I received a text message from my cousin Sarah early this afternoon to report that her daughter, Suzanne, has given birth to her second son (Marcus’s baby brother).

Another son.  Not a daughter, as I had feared and (inexplicably) expected.  Maybe there is a God.  Paedo might not touch Marcus and As Yet Unnamed New Baby because they are male.  He might not have touched either of them anyway, but it’s stupidly reassuring nevertheless.  Not that I will be any less vigilant in the company of him and his two great-grandsons, having said that.  As I’ve said in the past, if I suspect he has done anything inappropriate towards them, I shall act.

Why won’t Paedo just hurry up and die?  His life sucks horse bollocks anyway, so remaining alive isn’t exactly doing the miserable old sod any favours.  I believe I said it before; death would be a mercy to him.  It wouldn’t make any difference to me from the perspective of my abuse at his hands, but it would put an end to my worries about the possibility of him trying to fuck his underage descendants, and that would be a major weight of which to be rid.

Anyhow, I bring this up as, perhaps unsurprisingly given the subject matter of recent therapeutic sessions, shit with Paedo was the main crux of what I discussed with C on Thursday past.

I don’t remember a tremendous amount of the dialogue.  I do recall that I whined and whined and whined that I was a fetid, disgusting whore and that C kept asking what evidence I had for that, and that I responded that it was a clearly ridiculous statement but that that didn’t keep me from believing it fervently anyway.

I told him that one thing I couldn’t bear people calling me was a slut, and how I had reacted very viciously on the rare occasions that anyone had done so.  “And yet,” I went on, “it’s exactly what I think of myself.”

He asked if I thought it was ever appropriate for an adult to have a sexual relationship with a child, and I responded that of course it wasn’t, but that didn’t mean that I couldn’t find (make up?) evidence justifying what Paedo had done to me.  In other words, in other cases one can never justify child sex abuse, but it is perfectly acceptable to do so in mine.  Thinking back on this statement, what hideous kind of inverted narcissism am I guilty of?!  How dare I make myself out to be such a special case, even if in a twisted sort of way?

At one point C very gently asked me if I could actually describe some of the stuff that happened.  I wanted to tell him.  In fact, I fucking longed to tell him.  But every time I went to open my mouth, a pathetic groan or muzzled whimper was all that emanated from my mouth, and absolutely nothing of any substance was forthcoming.

I am so ashamed.  So ashamed.  So dirty and filthy and vile.  I am damaged goods.  If I tell him what happened then he will know all that and he will be repelled by me, so filthy and horrible am I.  Shockingly, I told him that I thought this, and then went on to admit that although I do not agree with it in the least anymore, that I was brought up with my mother telling me that sex outside of marriage was a bad thing.  Ergo, I was a slut for having a sexual relationship wth my uncle.  I wasn’t married to him, at a time when I was told I had to be for it to be ‘right’.

What, for me, was most curious about this session was that for what was probably the first time, I felt the full force of a flashback.  I have ‘seen’ images of the abuse in fleeting moments on plenty of occasions, but on Thursday, with C, I felt it physically too.  I cannot believe I am about to type this, but I felt pain and what I can only describe as a nebulous but ghastly sensation in my genital region (I just went to thesaurus.com looking for an alternative word to ‘genital’.  The very act of typing that word fails me with shame and horror).  I felt the physical sensations of his hands on me.  I heard his laboured breathing, and felt my own chest constricting as I tried not to breathe in the futile hope that what was happening might just go away.

And yet, the imagery remained largely third-person.  I saw him push me down as if I had been a bystander, and yet nevertheless I was so strongly feeling the sensations of all that had happened.  There’s a book I saw on Amazon called The Body Remembers: The Psychophysiology of Trauma and Trauma Treatment.  Clearly my body does remember…certain things, anyway.  But, I ask myself, does my mind?

Well, the answer to that seems to be a definite “yes” and “no”.  My mind must love ambiguity; it knows I hate it and it wishes to torment me, I should imagine.  As C and I sat in his office silently with these physical sensations and third-person images battering my psyche, I was suddenly flooded with an abject barrage of other gruesome images, in tiny flashing bursts.

The concealed alley-way beside the garage.  A laybay off a road behind their house.  Beside the old dog shed, which was only there until I was about five making it especially fucking troubling.  Their living room.  The back of my wendy house at my mother’s house.  My darling grandfahter’s house and outhouses

Penetrative vaginal sex.  Forced fellatio.  Fingering.  Other touching.  My reluctant acquiescence versus my attempts to fight him off.  His ‘gentle’ attempts to get his way right up to his brutal forcefulness causing searing pain that shouldn’t be experienced by a child.

It all smothered my consciousness in a racing deluge of awfulness that, despite the considerable scope of it, could only have lasted a few seconds.

I looked up at C in horror and told him, omitting specific details, what had just happened to me.

“It’s false memory syndrome, isn’t it?” I begged him.  “Mum would certainly think it was and she would be right.  These memories can’t be true.  Can they?”

“Look at the filing cabinet,” he said, nodding in its direction.  “The memories that our minds use to build up our conscious recall, our personalities, relationships and whatnot – they’re normally filed coherently in our brains, just like files are put in there in an orderly A – Z fashion.  Trauma memories aren’t so easily categorised.  Because they’re so difficult to deal with at the time, as you know many people find themselves dissociated to a greater or lesser degree, so the memories are completely fragmented.  Even when the person doesn’t dissociate, the memories tend to fragment anyhow, in order that the mind may cope with the trauma.  So if you open trauma memories in the filing cabinet, it would be like seeing a load of files or documents just being thrown in there haphazardly, with no order to them.”

He said, “because of the fragmented way in which the mind stores these memories, recall of them is complex.  Something may just suddenly trigger them; they may simply come back over time; they may not come back at all, but still leave their impact on other areas of the person’s life.”

“So you don’t think if I told you about this stuff that I would be a fucking liar then?” I asked, appreciating what he was telling me but doubting my mind’s capacity for truth-seeking nevertheless.  I accused myself of having an overactive imagination.

C replied by saying that in a sense it didn’t entirely matter if what had invaded my consciousness was an 100% accurate depiction of the sex abuse.  “In the first instance,” he explained, “none of us remember events 100% accurately 100% of the time, whether those events are traumatic or otherwise.  And secondly, if your mind is storing this information, then it is clearly bothering you – whether at a conscious or unconscious level – and that’s the most important thing.”

I don’t think he ever said it in an outright fashion at any particular juncture, but I distinctly got the impression from him that he felt that the memories were (at least mostly) accurate.  Maybe it was his gentleness, his empathy – I don’t know.  In part I wish he’d shouted at me and said that yes, I was indeed a horrible little slut, and that my lies were unspeakable and abhorrent.

Maybe then – just maybe – it might not seem to be true.

I have this enduring and recurring image of watching, from my perspective on the chair opposite C, a (faceless) little girl climbing into C’s lap, curling up and burying her head in his chest as he puts his arms around her, strokes her hair and gently soothes her in softly spoken words that I can’t quite hear.

I assume that she’s me.

Writing this makes me cry.  I am so ashamed and horrified and disgusted about all of this stuff, and today should be a happy day because it saw the release of Final Fantasy XIII.  I’m not sure that there was a great deal more of substance in the session anyway, so I’ll try to conclude.

The long and the short of things is that I still didn’t describe any detailed aspects of things with Paedo to C, either from the stuff I recall clearly or from the ‘new memories’.  To that end I accused myself of “capably playing yet another game of avoidance.”

In actuality, even though I thought that, I still thought the session had perhaps been a step in the right direction, and when he refuted my claims of avoidance, he seemed to agree with that assessment.  He actually claimed to think that I’d been very open and that if I was unable to verbally articulate certain things, then that was really not surprising at all, and shouldn’t be something over which I beat myself up.

I said, in that laughably child-like and black and white way of which I am so often guilty, “so, is this good?  Is it good that I’ve told you what I’ve told you?  Has this session been good?”

He replied that if that was the word with which I felt most comfortable, then yes, it had been “good”.

Oh, give me a star medal!!!

He had, at the start of the session, asked me how strong the impulses to kill or harm myself had been since the last time I saw him, and I’d said that whilst I still thought about those things with great frequency, that I hadn’t felt the same compulsion that I had last year or in the earlier part of this one to act on those thoughts.  He’d been encouraged by that of course, but given how much slightly-under-the-surface-bubbling a mere reference to any of this wank had caused me before, he was concerned that such candour as I’d apparently expressed on Thursday would drive me back to hurting myself.  He practically begged me to find something to do to occupy myself in at least the immediate aftermath of the session.  I told him I had been intending to go for swim and a coffee when I got back into town.

He liked that, then asked if I could occupy myself after that until A got home with the X-Box or a walk or something.  I agreed, though in the end I went to get some groceries instead, and I was still quietly pleased that he (ostensibly, anyway) gave enough of a toss to care about what happened after I left his room.

He asked if we could “park” the sex abuse discussion until next week, and discuss a few practical matters.  Unsurprisingly, one of these was the stupid letter from the twatfaced Mental Health Director.  I was taken aback to learn that C had heard absolutely nothing more, and was merely wondering if I had.  If I were C, I would find it professionally unacceptable that he had not been apprised of the ‘progress’ of the issue.

I hadn’t read the letter in detail at that point, so outlined it in basic terms only, telling him that I found it an amusing waste of time.  He misunderstood, thinking I meant that my whole complaint had been a waste of time, and very earnestly and reassuringly said, “I don’t think it was a waste of time.”

Apparently I have flagged up just how inadequate services are in my Trust area for conditions of the ilk that I present.  He suggested that not only had it been good for the head office twatheads to learn of this, but it even aided his immediate bosses in Psychology.  He thinks I have done A Very Good Thing.

I let him think I was completely letting it drop, which was at the time my broad intention.  I will let him know this week, out of respect and courtesy, that that is no longer my intention, and I will show him the pathetic letter that I received to demonstrate why indeed it should not be.

As I left he told me to enjoy my coffee which, wretchedly, made me want to hurl my arms around him and cry.  Why am I such feeble, pitiful bitch?  To add to that sentiment, what has pervaded the forefront of my mind since seeing him has not so much been horrid flashbacks, though that is not to say that they have not been in evidence at all; they have.  But what has played out mentally most commonly, what has dominated my psyche, what just won’t go away no matter how much I try to distract myself, is that sad, prevailing image of a damaged child seeking some sort of comfort or solace in the safety and reassurance of C’s lap.

EDIT: Literally about fifteen minutes after publishing the above, Sarah sent another text message to advise that Suzanne and her husband are calling the baby after Paedo.  This made me feel utterly physically sick and mentally horrified.  Even whenever Paedo does die, the child will always remind me of him and what he’s done.  Fuck.

He is off this week, which is why I’m writing about last week’s session on what would normally be my Therapy Thursday.  I miss him.  I miss him very much.  On Tuesday I had a moment (read: quite a long time) of utter desolation pertaining to his absence, accompanied by my old friends of depression, self-loathing and suicidal ideation.  If my inability to cope without him is so acute and all-consuming after a matter of days without seeing him, what – in all seriousness – are things going to be like when the 59th session has been and gone?  I can already see myself falling into an abyss of, at a minimum, abject depression.  I have contingency plans, of course, but can they ever be the same?  I’ve seen something like nine therapists over the past decade.  C was/is the first and only one with whom I really connected.  How long will I have to wait, how many more people will I have to see, before I can find a relationship with someone else that even approaches the quality of this one?

A doesn’t think attachment to a therapist is good.  I know some others, including mental health professionals, don’t either.  Personally, I don’t think it is ‘good’ either (in the sense that it is a difficult position for the client to be in), but as a somewhat-proponent of the psychodynamic school of psychotherapy, I believe that some form of transference – and, if it is vaguely positive, therefore attachment also – is necessary.  As research consistently finds, the most important aspect of successful psychotherapy is the therapeutic relationship.  I have a good one, and yet it is on the verge of being brutally severed.

But enough with my pointlessly whiny ruminations.  42 is the answer to life, the universe and everything, apparently.  I’m not sure that C: Week 42 was necessarily the answer to my life, my universe and my everything, but then – just like in the Hitchhiker’s Guide – I’ve never been entirely sure what the precipitating question was or is.  I merely have had and do have the awareness that many things have been afoot in my world.

Anyway.  The first thing that struck me was, once again, the beard.  It is still there.  I have nothing against beards – on people who suit them.  C suited his erstwhile goatee reasonably well (he looked a bit like Derren Brown), but this full beard makes him look like a walking statue of Christ.  What was of particular note last week was that it was perfectly trimmed.  It was so exact that it must have some mathematical or scientific use – perhaps it could be used to plot planetary movement around stars or something.  I longed to leave, drive to the nearest petrol station, buy some fuel, return, douse the beard in said fuel, and light a match.  I don’t want to cause him any pain, but really.  The beard needs to go.

As ever he tried to find out where I wanted to start our discussion, and as ever I stubbornly shrugged and claimed not to know.  Luckily – in a sense, at least – he had planned for this, and reminded me that in the previous session, we had agreed that we would spend some time talking about the various incidents that took place with Paedo when I was a kid.

In all honesty, I don’t remember a great deal of what we discussed.  In fact, in the end a lot of what we covered was related to my mother’s reaction to my revelations to her about the sexual abuse (see bottom of the page of the link in the previous paragraph).  I do remember telling him that I was absolutely able to be open and frank about what happened in writing (namely, here, on this blog), but that I simply couldn’t manage to get the words out to him.

Of course he wanted to know what I thought he would think about me if I did say what needed to be said.  I couldn’t think of the word at the time, but what I think I was trying to articulate is that he would be ashamed of me.  My own shame, my anxiety about uttering the word ‘rape’ to him and my utter inability to actually eventually do so would seem to confirm that.  It was like there was a metaphorical stopper in my mouth; every time my lips tried to form the word, or my vocal chords tried to convey it, something stopped it from being enunciated.  Maybe some ethereal presence put its hand over my mouth and silenced me.  Utterance of that word, and the specifics of the incidents, was impossible.

Without putting it in so many words, I basically conveyed to C that I had a supreme difficulty in verbally declaring some of the stuff that I should be discussing with him.

He reminded me that a few months back I had put together a range of material, largely garnered from my writings here, that I had wanted him to read.  He had refused, to my considerable disgust.

“What of it?” I inquired.

“I’m not sure exactly what that stuff consisted of,” C acknowledged, “but I believe that you were trying to reach out to me in preparing it, that you were trying somehow to tell me about this stuff.  But…[thoughtful pause]…but I think we need to get you to say it.  To say it out loud.”

I’d always suspected that at least part of his reasoning for refusing to take the myriad of pages I’d printed that day was related to the fact that he wanted to hear me actually verbalise this shit.  I still fervently believe that it was mostly about his refusal to have anything to do with me beyond my allocated 50 pathetic minutes, of course, but I did and do believe that his secondary motivation was to get me to actually speak.  I just wish he’d bothered to have told me that at the fucking time.  I would not have been so out-and-out furious had he done so.

Back to what I thought he’d think of me if I did speak of these experiences: I told C that I felt like a filthy whore and to that end provided him with the details of my complete knobbery from a fortnight ago, where I endlessly castigated myself as a slut of evil (we both agreed that I need to take care vis a vis alcohol whilst taking Quetiapine).  I also confided in him that in huge, angry letters the word ‘SuzanneUT’ is etched, permanently, across my lower abdomen (along with its kindreds of ‘HATE’ ((the second incarnation thereof)) and ‘DIE BITCH’).  ‘SuzanneUT’ is the most dramatic, however, and seems to have been the deepest of the various mutilations (all garnered, if memory serves me correctly, on the night I tried to kill myself last month).

“It’s ridiculous,” I admitted, finally.  “Of course I’m nearly as far from a slut as it is possible to be [not quite perhaps, but largely]; I see that rationally.  But I still believe that I am one, whilst at the same time believing that I am not.”

He referred back to schema models, about which we have talked on several occasions now.  He said that the part of me that felt that my belief that I’m a slag is ridiculous was, in many ways, an example of a healthy adult; she is rational, and can see things in a sensible, evidential sort of way.

“However,” he went on, “your healthy adult seems to have become rather merged with your punitive parent.  You can be very logical and whatnot, but when you do so, you’re very critical of the more child-like, emotional sides of yourself – not that you’d use the word ‘emotional’ [he added dryly] – in this case, you use the word ‘ridiculous’, but on other occasions you’ve been even more disparaging.  You would agree that that’s punitive, I take it?”

“Yes, I suppose so.”

“So there is hope there, in the expression of the healthy adult,” he said, “but we need to separate that punitive side from her…”

“Well, as you know,” I interjected, “I don’t ‘do’ self-compassion especially well.”  He has consistently told me that having some genuine compassion for myself would be a major breakthrough.  I have to say that in all honesty, this still seems as unlikely to me as it did when he first mentioned it months ago.  I feel sorry for myself at times, I think some of what I’ve gone through is unfair at times – but I never feel what I would call ‘compassion’, and frankly that applies to others as well as myself.  I have tried to develop some sense of it – I’ve read the stupid books and I’ve cried (admittedly rarely) under C’s watchful gaze.  But it still isn’t happening.  I don’t think years of psychotherapy can induce this supposed quality in me.

Somehow the dialogue progressed to an analysis of my mother’s response to matters with Paedo.  In particular, I told him how outraged I had been with her comments to the McFs in the immediate aftermath of my last therapy session (see the last few paragraphs of here).  Cue much questioning along the lines of the inveterate “how did that make you feel?” type.

I felt physically sick, not something common in my mentalness.  Struggled not to throw up.  Despondency followed.  Which was later subsumed by a raging inferno of anger.

I’m sure I’ve told him before (well, I know I have), but I felt compelled to outline again that my mother had initially said that I had “misinterpreted” Paedo’s actions, which – when I stupidly admitted the true extent of things – was later replaced by an accusation of outright lies, which were apparently fuelled by my desire not to see my family.

I didn’t get particularly angry in relaying this information, but nevertheless, the picture I painted of my mother to C was wholly negative, and at some point or another, I became acutely aware of that.

“I make it sound as if she’s a terrible person,” I sighed.  “She isn’t.  It’s just…this.”

(Actually, it’s not just ‘this’; I’ll have to introduce C to the tales of how she would viciously beat me up, leaving temporary but significant bruising, almost daily during periods of ((my)) intense depression when I was a teenager.  But I’ll leave that for another time…not that I have that many ‘other times’ remaining).

He responded by saying that he was well aware that, broadly speaking, I presently have a good relationship with my mother and that I didn’t see her as a ‘bad person’.  He shrugged.  “We all have different facets to our characters, as well you know.  She’s made mistakes in this regard, but just because you’re highlighting them to me doesn’t mean that I necessarily think that that’s representative of her entire personality.”

“I wrote a rant about her behaviour last week on my blog,” I murmured, absent-mindedly.  He asked about the content of it, and I said that it largely mirrored the information that I had just relayed to him, except that it was furious and bitter.

He nodded thoughtfully for a minute, then asked about my audience here.  Was the blog open for everyone to read?  How many read it?  Who, broadly speaking, might my readership be?

I told him that I do password protect the odd post, though if I am honest I probably gave him the impression that I do it much more than I actually do (this is my 121st post; out of all those 121, only three are password protected.  Two of those three are about C, if that reveals any deep psychological insights).  I said that the majority of my audience seemed to be others involved in various mental health systems, mainly but not exclusively from my side of the couch.  And that there were, at that point, in the region of 20,000 hits.

“But it’s all anonymous?” he checked, which irritated the fuck out of me, as we already had this conversation, leading to a particularly fraught interaction between us and a horrible few post-therapy hours for me.

“Yes.”

“And no one in your “real-life” reads it?”

“Not ‘no one’.  There’s a few, but they’re a select few.  It’s definitely not for my mother’s eyes.”

“And maybe you think it’s not for my eyes either?  Maybe you’d feel uncomfortable about me reading it?”

Oh for God’s sake, C.  Not this crap again.  “Why, have you?” I challenged, looking him straight in the eye.

He too had been looking directly at me, but as he replied, “No, I haven’t,” he tellingly lowered his eyes.

I don’t believe he is lying, but I do believe the statement was a half-truth.  It would be hard for C not to find this blog, given some of the Google terms he is likely to be searching for in his line of work; therefore I believe that he’s probably come across it.  He would have recognised me after having read a mere few lines though, and in his defence he is a professional, so is unlikely to have read any further.

I told him I didn’t care if he’d read it or not, as there was nothing contained within these pages that I wouldn’t say to his face.  He was about to respond when I interrupted, saying that technically that wasn’t entirely true, as I was fully able to discuss the issues of child sexual abuse on the blog, but not with him. (Specifically, I can write ‘rape’, but not say it, at least not to him.  Look, see: RAPE RAPE RAPE RAPE RAPE RAPE RAPE RAPE.  The day I do that in therapy with particular allusion to myself is the day I eat the contents of a 14th century latrine).

“But you know what I mean, I hope,” I continued, and he confirmed that he did.

There was a lull for a few minutes, then C noticed that I was laughing softly.  Naturally he asked why.

I had been thinking about the fact I have an entire alter-ego here through this blog.  My material is searingly honest and intensely personal at times, and yet it’s a very tiny fraction of my readers that know to whom this intimate information really belongs.  As things stand now, that’s an unfortunate necessity, but it doesn’t keep it from being ever-so-slightly odd, and hence vaguely comical (at least to me).

We had a brief conversation about how the cloak of the internet allows one to accentuate particular parts of one’s personality.  In my case, in this guise at least, the accentuated part has been my madness.  I’ve had other guises related to other specific parts of my personality, of course, but relatively few that have been about ‘me’ as a whole, whoever she even is.  Anyhow, this was part of the reason why I felt that I should consider giving myself an actual name on this blog, even if it’s still not the ‘real’ one.

This saw the end of the session.  C said that we have a lot of material to work with over the coming weeks – well, my friend, isn’t that a shocking surprise! We still won’t grasp it all, though; we can’t in the time we have remaining together. As I departed, he wished me all the best.  Little things like that make me feel pathetically good about our relationship, perhaps because it gives me the impression that he cares about me, however tangentially.

So, no strong revelations as to my life, my universe and my everything in week 42, but as he says, there’s material to work with for a while.  Can we find the ultimate question?  Moreover, can we find it in the small window of time that remains?

The author, Kimberley, discusses an article on the phenomenon from Pandora’s Project, which is a support site for those effected by sexual abuse (interestingly, ‘Pandora’ is the name currently leading my poll on what I should be ‘called’).  Firstly, Kimberley discusses the symptoms that are commonly seen in this illness, such as hypervigilance, flashbacks, severe anxiety and dissociation, though she then moves on to outline the biological research undertaken into PTSD.

The bottom line is this: PTSD is not just a psychological illness, but a physical one too.  Trauma does not just damage our psyche, it can actually change the physiology of our brains.  In particular, traumatic events seem to affect the hippocampus (a part of the brain that has responsibility for a lot of memory functions) and the medial prefrontal cortex (responsible for cognitive functions such as personality expression and decision-making).

I have come across information like this before, but Kimberley’s analysis of the Pandora article is worthy of particular note for her eloquence and understanding of this subject.

PTSD and Your Brain

Now, this I like.  Anyone who has followed this blog in the long-term knows about my complete disdain about all forms of cognitive behavioural therapy.  I think it’s the biggest pile of toss in the history of psychology, at least for people like me.  To say that I have faith in the psychodynamic and analytical schools of therapy would be false, because I am not sure that I really believe any form of psychotherapy works entirely.  Nevertheless, I hold the latter in much higher regard than the ‘newer’, in-vogue, supposedly cost-efficient therapies.

The problem in this position in the last few years has been that the psychodynamic schools have lacked empirically-based evidence for their effectiveness, whereas (surprisingly for me) CBT and its kindreds are backed by a myriad of studies supposedly supporting their effectiveness in treating various forms of mental illness and distress.

Well, finally it seems the psychoanalyst types have sought to prove the efficiency of their practice.  This article from Scientific American (reported prolifically elsewhere too) discusses a recently published journal article apparently demonstrating that psychoanalysis and psychodynamic therapy not only work, but keep working after cessation of treatment.

The piece claims that psychodynamic therapy has been shown in controlled trials to effectively treat anxiety, depression, eating disorders and, crucially for yours truly who is in psychodynamic therapy, personality disorders.  According to the author of the original journal article, this type of therapy enables patients to develop tools to better function in the “real world”, increases self-confidence and decreases the symptoms of their illness(es).  A key ingredient in achieving this is, of course, the therapeutic relationship.

Like the preceding article above on PTSD, there’s a wee bit of neuroscience thrown in here; current research seemingly suggests that psychodynamic therapy can produce changes in the prefrontal cortex of the brain, as patients begin regulate emotional health.

Naturally this isn’t a faultless paper; for one thing, the studies therein simply aren’t numerous enough in number.  But, not unsurprisingly in my view, most of the main detractors of the article’s findings are CBT devotees, who complain that this study is across various mental disorders, rather than focusing on just one.  Fair enough, but the analytic schools had to start somewhere (and admittedly should have done so sooner), and ‘somewhere’ is proving to be a promising start.

Talk Therapy: Off the Couch and Into the Lab

A few other articles of interest came up this week, but I think I’ve drivelled on enough.  Enjoy.  *coughs*

C is off tomorrow   So I shall report on last week’s session then, hopefully.

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

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

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

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

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

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

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

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

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

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

He nodded.

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

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

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

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

He started.

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

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

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

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

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

SI: [incredulous] Obviously, yes…

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

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

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

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

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

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

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

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

I nodded.

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

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

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

“What strength are the tablets?” he asked.

“10mg each.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I confirmed that it was the latter.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“It’s not a battle,” he alleged.

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

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

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

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

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

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

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

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

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

He had no response to that.  Hahaha.

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

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

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

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

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

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

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

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

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

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

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

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

I was glad to see C again, having missed him and craved his protection over the three weeks since I last saw him.  However, he has committed a cardinal sin.  He has grown a beard.  Not like the goatee, Derren Brown-esque beard he had when we first met, but a full-on, proper beard.  I’ve nothing especially against beards, but honestly – he looks like something out of a children’s illustrated Bible.  When he came to the waiting room to get me, I was aghast to be greeted by Jesus (or Judas if you prefer, he could be either).  It took me a quite a while to stop fixating on this newly arrived hirsute feature.

As has been the case since C has been back in VCB’s stomping ground (as there is building work going on in his office), we opened by taking a few moments to compose ourselves.  The waiting room in the place is usually full of people, unlike that for C’s proper office which is always empty.  The people unsettle me, and C has realised now that he has to give me a few minutes for this anthropophobic anxiety to abate somewhat.

Of course, I had C anxiety as well.  I always feel nervous before I see him, and it was especially strong on Thursday given that I had not seen him for three weeks.  To that end, initially I was stubbornly refusing to speak in anything other than one word answers to questions.

Eventually, he asked me how Christmas had been.

“I’m not going to discuss that,” I brattishly declared.  I knew, of course, that he would follow that up with a question as to why I was not going to discuss that, so before he got the chance to do so, I changed the subject and told him about the latest troubles with the health service.

The first thing was the whole bullshit about the GP talking down to me, just after I’d last seen C.  I told him all about it, going so far as to re-enact some of the mannerisms that Dr Arsehole had employed during his irritable rant towards me.  This was before the reply to my complaint had arrived.

“How dare someone earning as much as a GP does behave in that fashion?” I raged.  “How dare the jumped-up twat speak to me like that?”

“How were you in the room with him?” asked C.

“Pathetic,” I admitted.  “I just sat there and took it.  I did try to argue with him at one point, but he just kept on and on, and I backed down.  As I was leaving, I even thanked him!  A reckons I need to discuss my remarkable ability to be so horribly passive with you.”

The second NHS issue, which I’ve only mentioned in passing here, is that apparently VCB is no longer my consultant psychiatrist.  When I last saw her in November, she said she’d see me again in a month, which she didn’t (surprise surprise).  Then, when I finally did get a letter inviting me for an appointment with Psychiatry, it merely said that I had an appointment on 20 January with Dr M, not VCB.  It made no reference as to the change of individual whatsoever.

C said, “as far as I know there’s been a shake-up in Psychiatry in terms of geographical location.  They’ve changed the boundaries that each consultant operates in.  Is that what happened?”

“No one told me anything, so I wouldn’t know,” I spat, disgusted.

“I’m not going to lie to you,” I continued, “I’m not VCB’s biggest fan.  But at least I had some sort of relationship with her – I knew her, and she was at least in some ways familiar with my case, so this is incredibly frustrating.  It strikes me that Psychiatry is possibly the worst branch of medicine in which such nonchalance and disruption should be in evidence, what with issues of trust and attachment being so much a part of certain illnesses.

“But what do I know,” I added bitterly.  “I’m just the mental that sits opposite you people.”

“Is that how you see yourself?” C jumped in.

The truthful answer to this is that I don’t know.  The comment had been intended as a slight on the Psychiatric “service” and indeed on mental health services on the NHS in general, but of course I exist in a perpetual state of self-loathing and self-disgust, whether im- or explicit, so yes, it probably is – to some extent – how I see myself.

I told him so, adding that I have no right to be mental because what has happened to me is so considerably less serious than that to which many others have been subjected.  This came up a couple of times in the session – basically I feel guilty for being a mental when other people who’ve endured worse aren’t or, if they are, then they have more right to be than I.

C mulled it over for a minute or two, then said, “one thing about you is that you’re defined by contradictions.  You mentioned earlier about being passive – there is that side, yet there’s another side that can be extremely assertive in the right circumstances.  It’s the same with your belief that you are somehow not entitled to be a mentalist [interesting use of that word, I thought].  You hate yourself for being this way, you think you have no right – yet you will fight to the death to get the treatment to which you feel you are entitled.”

“It’s hardly rocket science, though,” I responded.  “In some ways, whether or not I’m entitled to be mad is irrelevant; the fact is, I am.  Regardless of the reasons for that, I should be entitled to treatment, under the foundations on which this health service was based.  If I kicked that wall over there and broke my toe, the stupid manner in which I broke my toe would be irrelvant to those treating me; I would still be entitled to their medical attention.  I don’t see why it should be different for one’s mental health.”

“It shouldn’t,” he agreed.

Oh really?  OK then, why are you cutting short my fucking therapy?  Not that I brought up that issue specifically, because I didn’t want to engage in the pointless navel-gazing that had been the previous session.  If our time is limited, it must be used effectively.

Anyhow, I don’t remember how he phrased it, but basically he said that a person’s history and indeed how they respond to it is completely relative.  He said that we can only develop from our own experiences and, essentially, that I really shouldn’t beat myself up for being mental.  Later on in the session, he almost went so far as to say that I have every right to be, but I’ll come to that later.

Of course, I can rationally accept a lot of this, and indeed I know that certain mental illnesses with which I have been diagnosed are thought to exist in individuals who are biologically predisposed to having them, the symptoms manifesting after some sort of psychosocial trigger.  So of course I am not to be blamed for being mental…says Rational Me.  In-Control-Irrational-and-Ironically-Mental Me does not agree.

We also discussed how the anger I feel is sometimes misplaced.  I contend absolutely that my anger towards the health service is completely just, so that’s not one such example, but I will fly into a genuinely murderous rage at either myself or, say, my mother (particularly my mother) for something ridiculously stupid like dropping a pen – yet I am not angry at my uncle.  I am angry at my father, but that miserable sod had the audacity to die, so I’m hardly likely to be able to direct that towards him.

Of course, mention of my uncle in the context of anger was A Very Bad Move.  C said, “so, are you going to tell me what happened at Christmas?”

I glared at him.  “Did I not already say that I don’t want to talk about that?” I sneered, eventually.

“You did, yes.”  He looked at me enigmatically.

Oh, but you can read my mind, can’t you C?  Saying that I didn’t want to talk about it is some sort of conspiratorial Newspeak for, “I want to discuss that with you in intimate and excruciating detail”, isn’t it?!

“You don’t want to tell me about your Christmas, do you?  No – you don’t.  So why should I tell you about mine?” I challenged.

It was meant mainly as a sarcastic and rhetorical question, but he answered anyway.  “If we met in other circumstances, that’s probably exactly the conversation we’d be having,” he mused.  “But I know that you know that this circumstance has to be one-sided.”

As it happens, I do know, thanks very much – and I don’t like it and it isn’t fair.  And yet it protects me from the probable sheer ordinariness of this man that I so pathetically look up to.  But that’s another matter.  I told him, truthfully, that if we met socially, I would still not be telling him the specifics of what happened at Christmas.

Actually, if I’m 100% honest, of course I wanted to discuss it with him (in his capacity as my psychotherapist) – aspects of it anyway.  I was horribly mortified (as well as disturbed) by what ‘They’ wanted me to do on Christmas Night, and didn’t especially want to outline that in specific terms, but I did want to tell him of the fear and anguish that took me to that point.  Yet I felt absolutely unable to give myself permission to do so.

We sat in silence for a bit.  I knew he would break me sooner or later, but I decided to fight him anyway.  I was thinking about the psychoses, which led me to question how I had described them here on WordPress.  In doing so, I was reminded that I won an award for this blog on New Year’s Day from the fabulous Mental Nurse blog.

“My blog won an award,” I randomly blurted out at him, with thinly-disguised pride.

C seemed quite excited by this news and congratulated me, then paused.  “I really want to ask you more about this,” he began, “But I’m wondering if we shouldn’t leave it until later – I don’t want to avoid the issue of Christmas.”

I wanted to avoid the issue of Christmas.  It’s my fucking therapy, can’t I talk about what I like?

But I gave up the fight, and gave the man what he wanted.  “There were issues with the voices,” I admitted finally, tapping my head (as if he didn’t know what voices I damn well meant).

“OK,” he started.  “What sort of ‘issues’?”

“No, no, no, we’re not going down that road.  It’s enough that you know that the day was stressful and I went doolally in the evening, though mercifully not in front of the 3,820,691 people with whom I was forced to spend the whole sorry day.”

“But how could it not have been traumatic?” C asked.  “I really fail to see how it could not have been, what with you having to see and interact with your uncle.”

“You’ve built it to be all about him,” I replied.  “It’s not – not entirely.  To say my family is a freakshow is to insult freakshows.  I just cannot put into words how fucked up and weird they all are, and how much I have nothing in common with them.”

“I remember you saying before that their ‘weirdness’ was difficult to convey, but I do have some sense of that.”

“They’re worse in a collective,” I continued.  “As individuals – well, I can’t pretend I’m their biggest fans, but they’re more tolerable.  But their group dynamic is seriously – epically [not that that's a word] – bizarre.”

Moving away from this slightly, C went back to the voices.  I told him that I had already said I was not going into that and requested that he left it be.

“I’m not really so concerned about what they actually said,” he told me.  “At present I’m more interested in why you don’t want to tell me about it.”

I should have been expecting such a question, but I hadn’t been.  I thought about it for a moment.

“I’m very aware that we’re sitting in Psychiatric Outpatients and that the bin’s over there,” I said, leaving him to infer the rest.  “I can’t get away quickly here.  At least in your normal office I have time to flee before you all catch me.”

I got the usual spiel of crap about how he would only call a psychiatrist or my GP if I was at a serious and imminent risk of harming myself.  Or others, he added, almost as an afterthought.  I laughed bitterly.

I don’t remember the exact discussion that followed, but he seemed to have established that on Christmas Night it was ‘others’ that ‘They’ were trying to get me to hurt.  He never said it straight out, and I never confirmed it, but there seemed to be a shared, implicit understanding that this was what had occurred.  He sought to reassure me in as strong terms as he’s allowed to that he would not call anyone to have me sectioned unless he thought that such harm was absolutely imminent.

“I don’t believe you,” I told him.

Ouch.  I think that one cut him a little (no pun intended, not that I’ve been too bad vis-a-vis self-harm of late).  He asked why I doubted him.

In part, it is because I feel that some of the trust has been broken between us, owing to the whole uncertainty over the continuation of treatment – though in fairness, he was good in this session and I feel it might have been built up a little again.  Other reasons are just how terrible the episode was – I mean, I was told to kill a fucking not-quite-two year old, how much worse does it get? – and the fact that I’m preposterously paranoid.  Probably the simplest reason is that I often genuinely feel that I should be fucking sectioned, though I really, really don’t want to be.

In any case, I do believe that C wouldn’t section me unless he felt it absolutely imperative, yet I don’t believe it at the same time.  I believe two absolutely polar opposite things simultaneously – not an unknown state for me.  I told him so, and he seemed to understand that.

For some reason, presumably relating to all the discussion about Paedo and the multitudinous weirdness of the McF dynasty, C and I ended up discussing how my mother didn’t believe me about the sexual abuse, and about how she seems to go out of her way sometimes to put me down, or to compare me (negatively) to others (particularly Suzanne, who she seems to fucking idolise).

C said, “it seems to me that your mother has been severely traumatised by her relationship with your father.”  Now, I genuinely don’t recall what he said next, but I think it was something along the lines that she therefore seeks solace in the McFs and, despite what she may say, finds it hard to believe that they are capable of fault – even when it’s rape of her daughter.  I don’t want to put words in C’s mouth, though, so don’t take that as gospel.  Of course, whilst I cannot disagree with the aforesaid conjecture, my own take on things is that she will always remember that I am my father’s daughter (she will even say it from time to time when she wants to hurt me).  In any case, I am certainly not the daughter that she would have wanted.

I agree with C that she is completely traumatised (not that she’d admit it herself), but was surprised by him coming out and telling me that was his view in such forthright terms.  In any event, this tangent didn’t especially add much to the session, except to exacerbate the rawness of the hurt I was already feeling.

So that was his next tactic – the perennial, “how are you feeling?”

I couldn’t verbalise it at first.  I just felt so something, so indefinably sad and upset and low.  He quietly encouraged me to try harder to express it more exactly.

Eventually, through gritted teeth, I seethed, “I feel hurt and sorry for myself and vulnerable, are you happy now?”

Unfortunately he thought this comment was sarcastic, intended as a snide take on what he wanted to hear.  Admittedly, the manner in which I had said it could easily have been taken that way, though it was meant to have come across as a dramatic, “there!  I’m finally admitting the truth!  I’m deflated but this is progress, isn’t that fantabulous?” kind of gesture (fail!).  I apologised, and advised him that the content of my comment was serious.

Yes, I admitted to being vulnerable.  What I didn’t admit, of course, is that I want C to protect me from all that which makes me vulnerable.  I want him to put his arms around me, stroke my hair, tell me in his gentle voice I will be OK, and protect me from all the bad that exists in the world.  Of course I didn’t tell him that, but admitting to this hideous vulnerability that I’ve been repressing for I don’t-know-how-long was a start.

“Unwillingness to feel or express feeling of these things is very common in people who’ve been brought up in abusive and traumatic backgrounds,” he told he, tilting his head to gauge my reaction.

“‘Abused’,” I repeated wistfully, looking away.  The branches of the trees outside were blowing back and forth in the wind, stripped bare of their leaves.  I felt as emotionally naked in front of C as they looked.

“You don’t think you’ve been abused?” he checked, apparently confused.

“No,” I replied quietly.

“You were sexually abused by your uncle!” C said, determinedly.

“And I responded to that and other things by dissociating and emotionally numbing myself.  Fat lot of good it’s done me.”

“It probably did at the time, though.  It was a means of self-preservation during those times.”

There was a pause, then I randomly spat out, “I disgust myself.  My vulnerability disgusts me.  I disgust me.  Fucking schizo bitch!”

“You’re one of the most self-critical people I’ve ever known,” C told me, taking a very slight tone of authority.  “My worry is that this is a major stumbling block.  I really think if we can develop some self-compassion in you, it will help a lot.”

“You said a moment ago that dissociation etc was a means of self-preservation.  It ties in with the psychology discussed in a book I’ve been reading.  It is, shock horror, a self-help book, one designed to teach you strategies to soothe yourself when you go mental.”

C was delighted by this.  He asked me if it was any good, my response being that a lot of it (as with any such text) was “wank”, but that despite this, there were some good, and vaguely intelligently written, parts to it.

The thing is, I’m not always as critical of myself as I seem to be in psychotherapy.  I can only surmise that that is when the truth really comes out.  The raw, visceral nature of everything that’s gone or is wrong with my life is so palpable and explicit in those 50 minutes, and the true depth of my self-hate is exposed.  Eugh.

He went on to say that it was not desirable to rid me of my “sarcasm and [my] wit” (he said I was witty!!!  Smiley me!), but that he thought aspects of that fed into my lack of self-compassion, and that we needed to strike a balance.

“And I’m encouraged by the fact that you’re trying,” he concluded.

I left feeling psychologically battered and bruised, even so much as allowing myself a tear as I drove home (how self-compassionate), but I was also quietly encouraged and reassured.

This post shouldn’t be overly detailed, as a lot of it was repetitive bullshit regarding the annoyances of the previous week. Nevertheless, here we go.

Upon leaving C’s company the previous week, we had agreed that we would use week 35, the last week before a break of three weeks owing to Christmas, as a session to discuss how I would manage the so-called festive season.  In reality, that bit ended up taking approximately five minutes at the end, and although it was ever so slightly more helpful than some of the nonsense he’s come off with at other breaks (“breathe!”), it was still not entirely helpful.  But then again, he’s not my guardian, is he?  Much as I would like it that way.

I say we were flogging a dead horse because the majority of the discussion centred around the same crap we had discussed over the previous week (leave a comment or get in touch if you need the password) and the week before that, ie. my anger and distress about his decision to cut short my treatment, and my general disgust about the NHS’s abject failure to adequately treat me since I first sought help for my mental health problems.  I do understand that in some ways maybe C sees exploring my reactions to this as a form of projection or transference, and maybe in some ways it is: perhaps I feel so rejected and aggrieved because that’s how I was meant to feel about my father, uncle, ex, etc etc.

However, it endlessly frustrates me that I cannot just simply be angry because I have been so horribly fucked about by the health service.  Again, in this session, C reiterated that the 24 week limit (starting from tomorrow) was his decision; he said he was “not a robot” controlled by the NHS.

It completely contradicts all the stuff he says about my right to be annoyed and about how BPD should really be treated, and we went round and round in circles on how I could not reconcile his two contrasting views, and about how he either couldn’t or wouldn’t explain it properly.

I also, having decided as a result of the preceding week that he hated me, went to find out whether or not this was indeed the case.

I said, “if I ask you a question, will you promise not to answer with a question?”

He shifted uncomfortably, then admitted that he was unsure as to whether or not this was achievable.

I asked him anyway, on the proviso that if I thought he was “blagging” his way through his answer I would pull him up on it.

He did come off with the form bullshit such as, “why is it important for you to know that?” and whatnot, but I was pleased when he finally admitted that he too had found the preceding week “frustrating”.  So he is a human after all!

He said that I had been “very angry” with him, which I thought was unfair.  I told him that I genuinely hadn’t been angry with him, merely the system, until he confessed to having been the one that decided on the time limit.

“But you were angry with me then,” he pointed out.

“Yes,” I said.  “You had seemed so supportive of me prior to that; you agreed that my situation was wholly unfair.  Then you completely contradicted that by admitting to this arbitrary limit crap.”

And so back we went to flagellating that deceased equine.  More questioning demands from me, more bullet-dodging from him, no progress from either of us.

He had asked me in week 34 to seriously consider whether or not to continue with therapy, as I “had” to agree to the time limit as part of the contract (which strikes me as being quite unreasonable, as contracts are meant to be negotiated rather than forced in this type of setting).  Apparently if I don’t accept the limit, I cannot continue treatment.

“On that note,” I told him, “I am prepared to accept it, but only if you accept – because this works both ways – that I am going to fight it.”

He asked what I meant by ‘fighting’ it, prompting me to withdraw a copy of the letter to the advocacy groups out of my pocket.

“It’s only fair that you read that, given that you’re going to be involved,” I told him, handing the document over.  He took it and began reading.

I sat there and watched him reading it for a minute or two, then stood up and walked to the window, knowing perfectly well that he would almost certainly comment on this, as he had done two weeks previously.  Indeed, he didn’t disappoint.

“I’m wondering why you got up, SI…” he pondered, as he continued reading the letter.

“It’s not reflective of anything,” I spat cynically.  “I’m not denying my hurt or failing to face up to my problems.  I’m simply looking out the window whilst you are occupied with reading that.  Am I not allowed to get up, C?”

He shrugged and muttered something along the lines of that I was, in fact, allowed to get up, then continued reading in silence.

He eventually looked up and said, encouragingly, “it’s a good letter.  Who all are you going to send it to?”

I told him about the advocacy groups, Mindwise and the NI Association for Mental Health.

I was astonished – and delighted – when he then proceeded to actively encourage me to also send it to both the Chief Executive of my Trust, and the head of the mental health directorate of same.  In the end, he forgot to give me the person’s name, but as it turns out it’s been passed to him anyway (more details on how the letter has progressed in a future post).

C said, “you’ve also made reference there to people I think are in England – perhaps it would also be worth adding information about provision for personality disorders in other Northern Ireland Trusts.”

I asked him what such provision existed, knowing that people with the most serious PDs are in fact sent to specialist units in England as there are no facilities to treat them here at all.

C said a self-harm team exists in one of the other Trusts here.  “Although not everyone who self-harms has BPD, and not everyone with BPD self-harms, they would probably see a disproportionately high rate of people with your diagnosis,” he said.  “No such team exists in this Trust at the minute.  There’s discussion ongoing about making the existing team a regional, cross-Trust one, but it hasn’t yet come to anything.”

He talked on for a few minutes about plans our Trust has for action on personality disorders, and how they don’t seem to much be coming to fruition.  But the best part of the session was when he asked me if he could have a copy of the letter.

“I think it would be good for my line managers to know how you feel about all this,” he said.  He went on to say something (I don’t recall what) indicating that there might be some benefit to me in this, but was very quick to point out that it was my choice as to whether or not he did take a copy for them.  I readily agreed, of course, delighting in his apparent desire to act as my advocate to the bureaucrats above him.

Now, of course, I am convinced that he took the letter so he and his twatfaced bosses of evil can formulate some plan of self-defence in advance of hearing from the advocacy groups.  It was not in my interest at all – merely their own.  No doubt over the next few weeks we’ll see which way it actually is.

Eventually – I don’t remember how – I said that he must get sick of his job, what with all the whinging he would have to listen to.  “I accused you of being a sadist a few weeks back,” I said.  “Now I think you’re a mashochist.”

He accused me (sympathetically, to be fair to him) of splitting, which on reflection makes me slightly irritated, but at the time I agreed and called myself all the names of the day for employing this “silly psychological process.”

C leapt to my defence.  He said he knew that I had long since known I was guilty of splitting, but that it’s now “emotional for [me]“, not just something I recognise intellectually.  And it is OK, I do not need to berate myself for it, because I have suffered serious traumas, apparently, that have caused this defence mechanism (which is not silly, he contends) to develop.

On that note, as I recall it anyhow, we moved on to the discussion about the dreaded Christmas.

C’s advice was basically to get the fuck out if I felt anxious or overwhelmed.  I said that was easy to say, but he didn’t have to listen to my mother’s wrath if I did so.

He advised me to talk to her in advance, but I protested against this as well.  “When I told her about what happened with my uncle, she said I made it up to avoid going to his house,” I reminded C.  “So how can I justify my anxiety?”

“Blame your crowd phobia,” C said.  “She can’t be critical of that, can she?  There will be a crowd there, won’t there?

“Yes,” I replied.  “And they’re all part of the problem – it’s not all about my history with my uncle.  I have nothing in common with them and it’s a weird matriarchal set-up, where about 18 different generations all live under the same roof.  They’re freaks.”

He said, “are there children living there?”

I was horrified.  He was obviously wondering if anyone else is presently at risk from Paedo.

“Now you’re angry with me for putting the baby and all the other generations in danger.  I’m sorry,” I raced, in a bizarre panic.

C looked at me, his eyes wide-open.  “Where did that come from?” he enquired, surprised.

“Oh, you’re not angry with me?  Then I’m using you as a board for my anger at myself, am I?”

“OK, you’ve lost me,” he admitted.  “Just…just remember – get out.  Talk to your mother in advance, blame your crowd phobia if you have to, but if you feel yourself becoming tense, get out of there, even if only for a few minutes.  Allow yourself to be anxious about this.  How could you not be?”

And that, folks, was really that.  Of course, you know how ridiculously awful Christmas turned out to be, but I did remove myself from the others when I went so horribly mental, so I suppose I did at least follow the advice given.

As I was leaving, I wished him a Merry Christmas.  He said, admittedly cautiously, “you too,” causing me to laugh bitterly.  I think he knew that it was inevitable that the season would be utterly shite.

So, the three week gap is due to be over tomorrow.  Of course, I am convinced that C is dead again; either that or therapy will be cancelled due to the stupid, horrible, pointless fucking snow, and I need him so desperately at the minute.  Though I have not heard anything about a cancellation today, and I suppose I would have expected an advanced notification were the snow to fuck everything up on the monumental scale that it has in Britain.

The last time he was on holiday, in August, I didn’t miss him that much.  But this time I have, and I need him to help me pick up the pieces of the last few weeks.