BY POPULAR DEMAND, AND FOR ONE POST ONLY…

CONFESSIONS OF A SERIAL INSOMNIAC BRINGS YOU...

THE
NEXT
THRILLING
INSTALMENT
OF

C

WEEK 57

CUE LA MUSICA DRAMATICA:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Yes.  Watch it.  It’s good.”

“You saw it recently?”

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

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

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

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

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

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

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

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

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

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

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

“You’ll be here next week?”

“Yes, unless something dramatic happens.”

“Where has this come from, Pandora?”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

And then….

Nothing.

Except…

Tick, tock…tick, tock….tick, tock.

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

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

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

“I’m used to that,” I whined.

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

“Hmm, hmm,” he responded.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“OK,” I nodded, and I went to leave.

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

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

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

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

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

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

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

Click here to view the embedded video.

What a pile of utter wank.

On the other hand, what an opportune time to note that…

Or, rather, he was a fucking wanker, as he met his (rather regrettably late) demise in September 2007.  I wish it had been years sooner.

So, V, you raping, attempted-murdering, wife-beating, daughter-hating, piece of rotting worm-food shit, I hope you’re having a really, really crap death

See you in hell, cunt!

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Dear Mr Director Person

Re: Accessing Mental Health Services

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

I note with interest your willingness to point out that NICE guidelines are not always applicable in this jurisdiction, and that a regional team is “considering” the application of the KUF. I also have taken note of the information that a plan is being “worked on” to develop services in this Trust and that a NI Strategy for PD apparently exists. I am cautiously encouraged by this information.

However, you will recall that in my letter of 11 March, I specifically requested details on what is being done at this time to adequately govern the treatment for the serious difficulties faced by people with mental health issues in Northern Ireland. I would hope that your lack of a response to this question was an oversight and, therefore, I look forward to hearing from you in this connection by return. I would ask that you also detail how the rights of such individuals are secured within the community mental health system.

In relation to my own case specifically, you may be aware that <NewVCB> considers that I am afflicted with (amongst several other conditions) a form of complex post-traumatic stress disorder. I would refer you to Trauma and Recovery by Judith Herman and The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization by Onno van der Hart (and a multitude of other literature) on this subject. As I am sure you are aware, these sources (and many others) quite definitively assert that whilst psychotherapy is a vehicle to recovery, the inadequate provision of same can lead to re-traumatisation of the patient to whom the therapy is provided. I would assume that an explanation of the potential dangers of such a scenario is not necessary.

Given your evident familiarity with my case and your contact with C, it will probably come as no surprise to you that I have become thoroughly re-traumatised as a result of recent work with him. This is, I acknowledge, often a necessary step in the therapeutic process. My dissatisfaction with the service provided by the Trust stems from the fact that the Trust is allotting me very little time, by way of further psychotherapy, to address this. In short, the Trust is effectively releasing from therapy a patient who, as a result of the therapy being cut short, is in poorer health than at the beginning of the therapeutic process. Is it the Trust’s intention to discourage healing and indeed bring about psychological damage to ill and traumatised individuals? I do not believe that it is possible for even the most gifted therapist to alleviate this trauma within a matter of weeks, and have today discussed this issue with C, a meeting wherein it was agreed that my precarious situation within the Trust is, to put it diplomatically, “less than ideal”.

The Trust may, of course, claim that it is not bringing my treatment to an end. It is, I note, proposing to refer me to a CPN or mental health social worker after my contact with C ceases. With the greatest of respect to such members of the CMHT, I feel that this is far from adequate.  Given my re-traumatisation, I would enquire as to how a CPN or SW could (on their own, at least) possibly be considered a better choice than a qualified psychologist as my primary contact within the system, particularly given that such individuals often practice the supposedly panaceatic techniques of CBT or DBT, which I have found to be extremely unhelpful and indeed counter-productive in the past. I am not entirely sure what other kind of work such individuals could help me with, and would appreciate your kind clarification on same.

If the Trust’s actions are being determined by concerns around costs and NHS targets, then I would at least appreciate an acknowledgement of this. If, alternatively, the Trust considers that my therapy should end as a result of perceived psychotherapeutic attachment or reliance, perhaps you could admit to that fact (though of course most research in the area agrees that these issues, if present, should be fully explored rather than ignored).  In short, please advise on exactly why my psychotherapy is being cut so profoundly short and why my case is being transferred to an as yet unknown individual who may lack the expertise to deal with the kind of conditions with which I am diagnosed and indeed with the severe re-traumatisation of the kind that I am now experiencing.

For the avoidance of doubt, whilst I am willing to try to engage with a CPN or SW, I would strongly prefer that my psychological therapy with C continues past the currently proposed end date (circa September; in terms of actual meetings, this contact amounts to one year). Furthermore, I would also request that said therapy continues for as long as is necessary, bearing in mind two important factors. Firstly, it took over 12 years to finally be assigned any type of useful therapy, despite my having been referred by my GP to a number of other mental health practitioners (who, for various reasons for which I am not responsible, failed to be of any assistance). Secondly, as discussed with both C and <NewVCB>, it is highly likely that in the event of my discharge now, I will, in future, merely be re-referred for psychological therapy, thus rendering pointless any supposed cost-saving efforts surrounding the current process.

I would like to emphasise that I have found the current psychotherapeutic process at least modestly useful, and believe that through further contact with C, it could continue to help me.

I am certainly well aware of the strain on resources a case like mine presents, but as stated in my original correspondence to you, I am aware of quite a number of individuals in other Trusts that (have) receive(d) psychological therapy for years, if that is or has been deemed necessary (and in my own case it is accepted that long-term treatment of this nature is what is considered the best course of action). As you may be aware, mental health care receives approximately 50% less of the health service budget in Northern Ireland than it does in other parts of the UK; nevertheless, I know individuals in other Northern Ireland Trusts that still receive(d) ongoing psychotherapy for the required time (of course, by the same token, I do appreciate that some Trusts in Britain exhibit failings in mental health care too). Do you think that this postcode lottery vis a vis treatment – not necessarily PD specific – is acceptable? If not, what does the Trust propose to do to counteract the deficiency?

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

Thank you for your time once again. It is appreciated.

Regards.

Yours sincerely etc.

Thoughts? I will detail this morning’s session with C when I have actually bothered to adequately detail the last one. As you may note from the above, I have decided to pursue therapy to the end (thanks for your advice on same), though I was completely honest with him for once and told him about my having considered cutting it short and about how re-traumatised I feel.

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

Dear Pandora

Re Accessing Mental Health Services

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

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

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

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

Yours sincerely

Mr Asshole Director-Person Cunt.

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

Anyhow, this is my proposed response.

Dear Mr Director-Person

Re: Accessing MH Services

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

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

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

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

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

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

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

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

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

Thank you for your time.

Regards

Pandora (Ms)

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

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

Thanks again lovelies.  x

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

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

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

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

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

Some gems:

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

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

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

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

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

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

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

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

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

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

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

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

Much love

Pandora x

Anyone with any knowledge of mental illness that has read Seaneen’s blog knows that it is 100% fucking clear that she has manic depression. It doesn’t take the abject wankery of a psychiatric qualification. She has never had a manic episode? WHAT THE FUCKING FUCK? I don’t know Seaneen, and I don’t profess to be some sort of guru on mental illness, but her descriptions of what sound strongly like mixed states with psychosis are nothing like BPD. OK, so agitation and psychosis are common in BPD – I have both, myself – but the sheer extent of her symptoms strikes me as different.

I have never objected to my borderline diagnosis. If anything, I almost encouraged it; I knew I met the majority of the symptoms, and reading I Hate You, Don’t Leave Me was like reading an autobiography. However, since the diagnosis, I’ve learnt so much more about how people with this diagnosis are generally treated in the system.

I contend that borderline personality disorder, at least in many cases, is a sexist, demeaning diagnosis given to women who:

• are intelligent and self-aware, and therefore capable of challenging psychiatrists, which pisses their sanctimonious sense of intellectual superiority right off
• are “difficult,” which is a pejorative term acting essentially as code for shrinks being too fuckwitted to fully investigate your diagnosis (presumably because it might keep them from their lunchtime Vanilla Frappes)
• have issues of trauma (not in all cases). Way to go, psychiatry; re-traumatise people with this stigmatic bollocks after all they’ve already been through.
• seem mildly irritated once, because this clearly represents significant anger issues.

I am, of course, bring slightly facestious here – but you get my drift. I do not object to BPD as a concept, and unlike most people I don’t object to the name of the illness (because, at the end of the day, the concept, not so much the semantics, is what is stigmatised).

What I object to is the fact this is a wastebasket diagnosis oftentimes thrown about by psychiatrists who either don’t give a shit about their patients or can’t be arsed to understand them. What I object to is the way people with (or diagnosed with) BPD are often treated by the mental health system – “oh, fucking hell, not a borderline!” – which totally demeans the very real psychological distress and sheer fucking mental agony that the person is in and, most often, has gone through. In essence, what I object to is not this diagnosis per se, but the way it seems to be so frequently applied.

For people like me, who quite clearly do have BPD, fair enough – give us the diagnosis if you must. Just don’t treat us like shit as seems to be your pathetic little wont. For others that you just fancy throwing it at – stick your stigmatic, defiling diagnosis right up your supercilious arses.

“Well and contented” would be a laughably optimistic description of my current physical and mental status, at least in some ways – but we’ll start with the good things, shall we?  I’ve had the pleasure these last few days of connecting and re-connecting with friends whilst I was on a short break.

TEH GOOD STUFFZ

I have already mentioned K on this blog; it was with great pleasure that A and I saw her (again, in my case) on Monday night, along with her boyfriend N.  We spent several hours discussing BPD, cats, our obsessive attachments to our respective therapists, K and N’s work (both together and independent of one another), the sheer inadequacy of mental health services on the NHS, politics, how K’s and my BPD impacts on N and A, and general life.

The day prior to that A and I met Annie for the first time.  I would have called her ‘A’, but that would seriously confuse issues!  Annie and I have known each other online for quite a few months now so it was great to finally meet her.  We spent a great afternoon chatting about her kids, her pets, our pets, mentalism (Annie has bipolar disorder; her aunt to whom she is close also does, as well as possible BPD), Doctor Who (does anyone else think Matt Smith is fucking awesome?  Pertwee and Baker are still my favourites, but Smith is already vying for third place with McCoy) and Postman Pat (don’t ask).

I consider myself a highly fortunate person to have met such wonderful folks online such as these two.  And I’m meeting CVM next month too.  And then there’s all the lovelies I haven’t met, primarily but not exclusively from Twitter.  <3 you all.

TEH SHITE STUFFZ

Following on from that point, last week a situation emerged wherein the support of such people as aforementioned was so profoundly welcomed.  As soon as I made others aware of the problem emerging, I received lots of supportive comments, tweets and emails, for which I am eternally grateful.

It made one thing brutally clear to me: this blog, and the people I’ve met through it in one way or another, mean more to me than nearly all of my entire family.  Family-orientated individuals may find that an outrageous and utterly callous statement, but I don’t care.  It’s true.

What happened was entirely my own fault.  I didn’t do anything consciously if that in any way mitigates my actions, but I was remiss – even reckless – in my accidental use of this online persona, one that is meant to be almost entirely disconnected from my offline one.

I had a couple of pictures on my iPhone that I wanted to share with my mother, so I simply emailed them to her using the built-in mechanism on the phone.  For those of you unfamiliar with the device, it lets you send photographs without the need to actually open your email client.  Unbeknownst to me, though, when you do this, it defaults to a particular email address of which I have three.

If you don’t know already, you can guess the rest.  When I checked my emails the next day I was horrified beyond description to see a response from my mother to the aforementioned email in my serialinsomniac.com accoount.  F.U.C.K.

A and I were due to head away for a few days that day, but I decided to call with my mother under the pretence that I needed to borrow something.  The plan was to get A to distract her whilst I went in to the PC and permanently deleted the email from her computer.  She’s not especially technical, so we reckoned we could just blame its absence (if she even queried it) on the fact that Microsoft is a pile of steaming horse manure (I’m a Linux girl ).

It was straightforward to accomplish this mission, and for a few minutes A and I breathed a mutual sigh of relief.  As if on cue, though, my mother then declared that she had forwarded the email on – to two of my cousins in the McFaul (McF) dynasty.

FF UU CC KK ad infinitum

This rendered the matter completely out of my hands.  Fuck fuck fuck.  I wasn’t so worried about one of the recipients – her being an internet novice even more than my mother – but the second person would have the potential lack of stupidity to Google the term ‘serial insomniac’ had she noticed it or cared about its relation to me.

So, my first instinct was to password the entire blog, as you can do with blogs hosted at wordpress.com (as I used to be).  However, since I now run the blog myself, this option does not exist; I assume that WP’s supposition is that you would not pay for a domain and hosting if you didn’t want people to read that which was on the domain and hosting.  Instead I looked for a plug-in (a third party application that adds further functionality to WP) that would permit passwording of the entire site, found one, and installed it straightaway.  A and I left to head to our destination, feeling that the problem was temporarily solved; all my regular readers could visit essentially as normal, random voyeurs who might be my family could not.

When I arrived I was distraught to note that the blog was totally inaccessible; the plug-in had completely fucked it up.  It wouldn’t allow you to get to a page where you could enter the password and I couldn’t even get into the administrative pages, so I couldn’t delete the damn thing.  It was stuck on an endless loop of blank-screeniness.  My original concern of having been ‘found’ was replaced with a new one – that of having lost everything.

The first few hours of our break were therefore devoted to looking for a wireless network so as A could download an iPhone FTP program and access the site directly, independently of WordPress.  I was crawling up the walls with crazy.  I don’t know how many words I’ve written during my time on this blog, but I have something like 125 posts – of up to 8,000 words each (as seen here) – chronicling, so far, one of the most difficult years of my life.  Not to mention over a thousand comments of wonderful feedback and support.

In those few hours I made the realisation that I cared more about the preservation of the blog than I did about the potential discovery of it by my family.  If all hell broke loose – well, it just did.  I didn’t (and don’t) want it to, but that is actually preferable to being silenced or hidden.

The long and the short of the story is that Lovely A rescued the blog, and I password-protected certain key posts rather than the entire thing (I’ve since removed all passwording except the original four and the family tree).  Over the next few days, I monitored closely search terms that were getting here (after initially revoking search engine access, I later asked myself why the bloody hell I should do so.  Those few days have adversely affected my stats, but onwards and upwards, eh?) and what posts were being read, to see if there were any suspect or anomalous referrals.

TEH OUTCOMEZ

In my view, some of the search terms leading here and some of the reading patterns were kind of unusual.  Disproportionate numbers seemed to be searching for “serialinsomniac.com” or “serialinsomniac”, rather than “serial insomniac” – in others words, it looked to me like someone was Googling the actual URL rather than the blog name (as if having seen the URL in an email).  This isn’t unknown in the past, but it’s not been terribly common.  In all probability, I’m being over-sensitive, but one never knows.

I’ve started making an effort to change some names.  You can see some of the key ones on this page, and others are already changed in the archives which you can look at it if you need context.  I’m abandoning many of the old initials completely so if you need clarification on who a new name refers to, you’ll need to contact me.  I’ll try to add to the ‘Emsemble’ or family tree page with names that weren’t previously included as soon as I can.

I’m also monitoring the geographical location of people finding their way here.  I’d like to assure you that if you are outside a very tiny geographical triangle of Northern Ireland that I will pay no attention whatsoever to where you are, what your IP is, etc – so normal, genuine readers should not feel discouraged from reading.  Please, please don’t stop reading and commenting!

TEH AFTERMATHZ

To the Family:  If you’re from the McFaul family (or any other part of it for that matter), with the IP tracking site I will see you and I will block your IP addresses, rendering you unable to access this website.  I don’t care if I have to pay a fortune to maintain that; you have no place here.

If you are concerned that you recognise yourself, then grow the fuck up.  Everything has been, and will continue to be, anonymised.  The lengths that I have gone to to protect you should be appreciated, not condemned.  And if you don’t want to become aware of matters about which I write then don’t fucking read what I write.  Think I’m lying about Paedo?  I don’t give a shit; what I’ve had to go through thouroughly and utterly trumps any disgust you may feel at what I’ve revealed.  Think I’m being unreasonable about how manipulate and oppressive Paedo’s missus is?  Then you’re deluding yourselves.

In short, I won’t go into a closest for you people, and I don’t care if you don’t like it.  Try and read if you want to, but I will stop you; I’m not going to be in the position where I have to try and pay lip service to you here, on my own fucking diary, as well as in ‘real life’.  This journal is my pride and joy, my own little corner to bitch and whine with impunity about my illnesses, to rant and cry about what all of my family have done to me at various points in my life, to explore the weird dynamics of therapy.  And everything else in between.  And it’s staying as it is.

To everyone else:  So I’ve joined the ranks of mentalist bloggers that have been found by real life.  I know I’m in a long-line of such people…how did you handle it?

There’s a good bit more to report than that which has been detailed, mainly in reference to the aftermath of recent discussions with C, but I’ll leave that for another post.

I’ve been absolutely shite at replying to comments, emails and even tweets recently.  I am genuinely sorry for this, and hope you don’t think it means I value each and every one of you less, because I love you people.  I do.  I know I haven’t met most of you, and I don’t even know most of your ‘real’ identities – but it doesn’t matter.  Your feedback, empathy, advice and wonderful support has meant so much to me over the last 11 and a half months.  Here’s to the next 11 and a half years.

If you have:

• any sense
• an aversion to cursing
• a belief in blood being thicker than water
• a hatred of gratuitous, not-really-emphatic bolding
• or if you generally hate me for whatever reason

  then you probably shouldn’t read this.

If, however, you are my Aunt of Evil, Georgie, then you most indubitably SHOULD read this, cos I COMPLETELY despise you. OK?

Nothing pisses me off more in the world than my family in the United States. Not because they’re in the US, obviously – I just use that as short-hand to distinguish them from the other lot of twats here. No, they piss me off just because they are complete and utter cunts from hell.

The arseholes were not content merely to rob me of the money in my father’s will, nor has it been enough for me to tell them to piss the fuck off. Today I have discovered they’ve not only kept up a running commentary on me with my bloody mother, but they are responsible for something about which they lied to my face more than once when asked about it.

Well, specifically my Aunt Georgie – the Aunt of Evil – is thus responsible.
I have specifically told my mother, and I told Aunt of Evil (AoE) in the email I sent her telling her not to contact me, that they are not to discuss me nor my mental illnesses with each other at all. They’re my mental fucking illnesses. Short of circumstances under which I could be sectioned, it should be me who gets to decide those individuals that are party to the sordid details. Both of them said they would respect my wishes in this regard (though admittedly my mother tried to put up a fight first). Yet they have continued, sometimes in considerable detail.

I know this because today I read a chain of emails between my mother and Aunt of Evil. Nosy? Clearly so (*vilifies self half-way to death*), but then my mother should not leave her fucking email client open at the fucking email in question when she knows I am going to be using her PC, should she?

At one point, AoE blathered on about how she had been thinking of sending me a birthday “note” back in November. Her hustwand, rather sensibly and accurately, opined that doing so would “irritate” me so AoE said that (for once) she was taking his advice. Oh, and that my mother was not to tell me. (She didn’t incidentally. I wouldn’t give a fuck one way or another except that when I have asked her not to share stuff with this old bint, she has gone and done so anyway! Having said all that, I’m not angry with my mother. I wish she wouldn’t do these things – it exasperates me utterly – but she means well and doesn’t intend to cause any harm. I love her and feel sorry for her, so am not angry with her. Just cunty AoE Bitch of Satan).

Then AoE states that she “regrets” her and her hustwand telling V, my ‘father’, to send me a birthday card when I was 21, as “it seemed to do more harm than good.” (A surprisingly accurate assessment).

That may seem relatively benign, but long-term followers of this blog will be aware of the fact that my father was a complete cockhead who chose never to have any contact with me, preferring instead to contact the bottom of a bottle several times daily. I was mystified as to why, then – almost 20 years after I’d last seen him – the old dick would remember my birthday. I challenged AoE when she was next in Northern Ireland, and she looked into my fucking eyes and denied that she and her hustwand had anything to do with it.

Cunts. Absolute cunts. They profess themselves to be Christians, but they are the most hypocritical, self-righteous, thieving, patronising, “we know best and you’re just the stupid bitch we know better than” group of self-obsessed fuckstains of evil bastardry upon whom my eyes have ever set (and upon whom I hope my eyes never set again, unless it’s when we’re all burning in hell).

I had a good, very productive session with C (during which I told him!!!!! Blog on same to follow) this morning which left me in a good, if slightly self-satisfied, mood. The continued revelations about these cunts served to annoy me in the extreme and slightly spoil that, though I have mostly gotten over my frustrations by now (still wanted to rant though; they are still fuckheads). I had the most beautiful dream this morning that I was literally rearranging my aunt’s face. How prophetic it turned out to be.

A and I were conversing about this matter a short time ago, a discussion in which I concluded that it was blithely amusing and perhaps ever so slightly strange that I hate Georgie / AoE more than Paedo (of course as you know I don’t particularly hate Paedo, but presumably I should). It does indeed seem bizarre. Here we have a woman who’s patronising, self-righteous and who encouraged the theft of my money. All bad, yes, but that’s up against sustained, long-term, systematic child sexual abuse. The latter, on paper, seems worse, yes?

But really, nobody has ever rubbed me up the wrong way (if you’ll forgive the unintended but possible pun-esque play on words vis a vis recent mention of sexual matters) in quite the way that this woman has – and, crucially, can. I’m not sure about this, but I think I might actually hate her more than anyone else I’ve ever met.

I want that to desist, however. I don’t hold to all the usual old bollocks that hatred is destructive and whatnot – my twisted mind tends to find it quite entertaining and amusing. It is a source of creative and wry energy for me most of the time. However, the fact that I hate her with such a profound and burning passion demonstrates the fact that, regrettably, I give a shit, if only in the most twisted and negative of ways.

I want her to be a matter of utter indifference to me. In my view, complete and utter indifference is the biggest insult you can give another human being with whom you are personally familiar. That would be wonderful. But how is this ambitious state achieved? Gaaaaaaaaggghhhh!

Sorry for this rant, but then it’s my blog so I suppose I am allowed to vent on it should I wish to do so.

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

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

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

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

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

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

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

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

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

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

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

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

—

Dear Pandora

Advocacy in Accessing Mental Health Services

Thank you for your letter dated 17 December 2009 about accessing our mental health services.  I am glad to note that you have developed a good therapeutic relationship with the clinical psychologist involved in your treatment[,] but am sorry that our services have not met your expectations.  [My "expectations"?  My "expec-fucking-tations"?  No, you miserable old bellend, they are not my "expectations".  They are my fucking needs and requirements!]

I have received feedback from Dr C J confirming that he saw you for the first [time] on the 19 February 2009 and [that] after three assessment interviews an agreed treatment plan was drawn up that offered weekly treatment appointments and also an assurance that an end to therapy would be identified well in advance of a contracted completion.  Dr J [he is not Dr fucking J!  He is C!  I don't care if this is an official fucking letter.  He is fucking C!] agreed with your view that some modest gains had been made during your contact with psychological services [aren't I the fucking lucky one].  He also recognised the complexity of your difficulties and so sought additional input in the form of a referral in May 2009 to [Old]VCB, Consultant Psychiatrist [that should have gone through months beforehand, after a referral from my fucking GP.  Useless twats].  I understand that you continue to be seen by the psychiatric team [yes, after more upheaval, and when they can be bothered, which is really rather infrequently].

At the time of your letter Dr J [FUCK] had made the offer of 24 additional appointments, which would bring your contact with him to an end at about the first week in June 2010, a treatment duration of about 16 months [actually, that is incorrect.  There will be 59 sessions, three of which were assessments, and four of which will be to end the process.  This gives an exact total of 52 therapy-specific sessions, which surely even in your clearly deficient brain equals a total of 12 months.  Fuck you.]. Dr J [fuck fuck fuck] expressed the hope that within these sessions, which would span approximately six months [my God, I would never have realised], [that] further work could be done that would help towards resolving, dealing with or managing your ongoing mental health difficulties.

It is clear that you have a good knowledge of the NICE guideline[s] on the treatment and management of borderline personality disorder [Hmm.  You are telling me that I know something that I know.  That was a productive use of your secretary's typing time].  Overall as the guidance states, the evidence base for individual psychological therapies in the treatment of borderline personality disorder is “relatively poor”.  Specifically, however[,] it recommends that brief therapies (under three months) should not be used.  Much of the guidance relates to provision within a specialist Personality Disorder Service.  The availability of twice weekly sessions, group psychotherapies and integrated team treatments [what the fuck?] are [sic] largely to be found within those highly specialist services [oh really, I had no idea Mr Director Important Person, thanks for clarifying].

The <Trust in question> does not have such a service [aha, and that's clearly the fault of the patient.  Nevermind the NICE guidelines saying in the absence of such a "service" that adequate generic therapy should be used.  Fuck you again], although we, along with all other local Trusts, are involved in the development of a regional approach to Personality Disorder services across Northern Ireland [wowee, I'm so profoundly impressed] and have recently interviewed for two specialist workers [two?  A whole TWO?  That's extraordinary!  Congratulations sir!].  Therefore we are planning to develop our services to people with personality disorders [I therefore assume that I can take this letter as confirmation that these "services" will be fully accessible by me...?].

As you state it is important that clients have access to a full range of mental health services appropriate to their needs.  We try [and fail] to ensure that needs are assessed in a collaborative way [hahahahahahahahahaha!!!!!] that involves both clients and mental health professionals [well, then.  That has been an epic fail!].  I would encourage you [who the fuck do you think you are, my father?  Fuck you in triplicate] to discuss these matters with the two professionals that you currently attend [yeah, because I haven't done that already.  Fuck you x4].  The Crisis Team provides mental health assessment and support outside 9am to 5pm hours in the working week, and can be accessed if appropriate through the out of hours primary care service [well, fuck me sideways with a broomstick.  I had no idea what the Crisis Team did, thanks for providing me with a lit pathway to therapeutic enlightenment.  Fuck you mark five].

Dr J [FUUUUUCK!!!] has confirmed that you have continued to attend his sessions following the writing of your letter [what was I meant to do?  Fuck a goat?  Oh wait, that's exactly what I was meant to do, right?  "The bitch is borderline, so she must be non-compliant with treatment and will instead go out and fuck anything to temporarily fulfill her emotional voids"]. I would hope [oh would you really?] that despite their finite nature you could still use the upcoming sessions to make progress.

Yours sincerely

Abject Twatfeatured Spetum-Faced Tosspot
Director of Mental Health and Disability Services

—

So.  He has succeeded in providing me with:

1. A chronology of events.  Woohoo.  Obviously the stupid mental couldn’t possibly know that she saw these individuals, nevermind know in which order she saw them, even less what they said!  Particularly when she’s an immature, manipulative borderline freak. So thank you, Mr Important Director Person, you have made my life and mental health treatment complete!
2. A commentary on the fact that I know what I know.  A tremendously useful and productive use of his time and mine; after all, I couldn’t know what I already know unless he told me, could I?
3. Um…that’s about it.

Altogether an epic success, I’m sure you’ll agree.

The letter is dated 17 February (how it took him two months to compose the above I’ll never know) and it actually arrived at Mum’s house a good while ago.  I made her read it down the phone to me, so I was aware of its content, but I only collected it the other day, and had (until now) refused to look at it.  I thought that due to its high degree of pointlessness and its utter failure to assuage my concerns, that it would upset me considerably.  After all, this is about the cessation of my relationship with C, which is an incredibly traumatic thing to contemplate.

However, when C asked about it this morning (blog to follow – big update on the beard!), I somewhat surprisingly found myself wryly amused as I reported a redacted version of its contents to him.  Therefore I’ve come home and written it up and am pleased to say that I still find it amusing rather than upsetting, probably because it doesn’t actually say anything.  OK, there’s maybe six or seven hundred words there, but it doesn’t actually – at any juncture – make any salient points at all.  It is a vacuum of a letter.  It is a nothing.  Empty space seems full relative to this page of black and white nonsense.  I’m glad it was printed on both sides of the sheet as I would have hated to see any more wood senselessly wasted on something so fruitless and silly.

Given the amount of money this moron is paid, I should really be rather angry, as well as disappointed and lost as to what to do next.  Instead, fair play to him, as he’s given me a laugh…and, in fact, some hope.  If someone with such poor (written) oratorical skills and an intellect clearly directly comparable to that of an earthworm can rise to such a lofty position within a large organisation, then my dream job is surely still within my reach.

In conclusion…FUCK YOU ONCE MORE, Mr Director Wankface Important Daft Person!

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.

Alas.  These evil bastarding illnesses don’t disappear because one has a few less shit days.  I had a very productive session with C on Thursday (blog to follow, mais oui), but it left me thinking about some shit that I don’t really want to think about, mainly about the stupid fucking sex abuse (like that’s the only difficulty I’ve ever faced in my life.  Why the hell am I fixating on it?).  Moreover, my mother – I am not unconvinced deliberately – made a particularly insulting comment vis a vis same a mere few hours later (details in the forthcoming C post).  Consequently, this stuff has been swirling around in my psyche for a few days, though I thought I was handling it quite well, as my mood remained on the less-shit-than-completely-and-utterly-shit level.

Or, more accurately, it did ostensibly.  However, beneath the surface the madness bubbles smugly in its little cauldron of neurons and silly levels of dopamine and eventually, when you least expect it, it attacks.

I made the stupid decision to go on a drinking bender yesterday.  Well, I say ‘bender’, but by comparison to some piss-ups I’ve frequented, it was actually relatively subdued.  Nevertheless, one should not be consuming alcohol when taking anti-psychotics.  I’ve always ignored rules on alcohol and medication, and have never encountered any noticeable side-effects, but then all of these tablets are different in how they interact with one’s personal physiology.

Anyway, all was going well up until the point at which A and I met G, our friend about whom I blogged on the DBT philosophy post.  Not that there’s anything wrong with G; he doesn’t act as some sort of intellectual trigger or something.  No, the reason it went wrong at this point was that it is the last point of which I have any recollection.

I woke up this morning in my own bed, fully clothed.  I must confess that I wondered at the time if I’d done anything mad…but I didn’t think it would be quite as bad as it turned out to be.

My party piece had apparently been to pass flat out in the disabled toilet.  Classy, SI.  A had begun to think I’d slit my wrists in there, and ergo G asked the barwoman if she would check the toilets to see if I remained in this plane of existence.  Unfortunately I did, but was lying there, flat-out unconscious.

I have to admit that in retrospect, this seems amusing – albeit in a twisted sort of way.  Stupid cow had too much to drink and fell asleep in the pisser, chortle chortle!  But it’s really not so funny when I actually think about it.  I have never passed out owing to alcohol before – and as I say, some days gone by make yesterday look fairly tame.  What’s more, I’ve never experienced such long-term memory loss like some people do as the result of pissing it up.  A few details get lost amongst all the murdered brain cells, certainly, but not hours of material.  It’s like an entire chapter has been ripped from a book, and the only thing that I really feel I can compare it to is the amnesia from a severe dissociative episode, like some of the fugues that have been my absolute joy to behold.

The story continues.  A brought me home, not unreasonably.  And there I really, really lost it.  He doesn’t recall most of the specifics exactly, but whatever the case I lodged a barrage of completely ridiculous and unfair allegations and insults at him.  Subsequent to which I levied them at myself – I’m a fetid, disgusting slutty whore, apparently.  Well, at least I got something right during this epic rant of stupidity and vicious pointlessness.

I am reminded somewhat of the behaviour that gave rise to this post, though at least my mind has the common courtesy to allow me to remember what happened in that incident.  Last night’s events were not as serious as that, and as far as I know there was no overt psychosis involved, but nionetheless – the stream of abuse that came out of my grotesque little mouth is simply unacceptable.  More lines crossed.  More boundaries of common fucking decency transgressed.

My current self-view is that I am a evil, utterly vile, indescribably despicable bitch of Satan.  Not, as a committed atheist, that I believe in Satan’s existence, but you take my point.  Oh yeah, and the fetid whore thing still rings true.  A said that my apparently unwavering belief that I am a slut is something that needs to be discussed with C in therapy.  Well.  Quite.

Perhaps the most bizarre thing about all this is that despite my complete self-disgust and total horror at what I’ve done, I’m actually still in a (relatively) favourable frame of mind.  I’ve gone about punching myself as punishment, but I don’t feel that overwhelming need to self-harm that one does when the strength of one’s depression is crippling.  I’ve actually managed to have a relatively non-shite day with A despite his revelations about what a complete twat I was.

So anyhow, I apologised to him and then started deriding myself a la the last-but-one paragraph.  He accepted my apology and refuted my blather of self-disgust, though I am clueless as to how he can hold me in any positive regard whatsoever.  And then…this is the best of it…my appalling behaviour was rewarded with breakfast in fucking bed.  I am a lucky girl.

My assessment as to the causation of the blackout is that it must have been attributable mainly to the combination of alcohol and Quetiapine, though I do think I must have been unconsciously harbouring some major stress.  Certainly, the outbust thereafter would indicate that – the actual catalyst might have been booze, but the content of the rant strongly speaks to me of underlying and unprocessed psychological bullshit.

However, that simply isn’t an excuse.  A may defend me on the grounds that I’m “mental”, but I don’t think that – or anything else – is a valid defence.  Being mental does not give one carte blanche to scapegoat the most important people in one’s life for things in which they were and are absolutely uninvolved.  No, the only human characteristic that deems that permissible is one that is strongly in evidence in my personality: that of being an abject cunt.

Fuck, fuck, fuck, fuck, fuck it all,
My fucking life.
Suck, suck, suck, suck, suck it all,
My fucking dick.

Here is my apparent equivalent in prose. Hilarious.

—

Fuck my existence.

Fuck therapy.

Fuck C.

Fuck (New)VCB.

Fuck the NHS in general.

Fuck V.

Fuck Paedo.

Fuck my entire famly except my mother.

Fuck my ex.

Fuck the school bullies.

Fuck the school fucking teachers.

Fuck university.

Fuck the Troubles.

Fuck politicans.

Fuck the Social Security Agency.

Fuck the government.

Fuck religion.

Fuck secularism.

Fuck human relationships.

Fuck feeling.

Fuck heat.

Fuck cold.

Fuck the UK and Ireland.

Fuck Earth.

Fuck the solar system, galaxy, local cluster, universe and multiverse, should the latter exist.

Fuck medication.

Fuck getting washed and dressed.

Fuck getting out of bed.

Fuck prejudice and bigotry.

Fuck the beautiful people (forgive irony vis a vis last point).

Fuck this blog.

Fuck my “life”.

Fuck everything.

That is all.

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I don’t want to stop writing. I really don’t. I want this blog to chronicle all my future negotiating of NHS (and possibly private) mental health services, all my thoughts, emotions, psychoses, episodes of all descriptions – the works vis a vis my mental illnesses. I want it for my own benefit, and I want it for others. I wish blogging had been in existence when I was a teenager, as I don’t think I would have felt quite so horribly alone back then had I been able to read that others were in exactly the same boat.

The problem is this. I am right in the midst of a major depression. I want to die. I have no energy, I have no focus, I hardly even have any thoughts beyond how much I don’t want to exist. I am consumed by my complete and utter misery. Typing a fucking Twitter message at 140 characters or less is a desperate effort, so you can imagine how profoundly difficult blogging is.

I am forcing myself to write this – and it is genuinely a physical effort that feels on a par with the gym on a bad day – because I know if I don’t write it, that the blog will progressively fall by the wayside, and that is the last thing I want. But I am not sure how much longer I can sustain any writing. Part of my all-consuming lethargy is probably attributable to the introduction of Quetiapine into my medication cocktail, but the cycle of depression had started before I started taking it, so it’s not entirely to blame. Ergo, in short, I’m concerned that even if the sedative effects of my new medication do pass soon, that I’ll still be finding it hard to write this blog.

I am not the first person to be afflicted by a major depressive episode that has a blog. How do the rest of you sustain your writing when your mood is at its lowest? Any advice would be appreciated.

A often tells me that I should describe how I feel whilst in the middle of an episode, so let me see how well I can do that:

• Suicidal ideation. I’ll not act on it in this state though – I simply do not have the energy to try to kill myself. Nevertheless, I’m completely pre-occupied with my death and how I can bring it about.
• Distracted, unmotivated. I can’t concentrate on anything. This post has been written in bits and pieces, has taken ages and is probably still disjointed and figuratively illegible.
• Emptiness. I don’t know how to describe this any better
• Worthless, listless. I have no function. I am pointless and (justifiably) disenfranchised and useless.
• Apathy. I don’t care about anything, and that includes feeling better. I can’t explain this; I feel so indescribably low and miserable, but I couldn’t care less about feeling less low and miserable. I just don’t care. I can only assume that that is because it seems like too much effort.
• Self-hate. Not as strong as it could be, though; I don’t have the energy to hate myself as much as I sometimes do. But I still do feel self-disgust. I feel worthless and horrid and fetid and disgusting.
• Lack of interest in anything. I don’t want to engage in anything that ordinarily gives me pleasure, including this writing. It has taken me absolutely ages to get to this point, and it is still requiring every last ounce of willpower that I have (which isn’t very much).
• Lethargy, exhaustion. I am utterly buggered. All I want to do is sleep. Despite my moniker on this blog, insomnia has been less of an issue (presumably) thanks to my new medication (I’m still waking at random times and finding it hard to get back to sleep, but that’s better than no sleep at all). I’m oversleeping at the moment, actually – maybe 10 or 12 hours on and off – but I am still absolutely shattered. All I want to do is sleep.
• Inability to concentrate. So forgive me if this is a bizarre entry.
• Psychotic. ‘They’ are hassling me. Not in the all-consuming way that they did in October and December, but they’re babbling on and on and on at the back of my head, with their usual ‘slut’, ‘whore’, ‘bitch’ mantras. I don’t have the energy to ignore or rail against them.
• Don’t want to talk to anyone. Self-explanatory.
• Sick of do-gooding. Ah yes, well-meaning interference…

This is going to make me sound like a miserable sod, perhaps with good reason, but I am so sick of peoples’ good intentions. I am not sick of good people’s support for me of course, but there are certain misguided manifestations of that that are driving me up the walls.

Telling me that I should remain in existence because I am intelligent or kind or whatever positive adjective you find appropriate does not make a blind bit of difference to how I feel. I still want to die. Wittering on about how I should have a course of CBT because getting better “can be that simple” denies the truth that CBT is a patronising load of wank, touted as a mental illness panacea by a government hell-bent on reducing costs, whatever they may say to the contrary. I still want to die. Telling me I have to “think more positively” serves frankly only to make me want to punch you in the face. I still want to die. It is not that simple.

I have a mental illness. I am not just having a bad few days; I am mentally fucking ill. Yes, I’m lucky that people care, but there are limits to that in terms of how they present their concern. Some of those that are engaging in this well-intentioned but horribly intrusive do-gooding I don’t even know well. How can they consider it appropriate to get involved in discussion of my (poor) health at all, let alone express such profound failures of understanding about the diseases with which I am afflicted?

Right now I don’t care if I get better. I just crave the comfort of unconsciousness, whether that is death or whether it is more bloody sleep. I am grateful for people’s simple understanding, and their offers to be there for me should I wish to avail of them, but their well-meaning pursuit of dialogue that goes beyond that merely serves to irritate.

I know I’m selfish and nasty and horrible for even thinking these things, and I know I should be grateful and to that end I’m sorry, but I’m so fucking miserable that I don’t care. It took me all my time to write this shit so I’m going to publish it anyway. At least it chronicles one of the bad days in an accurate, if intensely negative, fashion. Let’s see if I can manage to write up last week’s C session whilst continuing to endure this abject psychological torture. Hedge your bets now, my dears!

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Dear Sir or Madam

Re:? Complaint

It is with regret that I am writing to you in order to make a complaint about an appointment that I had with Dr Arsehole on Friday 18 December 2009 at 8.40am. In particular, I wish to make my views known about Dr Twatbag’s dismissive and patronising approach in relation to my health issues.

The appointment was primarily scheduled to discuss a physical health problem. I had been told previously by a colleague of Dr Shithead’s that medication was available to assist in the management of this condition, a fact that Dr Wanker confirmed. However, he then refused to prescribe me anything to alleviate the severity of my symptoms, citing my age without providing any substantive reasoning. I am baffled as to the relevance of an individual’s age to their need or otherwise for medication, and was not offered an explanation. Furthermore, Dr Knobjockey chose to fixate on my weight at this juncture. I do recognise that I am overweight, but as intimated to the doctor, have recently been dieting and exercising, resulting in the loss of over three stones. Despite my attempts to make this clear, the physician continued to speak condescendingly to me about the strain on resources that the “obesity epidemic” is causing.

However, it was a discussion around my mental health that caused the most offence and which, in my view, demonstrated not only a lack of sympathy for mental illness, but in fact ignorance surrounding this group of health conditions. When I asked for medication to help combat insomnia and anxiety, Dr Bollockfist refused, in an irritable and frankly almost hostile fashion. In the past I have been refused these medications, and would certainly not issue a complaint on those grounds alone. However, I do not think it is unreasonable for me to have expected this request to have been denied respectfully and sympathetically, with an explanation of the reasoning.

Regarding my chronic sleep deprivation, Dr Cuntfeatures unhelpfully told me that a lack of sleep, no matter how long-term, “won’t kill [me]”, failing utterly to offer any practical help or advice on the matter. Perhaps this is, literally speaking, true, but this denies the extremely serious effects a lack of sleep can have on normal daily functioning. I am also fairly sure that this does not constitute professional advice nor assistance. I should not have to point out that forced sleep deprivation is used as a form of torture.

Dr Bastardface discussed insomnia that he had experienced following a personal bereavement; whilst obviously I have the greatest sympathy for his loss, I fail to see the relevance of the example, and indeed believe that the implied suggestion was that because my insomnia is not necessarily circumstantial that it is therefore somehow less real or less deserving of attention than a lack of sleep caused by a distinct traumatic event. He then, to my astonishment, point blank denied a connection between psychotic symptoms and insomnia. Might I be so bold as to suggest that Dr Dickhead researches this more fully; insomnia is, in fact, well known to cause or increase psychosis and the symptoms of psychiatric illness (source).

In discussion of the illnesses that (at least in part) contribute to the aforesaid, I was dismayed by the allegation that I was simply trying to “medicalise” my conditions. I do not believe this to be fair at all – I am presently undergoing intense psychotherapy and merely wish to try and manage my symptoms until it has reached a satisfactory conclusion (incidentally, please see the enclosed letter to Mindwise regarding the disturbing possibility of a premature cessation of this necessary process. If I cannot receive psychotherapy to sort through my illnesses psychologically, I fail to see what choice I have but to seek medical intervention). I would add, also, that even if I were ‘medicalising’ my illnesses that they are, indeed, at least partly biological. Borderline Personality Disorder is thought to exist in individuals with a biological predisposition (sources) and bipolar disorder is considered primarily a medical illness (sources). Both are, of course, considered serious mental illnesses, having disproportionate rates of psychosis, suicide and self-harm (sources).

Incidentally, I noted with interest that my file does not reflect these diagnoses, still stating that I suffer from depression and anxiety. Whilst these co-morbidities do exist, my primary diagnosis is BPD (with psychotic features) with a differential diagnosis of bipolar disorder, type II.

Overall, it was not so much what was said that upset me (though I felt that to be lacking too) as the manner and tone in which it was said. Although I felt Dr Bellend’s response to my physical complaint was inadequate, it was at least presented fairly amicably by him. His attitude to my mental illness was, however, dismissive, unsympathetic and thoroughly unhelpful – I would say it bordered on disdainful, indeed.

Whilst I appreciate the subjectivity of this judgement, I would hope that the fact I have never made a complaint about [the practice] in my life until now would indicate that I am not wont to take things out of context. Unfortunately I got the distinct impression that the physician was dubious as to the sincerity of my illnesses and that it was felt that I did not have ‘real problems’ (though should he require a list of traumatic events that have helped to contribute to my psychiatric illnesses, I should be happy to provide same). It is sad that such stigma is not only present in society, but apparently in the medical professional also. Dr Cockhead, like anyone, has a perfect entitlement to hold such a view privately, but given his chosen career should not allow it to impinge on his professional practice.

I would like to make clear that, in general, I have felt very much supported by the professionals at the practice – in particular, I would like to thank [LGP], [the Nurse Practitioner] and all the nursing staff for the support, respect and professionalism that they have shown me. I have also had the pleasure of having positive interactions with Dr Ballbag in the past, and would therefore hope that this incident merely represents a ‘blip’ in the professionalism of his practice. However, given the distress it caused me and the apparent lack of awareness that it represents, I felt that it was imperative to bring it to your attention.

Thank you for your time.

Best regards.

Yours etc.

Enc (of the letter to the advocacy service).

Boxing Day has been a fucking nightmare too, though on a lesser scale. But the psychoses of last night are what matters. It is time to be hospitalised.

‘They’ told me that smothering Marcus would be “a mercy”. Maybe or maybe not, the very thought of harming him is beyond contempt.

Enough is enough.

Re: Advocacy in Accessing Mental Health Services

I am writing to enquire as to my rights and to what extent you can assist me in accessing the services to which I am entitled.  I am diagnosed with borderline personality disorder with psychotic features with a possible co-morbidity of bipolar disorder, type II.  I take anti-depressant and anti-psychotic medication, and although I only received the diagnoses in June 2009, I have been utilising mental health services both on the NHS and  in the private sector since 1998 (having originally been diagnosed with clinical depression and social anxiety).  The care that the NHS has provided has always been wholly inadequate; until recently, any therapy I have been offered has either not come to fruition, has ended abruptly or, in one incident, has seen me being regarded with outright hostility.

Since 29 February 2009 I have been seeing a clinical psychologist on a weekly basis for psychotherapy broadly of a psychodynamic nature (though the  approach is integrative).  As of today’s date, we have had 35 sessions in total. It has taken me some time to fully open up to and to trust this psychotherapist, but now that I have, I feel that progress is being made, albeit slowly.  I believe that further progress can be made through this relationship.

Unfortunately, my psychologist has informed me that he can only continue to offer me therapy for 24 further weeks (starting from the next session).  This would, of course, equal 59 total weeks of therapy (including three assessment sessions at the start, and four sessions to end the therapy).

As you will be aware, all published research on borderline personality disorder strongly recommends long-term therapy for the condition. Indeed, NHS and NICE guidelines on this illness and on personality disorders in general completely contradict the view that one year’s worth of psychotherapy is remotely adequate treatment.  I believe that the New Horizons consultation recently undertaken by the health service would not support this situation either.  I strongly believe that not only is long-term treatment advisable, it is in fact necessary to deal effectively with my condition and therefore I feel that it is my entitlement.

Whilst I appreciate that resources are limited, I am frankly disgusted by the postcode lottery that seems to be in operation.  For example, I am aware that there is a specific self-harm team within the <other NI area> Trust – whilst self-harm is not, of course, by any means the only symptom of BPD, I am sure that this team would work frequently with individuals with this diagnosis and would thus understand it well.  Furthermore, I am familiar with several other individuals that have this (and other) disorders – in most cases less severe than mine – that have received guarantees of treatment lasting at least two years (in some cases) and three years (in one).  I have yet to encounter a single other individual who has received only a year’s guaranteed treatment.  My psychologist himself admits that ideally BPD should be treated twice a week for a minimum of 18 months.

I believe that if therapy comes to an end as proposed that I will in fact undergo a significant regression, and probably end up utilising yet more NHS resources.  I am unable to work, and am in the regrettable position of being dependant on state benefits – a situation that I abhor.  Any saving of government resources in cutting short my treatment is, therefore, a false economy.  I also feel that the worry of treatment coming to a close will overshadow my relationship with my therapist thus preventing us from tackling more substantive issues together in the relatively short period we have remaining.

Additionally, I understand from the various guidelines from the health service that multi-disciplinary approaches are considered desirable and indeed necessary for personality disorders.  To that end, I am surprised that I have never been offered access to the CMHT’s social workers, CPNs or occupational therapists, despite presenting symptoms perhaps best dealt with by such individuals in conjunction with my psychologist.  Although I have had one experience of the Crisis Response Team (which, I might add, was an utterly appalling meeting), I have never been advised on how to contact them again in an emergency, of which I have had several in the past year.

I am not prepared for the NHS to once again treat me as a second class service user and am prepared to contact MLAs, MPs, the relevant Minister and Permanent Secretary, and indeed the media in order to obtain the treatment to which I am entitled.  I would therefore be strongly grateful for your advice and assistance on (a) ensuring that I obtain a guarantee of continued psychotherapy, in line with NHS guidelines on the longevity of same; (b) ensuring that said psychotherapy can preferably continue with the therapist I presently see, as of course issues of trust and abandonment are a big part of this illness; and (c) ensuring that I can have access to the full range of services from the CMHT and the Crisis Team in an emergency.

As you know, borderline personality disorder, especially when psychosis is involved, is a severe mental illness and in this case has not been taken seriously.  I feel that this matter is urgent and desperate, and to that end would be very grateful for your help and advice.  Should you require further details, or if you would simply prefer to correspond via another medium, please do not hesitate to contact me via email on <my email address>.  I look forward to hearing from you.

Thank you in advance.

Yours etc.

Copy to: Chief Executive of my Trust