In all seriousness I don’t really expect it to do any good, but you never know.  A friend of mine, through contacting her MP about the failures in her mental health care, did receive some very positive results, so it’s got to be worth a try.  At the very least, it’ll shake things up with C and Mr D-P

This will probably be a little repetitive if you’ve read my post on my history of therapy and if you’ve been following the Mr Director-Person series.

Dear Mr MP

Re:  Access to Mental Health Services, [My] Trust

I am writing to you as a constituent hoping that you will be able to assist me in accessing NHS services to which I am entitled for several serious mental health conditions. I am diagnosed with borderline personality disorder (BPD) and complex post-traumatic stress disorder (C-PTSD) with psychotic and dissociative features as well as clinical depression and social anxiety, and have been ricocheted around both the NHS and private systems since about 1998 when I was 14.

It is clear to me that the [My] Trust, in its approach to my mental health problems, is placing me at serious personal risk by refusing to offer me adequate treatment. In order to explain the situation, I feel that it is necessary to provide some background information and catalogue a series of NHS failures which have led to the dire situation in which I now find myself.

At about the age of 14, when I first experienced notable mental distress, I was referred to a counsellor whom I met only once. Some time later I was referred to a trainee (child) psychiatrist that I met several times; however, when she left to take another job, I was left without any support whatsoever. Several years later, after having severe difficulty pursuing my schooling, I was referred to [C's] Hospital for a psychological assessment, but was regarded by the assessor with open contempt and was not referred for any therapy or psychiatric care whatsoever.

However, with familial support I was able to somehow manage to go to university, during which time my mental health issues were relatively stable. Unfortunately, though, I had a major breakdown in 2007 during a Masters course, meaning that I had to leave my course with a diploma instead. Upon consultation with my GP, I was referred for an assessment at [Big Scary Bin]. Eventually I saw a psychiatric nurse who referred me for group Cognitive Behavioural Therapy (CBT), but given the lengthy waiting list for this, I saw both a psychologist and hypno-therapist in the private sector. Thanks in particular to the latter, I was able to return to a part-time job.

I was subsequently contacted by [Big Scary Bin] regarding the group CBT sessions, but unfortunately these clashed with my morning job. I asked the individual that had contacted me if it would be possible to arrange an alternative time, and he confirmed that afternoon sessions were available on a one-to-one basis, though the waiting list for this was much longer. I agreed to wait for these individual sessions; however, I was never again contacted by anybody in relation to this matter.

On 4 August 2008, after having battled against a major depression in my job (which had since become full-time), I broke down completely and had to go off work. I have been off work since. My condition was so bad that my GP sent out a Crisis Resolution Team (CRT) to my house, a referral only made in serious circumstances. Unfortunately I was patronised and all but openly derided by the CRT, who left claiming that they would, again, refer me to a CBT therapist.

Knowing how long the waiting lists for this were likely to be, in the interim period I consulted a CBT therapist in the private sector and saw her for several months. Although we had a good relationship, the cost of the treatment – for someone absent from work in particular – was prohibitive, and furthermore unfortunately CBT as a therapeutic modality simply did not help me at all. At this point it was considered that I was suffering from depression and anxiety ‘alone’, for which CBT is often an effective treatment. However, as was later determined, I also have BPD and C-PTSD, for which CBT is generally not empirically proven.

During a routine appointment with her Nurse Practitioner in late 2008, my mother found out that the CRT had not made any referral in my case as they had claimed they would. The Nurse Practitioner therefore referred me herself for an assessment at [C's] Hospital.

In January 2009, my GP also referred me to a psychiatrist.

On 29 February 2009, I first met [C], a clinical psychologist at [C's] Hospital. After three assessment sessions, [C] decided that an alternative approach to CBT would be appropriate and offered me the opportunity to keep seeing him specifically. I accepted this and, for the first time, I have found the relationship and the work conducted therein to have been of genuine benefit. As of the date of this letter, I have had 59 sessions with [C]; although since three of these were preparatory assessments and four are designed to facilitate the ending of the treatment, this amounts to a year’s therapy.

In May 2009, I was finally seen by a consultant psychiatrist (after a number of follow-up calls from my GP, and an additional referral from [C]). After assessment I was diagnosed with BPD (with a differential diagnosis of bipolar disorder, type II).

Research literature (and, indeed, my care team) is generally agreed that the treatment for BPD consists of long-term psychotherapy, of a minimum of 18 months – preferably twice a week (my therapy is once weekly). Medication can help manage certain symptoms such as depression and psychosis (in my case hallucinations), but therapy is considered the mainstay of treatment for this disorder. I personally know several individuals in other Trust areas that have received therapy for the same or similar ranging from two years up to over four.

Despite this, however, I was told by [C] in December 2009 (shortly after I lost my job due to my long-term absence) that he could only continue seeing me until August 2010. When I protested that longer-term therapy than what he was proposing was required, he agreed, stating that unfortunately certain constraints inhibited his ability to offer longer-term therapy, and said that he would support any complaint on my part. To that end, I wrote to the local mental health charity, Mindwise, and to the [My] Trust’s Director of Mental Health, [Mr Director-Person].

Unfortunately Mindwise dismissed my concerns, but [Mr Director-Person] did reply and I have been in correspondence with him since (copies enclosed). However, he has to date point-blank refused to allow my treatment to continue longer than the currently proposed timeframe, despite the inadequacy of the treatment the Trust is offering and the apparent postcode lottery that appears to permeate mental health care.

The Trust’s approach is in contravention of both personality disorder guidelines from the National Institute on Clinical Excellence, and the Northern Ireland Personality Disorder Strategy of June 2010. Although both recommend specific therapies for illnesses such as BPD (such as Dialectical Behavioural Therapy, Transference-Focused Therapy, and others) they also state that in the absence of facilities for same, more ‘generic’ therapy of the type I am presently receiving and finding useful should be provided.

In March 2010, my consultant psychiatrist (a different person from the one who diagnosed my BPD) felt that I was also afflicted with complex post-traumatic stress disorder (C-PTSD) as a result of significant trauma in childhood. This illness is similar to but distinct from BPD, and psychosis and dissociation are common in both. Unfortunately, exploring the traumas in therapy – something I was only able to do properly in about March 2010 owing to considerable defence mechanisms and even amnesiac elements surrounding the issues – has left me thoroughly re-traumatised (as well as strongly suicidal, depressed and anxious). Whilst I accept that this is an inevitable part of therapy, the problem is that a matter of mere months is simply not adequate to help me to deal with and get over not only the original traumas, but this level of re-traumatisation. The re-traumatisation has caused even more severe flashbacks, serious hallucinations and considerable dissociation, including but not limited to my ‘waking up’ in places without awareness of how I got there.

[C] and my psychiatrist, [NewVCB], have proposed discharging me to a community psychiatric nurse or a social worker upon the cessation of therapy, but no one has been able to tell me what these individuals do, how they could help me in resolving and managing my current difficulties and traumas, and how this can be considered an adequate substitute for continued psychotherapy. It is my belief, supported by academic literature and research, that the best person to give me any chance of recovery is a qualified therapist such as [C].

The struggle with the Trust’s uncooperative and frankly negligent approach to my condition has in fact contributed to the worsening of my mental state, exacerbating feelings of worthlessness and despair. The Trust provided a good, functional relationship with a competent therapist but is now determined to terminate that relationship unreasonably whilst providing no adequate replacement treatment.

As this letter has detailed, it took me over 12 years to meet a therapist that I felt could genuinely help me, and I feel it is not unreasonable of me to wish to continue with this helpful work, particularly in light of the problems the health service has produced in the past. Furthermore, I am all but certain if I am discharged from therapy now, that I will merely be referred – perhaps more troubled and traumatised than ever – in the future, which will not do anything to save health service costs. Finally, as I am still unable to work, the public sector is not in any way saving money by discharging me prematurely from therapy; if my work with [C] were allowed to continue, I believe that I could return to work sooner than otherwise, thus saving public sector funds in the long-term.

I am convinced that a discharge from treatment when one is in a worse state than when that treatment commenced would not happen in the realm of physical health, where conditions are treated until they are either cured/remitted or can be adequately managed by the patient alone. The lack of resources of the [My] Trust should not be translated into inadequate care for the mentally ill. It should not be forgotten that approximately one in four people will suffer from some form of mental illness, whilst only 5% (source) of NHS funds are directed towards resolving these issues.

In conclusion, I am asking you as my political representative to assist me in accessing the psychological treatment that I desperately need, and to which under the various guidelines and indeed the very ethos of the NHS I am entitled. Should you require further information on how my illnesses impact upon my everyday life, I should be happy to provide same. I am sending you this letter both in your capacity as my MP and as an MLA for my area. I am also copying this correspondence to other [my constituency] MLAs and to Michael McGimpsey in his capacity as Health Minister.

I understand that after my mother (and registered carer), [her name], contacted you regarding the provision of mental health services, you were very helpful in the matter, about which I am greatly encouraged. I would be very grateful for your prompt attention in this matter, especially as I am due to be discharged from my treatment at the end of August.

Thank you very much in advance for your time and assistance.

Kind regards.

Yours sincerely

Me

Encs

BY POPULAR DEMAND, AND FOR ONE POST ONLY…

CONFESSIONS OF A SERIAL INSOMNIAC BRINGS YOU...

THE
NEXT
THRILLING
INSTALMENT
OF

C

WEEK 57

CUE LA MUSICA DRAMATICA:

(Anyone that gets the aural reference gets a gold star.  I think I’m looking at you, Karita… )

This post follows on from the extraordinarily thrilling events detailed here.  The following may make no sense if you have not read them.  It may also may no sense if you have.  Then again, they were so tremendously exciting that if you read or have read them, you might die of a hedonism-induced heart attack, so proceed with caution.  Alternatively you might die of a boredom-induced heart attack so, again, proceed with caution.  If you really must read this pointless wank, be prepared to be blown away in amazement by my inspirational transcriptional crafting and the thrilling nature of the fabulous material contained herein.  Either that or expect to find a cure for chronic insomnia.

[The Scene:  C has just admitted to Pandora that it is inevitable that, as he has worked with her for some time, he cares for her in some way].

This should have set a fire of joy off in my heart; he was effectively telling me that he cared, in whatever way his profession allows, about me.  But I was too depressed, suicidal and fixated with his abandonment of me that I didn’t care.

Eyes firmly ensconced towards the floor, I made some noise of response suggesting that any response on his part was purely professional.

“Have these things been on your mind recently?” C queried.  I suppressed a laugh.  What a stupid fucking question to ask.  As if there’s ever anything else (other than suicide, I suppose) on my mind!

I shifted uncomfortably in the seat, and sat silently.  Eventually, whilst still avoiding his gaze completely, I nodded subtly.

“You’re frightened about how I’ll respond to what you want to say,” he said, proving once again his innate and remarkable aptitude for Stating the Fucking Obvious.

You know, at the time I didn’t make the connection.  Now, as I write this, the question seems slightly out of place with my refusal to admit to my suicidal ideation, and much more connected with my perceptions of what he felt about me.  Therefore, it seems he thought that the thing I wanted to say was that I am obsessed with him and want him to like and take care of me.  He’s bound to know that, is he not?  Why do I have to go through the affront of being forced to admit that verbally?  In this particular instance he was wrong.  I was considering telling him that I’m stockpiling medication.  Of course, whilst this is true, was my game-playing of telling/not telling him an avoidance technique to avoid telling him the rest?  Or was it, as I later denied, a “cry for help”?  Who knows.

Anyway, I told him that I didn’t want to discuss the matter with him, but he tried to point out that there were bound to have been things in the past that I had not wanted to address, but when I had, they were not as bad as I might have supposed.  Even though I couldn’t think of an example, I admitted that this had probably been the case at some point or another.

I listened intently to the progressively annoying rhythmic ticking of the clock throughout the ensuing silence.  At least the arseholes from the corridor had apparently been diffused (hopefully literally).

“It must be tricky to be in this position,” said C eventually, but I chose not to respond.  After a few minutes he went on a bit again about how I felt about him and what he thought about me, so he clearly thought – or, as he later proved, merely appeared to think – that everything I was hiding was related to this issue.

“So what if it’s tricky?” I asked mournfully, resenting the fact that he was making me more and more miserable – and, what’s more, visibly and verbally so – than I had been.

“I’m just putting that out there,” he replied.  I hate this fucking phrase of his.  Just say what the sodding hell it is that you want to say, C, please!  You’re the one that gets paid to have these fucking conversations, you need to do some of the fucking work here!

I ignored him, but was stunned – utterly stunned - when he said, “this goes back to what you said earlier about being homicidal or suicidal, doesn’t it?  Maybe you feel that you’re the cunt and that you may as well kill yourself.”

I looked up in a flash and gawked at him.  ”My God, you’re good,” I said, laughing in surprise.  I’ve said it before and I’ll say it again: he doesn’t just look (a little bit) like Derren Brown.  He’s a fucking mindreader too.  Just when I thought he was felt that my thoughts were related to something completely different, he jumps in and works the dirty little enigma right out.

He appeared to be surprised that he had read my mind, and asked in what way.  I admitted, finally – and before I could change my mind – that I was stockpiling pills.  He asked which ones, and I said anything on which I could get my hands that I knew could be lethal in overdose.

Then I said, “have you ever seen a film called The Bridge?”  [I have become obsessed with watching this disturbing but very human masterpiece in the last fortnight or so, and would heartily recommend it to everyone].

“No, but it’s on my to-see list.  That’s the one where people jump off the Golden Gate Bridge, right?”

“Yes.  Watch it.  It’s good.”

“You saw it recently?”

“Yes.  I was actually on the Golden Gate Bridge a few years ago,” I went on, sighing.  ”Unfortunately I was moderately sane at the time and didn’t consider jumping from it.  That was a mistake.”

He asked how long I’d been stockpiling for.  I wasn’t sure exactly but reckoned it was months.  I told him I’d become fixated with the film as I was fixated with suicide and that when I finally watched it, it was ‘beautiful’ (even if a jumper’s death itself is not the most pleasant).

Only 2% of jumpers have survived the leap from the Bridge.  C asked if any of them had been interviewed in the film, and as fortune would have it, one man with a severe form of bipolar disorder actually had been.  C was obviously hoping that this bloke would say he was glad that he was not killed.  As it happens, that’s exactly what he said, though I was cursory in my admissions of this to C.

In a later but related rant, I pointed out that stability in my life has been found on some occasions.  However, it’s only ever for a few months…maybe a few years if I’m exceptionally lucky.   The guy who lived to tell the tale of plunging into San Francisco Bay regretted jumping as soon as his hands left the railings, apparently, and was subsequently glad to have lived.  But…will he always be thus glad?  What happens if and when he’s back in the throes of the deepest, darkest, cruellest recesses of the human mind?  What happens if, for instance, his voices return, and order him to kill himself?  What happens, in general, if and when his stability is once again lost?

I wish him well, and hope that he doesn’t experience any suicidal ideation ever again, and I also hope he never has any reason to.  But in my own case, I don’t believe I can ever be cured, and indeed the whole ‘retraumatise-abandon’ issues of therapy’s closing weeks have led me to believe that I am going to be so badly traumatised all over again that a state where I can adequately manage my mentalism can never be attained.  Why bother, I philosophised to C, when it always comes back to this?  It’s a pointless, fruitless little dance of abject, round-the-fucking-mulberry-bush misery.  Why bother?

I went on to tell him about an interview in the film with the parents of a ‘successful’ jumper, the content of which mesmerised me.  The father said, his wife nodding quietly in agreement, that although they obviously missed their son very much and regretted that his life had been so marred by misery, they had a “who are we to challenge this?” attitude to his suicide.  They honestly felt that if his life was so unbearable, that it would have been selfish for them to have tried to keep him alive.  The father said, “some people talk of their body as a temple.  [Their son's] was a prison.”  Their mature selflessness, their humanity, brought me to silent tears.

“That’s an attitude that I think could be wisely fostered by many people,” I said.

“So, regarding you stockpiling these pills, you think I should just say, ‘OK, fair enough, kill yourself if you want to’, is that it?” he asked me.

“Maybe, but it wasn’t really you that came to mind when I regaled you with that story.  I’m more thinking about my mother.”  I exemplified by telling him about the third conversation detailed herein.

“Have you thoughts of actually taking these pills?” he questioned.

“Yes.  I am planning to do so, but not imminently.”

“You’ll be here next week?”

“Yes, unless something dramatic happens.”

“Where has this come from, Pandora?”

I considered the question briefly.  ”That fucking poison Venlafaxine doesn’t work,  this [therapy, a relevant gesture denoting his room] hasn’t work, isn’t being allowed time to work – I’m at least in the same mental position I was two years ago, and indeed it’s probably worse.”  At this juncture I went into the aforereferenced “what’s the point?  It always comes back to this” rant.

“This isn’t a life, this is an existence,” I declared (one of my favourite phrases, it seems).  ”That’s always been the case, but I had some tiny semblance of hope, quantum as it may often have been.  I don’t even feel that anymore.  Only a handful of people would miss me anyway, and what they don’t even realise is that they’d be better off without me.”

He asked how long my suicidal ideation had been building for, and I concluded it was since about April, which is when I started collecting prescriptions.

“If you take a massive overdose, you do realise you’ll be given your medication weekly,” he said.

“Of course, but that assumes that I awake from said overdose, which I have no intention of doing,” I responded in the blink of an eye.

“Are there times when you haven’t felt this way?  These thoughts seem especially strong of late.”

“I can honestly say that, in – oh? – the last 20 years, I think, there hasn’t been a single day that I haven’t thought about suicide to one extent or another.  I remember telling that to A once, and he said he couldn’t conceive of it.  I said that I couldn’t conceive of it not being the case.”

C annoyed me again by telling me that I am, he thinks, an expert in Not Killing Myself.

Right on, C.  What you don’t seem to realise, mate, despite my having already intimated the relevant information to you, is that I’m also an expert on not not killing myself.  There’s at least one newsgroup out there in the ether that details exact ways to do it (peacefully), and I am now intimately acquainted with the methods described therein.  In fact, there’s also at least three published books on the same issue – two get away with it by pretending they’re about euthanasia in the cases of terminal physical illness, but one is really open about having a pro-choice attitude towards topping yourself.  I have a copy of the latter.

(Actually, it’s a very interesting book to read even if you’re not intent on doing yourself in ((assuming you have some sort of interest in psychology, sociology, anthropology or any other -ology that takes an interest in the comings and goings of human beings)).  The first part of it, before the ‘methods’ section, includes quite a comprehensive consideration of suicide and suicidality as a societal phenomenon.  Much better than Emile Durkheim’s unbearable dirge on the same subject, though to be fair the whole approach is rather different and about 100 years more relevant).

Anyway, my feelings on suicide are meant to be for another post – one that is in the making, I promise.

I said, “it’s not through want of trying,” but the smug git instantaneously batted back with, “well, you don’t try to kill yourself every day.”

He cocked his head at me and said, “look, I take what you’re saying, I get that you feel this way.  I just think you must be fairly resilient as well.”

I laughed bitterly at him and proclaimed ‘resilient’ to be “not a word I would use to describe myself.”

And then….

Nothing.

Except…

Tick, tock…tick, tock….tick, tock.

I wanted to turn round, pull the offensive object off the wall and throw it out the window with a brute force seen only during absolute, unquantifiable rage.  Or maybe I could have considered throwing it at C’s face; that could have been an attractive option at points.  With the clock’s infuriating bloody tick tock mantra, I could hear my time with C ending, those few precious weeks disappearing down some cruel wormhole of time.  C rubs that finity in my face, NewVCB rubs it in my face, Mr fucking Director-Person rubs it in my face, and now even the bastarding clock thinks it is funny to rub it in my face (or, more specifically, eardrums).  Thanks, world.  Thanks so much, you fucking cunts!

After 17 super-eons (OK, there’s a considerable surfeit of casual cosmological terms in this post, what the fuck is that about?) he eventually said that perhaps I felt I was being left alone to deal with all this stuff.  I smiled cynically in response.

Wow, look at Einstein over there.  How insightful, C, that’s brilliant.  Well done.  Get out the champagne, my friend, because you have just come out with the psychological equivalent of the general theory of rela-fucking-tivity.  Or perhaps it’s something akin to the very first tentative bold but wise suggestions that the Earth was not, in fact, flat.  WELL. DONE. C.

“I’m used to that,” I whined.

I paused, then whinged for a few minutes more about how contemplating suicide was very comforting and liberating.  ”You know,” I said.  ”To know that you don’t have to put up with it any longer, to know that at any point you can just go, ‘fuck it, cheerio existence’.”

“Hmm, hmm,” he responded.

For some reason the ‘hmms’ enraged me, and I said, challengingly, “you don’t think I’m going to do it, do you?”

“That sounds like a dangerous mindset to get into,” he replied, furrowing his brow.  ”It’s like you think that for me to take how you feel seriously, you have to do something, such as taking an overdose, to make me believe…”

(Well, actually, asking for your help hasn’t fucking worked, so yeah, I could see how I might think this, as it happens.  STFU).

“I’m not trying to make a point to you,” I interrupted, shaking my head vigourously.  ”I just don’t think you think that I’m going to do it, and I am.”

He went off into a monologue in which he opined that he doesn’t think I have sat down and said, “right, let me make a point to C here…ha ha, I told you so,” but that I have, barely consciously, concluded that this is “the only way [I] can communicate how [I] feel”, and that the only way in which he will “actually understand” me is by my “showing it”.

“You see,” I sighed, again shaking my head at him, “you’re fixated on the idea that I want to communicate something.  I don’t want to communicate something.  I don’t want to exist.  That’s what I want.”  (Or rather don’t, I suppose).

Thinking that he was probably wondering why, then, I had bothered to communicate this information to him, I said that I was only telling him about it because he had already worked it out with his Derren Brown/Mysterion-like powers of mental deduction.  Which, although the matter had been floating around in my mind throughout the session, was sort of true.  Intellectually, I always knew I should tell him, but as already discussed, I really didn’t want to.

“What’s that like for you?  That you feel I’m not taking you seriously?” he asked.

“It doesn’t particularly surprise me,” I responded, in what might have been a slightly pompous, dismissive tone.  Just maybe and just slightly…hmm.  Then, “everybody thinks it’s a ‘cry wolf’ issue.”

He said, “so what did you think I was going to say?  Sort of brush it off and say, ‘oh never mind, she won’t do it’, or what..?”

I smiled cruelly and said,  ”I expected you to say, ‘maybe you should phone the Samaritans’.”  I laughed slightly at the idea, of which he had previously been a proponent.

This remark, to my considerable surprise, seemed to cut him to the bone, to the extent that, despite my palpable wryness at this juncture, I actually felt guilty.

C sighed and said, apparently very earnestly, “I hope I take you seriously – well, I do take you seriously…I hope you feel I take you seriously.”

“Is that a question?” I checked, and he nodded uncertainly.

Overcome with my own guilt, I said, “I do, yeah.”  Which is mostly the truth; I just get so frustrated at the difficult circumstances under which we presently find ourselves, and end up remembering every little thing he has done to piss me off.  In general, it is not my held position in the least that he patronises or dismisses me, and it was indeed cruel, by dent of my underhand Samaritans comment, to suggest otherwise.

“Look, I just wonder if the fact that I’ve actually bothered to tell you this means that you think it’s indicative of it being some silly cry for help, which it isn’t,” I told him, trying to be as nice as I could about it.

“That suggests that wanting help is silly, which I don’t think,” he told me.

“Let me rephrase, then.  What do they call people like me in general…manipulative?  Attention seeking?  Some other pejorative nasty referencing how annoying I am?”

He ignored the latter part of my statement and replied, with enraging reasonableness, that “I see it as that someone who is in distress quite justly wants or needs to be attended to”.

I looked away, unable to think of a clever comeback, and listened to the sodding, cunting, fucking, bastarding clock ticking away the last few seconds of my time with him that morning.

“We’re going to have to finish for today,” he predictably told me in due course.  ”But this is something for us to be looking at [oh, really?] and for me to be taking seriously with you.  I’ll be bringing this back up next week [oh really? x II].”

“OK,” I nodded, and I went to leave.

He stopped me from going however, which – as noted on the only other occasion that I remember him doing it, not that I can be arsed looking for the link right now – suggests that he is actually worried about my state of mind.  I suppose having had me just confess that I have a lethal amount of pills that I fully intend to ingest might just create such worry, to be fair.  Though it is only professional concern, I remain convinced.

“The most important thing for now,” he started, “is that that you’re saying that you don’t have any plans to enact this lethal act today, or in the immediate future.  You’re not going to do this now.  You will be here next week?”

“I have a date in mind which is not in the next week,” I confirmed.

He looked visibly relieved, though I suspect that is only in relative terms.  I tried to smile reassuringly, but I’m not sure I succeeded.

I was still alive for the next session, about which I hope to write soon, and during which I apologised for the laughable histrionics about which you have just read.  It sounds so pathetically childish and self-absorbed as I read it back, but then in thinking that I am betraying my own position on suicide, which is that it is not a per se selfish act.

For those of you convinced that I’ll be dead shortly, please don’t worry.  I told A on Friday night that I’ll try my best to remain alive until such times as a natural or accidental death is forthcoming, and that’s about as big a reassurance as I can give.

There’s very little of amusement on which I can end this.  So I’ll just take the finality of this post out of my hands  [Warning: do not view the embedded video if you are overly PC, offended easily, have a sense of humour that is not sick or twisted, yadda, blah, meh, gah, la, da, de, wah, etc]

Click here to view the embedded video.

I was bricking myself about this session with C, after his apparent transference-related realisations at the end of the last meeting.  I don’t want to tell him I want him to hold me, stroke my hair, soothingly kiss my forehead and softly whisper protective words in my ear.  I mean, who would want to reveal such intimate and one-sided desires?  I was totally dreading having to verbally enunciate such material, but in the end – although C made some references to the transference issues at points – I was successful in dodging much of it.  Result.  (Except that it’s not, of course, because presumably this is necessary discussion.  But, in the short-term, this worked very nicely for me).

However, we did end up having a protracted and painful discussion about something else – suicide.  Of course, we have certainly discussed this thoroughly in the past – but, shit suicide attempt in January excepted, this was the first time that I did more than just allude to it as a concept; I actually told him in depth that I had plans to do myself in.

First, however, I had house-keeping matters to deal with.  I was mortified to ask if he would provide me with a letter for the DLA people to confirm that I had been seeing him.  Now I’m mortified that I was mortified.  I should not be ashamed of being on state benefits, because I am claiming for genuine reasons – it’s not like I’m really some sort of shit dolescum twat.  Simultaneously, I hate being a claimant and find it an immensely degrading place in which to be, and it’s bad enough thinking about that myself, never mind having to remind someone that I all but revere of the fucking matter.  In fact, so disgusted was I about bringing it up that I was really quite disparaging about my claim.

I told him that the woman at the CAB had advised that, in light of my declaration of my C-PTSD diagnosis, C should note as part of the claim that I was seeing him, in part, to address trauma issues in the aftermath of child sexual abuse.  ”I don’t feel entirely comfortable with acknowledging that to the Social Security Agency,” I said, “but that’s what she advised.”  I shrugged, resignedly.

I went on to point out that acknowledgement of both psychoses and dissociation would also be helpful, then winced and said, “I don’t like having to ask you to do this.”  Read:  I don’t like you being reminded of the fact that I am a useless tax-scrounging cunt.  I want you to think of me as intelligent and articulate, but that’s not what you’re seeing.  So you must hate me.

He said, “I can certainly write them a letter, that’s no problem.  I can say you’ve been attending since February 2009 and we’re due to be concluding at the end of August 2010…”

Thanks C, rub it in.  Just what I need to hear at every fucking juncture.  Besides which, the people who work in the social security are not very bright.  They will assume that a cessation of therapy automatically denotes that I am now well.

“Can you not say that please?” I pleaded.  ”If they think you’re discharging me, they’ll think I’m well, which I’m certainly not.  They see things in very black and white terms in my experience.”

He agreed that he “would certainly not give that impression,” then asked me if I was really sure he wanted to reference child sex abuse.

I paused, considering it.  I mean, of course I don’t want that information floating about so evidently in the system.  But on the other hand, I need this claim to be renewed, otherwise I will not be able to survive and will have no choice but to catch the bus.  It is, aside from this, a mere option, but to be so financially fucked as a non-renewal would make me would very definitely make the decision for me.  I sighed, and told him to go ahead.

Rather than just agree to acknowledge the abuse very clearly, C proposed that he draft a letter, which I could then ‘OK’ or reject as applicable the following week, though he then went on to say that he had “mixed feelings” about being so forthright.  I agreed that if you have the symptoms, then you do – what has actually caused them is none of the SSA’s bloody business.

The session proceeded in a curious fashion.  There were several lengthy silences, which were then broken by C making some point about the claim and those assessing the claim.  He eventually asked was there some sort of “shake-up” in DLA, which I confirmed to be the case.

“I’m hoping it won’t affect me unduly,” I admitted, “because I hope to be back at work by then.  However, I expected to be back at work last time after a month or two, and here we are two years later.  So who the fuck knows.”

Time for C to try and annoy me.  It happens at least once every session, does it not?  I think they must be trained at Therapist University to make irritating points when engaging with clients.  It must be intended to force underlying tensions out of us or something.

“Have you ever considered returning now to some sort of work?” he asked.

“Nope,” I replied, straight off the bat.

He looked at me questioningly, so I explained that I can’t think beyond the next hour, never mind any more long-term than that.

He pressed on, asking what it was that I felt was so strongly preventing me from considering a return to work at the moment.

I said, scathingly, that being a risk of losing time, hallucinating and being overwhelmingly depressed and anxious did not present the best circumstances in which to rejoin the employment market, adding that having such an added stress before I was fully able to deal with it would be helpful to neither the potential employer nor me.

“But I suppose I’m thinking,” C replied, “that work doesn’t have to be an all-or-nothing thing.”

“OK, but even a couple of hours here and there – I just cannot conceive of how that’s feasible.”

My irritation was compounded by the fact that some pack of cunts or other were heard to be engaging in conversation outside C’s door.  The room is meant to be deathly quiet, devoid of distractions.  I wanted to go into the corridor and smash the offenders’ faces off the relevant party wall until they begged for mercy.  There is a whole hospital campus, with an extensive outside area (not to mention a canteen), where these wankers could have gone to engage in their banal drivel.  Outside a psychologist’s door that clearly indicates he is in a meeting and not to be disturbed was not the best choice to start up a conversation on anything much.

And bloody C himself wouldn’t let up on the jobs front.  Seriously, what the fuck?  I can understand the desire to challenge my current lines of thinking – but only within reason.  I made it very clear to him that this was not an area in which I felt there was an alternative view.  I know I cannot cope with work in any meaningful fashion as things stand.  And I’m not the only one: A and my mother strongly agree.  Sometimes C will challenge me on something, and I’ll think, “well, there’s maybe a point there,” and I’ll tell him that – but this is one occasion in which I genuinely felt I was the best judge of the situation, and ergo his constant harping served merely to frustrate and annoy.

He claimed, when I showed myself to be visibly pissed off, that he had no vested interest in whether or not I worked; he was, apparently, simply curious as to why I felt that I couldn’t.  ”Although,” he added, demonstrating the reality of his desire to pursue this line of questioning, “I suppose I do think that if a person can work, that that can be a very positive thing, even if it’s only volunteering for a couple of hours a week.  It’s not because it’s work, but it’s about being with people.”

As if I am not aware of such an argument as a proponent of jobs.  Of course I am.  I just can’t deal with people.  I said so.  ”They make me both homicidal and suicidal, and should go away and leave me alone,” I spat.

There was a long silence, save for the unabated deliberations of shite in the corridor.  The presence of those conversing underlined my point that other people make me homicidal.  I sat daydreaming for a bit about how I would smash them all in if they were still there upon conclusion of my meeting with C.

Eventually I was asked if I had any opportunities to meet new people, to which I responded by saying that nearly all such “opportunities” were rejected by me, as I do not wish to meet or see people, except within very strict parameters set by me.

However, I proceeded to tell him about a planned “Mad Up” next month (a group of mental health bloggers including Lola, Karita, Little Feet, me and more are meeting up in London, though I hadn’t confirmed my attendance at the time).  ”I mean,” I started.  ”That’s different.  If there’s ever going to be people I want to meet, then it’s them.”

He started wanking on yet again about internet relationships being different; at the moment this lot are all ‘good’, and perhaps if I had ‘normal’ off-line relationships with them all, I would be scared that they would not always be ‘good’.  However, meeting them for one day only mitigates that risk.

“Are you therefore suggesting that I move to England for the sake of making sure I form so-called ‘proper’ relationships with these invididuals?” I asked, not even trying to hide my contempt.

“No,” he said.  ”I’m just saying it’s not the same – yet, anyway – as what we might think of as more typical friendships.  However, I’m not discouraging you – I think that sounds really positive.  It proves there’s a part of you that wants to leave the sofa, leave the house, get out there and engage with the world.”

“It’s a small part,” I replied dismissively.  ”After all, most people are cunts.  Just…this bunch aren’t.”

Apparently I sounded angry when I used the word ‘cunts’, which I didn’t think was an accurate representation of the issue – you have to spit the word ‘cunt’ out, don’t you, otherwise it just sounds silly.  ’Cunt’ is phonetically designed to sound harsh, even if you say it with the most saccharine sweetness imaginable.  Perhaps he should have studied linguistics as well as psychology.  It could have been insightful for him.

This gave him an opportunity to say that apparently I felt that he was angry with me, and therein lay his chance to explore the transference issues apparently revealed to him in the previous session.  I reminded him that what I had actually said was that I believed he hated me because he was always accusing me of being aggressive.

“Have you become quite…focused on this idea that I don’t like you, then?” C asked me.

My head was fried thinking about it and thinking about how much I withdraw from life, whether deliberately or otherwise.  As I sit here now of course I can quite easily say that yes, I ‘focus’ quite a bit on the idea that C hates me.  At the time, I couldn’t think straight, so I told him I didn’t know.

He let it pass and we sat in silence for a bit.  I was desperately trying to get my thoughts together – in particular, I was trying to fight all the suicidal thoughts that had been pervading my consciousness for weeks, not because I have any strong opinion on them, but because I didn’t want to reveal them to him.  I’m always scared he’ll ring the bin and I’ll find myself locked up, even if my rational mind realises that to be unlikely.

But when he asked me what was “going on for [me]” as we sat there, I admitted that I was thinking about things that I thought I should tell him, but was scared to.

“OK, maybe you can tell me what it is that you fear about telling me,” he suggested.

I fear you having me locked up.  Yeah, that doesn’t give the game away or anything.

“To do so would be to provide you with the information anyway.”

“Right…well, how might I respond to whatever it is?”

“In a not particularly attractive fashion.”

“What fashion?”

“You see, that’s the point, C: if I tell you that, you’ll know what I’m talking about.”

He thought for a minute, then said, “but I think you can say that you reckon I’d be anxious, angry, concerned, worried, annoyed or something like that – I don’t think I’d be able to work out specifics from you saying that.”

This made me want to laugh out loud.  As if he would be any of those things.  It’s just a fucking job to him.

“Using any of those adjectives assumes an over-investment on your part,” I told him.

“In you?”

“Yeah.”

“I thought it might just be normal,” he said, making some hand gesture to supposedly support what he said.  ”You have thoughts and feelings about people you’re working with, and you and I have been working together for quite some time.  It would be a bit strange if I was just like a robot or something.  Of course you do know I have response to things.”

Ooooh!!!  Did you hear that, readers?!  Dun-dun-DUN!!!

Here, my loves, we leave our epic fly-on-the-wall voyeurism of Alice-like wonder and utter, indescribable joy.  Follow the amazing developments in Part II, coming soon to a PC/Mac/Linux or Unix OSed computer near you.

Has he complimented me?  Does he care?  Does he work the nature of the transference out?  Will I do myself in?  Will I do him in?  Will I get a life?  Will I care?  Will C get an iPhone 4?  Will his beard come back?  Will I transmogrify into a demon and attempt to possess him?

Find out all this and more meaningless bollocks in the next deeply un-thrilling instalment of C: Week 57…NEXT! [LA MUSICA DRAMATICA]

What’s wrong with me?  This pathetic malaise has been permeating my existence for weeks now.  I always had it to some extent, in fairness, but my small levels of creativity were at least granted some outlet here, and now I am disallowed even that simple pleasure.

I used to have a life.  A shit one, perhaps, but at least I could derive pleasure from some things.  I may not be quite as severely depressed at the minute as I have been at a number of previous junctures, but there’s something new now and it is, in some ways, almost as bad.  Everything is not a completely opaque sea of blackness, but I now see and experience everything as if there’s a veil between me and it.  Not in the sense of depersonalisation or derealisation necessarily, but as if there’s a haze of fuzzy discolouration everywhere that keeps me from enjoying any of the things I am genuinely lucky to have in this world, or even wanting to enjoy any of them.

This is an existence, not a life.

Anyway, I don’t know why but I wanted to write something.  I suppose I worry constantly that if I allow myself to avoid posting for a few days, I’ll fall into a rut of utter insouciance towards writing.  I’ve invested so much time and effort into this blog*, and I only want to discontinue writing when I actively choose to do so – which will not, I hope, be for many years.  However, I am intimately acquainted with the tenacious lure and power of inertia, and I do fear giving myself even so much as a few days’ break from writing will lead to a de facto dead blog.  I’m probably over-reacting, but I fear it considerably, and the thought makes me tearful and desperately sad.  How can one be so attached to a website?!

[ * I worked out today that over the 181 one published posts (before this one, which is 182), I have written in the region of 700,000 words.  I'm trying to get a plug-in to measure the figure exactly, but as a rough guide, there you have it.]

So, bearing in mind my fear of an apathetic fall from whatever low level of grace I may or may not be occupying, I’m going to publish the following pile of wank, which I wrote last Tuesday evening in the wake of the C session.  I was trying to articulate the exact nature of my misery, and while it’s drivelsome bullshit, I think it does grasp that reasonably well.  To be honest, it probably describes my current mood quite well too.

Alas.

I am not in the frame of mind to write anything here, but maybe that’s exactly why I need to do so.  Perhaps I need to articulate these so-called feelings that pervade my sorry consciousness (oops, did/does that sound like wallowing? ) I’ve had a strange day.  I saw C this morning – specifics to follow – which has set me up for a weird week; as I normally see him on Thursdays, I’m going about thinking that tomorrow’s Friday, and that A will be there for the weekend.  Since it’s not, the rest of the week stretches out, seemingly infinite in its loneliness. C has, I think, hit upon something I have been trying desperately to hide from him.  I don’t want to discuss it right now because it’s a sensitive issue, and in any case I might be mistaken in my reading of what he thinks (I don’t think I am, but then I suppose I wouldn’t think it if I did think I was wrong, would I..?  Hmm).  I may or may not be more forthcoming in my review of this session, but whatever the case, the matter reminds me yet again of how imminent the separation is (as Tossface Mr D-P still hasn’t bothered to respond to my recent ramblings) and how invested in therapy – in C – I am.  I mean, I already know this – I have done for a very long time – but until relatively recently I could box it up and store it away in some far-flung, virtually inaccessible area of my brain.  That fails to work nowadays, with this severance looming in the air.

So.  I feel rejected.  I feel lonely, yet simultaneously I feel the need to hide away from the world.  I feel forgotten and I feel cheated.  I feel desolate, sad, and depressed.  Tears prick my dissenting, hateful eyeballs, and I feel my bottom lip quivering in a threatening, child-like fashion that I have not felt (at least with this strength) for quite some time…well, apart from the last time I saw C, that is. I still think ‘grief’ is a good word.  Pre-emptive grief, but grief nevertheless.  I do not pretend to understand the horror of what living with the impending death of a loved one with a terminal illness (and I hope I’m not disrespecting anyone in saying this – many apologies if so), but this feels like the closest I’ve ever been to that situation.

Friendships often taper off in my experience, and whilst you may look back on them and regret not making more of an effort to sustain them or whatever, you’re not generally faced with the abject grief that an instantaneous dissolution of your relationship would bring.  The ending of some romantic relationships may be more sudden and hurtful, I suppose, but I still find myself thinking that this feels to me more akin to losing someone important to death.  Perhaps it is because I am fixated with death.  Perhaps I am just a histrionic bitch.  I don’t know.

Anyway.  That was pointless.  I’m always told I should put my “emotions” into words, rather than uttering an allegedly meaningless sentence such as, “I’m pissed off,” but then everyone knows how I’m tortured over the forthcoming end of my relationship with C.  How many dozens of thousands of words have I written on it?  Enough, that’s for sure.

I’ve been fairly lethargic for quite a while now but otherwise, in terms of my mood, I thought things were on the up.  Even at times I felt that perhaps I was even a wee teensy bit hypomanic, which would have been a nice bloody change.  Bipolar disorder is certainly a hateful fucking illness, but hypomania is the rare upside to the regrettable affliction.

There’s no hypomania today, though.  Not even a euthymic or ‘alright’ mood.  The weekend was pretty shit too, but not as bad as today, as today has seen me in an utterly wretched and pathetic state of narcissistic, all-consuming depression.

I want to cry but I haven’t got the energy.  I want someone to hug and take care of me and love me [FAIL!!!], but I feel nothing but empty loneliness.  I want to have some understanding of what it is like to enjoy life, or at least not feel utter ambivalence towards it (because I don’t even have the fire to hate it at the minute).  Even at the most abstract conceptual level, though, these things seem alien and unlikely.

I think Quetiapine is (at least partly) to blame for my complete and utter inertia of the last few days, but it isn’t to blame for the Black Dog of the last day or two, because it has always helped me in that respect.  It has definitely made my life better since I started taking it in January.  Perhaps nothing caused it specifically – I mean, I am an individual with a long history of largely melancholic depression…and even if I wasn’t, we all have our bad days, don’t we?

Yet it is my nature to analyse things, to search for reasons especially when reasons do not present themselves clearly and obviously.  So notwithstanding the above, I think that maybe I’m having a bit of a delayed reaction to last Tuesday’s unwanted events, and of course I am still mentally embroiled in a horrified fixation about the impending and enforced end of therapy (and have failed to review the last two sessions of same, which is ridiculous when I consider how important doing so is to me).  Surprise surprise!

I keep seeing images of my body flying off some of the high-rise buildings in the relatively near vicinity, or sometimes over the motorway flyover.  I go to put my tablets for the week into the little pill box that I carry everywhere, and I want to ingest the entire bloody lot of them.  If I can even manage to force myself to make some sorry form of rudimentary meal, I look at the knives involved and I want to stab myself all over with them.  In particular I want to stab the parts of my body that nobody likes to talk about (something about which bourach recently courageously wrote, and something that I have never confronted here or anywhere else for that matter…and which I am going to continue to avoid today).  So maybe it is about last week’s encounters with Paedo, or ongoing retraumatisation from therapy – who knows?

All I know for certain is that this is a miserable existence, and one way or another I don’t want things to continue like this.  Death or some modicum of “recovery” is required.  I am still hopeful that it will be the latter, but the journey is a hard and long one, and falling into gaping potholes – some with a seemingly infinite depth – is a sad but apparently frequent inevitability as the road is travelled.

[/pointless whinging]

(NB.  Please don’t worry, if you are kind enough to worry.  I don’t think I’m actually likely to do anything; again, I simply don’t have the motivation or even physical strength).

I’ve had a brief look through the archives for a contextual post to this, and cannot find one. The best I can do is the review of this session with C – in which an altercation arose over the group of Employment Support Allowance into which I had been placed – but it doesn’t really go into much detail about the overall issue.

Money Money Money

So: context. Employment and Support Allowance (ESA) is the replacement benefit for Incapacity Benefit (although as I understand it, those originally claiming IB still receive that instead). Full details on the nature of the benefit can be found on this site, but here’s a brief run-down anyway.

It’s awarded to people who cannot work due to illness or disability, so long as they no longer receive (or were not eligible to receive) Statutory Sick Pay, which one would get, usually, for the first six months of an absence from one’s job. After an initial 13 week assessment period, claimants are placed into one of two groups: the “work related activity group” or the “support group”. The former is where the majority of applicants are placed, and assumes that although their capacity to work is ‘limited’, there are certain things that they can possibly do to eventually move into employment. To this end, they make you go to tossy interviews and group meetings with Job Centre employees and other claimants to discuss what you can and can’t do. Great if you have social anxiety, obviously.

The support group of ESA does not require such interviews, though one can volunteer to participate in them should one wish to do so. I believe that eventually benefit reassessments to ensure one’s continued eligibility for this group are required, but I am not familiar with the specific timeframes.

Anyhow, the so-called doctor that I saw when assessed as to which ESA group I should be placed in decided that I had “bipolar disorder” that was apparently manageable, within reason. At that point I hadn’t really experienced more overt psychoses such as ‘They’, nor did I have the C-PTSD diagnosis, so obviously I didn’t declare those to him, but as well as having the BPD, bipolar II/clinical depression and anxiety diagnoses, I was having strong dissociative episodes which I did clearly mention.

He did not mention, at any juncture, BPD, major depression, social anxiety or dissociation in his pathetic report. I wrote to the Social Security Agency to complain, citing all of these issues, and requesting a revision of their decision. They wrote back and told me to fuck off. This was last August.

[Fuck. After saying I had no contextual posts above, I have just happened upon this post, which basically details what I've already written above. Well. I took the time to write the above, so it stays. It might save you reading the earlier rant anyway.]

Anyway, as I said, this was last August. I went to the Citizens’ Advice Bureau to discuss an appeal on the decision, and they prepared a letter to the Social Security Agency (SSA) for me, which was acknowledged a few weeks later. Then…nothing.

Hoping that they’d simply forgotten that I would have to eventually go to these daft work interviews, I didn’t chase it up. Occasionally, over the last 10 months, I mused on what might have become of my case – but I didn’t want to draw attention to things by kicking up a fuss about how slow and incompetent they were, so I continued to keep quiet.

The silence was finally broken by the SSA on Tuesday, when they remarkably and quite out of the blue called my mother (my registered carer). Thankfully they didn’t want to speak to me, but to her; their enquiries related to how often I need to be supervised to make sure I eat, don’t self-harm, don’t try to throw myself off a 40-storey building etc.

My mother responded by informing the caller that such supervision was a daily requirement due to the nature of my mentalism.

“Daily!” the man apparently enthused. “That was the key word missing in her original report!”

This is complete bollocks, according to the legislation under which I was assessed and, in particular, under the section of said legislation under which I was assessed. I can’t be arsed getting into the minutiae of it, but the relevant statute is here if you’re bored so much out of your skull that you’ve never had a skull in the first place. I was only assessed under Part 5, and should also have been assessed under Part 6, where there is a lot of wank about disconnection from reality in the case of mental illnesses. I should have raked up half a billion of their stupid points on this, but daily supervision does not seem to be as key an issue as Mum’s caller had suggested.

Anyway, the bloke told her that, as she had confirmed my need for daily surveillance supervision to ensure my continued existence, that in all probability my appeal would be successful. “In fact,” he continued, “there’s a possibility she won’t even need to go to appeal, what with this new evidence.”

‘Evidence’. If my mother’s testimony is considered ‘evidence‘ by these imbeciles, why didn’t they bloody well ask for it when I first queried the damn thing nearly a year ago? Do you have to have a PhD in Fuckwit to work for these people?

So, to today. A letter arrived for me which I had initially hoped was from Mr Director-Person, who – I note with snide interest – hasn’t bothered his bony backside to respond to my latest letter. He hasn’t even acknowledged it with a two-line paragraph as he has done with previous correspondences, and neither has his Assistant Director acknowledged my application to sit on the ‘service user’ personality disorder panel thingy-ma-bobber. Twats. But, alas, that rant is for another time; the letter was from neither Mr D-P nor his AD. It was from the SSA.

And…

I HAVE WON! Yes! I AM VICTORIOUS. Hahahahahaha! Mwhahaha!

They are not sending the matter to appeal because the decision has been changed in my favour: I have now been placed in the ESA support group instead of the stupid work group. Result! (Eventually).

Financially speaking, this means only £5 more per week in my bank account (plus a good bit of backpay for the year I’ve not received it) – but it was never about the money. It’s mainly been an issue of principle – why should seriously ill people be fucked over like this simply because there’s a few scroungers in the system? – though a secondary concern has always been that I wouldn’t be able to deal with the silly work-focused interview required in the work group, never mind work itself. This belated but satisfactory result also means that I don’t have to go through the inevitable trauma of a social security appeal, which I understand can be utterly gruelling and ghastly.

Apparently, I will still have to attend a medical, which of course is rather gruelling and ghastly in itself. But Tuesday’s Bloke appeared to suggest to my mother that this would be a mere formality, being as he is satisfied that I am actually mental. I will make sure she is with me this time, though, not to mention a hefty dose of Diazepam (though maybe not? Seeming vaguely sane might not be a good thing?).

It’s timely, given that I am about to try and renew my DLA claim and given the DLA proposals of Tuesday’s budgets. I also read on Tuesday that Kate from A Tangle of Weeds had been placed in the ESA support group, and whilst I was obviously pleased that her ESA ordeal was over, with what seems to have been the result she needed, I felt a wisp of regret that I had been denied that same thing, which I clearly need too. But no longer

However

As Kate noted in the afore-referenced post, there is a downside to all this. I mean, I’m glad of the result of course – grateful, indeed – but it must mean that I am really, really, really mental. I read somewhere recently that only about 10% of claimants are put into the support group.

Sometimes I think I’m one of the most fucked-up people alive. I write very candidly here, but there are things I haven’t, and probably never will, share(d). Dark things, disturbing things – stuff that I think could shock the un-shockable. On other days, whilst fully recognising that I struggle with mental illness, I think I’m just on the right side of cope – mad, certainly, but not necessarily at the most extreme end of the wellness-illness spectrum.

The support group decision supports the former view. Said view is my more default position, indeed, but knowing that other people agree really drives the point home.

Still, I shouldn’t – and from now on won’t – grumble on this point. I can now avoid having to worry about being forced back to work before I am ready for same, and have a quiet satisfaction in knowing that my point of principle has been upheld.

That’s nice. But how are you, Pan?

Not fucking good. Not fucking good at all. For the first time since I met him in February 2009, I cancelled a session with C today. Admittedly, I’m physically unwell (my yearly bout of hateful tonsillitis would appear to have finally arrived), but I’m in the worst frame of mind I have been since January / February (when, if you recall, things were beyond rock bottom, resulting in a pathetic suicide attempt). The cancellation is a measurement of my utter despair.

The visceral compulsion to self-harm is so strong that it alone is driving me into minor dissociative episodes, though amazingly I have managed to fight the urges nevertheless. I really, genuinely don’t know how I managed to pull that off. Visions of my scalpel dangle seductively in front of my eyes. It reminds me of Macbeth’s infamous line, Is this a dagger which I see before me? (Act II, Scene I, Line XXXIII). Not that Macbeth stabbed himself with the dagger, of course – but he saw it and kind of lusted after it, just like I do. I want it so much, and I want to watch my own dark krovvy spurt gracefully out of me, taking my entire self with it.

So yeah – you might ergo assume that I am strongly suicidal as things stand, and you’d be right. Don’t want to exist, don’t want to be here…just want nothing. Sweet, beautiful, empty nothing. Permanent delicious unconsciousness.

It’s almost as if I feel some sort of spiritual enlightenment as regards fixating upon death. It’s like when you look at a stunning piece of art, architecture or scenery; the apparently perfect crafting and overpowering beauty is so profound that you find yourself moved to silent tears of awe.

I (kind of) face death and so, overcome by how exquisite it seems, awe is what I feel. I hate the word ‘empowering’, but that’s what it is: knowing that none of this has to continue beyond a point of my choosing is hugely empowering. And, indeed, beautiful.

Time to deviate from such laughably ornate prose. I’m also having vicious, extreme nightmares – on the occasions on which I actually fucking sleep. I can’t bear the abject desolation of insomnia (see here), but I really don’t know if such epically troubled sleep as these nightmares produce is any better. They mainly relate to severe sexual abuse, though not at the hands of Paedo, nor anyone I know. This morning I got sectioned after a severely disturbing gang rape, wherein I’d been placed in an open coffin and forced to fellate four men, who then proceeded to pour acid over me. I was actually genuinely shocked when I awoke and found myself in my bedroom, and not in the psychiatric hospital of the dream (which was another vision of complete horror, though obviously in a different way to the rape). It was an intensely vivid, video-like little film of unconsciousness, with which I am sure Dr Freud would have had a field day.

I’m not particularly prone to nightmares in general, despite my unpleasant history. I have of course had them – haven’t we all – but they’re not normally that frequent. That I have had so many powerful ones this week indicates to me that this is part of my adjustment to my increased dose of Venlafaxine. It’s compounded, also, by an unintentional decrease in Quetiapine: I have loads of 300mg tablets from an old script, but have been unable for several days to collect one for my current dose of 400mg. My mother was meant to collect it today – but naturally forgot. Hmm. It’s my responsibility, I know, but then she did offer…

Anyway, ‘today’ is now ‘tomorrow’ and what was meant to be about 500 words is now over four times that, so I shall bid you adieu.

(Aside: I considered calling this ‘From Bleak to Batshit’, which I found pathetically amusing, but ‘Depressed to Doolally’ seemed slightly less obscure )

Q:

My symptoms, I think you’d agree, have gotten worse over – say – the last two years or so. There’s been overt psychosis, clear dissociation, significant self-harm, etc etc blah blah blah. As a result, you’ve seen stuff in that time that most ‘other halfs’ don’t see in a lifetime. Surely dealing with this stuff has been more difficult than dealing with someone who, three or four years ago, seemed ‘just’ depressed? But as noted previously, you were less tolerant and/or sympathetic then than now. Is it actually easier to deal with someone in the throes of a psychotic break than with a depressed person? If so, how is that? What has enabled you to tolerate all this stuff, when depression often drove us apart?

A:

Good question. To help you and indeed your readers understand this one, I need to refer you back to some of the ground I covered last week. My own journey towards a greater understanding of mental illness was quite long and, in its initial stages, I perceived that you had an amorphous condition known as ‘depression’ which, with time, would dissipate. At times my attitude was indeed unsympathetic, and this comes down to an view that I once had, and which I believe many of the uninformed share – that those experiencing depression ultimately still have some form of control, an ability to resist and to say “no” to the bleakness if only they could summon the willpower to do so. I label myself a hard worker, at least in the career context, and I expect others to struggle through adversity in the same way that I do. What I feel I didn’t realise was that this amorphous term “depression” referred to something very specific, requiring much more than willpower and self-control. It would not be possible to ‘pull yourself together’.

The stance I once took sounds very negative, and I’m not suggesting that I felt like this all the time, but I suppose a complete lack of understanding of your condition at times led me to think that you had more say in the direction your life took than you actually did.

I must confess to being a believer, to some extent at least, in the view that we create our own realities. I don’t want to get too philosophical here, but nothing is definitive; everything is perforce seen through the filters of our own perceptions. To take a very simple example, individuals can perceive the same photons entering their eyes, but their perception of what they are seeing is constructed through the lens of their life experiences. Everyday technology to me might be magic to someone else. If I show you a car and ask you what colour it is, we might agree that it is red; but do both of us use the abstraction “red” to mean exactly the same thing? I hope I’m making sense. Nobody really sees anything independently of their own perception. Following on from that, I take the view that it is possible, with effort, to change the way in which we perceive things, react to things, and so on. These are our perceptions and we can control them. You might call this a very CBT-ish approach, and perhaps it is. I understand your cynicism about this: if somebody said “You can change the way you feel if you just think about things differently,” I would be forced to laugh in their face (if feeling unkind) or hide my derision (if not). I do, however, believe that such change is possible with will and persistence. All this is a round-about way of saying that I thought it was possible for you, or anyone suffering from “depression”, to change things over time. I’m not saying I believed there was a magic bullet you could fire and fix everything overnight, but I did believe that time and persistence could be great healers. I still think that is not an unreasonable view.

There are several problems with this analysis in the context of your illness, though, not the least of which was my complete failure to understand what the umbrella term “depression” covered. A second problem is that I myself, while believing the above, have been completely unable to exercise such control over my own thought processes. Being mentally ‘healthy’, or fairly so, if I cannot do this myself, how can I expect others to do so, especially those suffering from conditions that I have never experienced? Self-change is possible, I don’t doubt, but I have concluded that it is very difficult without some form of external help (therapy, medication) or internal motivation (spiritual revelation, high motivation, etc).

I think another thing which perhaps drove us apart at times was my inability to understand what was wrong. My logical brain seeks an explanation for everything. If you are depressed, it figures, there must be a reason, and it is natural that I should wish to ascertain what that reason is, and to try to help in whatever way I can. Often, however, depression left you uncommunicative, leaving me with a sense of frustration, not knowing why you felt the way you did and being unable to do anything about it. At other times, you might cite some event many years ago, or some issue over which you had no control, as the reason for your low. In this case, my frustration would derive from that fact that I felt there was no point brooding excessively over something you were unable to change. Of course, that is easier said than done, but we’ve all had problems in our lives, and I wondered whether yours had been so much worse than those experienced by others. Of course, at this time, I was unaware of the full extent of some of the terrible things that actually did happen to you. You had spoken in general terms of the abuse, for example, but its long-term and systematic nature was something of which I was unaware. I think possibly you weren’t fully aware either.

So, I’ve not painted a particularly complimentary portrait of myself. So be it. We did have good times, and not every day focused on depression or related issues, so we generally got on with things, having the odd downward spiral in our relationship, but a range of good times as well. I don’t mean to suggest that I had no sympathy or made no attempts to understand, and I hope that isn’t how I came across. However, it is clear that the efforts I did make were not especially successful.

So why can I cope with much worse things now than the ‘mere’ depression of old?

I explained in my last post that my attitude changed as the concept of “depression” was happily (for me) dispelled in favour of a much clearer explanation of what you were suffering from and why you were suffering from it. Although you are much further ‘down’ than you ever were when you were ‘simply’ depressed, the fact that I now have some level of understanding is the crucial difference. Having an explanation makes it so much easier to empathise, and I’ve ceased telling myself “Well, if it was me, I would do x or y“, since I couldn’t possibly know what I would do – I’ve never been in your position. A clear diagnosis fulfils my need for a logical explanation of your state of mind. My understanding of where you are and why you are there mentally has been vastly enhanced since you entered therapy and started writing this blog. Now that I understand something of the conditions with which you are afflicted, I realise that the hole in which you find yourself is too steep-sided to climb out of on your own, or even with the assistance of those close to you. You need expert help. A sympathetic and well-meaning hand of personal friendship is not enough. A heavy duty problem requires a heavy duty solution – enter therapy and the dreaded (but seemingly essential) medication.

A second aspect of the current situation has made it easier for me. Now that you have diagnoses, I am able to see that there is scope for medically valid action plans providing a genuine ray of hope that you will eventually emerge from this in better shape. I am no longer naive enough to think that you will be ‘cured’. I may as well wish for my own permanent physical disability* to vanish. However, there are coping mechanisms, means of managing the condition and sharing your life with the demons stuck in your head.

In the end, it is the combination of increased understanding and hope with a logical basis that has enabled me to get closer to you despite the sometimes horrible situations in which you have found yourself (my least favourite of which was one night in Accident and Emergency after you had befriended a scalpel).

Easier to deal with someone in the throes of a psychotic breakdown than someone sitting on the sofa silently and broodingly?  Yes, it does seem a very strange thing to say.  I certainly do not find it at all a pleasant experience dealing with situations where you are dissociated, hallucinating, self-harming, and so on, but these are so far from being in any way associable with the common understanding of “depression” that I find it very difficult to compare the two.  I suspect the latter may be more readily faced by me because this is so clearly the outworking of a very serious medical condition.  Why that should give me some form of strength I am not sure.  Perhaps it is because I know I am not responsible for it, you are not responsible for it, neither of us have much control over it when it strikes, and we have to work together to overcome it in the long term, with the assistance of medical professionals.

I said it was difficult to compare the “depression” scenario with the psychosis one, but I will try.  In the former case, I think I have gone into some detail on that both earlier in this post and in my last one – in a word, my reaction was frustration.  In relation to psychotic episodes and the like, my reaction is one of fear, alarm, helplessness, adrenaline, confusion, worry, and other similar ‘flight’ type instincts.  Yet these conditions also force me to take some form of action.  I remember on that A&E visit, during your very long wait to be seen, you decided that you’d had enough and were going to walk out of the hospital and home.  You have told me you don’t remember this because you were in a dissociated state.  I have a very clear recollection, however.  I had to physically restrain you – block your exit from the building – for a minute or two before being able to persuade you that you must return to the waiting room.  There is a frightening adrenaline surge to events like this.  I don’t wish for it, but at least I am able to do something.  A similar occasion arose at Suzanne’s (Marcus’ mother’s) house over the Christmas period when, as your readers may recall, you went (to use your own terminology) ‘batshit mad’.  Again, a combination of my verbal and physical restraining, combined with the very last vestiges of your rational personality, prevented your condition from becoming evident to the whole gathered clan.  Once more, the need for action on my part was there.  I’m fundamentally not saying I like this – I abhor it – but perhaps there is more of a sense of satisfaction in being able to do something, however minor, than in being able to do the square root of nothing (in the case of depression).  I don’t want these situations to develop – ever – but they have been a fact of life and I’ve had to deal with them, as you have.  They are tangible in a way that ‘mere’ sofa blackness is not, and they are very clear manifestations of medical conditions, demonstrably so in a way that our old friend depression is not.

Does that explain things a little?

The above account doesn’t paint me in a particularly sympathetic light, and I don’t want to suggest that I speak for anyone else living with a ‘mental’, but it is my tuppence worth, and I hope it is at least of some interest.

* A is completely blind in one eye, and has only partial sight in the other.

I think one more thing to note is that generally my psychoses and dissociation are stress-induced and transient.  Not always, but normally.  Depressions can linger for months, with no clear end ever in sight.  I don’t know if this has any impact on A’s view of things, but I can see how it might.

For all his self-confessed cynicism, A does have a wee bit of idealism and hope inside him still  (I don’t, like, but I suppose it’s useful that one half does..!)

Next interview with A next week, all being well.

Me me me. I have this, I experience that. Me. I. Yours truly. Myself.

But it’s not just about me…is it?

For some time I’ve been thinking about ‘interviewing’ A on his experiences of living with a woman with mental illness. It’s of interest to me both intellectually and as a girlfriend, and I hope that it might be of interest to you, my dear readers, too – particularly if you are in, or are hoping to be in, a relationship. So I give you the first in a series I am going to call Perspectives from the Mentalist’s Partner (PMP): how through his relationship with me, A has developed a greater understanding of what mental ill health really is.

—

Q:

Let’s start at the very beginning. You knew I had a mental illness before we even met [I was diagnosed with severe clinical depression at the age of 14, and corresponded with A for nearly a year before we met when I was 19], but that didn’t completely manifest at first. When it did, you will recall that you viewed that mentalism fairly unsympathetically, though your mind has clearly been changed, as over the course of this present breakdown, you have been extremely supportive.

So I suppose I’m wondering – do you remember when you first saw evidence of my mental health problems, and how did/do you feel about that incident or period? Can you explain your reasoning for your evident lack of sympathy at the time – and what was it that modified your opinion into what it is today?

A:

It took me a very long time to realise what mental illness actually is. Sure, I was peripherally aware of depression as an issue, and you made it clear that you had suffered from it*. However, I probably wouldn’t have perceived it as a ‘mental illness’. I associated the term ‘mental illness’ with, well, very extreme conditions involving padded cells and the like. A very stereotypical view, for which I apologise to readers of this blog; however, I simply didn’t think much about it as it had not really affected me or others I knew. Granted, I’d experienced what I considered ‘depression’ at the age of 15-16, and I therefore assumed that what you suffered was some variant of that. Not at all a pleasant phenomenon, but something that would nevertheless gradually recede, with time. (In my teenage years, I think my own experience of ‘depression’ was one of those ‘growing up’ type problems, though I never have been and never will be a cheerful or optimistic type). Anyway, I am digressing.

When we first met, you seemed far from depressed. In a recent post [this], you talked of the dichotomy between Pandora and the ‘other’ you, the everyday person whose name I shall not utter here. The person I met was essentially Pandora; sociable; intellectually agile; opinionated (in a good way); lively; challenging; interesting – a person with aspirations and apparent self-confidence. Of course, we all package ourselves in similar ways, or try to, in order to impress those we wish to impress, especially in the first flower of a relationship. Sure, there may have been a bit of that, but it was certainly more than that, and indeed that part of you continues to exist now. When others meet that part of you in person, they are extremely taken aback to learn that you suffer from ‘depression’ (to use the generic term that most of us who are not informed might use).

As we got to know one another better, and the first flush of spring faded (it always does, as I know you agree), I started to see your occasional black moods. However, as I’ve said, I have not been a stranger to such in the past. ‘Depression’ was something that I felt, with time, one could ‘get over’. That will undoubtedly seem insulting to some, but it was how I felt.

I was also very much opposed to attempts to control depression through medication, believing that the solution lay in rethinking one’s approach to life (somewhat DBT-ish, you might say). I’ve never taken many pills myself, although I’ve been fortunate in my health for the most part. You’ll recall that I was no fan of you taking medication, and eventually made the drastic error of persuading you to come off Prozac**. Bad mistake. I suppose it was at that stage, several years into our relationship, as you really began to spiral downward, that it began to dawn on me that this was not something that would go away easily, without some form of concrete assistance.

My realisation grew as time passed and a pattern started to emerge. You were unable to hold down a job. You’d start one, seem to enjoy it at first, but gradually find it more and more difficult to cope, lying awake at night worrying about what might go wrong the next day or week. Of course, you were not helped in that by some of the horrendous managers you have had the misfortune to work for; still, even somebody as insensitive as I began to notice A Problem. Nonetheless, on my more cynical days I wondered whether it was just that you needed to find ‘the right’ job, and that you needed to foster a greater sense of ambition and commitment to achieving this. I have always been somewhat driven in the work sphere, if not elsewhere in life, and I suppose I expect the same in others. So, yes, at times I still thought less about illness and more about ‘what I would do’. Obviously, I couldn’t possibly know what I would do, given that I don’t suffer from mental illness. However, I didn’t always think like that at the time.

Really, then, although my realisation was dawning, I believe that it’s only in the past two years that I have really started to grasp what mental illness is, and the extent to which you are afflicted by it. Gone now is my illusion that you simply had ‘depression’ that you would ‘get over’, or that you could will yourself to cultivate a greater personal drive.

Just as an aside, thinking about my prior attitudes, I have come to believe that ‘depression’ is a horribly overused term, as in popular usage at least it can signify anything from a bad few weeks to serious clinical illness. I am not saying that those who actually understand mental health issues talk of depression in this way, but the word has become seriously devalued by its more general societal usage, whereby it can connote practically any bad feeling a person may have for a sustained period***.

Anyway, I suppose my first lesson in the seriousness of your illness, which came long before the realisations mentioned above, came from your occasional black moods. I remember in particular one Sunday evening where you did not really wish to speak or interact. You exuded a aura of bleakness, and no matter what I tried to do or say, there appeared to be nothing I could do about it. It left me wondering things like, “What have I done? Is this my fault? How can I fix this? Why is Pan behaving like this?” I didn’t know how to handle it. Your illness seems to have changed, and your black moods are subtly different now. I’m not sure I have figured out how to deal with them, from my own point of view, but I certainly know more about what to do and what not to do than I once did.

I might add that much of the understanding I have gained of your illness has come from you. As you have educated yourself about the issues, you have educated me. In that respect, Confessions of a Serial Insomniac has been a tremendous help. You write cogent, coherent, insightful and moving accounts here that you are often unable, due to the difficulty of talking about these issues, to express to me or anyone in person. I started writing ‘real life’ there for ‘in person’, falling into the dangerous delusion that the written form is somehow less real. Far from it. In fact, it allows one to be more revealing in some ways. I suspect that the closest you come to being able to communicate as you do on here, in verbal form, is when you meet C.

Anyway, next question please…

* Through our 10 months’ email correspondence prior to meeting face to face, I had shared a lot with A, including the fact that I had depression and that I took Fluoxetine (Prozac) to treat it it.
** This was during my postgraduate course – I would have been 21 or 22. I was taking, I think, 60mg daily, and initially cut it down, before I stopped taking it altogether. It was partly because I’d been feeling fairly good and fell into the trap of thinking I was ‘better’, and it was partly due to A’s encouragement. It – in part, at least – led to my second biggest psychological collapse (after the present one) to date.
*** One thing that A hasn’t mentioned here is that he has in the past said that he felt that my receiving a proper, psychiatric diagnosis was of great benefit. As I recall (and I welcome his correction(s) if I am misreporting him), he felt that saying, “I have borderline personality disorder” as opposed to “I’m depressed,” allowed one brought up with the views he had formerly held to note the presence of a real, tangible medical condition, rather than expressing their ‘having a few bad days’ erroneously. I would point out that I feel, have always felt, and that A now feels, that depression is a ‘real, tangible medical condition’. However, we are dealing with stigmatic stereotypical societal views here (how alliterative), and I would agree that most people probably do misuse and, indeed, misunderstand the term.

—

Next interview with A to follow soon…

Admittedly, I went in in a bad mood to begin with. I’d actually been in a good one hitherto, thanks to waking up to this lovely comment from Seaneen (and one already made by Nick, to which I alluded at the end of that post). I’m always thrilled when people compliment my writing; although the blog is still primarily for my own benefit…well, if it’s considered to be done well by others, then that’s a very worthwhile, confidence-boosting bonus. So yes, I was in quite a decent mood, and the sun was shining, and I thought that this confluence of relative non-shitness might lend itself to actually covering something useful with C for the first time in about 300 years. Although, having said that, when I’ve been in a good mood in the past I tend to go in, ramble on a little, then seduce him into a discourse of academic psychology and intellectualism. But anyway…

I arrived at the hospital, and was outraged to see a car in ‘my’ parking space. Who the sodding hell did they think they were? I park in the same space each week. In fact, I have a ritual. I drive to the back of the carpark, turn, drive forward into the space, adjust steering until I am exactly six inches from both right and left extremities of the space, and finally reverse/go forward until I’m right in the middle relative to the front and back of the space. And it has to be that space.

Were I not so utterly in love with my little car, I would have used Him to ram the other car of unwitting evil out of the space. How very dare it steal my space?!!

(A tells me that I have to write a post about my apparent OCD-ish behaviour. Another foible that he finds consistently amusing is the fact that I will not change the radio station in the car, even if the most offensive thing I’ve ever heard is playing, unless he’s with me).

So I had to take another space – one that actually brought me a good deal closer to C’s building – but I felt soulless and destroyed inside. I cursed myself for having failed to bring Diazepam with me. And then my nose started bleeding, as if symbolically voicing its own displeasure at the sorry circumstances in which it found itself.

I had no tissues with me, so holding my nose, I dashed into the building. Before I reached the toilets, however, I almost literally ran into C. This was about 9.20am, which freaked me out because C does not exist at 9.20am. He only starts existing at 9.30am when our appointments commence.

We exchanged awkward pleasantries, and I ran to hide in the toilet, blood trickling its surreptitious way out of my nostril. I plugged it up with bog roll (unused, just in case you were wondering), and stood behind the door, listening, waiting, for him to go past so as I didn’t have to encounter him outside session-time again.

How ridiculous is this? Seriously. How can someone so obsessed with and attached to her psychotherapist be thoroughly freaked out by seeing him outside of the allocated fifty minutes, especially when it’s mere seconds beforehand? There have been times when I’ve dreamt of bumping into him in a pub, a shop, I even half-hoped I’d see him at the recent Metallica gig at which we were both in attendance. If that had actually happened, though, it would appear that I’d have gone completely doolally. What the fuck is wrong with me?

Anyway, having heard someone that I assumed was him walk past the door, I sneaked back out to the waiting room, like some silly schoolgirl bunking off class. Eventually he emerged again, this time to escort me to that week’s 50 minute doom.

It commenced in the usual silly way. We acknowledged each other. I even asked him how he was, something I haven’t done in eons. Then there was silence. He glanced at me. Our eyes met. He nodded. I made some not unfavourable facial gesture in response, and looked away.

And the silence continued.

And continued.

And continued.

Eventually, he said something along the lines of, “where would you like to begin?”, to which I responded with resigned laughter.

C replied by saying that things seemed to be frequently commencing in this silent fashion. No shit there, Sherlock. 10 out of 10 for observation.

I think he then said something to the effect that he wondered if we could use ‘the time remaining’ to tackle some of the issues that were paramount in my mind.

Thanks, C. Rub it in. Just rub it right in. Pour a barrel of salty piss right into my gaping, agonising wound. Go ahead and remind me that said wound is going to be open and raw for some time – possibly forever.

“But you’re trying to protect yourself, aren’t you?” he said. “So you’re finding it difficult to communicate these things.”

Did I shrug at this? I think I did. Whatever the case, my response was non-committal.

“What about the sexual abuse..?” he asked tentatively, tailing off.

The mention of this most un-amusing of subjects somehow did amuse me – the very notion that I would discuss this more when I am being consigned to the dark recesses of rubbish bin of psychotherapy was tragically funny. I eventually said, honestly but reluctantly, “I don’t think I’m going to talk about that anymore.”

It seemed ‘tragically funny’ then, but it doesn’t now as I sit here writing this review. It fills me with a deep, foreboding, unforgiving sort of sadness, that I can actually feel physically as well as psychologically. It feels almost like a part of me – a physical part, no less – is being surgically removed without an anaesthetic. A huge gap or a hole somewhere in my stomach, just clawed out carelessly with a rusty scalpel. It hurts. It hurts. So very, very much.

I have so much I want – need – to address, and nobody seems to care. This leads me to believe that I have always been correct in my resolute belief that I deserved everything negative that has happened to me in my life, including though not limited to the child abuse and my father’s point-blank rejection of me. This proves it, surely. Nobody wants to help me, or pay attention to me – they just want to reject me all over again, so everything that has gone before must have been deserved.

But enough childish, whinging navel-gazing. The whole ‘I won’t discuss the sex abuse with you’ led to the typical bullshit discussion about the end of therapy, the one I am perpetually desperate to avoid. I can’t address it without fighting tears, and I don’t want to give C the satisfaction of seeing me cry over it.

Instead, I heard myself telling him how annoyed I had been when he last week accused me of saying (the week before that) that the process coming to an end was ‘tragic’. I actually went on a massive rant about this, although I did try to do so whilst not attacking him directly. In retrospect, ranting about this was completely bloody stupid as my fury was ignited over one tiny word.

“Tragic,” I declared, perhaps a little pompously, “denotes something big. The Cumbrian shootings were tragic. The 2004 tsunami was tragic. The end of a relationship between two people – out of over six billion people on this planet – is not tragic.”

“I looked in my notes after you left last week,” he replied. “They said you said it was ‘sad’.”

“Sad! Yes, I said it was ‘sad’ alright. I did not say that it was ‘tragic’. Do admit that I did not say it was ‘tragic’?”

“I suppose so..,” he replied, apparently rather bewildered at my passion over this almost meaningless semantic issue. “You seem to have an air of triumphalism in that, though, and I’m wondering why it’s such a big deal to you?”

Triumphalism. I had accused him of the same here in my write-up of last week’s session, so rather than help him explore his question, I told him so.

Why did I say that, readers? Why?! I accepted myself that I was probably over-reacting to the supposedly ‘triumphant’ comment, so why did I have to insult him by telling him of my paranoid thinking?

He looked quite dutifully stunned, and then I think I stated on the ‘mechanistic’ comment he had made.

“I’m grateful to you for saying that,” I started, smiling, “because it led to one of the greatest compliments I’ve yet received about my blog; someone [Nick, referenced above] said that that proved you’d not seen my blog, because apparently no one could say that about my writing.” Carried away by this train of thought, I also started wittering on about Seaneen’s comment, and several others I have received from a surprising number of you lovely people.

C sat there looking at me in utter bafflement. I could almost see the cogs of what the fuck? turning inside his mind.

Eventually he stopped my narcissistic rambling. “So, you’ve been hugely complimented about your blog,” he iterated. “You’ve met nice people through it. Unlike this big, bad, nasty therapist…”

To be honest I’m not sure I realised just how vituperative I had been at that stage. To his continued surprise, I told him that I had “not been having a go at [him].”

I watched his face carefully. He looked…I dunno, ‘wounded’? ‘Torn up’?…and I suddenly felt guilt and self-disgust surge through my veins.

“You’re insulted now,” I murmured, lowering my eyes regretfully. “That really wasn’t my intention.” And it hadn’t been. I still don’t know why The Bitch came out to play with such intensity.

He didn’t respond to that specific comment, but instead said that he felt two things were underlining this negative form of engagement with him. Firstly, it was indubitable that I had a lot of pent-up anger – whether or not it was directed specifically at him, it was coming out aimed at him (all well and good from the analytical point of view, of course), and that it was in fact probably suitable and right that I was bringing it with me and flinging it into the poor sod’s face. Secondly, he opined, I was going on an all-out crusade to avoid talking about my heartbreak (not his word) as regards the cessation of our relationship.

All of this was fair, and my silent response was intended and, I think, taken as confirmation of it. I looked down at the floor. Shadows created by the window-blinds breaking the sunlight danced insouciantly on the carpet. For a few minutes, this strange waltz captured my attention completely.

“Where has your mind wondered to?” C’s voice finally asked, breaking into my distracted consciousness.

I ‘came to’, and told him about the dancing shadow-shapes. He raised an eyebrow curiously but said nothing.

Another silence briefly ensued, which I eventually broke by blurting out, “I want to see the notes you hold on me. Can you just give me them, or do I have to apply in writing?”

He hadn’t been expecting this, and was visibly surprised by the revelation. He admitted that he didn’t know the procedure, but said that he would consult the Head of Department and advise me accordingly at our next meeting.

Inevitably, of course, he wanted to know why I want my notes. Was it simple curiosity?

I said that it was, and advised that I would not just be asking for his notes, but also NewVCB’s and my GP’s.

“I think I’ll request my GP’s since I was about 12,” I mused thoughtfully. “You know, just before I became properly ill.”

Then I chuckled slightly, and added, “yes, 14 years of notes. That’ll really piss them off!”

The utterance of this comment was a serious error on my part. I should have known that C would jump on it and wank on and on and on about it – which of course is exactly what he did. He became convinced that I was only requesting my notes to annoy the various medical professionals with whom I am involved.

This is not true. Is there a certain element of caustic satisfaction from the amount of work that inevitably goes into the preparation of such things? Inevitably there is, yes. But it’s both incidental and innocent; I take such sadistic pleasure out of any such situation, and it has nothing to do with winding the Trust and its employees up. For example, when W – who lives in England – got married, I went to great pains to wrap his (fragile) wedding present to unbreakable standards in preparation for postage. Although it took me about two hours to do this, I took pleasure from the fact that I knew it would take him (or his then-fiancee) similarly long to unwrap it. I told him so, and he found this amusing. It’s just a silly character trait, and I wish C wouldn’t overreact like this.

I became sick of his whinging about this, so said, “look. I know you’re trained to read a lot into every single little thing I bring into this room – I get that, I do. But I swear to you; my primary motivation is not to piss the health service off. I just want to know what my notes say. OK?”

I’m not sure if he believed me, but either way he conveyed his acquiescence through a nod and added, again, that he would look into the procedural issues of the matter for me.

Another brief silence came and went. I don’t recall whether or not he instigated the conversation or if it was me, but in any event, an in-depth discussion developed about my intention to seek out alternative therapy when my time with him comes to an end.

I had been with Lovely GP the day before, hoping that he would act as an advocate against the Trust’s intentions to end my therapy as he had said to my mother he would. I told him, in about as un-detailed terms as you can possibly get, about the abuse and how I felt that therapy had re-traumatised me vis a vis same. After asking if C had the expertise to help ease my traumatised mind – and my affirmation that he had – LGP went on anyway to suggest I saw the Nexus Institute. He made no further reference to ‘making a phonecall’ to make sure the therapy continued, and as such the appointment was only of any use in that he gave me some IBS medication to try.

Anyhow, I told C about LGP’s suggestion, but then sighed. “I fully respect what they do,” I told him, “but regardless of that I have, by association, a long-held negative view of them, even though it isn’t their fault.”

I explained how, when I had seen a therapy assessment woman (at the same hospital in which I see C and NewVCB) when I was about 17 or 18, I had been treated with utter disdain – “nay,” I corrected myself, “contempt” – apparently having been considered as an angsty teenager with no legitimate mental health concerns.

“I made the most oblique of references to having some experience of sexual abuse,” I went on, “and she immediately threw Nexus’ number in my face and all but demanded I get out of her office and stop wasting her time.”

He thinks that the following us my belief: if I end up going to see them, I am accepting and agreeing with her view of me as a time-waster. This hypothesis most likely true. I kept apologising to no one in particular for forming such an unreasonable view of Nexus, but every time I hear of them I remember that woman’s palpable antipathy towards me. I didn’t deserve that.

C proceeded to make some comment about how I’m perpetually derisive of myself. “You often sit over there and say that your wasting my time, or that you should just ‘pull yourself together’ and whatnot. You feel that you were treated badly by that woman, but yet you say these same things about yourself.”

Hmm. I bollocked around this for a bit, claiming that most of my ‘time-wasting’ self-castigations related to times when I sat in C’s presence without saying anything, and this is true. However, there have certainly been plenty of self-directed rants on how my problems are infinitesimal compared to those of some others. I think I finally rationalised my position to him by stating that, whilst in the grand scheme of things my psychological issues don’t really matter, that they were still nonetheless very real to me. “In the midst of my self-hatred, I just lose sight of that sometimes,” I admitted.

We continued talking about future therapy, and I asked him if he’d have any recommendations for private therapists. He responded in the affirmative, stating that they would, however, be primarily be from the analytic school.

“Good,” I responded. “That’s what I’m looking for.”

During the ensuing conversation, it emerged that he was familiar with a group of psychoanalysts that I have also come across. He mentioned one in particular with whom I am familiar, but asked me to bring in my overall short-list to see if he recognised the names.

“Bear in mind,” C cautioned, “that these people are more likely to lean towards traditional analysis.”

“What, like I lie on the couch and babble endlessly, and they never open their mouths?” I checked.

“Hmm…well, any therapist you meet will try his or her best to tailor the therapy towards what’s best for you as an individual, so not necessarily – but still, I reckon you can expect them to be less interactive than you’re used to here. What exactly are you looking for?” he queried.

A curious question coming from someone with a doctorate in psychology to a person with a Wikipedia knowledge of the subject, but then he knows that I am very well informed.

“Analysis-ish,” I replied. “I like your integrative approach. Psychodynamic, but sufficiently bending the rules of that persuasion so as things suit me. I like that you actually respond. I don’t think I’d be completely happy with someone who never said anything, but notwithstanding that I really have much more faith in the more traditional therapeutic approaches. I don’t think that CBT or DBT or things like them are remotely helpful practices, except possibly in the hands of exceptionally skilled practitioners.”

“I think that issue is key,” C stated. “As you’re probably well aware, research consistently shows that, generally, one of the main factors in successful psychotherapy is the relationship between therapist and patient, rather than the type of therapy specifically.”

I did indeed know this, and it has always been one of the key problems in the Trust ending my therapy with C. After all these years – after all these horrible, painful years – I have finally found a psychotherapist with whom I have a proper, workable, trusting and intimate relationship. He is just about the best person I could have asked for. Through our connection – for we do have a connection – good work was being done, and could have continued to be done, had I not had this constant menace of the curtain-down of things hanging over me. Yet such an encouraging prospect is being cruelly and unfairly being stolen. All because some fat, pen-pushing bastard sitting in some overblown office somewhere thinks that C should be driven by fucking time-directed targets and not real, life-changing, meaningful results demonstrating a significant improvement in a patient’s health or well-being. Fuck the health service! What is the point of it being a ‘health service’ when it prioritises statistics over its patients?

I think C saw an opportunity here, perhaps noticing some vulnerability in my stature or body language. He (quite gently, to be fair) brought back up the issue of me ‘fighting’ my feelings of sadness/grief/abandonment/rejection/etc.

Yet again I felt tears prick my eyes, and a lump form in my throat. Why does he want to put me through such pain? Does his ego really need stroking that much? (For what it’s worth, I suppose I do see, objectively speaking, what he’s trying to achieve, and no – it’s not really about his ego. But I can’t bear it, however much I intellectualise it now).

I sensed that the session was nearing its end, so decided I could get away with answering this rather than redirecting it. He wouldn’t have enough time to probe me further.

“Yes, OK, I admit it – I admit it freely – of course it makes me feel sad. How could it not? I don’t like it and I don’t want it. I don’t want it to end, not at this juncture. Yes, I’m sad and yes, it hurts. But I’ve sat here and insulted you in copious measure this morning so I don’t suppose that sense of regret is always entirely evident, is it?”

Of course, armchair-psychologist-Me realises that sitting there insulting him in copious measure that morning made it all the more evident, but I wasn’t feeling at my most intellectual at the time.

“I don’t feel insulted,” he reassured. “Things were rather adversarial for the first 30 or 40 minutes, I think, but no – I don’t feel insulted.”

“‘Adversarial’,” I repeated wistfully. “[submissively] I’m sorry, C. I was in a bad mood when I came in here. Someone parked in my parking space.” I threw him a weak smile at that, which thankfully he returned.

One thing I deliberately kept from him during these whole shenanigans was the fact that I had finally posted the most recent letter to Mr Director-Person the day before (it didn’t go exactly as detailed in the relevant post, but it was close enough). To recap briefly, said letter specifically requests (for the first time) that my treatment with C continue beyond the current allocated time, citing issues of re-traumatisation and the fact that a CPN or social worker – however good they may generally be – are under-qualified to deal with something quite so complex.

I don’t know why I didn’t tell C. Probably because I know Mr Director-Person is going to blab all anyway, and they can laugh together at my pathetic, desperate begging. Still, when I decided to respond to Mr Director-Person’s first stupid and borderline-offensive letter, I vowed to myself that I would see this fight through to the bitter end. And one way or another, we’re approaching that point now.

I just wish part of me didn’t seem so hell-bent on offending C before we get there. He may claim he wasn’t insulted – but I’m not stupid; I could see that he was effected by my words, and in fact I think he was hurt. At the end of the day, I actually think he’s rather fond of me (as I am of him), and listening to a constant barrage of criticism from someone you hate is hard enough, nevermind when it’s from someone you don’t mind. It’s part of his job, I know, but I feel hideously guilty anyway, and have resolved to try and be nice to him this week.

Maybe I’ll even allow him to see some real vulnerability.

So off I went to C, in this sort of weird, caffeine-induced disposition of much oddness. I wouldn’t call it hypomania exactly; I wasn’t in the throes of overwhelming, deliriously beautiful ecstasy, nor anything much approaching it. It was a bizarre cross of, perhaps, minor hypomania, wry- and snideness, let’s-play-games-with-C-ness and mini-fuck-you-ness. Is there a word for that? I don’t know. I can’t think of it. So let’s stick with ‘wry’.

Initially, this ‘wryness’ didn’t really manifest in my interactions with C, unless you consider the silence at the start of the session, now of clockwork predictability, to be game-playing. I don’t think it is; I just never know how to open a session, and he rarely lets me off the hook. Advice, fellow mentalists. What is the decorum in this circumstance? You’d think after knowing C for over a year that I might’ve worked it out, but apparently not. Perhaps the difficulty lies in the material addressed in therapy of late. Coming in, cheerfully intoning the words, “Hi C! Let’s talk about the day when I was six when my uncle stuck his cock in my mouth!” is not something that seems to flow naturally after an initial greeting.

Eventually the silence led to a desultory conversation on how bizarre it is to simply “switch on” for 50 minutes a week. I’ve probably done this to death, but seriously – what an intrinsically false, freakish sort of social situation therapy really is. It’s not at all easy to just vulnerable-ise yourself at the figurative flick of the switch, and yet I berate myself endlessly for my consistent failure to manage it.

In order to kickstart me, I presume, C eventually asked had anything much happened since our last session. In a sense, it had; the meeting with NewVCB the preceding day was something vaguely worthy of note. I told him that, due to my low mood of late, that she had prescribed me a higher dose of the dreaded Venlafaxine and then, indeed, the ‘kickstart’ mechanism swung into gear, and I confessed to him that NewVCB had essentially forbidden me from seeing Paedo.

“Forbidden..?!” he queried suspiciously, as if I had just told him that NewVCB had ordered me to sacrifice fluffy puppies to the Flying Spaghetti Monster for medicinal benefit.

“Well, it certainly sounded like it,” I said, slightly defiantly. “She shook her head vigourously at the suggestion and said that I ‘can’t’ see him because it would be ‘damaging’.” As I quoted her, I used that absurdly ugly gesture with my index and middle fingers that denotes the words are those of someone other than the current speaker. I despise it when other people do that, and have spent many a happy hour fantasising about breaking those supercilious fingers. Why, then, am I allowed to do it myself? I am a walking double standard of hypocrisy.

Anyway, he then asked why it was likely that I would see Paedo anyway. I sneeringly pointed out that Paedo is my ‘closest’ uncle, a fact of which he is well aware.

Pre-empting any response to this, I continued by advising C that my mother had been desirous of a visitation to Paedo and Maisie’s the previous day. I said that I had managed to get out of it, but that I felt as if I was in a very difficult position.

“How did this proposition [ie. visiting their house] make you feel?” C asked.

I um-ed and ah-ed a little; the truth was that I had actually taken with me a print-out of this post on my reactions to the suggestion and my dilemma about whether to go or not. My attitude to the notion of reading the material to him was not at all what I might have expected; it felt supremely weird, and it felt supremely wrong. This is something I’m going to have to write more about in due course, but in brief (disregarding all the competing sides of me in my head), it’s almost as if I am two different people these days (and please no DID references – I’ve dealt with too many recently already!). I have this identity – Pandora, the writer, the online persona, the primary mentalist ‘Me’ on Twitter and Fuckbook – and then you have the ‘real’ one. The boring, ordinary me, who just happens to have a string of psychiatric issues. I am increasingly finding transitioning between the two to be a strange, sometimes difficult, task.

I told him so. “If I read this to you, it’s really like these two worlds – these twains that are never meant to meet – are colliding. It’s making me feel deeply uncomfortable.”

He stared at me unhelpfully. In fairness, I don’t suppose it is possible that he can empathise with something of this nature.

“Well, should I read it or not?” I finally asked, slightly irritably.

He shrugged. “I suppose you have it here, the words are already articulated, so…”

I mulled it over again for a minute or two then took a deep breath and went ahead and read the thing.

I don’t remember exactly how he responded, but for some reason or another I found myself ranting not about Paedo, but about the women connected with the house (to which I shall hencefore refer as Hotel California).

“I hate their tactility, their enthusiasm for non-sensical feminine pursuits,” I spat. “I hate their constant emotional outbursts, whether those are positive or negative. They make me sick.” I shivered at the very thought of it. I went on to tell him about when my not-quite-step-Dad dropped dead suddenly when I was 11 – Maisie and Paedo came to stay at Mum’s (hmm), and I have this overriding memory of Maisie all but begging me to shed tears. I can still feel that sense of bafflement; I feel it so strongly that I could reach out and touch it. Yes, he was dead, and that was very deeply regrettable – but what good was bawling my eyes out going to do? And even if it did serve some purpose, what in the living fuck would be the point of demonstrating my capacity for tears and sadness to others?!

“So…” C began, when I had finally concluded my little anecdote. “It is because of the women, rather than your uncle, that you don’t want to go to {Hotel California}?”

“No. Well, yes. But…well, it’s both, isn’t ‘both’ allowed? And yet…and yet…hmm.” I left the sentence trailing in mid-air, pregnant with a palpable desire to be completed.

He subtly (but obviously, if you understand) probed me to finish what I had started.

“And yet…” I eventually went on, “…well, part of me doesn’t not want to go. Not entirely anyway.”

I hung my head in horror and shame at this admission, but raised my eyes just in time to see him sit forward contemplatively, his brow furrowed.

“Why’s that?” he inevitably asked me.

“Because…because…[almost whispering] because of the children…”

This instantaneously led to the launch of yet another self-directed vituperation of epic proportions.

“I hate children,” I shrieked, “I fucking hate them! I hate the sounds they make, I hate the way their alien-looking little faces srunch up like a deflated football when they scream, I hate the way some parents revere their offspring to the point of an utter lack of consideration for all other human beings in existence. Why the fuck do I concern myself about these ones?”

“You’re angry with yourself for expressing an emotion,” C claimed.

“No I’m not,” I protested, genuinely I think. “I’m angry with myself because I’ve just betrayed everything I’ve ever felt about this particular demographic.”

“I actually don’t think you have,” he said rather definitely. “You’ve not necessarily reviewed your attitude to children, even though I know you’re…um…not un-fond [wry glance at me] of {Marcus}. You’ve consistently told me of your worries that {Paedo} would harm {Marcus} and now his younger brother. I think that concern – that fear of harm coming to either or both of them – drives this.”

“Maybe. But what difference would my presence make anyway?”

He eyed me suspiciously.

“OK, C. What’s that look for?” I asked dryly.

“You want to protect them, perhaps. Even if your visits are infrequent, perhaps some small part of you thinks that you can at least keep an eye on them.”

We considered that in silence for a few minutes.

Then, “Fuck it, no! I don’t want to go to the fucking bastardhole and the children aren’t really at risk and I don’t want to have them yapping around my fucking ankles.”

To my astonishment, a broad grin grew across his face. He didn’t even bother trying to hide it; in fact, to my considerable perplexity, he started to laugh.

I gawped at him in confused disgust. “What could you possibly find funny about this?” I asked through gritted teeth.

“Your direct contradiction of yourself,” he replied, still seemingly amused. “A minute ago, ‘I want to see the children’…now, ‘sod the children, sod the entire place’.”

“I didn’t say I wanted to see the children. I said that I didn’t not want to go. Different!”

With the smile still smugly etched across his face, he raised his eyebrows cynically at me.

I didn’t think I was going to win this, my argument being as it was a pedantic point of mere semantics. Instead, I decided to be moderately sensible for once, ergo chosing to steer the conversation back to the issue of ‘Ways to Avoid Hotel California’.

Thankfully his face fell back to its serious, considerate expression. To my surprise, he then espoused a similar tactic to the one initially advocated by NewVCB.

“I know your mother doesn’t believe you,” he said, “but could you say to her that there are…issues with your uncle?”

“No.”

“Why not?”

“Because she’d ask what they are, of course!”

“How much did you tell her about what he did to you?”

“When I was about 14, I told her about some of the more ‘minor’ stuff – [uncomfortably] the touching, you know. More recently, I told her that he raped me, though I only told her of one such incident.”

“Sorry, when did you tell her that?”

I thought about it for a minute, and concluded that (as it was about the time I saw Edith, the hypnotherapist) it must have been in my earlier 20s.

“Still several years ago, then,” noted Dr Mathematical Genius.

“Yes. What’s your point?”

“I’m wondering,” he said, “that since some time has passed, could you not maybe broach the subject with her again? I mean, not necessarily tell her the extent of what happened, nor even use the words ‘rape’ or ‘sexual abuse’, but something like, ‘A few years ago, I told you some of what this man did to me. I know you don’t believe me, but nevertheless I cannot see him at this time.’ Something like that?”

Again: “No.”

Again: “Why not?”

“She didn’t believe me then, she won’t believe me now. So it’ll only lead to conflict, and I don’t like conflict.”

He once again took me aback when he said, “but you so often seem to find yourself in it, don’t you?”

Cheeky fucking cunt. I demanded that he exemplify.

Unfortunately that was not a difficult ask of him. “Well,” he said, slowly and deliberately. “With work. With the Trust. [Dramatic pause] With me.”

I defended myself vehemently regarding the Trust. They are the ones at fault here – they are the ones that have always been at fault, pushing me from pillar to post to nowhere back to pillar back to post back to nowhere and so on – and I think it is completely reasonable for me to challenge them for being incompetent and not patient-, but target-driven. Fuck them. Any assertiveness on my part in this regard is absolutely more than justified and I find myself offended that C – who fucking encouraged me to speak up in the first place – now wanks on about how I invite conflict. Tosser.

“Of course, it will not have escaped your notice that my ‘conflict‘ [said with heavy derogatory emphasis] with your Trust has all been by written correspondence. You may also remember in discussions you and I had about my work that when I was writing to {the Horse}, I was assertive and articulate. When I actually met her and my boss, I was a complete and utter mess, who could hardly say fucking anything. And as for you, if anything you should feel complimented that I bitch at you, just as I am presently doing. I wouldn’t be doing so were I not comfortable in your company. Remember when I first met you? It was all very nice, all very polite – all very conscripted and hence ultimately pointless. But that is no more, C. Surely that is good.”

I watched as he recoiled slightly, in a vaguely self-defensive fashion. The wryness with which I had approached the session began to replace the irritability and venom that had characterised the first half hour or so. I suppressed a slightly satisfied smile.

“OK,” he began again eventually. “So it’s interpersonal relationships in which you avoid conflict…with some exceptions, where you feel comfortable.”

“In essence.”

“You become panicky when conflict arises when you’re not completely comfortable with the person. Emotional, even.”

“Um…’panicky’ worked perfectly well on its own,” I corrected him, with a slight knowing grin.

He smiled in return. This interpersonal conflict was over. For now.

“But seriously though,” he persisted, eventually. “You try to deny any hint of emotion in yourself, but that’s just not true. Yes, you have this rational, intellectual, assertive side, but that’s not all there is to it.”

“But there is no function of this emotional bullshit. It doesn’t do anything, does it? It’s the domain of whiny, middle-aged woman who have no fight nor life left in them and have nothing better to do. Assertiveness, abrasiveness, intellectualising – these things can get results, they can achieve things. Emotion doesn’t do that. Not unless you’re an actor, I suppose…”

“You think you’re a ‘whiny, middle-aged woman’?” he laughed, slightly cynically.

I smiled apologetically. “Perhaps that was over the top. You know what I mean, though. I just don’t want a part of that.”

He said, “but the thing is, and I know that you know this really, emotions are integral to our personalities, to how we interact with the world. They’re not big, bad things to be brushed under the carpet. That leads to alienation, and further difficulties in one’s life. This is still one of your biggest issues, Pandora. You fight so hard to suppress how you’re feeling, and the thing is you need to feel it – and you need to express it.”

I shuddered. “But the thing is it doesn’t fulfil anything…” I started again, rather repetitively.

He interrupted me mid-sentence with possibly my favourite line from the whole 53 weeks (2,650 minutes – 2,680 if you consider the time a few sessions have run over – which is 44 hours and 40 minutes or one day, 20 hours and 40 minutes, or 160,800 seconds. I think). He said, his face wrinkled in thought, “everything with you has to be so…mechanistic.”

I was overcome with joy and amusement. What an absolutely fabulous way to be described. Mechanistic. Mechanistic. I love it!

(I’m not sure it was meant to be a compliment, but still – I thought it was spectacular. Just wonderful.).

I laughed heartily as he attempted to continue. “Yes, mechanistic,” he went on, pretending to ignore my laughter. “It’s like you input everything in your life into a big machine and expect every single thing to produce a clear result at the other end.”

“Well…I sort of do,” I responded, still laughing.

“But isn’t there another way of looking at it?” he pressed. Gah!!! It really pisses me off when C asks this eternally fuckwitted question. There’s another way of looking at everything, for fuck’s sake; there’s nearly seven billion people on this planet, how could there not be?! It doesn’t mean that is, or can ever be, my view. Stick you pathetic attempts at pathetic CBT right up your pathetic, boney arse, C.

So I responded by saying that there wasn’t, not from my personal perspective anyhow, which curiously seemed to prompt him to go on the offensive.

He said, almost challengingly, “well, you were emotional here last week.”

True. I shrugged, reluctantly.

“In fact,” he continued, with a slight air of triumphalism I thought (though I am quite possibly reading too much into it), “you confessed about the sense of loss you feel about this therapy ending. [Avoid his gaze, Pan, avoid it at all costs!] You said it was ‘tragic’.”

“I did not!” I exclaimed, horrified he had got it into his head that it was that big a deal to me. (It is, but I don’t want him to know that!). “What I actually said was that it was tragic that so many people probably end up dead because of health service inadequacies [this is true, despite his protestations to the contrary]. I did admit to a sense of loss, yes, and that is very, very bad indeed – but your recollection is not completely accurate.”

He looked me straight in the eye and said, “Well, I think it is. [Fucker]. But why is that admission ‘very bad indeed’?”

I went into a self-hating rant about how being so vulnerable, so pathetically demonstrative of my feelings, so impassioned and hysterical, was dreadful. I am supposed to be an intelligent, articulate, self-assured woman (ha! As if!). Such fits of histrionics are not permissible. No. No way.

He sighed and looked down, knowing the end of the allocated 50 minutes was nigh upon us, and that there was no way he could make any further points on this in the few seconds remaining. After about 30 seconds of silence, the inevitable “the session is over” mantra was intoned.

I was in surprisingly good form as I left him, despite some of the difficult or somewhat confrontational moments in the session. Aside from the caffeine induced ‘wryness’, I was still amused by the quite brilliant ‘mechanistic’ remark. A week later, I continue to be.

However, paradoxically, an ‘anti-mechanistic’ comment also gave me great pleasure this week. Nick Hewling, reading on Facebook that C had levied this particular accusation at me’, said, “that’s proof that he hasn’t read your blog. No one could say that about your writing.”

*blushes* Thank you, Nick. Thank you with mechanistic bells on top.

So.  Wednesday morning.  NewVCB.  She kept me waiting for 15 minutes, after I had rushed like blazes and broken the speed limit on a number of occasions to get there in time, believing I was going to be late.  I had dithered and procrastinated and wasted time for far too long before leaving the house ages late; all that was because I didn’t want to go.

Why do I always get worked up over psychiatric appointments?  I mean, they’re generally not that bad (or at least they’re not that long), especially since NewVCB took over the reins.  But of course, despite rationalisation of this description, I was a wreck anyway.  It’s the whole thing, isn’t it, that the thought of whatever it is is actually much worse than the reality of it.  Still, psychiatrists are an occupational hazard when one is as batshit as I am.  They have it within their power to section you, and I’m still bitterly terrified of that.  I assume that’s what always leads to the fear – I consciously or unconsciously convince myself that I’m imminently going to be sent to the bin, and I lose the plot even more.

As it happens, I still believe that the last time I saw NewVCB she made what I considered a thinly veiled reference to hospitalisation.  I don’t think the OldVCB would have done that.  I think, strange as it seems, that because NewVCB is nicer, because she actually appears to give a fuck, she is much more of a worry to me than her predecessor.  OldVCB would never have sectioned me (or recommended a voluntary admission), I’m fairly sure – she just didn’t care that much.  NewVCB wants to act in my rational best interests, and that is dangerous.

Anyway, when she finally came to get me, she led me to her room and I sat down close to her, as I always do.  She began with, “OK, how…no, sorry, I can’t not mention it.  I love your hair!”

It was a better reaction to my new pink hair than the one C had given – she happily acknowledged it, but didn’t make some banal, pointless statement telling me what I already know.

I couldn’t believe that a consultant fucking psychiatrist was complimenting me on my new hair colour.  I asked her if she was serious.

“Yes, absolutely,” she enthused.  ”It’s really nice.”  Her tone appeared to be genuine, so I thanked her.  She wore a sort of surprised but pleased smile, the function of which I couldn’t entirely decipher.  Maybe she read the fact that I’d bothered to do something like this as evidence of psychological improvement (which it’s not particularly, to my mind).  Maybe she’s simply one of those people that takes an interest in others’ hair colours.  Ho hum.

Anyhow, the appointment didn’t go on for that long (despite this being a fairly typical 2,000+ word post!), as there wasn’t a great deal for me to tell her I suppose.  The crux of it was that (a) the hallucinations are markedly reduced (not eliminated, but a hell of a lot better), (b) my mood has been quite low, to the extent where my suicidal ideation is quite considerably heightened again and (c) as detailed the other day, I am freaking out about how to face or avoid Paedo.

We agreed that Quetiapine had been a wonder drug and whilst things are not exactly fabulous, they are very much better than before I was first prescribed it in January (just after I tried to do myself in again).  She again emphasised that psychological therapy was key (someone apparently needs to tell the Trust and Mr Director-Person about that), but that medication did appear to be helping me deal with that sort of work.  She expressed concern about my suicidal thinking and low mood, and asked if I would object to her increasing my dose of Venlafaxine.

I’m not even sure that Venlafaxine makes any difference – it’s really been Quetiapine that’s helped me, in my estimation – and even if it does, I remember really horribly well adjusting to taking it in the first place – and then to an increased dosage thereof.  It is very, very much not in the least fun.  I must have given my reticence away, because she continued by advising me that for the most severely chronically depressed (like me, apparently) her personal observations were that higher doses of the drug made significant differences.

“I suppose it sounds obvious,” she said, “but the reality is that quite often moderate doses of anti-depressants make major differences.  In this case, however – in the worst cases anyway – I think higher doses are generally more helpful.”

I suppressed a self-satisfied smile, thinking back to Dickhead GP’s contentions that, at 150mg, I was already on a “really high” dosage of Venlafaxine.

I told NewVCB that I was scared about adjusting to a higher dose, given what had happened previously, but she actually felt that that was good: “you know that you are to expect that, that it isn’t your normal behaviour, and that it will pass.  Not everyone has that insight, even if I try to provide it.”

“But,” I said, pessimistically, “what if I want to come off it at some point?”

“Don’t ever do that!” she exclaimed, looking up urgently from writing the prescription.  ”Do.  Not.  Do.  That.  If we decide in the future to take you off it, I’ll be bringing the dose down by 37.5mg each week at most.”

She went on to tell me about another patient that had usually been relatively stable that came to see her one day literally clawing at his face, as if trying to peel it off.

“It turned out he’d not been taking his Effexor for three days,” she revealed.

Well, that’s tremendously encouraging.  I’m going to be taking the cunting, evil stuff for the rest of my life, aren’t I?  Shit.

Anyhow, I slightly reluctantly agreed to let her increase the dosage of Venlafaxine to 225mg, with a view to considering 300mg in future.

This should be interesting.

Leaning forward towards me, she looked conspiratorially me straight in the eye and said, “I have to ask.  [Almost whispering] Just how strong is your suicidal ideation at present?”

I admitted that I frequent pro-suicide newsgroups and that I ergo know what would be most likely to kill me and what wouldn’t.  ”I keep thinking about overdosing, and I am very well aware that unless you have exactly the right ingredients and you plan it very well, ODs are very unlikely to work.  I don’t have the energy to plan something like that, so an overdose would be an impulsive act and therefore probably non-lethal.  Plus I don’t have the figurative balls to jump off a building and I won’t deliberately crash Disraeli, my car, because I love him too much.  In short – I don’t think I’m in any imminent danger of offing myself.”

“OK,” she replied, seemingly relieved, though I’m not sure if relief is the appropriate response to the admission that I can’t guarantee I won’t take an overdose.  ”Because you’ll be aware,  I’m sure, that starting to take Effexor – and, indeed, increasing the dose thereof – can lead to increased suicidality in the short-term.”

I’ve always loved this irony about anti-depressants.  I know that that risk is, generally, only temporary in nature – unless you actually do top yourself, and then it’s kind of permanent – but I find it amusing that the very thing that is meant to alleviate depressive and suicidal thinking can increase it.  Bizarre indeed.

I confirmed that I was thus aware and reiterated that I did not feel in real danger.  I don’t know that I completely agree with that assertion, but I’m not going to give her any more ammunition to throw me in the bin.

She said, “I don’t think you can expect your suicidal thoughts to go away any time soon, given your long history of illness and the intensity of therapy, but hopefully, after the initial few weeks, medication can at least ease the strength of them.”

I laughed.  ”I don’t expect to ever be rid of suicidal thoughts.  There has not been one single day that has gone by in – oh?  At least 20 years? – that I have not thought about killing myself [see this post].  It’s simply a matter of the degree of strength that those thoughts have.”

She accepted that, and agreed that if this line of thinking could be reduced in (a) frequency and (b) intensity, that would be good progress.

For some reason the bloody child abuse topic surfaced, as it usually does.  It never came up with OldVCB, except perhaps briefly in the assessment session that I had with her and her SHO, Dr N.  Again, this disparity seems to be because NewVCB gives a shit.

Anyway, I don’t remember the intricacies of the conversation, but at one point I know that I whined about how I didn’t know how to cope with seeing Paedo.

She interrupted me mid-sentence, shaking her head violently.  ”You can’t see him,” she said simply and definitely, making a ‘no’ gesture with her arms.  ”It would be damaging, given the strength of your reactions to at Christmas and indeed to discussing matters in therapy.  No.  You can’t see him.”

I pointed out how difficult not seeing him would be to execute, given that my mother doesn’t believe me about the sex abuse and loves her family almost to the point of reverence.

NewVCB said, “can you say to her something like, ‘I know you don’t accept what I told you about this man, but nevertheless I cannot see him – not at this point, anyway.’  Would that work?”

I admitted that I had never really considered bringing the topic back up with my Mum, and that I was petrified of doing so.  ”It’s a right can of worms to be opening up,” I sighed.  ”I don’t know if I can do it.”

We pondered on whether or not I could blame my social anxiety issues, given that Maisie and Paedo’s house always seems to be full, always seems to be loud, always seems to be a situation in which I cannot cope, irrespective of Paedo’s presence.  I agreed to give this lie excuse a go.

[As it happens, A has actually come up with a very good short-term excuse to avoid Paedo and friends.  Because the increased dosage of Venlafaxine will, in all probability, fuck with my head for a few weeks, he suggests telling Mummy Dearest that for, say, four weeks or so I need absolute routine without any deviations whatsoever.  I think this could work quite well in my quest to avoid Paedo.  My mother will object, of course, but I can say that I am under medical orders.  Which, if you bend the truth slightly, is not a complete lie, because I am under NewVCB's orders not to see Paedo.]

In any event, NewVCB then announced that she she would be off for four weeks in July, adding, “would you like to see someone else or wait for me to come back?”

I asked would the alternative someone be a consultant – ie. someone who can muck about with the medication if required, rather than an SHO on rota to his/her GP training – and she confirmed my suspicions that it would not be.

I advised that I would therefore wait until her return, remembering the pathetic debable of incompetence that took place when I last saw an SHO.  If something major happens during the period of NewVCB’s absence, I suppose Lovely GP has some knowledge of psychiatry and can try to help.

All in all, I suppose it was a relatively successful encounter, though I am worried about the increased Venlafaxine dosage, particularly when she’ll not be about to monitor it.  Still, as she pointed out, it is considered one of the most effective anti-depressants, and if I need a higher dose to get the full value from it that I need, then so be it.

If nothing else, losing my mind yet again for a few weeks could lead to some interesting blog entries..!

Anyway, here is the latest letter from Mr Director-Person, in response to my correspondence of 11 March.  I am very impressed with his wonderfully speedy return on this.

Dear Pandora

Re Accessing Mental Health Services

Thank you for your letter of 11 March 2010 and I apologise for the delay in replying.  As we have acknowledged previously you are correct in your interpretation of the NICE Guidelines in relation to personality disorders.  However NICE does not apply automatically in Northern Ireland.  Currently a Regional Personality Disorder Group, brought together by the Department of Health, Social Services and Public Safety is considering the Knowledge and Understanding Framework (KUF) as a way forward to developing better services in Northern Ireland.

Locally, a group run by <Mr Twathead>, Head of Mental Health Nursing in our Trust, is working on a plan to improve services for people with personality disorders.  This service will support the objectives of the Northern Ireland Strategy for Personality Disorder.  The Trust is also in the process of recruiting Personality Disorder Practitioners who will work with community teams to provide a more locally responsive service.

As a Trust we are committed [hahaha!] to user involvement in the planning, delivery and monitoring of our services so we would be grateful if you could get back to us with an expression of interest in helping us develop better services for people with personality disorders – please contact <BitchBrain>, Assistant Director Mental Health Services, <Big Bin>, <phone number blah blah>.

In relation to your own treatment and care, <C> has spoken to <NewVCB> about follow-up sessions.  It was agreed that there would be a seamless [*explodes laughing*] transition at that time [<pedantry>at what time?  What point of your letter are you referring back to?</pedantry>] to the provision of support from either a community psychiatric nurse or a social worker from the community mental health team.  The details of who this will be and the extent of the contact will be negotiated closer to the time of transfer.

Yours sincerely

Mr Asshole Director-Person Cunt.

One thing that really annoyed me that has no relation to that actual content of the letter was that he addressed me as ‘Mrs <my new surname>’, assuming that any female changing their name must be doing so owing to marriage.  My cunting bank did this as well, which send me into a spiralling fury of ranty anti-capitalist rage.  What a pile of outdated, presumptuous, misogynistic crap.

Anyhow, this is my proposed response.

Dear Mr Director-Person

Re: Accessing MH Services

Previous correspondence refers.  Thank you for your eventual response of 12 May 2010.

I note with interest your willingness to point out that NICE guidelines are not always applicable in this jurisdiction, and that a regional team is “considering” the application of the KUF.  I also have taken note of the information that a plan is being “worked on” to develop services in this Trust and that a NI Strategy for PD apparent exists.  However, you will recall that in my letter of 11 March, I specifically requested details on how the treatment of the very real challenges faced by Northern Ireland individuals with mental health difficulties (not just personality disorders) is being adequately governed and protected now.  I am disappointed to note that you have failed to provide this information.

You may be aware that <NewVCB>, whilst reluctant to continue the tradition inherent in the system of providing stigmatic diagnoses, felt that I am afflicted with a form of complex post-traumatic stress disorder.  I would refer you to Trauma and Recovery by Judith Herman and The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization by Onno van der Hart on this subject.  As I am sure you are aware, these sources (and many others) quite definitively feel that whilst psychotherapy is a vehicle to recovery, the inadequate provision of same can lead to re-traumatisation.  Given your apparent familiarity with my case, I believe that I can fairly reasonably conclude that you will be aware that I am thoroughly re-traumatised thanks to recent work with C.

To that end, I should be grateful if you could clarify the mandate of mental health services within your Trust.  Is it your actual goal to discourage healing and indeed bring about psychological damage to ill and traumatised individuals?

In particular, I must question the decision to refer me to a CPN or mental health social worker after my contact with C ceases.  I must confess to being amused at your contention that the transition from C to this person would be “seamless” – aside from the fact that it is impossible for you to predict the level of “seamlessness”, and the fact that I am well acquainted with C without any knowledge of his “successor” (and bearing in mind social anxiety is one of my many diagnoses), as yet no one has been able to tell me exactly what such individuals do other than to attempt to encourage their charges to complete day to day activities.  C-PTSD and BPD, as you know, require significant psychotherapy, not reminders to undertake simple tasks (which, I might add, are often impossible regardless of external encouragement).  Whilst there is arguably a place for such professionals as adjunctive workers involved in a person’s treatment, at present I utterly fail to see how assigning them as the primary contact can be of significant benefit, at least to someone someone such as myself.

On the other hand, I am also aware that certain individuals of these specialisms practice the supposedly panaceatic techniques of cognitive and dialectical behavioural therapy.  After my 12 years of being richocheted around your system – and of being forced into the private sector thanks to its failings – I have experience of these “therapies” and feel strongly that not only are they ineffective and patronising, they are indeed offensive.  Their practice is in keeping with the victim-blaming culture that seems inherent in psychiatry and allied professions in reference to BPD.

Whilst I accept that the above view is personal and not held by everyone, and that these techniques can have at least temporary usefulness for some sufferers of mental illness, it has been accepted by those involved in my own case that this would not be appropriate for me.  I would therefore hope and expect that it is not suggested.

I would, ergo, again enquire as to the relevance of a CPN or SW as opposed to a qualified psychotherapist as my primary case worker.

I would like to convey my sincere thanks to you for inviting me to express interest in your user involvement scheme.  I shall be writing to your AD, <BitchBrain>, with said expression forthwith, and look forward to hopefully making a worthwhile contribution to personality disorder services within our Trust.

Thank you for your time.

Regards

Pandora (Ms)

I whacked this response out on a secluded beach on the Turkish Mediterranean.  My God, what a sad, pointless life I lead!

I’m seeking advice on this one because, although I feel my letter is fairly good, it doesn’t ask many direct questions, meaning that Mr D-P can cleverly wriggle out of answers yet again.  To this end, I wonder if any of you would like to suggest amendments, additions or direct questions that I could use when writing back to him.  As with the last post, all views are most welcome.

Thanks again lovelies.  x

Anyway, I may report on the holiday in due course, but for now I need your advice, my precious lovelies.  I’ve been thinking seriously since I last saw C – and before, for that matter – of just quitting therapy.   I will outline my reasons and the pros and cons of this, but whatever the case I would really value your advice or tales of your experiences of same.   Thanks so much to all of you on Twitter and Facebook that have already provided such counsel.

Basically, I feel that the whole situation with C is completely out of my control, and this is doing my head in.  I’m not exactly a control freak, but I know that if things are in my hands, then at least I am not in as vulnerable a position than I would be in the case where the power is firmly in the hands of others.  The therapy is ending in – what? –  seven or eight weeks anyway, so why not take control of things in one of the few ways I now can?  What are those few weeks going to actually even do, apart from fuck up my life even more?

I’m also at the stage where I believe firmly that therapy is thoroughly re-traumatising me.  I accept that a certain amount of this is inevitable – indeed, I’m sure, necessary – in trauma therapy, but the thing is in most cases the therapist continues working with the client at least until he or she has been able to overcome that re-traumatisation (or, in the worst case scenario, not be quite so hideously haunted by it).  This will not be the case with me, unless C can miraculously process all my traumatic memories – those of systematic, long-term child sexual abuse, abandonment/rejection, bullying and betrayal – in a few pathetic weeks.  He doesn’t even know about it all (not because I have deliberately withheld information, simply as some things have to take priority), so how can he?  Basically, I am completely re-traumatised and it is all but impossible that I am going to leave therapy in a different state.

Useful work is not even being done at this stage, in my view, because I’ve become terribly defensive again.  At least, I assume that it is defensiveness – it never feels exactly like that in session, it’s just that I can’t seem to talk about anything worthwhile anymore.  But of course I can rationalise that behaviour out of session: I know that I’m teetering on the precipice of being hurt with a pain unparalleled in years, so it makes sense for me to clam up in order that I can protect myself from being even more at C’s mercy than I already am.

So, pros and cons of ending therapy of my own accord.

Pros

• Regaining control of the situation.
• Earlier transition to a private (and hence more reliable) therapist, and an earlier start at interviewing those on the shortlist.
• Satisfaction of beating C at his own game.
• Reduction of further re-traumatisation.
• Reduction of further wastage of 50 minutes each week on both sides.

Cons

• The Trust will almost certainly interpret this as typical borderline behaviour and note further stigmatic bullshit all over my medical notes.
• The Trust will consider the fact that I quit therapy of my own volition in any future referrals and presumably respond with a giant ‘fuck off’.
• I might miss C and end up regretting finishing interaction with him before the last possible minute that I could have done.
• W claims that therapy seems to have been working of late, presumably owing to his objective and detailed reading of my material here.  It certainly was doing so, for a while, though I don’t really think it is at present.  But if it is, then I could be ‘blowing it’.

One thing I am going to do – to wind C and the Trust up if nothing else – is demand some material from them.  One, I want copies of the entire files that C and NewVCB hold on me.  They will be requested, respectively, tomorrow and at my psychiatric appointment next Wednesday.  Two, I intend to launch a Freedom of Information request into the minutiae of certain Trust expenditure, so as I can quote the Trust’s almost inevitable wastage in my ongoing dispute with Mr Director-Person (more on that cunt later today).

So.  In conclusion, I would really, really appreciate all your thoughts on this matter.  Any views of any persuasion are most welcome.  Should I quit therapy with C before he quits it for me, or should I ride it out to the end?

Thank you all.  x

I am going on holiday this evening. Ergo, I will be (mostly) in absentia until at least 24 May.

Unlike the preceeding hours before the last time I went on holiday, I am not in a good mood. I am, in fact, muderously livid. C is to blame (surprise surprise), even though it’s not his fault.

So, the latest on the wanky questionnaires is that either I have DID or I’m exaggerating my dissociative symptoms. He tried to dress it up, but that’s what it comes down to whatever he says.

So typical of borderlines, yes? Neurotic, attention-seeking, self-obsessed, manipulative narcissists.

Beyond that the session was thouroughly pointless. It was just more of me slagging myself off endlessly. He didn’t even bother to defend me this time, like he has been known to do, because apparently I am trying to manipulate him into doing so or something.

Some gems:

I’m a five year old fantasist trapped in a womans’ body. A pretty smart five year old, but a five year old nonetheless.

I’m an immature, pathetic, stupid waste of space. Well…not stupid. But stupid all the same. Just not stupid-stupid. But the stupid kind of stupid. Except not actually stupid, just…stupid.

[On seeing Trust headed paper being used, as intended, for rough notes] You do realise that I’m internally raging, don’t you? That exemplifies your pathetic public sector inefficiency. No wonder the Trust has no money. Such wastage. [Genuinely seething inside - proper, murderous anger].

I’m sure there was more but I can’t recall it all and anyway, I’ll write about this session properly when I get back from my travels.

My mother had called me during the session so I called her back to see what she wanted when I left. Mr Director-Person had finally responded.

My analysis of the NICE guidelines etc is apparently quite correct, but – it now emerges – the NICE guidelines don’t automatically apply in Northern Ireland. Well, that’s brilliant, isn’t it? Great job. How eminently rea-fucking-surring to know that we are safeguarded in this country as well as the rest of the UK. OUT-FUCKING-STANDING.

Blah blah blah…we are developing a PD service…we welcome “service user” (I fucking hate that term) involvement…please register your interest with this tosser at this hospital…

Readers, I will. In fact, if they do indeed accept me on board, I will turn it into a personal crusade. I will twat the system from inside the bastarding system.

Blah de blah…[C] and [NewVCB] have agreed to put you under the care of either a CPN or a mental health social worker…details to be worked out closer to the time…

Go and fuck yourselves. What is some CPN going to fucking do? Remind me it might be a good idea if I fucking washed occasionally? Attempt to patronise me with CBfuckingT?! No. No. I need psychotherapy. If I am not to receive psychotherapy, then you can all just go and die, you supercilious, self-interested bunch of despicable cunts from hell.

So that, dearest readers, is the latest. I am sure I’ll calm down a bit – but probably only when we finally reach our apartments tonight, as hanging around airports is supremely frustrating, and flying is supremely boring.

I have got a data abroad package on my phone so will probably be about occasionally on Twitter – I might even post here if you’re (un)lucky. Otherwise, thank you all for reading and thank you for your unwavering support and friendship.

Much love

Pandora x

My first piece of writing here was the ‘About‘ page, which still retains the same basic structure as it did on 4 May 2009, but has been modified in terms of content as circumstances have changed. My first actual post was written on 5 May, and can be found here (it’s also since become the subject of another page, as I thought it gave a lot of useful contextual information).

Confessions began life at serialinsomniac.wordpress.com. I moved to the self-hosted domain of www.serialinsomniac.com in January this year, as I wanted more control over the aesthetics of the blog. I still have a redirect from the old WP hosted blog, which will run until January 2011.

SIGNIFICANT EVENTS AND POSTS

A lot has happened in these 12 months.

2009

I started self-harming again in May (though I’ve been ‘clean’ since January this year) and was subsequently diagnosed with BPD and bipolar disorder in June (at which point my medication was changed from Citalopram to Venlafaxine). I started hearing a (benign) voice in September, whilst in October the hallucinations became malicious, in the form of ‘They’. It was also in October that I lost my job, owing to my lengthy mental illness-related absence. I completely lost my sanity over Christmas, leaving me in not quite the best frame of mind in which to see the new year. The problems were mainly related to being forced into seeing Paedo, but C’s revelations that he would be offering a curtailed number of sessions in 2010 didn’t help either.

2010

In January, I bit the bullet and did something that I’d been intent on doing for about two years – I changed my (sur)name, thus dissociating myself entirely from my aunt and uncle, Georgie and Merv, not to mention my deceased father V. The new year also saw me receive my first blog award, from the wonderful Mental Nurse, who have also been kind enough to feature me in their weekly round-up of mental health blogging (TWIM) a number of times. Despite these positive developments, I spent the entire month in a depression of epic proportions, and I tried to kill myself in the early hours of the 16th. However, shortly after that, I was allocated a new psychiatrist (Dr M, mostly known as NewVCB) who prescribed the anti-psychotic Quetiapine (brand name Seroquel) on top of Venlafaxine to curb the voices and hallucinations, and also to act as a mood stabiliser. It has really been a force for good in my life. NewVCB later agreed with my self-diagnosis of complex post-traumatic stress disorder, so I was able to add that to my arsenal of diagnoses. The C-PTSD was mostly in relation to the sexual abuse I went through as a child, the full memories of which came back to me through discussion in therapy, the extent of which I finally admitted to C some weeks later. It is an ongoing psychotherapeutic topic.

A year on from commencement of writing, the importance that this blog now has in my life was underlined by an incident in which it initially looked like my family had found my online home (which would have been a huge disaster for all concerned). I now do not think they have, but my conclusion whatever the case is that I will not be silenced.

ACKNOWLEDGEMENTS

As you might expect, there are far too many to list. I would like to thank all that read here, and in particular those of you that leave comments – your interest and support make this project worthwhile (though of course I still maintain the journal primarily for my own benefit). There are a few people that I have to single out though.

Obviously A has been a source of immeasurable support and I’m fairly convinced I’d have done myself in were it not for him throughout the past year. There are no words great enough to convey my appreciation of his unwavering tolerance and care – I can only say that he is treasured and loved very much. CVM, K and Annie (internet friends that I have met or will meet) and my close friends Aaron, Daniel and Brian also deserve my gratitude.

In terms of my online friends, I owe particular thanks to Alix, Splintered Ones, Tiger, Lola, Kim, Wounded Genius, The Same Sky, Bippidee and Phil. I’d like to especially single out bourach, as it was her blog that inspired me to start this one. Thanks also to the aforementioned Mental Nurse for featuring my blather in TWIM from time to time, and for yesterday devoting a whole post (albeit a short one) to my crap

SOME STATISTICS AND TRIVIA

At the time of this writing Confessions has had 48,213 hits. The counter is only updated twice a day, so if you see any disparities (eg. the counter not updating despite you visiting several times), then that is probably why.

The overall most read post is ‘Suicide Attempt Epic Fail‘, which has presently been read 402 times. At the old URL, the most read post was ‘Signs of Childhood Sexual Abuse‘, which is still the second most read overall post with 332 hits. In both incarnations, ‘About the Author‘ has been the most popular static page, with a total hit count of 771.

The post most frequently reached through Google searches is ‘BPD vs C-PTSD‘, which with 329 hits is currently just short of being the second most read post overall.

The longest post, with over 8,000 words, is ‘A (Half-)Life in Therapy‘.

The busiest day on the blog to date was Friday 16 April 2010, when there were 614 visits. The quietest days were, unsurprisingly, last May when the blog was shiny-new. Since then my quietest period was about a week in April 2010 when the aforementioned worries about my family possibly reading the site surfaced. This was due to my efforts to hide the blog from their eyes, but of course had the knock-on effect of preventing others from reading too.

The busiest month so far was March 2010, when Confessions received a total of 10,529 hits. The quietest month was, unsurprisingly, way back in the beginning in May 2009 when there were 824 visits. Interesting point of comparison: this May is only just into its fourth day, and the hit count for it is 1,082 – half as much again in four days than were received in the whole month of May last year.

On the other hand, May 2009 was (ostensibly) my most prolific month of writing, as 23 posts were published during that period. I say ‘ostensibly’ as, as my writing here has developed, my verbosity has similarly developed and increased notably, so in reality even though I may have been writing less posts in other months, I was probably writing more words. The month with the least posts published was August 2009, where I only wrote a total of seven.

The sites that send me the most traffic are BlogSurfer, StumbleUpon and, of course, Twitter. The actual blog that refers folks here most frequently is Bippidee‘s

The most commented-on post was, perhaps slightly ironically, a password-protected post: ‘Things I Know That I Should Not Know‘ has 47 comments.

The most common search terms are variations on the blog’s title, ‘confessions of a serial insomniac‘. ‘C-PTSD‘ (and variants thereof) is currently the second most popular, with ‘i hate my therapist‘ (presumably for this), ‘letter to my therapist‘ (this) and ‘Julian Hendy‘ (this) also featuring prominently.

Some of my favourite search terms are ‘hallucinating gnomes‘ (referencing this), ‘dr bellend‘ (this), ‘dbt is patronising‘ (too many possible posts to list), ‘fuck you therapist i hate our relationship‘ (this again, I assume) and ‘arsecunt‘ (apparently this, which was otherwise fairly innocuous!). There are also a variety of searches ranging from fairly dull to outright weird that incorporate variations on the word ‘wank’ (because of this).

Including this, there are a total of 154 published posts. Including track- and pingbacks, there are 1,572 comments.

A POINTLESS YOUTUBE VIDEO TO PROVE THAT I CAN EMBED THE DAMN THINGS…AND MEH

The following song quite adequately sums up how my life has been in the year chronicled on this blog (and well before it at that)…

Click here to view the embedded video.

…not especially cheerful, I know. It hasn’t been an especially cheerful year. But still, something positive has come out of it; Confessions of a Serial Insomniac is my pride and joy. It might not be the best written blog, nor the most popular, nor useful nor helpful nor politically cor-bloody-rect in any way. But it’s mine – all mine – and I love it, follies and all.

The Blog-and-life-inertia-itis is compounded by the fact that I’ve completely blocked out most of this session from my conscious memory. I remember how things started, and I remember how they ended. What happened in the ‘middle’ portion of the meeting is frankly anyone’s guess; it’s almost like the chunk of my brain where the recollective (yes it is a word) neurons pertaining to those 30 or 40 minutes were stored has been cut out with a sharp knife. Well, así es la vida. On the bright side, I’ve always wanted a lobotomy.

As far as this session went, with the exception of a few minutes at the end, I’m not sure how much it really added to what had happened in the last meeting and the one before that – how could I be thus sure, however, when I don’t remember what the sodding hell happened. We started with the usual crap of silence – he asks where to begin – I say I don’t know – silence, which in fact has almost become the subject a parody between us now.

C was the first one to cave in. I’d noticed a couple of sheets sitting on the coffee table that sits between us (where the hateful, cheap tissues are housed for when mentals ((or rather, ‘mental’ – singular – because of course I am his only patient *cough*)) start bawling their eyes out), and was interested to see him gesture towards them.

He explained that he had obtained dissociation scales to measure just how extreme my ‘general’ episodes of dissociation, derealisation and depersonalisation were, as well to determine the seriousness of the dissociative psychoses. He had two such survey things; one is a standard dissociation scale, the second a much more in-depth questionnaire. He had apparently initially hoped I could fill them in during or at the end of the session, but given the length of the longer one (218 questions or something), he’d decided it was best if I filled them in at home then just posted them back to him.

He then mused about when he might receive them back, supposing it would be Tuesday (tomorrow). I was surprised to learn that he does not work ‘there’ on Tuesdays or Wednesdays; I missed the opportunity to ask what, if anything, he does on those days, but if I had to guess, I would say those are research days as I am aware that he has been involved in research in the past at least.

At any rate, he advised me not to sell myself short in the questionnaires; he feared I’d downplay the severity of my symptoms.

“On the other hand,” he continued, “you obviously don’t want to exaggerate them either, so…”

“So go with my first instinct,” I finished, to which he nodded. “I’ve always been advised when completing psychiatric questionnaires that I should basically go with the first rating that my mind thinks is appropriate.”

He agreed with this and asked if I had any questions regarding why he wanted me to fill these in.

Of course, I did. “Are you going to use these to bin me?” I enquired.

For some reason he initially smiled at this but, seeing from my facial expression that my question was serious, he desisted from that with very quick effect. “Not at all,” he replied.

I asked what, then, he hoped to achieve through the exploration of my answers to the questions, and he said something about it being able to inform deeply the way we work together. Apparently it could give him great insight.

I filled in the two questionnaires that afternoon, but found mysef to be somehwat irritated by the way in which they scale dissociation. Both ask what percentage of the time you have symptom x; for example:

Some people have the experience of finding themselves in a place and have no idea how they got there. [Thanks for not patronising me there, questionnaire, thanks very much ineed].

Circle a number to show what percentage of the time this happens to you

0% 10 20 30 40 50 60 70 80 90 100%

(Source)

When it says “what percentage of the time” what exactly does that mean? All the time? Times when you’re unwell? In the above example, how can that possibly be 100% of the time – surely that’s impossible. If you didn’t know why you were somewhere every time you were somewhere, which is a state of permanence, then…no, fuck it, it’s too late in the evening to try to articulate what I mean properly. Just…it’s odd. I would have liked some proper context to these questions, and it wasn’t there. So I added a note for C stating that, and advising that in the absence of such information, I was answering the questions at face value – ie. assuming that “percentage of the time” meant all the time. In all probability, having done so may well end up minimising my levels of dissociation as far as these scales go, but all I could do was be honest within the framework I was given.

Two things concerned me about the longer test (the MID) in particular. Firstly, a cursory search online suggested that the MID is used to diagnose Dissociative Identity Disorder (DID). Even though I’m all but certain this diagnosis is not at all applicable to me, I worked myself into a panic and convinced myself that C thought I had it. Not that there would be anything wrong with having it, obviously, but given how much I don’t think it applies, it would create an incongruence between C and I if that were his opinion. Fortunately, I now see that the scale is used more widely than just in relation to DID; it’s also applied to measure borderline and PTSD dissociation, which of course is me right off to a tee. So hopefully C is on my wavelength after all.

The second thing to annoy me was that there are several questions that ask about how much you exaggerate your symptoms – either physical or psychological – in order to get attention (or variants thereon). I know C didn’t write the MID, but I nevertheless took this as a personal insult. Does he really think I am faking all of this?! On a more logistical note, even if I were, am I really going to own up to that to him, the very person in front of whom I would be faking (at least psychic) symptoms?! Now, in fairness, I’ve been known to exaggerate some physical issues, but never ‘for attention’ – at least, not in the traditional sense. I’ve done it only when I know a completely honest description of the problem would not garner the treatment required, as is quite typical throughout the NHS (at least in my experience). To the best of my recollection, I’ve never done it in relation to my psychological health – if anything, the polar opposite is more likely to be the case.

C had thought we wouldn’t get to discuss the questionnaires this week as he reckoned they’d have arrived tomorrow (Tuesday) and he wouldn’t be back in that office until Thursday (at which point I am the first person, other than his secretary I assume, that he sees), but I ended up posting them in time that they may well have gotten there today, thus affording him the opportunity to study them in advance of this week’s session should he wish to do so. We shall see if indeed that comes to pass.

Anyway. I’ve diverged from a discussion about the session to a discussion of dissociative scales, so let’s move back to where we were meant to be.

Eventually, for reasons I can’t particularly fathom because it wasn’t relevant to anything we’ve been discussing in-session recently, I mentioned briefly to C that I had been out the evening before with A, as it had been the anniversary of my meeting him.

C asked me how things were with A, which was a curious question I thought; I don’t believe I’ve ever led him to believe that things were anything other than good between us. Of course, as I was typing that last sentence I remembered that of course I’ve told C about what a cunt I’ve been to A at times (for example, here) so I suppose it wasn’t such an odd question after all. Anyway, I said that things were good and that “A takes care of me.”

Unfortunately, I literally said that “A takes care of me.” Not his real name, but A. I corrected myself and continued, thinking of it as nothing more than simple absent-mindedness, but C interrupted me and asked what I had meant by ‘A’.

“Oh, that’s what I call him on my blog,” I said dismissively. “I suppose it shows what a big part of my life it is.”

I was ready to move on and discuss something that might actually have been vaguely useful, but C started harping on my apparent allegation that “the blog had taken over my life.” He looked suspicious, which disturbed me considerably. My paranoid mind is now convinced – especially in light of the exaggeration questions in the MID – that he thinks I make stuff up, or that I exaggerate and embellish to a significant degree, to make things sound interesting here. I don’t think that’s true. Is it? I know I’m guilty of paraphrasing and perhaps not always describing things exactly as they happened, but isn’t that the nature of any subjective human experience? Am I fucking things up?

And here we hit the brick wall of nothingness. I don’t remember the next half hour to 40 minutes at all. I could understand it if I just forgot little bits and pieces or nuances, but I literally remember nothing. My supposition is that this is because – hurrah, you’ve guessed it – I dissociated it. I’m almost certain that I didn’t reveal any specifics to him as regards our ongoing subject matter of child sexual abuse, because I remember having a discussion dodging that later. But I don’t know what I did say. I intend to ask him on Thursday, because I can’t tolerate this blankness, longed-for-lobotomy or not.

The next thing I recall was telling him that I hadn’t really discussed the flashbacks I’d been experiencing with him the previous week, owing simply to the fact that we hadn’t had time (as the session was almost entirely spent discussing the hallucinations). There was a bit of (largely un-recalled) probing from him, and a lot of humming-and-haing from me, though I think I admitted that the flashbacks occur as if they were my ‘present’ and not my past. I’m sure he asked me something on that point, but – wahey – I don’t remember what it was. Well done, P.

Eventually, I admitted to the somatic symptoms that accompany my flashbacks and, indeed, that often stay put quite independently of them – the almost constant physical pain that has plagued me as part of this whole nightmare for the past few weeks. I think he may have asked me similar questions to those he posed in this session – namely, were the somatic symptoms in my genital region – but I don’t remember fully.

What I do recall is that eventually I told him my back hurt like blazes all the time, and that it’s especially pronounced during a particular recurring flashback. He asked in what way it hurt, and I responded by telling him that I had been forced to sort of stand against a wall and that that was what had caused me pain in that area.

Cue a lot of investigation from him as to exactly how I was standing and a lot of attempted avoidance from me. In short, this flashback is one wherein I was pinned to the (outside of) the garage wall, my knees bent forward considerably so that I was at the ‘right’ height and angle to suck Paedo’s cock. The pain emanates from the pebble-dashing of the wall pressing into my back, as well as being pushed against the wall with some force during each hideous thrust.

I managed to get out of telling C what went on, but he couldn’t understand what way I was standing during the incident in question, leading to much confusion. I was about to act it out for him, but found that I couldn’t bring myself to do so, and told him as much.

He said, “could you draw it for me?”, pushing a pen and a bit of the bland Trust-headed note-paper towards me.

I was surprised at the request, and ever so slightly horrified, but made some gesture of reluctant acquiesence, and drew a stick-figure me contorted against a wall in the aforementioned grotesque fashion. To my immense revulsion, C then went to the wall and physically depicted the stance I’d drawn myself in. “Like this?” he asked.

I nodded, and looked away, suddenly ‘back there’ for a minute or two.

Fortunately – or otherwise, depending on your perspective – this was at the tail end of the session and he couldn’t probe me deeper any further. He said that his supposition was that this particular incident was a forced incident of oral sex (no shit).

“But,” he added thoughtfully, stroking his chin. “I don’t think calling it ‘oral sex’ is an accurate term. It’s not sex; the word ‘sex’ implies consent, not to mention the ability to consent.”

I stared at him blankly, determined to give nothing away.

And that’s suddenly reminded me of one thing that happened in the ‘lost’ half hour: I remember repeating over and over again that “shagging one’s uncle at the age of five is disgusting,” and C reminding me that a five year old can’t consent, and my counter-protesting that I knew that, but that didn’t change my view on how disgusting I was/am and that no amount of evidence or rationalisation ever would.

Indeed, I now remember that I repeated the word ‘disgusting’ in relation to myself and what happened over and over and over and over again, then went into a self-vituperation of epic proportions for failing to employ synonyms of ‘disgusting’ in my speech, thus in turn failing to utilise the English language in a more creative fashion. Very rational and helpful, I’m sure you’ll agree.

Anyhow, discussion of the forced-fellatio-flashback completed (that even sounds like a dubious sexual practice), I was feeling physically ill and as if I were about to explode with a doom-filled internal energy. I joked to C that I was going to throw up all over him, and he joked back that he would dodge the vomit and catch it in the bin. For some reason the gentle banter calmed me slightly – but I was still in full-on crazy-mode.

As a consequence, I held out my hand in front of me, in order that I could measure how much it was shaking. This harks back to an incident when I was 15. The day after I’d found out about my ex’s colossal betrayal – an incident about which I must write one of these days – I was sitting in school, literally shaking from head to toe. At one point I noticed my extended right hand shaking up and down, like the Golden Gate Bridge shaking in an earthquake. Ever since, I have used that as a benchmark to determine my levels of overt anxiety.

It was shaking a fair bit on Thursday, but not unmanageably so. “That’s OK,” I muttered thankfully, mainly to myself.

I noticed C’s raised eyebrow, and explained what I was doing. I was delighted when he said that he’d seen me doing it before. I know he’d seen me doing it before, but it was the fact that he remembered such a small, meaningless thing about me that was so pathetically important.

I was further delighted when he described my facing up to the fellatio flashback with him as ‘brave’. He’d also said I was ‘brave’ in the last session, and I have to say, the fact that he thinks this makes my heart and mind sing like something out of The Sound of fucking Music.

Clearly, though, C does not know that his endorsement (if that’s the right word) has such a positive effect on me. He said, “you probably don’t like me calling you ‘brave’, do you?”

I nonchalantly responded that I “didn’t mind” the use of the adjective in reference to me. Oh, what a belier of truth I am!

I went on and told him that although I appreciated him saying that, that it really didn’t “fit” with what I felt about myself.

“I’m not brave in my mind,” I murmured quietly.

“Well,” he responded, rather definitely and slightly authoritatively. “I think you are brave.”

And for the second week running, I got an “all the best” as I left, which always makes my week. I’m still desperate for him to actually like me, which I know rationally is probably a silly pipedream. But his present extension of an arm of kindness comforts and reassures me, and I’ll continue to bask in its loveliness for some time to come.

If the police are ever involved in my psychiatric life, then all hell will break loose. I will be fucked. A – and possibly a range of others too – may well be forced to give out information about this blog and the history of my mentalness. If that happens, not only will the peelers (Northern Ireland colloquialism for the cops) probably have to instigate a historical enquiry vis a vis Padeo, but they will have no choice but to contact social services about him, given his access to Marcus, Marcus’s baby brother and a couple of teenage grandchildren that hover about in his life from time to time.

It’s bad enough to have gone through sexual abuse as a child and to have to relive it all so vividly and painfully now. But now I have to be responsible for not losing my mind, when my mind dangles so precariously on a precipice somewhere between semi-sanity and complete insanity. That is not fair. Haven’t I gone through enough? How am I meant to control that which almost by definition is uncontrollable? And yet, the ramifications of not doing so are way too big – life-ruining and terrifying. I am holding it together now, but I know it is by a mere fickle thread.

And, mais oui, I’m effectively being re-traumitised with all this abuse bollocks by psychotherapy, during the middle of which C will just up sticks. How unfair can you get? I know this stuff needs to be psychologically addressed, but it can’t just be done in a few short weeks; it won’t just be OK or even vaguely manageable just like that. Of course, that assumes that I can even talk about it at some point between now and June, and that’s a very big ‘if’. I know from others – bourach and Splintered Ones, most notably – that if specific discussion of these matters comes at all, then it simply cannot be forced. So how am I meant to ever do this with C, given the short timeframe that remains of our relationship? I resent the notion of going private, even though I recognise it as all but inevitable, because I have done (or at the very least have tried to do) my duty to the stupid, hateful Trust by working since I was 16, and happily paying my national insurance to its governing Department during that time. Fuck them. It would serve them right if I never worked again simply so as I could avoid paying them a penny more.

I’m not even going to bother giving discussion of my last session with C its own post as I normally do. It was a complete waste of time; if he wants to play psychological academics, then he should have gone into full-time research, not clinical practice. Not that I mind the psychological academics per se – but I do hate an inordinate amount of time being devoted thereto when there are very real and serious matters that must be addressed now. Otherwise they never will be.

Apparently, I cling to “a tyranny of ‘shoulds’”, particularly regarding the sex abuse, meaning that I am convinced I should discuss the specifics of said rapes etc, I should resolve it in my own mind, blah blah blah blah de fucking blah blah. He thinks I hinder myself by demanding so much of myself in this way, which is probably true – but the alternative is surely even worse. As I told him, if I do not openly share this information with him, then it will remain unprocessed and unresolved. It will only continue to haunt me should that be the case.

I told him that I pretty desperately wanted to talk to him, and he said that that was encouraging – but is it? 14 weeks (or 10, if you account for the four sessions to deal with the cessation of the process) is not enough time to resolve several years of systematic child sexual abuse of almost every conceivable description, not to mention all the other issues – the bullying, the ex, and the continued unresolved shite about my father – and even mother for that matter. How can I be expected to continue to trust him in such circumstances? I mean – I do trust him, but that’s because I am deliberately trying to fool myself into not realising the relative imminence of our last sessions.

C said, to my considerable annoyance, that some people enter therapy expecting to be cured and that that’s not necessarily what it’s about (or words to that effect). I found this patronising in the extreme, especially because I have consistently told him that I don’t want or even believe in cures. What I want, and I do not think this unreasonable, is to fully explore my considerable wealth of issues with someone I trust implicitly and that is trained to explore them with me. This is in the hope that I can adequately process and in part resolve said issues, thus leading to an ability to fucking manage being mental in an everyday, vaguely normal-ish life. Oh, and this can not be achieved using the abject fuckery of either DBT or CBT, which DON’T FUCKING WORK (for me) and are not the panaceatic solutions that the NHbloodyS likes to pretend they are. So if Mr Director-Person tries fobbing me off with that old dog-dirt-coloured chestnut, he’d better be ready for the ongoing fight to step up yet another notch.

C also accused me of playing a game of mental “tug of war” with him, all because I responded to him in some really rather subtlely pass-remarkable fashion. It was a throwaway comment, but it’s not allowed to be throwaway in a psychotherapy session, is it? Everything you say, do, even bloody think (so it sometimes seems) is subject to deep analysis by the alleged science of psychology. Actually, I’m being unfair in being so bitter about that – the dark arts of psychology have helped me a little through C to date, and I do think he is skilled in them.

However, it is a character trait of mine to be unnecessarily – and quite possibly inappropriately – flippant at times. Maybe that means something in the grand scheme of things – I don’t know. But I didn’t think it fair for one particular instance of it to be singled out, especially given that I really didn’t feel I was playing any sort of games with or fighting against C that day.

And that’s really all that happened. A pointless session, just like the one prior to it had been, except on this occasion it was mainly his fault, not mine.

What else? I’m feeling alright – not great, but I’m managing. Thank you, Seroquel, my favourite drug in the entire universe (even though I simultaneously hate it too, because rather like Venlafaxine it fucks with your head if you miss or come off it). The recollections of the abuse prey on my mind, and the sense of yet another imminent abanodonment haunts my consciousness when I allow myself to think of C. IBS troubles me, as do headaches. I’m getting through Trauma and Recovery by Judith Herman quite well considering my poor concentration span, and find myself nodding with her analyses at most junctures. Despite taking the drugs at the fairly tame time of 9pm, I’m rarely asleep before 2am, and rarely awake before midday as a consequence.

But for the meantime at least, I’m surviving, if only capriciously. It’s the calm before another storm, I’m sure, but I’ll take the little I get.

This goes into much more specific and disturbing detail than my last post of this nature.  Please, please take care in reading this. If you’re in any doubt about how much you may or may not be triggered, click here instead.  P. xxx

Earlier, bourach at Conversations with my Head wrote an incredibly brave and personal post on the sexual abuse to which she was subjected at the hands of her father.  Although it’s utterly heart-wrenching, bourach’s usual eloquence and bravery in facing her horrible experiences comes through, and she deserves much credit as always for that.

‘Armed’ with both my ‘new’ memories, and the ones I already had, I had been thinking for a while about trying to do something similar, but had been deliberately avoiding it.  bourach has finally inspired me to get my arse into gear and do it.

I don’t know what C would say about the hitherto avoidance.  Is it good that I psychologically dodge this bollocks when I’m away from him (so as I don’t end up gaining an Art degree from the portfolio of my stomach, or have a go at slitting my wrists again), or should I be working my way towards finding the words to express it to him in session?  I don’t know.  Who cares?  I’m ruminating on it anyway, so why not try to put it into words…even if they are only written ones for now.

I’ve been able to say the word ‘rape’ a few times to A, and once, as you may know, to my in-denial mother.  Last week I think I even said the words ‘forced fellatio’ to A, which is a first.  Hurrah?  I still can’t imagine saying these words in therapy, though, which is where they need to be said.  A may be able to support me, but he can’t therapise me.  Or maybe he can, what the fuck do I know – but I shouldn’t think it’s his primary function in my life.

Is it because C is a man that I find expressing myself to him about this so difficult?  Do I feel all the more defiled in front of him because of some inherent (and, I assure you, unconscious) anti-feminist bullshit that’s been planted in my head?  That I’m not meant to be a debased whore in front of a man…that I’m meant to be pure?  Maybe it’s the stupid fraternal-paternal transference bullshit – don’t want my nice Daddy-friend-person to think of me as the tramp that I think I am.

Would it be any different with a woman?  I think I might be able to say rape, but I’m not sure how much further I’d get than that.  But yeah, maybe in front of a woman, in front of whom my sense of defilement would seemingly appear to matter less, I could discuss this bollocks in the most literal of terms.

Detached.  Aloof.  Depersonalised.  Third person-esque.  It’s all a technicality.

I recognise, therefore, that in the long-term sense this is why C really is the best person for this stuff; it can never be so emotionless and abstracted because of our shared relationship and my attachment.  Ha.  The beauty of the ‘long-term’.  Aside from the very real logistical difficulties of that – in the sense that I will stop seeing C in June or July – the reality is that in the short to medium term this is the most horrific, unbearable thing that I can imagine doing.  I do not want to relive this stuff.  The sense of shame and utter debasement of it all paralyses and sickens me.  Whore whore whore slut slut slut bitch slut whore tramp cunt.

As bourach rightly said in her post, the recall of the sensations is some of the worst of it.  The one that is my current psychic fixation is the terrifying choking mechanism of when he inserted his penis into my mouth.  Can’t breathe, can’t breathe…tiny hands push his legs, trying to move him, scared of choking to death…but he seems to like that – back and forth it goes, deeper and deeper in my mouth, harder and harder.  Can’t breathe.  Please stop.  Tears.  Not sure if they’re from being upset or the physical problem of choking.

And finally it ends, but not before he squirts a horrible drink right down the back of the throat.  Oh help…I’m gagging…gag gag gag…but he moves back, it’s out…thank you God…spit spit spit.  Wipe it away at the corners of the mouth.  Something between teeth…one of those strange hairs the eyes were faced with when he was doing the choking.  He closes his trousers…walking away now.  Safe.  Safe.

Fuck.  I feel violated and physically sickened all over again.  What is striking is that I feel choked again, just remembering / writing, even though there’s nothing physically making me feel that way now.

I feel the sensation(s) so strongly; the physical ones, the mental ones.  The gagging, the terror, the utter bewilderment, the pain of being forced to stand at the angle I was.  My back hurt, my legs hurt.  I remember my eyes being about level with the top of his pubic hair.  In every other way, though, although the first person sensations are so completely and thoroughly mine, the visuals of this are all third person.  The man is my uncle, and the little girl is me.  But I’m watching this from elsewhere – from an angle not even physically possible in the environment that this particular incident (and others) took place.  It’s like a vile pornographic film on loop inside my traitorous bloody mind.

Oh, and then there’s rape.  I didn’t know that word at the time, even though I did have a rudimentary knowledge of sex.

Incidentally, a couple of people have asked me – just in the course of silly conversations in which friends sometimes engage – how I found out about sex.  I always said, truthfully, that I really didn’t remember, and I still don’t.  But, I now ask myself, could this abuse have ‘informed’ my tiny mind?  I don’t know.

Anyway.  Rape.  I was about to say that, officially, that’s where the penis is inserted into the anus or vagina without consent, but I see that it apparently now includes oral penetration too.  Um…yay?  It’s a good thing, I think, but it’s hard to feel anything approaching cheer in this subject matter.

But let’s go with my original, uninformed interpretation.  Thank merciful God, there was never any anal rape – not that I can recall, at any rate.  But there was certainly vaginal penetration.  Oh yes.

I feel suffocated as I type this.  Literally.  God.  Fuck fuck fuck fuck fuck fuck fuck.  There’s that old can’t breathe again.  This time for different reasons.  I see him there, on top of me, crushing my small body.  And the pain…oh, the pain. [Wincing now]  It hurts it hurts it hurts…please, God, stop the pain.  Won’t be bad again if you just stop it.  Can’t breathe…pain…gasp for breath…he goes in and out, didn’t even know there was anything ‘down there’ to go into before…but it hurts [Wince wince wince] it hurts so much…please stop

What are these noises he makes…gasp gasp pain pain…why does he move like that…what is this about…it hurts…he sounds like he is hurt too, every time he moves he makes those weird noises…why…what…

Very loud noise now…[he arches his back]…’down there’ where he put it in, it feels strange along with the pain, like there’s water in it…pain…gasp…oh God oh God why has he fallen on top of me…can’t breathe, can’t breathe…is he dead…gasp gasp…oh thank you God…he’s moving, onto his honkers…it’s out…relief relief relief…breathe breathe breathe

Pain still…something oozing…what…don’t know what is happening…oh good he’s putting his trousers back up, maybe he will get something to help the pain?  Why is he sweating, why are his cheeks red like that….pain pain…OH GOD BLOOD…what what what??!!! Pain, breathe, blood…and white stuff, pink stuff…it’s there, with the blood…Oh God what is it…he stands up.  “Pull your pants up Pandora, and put your skirt back down,” he says [something like that], “there’s a good girl.  Then come back inside.  You’re OK.”

But not OK…it hurts…crying…always was crying….he’s leaving…cry…hurt…breathe.  Dress.  Follow him outside…walking is hard.  Aow…

On both of these occasions he was waiting for me outside / round the corner.  If I was under his charge, I presume that it would have looked suspicious if he was suddenly spotted wondering around without me.

It hurts.  It hurts.  Physically.  Mentally.  All my nerves conspire against me like they did when I was experiencing akathasia in January.  It is so real, so overwhelmingly and profoundly fucking real, and so unbearably now.  It wasn’t then, it is now. Now.  Now.

I can’t write this anymore.  I’m sorry.

I rather think I win. You – in conjunction with your unwitting co-conspirators of my father, my bullies, my ex et al – may have made me mental. Nevertheless, I still win.

I may be mental, but then so are you. At least I am young enough to have a fair prognosis, even if I have been bandied about the system unproductively for over a decade. How long do you have left to recover? What years you do have left aren’t exactly destined for great things, are they?

I don’t assume that you have a conscience, but in the improbable event that you do, those remaining years are years during which you will have to continue to live with the knowledge of what you have done, of the heinous acts of which you are guilty. Moreover, what kind of existence can you expect in social and familial terms? You have a wife that hates you, four children that are either indifferent or resentful towards you and a string of grandchildren that will mourn your passing but not do much to enrich your existence during the (most likely short) period through which it will continue. You may have a great-grandkid named after you now, but you’re old and ill and won’t live to see him and his older brother grow up. Unnatural circumstances expected, I will. Hahaha!

I’m the one with the IQ of 148 and 8 / 12 (depending on whether or not you include the ‘Hons’ bit) letters after my name. That is compared to your IQ of…hmm, circa 80? And your sum total of no qualifications whatsoever. I may not have worked for a year, but I have the intellect, capability and hopefully in future the opportunities to develop a successful working life for myself. You never achieved that, did you? What’s more, you never had the capacity to do so. And now you never will

I don’t profess to be the world’s most popular person, but I have a loving, satisfying relationship with my partner – something that you can hardly say about your dealings with your wife – and I have good and close friends that give a shit about my welfare and with whom I have had, and will have, many many laughs. Do you? No, thought not.

I may not be capable of doing much at the minute, but I have interests and will have opportunities to enjoy myself. Your existence consists of sitting about mournfully in your oppressive, Hotel California-esque* domicile and acting as an unpaid taxi driver to ungrateful, demanding offspring – though with your health as it is, you will soon lose your driving licence, meaning you’ll hardly ever leave the house. Oh well. My heart hardly bleeds.

What you maybe don’t realise is that I have the power to fuck up your miserable life even more. The chances of me doing it aren’t high, but I have that within my capability all the same. It doesn’t matter whether or not I prosecute you, not really. As your granddaughter recently observed in relation to similar allegations, mud sticks, Paedo. I now know so much more about what you have done than I formerly did, and I can completely twat you with that knowledge. One word from me and your inoffensive reputation is totally down the shitter. Hahaha!

On a similar note, although they don’t know your specific identity, many, many people sit in awareness of your paedophilia. I have the quiet satisfaction of knowing that every time I look at you

Above all, Paedo, what kind of sad, miserable bastard gets his sexual kicks from fucking children? It is truly a terrible thing to think that your life was so devoid of any sense of love, purpose and empathy that you felt that the violation of the most vulnerable known to you was an acceptable way to excite and prove yourself. How utterly, utterly pathetic you are.

Anyway, I’m an adult now and you can no longer touch me; I think you know that would be a very bad idea, that would land you in a lot of trouble. Boohoo! I may be overweight, severely mentally ill and live on the verge of social sequestration, but I have one thing you really, completely and utterly don’t – some semblance of hope. I’m intelligent, at times interesting, occasionally witty, relatively attractive and nigh on always determined. Though you may be in part responsible for the bad in my life, you are not at all responsible for conceiving the positive therein. All you have done in that regard is to act as a catalyst for me to begin to discover strength that I have always had, strength that your actions towards me most assuredly did not create.

You are nothing. Nothing. Just an all-but-lifeless, useless, sad old man. So I win, Paedo. I win. Fuck you very much indeed

Best

Pandora

* Remember The Eagles’ song, Hotel California?  There’s a line that says You can check out, but you can never leave. That’s exactly the environment in which Paedo lives.