This is not a hugely significant entry, but since so many of you were so kind to comment on my review of my surprisingly positive assessment session with the Nexus Institute on Tuesday, I thought I would update you as to the current state of affairs with regards to them – or, at least, as regards to what I am hoping from them.  As advised by yourselves and A, I have written to the main administrator of the Institute asking to  be specifically seen by a male counsellor and, if at all possible, Paul himself.  I have not as yet received a response to this email, but in fairness I did only send it about 4.30pm on Friday 3 September, so it is reasonable that I will only hear from the nice woman in question on at least Monday 6th; obviously, whenever I do hear from her, you shall be informed

Hello NLTWFN

Thank you for contacting me during the week regarding an assessment session and for such a prompt arrangement of same; I greatly appreciated this.

I have been thinking about my upcoming counselling with Nexus and was wondering, even though it may make my waiting time longer, if I could possibly request to definitely see a man rather than being OK with seeing either a man or woman.  I apologise if this causes any inconvenience, but I am concerned that I would find it difficult to ‘click’ with a lady and to that end would not like to waste either her time nor mine and have to go back on a waiting list to see someone else.

I saw Paul for my assessment on Tuesday 31 August and felt that perhaps we could develop a rapport, particularly given his interest in mental health issues (of which I have many!).  I was wondering if it is possible to request to see Paul specifically for the counselling when appointments with him become available?  I would be willing to wait longer for this.  However, I do appreciate that the Institute may not be able to facilitate this given the resources available, and am sorry if this request seems churlish given the Institute’s much-appreciated willingness to help me.  I figured I had nothing to lose by asking!

Anyway, once again, thanks for all your help to date and I am sure I will talk to you soon.

Take care and best wishes

Pandora

I swear to living fuck that the Trust will not win this fight if I have breath in my body and blood in veins. I will battle them to the very death – literally, if needs be.

This is, of course, in response to yesterday’s received correspondence from Mr Director-Person. Your thoughts and comments on the letter are, of course, most welcome as always.

Dear Messers McGimpsey and [MP]

Re: Access to Mental Health Services

Thank you both very much for your recent kind assistance in communicating with the [my] Trust on my behalf. By now, you will have received the response from Mr Director-Person, the Director of Mental Health Services, dated 24 August 2010. I apologise if this letter crosses in the post with any communication from yourselves to me.

I remain very dissatisfied with the Trust’s response to my concerns for a number of reasons, and would hope that you could therefore kindly continue to assist me in this matter. I have not responded to Mr D-P directly, as such dialogue has, to date, proven to be an utterly fruitless pursuit. As you can appreciate, the Trust’s negligent and frankly dismissive stance on this matter has greatly added to my psychological distress.

I would make the following points in response to Mr D-P’s recent correspondence:

• It is contended that Mr D-P has been informed that I was advised “early on” about a “therapy end point”. This is factually incorrect. [C] and I first met in late February 2009, at which point we worked on rolling contracts of six to 12 weeks, although there was always an expectation that unless significant progress had been made, these would be extended (which they were). I was not advised of a “therapy end point” until December 2009. Eight months subsequent to the commencement of the process cannot accurately be described as “early on” therein.
• Mr D-P also alleges that my treatment programme with [C] was of a duration of 18 months. Technically, in a wide sense at least, this is correct – however, the impression given is misleading. I met [C] for exactly 63 weeks, which is obviously one year and 11 weeks – ie. just under 15 months. I point this out because I would not like the Trust to be allowed to overplay the sufficiency of their frankly inadequate service.
• The cessation of therapy was against the specific clinical opinion of my consultant psychiatrist, NewVCB (of [Relevant Hospital]), as acknowledged by both her and [C] on at least two separate occasions. I am astonished that consultative medical advice counts for so little within the [my] Trust. Furthermore, [C] admitted in our final session on 26 August that I had been significantly “let down” by the Trust.
• The aforementioned consultant psychiatrist, whilst acknowledging that I have a form of complex post-traumatic stress disorder due to significant childhood abuse, has stated to me on several occasions that she does not want to engage in diagnostic “labelling” of me, and instead wishes to treat my specific symptoms and circumstances in an individually appropriate way. The Trust’s attitude to my case would again appear to be in in opposition to her quite reasonable position; although I have never tried to hide or deny my earlier (ie. prior to NewVCB) diagnosis of borderline personality disorder, it seems clear to me from his letters that Mr D-P and his colleagues have chosen to fixate on this “label” specifically. Borderline personality disorder is probably the most stigmatised of all the psychiatric diagnoses and I must confess that I am coming to believe that I am being discriminated against considerably because this diagnosis has been applied to me.
• Chief Executive Mr Chief Executive’s acknowledgement letter in response to my original complaint to yourselves suggested that, as well as investigating my complaints with regard to my current situation, an investigation into the Trust’s failings in my mental health care for over a decade prior to same would take place. It is evident that this has not been the case; Mr D-P’s letter of 24 August focuses solely on my present circumstances. Only the most cursory of apologies was offered for the present inadequacies, and none whatsoever proffered for the many errors and misjudgements of the past.
• Perhaps most tellingly, Mr D-P claims in his letter of 24 August that “further support” would be “in place when [my] sessions with [C] come to a close” and that “…through close working between the psychological therapies service and the [Community Mental Health Team] it is planned that the work done with [C] will be incorporated into the ongoing support from the team.” This is categorically untrue. My sessions with [C] ceased on Thursday 26 August, and apart from my pre-existing relationship with my psychiatric consultant, I have absolutely no “further support” whatsoever, and in my latter sessions with [C] no such references were ever made. The matter of a referral to a community psychiatric nurse or a mental health social worker had previously been discussed; however, my psychiatrist and I were agreed that such a referral would probably be inappropriate in my case, at least as a sole support system. No such referral came to pass and I have not heard anything to suggest that any “further support” will come to fruition. It was certainlynot in place at the end of my psychotherapeutic treatment.

In light of the factually inaccurate statements made by the Trust, I feel that it is appropriate that you be made aware of the above to correct any misapprehensions that may have been created. I understandably feel let down by the Trust and am seeking your assistance to secure appropriate treatment.

I am aware that it is relatively common for the Trust to outsource psychotherapy to private sector third parties; indeed, I know of several individuals who have been treated in this way, and [C] advised me in our final session that it was certainly a possibility for me (we had discussed the possibility of my entering psychoanalysis in the private sector in particular). I am reliably informed by both professionals and other service users alike (within both this Trust and others) that, through your continued advocacy and support, this is something that would be obtainable for me. That being the case, I would ask that, as my political representatives, and in light of the Trust’s continued failings, you help secure assurance of this or an equivalent form of treatment for me.

I feel that I ought to note that I am the author of one of the most popular mental health blogs in the UK (currently written under an anonymous pseudonym and widely supported and read by both service users and mental health professionals) [let's not piss about with false modesty here, people - no arrogance intended, but, y'know - it kind of is], and that as a result of the deficiencies of my experiences within the [my] Trust my case has become something of a cause celebre across the aforesaid blog and various social networking internet sites. More formally, I write occasional freelance articles for a popular online magazine, and am giving very serious thought to specifically addressing this matter therein. I would certainly prefer to keep this issue private and anonymous, but if speaking out publicly about it will help me secure the care and treatment that I clearly need, I will not hesitate to draw wider attention to the matter.

I would like once again to thank you for the interest in my case that you have shown to date and would also wish to thank you in advance for your continued support. Please do not hesitate to contact me should you require any further information.

Kindest regards.

Yours sincerely

Pandora

In response to both my last letter to Mr Director-Person and my MP‘s intervention.

Dear Pandora

Further to my letter of 3 August 2010 [wherein he acknowledged his failure to reply to the letter first linked above, not replicated here], I am now in a position to respond to your detailed letter [ie. the one to my MP and friends] outlining the background to your situation and the treatment received from our Trust.  I am sorry that it has fallen short of your expectations and that you feel that the progress initially made with [C] has not been sustained.

As indicated in my letter of 12 May 2010* the provision of specialist services for people with personality disorder is at an early stage of development in Trusts across Northern Ireland.  The [my] Trust did receive some additional funding last year towards such services and we have appointed a dedicated practitioner**.  The major focus of our approach in using this practitioner is to provide training and support to generic services both in-patient and in the community to improve their capacity to support people with a personality disorder***.

Within the generic mental health services we make every attempt to match individual client need to an appropriate level of intervention within the resources that are available to us.  With regard to your situation, [C] made a clinical judgement that was endorsed by his clinical supervisor to offer a treatment package consisting of weekly appointments and I am advised**** that early on you were given information about session numbers and therapy end point.  This was to establish clear boundaries to treatment facilitate the working through of any concerns that ending therapy might arise, and prepare for any potential transfer to CMHT colleagues.  This has resulted in the delivery of a package of assessment and treatment over an 18 month period******.  During that time it was recognised that you could benefit from further support and this will be in place when your sessions with [C] come to a close*******.

Given these inputs from our services the Trust believes that it is appropriate that this phase of your treatment is brought to a conclusion.  However through close working between the psychological therapies service and the CMHT it is planned that the work done with [C] will be incorporated into, the ongoing support from the team******.

The Trust is continuing to work on developing services for people with personality disorders as resources become available.  Thank you for your offer to provide service user input to this service development, which we will be in contact with you about in the future, and we appreciate your support with this.

Yours sincerely

Mr Director-Person
For Mr Chief Executive

Copy to:  Michael McGimpsey [NI Health Minister] and my MP

I have tried to retain in the above replication the multifarious punctuation and grammatical errors, though I’m sure some have slipped past me.

—

* Yes, I know: I did receive your letter of 12 May, after all.  Why are you repeating your self?  I am mentally ill, not fucking braindead.

** Wow, a whole practitioner?!!!1!!11!!!!eleven!!!one!!!!three!!!26!!!!  He or she will indubitably serve thousands of people quite eminently fabulously by themselves!

*** Jargon designed to confuse, Mr D-P.  But what you are, in essence, saying is that your appointment of this individual is already failing, because generic mental health services are apparently fucking scared of people with ‘personality disorder’ and thus do not seem to want to bother to treat them.  C admitted to me in one of the sessions about which I have not written that I was at least in part being discharged because of my wanky diagnosis of borderline – “the service cant continue to fund personality disorders,” apparently.  This is clearly a fail.  What a surprise.

**** You were advised incorrectly in that case.  C and I always worked on rolling contracts – until Christmas anyway – so there was no way that I could have been advised “early on” even in a vague sort of way about treatment ending.

***** This is incorrect.  I had a total of, I think, 63 sessions with C.  That equates to just under 15 months.  One year and 11 weeks.

****** Who?  My sessions with C have already ‘come to a close’ and I am not in receipt of ‘further support’.  None at all.  Admittedly, NewVCB and I agreed that a CPN or mental health social worker was essentially pointless in a case like mine, but the point is that Mr D-P either doesn’t know or doesn’t care (or, in all likelihood, both) about the accuracy of his claims.  So he may say that ‘further support [would] be in place’ when things with C ended, and that ‘through close working between…psychological therapies…and the CMHT it is planned that work done…will be incorporated into ongoing support from the team’, but this would be (and is, obviously) absolutely untrue.  His blatant fallacies (or at least ignorance) are, of course, to my considerable advantage: he has been caught in the throes of an outright lie on paper

Other observations:

• I note with interest his failure to acknowledge that NewVCB, my consultant fucking psychiatrist, railed against the end of therapy at what she (and I) perceived to be such an early state.  C and his ‘clinical supervisor’ apparently therefore actively ignored direct, consultative medical advice, but of course Mr D-P wouldn’t like to admit to this.  Well, that’s OK with me.  His lie-by-omission will be openly highlighted in my response to my MP and Michael McGimpsey.  Mr D-P had better not say this is a borderline manipulation of the truth or something, because let’s just say that I have evidence that NewVCB’s disapproval of C’s actions is absolutely factual.
• As usual Mr D-P completely ignores my references to complex post-traumatic stress disorder and my retraumatisation at the hands of C.  ’Progress initially made…[having] not been sustained’ merely suggests I’m mildly annoyed – perhaps not much better, but not much worse either – and does not in any way, shape or form grasp the levels of trauma that psychotherapy at the shocking mercy of his Trust has put me through.
• What is really galling, what is really really fucking galling, is that he has completely ignored everything that I had written about my frankly appalling experiences within the health service prior to my meeting C.  About how I was pushed from pillar to post.  Regarded with open disdain.  Left in the lurch with no support by resigning members of staff.  Referrals not being made.  Referrals that were made then being ignored by those to whom they were made.  Over the course of 12 fucking years.  12 years!  So many of them formative ones at that!  No wonder I’m a complete fuck-up at the age of fucking 27!  He doesn’t care about any of it despite the possibility that (as pointed out to him), if I had received adequate treatment back then, I might have been reasonably well recovered by now, and functioning as a normal member of fucking society – ergo topping up his own bastard of a salary with 11% of my own earnings.  He doesn’t have to be altruistic about it; it would have been in his own best fucking interests.  Regardless, does he actually think that is acceptable?  Remotely acceptable?  Does he think that is an adequate response from the NHS to serious, life-threatening health concerns?
• There was something else about which I wanted to rant but in the course of the rage of the last point I’ve forgotten what it was.  I will add it in the comments later if I remember.

—

Now.  Is it time to craft my reply?  Or just relax and work on it with A tonight?  And is it too early for red wine?  Red wine and a Pot Noodle, methinks.  With extra burning hot chillis.  Oh yes.

Cunts.  One and all!

It – the impromptu counselling assessment session with the Nexus Institute on Tuesday 31 August – went well.  Thank you all very much for your lovely supportive comments, tweets and Facebastard messages.  It meant a lot knowing that my great online friends would be there to provide a figurative shoulder on which to cry, regardless of how the appointment went; your encouragement enabled me to face said meeting with more confidence than I might otherwise have expected myself to do.

To be honest there’s really quite a limited* story to tell; it was, after all, a mere assessment session.  What’s more, there is far from any guarantee that I will actually see the bloke I met yesterday in a capacity as my “counsellor” as opposed to simply my assessor.  The way it works is that you’re put on a list, which is dependent on the location in which you wish to be seen, and that when a therapist in said location becomes available, you are offered his or her first available appointment (within brackets that also suit you, of course).  I had told them several times that whilst I am theoretically tolerant of being allocated a woman on the off chance that I might be able to engage with her, I would really prefer a man.  However, I get the impression that either (a) they have more men working for them than women or (b) most of their clients request female counsellors, because they seemed not to worry too much about this and told me I would get seen quicker if I said either would do.  The point I’m making is that if these factors did not apply, I would have expected them to have given a lot more weight to my concerns about the therapist’s gender.

Unfortunately I’m now neurotic about this in the extreme.  I really don’t want to see a woman, whatever her skills or character may be.  Should I email them and ask them to note this more definitively?  I feel like a bit of a cock doing so; I am, after all, a woman myself and indeed a feminist (though perhaps something of a post-feminist feminist, but this is not a blog about theoretical political philosophy, so I’ll not get into that).  But on the other hand, even though you can change your counsellor after meeting them if you don’t ‘click’, why waste their time and mine if I can already predict now what may well be the case if a woman is allocated to my therapy?

Anyway, I’m getting off the point.  In terms of this blog, I had become sick of so impersonally referring to C as ‘C’, so now that he is apparently out of the picture (though a letter from the Trust of Evil is en route from my mother’s house to mine as I type…oooh-er), I’m going to abandon initials for new characters in this weird theatrical dance detailing my life, ergo calling the bloke I saw yesterday Paul.

In some subtle ways Paul was/is the polar opposite of C.  He was fat, cheerful and extroverted, as opposed to skinny C’s soft and gentle introspection (leading to a lot of smugness on my part on the occasions on which I actually made him laugh).  C’s probably about 34 or 35.  I’d guess that Paul is at least 10 years older.  He wore a loose (and therefore rather immense) blue shirt, untucked, which sagged at his navel, revealing his belly-button.  This disturbed and amused me in equal measure.

At first I was dubious, probably because he was not what I’d expected – though having said that, I didn’t expect anything in particular, because I know that that always leads to disappointment.  He led me up the stairs to a very pastel-ish, counsellor-ised but not-quite-as-offensively-so-as-I’d-expected room, making smalltalk about traffic and whatnot as we walked.

He sat down opposite me, and welcomed me to the Institute, giving me a quick lowdown on how the assessment session was likely to proceed.  To all intents and purposes the procedure was as you’d expect from any assessment that has even the vaguest relation to mentalism, which is generally a frustrating and upsetting thing – but something in his jovial manner managed to put me at my ease, and I felt able to talk to him with only a small amount of reserve.

Most of the questions Paul asked me were your standard-ish, predictable but necessary-for-this-kind-of-thing bollocks.  Name, address, GP, consultant, employment status, educational background, significant relationships, the specifics of your family tree, any medications (“ah, Seroquel?  Very popular these days…”).  He eventually got round to asking me about my physical health and then,  in an almost sheepish or embarrassed fashion, he made enquiries about my mental health.  The question’s rather abashed nature was caused, I think (well, I know) by a number of allusions I’d already made about being off school, university pr work due to depression and related issues.  I laughed out loud thinking about it, which he appeared to have expected.

I gave him the lowdown on how I was diagnosed with clinical depression as a young teenager and social anxiety as an older teenager.  ”More recently,” I went on, “I was told that I have complex PTSD.  And, of course, the dreaded borderline.”

*fanfare*

I shall now interrupt this broadcast with to bring you an “infomercial” on the evils of “BPD’s”, “Cluster B’s”, their primary enablers Mental Nurse, and my now seemingly infamous quote of I still haven’t taken my tablets.  Normal service will be resumed forthwith.

Click here to view the embedded video.

Hello!  I’m back now.  So yes, anyway, Paul.  I added the reference to ‘borderline’ in referencing my not-inconsiderable collection of psychiatric diagnoses.  Paul was making notes of everything that I’d told him, but I noted with interest the sharp and disgusted intake of breath as I rolled out that particularly hideous word.  He continued writing for a minute, finished the section he was at, then put his pen down and looked up at me.

“‘Borderline’,” he repeated.  ”I hate that concept.”

I reckoned he was being supportive in his hatred – ie. I believed that he felt that BPD was a defiling, often unfair diagnosis rather than that he felt that people with the disorder, having as they do an inaccurate but traditional image of being manipulative, abusive bitches, were the ‘concept’ worthy of dislike (which of course abusive, manipulative people are, but it applies to many people without BPD, just as it doesn’t to many with the illness).

“Yes,” I started uncertainly, just in case my perception of his view was incorrect.  ”It’s not a very well-liked diagnosis, is it?”

“I don’t think it is a diagnosis,” Paul responded.  ”It’s just an insult.”

OK – a bit harsh, I though, but definitely on my side, so fair enough.  There followed a brief discussion on how so often BPD is thrown at young women who either (a) self-harm or (b) don’t take shit from nor lie down and universally accept everything said from psychiatrists.  I told him that I felt I certainly met the requisite five criteria for a fair diagnosis, but I knew that so often that wasn’t the way of things, and that in that regard I had been relatively lucky.  He agreed that so often it’s just slapped on someone’s forehead because a psychiatrist merely had a ‘difficult’ interaction with the patient, and then spent a few minutes complaining about how such “labelling” (a term that, in this sense, I despise) demoralises and stigmatises vulnerable people, and renders treatment from the NHS mental health system difficult because of its complete unwillingness to provide adequate therapy for such conditions.

Of course, my own story came into play at several points, and this was no exception.  I told Paul how although I had seen C since February last year, that we met only once weekly and that the whole thing amounted to just over a year’s therapy in real terms – in complete and utter contravention of the cocking NICE shitelines, of course.  I admitted that I had only relatively recently come to a point where I had began to trust C enough to share some really nasty, hardcore (no puns please) stuff with him but then, right in the midst of the resulting psychological whirlwind, I found myself inexplicably being chucked out of the sorry system like a bucket full of dirty dishwater.

He put down his pen again, and sighed, annoyed apparently.  ”I hate that,” he intoned, shaking his head disapprovingly.  ”I hate it.  It just leads to further difficulties, doesn’t it?”

Um…YES!  Thank you for seeing that independently of my pointing it out, unlike every pathetic overpaid cunt with whom I have dealt within the health ‘service’.  I confirmed my agreement by referring, yet again, to my retraumatisation issues resulting from how things with C ‘progressed’, ‘developed’ and ended.

In discussing my history of treatment, I mentioned the failed referrals I had had from the Crisis Team and some CPN or other for CBT, as well as my brief but deeply regrettable experience of it in the private sector.  I was surprised to note a cynical smile creep surreptitiously across Paul’s jovial face.

“I just don’t think there’s any way that CBT, even with the most skilled therapist, would work for you,” he told me.  ”I mean, that’s a big judgement to make on the basis of having known you for half an hour, but you really strike me as being…” –  he searched for some sort of half-formalised sort of term – “well, somewhat ahead of that.”

I suppressed a satisfied, vindicated smile.

He continued: “I don’t think that CBT solves everything in the way the government would like to portray it as doing.  It works for some people some times, but it’s not a blanket solution.”

“Indeed,” I concurred.  ”The only reason that it is touted as a fits-all mental health panacea is because of the health service’s obsession with targets and costs.”  He appeared to be impressed with this brief diatribe.

Eventually, given that Nexus is an organisation devoted to counselling those that have been sexually abused, he inevitably had to ask questions about that.  When I said something to the effect of, “I was raped from the age of five,” he sighed yet again and told me that although he had heard similar words spoken many times before, they “never stop affecting” him.  Of course, it is inevitable and necessary that therapists distance themselves from their work to some extent, but it’s also good to know that they (or at least he) still have some feeling about traumatic and difficult issues; I mean, how could they develop any sort of empathy otherwise?

I found two of his questions especially difficult.  The first one was why I was coming to see the Institute now, as opposed to five, ten, whatever years ago.  After umming-and-ahhing for a bit, I concluded that for all the trouble that my relationship with C had ultimately caused me, that in fairness he (C) had apparently brought me to a point where at least I knew and accepted the reality of my history, even if I had not been able to fully explore and resolve the difficulties and specifics thereof.

“To that end,” I said, “I now want to face up to it, to discuss it…even if it’s as hard as it will inevitably be.  Before now, I seemingly just dissociated or ignored or somehow otherwise mentally compartmentalised it, but of course burying stuff deep in that way only leads to intangible but at times almost unbearable surface suffering.  So, I want to fully address that now.”

The other awkward question that was asked was what I wanted to achieve in therapy with Nexus.  I’ve always hated questions like this because the answers are, almost by their very nature, amorphous and unquantifiable.  I want to be in therapy because I want to feel better - but how is that measured?  Is it by my ability to get out of bed in the morning?  By whether I can go out of the house alone occasionally?  By having enough of a concentration span to actually read a full chapter in a good book for once?  By going back to work?  And even if we can decide on the end measurement, where’s the demarcation line that separates ‘goal achieved’ from ‘goal failed’?

I bullshitted around the enquiry with something like I felt that I had reached a point in my life where I was ready to face things rather than hide from them (as previously noted), and that whilst I did not believe that Nexus could ‘cure’ me, I did feel that given the seemingly unanimous praise that they receive that they could at least help me deal with this one major issue, and that in so doing, I could begin to move forward in terms of recovery.

A nebulous answer to a nebulous question.

Paul felt obliged to remind me that as a voluntary sector body, time with Nexus is limited (to “about” 26 sessions, he said).  I accept that without question, in perhaps stark contrast to my experiences with the NHS, but perhaps if my time with C had only ever been agreed at a year or so, I would have felt differently about it.  Perhaps C has got a raw deal here too, because he’s the one that started to uncover all the abuse bullshit, then the poor sod was essentially forced to discharge me from his care, and now someone else is coming along to (hopefully) just pick up where he left off.  If it works, it is they – not C – that will get the credit for helping me.  I don’t know; maybe this is too much like optimism from me.  Whatever the case, although I am uncomfortable with another therapeutic time limit being imposed upon me, I do understand and accept this one.  I can have these services absolutely for free should I wish (as it happens, I will of course donate what I can, when I can).  The NHS pretends that its services are free, but of course they are not.

Anyway.  The long and the short of this very long post is that Paul is obliged to seek confirmation from NewVCB in her capacity as my consultant that the type of therapy offered by Nexus is appropriate for me.  He “see[s] no reason whatsoever why it wouldn’t be,” though, and that once they hear back from her, I will be allocated the first appointment mutually suitable.

There is, as I said somewhere above, no guarantee that the appointment nor the therapy would be with Paul; he was ‘only’ my assessor.  However, I felt that we kind of almost clicked, and I personally would be quite keen to work with him if I can.  He also told me as I was leaving that he has a particular interest in clients who, like myself, have specific mental health issues, and that he finds it hard after assessing someone to not then have them allocated to him for therapy.

So would he try and fit me in to his schedule?  Probably not specifically, because that’s not how these things work.  It is a charity after all, and for that reason I would not like to try and pressurise them into allowing me to see one specific individual as opposed to another.  Personally speaking, I’d be happy to wait a month or two for sessions with Paul to become available to me, but it seems horribly churlish to specifically request such an accommodation when they are trying their level best to get me seen as soon as they can.  Besides, their other therapists may be as or even more appropriate for me.  Though I still can’t shake off the worry of them being female.

Anyway, that was that really.  He saw me to the door, wished me all the best and smiled as he said goodbye.  I liked him, and if he is representative of the organisation in general, then I do think that there is at least the potential for positive work to be done with them.  As I said above, and as I’ve written elsewhere a million times, I don’t believe in cures to mental health problems.  Nexus won’t cure me.  They can’t even treat all of my issues, because their mere existence is predicated upon addressing one specific type of issue.  Nevertheless, that ‘one type of issue’ in my life was and is a significant one, and if someone specifically trained in the area can help me at least start to move on from the effects of it, well – that’s not a bad start in the wake of the NHS disaster that refused to provide this type of help.

—

* ‘Limited’?  After almost 3,100 words I can hardly describe my account of it as ‘limited’.

Points of interest that occurred to me after the composition of the main body of this post:

1. Paul said that after the individual counselling has to finish, clients can additionally go on to a waiting list for a weekly group session.  I told him the idea of group therapy terrified me, but he said – rather enigmatically I thought – that I would “be excellent in a group”.  A opines that it’s a bit like when I did my undergraduate degree; my fellow students would gaze vapidly at the lecturer (or wall, or door, or – more commonly – they would gaze animatedly at their mobile phones), whilst my indomitable narcissism would result in considerable (and, I have to say, generally worthwhile) discussion between the lecturer and me.  Of course, back then I had some confidence and was possibly in a prolonged period of hypomania.  Things are very different now, but then perhaps the side of myself that I projected to Paul was more like the outgoing, vivacious one that hides in the dark recesses of her own mind most of the time.
2. Unlike C, who thought I perhaps put too much emphasis on electronic friendships (and was thus, in his defence, very glad that I attended the recent Mad Up, thus making my online friends more ‘real’), Paul thinks that when you are already socially isolated as I largely am, online friendships (particularly with others who understand what living with a mental illness is like) are healthy and productive things for which to strive.  Regardless of who’s right or wrong on the issue – and I can see C’s point in this – I must say that I like Paul’s take on it better  Because me loves the Madosphere so much

Night night lovelies.  x

I am (for now) making no comment on this morning’s final session with C, other than that everyone who predicted that last night’s uncharacteristic indifference would not continue after, say, 10am today, would not have been completely mistaken.  I do not want to think about it so meh, let’s just ignore it.

So, therefore, here is something not-so-completely different.

As per Lovely GP’s advice in the afore-linked post, I contacted the Nexus Institute – a voluntary sector organisation offering ‘counselling’ to those who have been a history of sexual abuse, whether chronic or acute – last night.  Given my phone phobia, I emailed them with the following:

Dear Nice Lady That Works for Nexus (NLTWFN)

My GP suggested I get in touch with the Nexus Institute to discuss the possibility of receiving counselling with yourselves.

I am coming to an (enforced) end of psychodynamic therapy on the NHS, which only began to touch on my history of child sexual abuse. Unfortunately this therapy has left me re-traumatised as, despite long term mental health difficulties, I had not faced the issues before (partly due to dissociative symptoms, partly due to conscious ‘blocking out’), and to this end my GP felt that addressing these issues with yourselves specifically could be helpful for me.

I understand that there is a waiting list for your services but I would be very grateful if you could perhaps advise me if and when an appointment might be available. Perhaps you might also advise on how many sessions you are able to offer and provide any other information that you consider relevant.

I live in the [my area] area. Should you require any further information, please do not hesitate to email me; I check my email several times daily and it is the fastest way to get in touch with me.

I look forward to hearing from you and thank you in advance for your help.

Kind regards

Pandora Serial-Insomniac

That was about 7.30pm last night.  I was astonished when the woman wrote back with the following within 45 minutes.  In my last job I would religiously check and respond to my email at strange out-of-office hours, even in the middle of the night, but I thought that (twats like bankers aside) I was fairly uncommon in doing so.  So I was quite impressed with her quick response:

Dear Pandora

Thank you for your email. I think if you would email me a telephone contact number I could call you tomorrow and give you a bit more information about ourselves. We do have a waiting list but it varies on so many different things eg we offer outreach work in [blah]/[yadda]/[etc] areas and also the [la la la] area but if you are available and able to attend the [dum dum dum] office and don’t mind if you see a male or female counsellor the waiting time for ongoing therapy could be as little as 6 weeks. Again depending on how flexible you are with your time you should get an assessment within a week or two. I look forward to hearing from you.

Take care.

NLTWFN

As it happens, the [dum dum dum] office suits more than any of the rest that she mentioned, so that was something of a win, though I was horrified at the prospect of having to speak to her on the phone.  Even so:

Hi NLTWFN

Thanks very much for your quick response. I won’t be available tomorrow morning but you can contact me in the afternoon or on Friday if that suits better – the number is 666-666-666-666-666-666.

To be honest the [dum dum dum] office is probably the easiest office for me to get to so I would be more than happy with that. For some reason I think I’d prefer a male counsellor but that certainly isn’t set in stone and something I am happy to discuss.

Anyway, thanks again for getting back to me so promptly and I’ll talk to you shortly.

All the best

Pandora

I have been lying on the sofa under my duvet since I got home this morning and what with all the drugs in my system I was fortunate enough to doze off for a while in the early afternoon.  When I looked at my phone, there had been a missed call from a ‘Blocked’ number.  Why must organisations/companies/offices ‘block’ their fucking numbers?  Why don’t they just show outgoing calls as coming from their main switchboard as my former employers at least had the decency to do?  As if the phone wasn’t shit enough to have to fucking use.

Anyway, it rang again with a ‘Blocked’ number at twenty to three so, expecting it would be NLTWFN, I took a massively deep breath and answered the evil bastarding thing.  It was indeed NLTWFN.

Basically, the craic is this.  Because I am a dolescum and am therefore flexible on dates and times, can go to [dum dum dum] office, and am at least theoretically tolerant of a ‘counsellor’ of either gender,  she reckons I can get an initial assessment next week, from whence there is approximately a five or six waiting list for the actual therapy.  Apparently they receive loads of cancellation appointments each day and then seek to allocate them to other listed clients on a first-applied-first-served basis so all being well, she or her colleague will ring (damn) me in the next few days to give me mine.

I asked how much therapy they are willing/able to give, and she said that they usually work on six week rolling contracts, but that they can offer up to 26 weeks of therapy (six months, of course).  Whatever way she phrased it, she seemed to infer that although the therapy didn’t have to last six months, it usually did (or, at least, that it certainly wasn’t a problem for it to do so).  I didn’t ask her, but presumably they are well enough established that they can advise on other individuals for you to contact thereafter if needs be (not that jumping around from one therapist to another sounds like a lot of fun to me, but there you go).  She said that because I have been involved hitherto with a “third party” (C), they would have to contact him after the initial assessment to double check that he felt that this was a suitable follow-on from the ‘treatment’ he gave me, but she said that it almost always is considered thus, so that that shouldn’t be a problem.

So that was that really.  How strange to move so quickly from C(unt) – N(exus); I certainly wasn’t expecting that as a possibility.  Another issue – which unfortunately involves an unwanted allusion to C – is that my fighting with the Trust isn’t over, even if my engagement with their Psychological ‘Services’ is.  C said that it isn’t unknown for them to contract out therapy to the private sector, thus footing the client’s bill, and he wonders if that is a possibility for me (why the fuck not just pay those you already pay, you fuckwits?!).  ”They won’t fund traditional five-times-a-week psychoanalysis,” he told me (oh really, I’d never have guessed, thanks C), “but they may be willing to fund something.”

I’ll believe it when I see it, but for now we’ll see how things with Nexus proceed.  I’m a bit nervous about the possibility of the ‘counsellor’ – a word I hate, even though I know that ‘counselling’ is distinct from ‘psychotherapy’ and is thus the more correct term – being a female though.  I still can’t work out what my aversion to women is – though, as I have discovered (most notably on Saturday!), it certainly does not by any means apply to them all.

But that said, the thought of pouring my heart out to one terrifies me.  I remember when I met Margaret, my erstwhile CBT therapist.  I had booked the appointment without knowing the therapist’s name – something that I have very definitely learnt from – and simply expected that it would be a man.  I have no idea why really.  When Margaret greeted me that first time, I was horrified.  (As it happens she was actually a nice woman, quite intelligent too, but we never ‘clicked’ in the way I did with C, and even if we had, CBT simply wasn’t appropriate for me).

The reason that I told Nexus that I was flexible on this issue is that they are open to you changing your ‘counsellor’ if you don’t “click” with him or her.  Whilst I’d prefer a man, if I get the right woman, it could be OK.  Regardless of their sex, if I don’t form a decent rapport with them, then I can seemingly ‘change’ them anyway, even if it does mean going back onto a waiting list for a bit.

So, whilst I’m cynical about what counselling as opposed to intense psychotherapy can do for me, I suppose their willingness to see me so soon is something considerably to their credit, and it is worth giving them a chance.

Plus Bye Mum! and The Obligatory ‘I Had an Appointment’ Post.

Let’s start with the first one.

Bye Mum!

One of two things has happened as regards my last post, in which I speculated that my mother was reading this infernal bollocks that I call Confessions of a Serial Insomniac.  Either I have been suffering from a paranoid psychosis (or, in less hyperbolic terms, just paranoia) regarding all the reasons that I thought she was reading it, or she has become shockingly technically savvy over the last few months.

I went to her house this morning after an appointment with Lovely GP and, when her attention was distracted, I searched her history, cookies and Temporary Internet Files on both Firefox and Internet Explorer.  There was no evidence of any visitations to this site at all, save for one single cookie which is probably from a time I wrote a post from her PC (as it had some references to an upload, to which, of course, she would not have had access.  For the record, I thought I had deleted all reference to that session, but meh).  When I say ‘searched’, I actually mean that; I used the built-in search boxes to search for terms such as ‘serial insomniac’ or ‘confessions’, rather than really rip the piss out of her privacy by wading through each single thing.

So seemingly I stand corrected on my earlier accusations.  Mother, I apologise.  Even though you aren’t reading this and don’t know about it.  Hmm.  Sorry anyway.

The Obligatory ‘I Had an Appointment’ (Part of the) Post

I saw LGP at the unGodly hour of 8.50am.  OK, so for a normal person, that’s not that bad, but I’m still registered at my mother’s old surgery, and since I live at A’s in the main, it involved a drive to the other side of town and then a hike up the motorway for a while.

I realised with horror last night that I had failed to fill in a form for the admin staff at the surgery.  Rather than do any work themselves when they receive DLA claims in from Social Security, they write out to the applicant asking them how their disability or illness affects them.  To be honest this suits me fine as they don’t really know how being mental affects me, and of course I do, but nonetheless I’d received the form the other week and had kept putting it completion of it off, despite their request to return it promptly.  I therefore sat in LGP’s car park immediately before my appointment and scribbled all the bollocks I could think of down – psychosis, dissociation, failure to engage in everyday tasks, severe anxiety, major depression, self-harm etc.  I hope I’ve covered everything.

Anyway, the main reason I went to see LGP was to scrounge Diazepam due to the now absolutely-imminent abandonment of me by C(unt).  LGP was sympathetic towards me given C/The Trust’s unprofessionalism, and seemed to understand that I have been completely retraumatised by the experience; however, the poor sod seemed unable to do anything about it.  He asked about NewVCB, and I said that she too was horrified about what C/The Trust are doing, but that she also seems uterly powerless to do anything about it (though she did try to dissuade C from cutting the process short, but the miserable git chose to refuse to listen to her).

The last time I saw LGP he had suggested going to see the Nexus Institute in the wake of the whole disaster that my therapy with C has become.  As I noted in the post in question, by psychological association I’ve developed an aversion to the Institute due to a really antiquated encounter with some NHS assessment bitch, but nonetheless I have been thinking about the suggestion and have perhaps warmed a little to it.  My concern now is that they offer, according to C anyway, a maximum of 24 sessions, which seems hideously inadequate to me.  When LGP raised the issue again this morning, I said so to him.  I pointed out that I felt that about 15 – 20 sessions was the minimum required to open up to a new person – and that was when the relationship was a good one.

He said that his experience of patients using the Institute’s services was that they had managed to actually achieve a lot in that timeframe, therefore opining that it was at least worth a shot.  He told me that they have a waiting list as they genuinely seem to be good at what they do.

Fair enough, but I bet they have never met a cynical, snide fuck like me before.

Anyway, it was left with me telling him I would, indeed, do as I was told for once and contact them for an appointment.  I am shitting myself at the mere thought of this, so how the fuck will I feel when I actually get round to the fucking meeting?!  And my concern is also this – my relationship (or, rather, the premature cessation thereof) with C has traumatised me so severely that that’s yet another thing for a new therapist to have to deal with.  It’s not all about the sexual abuse in the first place – it never was.  Now there’s just another layer of trauma-shite to add to:

• the sex abuse
• the bullying
• the whole dreadful saga with my ex that I’ve still never written about here
• the fact that I still weep for my grandfather nearly 12 years after his death
• V’s abject cuntery towards me
• V’s abject cuntery towards my mother
• V’s relatives’ abject cuntery towards me and, to a lesser extent, my mother
• an issue I’ve never discussed here pertaining to how my mother treated me when I first manifested severe depressive symptoms as a teenager
• general life disillusionment that, unresolved, simply leads to further crippling depressions.

Can a therapist trained in helping people overcome sexual abuse deal with all that bollocks as well?  And do they have any expertise in treating people fucked up the arse by the NHS and being more of a mess as a result?  (Actually, they probably do; I’m sure my situation isn’t terribly uncommon).

Of course, the long-term plan is for me to enter analysis, but at least Nexus are free (donations notwithstanding), so I shall try them first.  I just hope that the limited timeframe afforded is not going to end up with a repeat of my current therapeutic disaster…more psychotherapy-induced trauma?  Oh yes please, world – give it to me, yeah!!!

Anyway, I risk never getting to the point if I don’t stop blathering about points made a zillion times before.  I led LGP to believe* that I was having a breakdown within a breakdown over the end of things with C and begged him for Diazepam.  ”The last time I had any was May!” I pleaded.  ”Please!”

It was truly pathetic.

He checked my notes and confirmed that May was the last time I was issued with a script for the beautiful, wonderful, amazing, fabulous tablets, and noted that I am “clearly not abusing them.”  No shit, mate.  He agreed to give me some more, though I was disgusted when I left the surgery and read the prescription that he had only issued 14!  I have seven left from the previous script, so there’s 21 – that’s only a fucking week’s worth!

To be fair, he said that if I was having a really hard time, that I was to ring him and he’d let me have some more.  You can be sure that I will be “having a really hard time”.  I feel that I need to hoard them, to have a proper size of a stash – just in case.  You never know when they’ll be needed, do you?  On that note, I observed with amusement that the back of the script paper now instructs you not to heard medication, as apparently that’s stealing money from the NHS or something.  This caused me much merriment – I hoard like fuck.  Too bad.  They failed to give me what I needed, so if I’m ‘stealing’ from the fuckers (such melodrama!) then I feel like a Robin Hood character, and am glad to be involved in screwing them.  Fuck them.

LGP asked the old rote question of whether or not I would overdose on the Diazepam.  I said that I wouldn’t, and then proceeded to tell him that I’d had my stomach pumped before and had no wish to relive the heinous experience.

“But are you having suicidal thoughts?” he asked.

I laughed in his face.  ”Of course I’m having suicidal thoughts,” I chuckled.  ”My entire life revolves around suicidal ideation.  But I won’t overdose, don’t worry.  I know how to do myself in and, unless you plan really carefully, that is not an outcome facilitated by overdoses.”

He raised his eyebrows, intrigued.  ”You’ve become something of an encyclopaedia about mental health issues,” he said, smiling.

“Well, I read a suicide newsgroup, so I know a bit about suicide methods,” I admitted.

He nodded.  ”But it’s not just that,” he went on, “you’re very self-aware, aware of what’s going on with you, and you’re extremely articulate about it all.”

I couldn’t help but blush.  That was nice.  I think.

He asked if my interpersonal relationships were of a satisfactory standard, and I responded that I had the support of A, a mass group of wondrous online friends, and a number of non-online friends that were supporting me unwaveringly.  I also told him that relations with my mother are at a reasonable point, though at the time I was still paranoid about what she was or wasn’t reading.

“It’s not that I think you should be grateful for the situation you’re in,” LGP said, “of course you shouldn’t.  But at least you do have a support network, it’s better than absolutely nothing.”

I suppose it is.  I asked if I could see him in a month as support additional to NewVCB and he said that of course I could.  He then mused for a second, and when asked what he had been considering, he told me that they also have counsellors that operate in the surgery.

“However,” he said, “I don’t think it would be appropriate for you.  Firstly, your issues are clearly very complex.  And secondly, you are clearly…” he searched for the words “…at a level above that sort of therapy.”

I regarded my lovely (but, alas, ginger) doctor with interest.  Was he implying that I am more intelligent than his almost-certainly-CBT-practising staff?

Mwhahaha!

He took my blood pressure, which he felt was pretty high.  He reckons that this is generally the usual PANIC PANIC that people get themselves into when in medical appointments, as well as stress over C.  ”I suppose I should also recommend losing some weight though,” he added, clearly uncomfortably.

I advised him that in the last year I have lost over four stone (yes, those of you that met me on Saturday – that does mean that I was even more the size of a mansion a year ago) and am continuing to lose pounds.  He was beside himself with joy (!) and kept congratulating me over and over, which was in hilarious stark contrast to the battering I took from his cunt of a colleague in December.

I left with the Diazepam script, a promise to him to contact Nexus and an agreement that we would meet again in about a month.  Ah.  Sighs.  I do like LGP.

I went to the chemist next door to get my medication, and whilst waiting looked around for other bollocks to spend money on.  I chose some Rescue Remedy, to aid the workings of the Diazepam, plus some anti-IBS stuff and Pro Plus.  Then I saw Seri-Strips, bandages etc – and I jumped on them.  I don’t feel like self-harming at the minute, but who knows what tomorrow will bring?  Better to be prepared, because it could go totally tits up after my final session with C(unt).

Which leads me to…

The Final Countdown: The Eve of the End of Therapy

So.  Here we finally are.  All my efforts to fix this dire situation have been a waste.  After 10.20am tomorrow, I will never see C again.

I look through my archives on this subject and actually find myself laughing at some of the histrionics displayed therein.  Wa wa, I can’t cope without him.  Wa wa, my life is over.  Wa wa, I’m so miserable, I can’t cope, please kill me someone please!  Tonight I feel…

…

…

…

…ambivalent.  Fine.  Asi es la vida.  I don’t care.

Now don’t get me wrong.  I am still positively full of righteous anger and indignation at the appalling way I have been treated by the Trust, and I don’t intend to just lie back down under it and let the fuckers abuse me more.  However, as regards C as an individual specifically, I really don’t feel anything much about our soon-to-be-permanent-separation.  * In this sense, my “I’m having a breakdown within a breakdown” performance to LGP was perhaps slightly exaggerated in pursuit of drugs.  Maybe I should contact Narcotics Anonymous whilst I’m in the process of contacting new therapists?!

There are two probable reasons for this.

One: I have already done most of my grieving.  About a fortnight ago – after a session itself after an unpleasant meeting with NewVCB – I was in a particularly bad state, so much so that I caused a fuss on Twitter, apparently having implied I was going to do myself in.  That was a bad day, but it was one amongst many.  I have shed millions of tears over this and whined and bitched and moaned about it here so much that it will no doubt seem like another blog once I desist from such shittery.  My pain was so real, so deep, so astoundingly visceral – and now, it’s just not.  It has apparently played itself out.

Two:  a limited number of people know this, simply as I haven’t written about any of my sessions with C in five or six weeks, but in that time my view of him has shifted almost 180 degrees.  I know that the fault in this whole sorry mess is only partially his, but he has become the fall-person for my disdain and derision.  I used to respect him greatly and I was very fond of him, and that was on top of my issues of transference and attachment.  Now, I kind of feel like he’s…I don’t know…a fly or something.  He’s there and he’s actually rather irritating and frustrating, and you feel like swiping him – but, ultimately, he’s something of an irrelevance, his existence little more than a passing inconvenience.  And that existence, in terms of my life anyhow, will cease to be in 13 or so hours.

It should have been different.  Of course it should have been different.  There is a small part of me that feels sad that I have come to view him thus, and as stated I know that it’s mostly not his fault.  But this is the reality of things as they stand; he is the figurehead for every failure I’ve ever experienced thanks to his employers.  Poor C.  But not poor C too.  Who cares?

Is this a defence mechanism?  Probably.  And it could unravel completely in the morning and I might be a suicidal, dissociated, agitated mess.  For now, though, for this one important evening, I am OK.  Surprisingly but genuinely OK.

Now.  Who likes my new logo?!

Pan x

I wrote these melodramatic words the other day:

I shall never see C again.

Officially I am supposed to see him on Thursdays 19th and 26th August, but I shall not.  I shall never see him again.  I have pretty much decided not to go, as I’m certain it would only cause me further pain, and I think he’s put me through enough (as if I didn’t already have a fair dollop of it in my life, but let’s not wallow).

I have not written about my most recent four sessions, though I have my own records of them.  I may get to the minutiae of it all one of these days – when it seems less traumatic, perhaps, if indeed it ever will – but for now I think it’s enough to say that the last few meetings, in particular the very most recent (when the “personality disorder” bollocks that he came off with was actually outright offensive), have been pointless and circular.  Nothing has been achieved and if anything, they have been damaging in an individual kind of way, just like therapy as a conceptual process has been for quite a while now – basically, since I spoke of the longevity and severity of my experiences of child sex abuse only to be told to fuck off out of C’s hair.  How can that not be completely and utterly damaging?  He keeps banging on that he sees ‘worth’ or ‘value’ or some other such meaningless word in continuing to the bitter end, but he’s not the one that has to live with the grief and despair of the situation in which he and his targets-obsessed bosses have put me in.

I know that anything I say ‘on record’ so to speak will be regarded as confirmation of the bloody BPD bollocks, but fuck it, I don’t care.  I’m sure, despite C’s claims to the contrary, that I have got the words ‘non-compliant patient’ and ‘archetypal angry borderline’ scrawled all over my notes in red pen anyway, so what does it matter?  Once you get this fucking diagnosis it stays with you for the rest of your cunting existence whatever you may or may not do, however much you may or may not progress.  So I might as well tell the fat-catted-fat-cunted fuckers what I think anyway.

I can’t just leave him without some acknowledgement, though, so I am penning a ‘goodbye’ letter.  I want to make clear that I feel that my anger is absolutely justified (which it damn well is), but that it is only partly aimed at him, and that in the right circumstances (ie. adequate fucking time) he could have improved rather than destroyed it.  I do feel it’s important that he knows that he has destroyed it, though – I think it’s imperative that they (the Trust, the Psychology Department) understand the power that they have over vulnerable people, because it seems to be a point that whooshes blindly over their heads at the minute.  But that said, I would like C to know that, although our relationship has been irreparably damaged, I have much fondness and respect for him as an individual.

I then found myself too distressed to actually write the letter, so waited until this morning.  My mother had asked me to head round to her’s as Sarah, Suzanne and the latter’s children were in attendance; it is quite reasonably viewed that just because WWIII has split the sorority of my mother and Maisie doesn’t mean it has to split everyone else.

Helps or Hindrances?

Knowing that I would have to fight any distress whilst in their company (as opposed to lone time giving me time to ruminate and wallow) gave me the confidence to sit down and write the letter there, but my mother caught me doing so and tried to persuade me to return to see C on Thursday.  I argued vehemently against it, citing the damage I felt recent sessions had done and how I could not see future ones being any different, but she said that no matter what C may say, no matter how model a patient I have been, and no matter what my notes already state, that the Trust will find some way to corrupt the situation and deem me “non-compliant”.  Pan is teh b0Rdel1NE ev1L innit!!eleven1!!!1!11!!

Suzanne, who has a friend working in the main psychiatric hospital in the Trust, overheard the conversation, and seconded my mother.  She admitted to not being particularly familiar with complex PTSD and BPD, but stated that she felt it was important not to give them any excuse to piss about further.  She also pointed out that, if in the event that the Trust do agree to extend the psychotherapy, I wouldn’t want to damage my already damaged relationship with C any further by not returning.  I felt that this was a fair comment.

There followed a long discussion – or, perhaps more accurately, something of a monologue on Suzanne’s part – on how she “really believes” that I can get through the next few weeks, even if my crusade for extended therapy fails.  Maybe so, maybe not.  She pointed out that we have very different beliefs, but that she wanted me to know that it was still her’s that whilst I will probably always deal with at least residual mental health problems, my life and illnesses can improve.  Theoretically, I do not disagree (and indeed, I think subtle progress may already have been made – see below), but I felt like she was patronising me, and rather than express irritation or a counter-argument, I just sat there submissively and meekly nodded every so often.  On reflection – and I think I realised it at the time too – I know she was just trying to help, or to encourage me, or to cheer me up, or whatever.  So I suppose I ought to be grateful, but it did feel strange having life and pseudo-medical advice extended to me from someone who (a) admits to not having full cognisance of the core issues, and; (b) I was the elder protector of as we grew up under the watchful eyes of a paedophile (not that she seems to have been afflicted that way, given as she called her second baby after said paedophile – but anyway).

One thing she said that was true but still mildly annoying was, to paraphrase, that my fixation with the end of therapy is self-defeating.  Therapy has been useless for several weeks now – probably since about June or early July-ish – and at least in part that’s because I’ve gone into lockdown knowing that I can’t discuss what I need to discuss with C, because the time I have with him means it cannot be resolved.  Suzanne is right – it is self-defeating, at least in some ways (though in fairness to C he’d point out that the dyad is a co-construct, so any failings of recent weeks would not to his mind be solely my ‘fault’).  But what, of necessity, Suzanne does not know is a lot of why I’m in therapy in the first place.  Were she thus aware, I suspect she would understand why preventing such lockdowns as I am now experiencing is nigh on impossible.  All that said, her point is valid in a way – but I can’t just CBT myself into being grateful that I actually have 15 full days (as opposed to only having two mere weeks) before I never see C again.  If I could do that, I’d never have ended up being mental and/or in therapy in the first place.

Anyhow, apparently I need to focus “not on the time left” but “on really getting better, by whatever avenue”‘.  Apparently as a door closes, a window opens.  Notwithstanding the fact I’m too much of a pie to fit through the window in question, I don’t see any reason to agree with the sentiment, and even if I did, the transition through the window will be long and damaging in itself, I fear.  As you will know, it is my plan to seek private therapy in the wake of the disaster of that is NHS mental health services.  If I form the required therapeutic rapport with the first private therapist I see, then brilliant – but can I really expect the same luck in that regard that I had when I met C?  It will almost certainly take a lot of time, and a lot of time when you’re a depressed, confused, disconcerted mess is not always a commodity frequently at your disposal.

To continue the vein of familial do-gooding, my mother then announced – to my abject horror – that she had tried to phone C this morning.  As C does not work in his normal location on Tuesdays, I hoped for a few precious seconds that nothing had come of her attempt to contact him and that he would be unaware of it.

This was not the case.

My mother spoke to C’s secretary who said she would get hold of him and get back to my mother.  She did, with the quite predictable message that C could not comment on patients’ treatment to third parties.

“But,” my mother protested, “I don’t want to discuss the content of their sessions with him.  I want to discuss the recklessness of his decision to end her therapy at the end of this month.”

This is where things start to get interesting.  Apparently C’s secretary – let’s call her Lorraine – was stunned to hear that C is kicking me out of therapy.  She said, incredulously, “but is the decision to end things not Pandora’s?!”

My mother laughed out loud and said that no, the decision was very clearly not Pandora’s.  A stunned silence from Lorraine apparently followed.

How can Lorraine possibly be under this impression?  C receives copies of all the correspondence between Mr D-P and myself, which surely must go to her first.  Maybe my experience as a secretary when I was putting myself through university is different to that of others, but I really find it bizarre that she doesn’t know this somehow.  C wouldn’t have deliberately let her think that ending therapy was my choice…would he?!

Whatever the case, my mother went on to say that she could absolutely guarantee that if the cessation of the relationship ‘progresses’ as planned that my condition will regress markedly (true, obviously).  She told Lorraine that, in her admittedly layperson’s view, I required about another 18 months of therapy (which sounds roughly fair to me), but that even if they would allow me another six months, at least that I would be able to ‘move on’ with more confidence, trauma-resolution and social ability than I presently have.

Lorraine said that C would want to discuss this material with me, which amused me endlessly.  What has been going on for the last 700 years if not discussion of this bollocks?

Anyway…

Part of me is furious with my mother for phoning C, because he will assume that I put her up to it, which is most assuredly not true.  On the other hand, futile as I expect her efforts to be, I also know that she (and Suzanne for that matter) is/are just trying to help.

Today’s assembled adults agreed that I am seemingly a little improved from when I first had this breakdown, which is now pretty much exactly two years ago (I went off work on 5 August 2008, after battling a severe depression for several months beforehand).  This apparent improvement is, to their minds and mine, testament to the effectiveness of psychotherapy with C.  The drugs may help, but as NewVCB keeps telling me, they are only to take the edge off things – and I think that is all they really can do.

No doubt the Health Service would deem this information evidence that I no longer need therapy.  Things are not as bad as they once were = things are perfect and delightful in their (possibly ironic) black and white world of arbitary targets and lives reduced to mere figures on a database.

My view is that, if anything, a slight improvement in my condition is at the crux of continued therapy.  It proves that working with C, as an individual, has been an effective treatment for me – to a point.  I’m still very, very ill – let’s be clear on that.  However, things are a little bit better than they were – thus, does it not stand to reason that they could continue to get better were a productive treatment not continued, to the point where (a) I can go back to work and (b) I no longer need the CMHT?  And in doing so, (c) WHERE THE FUCKING HEALTH SERVICE DOESN’T HAVE TO INVEST ANY MORE OF ITS PRECIOUS FUCKING RESOURCES (read: managerial salaries) INTO MY SORRY BACKSIDE?

But we’ve been over this ground before a hundred million times, and I am boring you now surely.  Query: do any of you actually want to read the minutiae of the last four meetings with C, which I’ve shied away from writing?  Some points therein are more notable than others, but the sessions were in essence useless and merry-go-round-ish.  Nevertheless, I could rustle up a summary if you wish, unless you really want to hear all the anal details.

Still, maybe this week’s session, now that I’ve changed my mind and am intending to go to it, will be more interesting.  I’m still going to write the letter, you know.  The only difference now is that I’m going to watch him the contortions of his facial muscles as he reads it

Update on the Political Intervention Against the Trust

Sorry for not apprising readers of this blog on the current status of my complaints to my MP and other politicians about the Trust’s decision to end my therapy. I had mentioned it on Twitter, but not all of you are onTwitter, so that wasn’t very fair! Here’s what has, to date, happened.

The first person to respond to me was a civil servant – let’s call him Adam – writing on behalf of Michael McGimpsey, the Northern Ireland Health Minister. Adam oh-so-helpfully advised me that “clinical decisions on these matters are made by the various Trusts”. That is something of which I clearly had no knowledge. None at all! Adam had, therefore, “written to the [My] Trust to ask them to respond to [me] on the matter.” Definitely a highly useful thing for Adam to do, given that I have been writing to the Trust myself since December 2009. Adam kindly advised me that he hoped that “this matter will be resolved favourably.” I am, of course, profoundly touched by this overflow of concern.

In all seriousness, one thing he did do of minor use was provide the details of the Patient Care Council, whom I may contact if things don’t go according to plan (which they won’t, so presumably I will be contacting them). In any event, Mr Director-Person’s boss subsequently wrote to me, on the back of Adam’s epic piece apparently ending up on his desk. This person is called Mr Chief Executive. Mr Chief Executive claimed to be “sorry to hear of the difficulties [I have] been experiencing, and [is] grateful to [me] for bringing the matter to [his] attention.” I’ll bet. I wonder if he recalls that my first letter in this crusade was copied to him (its main recipients being the advocacy charities, who were universally fuckwitted), but passed by him to Mr D-P because he could not be arsed with it at the time?

He claims that an investigation has been launched “into the issues raised” in my correspondence to McGimpsey / Adam, so in fairness to Adam, at least something has come of his intervention that didn’t come of my own. This, in all probability, means one of two things. One – the outcome of the ‘investigation’ is already decided, and is essentially along the lines of “Pandora = WRONG. Trust = BLAMELESS”. Or two – they actually do investigate the issues raised…namely, however, the whole catalogue of errors that the past decade’s ricocheting about the system has brought. That would, of course, be welcomed by me, but what it potentially means is that they can avoid providing extended therapy and seem saintly by merely apologising for all that has gone wrong before.

Maybe I am being unduly cynical. I don’t think I am, but one never knows. As I said above, at least it is something. I really think it’s very far from perfect, but at least it’s not the nothing that was endlessly circular-ised in the correspondence between myself and Mr Director-Person.

The second, and so far only other, person to respond to the letters was the MP himself. His letter was friendly and courteous, and he said that he had written to the Trust on my behalf. He said he’d get back to me as soon as he received their response.

There was a letter from the House of Commons when I arrived at my mother’s – after a NewVCB appointment – this morning. I opened it with my customary dread, but found that it was just an update – my MP had received a letter (copied to me) from Mr Chief Executive, stating that I had written to the Trust directly and that his so-called investigation had been launched. He advised my MP that he would send him a copy of the investigation’s report once completed.

So that’s really it as things stand. Hardly life-changing stuff, but perhaps a small step in the right direction. At least the bastards now know I will not go away without a considerable fight.

NewVCB Appointment

NewVCB kept me waiting for 25 minutes, which is a record for her. During the whole time I was waiting I started blankly at the non-descript carpet, not moving, barely blinking. I heard a couple across the room remark on my probable mentalism. The man’s comment was inaudible, but his female companion, who was incapable of modulating her voice, was heard to comment that I look very depressed and “spaced out – as if her brain’s stopped working, like. Kind of freaky, isn’t it like?”

Interesting. I suppose it really must be a universal surprise that one would find a mental person IN A FUCKING PSYCHIATRISTS’ WAITING ROOM.

Anyway, the meeting was to all intents and purposes pointless. I seem to have an unlikely ally in NewVCB, who agrees that there is a lot of work that remains to be done in therapy. She claims, however, that there is nothing more that she can do on the issue.

Apparently she’s spoken to C and tried to persuade him to at least see me again after a break from the current process. She didn’t advise as to exactly what he said to that, but the inference seemed to be that it was going to be the probable outcome.

Good?

Should be good.

Doesn’t feel good.

Whatever the case, as of her last conversation with him, things are still ending in a fortnight, regardless of whether or not they’re picked up again in the future. I don’t know when their conversation took place, so as of right now it’s hard to say whether or not this was before or after the politicians’ involvement.

I told her that I thought that, finally, my mood had perhaps stabilised a little – I’m certainly still depressed, but not quite as morbidly so as is my norm. I would say it’s at a moderate level on average, which is good compared to the usual state of affairs. I pointed out that adjusting to changes in Venlafaxine totally fucks with my head for quite a number of weeks, so she agreed not to change my doses of either medication at the minute.

However, I told her, paradoxically the whole flashbacks/hypervigilance/rumination shit is as bad as ever. “I wish I’d never met C,” I said. “Or, at the very least, I wish I’d kept my mouth shut about stuff to him. I had many, many issues before I met him but he’s made it all ten times worse, and his choice of point on which to end therefore seems criminal.”

She said that she didn’t think this “turmoil” was paradoxical, and indeed that what I was reporting was quite common. She claims – and I don’t really believe her in the sense of its applicability to me – that sometimes the brain “works through these things on its own” before returning to therapy. Forgive me if I say that that sounds rather convenient.

She then came off with some bollocks about a new service being in development for people who “have complex issues and a history of trauma” and that “that might be an option.” This description irritated me in the extreme. She was clearly describing the personality disorder service that Mr Director-Person has wanked a bit on about to me. I asked for confirmation that this was indeed what she was referring to and she said that it was.

I said, “what, do you mean like DBT?” but before she could finish, I told her that I thought that DBT was a pile of utter bollocks, out-bollocksed only by its older cousin, CBT.

She asked why I held this view and I said that they were both victim-blaming, patronising, invalidating crap. I exemplified.

She agreed that CBT is a treatment unsuitable for me but started blathering on about how it’s used sometimes to ease the “most disturbed” patients into deeper stuff that “they couldn’t otherwise cope with emotionally.” It’s like peeling layers off an onion, apparently. Really, how interesting, NewVCB, thank you. Then she said that DBT was used by the self-harm team in the next Trust.

“Yes,” I sneered, “it’s supposedly empirically proven to treat that and suicidality. That’s very nice, but it doesn’t mean it treats the underlying causes of those behaviours, the psychological distress that they alleviate.”

“That’s my point,” she replied, to my considerable chagrin. “It stops that first, and then we can take the person deeper thereafter.”

OK, fine. Whatever. Just as long as your cunt bosses allow adequate fucking time to “go deeper.” Just as long as your cunt bosses don’t go about pretending that DBT is some sort of universal cure for BPD and related conditions, the way they have gone about pretending that CBT is a complete panacea for some other mental illnesses. Can DBT alleviate certain symptoms? In appropriate individuals, yeah, probably. Can it alleviate everything? I doubt it. Can it work for everyone that fits the BPD demographic? I’m absolutely certain that it can’t.

I asked NewVCB what she thought about C’s high-IQ idea of referring me to a CPN/SW upon discharge. She claimed to disagree with C’s take on this, stating that, “if I was referring someone to such a person, I would need a clear idea of what it is that they’re going to do together, and in your case…well, I don’t have such an idea. I just don’t think it would work for you.”

Excellent. At least she knows that much.

“He also said that you might be able to see me a bit more frequently, in the event that there was no CPN,” I told her.

She said she’d see me once a month “for a while” and that “we’d take it from there,” whatever the bloody, sodding Christ that means.

As she showed me out, she said, “sorry it’s not all good news,” and looked sheepish – even embarrassed – at both the historical and the ongoing colossal failures of her employers. At least someone has the grace to show it.

It was a waste of time, but it wasn’t a bad appointment, not ostensibly. I mean, she agreed with me on at least two points, one of which is quite important (ie. that the therapy should not be ending). Despite this, the whole thing has left me in a foul mood. I even considered ringing Lovely GP and asking him to send the crisis team out, because I feel like I’m a danger to myself. There’s this sort of raging foreboding constricting my internal organs and burning through my skin. I know that sounds daft, but it’s physical as well as psychological. My mind won’t stop; it’s in a whirlwind of negative thinking. I keep seeing my mother’s largest bread knife dangling in front of me and have beautiful images dancing in my head of my going to town with the knife on my arms and possibly even neck. I even told my mother that I was going to kill myself, but her response was a predictable one of withering derision and room-leaving.

I haven’t done anything yet, aside from deciding against getting the scheiße-st cunts involved because they’d only make me more mental, just as they have done in the past. Anyway, don’t worry. At least I have my Twitter group therapy friends and lovely blog readers. I’m sure it’ll pass, though perhaps not until I’ve got tomorrow’s session with C – week 61 out of 63 – out of the way. I have a lot of catching up on his sessions to do, I know. I also have some additional commentary that I need to share with you, but all in good time. I shall endeavour to remain alive so that I can impart these details to you

Oh, and as an aside – the below image shows why I’m being chucked out of therapy despite not being ready for discharge. This is taken directly from the Trust’s website.

As my friend More Voices said to me on Twitter, it’s “amazing how therapy can be set to numbers measuring nothing of value or real importance.” I couldn’t have put it better.

Hahaha!  Didn’t see this coming, did you Mr Director-Person?

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

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

Dear Mr MP

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Kind regards.

Yours sincerely

Me

Encs

AND NOW…

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.

Apologies for the delay in the third post in this series; we had something of a disrupted week last week and last night represented A’s first chance to explore these issues. In this post, we’re talking about the direct impact on him of my illnesses, history of trauma and current treatments.

I have been trying to review last week’s session with C in my usual detail, but I’ve had a very stressful day (gruesome CAB appointment, and much Disraeli trouble ) and that, coupled with my ungraciously low mood and lethargy of late, has left me weak and defeated.  I’m going to eat and try writing again, but it may just have to wait.  As the wonderful Splintered Ones is always good enough to remind me, it comes when it comes and can’t be forced

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

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

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

Alas.

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

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

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

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

I was a complete bitch to C last week. I just sat there and insulted him for about half the session – perhaps more – and he didn’t really deserve any of it. It’s not his fault he has to abandon me at the end of the summer, and even though my rants weren’t necessarily focused around that issue, that was surely what was driving them. Unsurprisingly, he appears to believe that my reacting angrily to him is a defence mechanism to deflect from the sorrow and despair that I feel regarding the imminence of our separation.

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

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

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

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

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

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

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

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

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

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

And the silence continued.

And continued.

And continued.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

I suppose I was in a strange mood last Thursday morning. What has been the case of late is that I don’t sleep well on Wednesday nights – ooh, surprise sur-bloody-prise – so when I arise the next morning, I pour an overdose of caffeine into my bloodstream, in the form of both coffee and Pro Plus tablets. Normally I don’t finish the coffee, so am not exactly jumping off the walls. Last week I drank every last droplet. Per chance not the best idea in the history of evolution/creation/The Matrix/The Sims/the life span of the universe/I think I’ve stretched this far enough/whatever.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

“Why’s that?” he inevitably asked me.

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

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

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

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

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

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

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

He eyed me suspiciously.

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

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

We considered that in silence for a few minutes.

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

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

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

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

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

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

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

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

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

“No.”

“Why not?”

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

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

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

“Sorry, when did you tell her that?”

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

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

“Yes. What’s your point?”

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

Again: “No.”

Again: “Why not?”

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

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

Cheeky fucking cunt. I demanded that he exemplify.

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

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

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

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

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

“In essence.”

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

True. I shrugged, reluctantly.

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

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

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

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

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

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

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

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

Last Thursday’s session with C was the first one after the whole, ‘fuck it, I’m quitting therapy’ debacle of hilarious histrionics about which I wrote last Wednesday. I suppose my thoughts weighted in favour of leaving treatment at a time of my choosing were partly in light of the whole DID discussion that we had had before I was away for a week, but it was very much more than that. I wrote over 1,000 words on that DID post – but, in actuality, that only referred to 15 minutes at the beginning of the session. What’s more, C added those 15 minutes onto the end of the meeting to allow the 50 minutes for actual therapy. I reported all but nothing of those 50 minutes, largely as there was sod all worth reporting. Therein lay – lies, to some extent – the real difficulty. Nothing has been happening, on and off anyway, for weeks (take this unmitigated bollocks, for example). I am in lockdown.

Anyway, after the lively discussion in the comments section of the ‘To Quit or Not to Quit’ post, I had determined that I would attempt to be honest with C about what I had been thinking and about the disillusionment I was feeling with the process. To my own considerable surprise, I did all this and more. It was a productive session, if rather – what’s the word? Saddening? Full of regret for what will be lost? Yes. It was productive, if rather [insert mournful word of your choice here].

When I rather arrogantly arrived in the waiting room, which I have come to regard as my own exclusive, personal space, I was horrified to see another woman sitting there. There is never anyone there. A curiosity of the building – indeed, this specific corridor – is that it houses both Psychology and Audiology, so occasionally one will see an elderly person there to have his or her hearing tested sitting on the other side of the corridor, in the ‘other’ waiting room, which is just an extension of the Psychology one really. But no one except me is ever in the one quite subtly, but paradoxically ostentatiously (due to its stigmatic nature), marked ‘Psychological Therapies’.

Another point of note is that the corridor is almost always deathly silent, save for the creaking of the door on the rare occasion that it is opened. I’ve gotten used to it now, but for a number of weeks I found it strangely ethereal and disconcerting – the opposite, surely, of the kind of place in which people with mental health problems should find myself. The phrase “as quiet as the grave” often comes to mind (perfect for suicidal types). On the other hand, busy, noisy waiting rooms, such as NewVCB’s (which was also C’s way back at the start of our relationship) freak me out too.

Anyway, it was probably evident to the woman that I was slightly freaked out by her presence, but we politely acknowledged each other then mutually pretended to think about something other than the fact that we were sitting there together. When the bloody door started creaking, the woman passed remark on this irritating feature. This led to a desultory conversation deriding the waiting room, but it eventually developed into a discussion that tangentially referenced why we were both there. It transpired that the woman was there for the first time. By this point, I had convinced myself that I’d got my dates/days/times/life wrong, and that this person was one of C’s other non-existent patients, but when I asked her who she was seeing, it was indeed someone else.

Which led me to another silly internal dilemma. I have never seen anyone from Psychology apart from C and his secretary. The person who has the opposite office from C is some audiology person. It’s like C is the entire department. Or maybe he and his department exist in some alternative plane of dimension, who knows – the former creepiness of the waiting room might lend itself to that fantastical theory. Maybe the waiting room is purgatory and C is its gate-keeper.

OK, I’m babbling and infinitely regressing – the point was, it was bizarre to learn that there really are others working there, including (as in this case) other doctors of clinical psychology. I knew it rationally, of course, but when there is no physical evidence available to you for something, well – the mind is a funny thing. Or at least it is when you are a nutjob.

I tried to reassure the woman, but possibly the admission that I was still in attendance after an entire year merely served to intimidate her. Either way, I never got to see her fabled psychologist, because C arrived to escort me to my weekly doom before him/her/it.

Point of note: my formerly dark hair (the photo on the right is…er…not accurate. It is me, but it doesn’t really represent me. Which is exactly why it’s there) is now bright pink. I bleached it to fuck then slapped some purple muck-rubbish over it on the Tuesday of last week, and even though I failed to obtain the intended purple result, the resulting pink was drastic and eminently satisfactory.

So out came C, expecting to be greeted by a dull-looking fat woman with slightly-off-red-brunette-ish-thing coloured hair, to instead be confronted by a dull looking fat woman with flourescent pink hair. He was visibly taken aback. He started. He stared. Very good. Very good indeed

I wished the other woman luck and followed C to the office. I always hate walking past the secretary’s room. She knows who I am and why I’m there and for some hateful reason, that makes me feel mortified and shamed. The thing is, in general, I do not feel shame for my mental illnesses. Why should I? They are what they are, and they are a part of me. For the most part I am open and easy going about disclosure, sometimes even actual discussion, of same. So why the secretary’s probably-uninterested knowledge in me freaks me out is beyond me.

Well over 900 words and the session hasn’t even begun. That is surely a record even for me.

So. I went in and sat down; he joined me and said, “you’ve dyed your hair.”

Readers, why – why – do people make such inane, asinine statements? Why?! I know that I have dyed my hair, C – I dyed it (or in other cases, I allowed someone else to do so). It wasn’t done when I was dissociated to fuck or anything – and even if it had been, might I not have noticed the change by now? I mean, I’m not at all criticising him for commenting on the change – it was all but unavoidable – but the pointlessness of the actual statement he did offer both irritated and amused me.

“Um…yes, I have…” I said slowly, as if speaking to a child, making a hand gesture intended to convey a WTF? sort of message

“It looks well,” he said, nodding slightly as if self-referentially agreeing.

“Thank you,” I responded.

Two weeks hitherto I would have dissected that small three-word statement of his to death with something along the lines of:

OMFG did he just compliment me? Oh wow! Does that mean he likes me? Does he care about me? Does he genuinely think I look OK? Or is it some sort of psychotherapeutic trick? But hang on, is he even allowed to say that? Isn’t that treading into countertransferential territory that he should be having out with his supervisor? Isn’t that dangerous…? Does he…will he…what if..?

Blah blah blah

Yadda yadda yadda

La la la

Etc etc etc ad infinitum

The fact that I have written that at all, of course, suggests that I am dissecting the living fuck out of what he said, but at the time of his comment, I just nonchalantly accepted the remark as I would nonchalantly accept similar from anyone. That is not my default position around C at all, as you will probably be well aware.

Anyway, we discussed a few boring housekeeping issues for a few minutes, culminating in my telling him that I had an appointment with NewVCB scheduled for Wednesday 2 June. For some reason, this prompted him to ask about the status of my ongoing war with Mr Director-Person.

I advised C that I was finding each response from Mr D-P to be increasingly pathetically amusing. I ranted a bit about how Mr D-P clearly didn’t know the answer to some of my questions, and about how if I were in his position and receiving his salary that I “would damn well know how to do my job.”

(Interesting aside – Detective Inspector Google advises me that Mr D-P does not have a background in mental health at all. He comes from fucking management! Well chosen, Trust…).

Anyhow, given Mr D-P’s closing statement in his latest letter about the assignment of a CPN or SW instead of C to my case, I told C that I thought this was a load of wank because, apart occasionally from shite therapies that don’t work, such members of the CMHT don’t seem – to me – to actually do an awful lot. I know some of you disagree with that – it’s just my observations at this stage really.

He denied that there was a major likelihood of any of them bollocking on about CBT and other such nonsense, but when asked what they would actually do instead, he said something like, “well, you see them at the CMHT, sometimes in your own home, and they support you.”

I laughed in his face. He’d been expecting such a reaction, to be fair – it seems he’s not entirely sure what the rest of the CMHT do either. I suppose I can understand that – back when I was still at work, I didn’t know what some staff in other departments did either. At any rate, I don’t remember the full details of the conversation, but I recollect that I agreed to meet the designated person a few times to see if there could be any value in such liasion. Then something struck me.

“Are they all women?” I asked.

“Well…about 90% are, yeah.”

“Oh no no no, that won’t work at all. I don’t get on well with women at all.” Pause. “At least not here, not in the real world. [Philosophically] If this is even the real world…”

It’s not just that I don’t get on with other women, aside from exchanging the time of day with them or whatever. I’m actually moderately afraid of them. I’m wildly different from any stereotype of a woman, but then so are plenty of people of this gender, so what makes me so bloody special? This is something I will have to think about, but not now, because in whatever way C responded, we didn’t dwell on my woman-fear. What is especially weird about this is that the majority of my online friends are women, including two (K and Annie) that I’ve met. I don’t fear or not get on with any of these ladies – very much the opposite. Well. Who said I was anything other than a walking contradiction of abject strangeness?

During the anti-SW/CPN thread of conversation, I had thrown in a “that’s something else about which I must inform you,” in reference to my ending therapy proposition. He picked up on that, and asked me what the ‘something else’ was.

I was completely honest for once and just told him that I had been seriously considering coming in there that morning, thanking him for all he’d done, and then shaking his hand and leaving. Permanently.

The instantaneous surprise that suddenly permeated the room was palpable. His eyes widened, his brows furled. Again, he actually physically started. In fact, it was more than that – in an apparently instinctive move, he almost defensively sat back, as if wishing to create a distance between us. The expression on his face was not one I’d seen before – the closest it had come to that previously was only about 15 minutes ago, when he’d been taken aback by my dramatic change in appearance. ‘Taken aback’ is too small a phrase for his behaviour this second time round, despite the post title. He was stunned. Absolutely astonished.

This gave me no pleasure, despite my sometime sense of misanthropic sadism. I like C. I feel like I know him, even though I don’t. I don’t want to hurt him or inadvertently question his practice or professionalism, which it felt like I was doing. I felt like an evil bitch that had just stabbed her best mate quite royally and deeply in the back.

I tried to make him feel better by telling him that I had changed my mind, but when he asked why I had done so, I was – once again – entirely honest, and admitted that it was for logistical rather than therapeutic reasons.

“I am certain that as things stand that I will have to be re-referred for therapy in the future,” I told him. “I don’t want the Trust to have ammunition against me – ‘oh, that one’s just a borderline, ignore her – she walked out last time she was in the system, so she can’t have any more treatment”. I know that’s exactly what would happen and I can’t take that chance. So you’re stuck with me for now.”

“We’re going to have to have a conversation on why you were even considering this,” he responded, not unreasonably. “But in terms of actual practical matters, I don’t think that that would be the case at all. You attend appointments as scheduled and are always on time. You can work psychologically and you commit to that work. In my view, you’d be perfectly eligible to have any future referral considered as normal, regardless of whether you previously left therapy by your own choosing.”

“For the avoidance of doubt,” I pressed, “you are telling me that leaving therapy now would not in any way impact negatively upon my position within the CMHT and mental health system in general in the future?”

“I really don’t think it would, no.”

“OK.”

And so began the ‘why?’ conversation. Preamble: I don’t remember all of this. It was a week ago and it was a stressful topic to cover.

My first point was that if I was going to seek private psychotherapy when things with C end – and I am – that it would just be preferable to start to interview potential analysts/therapists now, rather than dither in the pointlessness that I expected to be the remaining time with C.

Why did I suppose said time would be pointless?

I told him that I thought therapy had been generally useless of late, not through any fault of his but entirely through mine, and that ergo it was my expectation that I could expect more of the same. “I come in here every week, and I stare at you or at points in your room, and I say fuck all. We dance around important material because I am not willing or able to discuss it, and the whole thing just becomes an exercise in futility. It’s a waste of your time and mine. It’s not doing anything at the minute, except maintaining (or perhaps even worsening) my sense of re-traumatisation.”

For some reason, he raised his eyebrows and asked me if I felt re-traumatised – I would have thought the answer to that would have been quite obvious given things like this and this.

I was very frank with him and said that I believed, intellectually at least, that I was trying to protect myself from further re-traumatisation. “The most gifted therapist in the world cannot change this state of being in a couple of months,” I told him (an honestly held belief). “I believe that it can, ultimately, be changed – but not in the timeframe you and I have remaining together. So I think that, unconsciously, I’ve shut down and won’t talk about anything important, because I know that’s going to cause me much hurt, and there will in the end be no outlet for that pain.”

I hate talking about the end of therapy. I always direct the conversation away from it when it comes up, in part as it is presently the only thing that makes me cry, and I don’t want to cry. I don’t want to cry because I fucking hate expressions of emotions, but moreover, I don’t want him to know of the strength of my feeling for him. Why? Because it’s so asymmetrical, so quintessentially patient-therapist, so un-returnable, so needy and pathetic. It is A Very Bad Thing.

So for me to almost direct the conversation that way was really rather unusual. OK, so there was an inevitability about it ending up at that juncture, I suppose, but it was the fact that I actually brought it there that was odd.

C sat back in his chair and sighed deeply. Eventually, he sat forward again, and began to reward my candour with some of his own.

“I’ve been in a difficult position,” he admitted. “I’ve said to them [there's always An Enigmatic 'Them', isn't there?], ‘look, this person needs long-term psychotherapy,’ but there’s always issues of targets, or of costs, or of whatever. And we’re trained to mostly only provide short-term therapies.”

Oh. So when you said that curtailing things was your decision, and not the Trust’s, I was right in supposing that that was accurate in only the most technical of senses, was I?

Basically, yes. Apparently, “I could have kept it under the radar. They wouldn’t know how long I have been seeing you for, but I decided the end point on the grounds that I did declare how long we’d been seeing each other to them.”

Dun-dun-DUN! I feckin’ knew it. I feckin’, feckin’ knew it. I resisted the urge to smile a smug smile.

I appreciated his better-late-than-never honesty and told him so. Would it have been nice for him to have kept this apparently most sensitive material ‘under the radar’? Yes, of course it would. But even I don’t expect him to all but lie for me. If he gets in trouble, my continued psychotherapy is not exactly going to be assured.

Anyway, there developed a discussion about part of my thinking about quitting therapy being about punishing him, or finding him less competent that one should be given to expect. I vehemently denied the latter point and demanded that he disabuse himself of the idea were that his belief. As for punishing him, apparently I want him to feel the same sense of loss that I feel as regards the termination of the relationship.

Time for me to be pathetic. “No [looking meek and helpless]. I don’t…I don’t want you to feel bad.”

‘Bad’ and ‘nice’ should be fucking banned from the English language, at least if you are above the age of nine. Fuck’s sake. How child-like and grotesquely piteous can one be?

He made some gesture of acceptance, but continued by saying, “but I think you’re very often angry with me – you blame me for the end of this, you’re angry about the way I sometimes speak to you, content shared between us can infuriate you.”

I denied this once again. “You make t sound like I’m permanently angry with you, and I’m not,” I protested. “Do I get angry with you? Of course I do. That’s to be expected in any interpersonal relationships, and I know there are times when I piss you off too. But I don’t think there’s some big transferential thing here for you to hook on – it’s just normal, surely?”

He claimed that I was angry in that moment (which perhaps I was, I don’t remember) and I started ranting about being furious with the system, which I perpetually am. If he wants to examine a permanent anger, then it’s with The Enigmatic ‘Them’, not him.

I remember saying, “I just wonder how many people end up dead because of something like this. People that could have been helped, but because silly targets and other bureaucratic faff and unlucky postcodes and grubby pieces of shite like that get in the way, they end up at the mercy of their illnesses, are completely fucked and alone, and they see no way out and they top themselves. It’s tragic, C. Tragic.”

My passionate, warrior-like micro-soliloquy was laden with what he would call emotion, and I got the usual, “you look like you want to cry” crap.

This perennial phrase of C’s pisses me off. No, C, of course I do not want to cry. I hate expressing these feelings, let’s not forget. If I am looking or sounding tearful, then that is because it’s visceral and un-chosen. Automatic. Unavoidable. I do not want it! I know I’m playing a silly semantics game here, but it does piss me off.

I continued to try and fight against these Christ-forsaken tears, but I think that they probably won in the end. I didn’t end up breaking down exactly, but I did let a few of the monstrous droplets of salty water pass from my traitorous eyes to my cheeks and fingertips.

Whether it was solicited by him or not, I don’t recall, but I have some memory of, through these tears, admitting to the sense of loss – the sense of grief – that I feel about the cessation of my relationship with him. Eugh. How gruesome an admission that was, and will always be. A Very Bad Thing. A Very Bad Thing, indeed.

And then…

“We’re going to have to leave it there, Pandora.” At least he had the grace to sound apologetic.

One thing we briefly discussed in a housekeeping capacity was to continue things until – if memory serves me correctly – the start of September, rather than have a set number of weeks remaining. He is taking two weeks’ leave over the summer, and it will therefore work out at approximately the same number of sessions as he had previously offered, but I think I might be wrangling one or two extra out of it. Very-tiny-win. Maybe.

I hate these discussions. I was particularly vexed by them in and around Christmas, where it felt like it was all C wanted to talk about. That seemed endlessly circular and futile to me, as if we were avoiding the very issues for which I sought psychotherapy in the first place. And in the main that’s very much still my view. Still and withall, though, it’s hard to deny that a lot of my attempts to avoid the topic lie in the very obvious points that I simply don’t want, or feel unable, to ever be without him.

The latest draft.

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.

I should turn this into a series of posts.  It’s becoming something of a recurring theme, my own little comedy of errors if you will.  It frustrates me endlessly, of course, but if you dig a little deeper there is something pathetically amusing about the whole sorry business, in a sort of wry, dark kind of way.

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

Hello once more, all.  I returned on Monday from Turkey having had a lovely time and being in a surprisingly non-shit mood upon arrival back in Norn Iron.  I think the good weather here helped; this country, for all its faults, is stunningly beautiful especially whilst bathed in bright sunlight.

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

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

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

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

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

Pros

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

Cons

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

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

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

Thank you all.  x

WARNING: RANT

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

I say ‘the End’ in the title, as this will obviously be my last post in this series before the big day tomorrow when we head to the polls; however, in the interests of equity, I will at some point look at what the main parties in the Republic of Ireland have to say on the provision of mental health services. The health service in the Republic is quite different from here in the North, but I’ll address that in the post in question. I’m not saying I will necessarily write this anytime soon, but I’ll get to it eventually.

Anyway, it’s the eve of the election and I’m simultaneously excited and anxious. I’m excited because I’m a total politics nerd, and I always get a thrill out of exercising my democratic right to vote. I’m anxious because I am worried that Gordon Brown will end up back in 10 Downing Street; I pathologically detest the man. I hate Cameron too, mind you, but nowhere near as much as Brown. Like so many people, I now am a fervent supporter of a Liberal Democrat win. I don’t think we’ll get it – not this election – but fingers crossed for the future.

Anyway, it’s kind of moot because I can’t vote for any of those three parties (unless you count the strange alliance between the Tories and the Ulster Unionists). We’ve already looked at both the Unionist and Nationalist parties…but are there any other options, and if so, what do they offer to the Mental Vote?

Well, the answer is that there are other options: here we are with the ‘Others’, the parties often forgotten in coverage of Northern Irish politics. Two of them – the Alliance and the Green Party – are not along the normal Northern Irish sectarian lines. The third – The Traditional Unionist Voice – clearly is. Of course, there are a number of other smaller parties in existence in our wee country; however, mostly they are not running in this general election. Some are – mostly independents – and you can see their details here. However, I am not exploring their positions on mental health provisions, for the simple reason that they are unlikely to have any, being mainly one person parties. Even if they do have something to say on the subject, their chances of election are minimal*, and even if they were elected, as single candidates in Westminster they would need to vote with bigger parties to have any influence whatsoever.

(* With the possible exception of Sylvia Hermon, as she is also the outgoing MP for South Down and has been considered fairly popular in her constituency).

So we’re left with the Alliance, the Greens and the TUV. what if anything do they have to say on mental health services provision?

The Alliance Party and Mental Health Service Provision

Ideologically, the Alliance Party are my preferred party, as they were the first Northern Ireland-specific party to embrace cross-community unity, rather than organising themselves along the usual tribal lines. It turns out, too, that there’s a lot to be grateful about in terms of their mental health policies.

Navigate your way over to here, a page on the Alliance’s website. An entire policy on mental health issues, rivalled only in my investigations by the DUP’s (which was shockingly comprehensive, and about which I wrote the other day).

Unfortunately the page presents some alarming statistics; apparently, there are 20% more mentally ill individuals in Northern Ireland than in the rest of the United Kingdom (which tallies with other material I’ve read attributing this greater incidence to Troubles-related PTSD and depression), yet simultaneously we are the least resourced region to tackle this group of health conditions. Well, what a surprise.

The Alliance Party propose to tackle this sorry state of affairs in the following ways:

• [by] tackling segregation – addressing the exclusion of those with mental health and mental health issues;
• [by] re-balancing the economy – addressing the costs to businesses and the loss of GDP that arises from mental health and learning disability, and allowing people to develop to their full potential; and
• [by] providing of sustainable public services – delivery of a modern system of properly funded services.

All sounds grand to me. Of course, the difficulty with this is that it means fiscal resources will have to be allocated to mental health service provision instead of other areas of importance. I’m only speaking for myself here, but I would genuinely be happy to be more highly taxed/National Insurance-d if psychological and psychiatric resources were improved and developed. Furthermore, if some capital has to be removed from other (non-urgent) areas of the health service to accommodate the Alliance’s proposals, then I could quite easily live with that too. I admit that I am seriously biased here, but don’t forget the old statistic that at least one in four people will be directly affected by mental or emotional illness at some point in their lives. Some lobbyists are arguing now that the figure is one in three. The Alliance also point out that:

Over 19% of the total burden of disease in Western European Countries is attributable to mental illness compared to 17% for cardiovascular disease and 16% for cancer (WHO 2004)

It is sobering to know that mental illness affects more people than the openly-discussed ailments of heart disease and cancer in Western Europe – yet how often have you seen it mentioned in the media, at least without Sun-style sensationalism of ‘Schizo Freak Murders Fluffy Kitten!!!1!1!!!!eleven!!!’?

Moving on from what could easily become a rant, the Alliance Party at least do move on to tackle the fundamental issue of funding. One of the primary failing of political pledges, in my view, is that there is endless rhetorical sentiments expressed, without any substantive explanations of how the pledges can be achieved. At least here we have an awareness that achieving what is desirable will not an automatic development; it’s something that requires compromise and hard bloody work.

The party then move on to discuss what they term ‘Key Issues and Principles’, which (conveniently, a cynic might say) are right in line with the perennial Bamford Review.

The lines that interested me most was these ones: ‘Services should be needs-led‘ and ‘[we need] increased access [to] psychological therapies‘. Sounds obvious, doesn’t it? Yet as my own case underlines, that’s not the way it is in the current NHS in this region (and in the country in general in many cases), oh no. Access to psychological therapy and services in general are resources-led:

Therapist: I’m dealing with a really mental bird at the minute, she has about 403 different diagnoses and she needs long-term psychotherapy.

Manager: Throw a few weeks more at her, then kick her out, we can’t afford her.

Therapist: But what if she’s not better?

Manager: Oh my poor dear man, you’re new here, aren’t you? That’s not how it works!

The above was, of course, an entirely hypothetical scenario. *whistles innocently*

The Alliance also draw attention to the need to tackle stigma head on, and in a particularly commendable move address the issue of greater focus on the needs of carers for the mentally ill. They are the only party that have also pointed out that the recommendations of Bamford are not always fully transparent and, indeed, fully achievable.

Finally, they point out that the current situation regarding the Mental Health Act in Northern Ireland. Apparently, two major revisions were due to this legislation as it applies here in both 2011 and again in 2014. Sound fucking stupid to have two modifications? Well, the Alliance concur. In a demonstration of the fact that they can make a difference in this policy area, after their lobbying of Michael McGimpsey, the Health Minister, it has been agreed that – in principle at least – one modification will incorporate all the proposed statutory changes.

Result.

The Northern Ireland Green Party and Mental Health Service Provision

I’ve been wittering on in this series of posts about how we in Northern Ireland are not afforded the right to vote for the ‘mainland’ parties, but I suppose this kind of contradicts that a little. The Green Party are, of course, a national force – national in both the sense of the UK and Ireland.

Their widespread nature means that someone, somewhere, will inevitably have had to bring up the issue of mental health. In Northern Ireland, it seems primarily to be student Karly Green. Ms Green is heavily involved in developing a cross-party youth initiative on mental health, and that’s not to mention her considerable involvement in lobbying current politicians for better care for mental illness in our wee country.

(An aside – Ms Green’s hard work makes me wish I’d taken a more active role in politics at university. I was involved heavily in student politics – the running and management of the Students’ Union – but never in actual, meaningful party politics. I feel like I wasted my youth when I could have been out there making a fucking difference).

To get more details on the Greens’ position on this matter, however, we need to look at their policy South of the border. This has, quite obviously, questionable relevance to a Westminster election, but their UK health policy is surprisingly and disappointingly silent on the issue of mental illness.

As with the Alliance, the Greens argue that mental health is an area that is ‘greatly neglected,’ and interestingly, they’re the only party of the lot that I’ve looked at that has made more than a passing reference to preventative medicine and its relation to mental illness, which is to be applauded.

Of course, with this document focusing so heavily on the Republic, the contents are not always 100% applicable to those of us in the North; for example, they discuss how many patents with mental health difficulties are seen only under their GP. This is actually true up here too – the CMHTs generally only manage more serious cases – but in the Republic, the whole system is different, meaning that some people do not even have the primary care of a GP (something that is rarely true in Northern Ireland). Clearly this is an appalling state of affairs, and I would hope that the main parties down South are looking at this deficit too.

One point that applies to this jurisdiction is that they want to emphasis the need for psychological treatments, rather than an over-reliance on drugs. Remember this moment, readers, because it is possibly the only time you will see the Green Party agree with the DUP (see somewhere or other in the Unionist post).

Alarmingly, the Greens point out in this policy that apparently Irish mental health spending is less than half what it was 20 years ago. I suppose the rationale was along the usual lines that people were severely traumatised by the violence of the Troubles (any flippancy is to do with the fact that the Troubles existed at all; I don’t for a second see how anyone could not be traumatised by so much of what happened). Whatever the case, the fact that this party want to see at least 12% of the health budget devoted to this area is a worthwhile aim.

I particularly like their pledge to offer more post-graduate positions for the training of clinical psychologists. It rather seems to me that we could do with some of that up here too.

A few of the parties I’ve looked at in the course of this series have alluded very briefly to the human rights of the mentally ill (the UUP were the main ones that I mentioned, if memory serves me correctly). The Greens, however, have their own page as part of their general mental health policy devoted to this. Although their point is indeed commendable, unfortunately they miss the opportunity to fully address what could and should actually be done about the difficulties faced by many individuals on involuntary detentions. At least the UUP had the clear viewpoint that they would support amendment to legislation that shifted the legal onus on hospital release from the patient to their assessing tribunal.

In essence, in the area of mental health provision, the Green Party want to see greater staffing, greater funding and greater community, non-institutional care. I don’t think any of us would agree with these fundamental aims, but the approach sadly feels a little lacking in substance and discussion in how these aims could be achieved.

The Traditional Unionist Voice and Mental Health Service Provision

Hahahahahahahaha. I’m not even going to waste the energy it takes to type anything vaguely related to this non-entity of a vicious, nasty little scumfuck of a so-called political party. Well, except this rant of course. Just read their manifestoss (no spelling error). Nothing on mental health, scant on health in general, scant on education except their hate-filled bile, scant on sanity. I guess I’ll see Jim Allister in the bin.

Conclusion – Alliance, Greens or TUV

I don’t think you’ll be stunned to hear that the TUV are very instantly ruled out, and indeed it wouldn’t be a huge leap of faith for you to think I’m siding with Alliance as the victorious party amongst the so-called ‘Others’. The aims of the Green Party are certainly admirable, but they fail to fully articulate how they hope to achieve them, and cannot exemplify any occasions in which they’ve made a difference in this arena in the past. Furthermore, there is very little information on their exact position in this specific region.

The Alliance Party, on the other hand, have set out a number of very clear mental health objectives, and fully recognise the challenges of achieving these – yet they can articulate with some authority how they would achieve them. They can even cite an example of when their lobbying of a minister has previously made a difference to mental health issues.

I was not surprised to find that they had a mental health policy, but I was most gratified by its comprehensiveness and the fact that their aims are not all pie-in-the-sky-ness, but real, obtainable goals.

OVERALL CONCLUSION

So, here we find ourselves at 11pm on the eve of the election, having investigated the policies on mental health of the main UK parties, the NI Unionists, the NI Nationalists and, finally, this, the NI nebulously-named ‘Others’. Who’s getting my vote?

It’s important to note that I am not, nor should I be, a single issue voter. I have a view on the economy, on Iraq, on crime, education, etc etc etc.

Most of all I have a view on the tribalism that Northern Irish politics has traditionally presented. To that end, I have almost always supported the Alliance Party, and my enthusiasm about their mental health manifesto above was surely palpable. I was undecided as to whether to vote tactically tomorrow but this has been the final deciding factor: the Alliance Party will, once more, get my vote tomorrow. They won’t win, but I aim to be a conscience voter, and the things that they strive for (not just in terms of mental health) are things that, for the most part, I want.

In terms of this series of posts, I still think Alliance have trumped the other parties, but the mental health policies of Sinn Fein and the DUP were actually surprisingly impressive, even if I don’t trust either of those parties as far as I spit out my own shite. I was very disappointed by the UUP and the SDLP, parties that I otherwise don’t mind. It was hard work finding anything on the UUP at all, and whilst the SDLP had a little more substance, ultimately they seemed to be trying to echo points already laid out by SF.

It’s time mental health was an issue taken seriously by all political parties; just like I did at the bottom of the first post, I would again urge you to sign Rethink’s petition for the next government.

In conclusion – please, whatever you do, don’t be apathetic tomorrow. In some ways it doesn’t matter who you vote for, as long as you give enough of a shit to go out and put one ‘x’ on one bit of paper. This is a democracy. We have the right to vote here. Not everyone has that right, so please exercise yours.

Happy voting, darling readers.