refrained from referring to whether or not there was a reflection of him anywhere in there.

“OK,” he said, “I think we maybe need to trackback a bit.”

Which means he did think I was rambling, and I wondered that when I was evidently going to realise that, why he didn’t just answer my original question, but I forgave him and let him continue.  To be honest, my memory is not 100% clear on what it was to which he actually did backtrack, but it was something to do with the whole empathy crap.  Presumably I am meant to allow myself to be hyper or whatever and not berate myself for it.

He asked me if I had heard of a bloke called Paul Gilbert.  I had.  I read his Overcoming Depression when I was about 16.  It wasn’t the most patronising self-help book I’ve ever read, even if it employed a bit of CBTish nonsense, but nonetheless, here I am about 10 years later and I’m completely off-my-head mental, so it didn’t exactly fucking cure me, did it?

C said, “there are two books of his that could be useful; they both have ‘compassion’ in the title…” He trailed off, I am convinced in order to gauge my reaction to this.

I actually laughed out loud.  Naturally, he wasn’t surprised by this and in fact laughed a little himself.

“…one is an academic book,” he continued, “the other is…” He paused again.

“Self-help,” I said, finishing his sentence with evident disdain.

“Quite.  I know you’d prefer the more intellectual style of the first one, but…”

“Let me stop you there,” I interrupted.  “If you’re asking me to read one of these, it’s going to have to be the first one.  There are a few things I can’t tolerate in life, and being patronised is one of them.  That’s what self-help books do, sorry.”

“Isn’t that like saying that all works of fiction are shit?” he asked.

“Well…OK, it’s a gross generalisation, but I can only speak from my own experience, and my own experience of self-help books is that they’re universally shit.”

To be fair to him, C admitted that a lot of them are rubbish.  He described the ones like that as having a “new-agey American* love-in tone”, which he appreciated I would hate, and for which he didn’t have much time either.  But he was keen to make clear that in his view they’re not all like that.

(* Sorry American readers – his words, not mine.  I did laugh though, I admit, and he did acknowledge that there are plenty of British knobs writing the same wank.  I’m sure cynical readers will appreciate what was meant; the whole “you can change your life by thinking happy thoughts about your inner rainbow flying out of your arse [ass, if it's Transatlantic, presumably].  Remember, I – who do not even know who you are because I am merely  writing this bollocks and not spying on everyone who buys it [hopefully] – love you, and so does everyone else despite the fact that in your life you’re likely to meet maybe 0.0000000000000014% of the world’s population, some of whom will actually hate you, except that they don’t because everyone loves you, because that’s the way it works in my world which is as black and fucking white as yours, except I pretend it is white whereas you think it is black.  Remember, the only person that doesn’t love you is you, except for all the world’s population that are indifferent to you because they don’t know you exist, not to mention the ones that do know you exist and think you’re a prick!  Smile, it can change your day and help you love yourself, not to mention the added bonus of a punch in the face because people think you are a smug, condescending piece of shit!  You are worth loving, for now at least because if you feel worthwhile you will feel inspired to recommend me to your wrist-slashing friends and I will earn even more undeserved money! Etc etc, blah blah, yadda yadda, now fuck off cos I’ve got my royalties from your purchase you despicable, self-indulgent, psycho piece of shit that I’m exploiting by writing this jism” thing).

Ahem…*clears throat*.  Again, where was I?  Yes, C was keen to reinforce his point to me that not all self-help books are of the ilk of the preceding paragraph.  He went over to his desk and looked both books up on Amazon.  I joined him, and he showed me that – slightly unusually for Amazon UK – they had the ‘Read Inside’ feature.  He turned to me and asked if I would look up the self-help one, read inside it, read the reviews of it and at least consider getting it (or, “if I must”, the academic one).

We sat down again, and I agreed to at least look into it.  “If I buy it, though, and it’s rubbish,” I wryly told him, “I’m sending you the invoice.”

To wind C up, I told him that I was reading a very analytical and academic book at present called Social Factors in the Personality Disorders: A Biopsychosocial Approach to Etiology and Treatment.  The effect of this attempt to tease him was rather lost because I couldn’t remember the name in its entireity.  FAIL!  He said, “that sounds interesting.”  It wasn’t meant to sound interesting; it was meant to underline the point that I need something ‘proper’ to read.  But the fault is mine for not remembering the name properly.  (For some reason, I never can.  I have to go back and search through my previous posts here if I don’t have it to hand, as the book in question was very kindly recommended to me by one of my commentators, beautifulstones).

To compensate for not having the intended effect, I decided to be critical of Lost in the Mirror, which I recently finished, reviewing it as having “interesting psychological points, and being empathetic towards this hateful borderline condition, but not being helpful because of its extraordinarily childish and ergo patronising prose.”

I was interested to note that the above was the first time since I related my diagnoses to C that I have used the term ‘borderline’ in front of him.  Hitherto the very thought of doing so has made me cringe.  I still avoided looking at him when I said it, but say it I did.  This is progress.  As anyone who read the end of this post will know, I was convinced C would no longer wish to treat me, given the intense dislike of BPD that still permeates many mental health professionals.  Thankfully, it does not at all seem to be the case.  (Incidentally, regarding the diganosis of BPD, there has been an interesting discussion on the comments of my last post regarding its validity.  I had hitherto had little doubt that it was correct, but some interesting points against it were raised).

To get back to the books C had recommended, I asked if ‘compassion’ referred to extending same to the self, or to others.  He contended that they go in tandem; one feeds off the other.  I wondered to what extent I agree with that, as whilst feeling I am a complete piece of crap I don’t necessarily that think others are (not that the concept of compassion is as simple as that, but you know what I mean).  On reflection, though, I do think it makes some sort of sense.  I am incapable, or at the very least unwilling, to demonstrably extend compassion to others in my life who clearly deserve it at times.  When my Mum’s partner died when I was 11, my way of comforting her was to say something like, “um…right…sorry?”  When her brother died when we were on holiday in 1996, I couldn’t deal with her grief and started an argument with her!  (For the record I am citing these examples only here; I didn’t relate them to C at the time because I didn’t think of them).

After he’d stated his position on compassion, I must’ve looked contemplative because he asked me to articulate my thoughts.  I said, “I’m not for one second going to sit here and tell you I don’t need practical help for being mad; clearly I do.  However, I am keen that we also establish the causal roots of my mental health problems – I don’t want to just have the symptoms treated, you know?”

He jumped in quickly to that, emphatically denying that providing practical treatment alone was what he intended.

“I think, intellectually, you’d much prefer something like psychoanalysis…”

I interjected stating that I didn’t want to still be sitting in his office every Thursday morning in ten years’ time, but let’s face it – as of now that is a lie.  I would be quite happy for that to be the case.  Or at least I would at the minute – there are times when I don’t want to see C ever again for as long as I live, but now isn’t one of them.

“…but,” he went on, acknowledging my comment only with a subtle grin, “you present a number of symptoms that are proven to be treatable by practical methods, so I think it’s important we do some work in that regard.  Having said that, it’s only one dimension to what we should be doing here – I do agree that we need to delve deeper and explore causes.”

“A dual approach,” I murmured.

He nodded, then looked directly at me, smiling reassuringly.  “Don’t worry,” he said.  “We’ll get there.”

I am not sure I will ever forget the profound feeling of reassurance I took from those five words.  Anyone can say something like that, of course, but I felt that he really believes we can get ‘there’, wherever ‘there’ is.  Not only that, but he wants to get me ‘there’, not (just, anyway) because he has to meet some stupid Health Service quota or because he’s scared of getting in trouble because I have topped myself or ended up in the bin, but because he actually gives something of a fuck.

This was the end of the session.  As I was walking out the door, he said, “all the best,” which is not something he’s said to me in ages – perhaps not since our initial assessment meetings back in February or March.  It’s a stupid thing to feel pleased about, of course, but it just adds to my general feeling about the session.  The whole thing, however temporarily, set my perpetually troubled mind at ease, at least as regards psychotherapy, which can be a difficult and murky process.  I felt there was a clear rapport in the dynamic, perhaps even a sense of camaraderie insofar as that’s permissible in the circumstances and the relationship, and moreover, C seemed to me to make a real effort to try and alleviate a number of concerns I expressed.  ‘Reassure’ is a word I’ve used a lot on this post, and whilst it’s still the most appropriate one I can find, it doesn’t even seem to grasp the safety I felt.

In terms of my current thinking, almost two days later, I hesitate to use the word ‘hope’, because I’m way too cynical to even believe in that concept anymore, in its most abstract sense anyway.  But let me put it this way; for now, for this week at least, and even if it never happens again, I feel a very slight tingle of cautious optimism that there may be some light somewhere down the tunnel, that is for once not a train hurtling towards me.

For a variety of reasons I simply haven’t had the opportunity to blog about my most recent session with C to date, so, with it now being the septiversary of our last meeting, it seems appropriate to try and do it now before my memory of the meeting dwindles further.

Last week was weird, because for once he actually opened the conversation, rather than just fucking staring at me for 140,618 years, waiting with futility for me to express my thoughts. He wanted to know how I had coped the previous week without him, and what plans we were going to put in place in case (or rather when) I go batshit mad during his annual leave which will be ongoing until 20 August (might as well be 2079 to me right now for all the closer it seems).

I was encouraged by this: I thought he was going to explain the procedures that the CMHTs have in place to deal with attached-to-shrink mentals in the absence of said shrink.  Which of his colleagues should I contact in an emergency, who should I get it touch with should I need general advice, blah blah.

Was he fuck!  The exercise, and frankly most of the session, was a load of naval-gazing, useless dross.

“We need to formulate a plan,” he declared.  It seems his idea of a plan has four progressively mental points in the key of D:

1. Mental: DBT Distraction Plan
2. Quite mental:  Discussion About Being Mental
3. Very mental:  Doctor – Either LGP or Out of Hours
4. Suicidally mental:  Death Avoidance – Casualty

He didn’t use this stupid ‘D’ thing; that’s of my doing, because it’s equally fucking patronising to the whole bloody ‘plan’.  I actually laughed in his face about the discussion bit.

“Who the fuck am I going to discuss this with?” I asked.  He reminded me that the first time he’d been unavailable for a session I called D, my best mate, to expunge myself.  I don’t think I was keeping this blog then.  Not sure.  It was a while back anyway.

This is true, but whilst D is mostly aware of the issues that have given rise to my mental health issues, I really don’t want to discuss them in detail with him.  He reads this blog from time to time, but I’m quite analytical here, not off-my-head mental, so even though the material here may well be disturbing to normals, they don’t get to hear or actually witness what it’s really like. I need to protect people from it.

I said so to C, who by virtue of his chosen career has de facto committed himself to hearing about and witnessing disturbing behaviour.

He asked could I not speak to A, then.

Yes, I can, as it happens; he bears witness to many of the worst moments and is certainly aware of the others.  In fact, of late, I’ve noticed many of our conversations have been about my being mental – I think I’m trying to forge some sense of identity by being obsessed with my madness, but that’s an entire other post.  The point is talking to A doesn’t always alleviate the problems; not that it’s specific to A though, talking to anyone doesn’t make a difference, at least depending on the type of episode anyway.

Yet still C wanked on about it.  The Samaritans then.  Lifeline.  Some such 24 hour crisis line.

This was winding me up to fuck, so at this point I expressed my annoyance yet again through a cynical laugh.  This didn’t go down too well – not that he criticised me, but just because he’s the one trained to be perceptive doesn’t mean that he is the only one that actually is perceptive.  I could sense an annoyance, or at least a confusion, at my reaction to his suggestion.

I explained that whilst I had every admiration for the volunteers operating these services, recognised their well-meaningness, and in principle fully supported them, that I had not found them helpful in the past.  To be fair, I was overplaying my use of them, letting C believe I’d called them a number of times when in actuality it was only once or twice.  But when you know something isn’t helpful (or indeed is), then you do.

He hides it well, you know, but I sensed exasperation.  I said the point was that I cannot talk to anyone other than him, and to a lesser extent LGP and Dr C, about the darkest things.  Even then the discussions are abstracted, formalised or structured by me so that I can avoid talking about those things that I wish not to discuss (or at least discuss them in a ‘safe’ way).  In front of them, I don’t behave in the angry, frenzied, self-destructive way that I often do otherwise, and that I frankly long to do in front of them at times.  I try not to express emotion, and when I do I either force myself to desist from it or end up apologising for half an hour for my failure to control myself.

Simply put – it’s hard to talk to anyone.

Anyway, C said this was about my inability to ‘do’ empathy.  I asked what the hell ‘empathy’ had to do with it.

He said, “you despise the emotional side of yourself so much that you don’t allow yourself, or feel unable, to empathise with others, would you agree?”

“Not entirely,” I replied, “but in the main, I suppose the answer would be affirmative.  Why?”

“You can’t empathise with others because you can’t empathise with yourself.  I think that has to be one of our goals here, to allow you to gain, or regain, that sense of empathy.”

I protested that I didn’t want it, I don’t do emotions, I like to be rational, this arse shouldn’t come into my life, thank you very much, the end.

C wanked on and on about emotions for a while.  I do do them, of course, he contended.  He didn’t say this, because labels are so evil and unhelpful, don’t you know, but of course the cornerstone of a diagnosis of BPD is an inability to regulate emotions properly, thus you go mental.

So, he concluded, my emotions are clearly very strong, and my lack of empathy for myself is profound.  “For example,” he said, “you carved ‘hate’ into your body.  Don’t you think this is a way of expressing a strong emotion, without expressing it in a ‘normal’ fashion?”

Once more I laughed in his face.  “You think ‘hate’ is bad?” I sneered.  “You want to see some of the stuff that’s been added since!”

He raised his eyebrow and said, “you say that with almost a sense of glee.”

“Yeah.  So?”

“Well, I’m getting the sense that you delight in self-harm – it’s a further, and outer, manifestation of your self-hatred.  You mask ithe hatred well outwardly, for the most part, but you need to confront it eventually, in ways that aren’t self-destructive, in order to get over it.  Thus, you need to be able to empathise with yourself.” He also stated that carving things such as ‘hate’ into myself was a form of punishment for feeling emotions. He seems to think that’s at least partly why my mood improves after self-harm; I am sated because I am punished and have got what I deserve. Probably fair, admittedly.

“Yeah, whatever,” I said, “but the point is, cutting is quick, and it works.”

“Maybe so, but it is self-destructive.”

I shrugged.  I mean, he’s probably right in the sense that it is an outer manifestation of something I don’t generally express in other outward ways, such as through talking.  It certainly is self-destructive, though I don’t really see how that matters, but still, how could I argue?  I simply told him that I genuinely cannot foresee him being able to get me to ‘empathise properly’ – not in the manner that he means, anyhow.

An interesting side-note is that I’ve observed from re-reading parts of this blog that I’ve (unconsciously) stopped putting words like ‘emotion’ and ‘feelings’ in quote marks (except in circumstances like the immeadiate foregoing where they are necessary to denote they’re not active nouns in the sentence). I told C this, laughing that he must have made some progress with me in this particular area. Interestingly, he did seem mildly encouraged by this.

Anyway. We discussed suicide ideation for a bit, in relation to the stupid plan of action for when I go doolally in his absence.  He said something like, “…if you start thinking about suicide…” at which point I interrupted him, yet again with a sneering laugh, stating that I thought about suicide every hour of every day.

He asked why.

I said because I want to not exist.

He replied, in my view rather confrontationally, “so why have you not done it then?”

“Cowardice,” I responded instantly, without a mere second’s hesitation.  I’m fairly sure he was expecting some humming-and-ha-ing, but I’m already well aware of the answer.  I’m too fucking pathetically scared.

I did concede that not all shreds of altruism are lost amongst my endless waves of narcissism; in part, I haven’t topped myself because I know it would annoy A, Mum and my friends (plus – in my view, oddly – the family, but who cares about them).  But the main reason, selfish or otherwise, is simple cowardice.

He didn’t quite seem to know how to respond.  I think this was one of many points where he irritated me intensely by silently staring at the floor for what seemed like eons, with his index finger ensconsced thoughtfully over his mouth.  Eventually, this pissed me off so much that I said, “you do realise, don’t you, that I’m trying to work out what you’re thinking?  Isn’t that a role reversal?”

“Do you mean,” he enquired, “that you think you feel like the therapist?”

“That’s patently ridiculous,” I said, but in quite a nice way.  “I suppose I’m asking if you think I play mind games with you.”

“Do you?” he asked.

“I think so, yes.”  I told him I felt there were times when I challenged him, whether overt- or covertly, to work me out, or answer difficult questions, or respond to deliberately provocative statements.

“‘Mind games’ isn’t the terminology I’d use,” he said, “but if you want to call it that, fair enough.  I think you’re testing me, is all.  You want or need me to prove my competence, understanding, whatever – basically that I’m worthy of your trust or time.”

I agreed with this.  I told him that he would, of course, have worked out by now that I had very strong defences built up and thus have big problems trusting people until they’d proven themselves trust-worthy.

“Consider yourself lucky,” I smiled.  “I do trust you – yet I don’t know you at all.”

He asked how I felt about not knowing him; I responded by stating that “this relationship is asymmetrical of necessity.”

“Perhaps,” C said, “but that doesn’t mean you don’t find it strange.”

“Of course it’s strange,” I replied, waving my hand dismissively.  “But I can deal with strange.  I’m strange.  My life is strange.  Strange is normal to me.”  Fair is foul, and foul is fair, hover through fog and filthy air… [Macbeth, Act I, Scene I, if memory serves].

I don’t remember really what that led to, so the next few issues I remember raising were my ongoing problems with my cunt office, although that rant was brief, though I then launched into a major invective regarding the situation with Dr C.  Well, I say it was ‘major’ – it was, but it was also very measured.  I did say to C that I was extremely angry but I couldn’t go on about it too much as I risked behaving in a “psychotic pacing ranting fashion” and that I didn’t want to do that “in front of him.”  I did say that I was sick of the pillar-to-posting I’d experienced under the care of the NHS for over a decade, and that it was particularly frustrating that when things actually looked like they might be moving forwards, I was yet again rejected.  I whinged that when I needed Dr C most, due to the problems with my medication causing serious and frequent mixed episodes, it was the time she chose to abandon me the most.

[Alas.  It is now Friday 7th, thus I didn't get this published on Thursday 6th, the septiversary of my last meeting with C, as I had planned.  Apologies.]

The truth is, I was hoping C would contact Psychiatry and tell them that my self-harm is getting worse and my suicide ideation is out of control, which I think it is, given that most people don’t seem to think about suicide and death all day, even if they are rather batty.  I mean, he had most of Thursday and all day on Friday to contact them before he went off on his stupid fucking leave.  But he made no such offer, and a week has now passed without my having heard from them, so it’s evident he made no such contact.

What do you have to do?  What the fuck do you have to do?  Do I need to run into a busy shopping area pointing a shotgun at my head or climb, very publicly, to the top of a tall building with the threat of jumping, to convince them that this is fucking serious and that I need help?  Nobody gives a fuck.  No one.  I’m sure most of C’s silences during this session were him fantasising about 5pm on the Friday when he’d be free for over two weeks.

Anyway, before the end of the meeting, he returned to the wanky Four-D Perfect FoolProof Anti-Suicide Plan.

“Look,” I said.  “I promise not to be dead in three weeks, OK?!”

He looked over his glasses at me in that strange enigmatic way he sometimes does.  “But you’re promising me, not yourself,” he mused.

“So what?  The effect is the same, isn’t it?”

Essentially this relates back to my lack of self-empathy or some such bollocks.  Whatever, who cares.  He asked me to definitively agree a plan of action with him before I left.  I should have tried a new mind-game and pretended (or, more accurately, admitted) that I didn’t agree with anything he was saying so as I could have made the session overrun, just to see what he did or said.

I did say, and in fact although I didn’t mention it above I had said it earlier, that the problem with any of this stuff is that by the time you’ve gone mad enough to need it, you’re far too mad to do it.  Fairly simple concept, yes?

“In advance,” C said, “write it down.  You’ll then have something tangible to which to refer.”

“It doesn’t matter,” I protested.  “The entire house could be wallpapered with plans for what I should do when I go mental, but when I am mental none of it matters.”

I tried, with absolutely no success whatsoever, to describe what it’s like when I’m psychotic, or panicking, or experiencing a mixed episode.  I couldn’t put it into words, but the point was that even though I may maintain some small awareness of rational issues that exist outside my head, that I did not have the cognitive functions to actually put any such things into practice.

“What do you think the answer is then?” he asked, again in what I felt was a confrontational manner (though I could just have been paranoid – who fucking knows).

“Valium and sleeping pills,” I declared.

His concern was instantly piqued and he went to protest, but I pre-empted it by saying I wasn’t talking about overdosing on them (I know from the suicide newsgroup that there’s practically no chance it would fucking work even if I tried), but rather about knocking myself out for a few hours in the hope that by the time I woke I’d have returned to my default state of quasi-sanity,or at least vague rationality.

He seemed cynical of this.  I don’t remember what if anything he actually said, but I got the distinct message from him that drugs were only part of the answer, if even that.

We were running out of time, and he kept pressing me to work with him to formulate the stupid plan.  In exasperation and to just fucking pacify him I finally said, “right – distraction, discussion, GP and casualty, OK?”

“Yes,” C replied – relieved, I think – “but you may want to add layers in between.  Remember the breathing exercises as well, for example, or specific distractions of your own.”

Well, as it happens I don’t fucking want to add ‘layers in between’, because I don’t think the bloody thing is of any adequate use anyway, unless someone is acting on my behalf (in stages three and four anyway).  But fuck it, I just nodded.

He said, “our next appointment is 20 August.  Do you want an appointment card?”

I said yes, as I would be wont to forget that, as each day runs into another when one is a dolescum.  He wrote it out and handed it to me.  I was irritated in the extreme to observe that he’d written “Dr C. J.” on the front of it.

I have been seeing you for twenty weeks, C.  That’s about five months.  I FUCKING KNOW YOUR FUCKING NAME.

I got up and wished him a pleasant holiday (though part of me was secretly hoping he spent it in mild misery with ((non-fatal)) swine flu or something – but only part of me ), and he thanked me.  As I left, I said, “take care.”  I was offended by the fact he merely said, “bye” and didn’t reciprocate.  Funny how silly, meaningless little things take on such importance in the therapeutic setting.

This post has made it sound like I am absolutely raging with C and that our last session was a confrontational battle of wills.  Neither of these are really true; it comes across differently on ‘paper’ than it really was, and of course I use this blog as a sort of secondary therapy where I can rant and rave all I like with (mostly) anonymous impunity.  I can castigate C to the high heavens here; even though my annoyance at him can be real, it’s also somewhat tongue-in-cheek and in any case my feelings towards him vary from day to day, maybe even more frequently than that.  Stupid transference.

I’ve managed relatively well without him thus far.  I’ve not been in good form by any means, but when am I (except when hypomanic)?  My only real major episodes were last night and part of today, but there were precipitating causes – the McFs, perhaps unsurprisingly – and that’s a story for another day, for it is now 1.40am in the UK and I must draw myself away from the computer.  It’s my first night of the tri-weekly sleeper-fast and I need to try and relax somehow in a perhaps futile attempt to get some rest.  Due to the almost certain insomnia of the next week, I have a horrible feeling that the coming seven days will not be much fun, but we’ll see.

Today sucks ram and ass bollocks.

My range of happy experiences since last night are the delightful following:

• The fabulous agitated depression *
• Severe depersonalisation
• Paranoia
• Anxiety (of course)
• Insomnia (what a surprise)
• Racing and disjointed thoughts (related to, or a symptom of, the agitated depression, naturally)
• Physical restlessness – rocking back and forth, desire to pace blah blah blah
• No particularly strong suicide ideation for a change, but certainly self-harm ideation

* I wrote about this state before, calling it “Simultaneous Mania and Depression“.  I didn’t know there was actually a psychiatric name for it – a Mixed State – but apparently there is.  In a sense this is reassuring as I was convinced this was an infinitesimally unlikely psychological place to exist and that ergo I must be the only person on Earth thus afflicted.  I am clearly not, however.

I am not anywhere near approaching the state I was in the night of my cousin’s birthday party, but what I described there is basically just a more extreme version of what’s been happening now.

I am trying to “mindfully breathe” (even the name pisses me off) and maybe I should find my stash of rubber bands or a fucking ice cube so I can feel lovely pain and maybe whilst I am at it I should paint on myself with red fucking dye or some such wank.  Heh, is it really bitchy that making snide remarks makes me feel marginally better?

This leads on quite adequately to a long discussion I had with A’s friend, G, on Saturday night.  As stated in the afore-referenced link, G has a degree in psychology and is incredibly clued-up on Eastern (as well as Western) philosophies.

Basically I complained that DBT and mindfulness were both a pile of patronising, meaningless fuck and that in particular even thinking about C’s particular choice of book on these matters made me angry.  I also told him of my recent diagnoses, making him one of only about five “real life” people that is aware of them (though having said that, I’m sure Mummy Dearest has told half the world by now.  On the other hand, maybe not, because perhaps now she knows it is not “just” depression, she is probably ashamed of me because I am certified by a consultant psychiatrist as being clinically insane.  Not a good conversation starter down the golf club, is it?).

My memory is absolutely awful since I lost my marbles, so I tried to take notes on stuff G said, which he found quite amusing (as I would have done had the situation been reversed).  The notes don’t grasp the conversation properly, but they do serve as something of a reminder that I wouldn’t have had otherwise.

The essence of the conversation is that G thinks this stuff has benefit.  He is dubious about Linehan‘s development of the background issues in dialectics, and argued that although statistically DBT has been proven to alleviate some of the typical symptoms in borderline people, there is very little empirical research to back up the actual science behind it.  Nevertheless, he claimed, the actual concept of dialectic argument has a strong and ancient philosophical background.  The main philosophers practicing what Linehan tries to call radical acceptance were the Greek Stoics.  I believe the argument ran that philosophical stoicism allowed the Greeks engaging in it to reach ataraxia (though if I am mistaken in this, please, please point it out.  I was very brave and gave G the URL of this blog so he – or anyone else with knowledge of this – can correct me if I have remembered it incorrectly).

He also told me to look into the works of Max Stirner, his current favourite Western philosopher, and Georg Hegel, who also wrote extensively on the concept of dialectics.  I haven’t done any of this, but it is my project for today and tomorrow assuming I can overcome my mixed episode and all its little idiosyncrasies.

I told G that I would review online material of all the above but that in the meantime I was still dubious about the notion of radical acceptance or ataraxia or whatever the fuck you want to call it these days.  I contended, as I had done here, that to simply accept everything was to cease to have an opinion, and therefore was equal to losing a sense of self, which in my case is something with which I very strongly struggle anyway.  I even went on a similar rant about Hitler, Ahmadinejad etc as I had done here.

G took my point but the man is too clever for his own good and has an answer for everything.  DBT is to be taken in four stages, of which acceptance is one of the early ones.  Once one has made psychological progress and is able to cope and deal with the symptoms of their illness, opinion can be reintroduced to the person  By this stage you are able to see the issues with which you struggle in a more rational, less all-consuming light.

He provided some really good physical analogy for this, which annoyingly I don’t remember.  My very inferior, shite and frankly airy-fairy-cunty alternative analogy is something like you have to take your clothes off to have a shower to rid yourself of dirt, but once you are clean you can put them back on again.  How fucking arsey can you get?  I fail as ever.

G further stated, when I whined and whined about my failure to develop a career and even hold down a job because I am mental, that if anything the intellectuals amongst us are in many ways the more hoodwinked in the world.  He said, quite rightly I think, that those with lower IQs and others who happily work in what some might see as “lesser” jobs are in actual fact much more savvy than those of us that think we are entitled to glamourous careers due to having brains because – funnily enough – they simply accept their lot in life and as such are happier people.  I agreed with him that oftentimes ignorance is very much bliss.

I’m not eloquent at all in my description of this conversation and for that I would proffer my apologies to G.  The reality is that his knowledge and persuasiveness was as strong as ever, and he articulated himself verbally in a much superior way to the way in which I do so do via any medium.

In any case, the problem, for me, is in learning to deal with acceptance of this nature.  I have already alluded fairly extensively to the fact that I have real issues with that.  You can’t just click your fingers and suddenly find that everything is accepted and unjudged in your mind.  So, today, I will try and read about Hegel and Stirner’s philosophies on dialectics, and indeed on the Greek Stoics.  I might well end up completely mind-melted, but at least I am not likely to feel patronised in the way the tossy book from C makes me feel.

Again, a lot of my issues with DBT lie in the presentation of it.  Some of the ideas have merit – though I certainly don’t think they all do by any means – but condescending wank just makes me angry and homicidal, and I would really have expected C to have been aware of this after nearly four odd months of therapy.  But perhaps Messrs Hegal and Stirner can convince me, and in fact I think I am now feeling sufficiently improved from how I felt when I first started writing this entry to actually go and try and read stuff about them.  In some ways writing this blog is cathartic, but in an additional way writing it serves as a decent distraction from fuckuppery.  (Ha – C will be delighted, as writing the blog is one of the activities on my “distraction plan”.  But on the other hand no doubt he’ll be fucking annoyed because he features so strongly in it.  Can’t win.).

At the very least, I can now go to C’s office on Thursday armed with loads of intellectual ammunition.  He’ll tell me that as ever I’m intellectualising matters, but at least he can’t accuse me of not making an effort to engage with this.

One of Dr C‘s minions phoned yesterday to report that an appointment has been made for me this Friday at 9.30am.

Aside from being frightened of nasty Dr C and the possibility of yet another panel interview-esque meeting with her and Dr N, I am kind of angry.  I was referred to a psychiatrist in January and didn’t finally see one until the end of May, and of course regular readers will remember that they fucked up my entire referral until C got involved.  Why, then, do they think it’s reasonable for them to click their fingers and expect me to come running?

Meh.  I suppose I ought to be grateful that they are seeing me again relatively soon after the last appointment.  C stated to me last week that he thought that Dr C was going to experiment with new medications for me, so hopefully that will come on Friday.  The thing is, due to the set-up of the first meeting with Dr C and Dr N, I didn’t get to talk to either of them in the detail I’d have liked.  In fact, after 14 weeks of psychotherapy, I haven’t even discussed everything I’d like to have done with C.

Given that circumstance, I am not sure how Dr C can accurately diagnose my condition on Friday and as such I am not sure how she can adequately prescribe appropriate medication.  Perhaps she just wants to talk to me in more detail about my symptoms?  Or maybe she feels her conversation with C has been adequate.  I don’t know; I’ll try not to pre-empt it I suppose.  Regardless of the fact I don’t like the woman, she is the consultant psychiatrist and for now I’ll try and assume that as such she knows what she’s doing.  Like it’s that simple.

And of course this is Wednesday evening, meaning that it is C tomorrow morning.  I forgot to mention last week that at one point I broke down in tears in front of him as I thought I had offended him (it was paranoia – logically speaking I very much doubt I did offend him, but hey, logic loves to fail me).  I thought I’d offended him because of something very minor., so minor that I don’t even remember what it was  Now I have to go in tomorrow and tell him what a complete pile of bovine manure I believe this DBT nonsense to be.  It’s not completely invalid I guess, but most of it is.  My worry is that when he first introduced me to it, C was so enthusiastic about it.  I’m concerned about raining on his parade.  He is, after all, only trying to help.

Am I just a cynical wankstain who needs to get over herself?  I want to want to give this a try, but just reading the stuff makes me angry.  I want to go to Marsha Linehan‘s house and firebomb it (Disclaimer to the thought police / government: this is deliberate hyperbole again.  I am not actually desirious of firebombing Linehan’s house; if nothing else there is the logistical problem that she is based in, I think, Seattle and I am in Northern Ireland).

Seriously, I have no idea what to say to C.  I am paranoid about upsetting him and having him abandon me.  Then there is the issue of his leave in July – I wouldn’t possibly be panicking already about that, now would I?  Oh wait, affirmative to that, I am.  I am fucking shitting myself.

What has become of me?  Why am I so intensely reliant on one individual that I don’t even really know?  How have I become a dolescum and how have I let my mind atrophy for the best part of a year by sitting about the house all day wallowing in my self-indulgent and pointless despair?

Speaking of dolescum status, today I have written to the office of much evil and malevolence asking for a copy of my contract of employment.  I revisited the CAB last week after my success in my application for DLA and lamented the fact that I was probably about to be fired.  Now, I have two very close contacts that are intimately familiar with employment law (one writes the laws in question themselves, another writes about them), and it is agreed that eventually evil work will probably be well within their rights to dismiss me.  The woman at the CAB, however, stated that in “some” cases unless they have a clause about dismissal on the grounds of absence written into the contract, they cannot dismiss you.

I have therefore written to nice personnel woman, not Horse, to ask for said contract.  Of course, like everything in my life, this is not as simple as it sounds.  I was initially employed on a part-time basis in what is now my assistant’s role.  I signed a contract for this.  When I was successful in my application to the current position, I did not receive a new contract.  There is not likely to have been a great deal of differences in the two, I suppose, and in any case I am advised that a contract for the more recent job would have been implicit between the organisation and me given that I was, for some time, undertaking the duties of the post and that they were letting me.  Nevertheless, I do wonder if this leaves room for a loophole?

Anyhow, I’ve written to nice personnel woman asking for the document and being overly sweet and friendly to her.  The reason for my uncharacteristic charm is twofold: one, she is a genuinely lovely woman and deserves people to be nice to her and two, I am fairly certain the letter will be passed to Horsey anyway, who will notice the significant disparity between how I communicate with her and how I communicate with the nice woman.  I want her to know, without my being unprofessional, or overtly nasty, that I dislike her.  Is that really bitchy?  Well, of course I already know the answer – of course it is.  But that’s kind of the point

After the Horse asking me to get straight back to her regarding the occupational health report, I note with interest that she is not getting straight back to me.  I made subtle (but obviously achingly polite) reference to this in the letter to nice woman.

A is of the view that I probably will lose my job and that thereafter I should remain off work for about a year.  He thinks that I should wait not just until I have made an adequate recovery from my current episode, but right until I am capable of completely coping with everything life throws at me.  The rationale is sound, but the problem is that, even with psychotherapy and medication, I am not sure his dream of me being able to completely cope with life will ever be entirely realised.

On another note, thank you all for the many responses to Monday’s post.  In two days it has become one of the most popular on this blog.  Perhaps I should be a full-time psycho-philosopher?  Is there a career ladder in that?!

Back tomorrow with C post-mortem.  I will force myself to do it tomorrow not next week this time!

I started writing the below on Thursday straight after C, but completely lost momentum at the bit where I was talking about telling C about my iPhone mood tracking from Tuesday.  I intended to write more on Friday, but that most horrible and frightening of things, real life, interfered.

On Thursday night, I received word that a good friend of mine, CVM, was seriously ill.  She had been in hospital for a few weeks but as I understand it her illness was not considered serious to the point where she was felt to be in significant danger.  Horrifyingly, though, on Thursday her condition deteriorated significantly; she was critically ill and in ITU.  Her family genuinely feared for her life.  I will not go into details as I was asked not to, and even though this is for the most part an anonymous blog, I still have no desire to betray confidences.

Mercifully, she has pulled through.  The last few days have been really hideous for me cos of this, so I cannot imagine how hard it must have been for her poor, lovely family.  I feel privileged that they kept me in the loop throughout CVM’s most serious illness, and am so very thankful that she is going to be OK.  She reads this blog fairly avidly (or at least did when she was not imprisoned in hospital) so I will not disappoint her by failing to put up the latest entry, so here we go…

—

Thursday has come to equal only one thing for me. *Drum Roll* — It’s the Cult of C! Yay!

Actually I am not that happy with Thursday’s session.  As you will know I wasn’t that happy with last week’s, but that was my fault.  On Thursday past I was annoyed with C, kind of, but of course then that lends itself to my being annoyed with myself because I am too cynical and should give what he is trying to do a chance.

I was busy on Thursday and of course more time has now elapsed so I am not sure that I will remember the meeting in as much detail as I would like, but it seemed to go on for an inordinately long time.  It’s the first time I’ve felt that; usually the 50 minutes seems to go by so quickly.

As usual he wanted me to commence but I couldn’t think of anything to say to the man so I let him guide me.  He started by discussing the DBT material.  Although I find some of this useful in some ways I am still struggling to come to terms with it as an adequate method of psychotherapy.  In fairness, C is keen not to abandon our psychodynamic-esque discussions, but he feels – rightly – that I need practical help too.  I am just questioning whether or not this is the most appropriate form of practical assistance for me.

In any case, he said he thought the ‘distraction plan’ I had written was “very good” and that I had obviously put a lot of work into it.  I felt validated by this and couldn’t help a slightly flattered smile, though I hope he didn’t see it.  This is absolutely pathetic; regardless of my reliance on C, I do not want to be in the position where I need his vindication for everything I do, especially not some cack that I could have quite easily have come up with myself had I bothered to take the time.  Anyway, though, apparently that is the next thing.  I want C’s endorsement.  Brilliant.

We discussed some of the points briefly, then he asked me if I felt I could actually put them into practice when I need distraction or when I go completely mental.

I postulated the belief that it was all well and good to sit in a rational and comparatively mellow frame of mind and write the stuff out, but that it perhaps wasn’t so easy when one actually went nuts.  I told him about Tuesday night, about how depressed and angry I’d been watching the European election results (in particular the horrific news about the evil BNP‘s relative success) and how pathetically hyper and manic I’d become watching the Great Britain council election coverage, something that does not even affect me directly at all.

C didn’t seem overly concerned about my histrionics regarding the political matters.  In fact he seemed surprised when I berated myself for becoming (positively) manic after watching the council elections.  Perhaps he is a politics junkie-nerd too.

He did ask me to elaborate on Tuesday night, however; oddly, some part of me was reluctant to discuss this with him.  Is this yet more protection or was I simply embarrassed?  Whatever the case, I forced myself to read out to him the same stuff I wrote here on Wednesday (the edited version that didn’t mention him or Dr C) that was garnered from the mood tracker on my phone.  A long discussion ensued, much of which I don’t remember.

C said it was as if I was talking about someone else.  I was initially confused as to whether he meant the terminology I had employed when I wrote about my mania on the phone, or whether he was referring to my tone of voice when reading it back to him.  When I asked for clarification, I found his answer ambiguous, so simply said that when I read the stuff back to myself I had found it unpleasant.

“Definitely!” exclaimed C, very emphatically.  I was pleased at the time that he was taking an interest, but now I am worried by the passion he put into the statement.  Have I contaminated his mind with mine?

I don’t really remember what happened next (I am writing this on Sunday) but I do remember him asking me how I felt about not sleeping.  I said I was used to it, that unless I had sleepers I almost never slept.  I told him that before I went off sick from work, I would have been awake all night, then got up and quite adequately fulfilled the duties of my job.  I said, in passing, “It’s not a big issue.  I’m used to it; I’m a serial insomniac.”

I don’t think it was my imagination; I am pretty certain that his eyebrow quivered ever so slightly at the use of he term ‘serial insomniac’.  Does he read this blog?  *WAVES MANIACALLY* HI C!  WELCOME!!!!! Seriously, it was almost certainly a coincidence.  But it’s not impossible; he does have a list of my mental fuckupperies that he knows was basically copied straight from this website – all he’d need to do is Google some of the specific terms therein.  However, this is paranoia on my part, as ever.  C has better things to do with his time.  I am his client (Or am I his ‘patient’?  Or, most annoyingly, ‘service user’?  I fucking hate that one), not his life.

Obviously he did quiz me on what had caused my going completely doolally.  If I wasn’t upset about the insomnia, what was annoying me?  The answer was simply nothing.  I just went mental.  There was no reason, or at least there wasn’t consciously.  I think I need to ask Dr C, my psychiatrist (more on her in a minute), for some anti-psychotics (if the old bag will give them to me that is) – it’s bad enough to end up in this state for a clear reason, but to experience it with no evident rationale whatsoever is very disturbing.  Though I suppose I should be used to it by now.

I’m finding this really hard to write.  I don’t remember what happened next with C.  I do remember we talked about the Tuesday night episode for some time, but I don’t recall any of the content.  I really should force myself to write up my psychotherapy sessions straight after they take place, but I just couldn’t do it for some reason on Thursday morning.  I think it was probably simply exhaustion from yet another week of insomnia.

So, given that I can’t remember any of that crap, let’s move on.  The next things I do remember were what made me angry.

He asked was I able to ground myself in the moment when I go mad and I laughed in his face as, self-evidently, I am not.  I said that often when I go mental I pace back and forth and bang my head off the wall, although I didn’t on Tuesday night as I didn’t get out of bed (I’m such a lazy fuck that even going nuts can’t make me rise from my pit).  I said that whilst the banging of my head on stuff was partly about causing myself deliberate pain, it was in many ways to achieve reorientation in the ‘here and now’.

C started into a monologue about ways to reorientate oneself (or “ground” oneself, as he put it) in a non-destructive way.  I have already spoken about stuff like using ice cubes instead of cutting as a way to feel pain, but this stuff was less tangible and much more airy-fairy.

He made me focus on the sounds I could hear – the clock, cars and birds outside, the fan on his PC.  He asked me to focus on the sound of his voice too.  I interjected at this point by asking if he was trying to hypnotise me.

He took this remark as evidence of my cynicism about what he was doing, but asked me to go along with it anyway.  I did as I was told.  I don’t know…I had mixed views.  On the one hand, focusing on his soft, gentle voice was rather hypnotic.  But focusing on stuff like the clock / car is all I can do when I’m on my own, and I really wonder if that is enough to abate the madness when it comes.

C asked what I had thought of the excercise.  I said that although his voice had a hypnotic quality, I largely thought the entire thing was “terribly silly”.  He accepted that but asked me to bear with him.  I heard myself acquiescing to this.

The second thing he wanted to show me was even worse.  It was a breathing exercise.  What a pile of patronising wank!  I already know that you are supposed to try and control your breathing when you are in a panic!  Sweet Jesus jumping Christ!

C went on demonstrate the technique.  I watched and listened in horror as he closed his eyes and exhaled heavily.  It seemed kind of indecent to me, and I almost felt slightly violated.  (I know, I know.  Only a diseased mind like mine could turn a simple breathing exercise into something dirty).

He asked me then to try it with him.  Quite clearly he detected my reluctance to do so.  He said, “you might feel a bit daft doing this.”

“Indeed,” I replied.  “I feel like a twat just thinking about it.”

He muttered something about understanding that, but asked me to indulge him.  I rolled my eyes and followed his lead.

It amazes me that some apparently well-established and regarded professor of psychology, Marsha Linehan, came up with this utter nonsense.  I could have come up with this horsebollocks whilst decomposed, dead and chained to a fucking crane.  It is as simplistic as taking a fucking piss in a fucking nappy.

To be fair, I can appreciate that advanced meditative techniques can be hard to master and potentially helpful for some people and for some problems, but really.  Breathing in through my nose and out through my mouth is hardly a fucking revelation in psychotherapeutic treatment, is it?

I was completely mortified throughout the entire ‘exercise’ and even if the bloody thing did have any value in it, I wouldn’t have been able to realise it as my discomfort was so strong and palpable.

With this shite completed, thankfully, C said that he recognised I was very sceptical about it (no shit, Sherlock).  However, intriguingly, he also stated that he felt part of me was interested in engaging with DBT and its inherent mindfulness.

Is this true?  I agree that I need practical help as well as therapy that uncovers the roots of my problems.  I am just not sure that this is the type of practical therapy into which I can buy.

A and I have a friend, G, who has a degree in psychology (though unfortunately he did not pursue the discipline professionally, which is a shame as he would have been a fabulous psychotherapist) and he is probably the most intelligent person I have ever met (and I am lucky enough to have met a number of brainiacs in the course of my life).  G is extraordinarily knowledgeable of Eastern philosophies and religions, and when combined with his knowlege of psychology, he is the obvious candidate to speak to about all this.  A asked him what he thought of DBT and mindfulness, and G responded saying that it was a very effective tool for some, but certainly not others.  We are meeting him next Saturday night to analyse these matters.  G is the most skilled debater I have ever known, and is remarkably persuasive.  If he thinks DBT actually has value, then there is a chance he might be able to make me see that.  At present, I have to admit that, with regret, C is not doing so.

In any event, C gave me the photocopies of the next chapter of the DBT book, which summarised the stupid exercises we’d been doing.  I read it when I got home on Thursday morning and fuck me.  If the session with C was irritating at times, this was infuriating.

Aside from its patronising tone and its espousal of the aforementioned breathing/grounding exercises, there is this pile of shit called Radical Acceptance.  Now, in fairness, what I was reading is a very introductory discussion of this concept, but I felt that my intelligence had been insulted by it.  Apparently, you have to tell yourself that “you can’t change the past” or “everything leads up to now” or “it’s a waste of time to fight what’s already occurred” or, my personal non-favourite, “the present moment is perfect, even if I don’t like what’s happening.”

The latter excepted, I already tell myself these things.  I know I cannot change the past.  I don’t fucking want to change the past.  I do not have an IQ of -1,000,000.   THIS STUFF IS FUCKING SHIT.

It goes on to ask you to formulate a radical acceptance plan.  For example, read a controversial news story without being judgemental, or wait in traffic jams without becoming irate.  Yes, cos it’s that easy, fuckstains.

It then asks you to come up with your own ideas of non-judgemental acceptance.  I have written the following:

• Try to re-read this chapter without getting annoyed
• Try not to self-criticise re: being irate about this chapter

This sounds like sarcasm, but I mean it in all sincerity.  If I can manage to read the chapter again without wanting to scream, the ideas may have some very small chance of having validity.

As well as this, the doctrine of radical acceptance as I understood it suggests that you have to lose part of your personality by deliberately choosing not to have opinions.  If you stop being judgmental, don’t you cease to opine?  If you cease to opine, do you not lose part of the very essence of your humanity?

Am I to sit here and say, “no problem that the economy is fucked.  I shall not make a judgment on that.  It’s OK that Ahmadinejad rigged the Iranian election and treats his ‘subjects’ as he does.  I shall not judge that.  Eastenders is not a programme that I despise.  It exists and that’s all.  I do not judge it.  So Hitler killed millions of Jews, gay, disabled and non-Aryan people.  I’m not going to judge him for that.  I accept it all.  I can do nothing about it and therefore it is all fine.”

Fucking complete toss!  Sorry, but I’m raging that our economy is cunted!  Ahmadinejad is a fucking twat.  Eastenders defines manure.  Hitler was murderous fucking maniac.  This is what I think and I don’t give a flying fuck if Linehan, or McKay, Wood or Brantley (authors of the workbook in question) think I am being cynical, snide or otherwise cuntish for it (but of course they don’t, do they?  Oh nooooooo!  They are all perfect and non-fucking-judgmental, so they have no opinion on my opinions).

Aside from all the annoying concepts, the actual terminology and tone of the fucking book is as condescending as nursery school – in fact, nursery school probably assumes its “consumers” have more fucking wit than this book does.  I think it thinks it is talking to fucking goldfish.  I have written infuriated annotations all over it.

I don’t want to offend C, but I have to be honest with him.  There may be some stuff that is useful in DBT, but one thing I cannot abide is being patronised, and as such at present this book is merely serving to create negativity rather than resolve it.  Perhaps as it becomes more advanced, it assumes more intellectual prowess, so I suppose I will allow him to continue with it for now.  But it would seriously need to improve its tone and writing-style for me to significantly re-evaluate my opinion of it.

C does know that I have considerable reservations, and was keen to remind me that this is still only a small part of our therapy.  He does strongly feel that we need to continue with the more freeform psychodynamic-ish stuff, but recognises that this will not solve my acute problems right here and right now.  As such some practical therapy is necessary.  I do agree, but I am dubious about the form that that is presently taking.

In any event, before I left we discussed the psychiatrist, Dr C.  C thinks that she is indeed willing to explore alternative medications with me, which is good as my time on a lower dosage of Citalopram (as instructed by her) has proven that it was no use whatsoever.  C also seemed to think that perhaps she will actually give a diagnosis (or diagnoses), which had previously been in doubt.  I told him how glad I was about this, as I really, really want to know what this/these illness(es) is/are.

Before he had the chance to butt in, I pre-empted his commentary and tried to enunciate why a diagnosis is important to me.  I said I was unlikely to become fixated with a name for my mentalism as I don’t want to engage in labelling theory, nor did I wish to be defined by a nice shiny tag.  Nevertheless, I said, I felt that I already am defined as an individual by being mental, and that a name for it would help me come to terms with that.

“In the absence of an official diagnosis, I am making them myself,” I told him.  “I don’t think that’s healthy, do you?”

“No,” he conceded.  “I actually think you have quite a sensible approach to this; being fixated with a label is obviously a negative thing, so your belief that you would not be consumed by that is encouraging.”

He went on to remind me that as a clinical psychologist, he was unqualified to diagnose (I fucking know, C!), but said that his department did have some questionaires which can indicate what your illness might be.  Initially my interest was piqued by this, but then he stated that if I wanted to explore this, I would need to do so with one of his colleagues.  This put me off.  I have never met any of C’s collegues but I hate and fear them anyway.  He is the only one I trust.  Though thinking about it, would they be about when C is skiving off work in July?  If so, they might be better than nothing, because I will collapse in a mess without him.

Ho-hum.  I suppose my next move is just to try some of this mindful wank and see where we end up.  I do look forward to G’s take on it.

Sorry this has been such a shite post.  My memory is skewed.  I willhave to force myself to write up the C sessions immeadiately after they take place in the future.

Last night, I had my first real episode of (negative) mania and loss of lucidity since the birthday party incident.  Well, strictly speaking it was this morning – shortly after 2.30am, during a fairly typical night of insomnia.  I was in a frenzy, though the physical manifestations of it can’t have been that strong, as A continued to sleep soundly beside me.  However, I was having trouble breathing, and rocked myself back and forth over and over again.

Even though I was going completely nuts, I did maintain enough lucidity to note the following symptoms of my insanity on an iPhone mood tracker that I downloaded the other week:

2.27am

• Severe suicide ideation
• Almost all-consuming desire to harm
  
• Bloody cursed evil shapes
  
• Fantasies about completely losing it with C and Dr C
  
• Imagining stabbing self in skull with knife used in cutting
• Composing suicide letters both to real people and people on fantasy world
  
• SHAPES!!!!!!!!! Evil hate hate hate hate
• Rocking back and forth
  
• Want to die die die die so much want to die
  
• Utter consumption of self-hate [I assume I meant, "utterly consumed by self-hate"]
  
• Hate self love self hate self love self
  
• Death death death
  
• Shapes death rage hate fuck fuck fuck

2.36am

• Make it stop make them stop go away evil shapes GO AWAY LEAVE ME ALONE MAKE THEM STOP PLEASE SOMEONE!!!!!!!!!!!!!!!!

Hmm.  For the record I have corrected the various spelling mistakes that exemplified my madness.

To distract myself, I tried to remember the DBT techniques, but I was unable to focus enough to force myself to get up and read them.  I did try nipping myself with severe force, which did help me reorintate myself a wee bit.  Having got to that stage, which was not good but marginally better, I sought refuge on the internet via my trusty phone.  I don’t remember now what I read, but whatever it is it must have detracted my attention sufficiently for some time, because I was eventually overwhelmed by exhaustion and after sytematically stretching all my muscles, was able to go to sleep.

I didn’t self-harm and I am still alive, so I suppose in some ways I won.

When I awoke this morning, as ever I was baffled about the coming of the madness.  I felt, frankly, embarrassed about it.  Behaving totally mentally in front of the psychologist and the psychiatrist was one of my many rambling thought-images during the night – I wanted to pace up and down their offices screaming, raving and behaving in a completely psychotic fashion.  In the cold light of day, I sincerely hope I do not do this.  I have even debated withholding the information on last night from them, or at least from C, though I am not sure whether that is out of a desire to protect, or whether it’s a desire to save myself from the mortification that discussing it would bring.

I have been trying not to post-mortem the episode – at least, not in a self-flagellatory fashion – as per C’s instructions.  I tried, but the incident nonetheless left me in a disillusioned, contemplative and rather depressed mood this morning.  What is most unacceptable about it is that absolutely nothing set it off.  I have also observed of late, and I’m sure others have observed for many years, that I fly into murderous rages with people over nothing, then worry that they are going to desert me.  Point being, my psyche responds negatively to absolutely anything.

A, who was still blissfully unaware of what happened during the night and indeed of my poor mood this morning, tried to persuade me to get out of bed, but I demurred, and remained there until after 11am, whenupon I left the house to come to my mother’s (since I have been off work, I come to her’s for a night or two per week).

My plan was to cheer myself up by listening to ‘uplifting’ tunes on the drive over to Mum’s,which is one of my ‘distraction plans’ from the DBT stuff.  But that failed as I have lost my iPod – didn’t panic-obsess over that or anything, oh noooooo – and I can never be arsed to sync my iPhone.  So I only have select music on it, and most of it is metal or gothic rock.  Very cheerful.

I ergo arrived at my mother’s in relatively bad form, but hallelujah!  It desisted fairly quickly (though much of the contemplativeness has now returned), not with joy at seeing the woman who gave birth to me, but from a letter from the SSA.  The SSA, I hear you ask?  How can correspondence from those evil tossers be good?

Well, subsequent to my visit to the Citizens’ Advice Bureau, they are going to award me DLA at £89.00 per week, backpaid today from some time in April.  The backpay amounts to over £600; it will solve my very severe short-term financial problems (that I have lots of debts and no money).  I don’t have a long-term plan, should I lose my job or be unable to return to it.

Of course, the positive letter was offset by a negative one demanding that I attend a medical assessment with the SSA – not in relation to the DLA claim, but regarding my Employment and Support Allowance, which I am receiving whilst I am off work.  Fortunately for me the appointment they sent me conflicted with next week’s C appointment so I won’t have to go to it, but the relief is temporary; they weill send another one and then I won’t have good news to balance it and I will totally crack up worrying about it.  A, a civil servant (though not with the SSA), advises that it’s really just a formality, but you know me.  I will worry and panic anyway.  Perhaps that is not a bad thing as at least they will see that I am a nutjob.

Anyway, it is C in the morning.  I have been wondering today what I want from psychotherapy.  The thing is, if I am ever successful in leaving perpetual the despair that is my present norm, where will I end up?  I actually do not want to be ‘normal’.

That is not to say I want to be mentally ill.  Who would choose this?  Yet, in a twisted way, it is my comfort zone.  It is what I know and what I have always known.  It is an inherent part of me, and whilst I hate myself sometimes, I actually don’t want to change my native and entrenched persona. I don’t want to be the slave of the illnesses, but if I had a switch to completely switch them off, I am not sure I would flick it.  I cannot enunciate exactly how I feel about this.  It’s weird and complex.

I remember watching Stephen Fry’s analysis of his bipolar disorder on BBC2; he, and most of those he spoke to, said they would not flick the metaphorical switch either.  I remember being reassured by this as I had always thought I was alone in thinking this.

All the same, I do not want to be experiencing suicidal episodes of depression nor do I want to undergo incidents of psychosis nor panics so severe that I can’t think or breathe.  I am a paradoxical dichotomy and I hate myself for my apparent indecisiveness – except that it’s not indecision, because I want both states of affairs.

I think what I want, and indeed the best I can hope for, is just to be able to manage these things when they come to bite me on the arse.  I want to go back to work.  I want to be able to function socially.  I want not to be angry with people for no reason and I want not fear being rejected by them and others.  I want to be able to control my depression, anxiety and more psychotic symptoms, not to have them control me.

But oddly, I remain scared of any of them going altogether.  I don’t think it’s likely to happen, but isn’t it odd I wouldn’t want it even if it was?

After my epic rant about Georgie and her familial cunts on Wednesday night / Thursday morning, I spent some time trying to calm myself by re-reading the DBT material from C. It wasn’t so much about finding coping techniques to deal with my anger, but I needed something tangible to distract myself, and since I hadn’t adequately prepared for Thursday’s session, it seemed appropriate to look at that.

I was surprised to find myself less sceptical than I had been.  Parts of it still profoundly annoyed me; the authors’ decision to constantly provide unnecessary and frankly patronising examples of their points is still the main irritation.  However, some of the distraction techniques are, I feel, valid, so I took a pen to it and re-annotated it with thoughts additional to those I had provided last week.

This is not to say my scepticism has vanished; that would be a lie.  Nevertheless, I feel my view is more balanced than it had been, so I hope that’s a good sign.

C thought it was, but I’ll come to that later.  In essence I am not really sure what the value of Thursday’s session was.  I don’t blame him for that, as I was in a frivolous mood and kept randomly laughing and grinning like a maniac.  C was keen to remind me that our relationship is dyadic and as such sessions are a co-construction, so I should not blame myself entirely for one that is less useful than others (indeed, C himself actually cracked a couple of jokes, but then I like this in some ways as it makes the psychotherapeutic process seem less difficult and hostile).  Someone else voiced the view that it’s really better that he sees me in all my moods anyway.  I accept these points but nevertheless I feel I should have taken it more seriously than I did at points.  Although I wouldn’t consciously have said this at the time, on reflection I think my odd mood was driving me to play mindgames with him.

This is a bit stupid.  Surely the last person, other than a psychic, with whom you should play mindgames is a trained clinical psychologist?

Anyway.  I shouldn’t be writing this as C has asked me to try and stop post-morteming everything.  Of course I am going to write it anyway.  I don’t so much see these reviews of C sessions as post-mortems, not in the self-berating sense that they usually are anyway.  I just want to remember what happened with him on a weekly basis and try and make some sense of it.  He keeps notes on me.  Why shouldn’t I keep notes on him?  The relationship seems less asymmetrical this way, but in a non-damaging way (because of course making the relationship more two-way can on occasion be dangerous; a reality revealed could be an understanding ruined).

500 words and I haven’t even started.  The discussion with C commenced with a review of last week’s psychiatric appointment.  He has not spoken to Dr C yet; she had left a message for him whilst he was out of the office, and when he returned her call she was out of the office.  He assured me he would get hold of her the day after our session (Friday), which is now yesterday.

He wanted to know how I felt the appointment had gone.  I thought long and hard about how to answer his question.  On the one hand, my visceral reaction was one of sheer negativity.  On the other, when I later analysed the appointment properly, it did not at all seem so bad.  Furthermore, I was aware that I had slagged off the NHS to C before and then castigated myself endlessly for fear that I had offended him.

But it would be pretty pointless to lie to him; not only would it fail to deal with matters of concern, he would see right through it anyway and it would be an unnecessary betrayal of his trust.  So I told him I had considered topping myself in the appointment’s aftermath, but that latterly, after thinking about it, I hadn’t felt it was really that bad.

I did lament for a while the fact that I had to provide yet another history of my problems to Dr N and Dr C – perhaps unsurprisingly, this led on to a rant about the failure of the NHS to utilise its considerable beaurocratic resources.  I then also complained that since the referral to Dr C had clearly come from C, that the one from Lovely GP would end up getting cross-wired and that I would then end up being invited for a second appointment.  At that point, I paused, and then starting apologising to C left, right and centre for engaging in flagellatory discourse against his employers and colleagues.

C briefly outlined the logistical procedures involved in the sharing of patients’ information amongst NHS professionals.  Basically they can’t share any written information without my direct consent.  I wanted to ask why Dr C had therefore not asked me directly if she could contact him, as I believe she would need written as well as verbal commentary for her files, but I let it pass.  He also stated categorically that there will not be an overlap in the referral process.  I hope his assurances prove to be correct.

C wanted to come back to the issue of my apologising but initially asked what it was I wanted of the psychiatrists.  I said I wanted adequate medication and a fucking diagnosis as, whilst I do fully accept that treating the symptoms of whatever it is I have is the most important thing, I feel a need to have a name for this.  I feel like I am owed it after all the pillar-to-posting of the past decade.  It will at least help me to deal with being mental if I know what form that mentalism takes.

C talked briefly about the medication angle, though I have no recollection now of the specifics of his words.  Then he said, “…and they may or may not give you a diagnosis.”

“May not?” I challenged, alarmed, raising my eyebrows.

C shifted uncomfortably.  “I don’t know,” he admitted.  “I’m not in a position to know what they will do.”

I felt sorry for C cos it’s not his fault.  So I told him that that was fair enough, and let it pass.  If Dr C does not diagnose me, then I will rant at her.  I don’t like her anyway.  Though on the other hand, I don’t want her to abandon me.  Dilemmas.

C returned to the issue of what he termed my self-lacerations when I kept apologising for being nasty about the NHS and in particular the terminology I had used when rationally considering the appointment with Dr C and Dr N (I had said something like, “what was wrong with it, you stupid fucking bitch?” apparently).

He asked why I was so angry at myself.  I said that I was not so much angry as mystified.  I couldn’t understand why I had reacted so badly to the psychiatric appointment, to my cousin’s birthday party, blah blah blah.  I said its lack of sense had later baffled me.  Rationally I can accept that madness just is – but what about parts of my brain have ever been rational?

C pondered this then stated that to him the word ‘mystified’ had connotations of curiosity, intellectual questioning, reasoning.  He felt though that I was exhibiting at least irritation at myself and was not simply just enquiring.

I said that I took his point, and again advised that I had a constant need to self-analyse and that it was partly for intellectual reasons.  I need something to stop my mind atrophying.

“You take my point?” C said.

“Yes,” I replied, puzzled at the question.

“You could be referring to anything,” he said.  “You talk about this stuff in abstract terms.  You want to avoid confronting emotional issues.  By intellectualising these matters you are at least in part trying to distance yourself from emotions.”

Astute observation, C.  I laughed in his face, told him that I thought the word ‘emotion’ and its derivatives were ‘despicable’, and then smiled enigmatically at him.  It was meant to be seen as a challenge, I think.

He proceeded by reminding me that I am a dichotomy, largely of my own choosing; I try desperately to suppress ‘emotion’ then fall about in a panicky, incoherent train-wreck.  I conceded that this was correct, and told him about my awe on the North Coast at the weekend nearly turning me into a gibbering mess.

C asked why it was wrong to feel awe and wonder at the beauty of nature.  I told him that it was not wrong to feel that, but to feel it as strongly as I had done was surely unusual, and my anecdotal observations suggested strongly to me that ‘normal’ people didn’t collapse in a mess.

I monologued briefly about my competing emotions that day.  Apparently I said, “they should reconcile the two competing sides of their personality,” or words to that effect.

“They?” he queried.

“I meant ‘I’,” I said, honestly, then dismissed the matter and talked on about the day a bit more.  But he wanted to explore this verbal typo.

“I find your use of the word ‘they’ interesting,” he told me.  “Do you think its indicative of competing sides of your personality?”

“It was a slip of the tongue,” I replied, trying not to laugh.  “Have you gone all Freudian on me?”

“Slips of the tongue can be interesting, though.  They can be revelatory, and yes, I suppose that is a Fruedian idea – but I think it’s a valid one especially in your case.  But this is not psychoanalysis, you know.”

“I know,” I said.

“How do you feel about me telling you that?” he inquired.

I thought this was a bizarre question.  I knew it wasn’t psychoanalysis, so why should I react to him simply stating that?

I decided to turn it back on him.  “How do you think I should react?”

I was slightly disappointed to find that he was able to answer promptly and calmly, thus clearly having anticipated such a question.  He was concerned, apparently, by his reminding me that our therapy was not psychoanalytic that I would be worried about bringing up references to Freud etc.  I advised C that I was not thus worried; I had simply interpreted his comment as a statement of fact and had not upset myself over it.  I felt quite pleased that he seemed reassured by this.

In any case, the discussion returned to my suppression of my ‘emotions’.  C drew attention to the terminology I had used in relation to the issue, such as the word ‘pathetic’.

Both of us lost our trains of thought when he chortled slightly, raised his eyebrows and said, “You’d love me to psychoanalyse that.”  For some reason, this small joke sent me into convulsions.  Sometimes I love C.

In any case, C stressed that emotions are as integral to our personalities as thoughts, relationships, blah blah.  He said that I need to stop over-intellectualising everything to avoid having to deal with them.  I admitted it all becomes too much for me sometimes, but then burst out laughing.

Poor C was puzzled.  I explained I was in a frivolous mood and kept apologising to him for wasting his time.

“Look, you’re doing it again,” he said.  “Self-lacerating.  Just tell me how it feels.”

I couldn’t enunciate exactly how it felt to be ‘frivolous’ – it just is – so I ignored the question and simply told him why I believed I was in such a mood.  “I had a rough night last night,” I said.  “I believe it’s a coping mechanism.”

That’s probably a load of psychobabble crap, but I couldn’t think of any other reason.  I had printed out my blog from Wednesday night and read extracts from it to him.  As I did so, I seethed again.  C conceded that I was under unfair pressure from my family to feel something that I didn’t feel and that I frankly have good reason not to feel.  I told him I would rather be bitter for the rest of eternity than succumb to G’s suggestions regarding V.

He said, in my view in an almost despairing fashion, “the whole thing is a tragic situation.”

I shrugged.  “I’m not the first child to be abandoned by their father.  My mother wasn’t the first woman to be beaten and raped by her husband.  My reactions are sheer self-indulgence.”

“There’s that self-criticism again,” C said.  “Is there anyone you can discuss these matters with outside here?”

I said that my first instinct when I saw the email from G was to forward it to A and D and then broadcast it to the world along with a customary rant.  He asked could I speak to my mother about how I ‘felt’.  I emphatically told him that that was out of the question, but as it happens I did later have a go at her, but I’ll maybe discuss that some other time.  The point I was making was that it is not appropriate for her to know the full extent of V’s impact on my life, as she will blame herself.  However, I am quite willing to point out to her that her conspiratorial email discussions are not just wholly inappropriate but deeply offensive.

Anyhow, I told him I was not prepared to behave in an emotional fashion in front of my mother, and indeed that I didn’t really want to do so in front of anyone.

“But you have expressed emotion here,” he probed.

“Yes, but as I have already stated, it is largely curbed.  You remember our earlier conversations on this matter,” I pointed out.

“Those in which you admitted that you protect me at times,” he pondered.

I recalled that he had asked me during said discussions if I felt he was incapable of dealing with me, so I took the opportunity to stress that I did not feel this in any way.  I told him that I supposed the matter was two-fold: on the one hand, it was complete self-interest as I would hate to be embarrassed about my behaviour in front of him, thus leading to endless post-morteming (as if there wasn’t enough of that already).  The second issue was borne out of altruism, though; I did not want to contaminate someone else’s mind with my reality.

He asked if I always post-mortem my sessions with him, which given so much of the writing on this diary seems a hilarious question.  Again, I turned it back on him, challenging him to tell me what he thought the answer was.

“I imagine you do,” he responded.  I was actually surprised that he did answer the question.

He went on to say that, whilst he appreciated the significant difficulty of doing so, could I try and stop post-morteming things.  Obviously you can tell what a success that has been.  I grinned like a maniac as he spoke, and eventually he asked why.  I said that I would try to stop (ha) but that I could not honestly conceive of it being likely, not at this stage anyway.

C accepted that, but said we will have to spend some time discussing ways to help stop it, as if reinforces all my self-criticism (not necessarily my post-morteming of my sessions with him, but in more general terms).

There were literally about three minutes of the allocated time remaining, and we hadn’t discussed the mood chart, the DBT and the discussion I had wanted to instigate regarding Marcus, all because I had rambled on about fuck all.  I briefly brought up the issue of DBT in response to his remarks about my self-castigation.  He asked me what I had thought of it.

I told him that he probably wouldn’t be surprised to learn that I had mixed feelings on the material, but I was keen to make clear to him that I wasn’t entirely dismissive of it.  A lot of my annotations had been very critical, and I had corrected the American English therein (sorry American readers – I’m just an anal twat Irish-Brit).  I pre-empted any worrying he might have done (that he almost certainly would not have done, let’s be honest) by stating that although I had written cynical remarks all over the stuff, I didn’t want him to be of the view that I thought it was all horseshit.  I said that I did genuinely opine that there was some potentially useful stuff included in the material.

C was concerned that my taking the time to so emphatically state that he was not to take my critical remarks entirely seriously was a further example of my protecting him, but nevertheless seemed really pleased that I had filled in the charts and the ‘distraction plan’.  He seemed pleased that I had “evidently spent a lot of time on it” and said that in fact he was glad my approach wasn’t polarised either for or against the technique(s) as it was healthy to have a balanced view; to recognise faults is natural and prevents the belief that the stuff is a miracle cure, yet to be too cynical would lead to a bias against it that would prevent it working properly anyway and would thus be self-defeating.

C said he would photocopy my sheets so he could read through my responses before next week.  I apologised for wasting his time and not getting time to discuss the mood chart and Marcus with him.

C pulled me up on the self-criticism yet again and pointed out that the situation was a co-construction.  Yet our plan had been to formulate our own take on the mood chart and discuss the DBT, and I had failed to allow us to explore that.

Still, never mind.  Better he sees me in all my weird and wonderful moods than not.

ScumFan McF phoned me this morning to advise that he had passed his driving test.  He is 19.

Generally ScumFan and I get along well and always have done.  I was genuinely delighted for him.  But could I just have been pleased for him?  Oh nooooooo.  What would be the fun in that?!

My narcissism has turned his success into an indictment of myself.  Admittedly, he failed his driving test eight times before passing it on his ninth attempt.  I did pass mine on my fifth attempt, as if that were something of which to be proud.  The difference is that he is 19 and I was pathetically 25 when I finally succeeded.  I had been learning on-off since I was 17.

Admittedly when I did pass the thing I hadn’t taken instruction for some time, so in a way it was like coming at it from new, but nevertheless, my failure to achieve such a normal thing at a younger age is clearly demonstrative of my failure at life.

I suck.  It is funny the little things that set you off, isn’t it?  It’s so often the little things, things that mean nothing to others and should mean nothing to you.  There have been a couple of other ‘little’ things that have sent me into moods these last few days, some of which I’ll go into now, some of which I can’t be arsed detailing.

I have been in a weird mood for several days.  I haven’t written anything here on this blog (other than the family trees) as although I have been doing stuff there has not really been much to report, mental-wise.  That is to say that I haven’t gone completely off my head, seen any mental health professionals, sliced at myself etc; it is not to suggest that I have been sane.  In any case, this blog was created for me to monitor and detail my moods, so I suppose I should have written anyway.  It is just hard to get motivated and to concentrate because of my various nefarious ailments.  But I’ll do so in some fashion now.

On Saturday, A, his best friend W and I went up the North Coast of Antrim, specifically to Glenariff, the Torr Road, Ballycastle and Bushmills, with a few stops along the way.  The North Antrim coast is some of the most stunning scenery I’ve ever seen; in fact, I almost obliterated all three of us whilst driving by not paying attention to the road, simply as the surroundings were so beautiful.  Yes, for once my almost-death was not brought about by my own intention, though it was my own fault (fail).

It was an absolutely fabulous day, weather-wise, and there were laughs a-plenty for various weird reasons, as we make a weird trio.  The thing is, I was at points totally overwhelmed by the beauty of nature, this divine nature right on my own doorstep, and as a result I nearly collapsed in a gibbering, weepy mess at times.  It is pathetic beyond measure.  C’s desire to try DBT must actually be quite well observed despite my concerns, as clearly I am completely unable to regulate my emotions in any way, and that is what that therapy seeks to address.  I also felt mild derealisation and depersonalisation, especially the latter, at times.

I make it sound like I did not enjoy the day and now A and W will read this and feel bad, because I don’t think they were aware of my being overwhelmed or fucked in whatever way.  I would like to unequivocally state that I did enjoy the day and they are by order not to feel bad at all.  It was one of the more relaxing and enjoyable days I’ve experienced in quite some time, it actual fact.  I am just in need of sorting out my reactions to nothing.

On Sunday, after a lovely lunch on the river with W, we went to A’s family for a barbecue, which again was relaxing and fun and enjoyed in spectacular weather.  Yet again, though, I had this niggling nothingness penetrating my psyche that inhibited my ability to truly get into the swing of things the way I have done in the past.  Again A will read this and feel bad and he has no reason to feel bad but I feel bad that he will feel bad and I am a fuck-up and I should be sectioned or shot or something because I am a waste of space and I am worrying about stupid fucking shit and should shut up and stop writing in long sentences like this one.

On Monday, after being awake all night, I mostly ignored the weather and fell asleep with the cats on the sofa and then I felt bad and guilty because it was a beautiful sunny day and I had effectively wasted it because I am a useless insomniac twat.  I did go to the park with A that evening, but the sun was going down by that point and the place was full of spides and millies so whilst it was certainly pleasant I should have made more of the earlier part of the day.

So on Tuesday, after braving the supermarket of evil in an effort to continue to fund my Chorizo addiction (which actually is an addiction; I have literally eaten nothing else today at all, but must have thrown half a pound of Chorizo down my fat gob), I went to a lovely park a few miles from where I live and read the book I bought about bints’ relationships with their psychotherapists.  But even then I wasn’t fucking happy because I was hot and I felt vulnerable because I was out in the open by myself and although there were not many people there, there were certainly a few and I was terrified that they would try and talk to me.  I forced myself to stay for a while, walked around for a bit, tried reading a bit more, lost concentration, got annoyed by flies and other assorted insectfucks, got overwhelmed by the heat and went back to my car and drove home.

Then A phoned to ask if I would be in the house at 4.30pm, which was indeed to be the case.  The reason was that a plumber was coming to fix the fucking piping in the bathroom that hasn’t worked since I was virtually a fucking foetus.  So then I panicked about some random stranger bloke coming to the house and talking to me, and then the bloke was late so I panicked that he was dead and I had somehow psychically caused his demise through my malevolence and nervousness, and then the bloke finally arrived and he was friendly and courteous and I felt guilty for pre-judging him and worrying about him speaking to me.

Later, I misplaced my ring so I went into a mad frenzy and panic and paced up and down the room in a fashion most commonly observed in secure institutions.  The ring cost me $20 in Las Vegas at Christmas, and was a replacement for another ring that I had cuntily lost there, a ring that A had bought me several years ago.  The one lost in Vegas was virtually worthless but had such great sentimental value that it fair ruined one of my days in the most fabulous city on Earth.  So I was not prepared to lose its replacement, or at least I was not prepared to do so with any semblance of sanity.  A asked could I have taken it off in the kitchen, and indeed wasn’t the fucking thing was sitting right there.  So I had let myself panic over fuck all, without even taking the fucking time to consider all the obvious possibilities.  It was a vicious circle because once I panic, I can’t think straight, so I can’t see those obvious possibilities, so then I panic even more.

Today is weird.  I feel depersonalised again, though only to a mild to moderate degree.  The above makes the last few days sound really shit, but that is not the case at all.  They were grand – indeed, in places, very good for a fucking change – they just had a few bad moments, which represent yet more issues with which I need to learn to deal.  Overall, my current mood – and indeed my mood for the last day or two – is one of contemplation and pensiveness.  There is no real clear reason for it, it just is.  The next issue of fuckuppery is that I feel so guilty about this because then the good weather will go away and I will feel sorry for it and for nature because I did not embrace them in the way in which I should have done and then I won’t have the chance to do so again for about 73 years.

Fuck up fuck up fuck up.  As if the weather and nature give a flying arse about me and my foibles.

Tomorrow too will be strange.  I have C first thing (and thus will have to review the DBT stuff this evening), then when I get back to my ma’s apparently the McFuckwits are coming, or at least some of them are.  Apparently MMcF has gone into an enigmatic foul mood and is refusing to see people.  The rest of them claim that they are unsure as to why this is the case, but I don’t care – nay, readers, I am glad – as it means I don’t have to talk to or see her.  But S, MrsRMcF, Suzanne and Marcus will be coming, so I will have to see little Marcus again and then worry some more about what action if any I should take as regards his welfare in relation to his great-grandfather.  This makes me despair as on the one hand I cannot be responsible for ruining an entire family, but on the other I cannot be partly to blame for the ruining of a child’s entire life.  Not that it’s about me; it’s about Marcus.  I do not want him to be harmed.  However, it’s not just about him,is it?  All my fears in this regard are probably completely unfounded and are just paranoia, and I don’t want my delusional personality to ruin the lives of dozens of people, as even though most of them are fuckwitted in many ways, they are essentially not terrible people, not for the most part.

Finally, tomorrow is the date of the European Elections and since I believe it is an abdication of adult responsibility to not vote, I will have to do so.  The problem is, of course, that the majority of the candidates are cunts.  I was raised in a Unionist background, but have long since despised all Northern Irish tribal politics myself.  I would vote for the Alliance Party, but I don’t believe they have a realistic chance of success.  The main contenders are likely to be Sinn Fein or the DUP, both of whom I despise (ironically, coming from a Unionist background, I despise the DUP more than Sinn Fein), so I cannot bear to place them highly regardless of their probable success.  So I think my first two votes will go to the SDLP and the UUP respectively (SDLP higher as my ma used to work with the candidate and said he was a genuinely nice bloke), though this pisses me off too as they are both surrogates of the two main political parties in the mainland UK and they are even bigger twats than many of the parties here.  So naturally I’m turning this into a dilemma, which is, in logical terms, ludicrous, because the fact that they’re politicans at all means that they’re tossers and it makes no difference what fuckwit is in Europe cos they’re all bloody shite.

I am not sure what the point of this post is.  As usual it can only really be for my own self-analysis.  Parts of it are probably rambling, racing and incoherent, but if that is indeed the case, then at least it is a reflection of my perpetually disordered mind.

But really, I am OK.  Things are just a bit weird and iffy. That’s at least better that than being in a suicidal mania.  I think..?

Thursday Morning C Show tomorrow!  I can already feel your aching anticipation of my weekly post-mortem!

Or maybe not

I do not know what to make of my visit the psychiatrist(s) today.   I am not even sure what the fuck to write about it.

I suppose it is worthy of mention that the appointment was in the building in which C used to be housed.  He has been gone from there for several months now, and it was really strange being back there.  His new office is better than his old one was, but the actual waiting area in his new building is a depressing shithole, which is funny given the nature of the clientèle.  The waiting room of this morning is much more appealing, though I was as nervous as fuck and was actually rocking back and forth in front of the other mental freaks there waiting for their appointments.  They kept looking at me, clearing believing that they must be sane in comparison to your humble narrator.

Anyway.  After waiting for what seemed like ages – coffee is very important to medics, let’s not forget – I was finally greeted by a young woman.  My initial reaction was, of course, one of annoyance; it seemed my fears that someone inexperienced would be treating me were realised.  However, she introduced herself as Dr N – the senior house officer of Dr C, the consultant, with whom my appointment was scheduled.  Dr N said that the way things worked was that she would take a case history, discuss it with Dr C, and that then I would meet her and Dr C both.  So that was a bit better.

Having said that, I am sick and tired of providing mental health professionals with ‘case histories’.  I have told it to C.  I have told it to my GP.  I have told it to previous NHS mental health fucks.  Can’t they share this fucking information amongst themselves?  Why don’t they ask questions about the here and now?  Why does NHS bureaucracy not actually work?

I won’t go into great detail about the conversation with Dr N, as it would be to repeat a lot of stuff I’ve already detailed on this journal.  Suffice to say I told her about V, about the sexual abuse and my worries about Marcus and the other generations, about school (which to my annoyance she kept calling a secondary school – it is actually a pretty prestigious grammar school, love), about my self-harm and suicide attempts, suicide ideation, how much school I missed, how long I could hold down any one job, etc etc etc.  There was much more I wanted to say to her – I had listed all my symptoms on a sheet of paper specifically for the psychiatrists last night – but she didn’t give me the opportunity.  Not that she was unpleasant; she was nice enough, and seemed understanding and empathetic.  I half-relaxed during my time alone with her.

A couple of things piqued my interest; firstly, it seems that the referral with which she and Dr C are dealing is actually the one from C, rather than Lovely GP.  I am now expecting to hear from some other psychiatrist on top of this, as NHS admin is clearly pathetic and will see it as two separate referrals, rather than two overlapping referrals for the one person.  The second point of interest was that Dr N specifically asked me what I thought was wrong with me. I had already told that her my endless capacity and need to self-analyse and diagnose was pointless, but she said, no, I was the one who knew my symptoms best.  So I told her that whilst it was very clear I do suffer from depression and anxiety, that I also wondered was it possible that I was borderline and bipolar, with elements of narcissistic personality disorder.  She noted this, but made no remarks to refute or confirm my suspicions.

Then she went off to see Dr C, whilst I waited in the room.  I was interested to observe that the daft cow had left several other patients’ files sitting on her desk; unsurprisingly all marked “confidential”.  I could have sat and read them in some detail had I so wished, as she was gone about 10 minutes.  I could be stalking the personnel concerned at their home addresses right now rather than be sitting here typing this spiel of cack.

In any case, eventually Dr N returned, and said that Dr C was ready to see me now.  This meant I had to talk to both of them, which was not an appealing prospect.

I despised Dr C on sight.  She oozed a complete lack of empathy and I felt that she was sneering at me.  That’s probably paranoia, but really – I hated her.  She is a hard-faced, hard-nosed, miserable looking old bitch.

She interrogated me as if I were some sort of criminal.  She asked for anal detail about how I felt when I was manic, how I felt when I was depressed, how I felt when I was in one of my frenzied panics blah blah blah.  This was not easy; it is hard to describe these things when you are experiencing them, so can they imagine how difficult it is when you are not experiencing them?  In any case, to exemplify the frenzies, I detailed as much as I could recall from the incident at my cousin’s birthday party.  She did say that these episodes are, in her view, probably just panic and do not necessarily represent psychosis.  Is it strange that I am actually upset rather than pleased by this?  Do I want to be mentally ill?!  I think perhaps that what I was hoping was that she would come to all the issues of delusions, hallucinations etc but since she didn’t, I felt I had to convey some of the more serious aspects of my madness in response to what she did ask.  Perhaps I simply didn’t put it eloquently enough, because that episode at my cousin’s was pretty hardcore in my view.

She asked what the worst part of it all was; I said, “dealing with people, though paradoxically I am terrified of being abandoned”.  Dr C said, “so it’s about relationships?  That is stronger than your depression?”

This annoyed me.  One factor is not stronger than the other.  I tried to articulate myself reasonably in response to her for a minute or two, then gave up and said, “I can’t say which is worse or more prevalent.  There’s just so much.”

To be fair to her, Dr C accepted that and changed tactics by asking what “work” I was doing with “Dr J”.  This infuriated me.  C is not Dr J.  He is C.  He doesn’t call himself Dr J, he calls himself C.  I call him C.  Dr C also called herself Dr C and her colleague Dr N.  Fucking bitch.  Does she think they are worthy of a pedestal status, sitting up there in their ivory towers, hiding behind their titles?  ‘Dr’ C and ‘Dr’ N are almost certainly not real doctors anyway; C is the only real doctor amongst the three.  He has a doctorate in psychology.  They have MBs or BAOs or whatever and almost certainly no ‘D’ after their names, so the old bag should shut the fuck up (American readers: medical doctors in the UK are not required to undertake MDs or PhDs or whatever doctoral study here.  Most of them have Bachelors degrees and call themselves ‘doctor’ only by convention).  After two hours between Dr N and Dr C, I still don’t know what either of their first names are.  It feels like being back at school.  In fact, it’s worse, as in sixth form at least I was actually on first name terms with two of my teachers.

In answer to her question, anyway, I said that my “work” with C had been largely of a psychodynamic bent hitherto, but that he now wanted to try DBT as well..  I’m not sure whether I brought it up or whether it was her sensing my cynicism but in any case this led on to a discussion of how I felt the DBT material was patronising.  I did tell her that I felt there was some useful stuff, but that it just seemed to me to be CBT in disguise and that that had not in any way worked for me.

I was quite annoyed, as she seemed amused by my annoyance at this type of therapy.  She has the most punchable face I’ve seen outside of TV in many years.

Basically, the long and the short of the meeting ended up being that they want to discuss my case in full with “Dr J” because at present they only have a brief referral letter from him.  In the meantime, Dr C has suggested cutting my dose of Citalopram from 40mg to 20mg.  This seemed odd to me, but to be fair her rationale was reasonable: if it is really not helping as I believe, reducing it will mean that I will see no marked deterioration in my condition when I next see her (in three or four weeks, apparently).  If I am mistaken and that it actually does do something, then I will feel even worse.  I agreed to do this, and for her part she will go off and talk to C and, between the three of them, they will “see if they can do something to help”.  At this point she finally smiled, and I think it was genuine.

I still hadn’t had the chance to show either of them the list of symptoms I’d spent so much time on yesterday so I made sure to give it to Dr C before I left.  She accepted it with thanks and did acknowledge that it can be hard to articulate oneself verbally, especially in unfamiliar and/or formally conscribed situations.  Then she actually volunteered the view that the sheet could be “very useful” and said she would peruse it in detail.  Then Dr N showed me out, saying that I would get a letter regarding the next appointment probably within the next week, after they have spoken to “Dr J” (this was annoying as Dr N had called him C, not Dr J, whilst we were alone and until Dr bloody C got involved.  Why couldn’t she have kept it that way?).

All in all as I write this, it doesn’t seem as if it was that bad and I think that I really should be grateful that at least they are willing to progress my “case”.  Dr C doesn’t seem, on (electronic) paper, as bad as I felt she was.  Perhaps detailing it here is cathartic because I feel a bit more positive about it now.  But I left the place with a very heavy heart.  As I was driving back to A’s along the motorway, I toyed with the idea of driving into one of the huge pillars that holds up one of the many bridges along the route, or even into the articulated lorry in front of me.  I quite deliberately broke the speed limit several times with this intention in mind.  As ever the only thing that stopped me was the horror I felt at the potential of having Disraeli, my car, written off.  My car is more important to me than my life.

As Twitter readers will know, after perusing the DBT material from C last night I reacted with some anger.  There are some fair points in it, but a lot of it is condescending rubbish, particularly the authors’ need to always exemplify their points.  I am not brain dead.  I understand the concept, fuckheads.  Really, I get it.  You do not need to explain it by telling me how fucking Sandra or cunting Ronnie, who don’t even exist, behaved or reacted.  I have annotated the sheets to this effect and will have no problem showing the remarks to C.  But then this makes me feel guilty and sad.  I don’t want to dampen C’s enthusiasm and I don’t want him to abandon me.  He knows me better now than to suggest something so apparently wholly inappropriate, doesn’t he?  He must really feel it’s worthwhile.  Perhaps I should just put my scepticism to one side and give it all a go, just like he told me to do.  As I told Dr C today, things have got to the stage where I’m willing to try anything.  If something doesn’t work soon, I’m either going to top myself or get sectioned.  So I will try and approach this DBT with as positive an attitude as possible, I suppose.  It’s just that everything is so hard and it’s all getting on top of me.  My new worry is seeing C on Thursday after the shrinks have spoken to him.  Will they tell him some of the more bizarre stuff, such as the shapes?  How will he respond?  More importantly, why the sodding hell do I care?

Meh.  I don’t get myself at all.

Today with C was weird.

We started by discussing the situation with the psychiatrist.  Apparently C had been blissfully unaware of the whole fuss surrounding the referral from Lovely GP, despite the fact he (C) had also made a referral.  He said he had contacted someone at the main asylum in Norn Iron but she had called his secretary and said she was re-referring me to someone closer to my home.  Indeed, tomorrow’s appointment is at the closer location.  But C was surprised that he had not heard that there was so much to-ing and fro-ing from the stupid twats in the same way Lovely GP had.  Anyway, he is glad that it has been arranged.  He feels that ultimately psychotherapy is more important than medication, and he is probably right.  However, he does feel that medication is not an insignificant element of treating my condition(s), especially when the tablets I’ve tried to date have thus far been so ineffective.  So yay psychiatrist.

During my rant about all the pillar-to-posting with the shrink, I alluded to having gone mental a couple of times since I’d last seen C.  Naturally he probed me on these matters, so I told him about both this and this.  He quizzed me on the self-harm; how did it make me feel at the time (relieved, and proud of my cuts), how I felt afterwards (indifferent as regards myself, but horrified that I’d upset others) and how I felt telling him about it (that I couldn’t really see the big deal – it helped me feel slightly better at the time, wasn’t that a good thing?).

C monologued for a while on the cutting issue.  He accepted that it is a release and talked about the various reasons I, and others, might engage in it.  He asked had I done it before.  I replied in the affirmative, but it was back when I was a teenager.  I was a very prolific cutter at the time.  He enquired as to what I had cut – random cuts, words, what?

The answer was that if I was feeling especially distressed or in a frenzy like I was on the night of the concert,I just randomly slashed my arms or wrote random sware words, especially “fuck” and “cunt”.  But if I was feeling a bit more measured, it was stuff like “bitch”, “twisted” etc, in reflection of my feelings and beliefs about myself.  I also mourned the fact that my scars of the word “Freddie”, carved in homage to Mr Mercury, had faded completely.  I was pretty proud of that one.  After all, it took ages to carve, and he was the frontman of my favourite ever band.  I viewed it as more of a tatoo on the cheap, I suppose.

In conjunction with this, and my vicious self-denigration over being off work (as it was this that set off the recent cutting episode), C said I was looking for ways to put myself down.  I laughed in his face and told him about my self-vilifications over not speaking out over the sexual abuse at the hands of Maisie’s husband.

Most of the rest of the discussion centred around this.  C seemed taken aback that every time I visit the various elements of the McFaul clan that Maisie’s husband is there.  He took the view that of course this was going to fuck me up.  As I told him though, my anxieties about seeing that branch of the family are rarely, if ever, consciously about him.  I accepted that perhaps there are a lot of subconscious forces about him driving the anxiety, but they are almost never at the fore front of my mind.  Or at least they weren’t until recently.

C asked if I realised that if I were to disclose Maisie’s husband’s name to him he would be bound to report it.  “Yes,” I said.  “That’s why I’m not going to do so.” He asked why I did not want to bring it out in the open.  I have already discussed the issues here and here, so I will not engage in unnecessary repetition by rewriting them here.

I felt a bit sorry for C.  He understood my reasons for not wanting to make this issue public, which is more than I can say for some previous therapists.  He seemed to so much want to help me find a workable solution to my concerns over Marcus.  For instance, he asked if I was on good terms with Marcus’s parents.  I’m not friends with them, but broadly speaking I get on with them (especially the mother) fairly well, insofar as it is possible to get on well with any of that family.  So C asked could I not have a ‘quiet word’ with Marcus’s Mum.

Of course I can’t, because to tell her would be to tell them all.  Maisie’s husband is her grandfather, for whom she apparently has the greatest love and respect.  The only circumstances under which she’d believe me would be if it had also happened to her, but I don’t think it did.  Her affection for her grandfather is very clear to me.

So I told this to C, who accepted the point.  His efforts to solve the problem may have been in vain, but at least he did try, so I am thankful for that.  I said I would ring the NSPCC but then when he quizzed me on what they may or may not do, I said that the discussion was in fact pointless because I am such a useless, cowardly cunt that I will probably not do anything at all.

Needless to say this further showed C my endless capacity to blame and criticise myself, as if any further demonstration of that was fucking necessary.  Basically he said that when I have self-critical and self-hateful thoughts I should just let them exist.

“What?” I asked.  “Just sit there and let myself agree, rather than try and talk myself out of it?”

“Well, that doesn’t work, does it?” he replied.  “The point is, just let it be.  It’s just a thought, let it be just a thought.  It’s there, don’t confirm or agree with it and don’t refute it either.  Just let it exist in the moment.”

“Well, that’s nice, C, but how do I stop overthinking it?”

“It’s a skill,” he said.  “You learn it over time.  It won’t work at first and you won’t take it seriously, but over time you can develop an ability to let it just exist.”

This all sounded like bollocks to me, which I think he could see.  So then he continued:

“We need to think about some practical solutions.  It seems to me especially from today that you have severe difficulty controlling emotions that you experience particularly at times of stress.  They become overwhelming for you.”

I agreed, but opined that it was impossible to stop oneself getting into a maniacal panic just like that.

“I have a book,” declared C, triumphantly.  “It’s a workbook that you could use, with some very practical solutions.”  He went to his desk, picked it up and handed it to me.

My heart fucking sank.  It was about Dialectical Behavioural Therapy and included reference to Mindfulness, both of which I had already discovered on the internet (incidentally, he knows I know about them.  He knows I try to develop some awareness of all types of psychotherapy and guessed I’d already discovered these two).  I had actually blocked someone on Twitter who kept wanking on about Mindfulness because it sounds like a complete pile of fucking shite to me, just like DBT.  To me, they both sound like more elaborate versions of CBT, which I found to be a complete pile of nonsense.  C is aware of that.

Evidently he detected my skepticism.  “Look, we have to take a pragmatic approach,” he sighed.  “Some of it will seem basic to you ['patronising' is the word I'd have used], but just read it and try it, then over time we can move on to the more advanced stuff.”  He did say that if it doesn’t work in any meaningful way we could re-evaluate things, but essentially only after I’ve given it a chance.

He went on to remind me that intellectualising our sessions was something that was mutually attractive, but nonetheless something that needed to be avoided.  He said, “you’d be interested, intellectually, in a more psychoanalytic approach to all this, but we can’t let it become just about intellectualising.  Psychoanalytic therapy may uncover stuff, but it won’t solve problems in the here and now on its own.”

I asked him if he thought our therapy had become something of an intellectual discussion.

“No,” he said.  “I actually don’t.  And I don’t think we should drop our freeform psychodynamic discussions either.  But I do think we should devote some time each week to these more practical approaches.”

I agreed to take some photocopies of the book and work on them before next week.  A quick glance through them seems to confirm my feelings that it is rather condescending in places, but there are some useful things I suppose.  For example, and C drew particular attention to this one, if I go mental and want to cut, it suggests you hold ice cubes against yourself instead.  It still causes intense and abrupt pain, but there is no lasting damage.  I’d heard about this elsewhere and dismissed it – who the fuck has access to ice cubes everywhere they go?  At least knives are found the world over.  But then this is unfair.  Frozen peas or something could have a similar effect.

I also showed him the mood chart to which a nice Twitter friend directed me.  C had seemed excited about the book, and his interest seemed considerably piqued by this too.  He felt that perhaps the left hand column was slightly redundant as (as yet) I only take sleepers and anti-depressants (in relation to madness, anyway) and it deals with anti-psychotics, Lithium etc.  Actually he felt in general it was a bit convoluted, though I did tell him I thought the lines on the right hand column were potentially useful as they provide a graphical representation of one’s madness on a day-to-day basis.  So his plan is that we formulate our own mood chart together next week, which may hopefully help me to work out patterns and triggers.

So as I said, today was weird.  The discussion was a lot more two-way than normal, and although it seems odd to have been offered a chance to explore practical solutions, after 11 weeks of psychodymanic-ish discussion, it is potentially useful to learn techniques of madness-management.  I am dubious about DBT, but I will try and follow C’s advice by being pragmatic and keeping an open mind.

An aside: DBT is a therapy devised for BPD (though I suppose in fairness it can translate to other mental illnesses).  If C thinks I have BPD, why didn’t he just tell me that when I asked him directly what, in his clinical opinion, was wrong with me?  I know he’s not qualified to make diagnoses, but it was an informal question.

Oh well.  At least he’s doing something, and at least he seems to be thinking in a long-term way about my psychotherapy.  At least he still wants my input and I do trust him to listen to me if I voice the view that, after giving it a chance, I think all this is a load of cack.  Maybe A and D will see his value now!

This afternoon’s plans: write list of problems for the psychiatrist and try not to catastrophise about the psychiatrist.  Hurrah!  Post-mortem tomorrow as ever, I’m sure.

(NB: I’m sure you all realise this, but the dialogue between C and me as detailed above was almost entirely paraphrased.  I can’t remember all the exact words, naturally.  I’m just paranoid that I will be done for slander if I make out our conversation followed the literal routes as outlined above.  Reassuring to know I’m still crazy, then!).