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	<title>Confessions of a Serial Insomniac &#187; therapeutic relationship</title>
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		<title>Notes for C</title>
		<link>http://serialinsomniac.com/2010/07/23/notes-for-c/</link>
		<comments>http://serialinsomniac.com/2010/07/23/notes-for-c/#comments</comments>
		<pubDate>Fri, 23 Jul 2010 14:20:11 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Fighting with the NHS]]></category>
		<category><![CDATA[aggression]]></category>
		<category><![CDATA[blah blah blah]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=2076</guid>
		<description><![CDATA[I&#8217;ve discussed in the past C&#8217;s accusations that I&#8217;m &#8216;aggressive&#8217; or &#8216;angry&#8217; or whatever.  I have also discussed the fact that I think that if I am these things, that I am perfectly justified in my being so, at least as regards the end of therapy and my ongoing battle with the misTrust. I&#8217;ve been <a href='http://serialinsomniac.com/2010/07/23/notes-for-c/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>I&#8217;ve discussed in the past C&#8217;s accusations that I&#8217;m &#8216;aggressive&#8217; or &#8216;angry&#8217; or whatever.  I have also discussed the fact that I think that if I <strong>am</strong> these things, that I am perfectly justified in my being so, at least as regards the end of therapy and my ongoing battle with the misTrust.</p>
<p>I&#8217;ve been reading some of your comments, here, on Twitter and on Facebook about this matter and almost without exception you agree with me both in my right to be angry, and in that there is <strong>no way</strong> I should be discharged from therapy.  I was wondering if you would mind if I presented him with a collection of these comments.  I wouldn&#8217;t, of course, use any names, websites or any other identifying information unless you specifically requested that I do so.</p>
<p>I&#8217;m not stupid enough to suspect that he will take an <strong>tangible</strong> notice of any such comments, but I think it&#8217;s outrageous that he&#8217;s going around thinking I&#8217;m being unreasonable (especially when he tried to encourage me to fight the Trust back in December / January), and I want him to know that I have yet to meet anybody that would even <strong>remotely</strong> agree with his apparent position.</p>
<p>If anyone objects to their comment being used, please just comment here.  On the other hand, if you would <strong>like</strong> something to be included, I&#8217;m game!  Let me know.  x</p>


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		<title>Perspectives from the Mentalist&#8217;s Partner (3): Impact on the Partner</title>
		<link>http://serialinsomniac.com/2010/07/15/pmp-3-impact-on-partner/</link>
		<comments>http://serialinsomniac.com/2010/07/15/pmp-3-impact-on-partner/#comments</comments>
		<pubDate>Thu, 15 Jul 2010 14:00:43 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[Everyday Life]]></category>
		<category><![CDATA[Interviews with A]]></category>
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		<category><![CDATA[benefits]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
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		<category><![CDATA[C-PTSD]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=2025</guid>
		<description><![CDATA[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&#8217;s first chance to explore these issues. In this post, we&#8217;re talking about the direct impact on him of my illnesses, history of trauma and current treatments. Q: On a day <a href='http://serialinsomniac.com/2010/07/15/pmp-3-impact-on-partner/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p style="text-align: justify;">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&#8217;s first chance to explore these issues.  In this post, we&#8217;re talking about the direct impact on him of my illnesses, history of trauma and current treatments.</p>
<div style="text-align: justify;">
<blockquote>
<p style="text-align: justify;"><strong>Q</strong>:</p>
<p style="text-align: justify;">On a day to day basis, what&#8217;s it like living with me? Like, really. Be honest. Be <em>brutal</em>.</p>
</blockquote>
<blockquote><p><strong>A</strong>:</p>
<p>A difficult question, I fear. One might well ask, “what&#8217;s it like living with anyone?” and my prior experiences of living with people have been experiences of living with friends who are male and do not suffer from any mental illnesses. On the comparative front, then, it is difficult to locate a suitable yardstick. Comparison, I think, will not work in this situation.</p>
<p>Perhaps a different approach, then. To be frank, it&#8217;s, well, normal. Normal for me, because it is what I am used to. On most days, even if you are not in the best of moods, you do a fairly good job of not allowing that to interfere with our interactions. You may be quiet and non-interactive at times, but then that is a trait that we share to some extent. Talk is cheap, and often I do not wish to engage in it any more than you might. At other times, we can have some great conversations and, when we&#8217;re both in the mood, that is exactly what happens. I don&#8217;t imagine that is any different from what most people in a relationship experience, though I can&#8217;t proclaim myself any expert.</p>
<p>So what is it like living with you when things are bad? Well, I think I have covered this ground before to some degree, but it&#8217;s&#8230;well, “challenging” might be the word. That said, I realise now that on most occasions there is probably little I can do to “fix” things for you. Maybe I am wrong, but when you are experiencing bleaker periods my reaction at present is often to ask you whether there is anything I can do for you, and if (as expected) you reply in the negative, then I leave you to your thoughts. I hope that does not sound cruel or harsh. I think it is just a straightforward approach. When there is nothing I can do, it is fruitless to try, and could In fact prove counter-productive. That doesn&#8217;t mean I will seek to ignore you at times like that, but I try not to interfere.</p></blockquote>
<blockquote><p><strong>Q</strong>:</p>
<p>So, there are certainly some times when I appear vaguely normal?</p></blockquote>
<blockquote><p><strong>A</strong>:</p>
<p>You appear vaguely normal, or indeed more than vaguely normal, most of the time. As I say, the occasions on which you clearly display symptoms are probably fewer than you think. You do a very good job of hiding how you truly feel, perhaps. Whether that is for the purposes of defending me or protecting yourself – or indeed both – I am not sure [<em>it is, for the record, both.  <strong>Mainly</strong> the former, but certainly both</em>]. Perhaps I should be interviewing you!  [<em>Be my guest!</em>] I often learn more about how you are feeling from this blog than from speaking with you. That is no criticism. You probably just find it easier to spill things out here. I am another individual who feels more comfortable expressing difficult things in writing, and so you won&#8217;t get any misunderstanding from me on that score.</p></blockquote>
<blockquote><p><strong>Q</strong>:</p>
<p>OK, but I think it&#8217;s inevitable that my sicknesses has impacted on you, probably in ways I can&#8217;t even understand. Could you outline the effect they have had on you, and how have you dealt with that?</p></blockquote>
<blockquote><p><strong>A</strong>:</p>
<p>I suppose there are a number of effects. The one that comes first to mind is the stigma that is associated with talking about mental illness. This doesn&#8217;t so much apply now, but at the beginning, when people did not know much about your condition, I felt in some way bound to say as little as possible about it to those I knew. The time that comes most to mind is when you were out of work for over a year, a time during which I continued to sell the story that you were working. It was the story you were telling most individuals as well, but I suppose concealment of that sort is not easy for anyone to manage on a consistent basis. Being out of work due to illness should not be an issue of embarrassment, but in fact there is certainly a [<em>huge, in my view</em>] stigma attached to it. There appears to be a widespread perception, or at least a perception that the media wishes to perpetuate, that the long-term out-of-work are &#8216;work-shy&#8217;. The concealment for over a year was a cover-up that I would have wished to avoid, but then what would I say, and would people understand? It was a necessity, really, until I got a better grasp of your conditions. As it happens, I know much more about mental illness now and can hold my own against anyone stupid enough to suggest that you might be work-shy. However, I suppose I – like you – face difficulty in communicating what this all means to people who are ignorant (wilfully or otherwise) of these issues.</p>
<p>How else does your illness affect me? I know of one other case where a carer for a mentally ill individual has himself begun suffering from symptoms of mental illness. Luckily for me, I do not believe that I am in that position. Some might say I am not normal, and I certainly have my quirks of character and a fiercely cynical perspective, but I&#8217;ve not changed substantially from the person I was &#8216;before&#8217;. Well, actually, I&#8217;m not the best judge of that. You&#8217;d probably have to ask a neutral observer. I feel like me, anyway, and I&#8217;ve not been battered into the ground by having to deal with difficulties you have faced. From time to time it has been stressful, of course; how could it not have been? But stress is stress and, while it can be a precursor to more serious conditions, in my case this has not yet been so.</p>
<p>Is it frustrating at times? I&#8217;d say so. However, we&#8217;re dealt imperfect hands by life (and I should know that as you beat me at poker all too often! [<em>almost always these days, my dear... <img src='http://serialinsomniac.com/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' /> </em>]) and we just have to get on with it. No point in my crying over what can&#8217;t be changed. Let&#8217;s look instead at solutions, such as seeking alternative sources of therapy when your time with C comes to an end. A horrific prospect for you, I know, but we&#8217;ve tried to knock some sense into the NHS to little avail. That isn&#8217;t to say we&#8217;ll stop trying, but the best and the worst planners alike need contingencies. So I temper some of my frustration by attempting to think of answers. Not cures, because they don&#8217;t exist in respect of some of your conditions. Answers that will assist, in whatever small way.</p></blockquote>
<blockquote><p><strong>Q</strong>:</p>
<p>I suppose there&#8217;s an issue here too about the extent of my history of sexual abuse. You knew <em>bits</em> – just like C, a few close friends and my blog readers knew <em>bits</em> – until really quite recently, when I admitted to C, and by virtue of that everyone that reads here, of much, much more. Do you feel hurt that I didn&#8217;t fully disclose things to you?  How does the reality make you feel overall?</p></blockquote>
<blockquote><p><strong>A</strong>:</p>
<p>How did I feel? Angry. Not at you. At the perpetrator. What you first told me of course sickened me, but I did not have a strong reaction to it because you did not suggest that the abuse was prolonged or quite so serious as it later emerged. I understood and sympathised with those first few things you told me, but it did not shock or disturb me unduly. You seemed to be over what had been a comparatively small if hateful incident or set of incidents, and it seemed best left that way. I have known one other who had experiences that were in some ways comparable, and that person seems to have managed to consign the hateful activity to the past and move on. So I assumed you were a similar case.</p>
<p>My sympathy for you remains, but now I also carry immense hatred for the perpetrator. Yes, I know only too well that hatred is not a constructive emotion, but I fail to perceive any alternative, so much does my blood boil now thinking about the true extent and severity of what he did to you as a defenceless child. The worst is attempting to stomach the bastard&#8217;s presence when we visit the McFaul household. I am not a violent person, but I only wish him ill. Hateful, despicable, monstrous, deceitful, subhuman cunt. Let him burn in hell forever – if I believed there was a hell.</p>
<p>Do I feel hurt that you didn&#8217;t reveal all before recently? Possibly a little, but I have to understand that you did not yourself realise the full horror of this until the therapy started to recover it from your memory. Or until it allowed you to start exploring those dark places. I wonder whether there is not yet more to what happened sometimes [<em>as do I</em>]; things you maybe haven&#8217;t been able to tell yourself yet, or things you have only been able to tell C. I hope not, but if there are, I have no right to know and it is entirely your choice as to whether to reveal it to me. So, hurt? Not really. The hurt is yours, and you can share or keep it to yourself as you choose. It must be extremely difficult to share any of this with <strong>anybody</strong>, and I commend your for your blatant honesty to date, particularly in this blog.</p></blockquote>
<blockquote><p><strong>Q</strong>:</p>
<p>I&#8217;m going to explore this more in a future post, but briefly – your thoughts on my experiences in psychiatry and, especially, psychotherapy? Have <strong>these</strong> processes impacted on you in any way?</p></blockquote>
<blockquote><p><strong>A</strong>:</p>
<p>Perhaps this is indeed worthy of a more detailed exploration in a future post, but in summary I would have to say that I remain somewhat dubious about the benefits of the therapeutic process – at least as it has applied in your case. Sometimes it appears to have helped you, yet one can almost guarantee that a week or two after a positive session, a follow-up session will have placed you in a black mood once more. I&#8217;m not saying the therapy is to blame for the black mood <strong>per se</strong>, but it is at times clearly a trigger. This is probably reasonable enough if one has a long time to discuss issues with the therapist – but 50 minutes a week is barely enough to dip a toe in the deep and dangerous waters of self-exploration. 50 minutes a week is a joke, quite frankly, and a rather sick one at that.</p>
<p>I also have issues with transference in the therapeutic process, again specifically relating to your case (because my experience is limited to it). I understand the purpose of transference to some extent, but to invest such trust in someone who is ultimately only a professional, whose service will ultimately be withdrawn, to me seems fraught with danger. Perhaps the process is designed to operate in a situation where there is no artificial time limit, as there is in your case, but even then I am somewhat uncertain – would the benefits outweigh the drawbacks?</p>
<p>Psychiatric treatment appears also to have been a mixed blessing for you, although I would be more positive about it since the advent of Seroquel, which really does appear to have assisted you since the <a href="/2009/12/">December</a>/<a href="/2010/01/">January</a> lows, both in terms of keeping away the voices and in terms of mood.</p>
<p style="text-align: justify;">We shall return to this subject, I would imagine, in more detail. However, I have pontificated enough for most people&#8217;s sanity by now, so I shall beat a hasty retreat.</p>
</blockquote>
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		<series:name><![CDATA[Perspectives from the Mentalist's Partner]]></series:name>
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		<title>Paedo, Aggression and Bastard Transference &#8211; C: Week 56</title>
		<link>http://serialinsomniac.com/2010/07/14/paedo-aggression-and-bastard-transference-c-week-56/</link>
		<comments>http://serialinsomniac.com/2010/07/14/paedo-aggression-and-bastard-transference-c-week-56/#comments</comments>
		<pubDate>Wed, 14 Jul 2010 22:05:25 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Traumatic Stuff]]></category>
		<category><![CDATA[Triggers]]></category>
		<category><![CDATA[aggression]]></category>
		<category><![CDATA[attachment]]></category>
		<category><![CDATA[attachment in psychotherapy]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[child sex abuse]]></category>
		<category><![CDATA[child sexual abuse]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[dealing with abuser]]></category>
		<category><![CDATA[dissociation]]></category>
		<category><![CDATA[family]]></category>
		<category><![CDATA[identity]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[mother]]></category>
		<category><![CDATA[paedophilia]]></category>
		<category><![CDATA[psychodynamic psychotherapy]]></category>
		<category><![CDATA[psychology]]></category>
		<category><![CDATA[rape]]></category>
		<category><![CDATA[relationships]]></category>
		<category><![CDATA[therapeutic abandonment]]></category>
		<category><![CDATA[therapeutic attachment]]></category>
		<category><![CDATA[therapeutic boundaries]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[transference]]></category>
		<category><![CDATA[trauma]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1957</guid>
		<description><![CDATA[This could be difficult to write about.  C has, I think, worked out things that I didn&#8217;t want him to work out, and which is he is going to bring up at the next session [now already passed - I have been writing this bollocks on and off for 83 eons].  I hate this.  I <a href='http://serialinsomniac.com/2010/07/14/paedo-aggression-and-bastard-transference-c-week-56/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p style="text-align: justify;">This could be difficult to write about.  C has, I think, worked out things that I didn&#8217;t want him to work out, and which is he is going to bring up at the next session [now already passed - I have been writing this bollocks on and off for 83 eons].  I hate this.  I hate it.  I don&#8217;t even know if I can write about it fully, but let&#8217;s see.  I shall, as ever, attempt to compose this in a chronological fashion, insofar as my memory allows it.</p>
<p style="text-align: justify;">This meeting took place on Tuesday 29th June (C had swapped his days from Thursday), but should have been on Thursday 24th.  As stated and explained the <a href="/2010/07/06/intimately-waving-a-white-flag-c-week-55/">other day</a>, for the first time in our entire relationship, I cancelled the session on the 24th, so this was the first time I saw him in over a week.</p>
<p style="text-align: justify;">Mutual agreement was that the session had ended up being a bit disjointed, but I think in some ways it was nevertheless useful &#8211; certainly much more so than the Thursday one would have been had I gone.</p>
<p style="text-align: justify;">The conversation opened with a rant from me on how horrified I was that, straight after leaving C&#8217;s office, I would be forced to <a href="/2010/06/30/forced-to-see-my-childhood-abuser/">see Paedo</a>, after my mother&#8217;s non-consultative decision to take me to Hotel California.  It feels a little odd writing about this now, as I have been and gone on this delightful little sojourn, and in the end it went as OK as such things can.  However, I was certainly not looking forward to it as I sat there with C, and must confess to being somewhat critical of my mother for some time.</p>
<p style="text-align: justify;">I don&#8217;t remember exactly what was said, but there was one point at which he really annoyed me.  He asked me if I was pissed off at having to see Paedo, or everybody else.  I responded by telling him that both troubled me.  He then went on to enquire as to whether there was “any value” in my mother encouraging me to see the non-Paedo members of the family.</p>
<p style="text-align: justify;">I pointed out that I had nothing in common with them and could not see what benefit having some sort of relationship with any of them would have.  “Of course,” I acknowledged, “whilst my view is that family is mere genetics, my mother&#8217;s is that blood is thicker than water.”</p>
<p style="text-align: justify;">“I think that&#8217;s the point,” he said.</p>
<p style="text-align: justify;">I&#8217;m sorry, but what the fuck?  Even if there was value in the pursuit, even if there <strong>genuinely</strong> was, it&#8217;s fucking irrelevant because <em>Paedo is there anyway</em>.</p>
<p style="text-align: justify;">I made some noise about not existing to keep my mother happy, and told him that the reality is that my mother is a hypocrite because she spends half her life slagging the McFauls off.  I bitch about them here and to A, for example, but I generally avoid unsolicited criticism of them in front of my mother.</p>
<p style="text-align: justify;">C responded by reminding me that my mother was also traumatised (due, of course, to her experiences of long-term domestic violence).  So that makes it alright for her to force me to live through <strong>my</strong> traumas, or for her to be have hypocritically?  How does that work?</p>
<p style="text-align: justify;">To be fair to C, I&#8217;m paraphrasing considerably here because of my poor memory.  I eventually conceded that although I fail to see the point of a relationship with most members of my family, I was willing to continue to have one of some description or another because it pleases my mother.  “However,” I said, “I still don&#8217;t think it reasonable to have to face him.”</p>
<p style="text-align: justify;">The stupid but inevitable question of whether I could see them without him was raised, but the answer is pretty definitively &#8216;no&#8217;.</p>
<p style="text-align: justify;">I&#8217;m not sure what I had been looking for in discussing this with C.  Was I looking for him to forbid me from going?  So that the reinforcement of the earlier opinions that I should avoid Paedo due to the psychotic symptoms he has induced re-emphasised to me how dangerous it was.</p>
<p style="text-align: justify;">Whatever the case, I also pointed out that this trip would see my first encounter with Sean, Marcus&#8217; baby brother, who is named after Paedo.  I told C that I was scared that I would react badly to the faultless child because he represents an honour bestowed upon Paedo.  He, to my considerable irritation, proceeded to point out to me that I had not reacted badly to Marcus, despite my general dislike for children.</p>
<p style="text-align: justify;">“Marcus isn&#8217;t named after the man who sexually abused me,” I seethed through gritted teeth.</p>
<p style="text-align: justify;">“No, but you told me that the baby is known by a shortened form of your uncle&#8217;s name,” he pointed out [if Paedo is James, the baby is Jim].  “Isn&#8217;t that the case?”</p>
<p style="text-align: justify;">This was correct, but I figured at the time that it would make no difference to my reaction.  However, it turned out that C was pretty much right; I definitely saw the kid as being the diminutive of his name, rather than as his full, Paedo-related title.  It&#8217;s funny how much difference a few little letters make, even if the symbolism is the same.</p>
<p style="text-align: justify;">Anyhow, C enquired as to whether I would hold the kid.  I told him that, if past experience was anything to go by, I&#8217;d have it pushed onto with or without my consent.  I have to say this has always made me feel slightly uncomfortable, but it happens and you deal with it accordingly.</p>
<p style="text-align: justify;">“So I&#8217;ll survive,” I shrugged.</p>
<p style="text-align: justify;">He smiled wryly, and said, at which point I wanted to smash his face in, that I might <strong>enjoy</strong> holding the kid.</p>
<p style="text-align: justify;">I told him that I did not share his apparent optimism, and decided that that angle of conversation needed to desist.  I confessed to feeling guilty about slagging off my mother, and told him I had a little anecdote.</p>
<p style="text-align: justify;">The previous evening I had been in the shower at my mother&#8217;s house and had seen a lot of little shower gels and whatnot that she&#8217;s picked up from hotels.  This reminded me that she had collected a bunch of these things for me a few weeks previously, but then had accidentally left a bag full of them in a coffee shop whilst out with her friend.  Upon realisation of this, my mother phoned the shop in question, got them to hold the bag for her, and went and retrieved it for me.</p>
<p style="text-align: justify;">I was disgusted that regaling this tale to C make my voice break because, as I said, “it&#8217;s the little things that count.”  I was advised that just because my mother has not always been the most validating figure in my life, it does not mean that she does not love me very much.</p>
<p style="text-align: justify;">Hmm.  So he reads my mother&#8217;s mind now too, does he?  She who he has never even met?  Before he had cause to irritate me – or, more accurately, before I actually fucking cried &#8211; I changed the subject.</p>
<p style="text-align: justify;">Don&#8217;t ask me how but I ended up telling him how laziness had dictated that I&#8217;d been taking a reduced dose of Seroquel for about a week, and had only the night before resumed taking my normal dose of 400mg.  When I started to space out shortly after this, he seemed slightly concerned initially but I protested that it was probably a drug hangover.</p>
<p style="text-align: justify;">“Is that normal with this medication?” he asked, and I confirmed that it was.</p>
<p style="text-align: justify;">He looked dubious, then admitted if there wasn&#8217;t more to my daze.</p>
<p style="text-align: justify;">“Maybe my mind has decided to dissociate this whole sorry day.  I do hope so.”</p>
<p style="text-align: justify;">This led to discussion of dissociation in general, though it was kind of brief and the content is consigned to history as I don&#8217;t remember it.  What did happen was that the topic naturally progressed to a discussion of identity and a revision of the bollocks of the previous week about (a) a possible over identification with mentalism on my part (something that I continue to dispute) and (b) a fear of intimacy on my part (something that I am willing to acknowledge).</p>
<p style="text-align: justify;">He banged on for a bit again about how much investment I have in engaging with other mentalists online.  “They&#8217;re very real, don&#8217;t get me wrong,” he told me, “but as I&#8217;ve said previously, it&#8217;s almost like you&#8217;re looking to have relationships that exist only at arms&#8217; length.  Real and meaningful, yes – but different.”</p>
<p style="text-align: justify;">This made me laugh a bit, which confused him.  I clarified by saying that I was laughing as some sort of stupid response to sadness because “even online relationships have the power to hurt you very greatly.”</p>
<p style="text-align: justify;">“Why?” he queried, seemingly slightly concerned.  “Has something happened?”</p>
<p style="text-align: justify;">I told him of the circumstances that led to <a href="/2010/06/28/i-am-what-i-am/">this post</a>, and advised on how I responded to it.</p>
<p style="text-align: justify;">I was astonished when he started – gently, in fairness, but still infuriatingly – questioning if I had been behaving in a fashion that reasonably precipitated this fallout.</p>
<p style="text-align: justify;">I denied this most vehemently.  So someone who&#8217;s opinion I had otherwise respected decided they think I&#8217;m a shit writer who&#8217;s self-obsessed.  That&#8217;s unfortunate, but other people&#8217;s opinions of me are only things that I can control within reason.  If I was being a complete bitch, that&#8217;s obviously something for which I am responsible.  If I was merely doing the same things that I have always been doing, as in this case, someone&#8217;s changed view of me is not something I caused or can change.</p>
<p style="text-align: justify;">I told him so, but wouldn&#8217;t let the fuck up.  He went back to all the wank with Mr Director-Person, my former colleagues, la la la.  I wanted to rearrange his face.  What&#8217;s especially galling is that C <strong>fucking encouraged</strong> my original correspondence with Mr D-P, and now he goes about accusing me of fucking aggression?</p>
<p style="text-align: justify;">Of course, my attempts to defend myself were seen as evidence of my aggression.  I find this circumstance grossly unfair.  Are there <strong>times</strong> when I&#8217;m aggressive?  Yes, of course there are.  That, I am all but certain, applies to us all at times.  Am I more so than others?  Possibly, yes, but I really don&#8217;t get his fixation with the issue.  It&#8217;s not <strong>that</strong> bad, and generally there is at least <strong>some</strong> (and usually more than just &#8216;some&#8217;) justification for such a reaction.  But C seems <strong>obsessed</strong> with it, insofar as any psychotherapist is ever obsessed with anything that applies to their clients.  I just don&#8217;t get it.</p>
<p style="text-align: justify;">Rather than continue defending myself and apparently prove his point in doing so, I shut the fuck up.  I glanced about me, at his desk, his bookcase, filing cabinet, yadda yadda.  Eventually my eyes returned to his desk, where I was interested to note the presence of his iPhone.  I noted with smug satisfaction that it was a 3G or 3GS, whereas I now have an iPhone 4.</p>
<p style="text-align: justify;">Silence ensued for a minute or two, when he broke into my thoughts.</p>
<p style="text-align: justify;">“What&#8217;s going through your mind?” he asked.  “You&#8217;re staring into space there.”</p>
<p style="text-align: justify;">“No I&#8217;m not,” I stated grandiosely.  “I&#8217;m looking at your iPhone and thinking, &#8216;fuck you, I&#8217;ve got an iPhone 4 now&#8217;.  Hahaha!”</p>
<p style="text-align: justify;">His face developed into an enigmatic sort of expression.  Jealousy?  Yes, I think so, but also bafflement.  It was vaguely amusing to observe.</p>
<p style="text-align: justify;">Eventually, he asked if I had <strong>really</strong> been thinking that.</p>
<p style="text-align: justify;">“Yes,” I confirmed, “why wouldn&#8217;t I have been?”</p>
<p style="text-align: justify;">“So, you have a sense of triumphalism – again – about this.”</p>
<p style="text-align: justify;">Jesus fucking Christ.  I mean,<strong> JESUS CHRIST</strong>!!!!!  Is there <strong>anything</strong>, <em>anything at all</em>, that does not have an ulterior psychological motive?!  What the fuck?!  Everyone who has got a fucking iPhone 4 is a smug, self-satisfied twat.  Why am I such a fucking guinea pig-like example to him of supposedly flawed psychology, when the reality is that in some ways I am just as fucking ordinary as anybody fucking else?</p>
<p style="text-align: justify;">I responded to his insult with a redacted and calmer version of the preceding paragraph.</p>
<p style="text-align: justify;">“Again, were you <strong>really</strong> thinking that?” he pressed on.  “During that pause you looked upset, not pleased or smug or anything like that.”</p>
<p style="text-align: justify;">I shrugged and proceeded to ignore him, instigating yet another silence.</p>
<p style="text-align: justify;">Eventually, I cautiously began to tell him that it seemed obvious to me from his continual harping on my alleged aggression that he thought I was a belligerent bitch of Satan and that he hated me.  This was perhaps exacerbated by a newly acquired submissive, almost child-like stance on my part.  Plus some evident upset at these possibilities.  Just a little of that.  Yeah.  Right.</p>
<p style="text-align: justify;">His reaction was extremely interesting to me.  He seemed taken aback by my assertion that I believed that he hated me – though I am certain I have postulated the idea to him in the past – and he took a few minutes to think about it.  Thanks for boosting my confidence there, C.</p>
<p style="text-align: justify;">Eventually he entered into a rather epic soliloquy about the issue.  He talked for quite a while, but the long and the short of it was that I have many, <strong>many</strong> different facets to me, of which assertiveness (as he had now renamed it) was only one.  “If you were always like that, well yes – it would be very hard to like you.  But you&#8217;re not, so&#8230;[here he clearly realised he was teetering on a dangerous line]&#8230;so, well, again &#8211; you have many more sides to you than just that.  I don&#8217;t think that <strong>defines</strong> you by any means.”</p>
<p style="text-align: justify;">“OK,” I responded, meekly and unconvinced.</p>
<p style="text-align: justify;">He sat looking at me intently, his chin in his right hand, his index finger crossing his mouth at a diagonal angle.  He always does this when he is considering something intensely.  I wonder if he is even aware of this behaviour.</p>
<p style="text-align: justify;">I avoided his gaze and stared at my shoes, but his eyes bored into me, and eventually he spoke.</p>
<p style="text-align: justify;">He said, very slowly and very definitely, “there&#8217;s more to this, isn&#8217;t there?”</p>
<p style="text-align: justify;">Such a simple statement, but so laden with deep connotations that someone outside the therapeutic dyad would surely struggle to understand.</p>
<p style="text-align: justify;">I pretended to think about it, the operative word there being &#8216;pretended&#8217;. <strong>Of course</strong> there&#8217;s more to it, and really it surprises me that he&#8217;s only worked out the magnitude of it.</p>
<p style="text-align: justify;">“Maybe,” I admitted, quietly.</p>
<p style="text-align: justify;">And so the immortal line of, “we&#8217;re going to have to leave it there,” came to pass – but there was a second part to the quotation this time.  “We&#8217;re going to have to look into this in much more detail.  You know that, don&#8217;t you?”</p>
<p style="text-align: justify;">I nodded and left, perhaps ostentatiously hurriedly.  I sat in Disraeli, my car, for a long time, hugging the steering wheel.  Thinking, contemplating, ruminating, musing.</p>
<p style="text-align: justify;">This all sounds very cryptic, but of course there was an unspoken understanding between C and me.  In essence, he&#8217;s worked out that issues of transference in our relationship are not just confined to attachment.  It runs very much deeper than that.  I&#8217;ve been fairly open on this blog on the issue in the past and I don&#8217;t want to repeat myself because it fucking hurts like hell to do so.  I don&#8217;t want to face it either myself or with him.  I want it TO GO AWAY.</p>
<p style="text-align: justify;">It&#8217;s difficult because, despite some of the twatty things he says and my anger at same, overall I am glad to report that I have a good therapeutic relationship, and one that I think is effective.  I also recognise transference as an inevitable side effect of that, demonstrative of the fact that the therapy is actually working to some extent.  The difficulty in this case is that I am in the throes of this transferential obsession and being discharged, before we will ever be able to properly address the issue.  Perhaps I am at fault because I never brought up the matter in terms of its intensity before, though the word &#8216;transference&#8217; is bandied about quite a lot in our sessions.  But, as any of you who&#8217;ve been there will appreciate, facing it head-on is a matter of profound difficulty.</p>
<p style="text-align: justify;">On the issue of the end of therapy, and because I want to avoid discussing this even more, Mr Director-Person has still failed to respond to my most recent correspondence.  I have therefore taken the liberty of writing back to him, a copy of the previous letter enclosed, asking for his response as a matter of urgency, though I was quite nice about it.  I did, however, hear from his Assistant Director, as regards the personality disorder steering group that the Trust is developing.  The letter was official but pleasant and stated that, whilst the development of their PD services are in their infancy at present, they would be glad to have my input and will be in touch again as things progress.  If C thinks he&#8217;s seen my aggression, he can think again <img src='http://serialinsomniac.com/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' />   They don&#8217;t know what they&#8217;ve let themselves in for!</p>
<p style="text-align: justify;">NB.  Please forgive the probably-multifarious amount of spelling, syntax, formatting and grammar errors in this post.  I&#8217;ve been writing it for about 40 years and am sick looking at it, so am just going to publish it without adequate – indeed, <strong>any</strong> – proof-reading.  Sorries.</p>


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		<title>Words Are All I Have</title>
		<link>http://serialinsomniac.com/2010/07/07/words-are-all-i-have/</link>
		<comments>http://serialinsomniac.com/2010/07/07/words-are-all-i-have/#comments</comments>
		<pubDate>Wed, 07 Jul 2010 19:06:46 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=1953</guid>
		<description><![CDATA[I have been trying to review last week&#8217;s session with C in my usual detail, but I&#8217;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&#8217;m going to eat and try writing <a href='http://serialinsomniac.com/2010/07/07/words-are-all-i-have/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p style="text-align: justify;">I have been trying to review last week&#8217;s session with C in my usual detail, but I&#8217;ve had a very stressful day (gruesome CAB appointment, and much Disraeli trouble <img src='http://serialinsomniac.com/wp-includes/images/smilies/icon_sad.gif' alt=':(' class='wp-smiley' /> ) and that, coupled with my ungraciously low mood and lethargy of late, has left me weak and defeated.  I&#8217;m going to eat and try writing again, but it may just have to wait.  As the wonderful <a href="http://splinteredones.wordpress.com" target="_blank">Splintered Ones</a> is always good enough to remind me, it comes when it comes and can&#8217;t be forced <img src='http://serialinsomniac.com/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> </p>
<p style="text-align: justify;">Anyway, I don&#8217;t know why but I wanted to write <strong>something</strong>.  I suppose I worry constantly that if I allow myself to avoid posting for a few days, I&#8217;ll fall into a rut of utter insouciance towards writing.  I&#8217;ve invested so much time and effort into this blog*, and I only want to discontinue writing when I actively choose to do so &#8211; 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&#8217; break from writing will lead to a <em>de facto</em> dead blog.  I&#8217;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?!</p>
<p style="text-align: justify;">[ * 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.]</p>
<p style="text-align: justify;">So, bearing in mind my fear of an apathetic fall from whatever low level of grace I may or may not be occupying, I&#8217;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&#8217;s drivelsome bullshit, I think it does grasp that reasonably well.  To be honest, it probably describes my current mood quite well too.</p>
<p style="text-align: justify;">Alas.</p>
<blockquote style="text-align: justify;"><p>I am not in the frame of mind to write anything here, but maybe that&#8217;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 <a href="/2010/06/28/i-am-what-i-am/">wallowing</a>? <img src='http://serialinsomniac.com/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' /> )  I&#8217;ve had a strange day.  I saw C this morning &#8211; specifics to follow &#8211; which has set me up for a weird week; as I normally see him on Thursdays, I&#8217;m going about thinking that tomorrow&#8217;s Friday, and that A will be there for the weekend.  Since it&#8217;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&#8217;t want to discuss it right now because it&#8217;s a sensitive issue, and in any case I might be mistaken in my reading of what he thinks (I don&#8217;t think I am, but then I suppose I wouldn&#8217;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 <a href="/series/the-mr-director-person-letters/">Mr D-P</a> still hasn&#8217;t bothered to respond to my recent ramblings) and how invested in therapy &#8211; in <strong><em>C</em><span style="font-weight: normal;"> &#8211; I am.  I mean, I already know this &#8211; I have done for a very long time &#8211; 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.</span></strong></p>
<p><strong><span style="font-weight: normal;">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&#8230;well, apart from the <a href="/2010/07/06/intimately-waving-a-white-flag-c-week-55/">last time</a> I saw C, that is.</span></strong> <strong><span style="font-weight: normal;">I still think &#8216;grief&#8217; 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&#8217;m not disrespecting anyone in saying this &#8211; many apologies if so), but this feels like the closest I&#8217;ve ever been to that situation.</span></strong></p>
<p><strong><span style="font-weight: normal;">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&#8217;re not generally faced with the abject <em>grief</em> 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&#8217;t know.</span></strong></p>
<p style="text-align: justify;"><strong><span style="font-weight: normal;">Anyway.  That was pointless.  I&#8217;m always told I should put my &#8220;emotions&#8221; into words, rather than uttering an allegedly meaningless sentence such as, &#8220;I&#8217;m pissed off,&#8221; but then everyone knows how I&#8217;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&#8217;s for sure.</span></strong></p>
</blockquote>


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		<title>Intimately Waving a White Flag &#8211; C: Week 55</title>
		<link>http://serialinsomniac.com/2010/07/06/intimately-waving-a-white-flag-c-week-55/</link>
		<comments>http://serialinsomniac.com/2010/07/06/intimately-waving-a-white-flag-c-week-55/#comments</comments>
		<pubDate>Tue, 06 Jul 2010 21:36:48 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=1919</guid>
		<description><![CDATA[It&#8217;s a long time since I&#8217;ve written about C, and in light of that this post relates to a session way back on 17 June.  I actually missed one meeting &#8211; the first one I&#8217;ve ever cancelled in the whole year-ish of therapy &#8211; on 24 June, for a couple of reasons.  Firstly, I was <a href='http://serialinsomniac.com/2010/07/06/intimately-waving-a-white-flag-c-week-55/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>It&#8217;s a long time since I&#8217;ve written about C, and in light of that this post relates to a session way back on 17 June.  I actually missed one meeting &#8211; the first one I&#8217;ve <strong>ever</strong> cancelled in the whole year-ish of therapy &#8211; on 24 June, for a couple of reasons.  Firstly, I was suffering a relatively-mild-but-still-dreadful bout of tonsillitis, which was long overdue (it&#8217;s usually a yearly affliction).  This made speaking difficult, and since speaking is kind of required in <em>talking therapy</em>, this presented a problem.  Secondly, though, I was also in a thoroughly bleak and depressed mood, and I know from experience that existing in that sort of plane merely leads to useless psychotherapy sessions.  So, although I knew I would miss him (and I did), I felt I might as well &#8216;save&#8217; the missed session for a time when it was going to be more productive.</p>
<p>So, back to the week before then, the week before I became ill.  Regular readers may recall that the session I had the <a href="/2010/06/15/how-to-hurt-your-therapists-feelings-and-your-own-c-week-54/">week <strong>before</strong></a> 17 June was a meeting characterised by (my) hostility and, in his words, acrimony.  Unsurprisingly, that informed at least part of what we talked about in this session.</p>
<p>C was running late again, but not so much that it ate in any way into our session, as it had <a href="/2010/05/10/wasting-time-i-dont-have-c-week-49/">once</a> previously done.  I ran into him in the carpark and walked into the shithole building along with him.  The poor sod was bowed down by his briefcase, a coat, some other thingy-ma-bobber and his little packed lunch.  For some utterly ridiculous reason, I found this image (particularly of him clutching his lunch) to be rather sweet and charming, and I felt a sudden rush of maternalism for him, longing as I did to ruffle his fluffy (if receding) hair.</p>
<p>He left me briefly in the waiting room whilst he went to get himself together, but he was only gone a few minutes before he returned to escort me to his office.  As we sat down he started coughing, and was clearly a little hoarse.  He apologised &#8211; yes, C, because it&#8217;s <strong>your</strong> fault you&#8217;re sick &#8211; but to be honest it didn&#8217;t impact much on my ability to understand him.  Indeed, it further fuelled my pathetic pseudo-parentalism for him, and I wanted to wrap him in a blanket and take care of him.  I could see myself handing him hot, steaming mugs of Lemsip and gently spoon-feeding him a soothing concoction of honey, glycerine and lemon.*</p>
<p>What the sodding hell is this about?  How can I feel such silly maternal feelings for someone who is (admittedly not that much) <strong>older</strong> than me, especially when I don&#8217;t feel maternal feelings for others, particularly children?  I&#8217;m used to issues of attachment and transference in therapy &#8211; all too well, and all too hatefully &#8211; and I&#8217;m even used to the idea of wanting to protect C from certain things.  This whole mother-like behaviour is odd, though.</p>
<p>Anyhow, the brief salutations over, I took a deep breath and and reached into my handbag for something I had brought with me.  It wasn&#8217;t an extract of this blog or something of that ilk, like previous &#8220;I brought this to therapy&#8221; items have usually been.  It was a silly little gift I&#8217;d made for him.</p>
<p>Uh-oh!  Taking presents for the therapist is a dangerous sign of deep intensity, no?  And they&#8217;re not allowed to accept them, right?  I don&#8217;t know, but all it was was this:</p>
<p><a href="http://serialinsomniac.com/wp-content/uploads/2010/07/photo4.jpg"><img class="aligncenter size-large wp-image-1983" title="A White Flag for C" src="http://serialinsomniac.com/wp-content/uploads/2010/07/photo4-225x300.jpg" alt="A White Flag for C" width="225" height="300" /></a></p>
<p>It is a little white flag that I&#8217;d made out of a bit of paper and wire, with a sad face and the word &#8216;sorry&#8217; ensconced across the front.  I waved it at him, briefly explained what it was (thus illustrating how crap it must have been), apologised for my behaviour the previous week and finally pushed it across the table to him.  I watched carefully for his reaction.</p>
<p>I was gratified and even quite touched to see his face break into a broad smile as he looked at the silly little thing.  He actually seemed a little speechless and taken aback, though apparently in a good way as he sat there doing not-very-much other smiling for a bit.  He has perfectly shaped teeth.  Not two fangs on each side like I do.</p>
<p>When he finally looked back at me, I returned his smile rather sheepishly and apologised once more for being a twat.</p>
<p>The inevitable question came up as to why I felt the construction of the &#8216;flag&#8217; was necessary.  I told him that I felt bad for how I had behaved in the previous session and wanted to make amends.</p>
<p>&#8220;Not that some crappy thing like that compensates,&#8221; I said, &#8220;but I wanted to do <strong>something</strong>, something other than simply offering some bland apology.&#8221;</p>
<p>We discussed what had enraged me the previous week for a while.  It had mainly been due to the fact that <a href="/2010/06/09/how-to-mechanistically-lose-friends-and-alienate-people-c-week-53/">he had</a> said that I&#8217;d pronounced the almost-imminent cessation of our relationship to be &#8216;tragic&#8217;, which is <strong>not</strong> what I had said.  I don&#8217;t think it was unreasonable for me to have pointed this out to him, but slabbering and bitching and ranting at him for 50 minutes was a massive over-reaction.</p>
<p>I told him so, and he enquired as to how I had felt after the last session.  He is very well aware that I post-mortem things absolutely to death, and am wont to hang on to words he says in session, questioning their meaning and mentally debating the nature of our relationship.</p>
<p>The thing was, although I did feel guilty about how I&#8217;d behaved, it wasn&#8217;t as bad as it really should have been.  If someone had spoken to me the way I spoke to him, I would have created a death list with them in the top ten positions**, so I really should have been berating myself all week.  As it was, I felt more sorry for him than actively conscience-stricken.</p>
<p>&#8220;It&#8217;s all very well to rationalise things like these by saying that you <strong>chose</strong> this job, and that things like this inevitably come up,&#8221; I told him, shrugging,  &#8221;and I know you&#8217;re trained to deal with clients&#8217; anger and whatnot.  But even with all that said and understood, you&#8217;re still human &#8211; and I actually thought that you looked hurt at one point.  It wasn&#8217;t fair that I made that happen.  So I&#8217;m sorry.&#8221;</p>
<p>He thought for a minute, scrunching up his face in that idiosyncratic way that he always does whilst musing, then replied with something along the lines of there being a necessity for me to bring anger to therapy if, indeed, I was angry with him.  &#8221;You&#8217;ve done it before,&#8221; he pointed out.</p>
<p>&#8220;Hmm.  I suppose last week wasn&#8217;t quite as bad as the time I called you a &#8216;<a href="/2009/11/30/i-hate-you-dont-leave-me-therapy-sucks-c-week-32/">sadistic headfucker</a>&#8216;.  I&#8217;m still sorry about that.&#8221;  I shifted uncomfortably at the recollection, particularly as he nodded to denote the fact that he too clearly remembered the incident in question.</p>
<p>&#8220;Well, anyway,&#8221; he said, &#8220;I checked my notes, and no &#8211; you didn&#8217;t use the word &#8216;tragic&#8217; in the way that I said you did.&#8221;</p>
<p>&#8220;Maybe not, but I still completely over-reacted.&#8221;</p>
<p>He looked at me enigmatically.</p>
<p>&#8220;What I said was that it was &#8216;sad&#8217;, that the forthcoming severance of this relationship was &#8216;sad&#8217;,&#8221; I recalled.  &#8221;And I think I may have also said that I felt a sense of loss.  That I <strong>feel</strong> a sense of loss.  That I think it <strong>is</strong> sad.  So there you go, I admit it.&#8221;</p>
<p>I do hate my treacherous fucking body sometimes; my voice broke and my lip quivered as I spoke the sorry words.  As he started to state the obvious by saying, &#8220;now you&#8217;re upset,&#8221; I waved my arms at him in a halting gesture and said, &#8220;no.  <strong>Please</strong> don&#8217;t go there, C.  Allow me to retain whatever <strong>small</strong> semblance of dignity I have left.&#8221;</p>
<p>&#8220;You don&#8217;t think crying or showing emotion is dignified,&#8221; he wistfully and completely pointlessly added.  However, he then smiled gently and sym-(or em-)pathetically, and was good enough to honour my request to desist from proceeding with that particular conversation.</p>
<p>Instead, he started talking about how I have a conflicted or ambiguous view of him at times.  I don&#8217;t remember all he said in this vein, but I tried to refute the idea that I sometimes regard him pretty negatively.  I mean, yes &#8211; I get irritated, even angry, with him at times, but as I said to him, that happens in <strong>all</strong> interpersonal relationships.  It doesn&#8217;t mean that the way in which I view him is not generally positive.</p>
<p>&#8220;Nevertheless,&#8221; he insisted, &#8220;those issues of anger, aggression &#8211; whether at me or whoever &#8211; they are very real, aren&#8217;t they?&#8221;</p>
<p>I made some noise questioning whether he thought I was always like that.</p>
<p>&#8220;Oh no, of course not,&#8221; he responded assuredly.  &#8221;If you were normally angry or aggressive you wouldn&#8217;t be able to do this work at all, so that&#8217;s not the case.  On the flip side, when these issues arise between us, we need to examine them together, so of course it&#8217;s necessary that you bring them here.  But I do wonder if, when you feel you&#8217;re not being heard or whatever, you don&#8217;t maybe behave a little <strong>too </strong>assertively&#8230;which could possibly alienate you from people.&#8221;</p>
<p>&#8220;If you&#8217;re talking about <a href="/series/the-mr-director-person-letters/">Mr Director-Person</a>,&#8221; I responded, raising an eyebrow, &#8220;then I believe that I have behaved in an exemplary fashion.&#8221;</p>
<p>He said that it wasn&#8217;t <strong>just</strong> Mr D-P of whom he had been thinking, but that he was one such example.  Another, to my considerable surprise, had been my engagement with my manager and the Horse regarding my absence from <a href="/categories/work/">work</a>.  Before I could contest that point, however, C queried as to why I felt that my correspondence with Mr D-P had been &#8216;exemplary&#8217;.  He (non-accusingly) asked if I felt that my protests were generally acceptable.  (I do, for what it&#8217;s worth).</p>
<p>I told him that this is an attitude that has been fostered in my character.  Apparently that was a cryptic remark (?!), so I proceeded to tell him that my mother, A, and a number of friends throughout my life have always spurred me on to defend myself to the hilt, particularly when I&#8217;ve been fucked over in some fashion, as with the NHbastardingS.</p>
<p>&#8220;With specific reference to Mr D-P,&#8221; I continued, &#8220;my mother doesn&#8217;t feel I&#8217;ve been harsh <strong>enough</strong>.  A helped me draft the most recent letter, so he clearly approves.  My friends seemed to think my correspondence has been reasonable.&#8221;</p>
<p>He seemed cynical at this, but let it be.  He asked of which friends I was speaking, and I confirmed that I was, generally, referring to those of you that I know from this blog and from Twitter.</p>
<p>&#8220;Your blog means a lot to you,&#8221; he stated.</p>
<p>&#8220;Yes,&#8221; I acknowledged, &#8220;it&#8217;s not some work of art, but it&#8217;s still my pride and joy.&#8221;</p>
<p>This led to a frustrating but ultimately intriguing conversation about intimacy.  C accepts that online friendships are fulfilling and meaningful and very much real, but he was very keen to point out that they&#8217;re &#8216;different&#8217; to ones formed in &#8220;real&#8221; life.  The blog is of course wont to encourage contact online rather than in the physical world, especially as it&#8217;s primarily anonymous.</p>
<p>He said, &#8220;how often do you correspond with your &#8216;real life&#8217; friends?&#8221;</p>
<p>I muttered something deliberately incoherent, but was forced upon his pressing of the issue to admit that my contact with them is pretty infrequent.  He then enquired as to how often I &#8216;speak&#8217; to some of my online friends, and I told him that in many cases that contact was daily.</p>
<p>I went to justify this (as if I <strong>need</strong> to justify it!) on the grounds that my online friends understand what it&#8217;s like to be mental &#8211; in most (not all) cases, that&#8217;s how I&#8217;ve met them.  At this juncture I heard utterances about over-identification with my mental illnesses, which given <a href="/2010/06/28/i-am-what-i-am/">this</a> was perhaps somewhat timely.</p>
<p>I ignored the rather annoying accusation and told C that another issue was that because I can contact so many people through Twitter and Facebastard, it means easy, enjoyable, and ergo completely <strong>genuine</strong> correspondence with them.  Contacting  people like Daniel or Brian involves using <strong>the phone</strong>.  I shuddered at the thought and provided him with a redacted, auditory version of <a href="/2010/06/16/phone-phobia/">this post</a>.</p>
<p>Much analysis ensured.  When I was unable to express myself why I am so bloody terrified of the phone, he proffered the view that this absolutely exemplified my fear of intimacy; typing on a computer screen is less interpersonal than actually<strong> speaking</strong> to someone, apparently (for what it&#8217;s worth, I do not concur).  I protested that I am not that bad with people <strong>in person</strong>, pointing out that I&#8217;ve met two people I know from Twitter in person and am due to meet a number more (you know who you are!).  I asked how, therefore, his contention could be accurate.</p>
<p>He responded by asking how much I go out and see people as a general rule.  How do I interact with people other than, say, A and my mother?  <strong>Can</strong> I interact with people other than A and my my mother, especially if one of those two is not present?</p>
<p>I looked at the floor, my silence confirming his suspicions that the answers to his questions were &#8216;hardly at all&#8217;, &#8216;badly&#8217; and &#8216;no&#8217; respectively (the latter is not <strong>universally</strong> true, but it is in the majority of cases.  Alas).</p>
<p>He talked on for a while more about my alleged fear of intimacy.  I have come, unwittingly, to equate it as a negative thing as a result of experiences with Paedo, V and all the others who have betrayed me over the years.  He accepted that I probably don&#8217;t <strong>consciously</strong> fear it, and said that I probably don&#8217;t <strong>mean</strong> to &#8220;keep people at arms length &#8211; or even to push them away at times&#8221;, and indeed he said that he thinks part of me actively <strong>yearns</strong> for intimate personal contact.  However, to completely paraphrase him, my reactions to intimate situations and relationships are maladaptive and ultimately self-defeating.</p>
<p>He even went on to remind me that I totally withdraw into myself for days on end, not contacting anyone I know (even my mother) in any way.  &#8221;The only exceptions,&#8221; he noted, &#8220;are your friends on the internet.&#8221;  [He threw in a little joke here that I could apologise to anyone I'd failed to contact as I should have by sending them a white flag.  I laughed, but told him that he alone was to be the recipient of such a thing.]</p>
<p>I&#8217;m making him sound really, really dickish, but all this was conveyed much more sensitively than I have portrayed it here (though it still perturbed me somewhat, of which more in the next post).  He went on to briefly allude to the inherent intimacy of the therapeutic relationship, and said that whilst he felt that we did work together, that I was  holding him too at arms&#8217; length.</p>
<p>&#8220;You&#8217;re usually so very careful to avoid showing vulnerability or emotion in front of me, though you have done it at times,&#8221; C said, looking me in the eye when I would allow him to do so.  &#8221;You&#8217;re protecting yourself, no doubt, but in doing so issues are sometimes avoided, and you try to keep things more abstract or business-like than I think you <strong>really </strong>want them to be.&#8221;</p>
<p>The problem is, not that I said this to him, that things can never <strong>be</strong> what I want them to be &#8211; but, again, that is something to be further explored in a future post.</p>
<p>I don&#8217;t remember exactly what gave rise to it, but in some sort of response to all this crap, I eventually asked if he felt that my transferential issues towards him were represented more greatly by aggression or by fear of intimacy.</p>
<p>He said that he felt the two were intrinsically related, but added that his view of this was probably different to mine.</p>
<p>&#8220;How so?&#8221; I asked, deliberately staring him right in the face.</p>
<p>&#8220;I think that you perhaps understand transference [he pronounced it '<em>tras-fer-ENCE</em>' rather than '<em>trans-FER-ence</em>' as I do] in terms of, &#8216;I&#8217;m angry at my father or my uncle, so I project that onto C,&#8217; would that be right?&#8221;</p>
<p>&#8220;Pretty much, I suppose, yes.&#8221;</p>
<p>&#8220;Well, I&#8217;m not saying those aren&#8217;t issues, but <em>I</em> see it more in terms of your anger towards yourself, and as far as these intimacy issues go, in terms of your inability to empathise with yourself.&#8221;</p>
<p>This was the end of the session, so I didn&#8217;t really get a chance to express my reaction to this hypothesis &#8211; I just sat there for the last minute or two reflecting upon what he had just said.  I&#8217;d never really considered things in that way before, but now that C had said it, it seemed absolutely blindingly obvious.  I mean &#8211; I think that some of the transferential reactions to him <strong>are </strong>related to others that are or have been (however tenuously) in my life &#8211; but yes, he&#8217;s the perfect way to punish and reject my own self without actually doing so, isn&#8217;t he?</p>
<p>Anyhow, again, I&#8217;ve made him sound like a twat in what I&#8217;ve written here, but really he wasn&#8217;t.  I felt that it was a productive, and co-operative session, and we parted on warm terms, with me advising him to get hold of some Lemsip.  I still wanted to mother him, you see.</p>
<p>[* Point of hilarity.  I originally mistyped this as nitro-glycerine.  Perhaps the week previous to this that would have been my preferred option!** <img src='http://serialinsomniac.com/wp-includes/images/smilies/icon_biggrin.gif' alt=':D' class='wp-smiley' /> ]<br />
[** That was a <strong>joke</strong>, GCHQ / MI5 / Big Brother / whatever other thought police may be reading this.]</p>
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		<title>How to Hurt Your Therapist&#8217;s Feelings (and Your Own) &#8211; C: Week 54</title>
		<link>http://serialinsomniac.com/2010/06/15/how-to-hurt-your-therapists-feelings-and-your-own-c-week-54/</link>
		<comments>http://serialinsomniac.com/2010/06/15/how-to-hurt-your-therapists-feelings-and-your-own-c-week-54/#comments</comments>
		<pubDate>Tue, 15 Jun 2010 21:51:24 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Moods]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[abandonment]]></category>
		<category><![CDATA[anger]]></category>
		<category><![CDATA[attachment]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[clinical depression]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[countertransference]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[defence mechanisms]]></category>
		<category><![CDATA[depression]]></category>
		<category><![CDATA[major depressive disorder]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[psychodynamic psychotherapy]]></category>
		<category><![CDATA[rejection]]></category>
		<category><![CDATA[retraumatisation]]></category>
		<category><![CDATA[sadness]]></category>
		<category><![CDATA[the NHS is shit]]></category>
		<category><![CDATA[therapeutic abandonment]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[transference]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1781</guid>
		<description><![CDATA[I was a complete bitch to C last week. I just sat there and insulted him for about half the session &#8211; perhaps more &#8211; and he didn&#8217;t really deserve any of it. It&#8217;s not his fault he has to abandon me at the end of the summer, and even though my rants weren&#8217;t necessarily <a href='http://serialinsomniac.com/2010/06/15/how-to-hurt-your-therapists-feelings-and-your-own-c-week-54/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>I was a complete bitch to C last week.  I just sat there and insulted him for about half the session &#8211; perhaps more &#8211; and he didn&#8217;t really deserve any of it.  It&#8217;s <a href="/2010/06/04/on-honesty-and-loss-and-taking-c-aback-week-52/">not</a> <strong>his</strong> fault he has to abandon me at the end of the summer, and even though my rants weren&#8217;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.</p>
<p>Admittedly, I went in in a bad mood to begin with.  I&#8217;d actually been in a <strong>good</strong> one hitherto, thanks to waking up to <a href="/2010/06/09/how-to-mechanistically-lose-friends-and-alienate-people-c-week-53/#comment-2970">this</a> lovely comment from <a href="http://www.mentallyinteresting.org.uk" target="_blank">Seaneen</a> (and one already made by <a href="http://carelessinthecommunity.blogspot.com" target="_blank">Nick</a>, to which I alluded at the end of that post).  I&#8217;m always thrilled when people compliment my writing; although the blog is still primarily for my own benefit&#8230;well, if it&#8217;s considered to be done well by others, then that&#8217;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&#8217;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&#8230;</p>
<p>I arrived at the hospital, and was <strong>outraged</strong> to see a car in &#8216;my&#8217; 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&#8217;m right in the middle relative to the front and back of the space.  And it has to be <strong>that</strong> space.</p>
<p>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 <strong>very <em>dare</em></strong> it steal <strong>my</strong> space?!!</p>
<p>(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&#8217;ve ever heard is playing, unless he&#8217;s with me).</p>
<p>So I had to take another space &#8211; one that actually brought me a good deal closer to C&#8217;s building &#8211; 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.</p>
<p>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 <strong>not exist </strong>at 9.20am.  He only starts existing at 9.30am when our appointments commence.</p>
<p>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&#8217;t have to encounter him outside session-time again.</p>
<p>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&#8217;s mere seconds beforehand?  There have been times when I&#8217;ve dreamt of bumping into him in a pub, a shop, I even half-hoped I&#8217;d see him at the recent Metallica <a href="/2010/05/12/the-reintegration-of-the-traumatised-self-c-week-50/">gig</a> at which we were both in attendance.  If that had actually happened, though, it would appear that I&#8217;d have gone completely doolally.  What the fuck is wrong with me?</p>
<p>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&#8217;s 50 minute doom.</p>
<p>It commenced in the usual silly way.  We acknowledged each other.  I even asked him how he was, something I haven&#8217;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.</p>
<p>And the silence continued.</p>
<p>And continued.</p>
<p>And continued.</p>
<p>Eventually, he said something along the lines of, &#8220;where would you like to begin?&#8221;, to which I responded with resigned laughter.</p>
<p>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.</p>
<p>I think he then said something to the effect that he wondered if we could use &#8216;the time remaining&#8217; to tackle some of the issues that were paramount in my mind.</p>
<p>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 &#8211; possibly for<em>ever</em>.</p>
<p>&#8220;But you&#8217;re trying to protect yourself, aren&#8217;t you?&#8221; he said.  &#8220;So you&#8217;re finding it difficult to communicate these things.&#8221;</p>
<p>Did I shrug at this?  I think I did.  Whatever the case, my response was non-committal.</p>
<p>&#8220;What about the sexual abuse..?&#8221; he asked tentatively, tailing off.</p>
<p>The mention of this most un-amusing of subjects somehow did amuse me &#8211; the very notion that I would discuss this <strong>more</strong> when I am being consigned to the dark recesses of rubbish bin of psychotherapy was tragically funny.  I eventually said, honestly but reluctantly, &#8220;I don&#8217;t think I&#8217;m going to talk about that anymore.&#8221;</p>
<p>It seemed &#8216;tragically funny&#8217; then, but it doesn&#8217;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 &#8211; a physical part, no less &#8211; 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 <strong>hurts</strong>.  It hurts.  So very, very much.</p>
<p>I have so much I want &#8211; <strong>need</strong> &#8211; 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&#8217;s point-blank rejection of me.  This proves it, surely.  <strong>Nobody</strong> wants to help me, or pay attention to me &#8211; they just want to reject me all over again, so everything that has gone before must have been deserved.</p>
<p>But enough childish, whinging navel-gazing.  The whole &#8216;I won&#8217;t discuss the sex abuse with you&#8217; led to the typical bullshit discussion about the end of therapy, the one I am perpetually desperate to avoid.  I can&#8217;t address it without fighting tears, and I don&#8217;t want to give C the satisfaction of seeing me cry over it.</p>
<p>Instead, I heard myself telling him how annoyed I had been when he <a href="/2010/06/09/how-to-mechanistically-lose-friends-and-alienate-people-c-week-53/">last week</a> accused me of saying (the week <a href="/2010/06/04/on-honesty-and-loss-and-taking-c-aback-week-52/">before</a> that) that the process coming to an end was &#8216;tragic&#8217;.  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.</p>
<p>&#8220;Tragic,&#8221; I declared, perhaps a little pompously, &#8220;denotes something <strong>big</strong>.  The Cumbrian shootings were <em>tragic</em>.  The 2004 tsunami was <em>tragic</em>.  The end of a relationship between two people &#8211; out of over <strong>six billion</strong> people on this planet &#8211; is <em>not</em> tragic.&#8221;</p>
<p>&#8220;I looked in my notes after you left last week,&#8221; he replied.  &#8220;They said you said it was &#8216;sad&#8217;.&#8221;</p>
<p>&#8220;Sad!  Yes, I said it was &#8216;sad&#8217; alright.  I did not say that it was &#8216;tragic&#8217;.  Do admit that I did not say it was &#8216;tragic&#8217;?&#8221;</p>
<p>&#8220;I suppose so..,&#8221; he replied, apparently rather bewildered at my passion over this almost meaningless semantic issue.  &#8220;You seem to have an air of triumphalism in that, though, and I&#8217;m wondering why it&#8217;s such a big deal to you?&#8221;</p>
<p>Triumphalism.  I had accused him of the same here in my write-up of last week&#8217;s session, so rather than help him explore his question, I told him so.</p>
<p>Why did I say that, readers?  Why?!  I accepted myself that I was probably over-reacting to the supposedly &#8216;triumphant&#8217; comment, so why did I have to insult him by telling him of my paranoid thinking?</p>
<p>He looked quite dutifully stunned, and then I think I stated on the &#8216;mechanistic&#8217; comment he had made.</p>
<p>&#8220;I&#8217;m grateful to you for saying that,&#8221; I started, smiling, &#8220;because it led to one of the greatest compliments I&#8217;ve yet received about my blog; someone [Nick, referenced above] said that that proved you&#8217;d not seen my blog, because apparently no one could say that about my writing.&#8221;  Carried away by this train of thought, I also started wittering on about Seaneen&#8217;s comment, and several others I have received from a surprising number of you lovely people.</p>
<p>C sat there looking at me in utter bafflement.  I could almost see the cogs of <em>what the fuck?</em> turning inside his mind.</p>
<p>Eventually he stopped my narcissistic rambling.   &#8220;So, you&#8217;ve been hugely complimented about your blog,&#8221; he iterated.  &#8220;You&#8217;ve met nice people through it.  Unlike this big, bad, nasty therapist&#8230;&#8221;</p>
<p>To be honest I&#8217;m not sure I realised just how vituperative I had been at that stage.  To his continued surprise, I told him that I had &#8220;not been having a go at [him].&#8221;</p>
<p>I watched his face carefully.  He looked&#8230;I dunno, &#8216;wounded&#8217;?  &#8216;Torn up&#8217;?&#8230;and I suddenly felt guilt and self-disgust surge through my veins.</p>
<p>&#8220;You&#8217;re insulted now,&#8221; I murmured, lowering my eyes regretfully.  &#8220;That <strong>really</strong> wasn&#8217;t my intention.&#8221;  And it hadn&#8217;t been.  I still don&#8217;t know why The Bitch came out to play with such intensity.</p>
<p>He didn&#8217;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 &#8211; whether or not it was directed specifically at him, it was <strong>coming out</strong> 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&#8217;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.</p>
<p>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.</p>
<p>&#8220;Where has your mind wondered to?&#8221; C&#8217;s voice finally asked, breaking into my distracted consciousness.</p>
<p>I &#8216;came to&#8217;, and told him about the dancing shadow-shapes.  He raised an eyebrow curiously but said nothing.</p>
<p>Another silence briefly ensued, which I eventually broke by blurting out, &#8220;I want to see the notes you hold on me.  Can you just <strong>give</strong> me them, or do I have to apply in writing?&#8221;</p>
<p>He hadn&#8217;t been expecting this, and was visibly surprised by the revelation.  He admitted that he didn&#8217;t know the procedure, but said that he would consult the Head of Department and advise me accordingly at our next meeting.</p>
<p>Inevitably, of course, he wanted to know <strong>why</strong> I want my notes.  Was it simple curiosity?</p>
<p>I said that it was, and advised that I would not just be asking for <strong>his</strong> notes, but also NewVCB&#8217;s and my GP&#8217;s.</p>
<p>&#8220;I think I&#8217;ll request my GP&#8217;s since I was about 12,&#8221; I mused thoughtfully.  &#8220;You know, just before I became properly ill.&#8221;</p>
<p>Then I chuckled slightly, and added, &#8220;yes, 14 <strong>years</strong> of notes.  That&#8217;ll <strong>really</strong> piss them off!&#8221;</p>
<p>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 &#8211; 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.</p>
<p>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&#8217;s both incidental and innocent; I take such sadistic pleasure out of <strong>any</strong> such situation, and it has nothing to do with winding the Trust and its employees up.  For example, when W &#8211; who lives in England &#8211; 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&#8217;s just a silly character trait, and I wish C wouldn&#8217;t overreact like this.</p>
<p>I became sick of his whinging about this, so said, &#8220;look.  I know you&#8217;re trained to read a lot into every single little thing I bring into this room &#8211; I get that, I do.  But I <strong>swear</strong> to you; my primary motivation is <strong>not</strong> to piss the health service off.  I just want to know what my notes say.  OK?&#8221;</p>
<p>I&#8217;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.</p>
<p>Another brief silence came and went.  I don&#8217;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.</p>
<p>I had been with Lovely GP the day before, hoping that he would act as an advocate against the Trust&#8217;s intentions to end my therapy as he had said to my mother he <a href="/2010/05/12/the-reintegration-of-the-traumatised-self-c-week-50/">would</a>.  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 &#8211; and my affirmation that he had &#8211; LGP went on anyway to suggest I saw the <a href="http://www.nexusinstitute.org/" target="_blank">Nexus Institute</a>.  He made no further reference to &#8216;making a phonecall&#8217; 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.</p>
<p>Anyhow, I told C about LGP&#8217;s suggestion, but then sighed.  &#8220;I fully respect what they do,&#8221; I told him, &#8220;but regardless of that I have, by association, a long-held negative view of them, even though it isn&#8217;t their fault.&#8221;</p>
<p>I explained how, when I had seen a therapy assessment <a href="/2009/09/02/a-half-life-in-therapy-the-fabled-post-of-therapists/">woman</a> (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 &#8211; &#8220;nay,&#8221; I corrected myself, &#8220;<strong>contempt</strong>&#8221; &#8211; apparently having been considered as an angsty teenager with no legitimate mental health concerns.</p>
<p>&#8220;I made the most oblique of references to having some experience of sexual abuse,&#8221; I went on, &#8220;and she immediately threw Nexus&#8217; number in my face and all but demanded I get out of her office and stop wasting her time.&#8221;</p>
<p>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&#8217;s palpable antipathy towards me.  I didn&#8217;t deserve that.</p>
<p>C proceeded to make some comment about how I&#8217;m perpetually derisive of myself.  &#8220;You often sit over there and say that your wasting my time, or that you should just &#8216;pull yourself together&#8217; and whatnot.  You feel that you were treated badly by that woman, but yet you say these same things about yourself.&#8221;</p>
<p>Hmm.  I bollocked around this for a bit, claiming that most of my &#8216;time-wasting&#8217; self-castigations related to times when I sat in C&#8217;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&#8217;t really matter, that they were still nonetheless very real <strong>to me</strong>.  &#8220;In the midst of my self-hatred, I just lose sight of that sometimes,&#8221; I admitted.</p>
<p>We continued talking about future therapy, and I asked him if he&#8217;d have any recommendations for private therapists.  He responded in the affirmative, stating that they would, however, be primarily be from the analytic school.</p>
<p>&#8220;Good,&#8221; I responded.  &#8220;That&#8217;s what I&#8217;m looking for.&#8221;</p>
<p>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.</p>
<p>&#8220;Bear in mind,&#8221; C cautioned, &#8220;that these people are more likely to lean towards traditional analysis.&#8221;</p>
<p>&#8220;What, like I lie on the couch and babble endlessly, and they never open their mouths?&#8221; I checked.</p>
<p>&#8220;Hmm&#8230;well, any therapist you meet will try his or her best to tailor the therapy towards what&#8217;s best for you as an individual, so not necessarily &#8211; but still, I reckon you can expect them to be less interactive than you&#8217;re used to here.  What exactly <strong>are </strong> you looking for?&#8221; he queried.</p>
<p>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 <strong>am</strong> very well informed.</p>
<p>&#8220;Analysis-ish,&#8221; I replied.  &#8220;I like your integrative approach.  Psychodynamic, but sufficiently bending the rules of that persuasion so as things suit <strong>me</strong>.  I like that you actually <strong>respond</strong>.  I don&#8217;t think I&#8217;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&#8217;t think that CBT or DBT or things like them are <strong>remotely</strong> helpful practices, except possibly in the hands of <strong>exceptionally</strong> skilled practitioners.&#8221;</p>
<p>&#8220;I think that issue is key,&#8221; C stated.  &#8220;As you&#8217;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 <strong>type</strong> of therapy specifically.&#8221;</p>
<p>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 &#8211; after all these horrible, painful years &#8211; 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 &#8211; for we do <strong>have</strong> a connection &#8211; 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&#8217;s health or well-being.  Fuck the health service!  What is the point of it being a &#8216;health service&#8217; when it prioritises statistics over its patients?</p>
<p>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 &#8216;fighting&#8217; my feelings of sadness/grief/abandonment/rejection/etc.</p>
<p>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&#8217;s worth, I suppose I do see, objectively speaking, what he&#8217;s trying to achieve, and no &#8211; it&#8217;s not <strong>really</strong> about his ego.  But I can&#8217;t bear it, however much I intellectualise it now).</p>
<p>I sensed that the session was nearing its end, so decided I could get away with answering this rather than redirecting it.  He wouldn&#8217;t have enough time to probe me further.</p>
<p>&#8220;Yes, OK, I admit it &#8211; I admit it freely &#8211; of <strong>course</strong> it makes me feel sad.  How could it not?  I don&#8217;t like it and I don&#8217;t want it.  I don&#8217;t want it to end, not at this juncture.  Yes, I&#8217;m sad and yes, it hurts.  But I&#8217;ve sat here and insulted you in copious measure this morning so I don&#8217;t suppose that sense of regret is always entirely evident, is it?&#8221;</p>
<p>Of course, armchair-psychologist-Me realises that sitting there insulting him in copious measure that morning made it all the <strong>more</strong> evident, but I wasn&#8217;t feeling at my most intellectual at the time.</p>
<p>&#8220;I don&#8217;t feel insulted,&#8221; he reassured.  &#8220;Things were rather adversarial for the first 30 or 40 minutes, I think, but no &#8211; I don&#8217;t feel insulted.&#8221;</p>
<p>&#8220;&#8216;Adversarial&#8217;,&#8221; I repeated wistfully.  &#8220;[<em>submissively</em>] I&#8217;m sorry, C.  I was in a bad mood when I came in here.  Someone parked in my parking space.&#8221;  I threw him a weak smile at that, which thankfully he returned.</p>
<p>One thing I deliberately kept from him during these whole shenanigans was the fact that I had finally posted the <a href="/2010/05/27/revised-letter-to-mr-director-person/">most recent letter</a> to Mr Director-Person the day before (it didn&#8217;t go <strong>exactly</strong> 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 &#8211; however good they may generally be &#8211; are under-qualified to deal with something quite so complex.</p>
<p>I don&#8217;t know why I didn&#8217;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 <a href="/2010/03/11/latest-letter-to-the-trust-with-a-giant-helping-of-screw-you/">respond</a> to Mr Director-Person&#8217;s <a href="/2010/03/04/hilariously-and-predictably-shite-response-letter-from-the-trust/">first</a> 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&#8217;re approaching that point now.</p>
<p>I just wish part of me didn&#8217;t seem so hell-bent on offending C before we get there.  He may claim he wasn&#8217;t insulted &#8211; but I&#8217;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&#8217;s rather fond of me (as I am of him), and listening to a constant barrage of criticism from someone you <strong>hate</strong> is hard enough, nevermind when it&#8217;s from someone you don&#8217;t mind.  It&#8217;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.</p>
<p>Maybe I&#8217;ll even allow him to see some <strong>real</strong> vulnerability.</p>


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		<title>How to Mechanistically Lose Friends and Alienate People &#8211; C: Week 53</title>
		<link>http://serialinsomniac.com/2010/06/09/how-to-mechanistically-lose-friends-and-alienate-people-c-week-53/</link>
		<comments>http://serialinsomniac.com/2010/06/09/how-to-mechanistically-lose-friends-and-alienate-people-c-week-53/#comments</comments>
		<pubDate>Wed, 09 Jun 2010 21:59:48 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[amusing]]></category>
		<category><![CDATA[bemusing]]></category>
		<category><![CDATA[bipolar disorder]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[child sex abuse]]></category>
		<category><![CDATA[child sexual abuse]]></category>
		<category><![CDATA[clinical depression]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[conflict]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[depression]]></category>
		<category><![CDATA[major depressive disorder]]></category>
		<category><![CDATA[mechanistic]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[paedophilia]]></category>
		<category><![CDATA[psychodynamic psychotherapy]]></category>
		<category><![CDATA[rape]]></category>
		<category><![CDATA[social anxiety]]></category>
		<category><![CDATA[the NHS is shit]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[trauma]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1750</guid>
		<description><![CDATA[I suppose I was in a strange mood last Thursday morning. What has been the case of late is that I don&#8217;t sleep well on Wednesday nights &#8211; ooh, surprise sur-bloody-prise &#8211; so when I arise the next morning, I pour an overdose of caffeine into my bloodstream, in the form of both coffee and <a href='http://serialinsomniac.com/2010/06/09/how-to-mechanistically-lose-friends-and-alienate-people-c-week-53/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p style="text-align: justify;">I suppose I was in a strange mood last Thursday morning.  What has been the case of late is that I don&#8217;t sleep well on Wednesday nights &#8211; ooh, surprise sur-bloody-prise &#8211; 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&#8217;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&#8217;ve stretched this far enough/whatever.</p>
<p style="text-align: justify;">So off I went to C, in this sort of weird, caffeine-induced disposition of much oddness.  I wouldn&#8217;t call it hypomania exactly; I wasn&#8217;t in the throes of overwhelming, deliriously beautiful ecstasy, nor anything much approaching it.  It was a bizarre cross of, perhaps, <strong>minor</strong> hypomania, wry- and snideness, let&#8217;s-play-games-with-C-ness and mini-fuck-you-ness.  Is there a word for that?  I don&#8217;t know.  I can&#8217;t think of it.  So let&#8217;s stick with &#8216;wry&#8217;.</p>
<p style="text-align: justify;">Initially, this &#8216;wryness&#8217; didn&#8217;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.  <em>I</em> don&#8217;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 <strong>is</strong> the decorum in this circumstance?  You&#8217;d think after knowing C for over a year that I might&#8217;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, &#8220;Hi C!  Let&#8217;s talk about the day when I was six when my uncle stuck his cock in my mouth!&#8221; is not something that seems to flow naturally after an initial greeting.</p>
<p style="text-align: justify;">Eventually the silence led to a desultory conversation on how bizarre it is to simply &#8220;switch on&#8221; for 50 minutes a week.  I&#8217;ve probably done this to death, but seriously &#8211; what an intrinsically false, freakish sort of social situation therapy really is.  It&#8217;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.</p>
<p style="text-align: justify;">In order to kickstart me, I presume, C eventually asked had anything much happened since our <a href="/2010/06/04/on-honesty-and-loss-and-taking-c-aback-week-52/">last session</a>.  In a sense, it had; the meeting with NewVCB the <a href="/2010/06/05/paedo-venlafaxine-and-suicide/">preceding day</a> 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 &#8216;kickstart&#8217; mechanism swung into gear, and I confessed to him that NewVCB had essentially forbidden me from seeing Paedo.</p>
<p style="text-align: justify;">&#8220;Forbidden..?!&#8221; 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.</p>
<p style="text-align: justify;">&#8220;Well, it certainly <strong>sounded</strong> like it,&#8221; I said, slightly defiantly.  &#8220;She shook her head vigourously at the suggestion and said that I &#8216;can&#8217;t&#8217; see him because it would be &#8216;damaging&#8217;.&#8221;  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 <strong>despise</strong> 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.</p>
<p style="text-align: justify;">Anyway, he then asked <strong>why</strong> it was likely that I would see Paedo anyway.  I sneeringly pointed out that Paedo is my &#8216;closest&#8217; uncle, a fact of which he is well aware.</p>
<p style="text-align: justify;">Pre-empting any response to this, I continued by advising C that my mother had been desirous of a visitation to Paedo and Maisie&#8217;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.</p>
<p style="text-align: justify;">&#8220;How did this proposition [ie. visiting their house] make you feel?&#8221; C asked.</p>
<p style="text-align: justify;">I um-ed and ah-ed a little; the truth was that I had actually taken with me a print-out of <a href="/2010/06/01/how-will-i-ever-deal-with-paedo-again/">this post</a> 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 <strong>wrong</strong>.  This is something I&#8217;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&#8217;s almost as if I am two different people these days (and please no DID references &#8211; I&#8217;ve dealt with <a href="/2010/06/02/the-three-scariest-letters-in-the-english-language-c-week-51/">too many</a> recently already!).  I have this identity &#8211; Pandora, the writer, the online persona, the primary mentalist &#8216;Me&#8217; on Twitter and Fuckbook &#8211; and then you have the &#8216;real&#8217; 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.</p>
<p style="text-align: justify;">I told him so.  &#8220;If I read this to you, it&#8217;s really like these two worlds &#8211; these twains that are never meant to meet &#8211; are colliding.  It&#8217;s making me feel deeply uncomfortable.&#8221;</p>
<p style="text-align: justify;">He stared at me unhelpfully.  In fairness, I don&#8217;t suppose it is possible that he can empathise with something of this nature.</p>
<p style="text-align: justify;">&#8220;Well, should I read it or not?&#8221; I finally asked, slightly irritably.</p>
<p style="text-align: justify;">He shrugged.  &#8220;I suppose you have it here, the words are already articulated, so&#8230;&#8221;</p>
<p style="text-align: justify;">I mulled it over again for a minute or two then took a deep breath and went ahead and read the thing.</p>
<p style="text-align: justify;">I don&#8217;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).</p>
<p style="text-align: justify;">&#8220;I hate their tactility, their enthusiasm for non-sensical feminine pursuits,&#8221; I spat.  &#8220;I hate their constant emotional outbursts, whether those are positive or negative.  They make me sick.&#8221;  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 &#8211; Maisie and Paedo came to stay at Mum&#8217;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 &#8211; but what good was bawling my eyes out going to do?  And even if it <strong>did</strong> serve some purpose, what in the living fuck would be the point of demonstrating my capacity for tears and sadness to others?!</p>
<p style="text-align: justify;">&#8220;So&#8230;&#8221; C began, when I had finally concluded my little anecdote.  &#8220;It is because of the <strong>women</strong>, rather than your uncle, that you don&#8217;t want to go to {Hotel California}?&#8221;</p>
<p style="text-align: justify;">&#8220;No.  Well, yes.  But&#8230;well, it&#8217;s <strong>both</strong>, isn&#8217;t &#8216;both&#8217; allowed?  And yet&#8230;and yet&#8230;hmm.&#8221;  I left the sentence trailing in mid-air, pregnant with a palpable desire to be completed.</p>
<p style="text-align: justify;">He subtly (but obviously, if you understand) probed me to finish what I had started.</p>
<p style="text-align: justify;">&#8220;And yet&#8230;&#8221; I eventually went on, &#8220;&#8230;well, part of me doesn&#8217;t <strong>not</strong> want to go.  Not entirely anyway.&#8221;</p>
<p style="text-align: justify;">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.</p>
<p style="text-align: justify;">&#8220;Why&#8217;s that?&#8221; he inevitably asked me.</p>
<p style="text-align: justify;">&#8220;Because&#8230;because&#8230;[almost whispering] because of the children&#8230;&#8221;</p>
<p style="text-align: justify;">This instantaneously led to the launch of yet another self-directed vituperation of epic proportions.</p>
<p style="text-align: justify;">&#8220;I <strong>hate</strong> children,&#8221; I shrieked, &#8220;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 <strong>these</strong> ones?&#8221;</p>
<p style="text-align: justify;">&#8220;You&#8217;re angry with yourself for expressing an emotion,&#8221; C claimed.</p>
<p style="text-align: justify;">&#8220;No I&#8217;m not,&#8221; I protested, genuinely I think.  &#8220;I&#8217;m angry with myself because I&#8217;ve just betrayed everything I&#8217;ve ever felt about this particular demographic.&#8221;</p>
<p style="text-align: justify;">&#8220;I actually don&#8217;t think you have,&#8221; he said rather definitely.  &#8220;You&#8217;ve not necessarily reviewed your attitude to children, even though I know you&#8217;re&#8230;um&#8230;not un-fond [wry glance at me] of {Marcus}.  You&#8217;ve consistently told me of your worries that {Paedo} would harm {Marcus} and now his younger brother.  I think that concern &#8211; that fear of harm coming to either or both of them &#8211; drives this.&#8221;</p>
<p style="text-align: justify;">&#8220;Maybe.  But what difference would my presence make anyway?&#8221;</p>
<p style="text-align: justify;">He eyed me suspiciously.</p>
<p style="text-align: justify;">&#8220;OK, C.  What&#8217;s that look for?&#8221; I asked dryly.</p>
<p style="text-align: justify;">&#8220;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.&#8221;</p>
<p style="text-align: justify;">We considered that in silence for a few minutes.</p>
<p style="text-align: justify;">Then, &#8220;Fuck it, no!  I <strong>don&#8217;t</strong> want to go to the fucking bastardhole and the children aren&#8217;t really at risk and I don&#8217;t want to have them yapping around my fucking ankles.&#8221;</p>
<p style="text-align: justify;">To my astonishment, a broad grin grew across his face.  He didn&#8217;t even bother trying to hide it; in fact, to my considerable perplexity, he started to laugh.</p>
<p style="text-align: justify;">I gawped at him in confused disgust.  &#8220;What could you <strong>possibly</strong> find funny about this?&#8221; I asked through gritted teeth.</p>
<p style="text-align: justify;">&#8220;Your direct contradiction of yourself,&#8221; he replied, still seemingly amused.  &#8220;A minute ago, &#8216;I want to see the children&#8217;&#8230;now, &#8216;sod the children, sod the entire place&#8217;.&#8221;</p>
<p style="text-align: justify;">&#8220;I didn&#8217;t say I <strong>wanted</strong> to see the children.  I said that I didn&#8217;t not <em>want to go</em>.  Different!&#8221;</p>
<p style="text-align: justify;">With the smile still smugly etched across his face, he raised his eyebrows cynically at me.</p>
<p style="text-align: justify;">I didn&#8217;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 &#8216;Ways to Avoid Hotel California&#8217;.</p>
<p style="text-align: justify;">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.</p>
<p style="text-align: justify;">&#8220;I know your mother doesn&#8217;t believe you,&#8221; he said, &#8220;but could you say to her that there are&#8230;issues with your uncle?&#8221;</p>
<p style="text-align: justify;">&#8220;No.&#8221;</p>
<p style="text-align: justify;">&#8220;Why not?&#8221;</p>
<p style="text-align: justify;">&#8220;Because she&#8217;d ask what they are, of course!&#8221;</p>
<p style="text-align: justify;">&#8220;How much did you tell her about what he did to you?&#8221;</p>
<p style="text-align: justify;">&#8220;When I was about 14, I told her about some of the more &#8216;minor&#8217; stuff &#8211; [uncomfortably] the touching, you know.  More recently, I told her that he raped me, though I only told her of one such incident.&#8221;</p>
<p style="text-align: justify;">&#8220;Sorry, when did you tell her that?&#8221;</p>
<p style="text-align: justify;">I thought about it for a minute, and concluded that (as it was about the time I saw <a href="/2009/09/02/a-half-life-in-therapy-the-fabled-post-of-therapists/">Edith</a>, the hypnotherapist) it must have been in my earlier 20s.</p>
<p style="text-align: justify;">&#8220;Still several years ago, then,&#8221; noted Dr Mathematical Genius.</p>
<p style="text-align: justify;">&#8220;Yes.  What&#8217;s your point?&#8221;</p>
<p style="text-align: justify;">&#8220;I&#8217;m wondering,&#8221; he said, &#8220;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 &#8216;rape&#8217; or &#8216;sexual abuse&#8217;, but something like, &#8216;A few years ago, I told you some of what this man did to me.  I know you don&#8217;t believe me, but nevertheless I cannot see him at this time.&#8217;  Something like that?&#8221;</p>
<p style="text-align: justify;">Again: &#8220;No.&#8221;</p>
<p style="text-align: justify;">Again: &#8220;Why not?&#8221;</p>
<p style="text-align: justify;">&#8220;She didn&#8217;t believe me then, she won&#8217;t believe me now.  So it&#8217;ll only lead to conflict, and I don&#8217;t like conflict.&#8221;</p>
<p style="text-align: justify;">He once again took me aback when he said, &#8220;but you so often seem to find yourself in it, don&#8217;t you?&#8221;</p>
<p style="text-align: justify;">Cheeky fucking cunt.  I demanded that he exemplify.</p>
<p style="text-align: justify;">Unfortunately that was not a difficult ask of him.  &#8220;Well,&#8221; he said, slowly and deliberately.  &#8220;With <a href="/category/work/">work</a>.  With <a href="/series/the-mr-director-person-letters//series/the-mr-director-person-letters/">the Trust</a>.  [Dramatic pause]  With <strong>me</strong>.&#8221;</p>
<p style="text-align: justify;">I defended myself vehemently regarding the Trust.  <strong>They</strong> are the ones at fault here &#8211; they are the ones that have <strong>always</strong> been at fault, pushing me from pillar to post to nowhere back to pillar back to post back to nowhere and so on &#8211; 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 &#8211; who fucking <strong>encouraged</strong> me to speak up in the <a href="/2010/01/06/flogging-a-dead-horse-with-c-week-35/">first place</a> &#8211; now wanks on about how I invite conflict.  Tosser.</p>
<p style="text-align: justify;">&#8220;Of course, it will not have escaped your notice that my &#8216;<em>conflict</em>&#8216; [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 <strong>met</strong> 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&#8217;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 &#8211; all very <strong>conscripted </strong>and hence ultimately pointless.  But that is no more, C.  Surely that is good.&#8221;</p>
<p style="text-align: justify;">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.</p>
<p style="text-align: justify;">&#8220;OK,&#8221; he began again eventually.  &#8220;So it&#8217;s interpersonal relationships in which you avoid conflict&#8230;with some exceptions, where you feel comfortable.&#8221;</p>
<p style="text-align: justify;">&#8220;In essence.&#8221;</p>
<p style="text-align: justify;">&#8220;You become panicky when conflict arises when you&#8217;re not completely comfortable with the person.  Emotional, even.&#8221;</p>
<p style="text-align: justify;">&#8220;Um&#8230;&#8217;panicky&#8217; worked perfectly well on its own,&#8221; I corrected him, with a slight knowing grin.</p>
<p style="text-align: justify;">He smiled in return.  <strong>This</strong> interpersonal conflict was over.  For now.</p>
<p style="text-align: justify;">&#8220;But seriously though,&#8221; he persisted, eventually.  &#8220;You try to deny any <strong>hint</strong> of emotion in yourself, but that&#8217;s just not true.  Yes, you have this rational, intellectual, assertive side, but that&#8217;s not all there is to it.&#8221;</p>
<p style="text-align: justify;">&#8220;But there is no <strong>function</strong> of this emotional bullshit.  It doesn&#8217;t <strong>do </strong>anything, does it?  It&#8217;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 &#8211; these things can get results, they can <strong>achieve</strong> things.  <em>Emotion</em> doesn&#8217;t do that.  Not unless you&#8217;re an actor, I suppose&#8230;&#8221;</p>
<p style="text-align: justify;">&#8220;You think you&#8217;re a &#8216;whiny, middle-aged woman&#8217;?&#8221; he laughed, slightly cynically.</p>
<p style="text-align: justify;">I smiled apologetically.  &#8220;Perhaps that was over the top.  You know what I mean, though.  I just don&#8217;t want a part of that.&#8221;</p>
<p style="text-align: justify;">He said, &#8220;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&#8217;re not big, bad things to be brushed under the carpet.  That leads to alienation, and further difficulties in one&#8217;s life.  This is still one of your biggest issues, Pandora.  You fight so hard to suppress how you&#8217;re feeling, and the thing is you <strong>need </strong>to feel it &#8211; and you need to <strong>express</strong> it.&#8221;</p>
<p style="text-align: justify;">I shuddered.  &#8220;But the thing is it doesn&#8217;t fulfil anything&#8230;&#8221; I started again, rather repetitively.</p>
<p style="text-align: justify;">He interrupted me mid-sentence with possibly my favourite line from the whole 53 weeks (2,650 minutes &#8211; 2,680 if you consider the time a few sessions have run over &#8211; 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, &#8220;everything with you has to be so&#8230;<em>mechanistic</em>.&#8221;</p>
<p style="text-align: justify;">I was overcome with joy and amusement.  What an absolutely fabulous way to be described.  Mechanistic.  <em>Mechanistic</em>.  I <strong>love</strong> it!</p>
<p style="text-align: justify;">(I&#8217;m not sure it was meant to be a compliment, but still &#8211; I thought it was spectacular.  Just wonderful.).</p>
<p style="text-align: justify;">I laughed heartily as he attempted to continue.  &#8220;Yes, mechanistic,&#8221; he went on, pretending to ignore my laughter.  &#8220;It&#8217;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.&#8221;</p>
<p style="text-align: justify;">&#8220;Well&#8230;I sort of do,&#8221; I responded, still laughing.</p>
<p style="text-align: justify;">&#8220;But isn&#8217;t there another way of looking at it?&#8221; he pressed.  Gah!!!  It really pisses me off when C asks this eternally fuckwitted question.  There&#8217;s another way of looking at <strong>everything</strong>, for fuck&#8217;s sake; there&#8217;s nearly seven billion people on this planet, how could there <strong>not</strong> be?!  It doesn&#8217;t mean that is, or can ever be, my view.  Stick you pathetic attempts at pathetic CBT right up your pathetic, boney arse, C.</p>
<p style="text-align: justify;">So I responded by saying that there wasn&#8217;t, not from my personal perspective anyhow, which curiously seemed to prompt him to go on the offensive.</p>
<p style="text-align: justify;">He said, almost challengingly, &#8220;well, you were emotional here <a href="/2010/06/04/on-honesty-and-loss-and-taking-c-aback-week-52/">last week</a>.&#8221;</p>
<p style="text-align: justify;">True.  I shrugged, reluctantly.</p>
<p style="text-align: justify;">&#8220;In fact,&#8221; he continued, with a slight air of triumphalism I thought (though I am quite possibly reading too much into it), &#8220;you confessed about the sense of loss you feel about this therapy ending. [<em>Avoid his gaze, Pan, avoid it at all costs!</em>]  You said it was &#8216;tragic&#8217;.&#8221;</p>
<p style="text-align: justify;">&#8220;I did <strong>not</strong>!&#8221; I exclaimed, horrified he had got it into his head that it was <strong>that</strong> big a deal to me.  (It <strong>is</strong>, but I don&#8217;t want <strong>him</strong> to know that!).  &#8220;What I <strong>actually</strong> 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 &#8211; but your recollection is not completely accurate.&#8221;</p>
<p style="text-align: justify;">He looked me straight in the eye and said, &#8220;Well, I think it is.  [Fucker].  But why is that admission &#8216;very bad indeed&#8217;?&#8221;</p>
<p style="text-align: justify;">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 <strong>not</strong> permissible.  No.  No way.</p>
<p style="text-align: justify;">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 &#8220;the session is over&#8221; mantra was intoned.</p>
<p style="text-align: justify;">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 &#8216;wryness&#8217;, I was still amused by the quite brilliant &#8216;mechanistic&#8217; remark.  A week later, I continue to be.</p>
<p style="text-align: justify;">However, paradoxically, an &#8216;anti-mechanistic&#8217; comment also gave me great pleasure this week.  <a href="http://carelessinthecommunity.blogspot.com/" target="_blank">Nick Hewling</a>, reading on Facebook that C had levied this particular accusation at me&#8217;, said, &#8220;that&#8217;s proof that he hasn&#8217;t read your blog.  No one could say that about your writing.&#8221;</p>
<p style="text-align: justify;">*blushes*  Thank you, Nick.  Thank you with mechanistic bells on top.</p>


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		<title>On Honesty and Loss&#8230;and Taking C Aback &#8211; Week 52</title>
		<link>http://serialinsomniac.com/2010/06/04/on-honesty-and-loss-and-taking-c-aback-week-52/</link>
		<comments>http://serialinsomniac.com/2010/06/04/on-honesty-and-loss-and-taking-c-aback-week-52/#comments</comments>
		<pubDate>Fri, 04 Jun 2010 01:02:09 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Fighting with the NHS]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[abandonment]]></category>
		<category><![CDATA[anger]]></category>
		<category><![CDATA[attachment]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[countertransference]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[ending therapy]]></category>
		<category><![CDATA[loss]]></category>
		<category><![CDATA[mental health services]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[paedophilia]]></category>
		<category><![CDATA[retraumatisation]]></category>
		<category><![CDATA[sadness]]></category>
		<category><![CDATA[the NHS is shit]]></category>
		<category><![CDATA[therapeutic abandonment]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[transference]]></category>
		<category><![CDATA[trauma]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1699</guid>
		<description><![CDATA[Last Thursday&#8217;s session with C was the first one after the whole, &#8216;fuck it, I&#8217;m quitting therapy&#8217; 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 <a href='http://serialinsomniac.com/2010/06/04/on-honesty-and-loss-and-taking-c-aback-week-52/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>Last Thursday&#8217;s session with C was the first one after the whole, &#8216;fuck it, I&#8217;m quitting therapy&#8217; debacle of hilarious histrionics about which I wrote <a href="/2010/05/26/to-quit-or-not-to-quit-therapy-that-is-advice-required/">last Wednesday</a>.  I suppose my thoughts weighted in favour of leaving treatment at a time of <strong>my</strong> choosing were partly in light of the whole <a href="/2010/06/02/the-three-scariest-letters-in-the-english-language-c-week-51/">DID discussion</a> 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 &#8211; but, in actuality, that only referred to 15 minutes at the beginning of the session.  What&#8217;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 <strong>nothing</strong> of those 50 minutes, largely as there was sod all <strong>worth</strong> reporting.  Therein lay &#8211; lies, to some extent &#8211; the <strong>real</strong> difficulty.  Nothing has been happening, on and off anyway, for <strong>weeks </strong>(take <a href="/2010/05/10/wasting-time-i-dont-have-c-week-49/">this</a> unmitigated bollocks, for example).  I am in lockdown.</p>
<p>Anyway, after the lively discussion in the <a href="/2010/05/26/to-quit-or-not-to-quit-therapy-that-is-advice-required/#comments">comments</a> section of the &#8216;To Quit or Not to Quit&#8217; 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 &#8211; what&#8217;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].</p>
<p>When I rather arrogantly arrived in the waiting room, which I have come to regard as my own exclusive, personal space, I was <strong>horrified</strong> to see another woman sitting there.  There is <strong>never</strong> anyone there.  A curiosity of the building &#8211; indeed, this specific corridor &#8211; 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 &#8216;other&#8217; 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 &#8216;Psychological Therapies&#8217;.</p>
<p>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&#8217;ve gotten used to it now, but for a number of weeks I found it strangely ethereal and disconcerting &#8211; the opposite, surely, of the kind of place in which people with mental health problems should find myself.  The phrase &#8220;as quiet as the grave&#8221; often comes to mind (perfect for suicidal types).  On the other hand, busy, noisy waiting rooms, such as NewVCB&#8217;s (which was also C&#8217;s way back at the start of our relationship) freak me out too.</p>
<p>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&#8217;d got my dates/days/times/life wrong, and that this person was one of C&#8217;s other non-existent patients, but when I asked her who she was seeing, it was indeed someone else.</p>
<p>Which led me to another silly internal dilemma.  I have <strong>never</strong> seen anyone from Psychology apart from C and his secretary.  The person who has the opposite office from C is some audiology person.  It&#8217;s like C is the <strong>entire department</strong>.  Or maybe he and his department exist in some alternative plane of dimension, who knows &#8211; 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.</p>
<p>OK, I&#8217;m babbling and infinitely regressing &#8211; the point was, it was bizarre to learn that there really <strong>are</strong> 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 &#8211; the mind is a funny thing.  Or at least it is when you are a nutjob.</p>
<p>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.</p>
<p>Point of note: my formerly dark hair (the photo on the right is&#8230;er&#8230;not accurate.  It <strong>is</strong> me, but it doesn&#8217;t really represent me.  Which is exactly why it&#8217;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.</p>
<p>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 <strong>stared</strong>.  Very good.  Very good indeed <img src='http://serialinsomniac.com/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' /> </p>
<p>I wished the other woman luck and followed C to the office.  I always hate walking past the secretary&#8217;s room.  She knows who I am and why I&#8217;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&#8217;s probably-uninterested knowledge in me freaks me out is beyond me.</p>
<p>Well over 900 words and the session hasn&#8217;t even begun.  That is surely a record even for me.</p>
<p>So.  I went in and sat down; he joined me and said, &#8220;you&#8217;ve dyed your hair.&#8221;</p>
<p>Readers, why &#8211; <strong><em>why</em><span style="font-weight: normal;"> &#8211; do people make such inane, asinine statements?  Why?!  I </span>know</strong> that I have dyed my hair, C &#8211; <strong><em>I</em><span style="font-weight: normal;"> dyed it (or in other cases, I allowed someone else to do so).  It wasn&#8217;t done when I was dissociated to fuck or anything &#8211; and even if it had been, might I not have noticed the change by now?  I mean, I&#8217;m not at all criticising him for commenting on the change &#8211; it was all but unavoidable &#8211; but the pointlessness of the actual statement he did offer both irritated and amused me.</span></strong></p>
<p><strong><span style="font-weight: normal;">&#8220;Um&#8230;</span>yes</strong>, I have&#8230;&#8221; I said slowly, as if speaking to a child, making a hand gesture intended to convey a <em>WTF?</em> sort of message</p>
<p>&#8220;It looks well,&#8221; he said, nodding slightly as if self-referentially agreeing.</p>
<p>&#8220;Thank you,&#8221; I responded.</p>
<p>Two weeks hitherto I would have dissected that small three-word statement of his to death with something along the lines of:</p>
<blockquote><p>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 <strong>allowed</strong> to say that?  Isn&#8217;t that treading into countertransferential territory that he should be having out with his supervisor?  Isn&#8217;t that dangerous&#8230;?  Does he&#8230;will he&#8230;what if..?</p>
<p>Blah blah blah</p>
<p>Yadda yadda yadda</p>
<p>La la la</p>
<p>Etc etc etc <em>ad infinitum</em></p></blockquote>
<p>The fact that I have written that at all, of course, suggests that I <strong>am</strong> 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 <strong>anyone</strong>.  That is not my default position around C <strong>at all</strong>, as you will probably be well aware.</p>
<p>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 <a href="/series/the-mr-director-person-letters/">Mr Director-Person</a>.</p>
<p>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&#8217;t know the answer to some of my questions, and about how if I were in his position and receiving his salary that I &#8220;would damn well know how to do my job.&#8221;</p>
<p>(Interesting aside &#8211; Detective Inspector Google advises me that Mr D-P does not have a background in mental health <strong>at all</strong>.  He comes from fucking management!  Well chosen, Trust&#8230;).</p>
<p>Anyhow, given Mr D-P&#8217;s closing statement in his <a href="/2010/05/26/latest-in-the-ongoing-me-v-nhs-saga-more-advice-needed/">latest letter</a> 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&#8217;t work, such members of the CMHT don&#8217;t seem &#8211; to me &#8211; to actually do an awful lot.  I know some of you disagree with that &#8211; it&#8217;s just my observations at this stage really.</p>
<p>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 <strong>instead</strong>, he said something like, &#8220;well, you see them at the CMHT, sometimes in your own home, and they support you.&#8221;</p>
<p>I laughed in his face.  He&#8217;d been expecting such a reaction, to be fair &#8211; it seems he&#8217;s not entirely sure what the rest of the CMHT do either.  I suppose I can understand that &#8211; back when I was still at work, I didn&#8217;t know what some staff in other departments did either.  At any rate, I don&#8217;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.</p>
<p>&#8220;Are they all women?&#8221; I asked.</p>
<p>&#8220;Well&#8230;about 90% are, yeah.&#8221;</p>
<p>&#8220;Oh no no no, that won&#8217;t work at all.  I don&#8217;t get on well with women at all.&#8221;  Pause.  &#8220;At least not <strong>here</strong>, not in the real world.  [Philosophically] If this <strong>is</strong> even the real world&#8230;&#8221;</p>
<p>It&#8217;s not just that I don&#8217;t get on with other women, aside from exchanging the time of day with them or whatever.  I&#8217;m actually moderately <strong>afraid</strong> of them.  I&#8217;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&#8217;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&#8217;ve met.  I don&#8217;t fear or not get on with any of these ladies &#8211; very much the opposite.  Well.  Who said I was anything other than a walking contradiction of abject strangeness?</p>
<p>During the anti-SW/CPN thread of conversation, I had thrown in a &#8220;that&#8217;s something else about which I must inform you,&#8221; in reference to my ending therapy proposition.  He picked up on that, and asked me what the &#8216;something else&#8217; was.</p>
<p>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&#8217;d done, and then shaking his hand and leaving.  Permanently.</p>
<p>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 <strong>more</strong> than that &#8211; 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&#8217;d seen before &#8211; the closest it had come to that previously was only about 15 minutes ago, when he&#8217;d been taken aback by my dramatic change in appearance.  &#8216;Taken aback&#8217; is too small a phrase for his behaviour this second time round, despite the post title.  He was <strong>stunned</strong>.  Absolutely astonished.</p>
<p>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&#8217;t.  I don&#8217;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.</p>
<p>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 &#8211; once again &#8211; entirely honest, and admitted that it was for logistical rather than therapeutic reasons.</p>
<p>&#8220;I am certain that as things stand that I will have to be re-referred for therapy in the future,&#8221; I told him.  &#8220;I don&#8217;t want the Trust to have ammunition against me &#8211; &#8216;oh, that one&#8217;s just a borderline, ignore her &#8211; she walked out last time she was in the system, so she can&#8217;t have any more treatment&#8221;.  I know that&#8217;s exactly what would happen and I can&#8217;t take that chance.  So you&#8217;re stuck with me for now.&#8221;</p>
<p>&#8220;We&#8217;re going to have to have a conversation on <strong>why</strong> you were even considering this,&#8221; he responded, not unreasonably.  &#8220;But in terms of actual practical matters, I don&#8217;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&#8217;d be perfectly eligible to have any future referral considered as normal, regardless of whether you previously left therapy by your own choosing.&#8221;</p>
<p>&#8220;For the avoidance of doubt,&#8221; I pressed, &#8220;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?&#8221;</p>
<p>&#8220;I really don&#8217;t think it would, no.&#8221;</p>
<p>&#8220;OK.&#8221;</p>
<p>And so began the &#8216;why?&#8217; conversation.  Preamble: I don&#8217;t remember all of this.  It was a week ago and it was a stressful topic to cover.</p>
<p>My first point was that if I was going to seek private psychotherapy when things with C end &#8211; and I am &#8211; that it would just be preferable to start to interview potential analysts/therapists <strong>now</strong>, rather than dither in the pointlessness that I expected to be the remaining time with C.</p>
<p>Why did I suppose said time would be pointless?</p>
<p>I told him that I thought therapy had been generally useless <strong>of late</strong>, 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.  &#8220;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&#8217;s a waste of your time and mine.  It&#8217;s not doing anything at the minute, except maintaining (or perhaps even worsening) my sense of re-traumatisation.&#8221;</p>
<p>For some reason, he raised his eyebrows and asked me if I felt re-traumatised &#8211; I would have thought the answer to that would have been quite obvious given things like <a href="/2010/04/15/acting-the-hidden-psychoses/">this</a> and <a href="/2010/04/19/death-of-sanity/">this</a>.</p>
<p>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.  &#8220;The most gifted therapist in the world cannot change this state of being in a couple of months,&#8221; I told him (an honestly held belief).  &#8220;I believe that it <strong>can</strong>, ultimately, be changed &#8211; but not in the timeframe you and I have remaining together.  So I think that, unconsciously, I&#8217;ve shut down and won&#8217;t talk about anything important, because I know that&#8217;s going to cause me much hurt, and there will in the end be no outlet for that pain.&#8221;</p>
<p>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&#8217;t want to cry.  I don&#8217;t want to cry because I fucking hate expressions of emotions, but moreover, I don&#8217;t want him to know of the strength of my feeling for him.  Why?  Because it&#8217;s so asymmetrical, so quintessentially patient-therapist, so un-returnable, so needy and pathetic.  It is A Very Bad Thing.</p>
<p>So for me to almost <strong>direct</strong> 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 <em>I</em> actually brought it there that was odd.</p>
<p>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.</p>
<p>&#8220;I&#8217;ve been in a difficult position,&#8221; he admitted.  &#8220;I&#8217;ve said to them [there's always An Enigmatic 'Them', isn't there?], &#8216;look, this person needs long-term psychotherapy,&#8217; but there&#8217;s always issues of targets, or of costs, or of whatever.  And we&#8217;re trained to mostly only provide short-term therapies.&#8221;</p>
<p>Oh.  So when you <a href="/2009/12/13/why-does-he-hate-me-c-week-34/">said</a> that curtailing things was <strong>your</strong> decision, and not the Trust&#8217;s, I was right in supposing that that was accurate in only the most <strong>technical</strong> of senses, was I?</p>
<p>Basically, yes.  Apparently, &#8220;I could have kept it under the radar.  They wouldn&#8217;t know how long I have been seeing you for, but I decided the end point on the grounds that I <strong>did</strong> declare how long we&#8217;d been seeing each other to them.&#8221;</p>
<p>Dun-dun-<strong>DUN</strong>!  I feckin&#8217; knew it.  I feckin&#8217;, feckin&#8217; knew it.  I resisted the urge to smile a smug smile.</p>
<p>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 &#8216;under the radar&#8217;?  Yes, of course it would.  But even <em>I</em> don&#8217;t expect him to all but <strong>lie</strong> for me.  If he gets in trouble, my continued psychotherapy is not exactly going to be assured.</p>
<p>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.</p>
<p>Time for me to be pathetic.  &#8220;No [looking meek and helpless].  I don&#8217;t&#8230;I don&#8217;t want you to feel bad.&#8221;</p>
<p>&#8216;Bad&#8217; and &#8216;nice&#8217; should be fucking banned from the English language, at least if you are above the age of nine.  Fuck&#8217;s sake.  How child-like and grotesquely piteous can one be?</p>
<p>He made some gesture of acceptance, but continued by saying, &#8220;but I think you&#8217;re very often angry with me &#8211; you blame me for the end of this, you&#8217;re angry about the way I sometimes speak to you, content shared between us can infuriate you.&#8221;</p>
<p>I denied this once again.  &#8220;You make t sound like I&#8217;m permanently angry with you, and I&#8217;m not,&#8221; I protested.  &#8220;Do I <strong>get</strong> angry with you?  Of course I do.  That&#8217;s to be expected in <strong>any</strong> interpersonal relationships, and I know there are times when I piss you off too.  But I don&#8217;t think there&#8217;s some big transferential thing here for you to hook on &#8211; it&#8217;s just normal, surely?&#8221;</p>
<p>He claimed that I was angry in that moment (which perhaps I was, I don&#8217;t remember) and I started ranting about being furious with the system, which I perpetually am.  If he wants  to examine a <strong>permanent</strong> anger, then it&#8217;s with The Enigmatic &#8216;Them&#8217;, not him.</p>
<p>I remember saying, &#8220;I just wonder how many people end up dead because of something like this.  People that <em>could have been helped</em>, 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&#8217;s tragic, C.  Tragic.&#8221;</p>
<p>My passionate, warrior-like micro-soliloquy was laden with what he would call emotion, and I got the usual, &#8220;you look like you want to cry&#8221; crap.</p>
<p>This perennial phrase of C&#8217;s pisses me off.  No, C, of course I do not <strong>want</strong> to cry.  I hate expressing these feelings, let&#8217;s not forget.  If I am looking or sounding tearful, then that is because it&#8217;s visceral and un-chosen.  Automatic.  Unavoidable.  I do not <em>want</em> it!  I know I&#8217;m playing a silly semantics game here, but it does piss me off.</p>
<p>I continued to try and fight against these Christ-forsaken tears, but I think that they probably won in the end.  I didn&#8217;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.</p>
<p>Whether it was solicited by him or not, I don&#8217;t recall, but I have some memory of, through these tears, admitting to the sense of loss &#8211; the sense of <strong>grief</strong> &#8211; 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.</p>
<p>And then&#8230;</p>
<p>&#8220;<em>We&#8217;re going to have to leave it there, Pandora</em>.&#8221;  At least he had the grace to sound apologetic.</p>
<p>One thing we briefly discussed in a housekeeping capacity was to continue things until &#8211; if memory serves me correctly &#8211; the start of September, rather than have a set number of weeks remaining.  He is taking two weeks&#8217; leave over the summer, and it will therefore work out at approximately the same number of sessions as he had previously offered, but I <strong>think</strong> I might be wrangling one or two extra out of it.  Very-tiny-win.  Maybe.</p>
<p>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&#8217;s very much still my view.  Still and withall, though, it&#8217;s hard to deny that a lot of my attempts to avoid the topic lie in the very obvious points that I simply don&#8217;t want, or feel unable, to ever be without him.</p>


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		<title>Revised Letter to Mr Director-Person</title>
		<link>http://serialinsomniac.com/2010/05/27/revised-letter-to-mr-director-person/</link>
		<comments>http://serialinsomniac.com/2010/05/27/revised-letter-to-mr-director-person/#comments</comments>
		<pubDate>Thu, 27 May 2010 15:07:22 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Fighting with the NHS]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[mental health]]></category>
		<category><![CDATA[mental health services]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[rant]]></category>
		<category><![CDATA[retraumatisation]]></category>
		<category><![CDATA[the NHS is shit]]></category>
		<category><![CDATA[therapeutic abandonment]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=1608</guid>
		<description><![CDATA[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 <a href='http://serialinsomniac.com/2010/05/27/revised-letter-to-mr-director-person/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p style="text-align: justify;">The latest draft.</p>
<blockquote>
<p style="text-align: justify;">Dear Mr Director Person</p>
<p style="text-align: justify;"><strong>Re: Accessing Mental Health Services </strong></p>
<p style="text-align: justify;">Previous correspondence refers.  Thank you for your eventual response of 12 May 2010.</p>
<p style="text-align: justify;">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.</p>
<p style="text-align: justify;">However, you will recall that in my letter of 11 March, I specifically requested <strong>details</strong> on what is being done <strong>at this time</strong> 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.</p>
<p style="text-align: justify;">In relation to my own case specifically, you may be aware that &lt;NewVCB&gt; 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.</p>
<p style="text-align: justify;">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 <strong>discourage</strong> 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”.</p>
<p style="text-align: justify;">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.</p>
<p style="text-align: justify;">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 <strong>that</strong> 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 <strong>exactly why</strong> 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.</p>
<p style="text-align: justify;">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 <strong>as long as is necessary</strong>, bearing in mind two important factors.  Firstly, it took over 12 years to <strong>finally</strong> 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 &lt;NewVCB&gt;, 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.</p>
<p style="text-align: justify;">I would like to emphasise that I <strong>have</strong> found the current psychotherapeutic process at least modestly useful, and believe that through further contact with C, it could continue to help me.</p>
<p style="text-align: justify;">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 <strong>years</strong>, 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?</p>
<p style="text-align: justify;">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, &lt;BitchBrain&gt;, with said expression forthwith, and look forward to hopefully making a worthwhile contribution to personality disorder services within our Trust.</p>
<p style="text-align: justify;">Thank you for your time once again.  It is appreciated.</p>
<p style="text-align: justify;">Regards.</p>
<p style="text-align: justify;">Yours sincerely etc.</p>
<p style="text-align: justify;">
</blockquote>
<p style="text-align: justify;">Thoughts?  I will detail this morning&#8217;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.</p>


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		<series:name><![CDATA[The Mr Director-Person Letters]]></series:name>
	</item>
		<item>
		<title>Latest in the Ongoing Me v NHS Saga &#8211; MORE ADVICE NEEDED!</title>
		<link>http://serialinsomniac.com/2010/05/26/latest-in-the-ongoing-me-v-nhs-saga-more-advice-needed/</link>
		<comments>http://serialinsomniac.com/2010/05/26/latest-in-the-ongoing-me-v-nhs-saga-more-advice-needed/#comments</comments>
		<pubDate>Wed, 26 May 2010 16:51:23 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[Fighting with the NHS]]></category>
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		<category><![CDATA[Mr Director-Person]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=1601</guid>
		<description><![CDATA[I should turn this into a series of posts.  It&#8217;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 <a href='http://serialinsomniac.com/2010/05/26/latest-in-the-ongoing-me-v-nhs-saga-more-advice-needed/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>I should turn this into a series of posts.  It&#8217;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.</p>
<p>Anyway, here is the latest letter from Mr Director-Person, in response to my correspondence of <a href="/2010/03/11/latest-letter-to-the-trust-with-a-giant-helping-of-screw-you/">11 March</a>.  I am very impressed with his wonderfully speedy return on this.</p>
<blockquote><p>Dear Pandora</p>
<p><strong>Re Accessing Mental Health Services</strong></p>
<p>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.</p>
<p>Locally, a group run by &lt;Mr Twathead&gt;, 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.</p>
<p>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 &#8211; please contact &lt;BitchBrain&gt;, Assistant Director Mental Health Services, &lt;Big Bin&gt;, &lt;phone number blah blah&gt;.</p>
<p>In relation to your own treatment and care, &lt;C&gt; has spoken to &lt;NewVCB&gt; about follow-up sessions.  It was agreed that there would be a seamless [*explodes laughing*] transition at that time [&lt;pedantry&gt;at <strong>what</strong> time?  What point of your letter are you referring back to?&lt;/pedantry&gt;] 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.</p>
<p>Yours sincerely</p>
<p>Mr Asshole Director-Person Cunt.</p></blockquote>
<p>One thing that really annoyed me that has no relation to that actual <strong>content</strong> of the letter was that he addressed me as &#8216;<strong>Mrs</strong> &lt;<a href="/2010/01/13/changing-my-name/">my new surname</a>&gt;&#8217;, 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.</p>
<p>Anyhow, this is my proposed response.</p>
<blockquote><p>Dear Mr Director-Person</p>
<p><strong>Re: Accessing MH Services</strong></p>
<p>Previous correspondence refers.  Thank you for your eventual response of 12 May 2010.</p>
<p>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 &#8220;considering&#8221; the application of the KUF.  I also have taken note of the information that a plan is being &#8220;worked on&#8221; 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 <strong>details</strong> 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 <strong>now</strong>.  I am disappointed to note that you have failed to provide this information.</p>
<p>You may be aware that &lt;NewVCB&gt;, 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 <em>Trauma and Recovery</em> by Judith Herman and<em> The Haunted Self: Structural Dissociation and the Treatment of Chronic Traumatization </em>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 <strong>thoroughly </strong>re-traumatised thanks to recent work with C.</p>
<p>To that end, I should be grateful if you could clarify the mandate of mental health services within your Trust.  Is it your actual <strong>goal</strong> to discourage healing and indeed bring about psychological damage to ill and traumatised individuals?</p>
<p>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 &#8220;seamless&#8221; &#8211; aside from the fact that it is impossible for you to predict the level of &#8220;seamlessness&#8221;, and the fact that I am well acquainted with C without any knowledge of his &#8220;successor&#8221; (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 <strong>do </strong>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 <strong>regardless</strong> of external encouragement).  Whilst there is arguably a place for such professionals as adjunctive workers involved in a person&#8217;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.</p>
<p>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 &#8211; and of being forced into the private sector thanks to its failings &#8211; I have experience of these &#8220;therapies&#8221; 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.</p>
<p>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 <strong>some</strong> 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.</p>
<p>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.</p>
<p>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, &lt;BitchBrain&gt;, with said expression forthwith, and look forward to hopefully making a worthwhile contribution to personality disorder services within our Trust.</p>
<p>Thank you for your time.</p>
<p>Regards</p>
<p>Pandora (<strong>Ms</strong>)</p></blockquote>
<p>I whacked this response out on a secluded beach on the Turkish Mediterranean.  My God, what a sad, pointless life I lead!</p>
<p>I&#8217;m seeking advice on this one because, although I feel my letter is fairly good, it doesn&#8217;t ask many direct questions, meaning that Mr D-P can cleverly wriggle out of answers <strong>yet again</strong>.  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 <a href="/2010/05/26/to-quit-or-not-to-quit-therapy-that-is-advice-required/">last post</a>, all views are most welcome.</p>
<p>Thanks again lovelies.  x</p>


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		<series:name><![CDATA[The Mr Director-Person Letters]]></series:name>
	</item>
		<item>
		<title>To Quit or Not to Quit (Therapy, That Is)?  ADVICE REQUIRED!</title>
		<link>http://serialinsomniac.com/2010/05/26/to-quit-or-not-to-quit-therapy-that-is-advice-required/</link>
		<comments>http://serialinsomniac.com/2010/05/26/to-quit-or-not-to-quit-therapy-that-is-advice-required/#comments</comments>
		<pubDate>Wed, 26 May 2010 15:49:05 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
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		<category><![CDATA[psychodynamic psychotherapy]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=1594</guid>
		<description><![CDATA[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 <a href='http://serialinsomniac.com/2010/05/26/to-quit-or-not-to-quit-therapy-that-is-advice-required/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>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.</p>
<p>Anyway, I may report on the holiday in due course, but for now I need your advice, my precious lovelies.  I&#8217;ve been thinking seriously since I last saw C &#8211; and before, for that matter &#8211; of just quitting therapy.   I will outline my reasons and the pros and cons of this, but whatever the case I would <strong>really</strong> 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.</p>
<p>Basically, I feel that the whole situation with C is completely out of my control, and this is doing my head in.  I&#8217;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 &#8211; what? &#8211;  seven or eight weeks <strong>anyway</strong>, 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 <strong>do</strong>, apart from fuck up my life even more?</p>
<p>I&#8217;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 &#8211; indeed, I&#8217;m sure, <strong>necessary</strong> &#8211; 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 <strong>quite</strong> so hideously haunted by it).  This will not be the case with me, unless C can miraculously process <strong>all</strong> my traumatic memories &#8211; those of systematic, long-term child sexual abuse, abandonment/rejection, bullying and betrayal &#8211; in a few pathetic weeks.  He doesn&#8217;t even <strong>know</strong> 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.</p>
<p>Useful work is not even being done at this stage, in my view, because I&#8217;ve become terribly defensive again.  At least, I <strong>assume</strong> that it is defensiveness &#8211; it never feels exactly like that in session, it&#8217;s just that I can&#8217;t seem to talk about anything worthwhile anymore.  But of course I can rationalise that behaviour out of session: I know that I&#8217;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&#8217;s mercy than I already am.</p>
<p>So, pros and cons of ending therapy of my own accord.</p>
<blockquote><p><strong><span style="text-decoration: underline;">Pros</span></strong></p>
<ul>
<li>Regaining control of the situation.</li>
<li>Earlier transition to a private (and hence more reliable) therapist, and an earlier start at interviewing those on the shortlist.</li>
<li>Satisfaction of beating C at his own game.</li>
<li>Reduction of further re-traumatisation.</li>
<li>Reduction of further wastage of 50 minutes each week on both sides.</li>
</ul>
</blockquote>
<blockquote><p><strong><span style="text-decoration: underline;">Cons</span></strong></p>
<ul>
<li>The Trust will almost certainly interpret this as typical borderline behaviour and note further stigmatic bullshit all over my medical notes.</li>
<li>The Trust will consider the fact that I quit therapy of my own volition in any future referrals and presumably respond with a giant &#8216;fuck off&#8217;.</li>
<li>I might miss C and end up regretting finishing interaction with him before the last possible minute that I could have done.</li>
<li>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 <strong>was </strong>doing so, for a while, though I don&#8217;t really think it is at present.  But if it is, then I could be &#8216;blowing it&#8217;.</li>
</ul>
</blockquote>
<p>One thing I <strong>am</strong> going to do &#8211; to wind C and the Trust up if nothing else &#8211; 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&#8217;s almost inevitable wastage in my ongoing dispute with Mr Director-Person (more on that cunt later today).</p>
<p>So.  In conclusion, I would really, <strong>really</strong> appreciate all your thoughts on this matter.  <strong>Any </strong>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?</p>
<p>Thank you all.  x</p>


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		<title>Holiday Rage</title>
		<link>http://serialinsomniac.com/2010/05/13/holiday-rage/</link>
		<comments>http://serialinsomniac.com/2010/05/13/holiday-rage/#comments</comments>
		<pubDate>Thu, 13 May 2010 13:50:51 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
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		<category><![CDATA[Mental Health Diagnoses]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=1587</guid>
		<description><![CDATA[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&#8217;s <a href='http://serialinsomniac.com/2010/05/13/holiday-rage/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p><strong>WARNING</strong>:  <strong><em>RANT</em></strong></p>
<p>I am going on holiday this evening.  Ergo, I will be (mostly) <em>in absentia</em> until at least 24 May.</p>
<p>Unlike the preceeding hours before the <a href="/2009/09/10/si-on-tour/">last time</a> I went on holiday, I am <strong>not </strong>in a good mood.  I am, in fact, muderously livid.  C is to blame (surprise surprise), even though it&#8217;s not his fault.</p>
<p>So, the latest on the wanky questionnaires is that either I have DID or I&#8217;m exaggerating my dissociative symptoms.  He tried to dress it up, but that&#8217;s what it comes down to whatever he says.</p>
<p>So typical of borderlines, yes?  <em>Neurotic, attention-seeking, self-obsessed, manipulative narcissists</em>.</p>
<p>Beyond that the session was thouroughly pointless.  It was just more of me slagging myself off endlessly.  He didn&#8217;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.</p>
<p>Some gems:</p>
<blockquote><p>I&#8217;m a five year old fantasist trapped in a womans&#8217; body.  A pretty <strong>smart</strong> five year old, but a five year old nonetheless.</p>
<p>I&#8217;m an immature, pathetic, stupid waste of space.  Well&#8230;not stupid.  But stupid all the same.  Just not stupid-stupid.  But the stupid kind of stupid.  Except not <strong>actually</strong> stupid, just&#8230;stupid.</p>
<p>[On seeing Trust headed paper being used, as intended, for rough notes] You do realise that I&#8217;m internally raging, don&#8217;t you?  That exemplifies your pathetic public sector inefficiency.  No wonder the Trust has no money.  Such wastage.  [Genuinely seething inside - proper, murderous anger].</p></blockquote>
<p>I&#8217;m sure there was more but I can&#8217;t recall it all and anyway, I&#8217;ll write about this session properly when I get back from my travels.</p>
<p>My mother had called me during the session so I called her back to see what she wanted when I left.  <a HREF="/2010/03/11/latest-letter-to-the-trust-with-a-giant-helping-of-screw-you/">Mr Director-Person</a> had <strong>finally </strong>responded.</p>
<p>My analysis of the NICE guidelines etc is apparently quite correct, but &#8211; it now emerges &#8211; the NICE guidelines don&#8217;t automatically apply in Northern Ireland.  Well, that&#8217;s brilliant, isn&#8217;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.  <strong>OUT-FUCKING-STANDING</strong>.</p>
<blockquote><p>Blah blah blah&#8230;we are developing a PD service&#8230;we welcome &#8220;service user&#8221; (I fucking <strong>hate</strong> that term) involvement&#8230;please register your interest with this tosser at this hospital&#8230;</p></blockquote>
<p>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 <strong>inside</strong> the bastarding system.</p>
<blockquote><p>Blah de blah&#8230;[C] and [NewVCB] have agreed to put you under the care of either a CPN or a mental health social worker&#8230;details to be worked out closer to the time&#8230;</p></blockquote>
<p>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 CB<em>fucking</em>T?!  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.</p>
<p>So that, dearest readers, is the latest.  I am sure I&#8217;ll calm down a bit &#8211; but probably only when we finally reach our apartments tonight, as hanging around airports is supremely frustrating, and flying is supremely <strong>boring</strong>.</p>
<p>I have got a data abroad package on my phone so will probably be about occasionally on Twitter &#8211; I might even post here if you&#8217;re (un)lucky.  Otherwise, thank you all for reading and thank you for your unwavering support and friendship.</p>
<p>Much love</p>
<p>Pandora x<br /></p>


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		<title>Wasting Time I Don&#8217;t Have &#8211; C: Week 49</title>
		<link>http://serialinsomniac.com/2010/05/10/wasting-time-i-dont-have-c-week-49/</link>
		<comments>http://serialinsomniac.com/2010/05/10/wasting-time-i-dont-have-c-week-49/#comments</comments>
		<pubDate>Mon, 10 May 2010 21:55:26 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[abandonment]]></category>
		<category><![CDATA[anxiety]]></category>
		<category><![CDATA[attachment]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[dissociation]]></category>
		<category><![CDATA[dissociation scale]]></category>
		<category><![CDATA[hearing voices]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[multidimensional inventory of dissociation]]></category>
		<category><![CDATA[psychodynamic psychotherapy]]></category>
		<category><![CDATA[psychology]]></category>
		<category><![CDATA[psychoses]]></category>
		<category><![CDATA[psychosis]]></category>
		<category><![CDATA[social anxiety]]></category>
		<category><![CDATA[stupid fucking bitch]]></category>
		<category><![CDATA[therapeutic abandonment]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[time wasting]]></category>
		<category><![CDATA[transference]]></category>
		<category><![CDATA[trauma]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1498</guid>
		<description><![CDATA[This is my first post from my new laptop, which I awarded myself (in part) for reaching my first blogoversary. Although it&#8217;s a Windows machine &#8211; and I am used to and prefer Linux &#8211; I still love it. As a tablet PC, it has a touch screen, which has been enabling me to do <a href='http://serialinsomniac.com/2010/05/10/wasting-time-i-dont-have-c-week-49/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>This is my first post from my new laptop, which I <a href="/2010/05/04/happy-birthday-blog/#comment-2360">awarded myself</a> (in part) for reaching my first <a href="/2010/05/04/happy-birthday-blog/">blogoversary</a>.  Although it&#8217;s a Windows machine &#8211; and I am used to and prefer Linux &#8211; I still love it.  As a tablet PC, it has a touch screen, which has been enabling me to do some e-drawing.  I&#8217;m not an artistic person, but I have been looking for some creative outlets other than simply the written word, and the laptop has enabled that quite ably so far.  I may share some of these images in time, as they relate mainly to my feelings about therapy and/or C himself.  For now, here instead are a few images of the laptop, which is a Lenovo x60.</p>
<p><a href="http://serialinsomniac.com/wp-content/uploads/2010/05/photo.jpg"><img class="size-medium wp-image-1558 alignleft" title="Standard Position" src="http://serialinsomniac.com/wp-content/uploads/2010/05/photo-225x300.jpg" alt="Laptop - Standard Position" width="225" height="300" /></a><a href="http://serialinsomniac.com/wp-content/uploads/2010/05/photo-2.jpg"><img class="size-medium wp-image-1560 alignright" title="Turning the Screen" src="http://serialinsomniac.com/wp-content/uploads/2010/05/photo-2-225x300.jpg" alt="Twisting the Screen" width="225" height="300" /></a></p>
<p><a href="http://serialinsomniac.com/wp-content/uploads/2010/05/photo-3.jpg"><img class="aligncenter size-medium wp-image-1559" title="Flatscreen Booky Drawing Machine of Joy" src="http://serialinsomniac.com/wp-content/uploads/2010/05/photo-3-300x225.jpg" alt="" width="300" height="225" /></a></p>
<p>&#8212;</p>
<p>Please note &#8211; I began writing this post about a week ago, but malaise and, later, agitation over the stupid election (something on which I should comment, though Z&#8217;s observations and my own comments on <a href="http://www.mentalnurse.org/2010/05/this-week-in-mentalists-scabrous-edition/" target="_blank">this Mental Nurse post</a>, as well as <a href="/2010/05/05/this-election-in-norn-iron-mentalists-part-four-the-others-and-the-end/">my conclusion</a> to the <a href="/series/this-election-in-norn-iron-mentalists/">election special series</a>, may provide enough of the comment required), so forgive me if the post is disjointed and rambling.  It&#8217;s also worth bearing in mind that this session was <strong>not</strong> my most recent session with C &#8211; this post relates to Thursday 29 April.  6 May&#8217;s instalment will hopefully be delivered in the next day or two.</p>
<p>&#8212;</p>
<p>Starting with the session that followed the one detailed here, I had a total of 10 psychotherapeutic sessions remaining &#8211; and that includes four to deal with the severance of the relationship (as if <strong>that&#8217;s</strong> going to be enough!), meaning only six weeks of <strong>actual</strong> therapy remained. Fuck-a-doodle-fucking-do.</p>
<p>As if that were not bad enough in and of itself, how do you think I responded in the session in question? <strong>By wasting the entire fucking session</strong>. Yay, Pandora, well done, girl! Way to go! Or, in other words – what an epic, epic fail.</p>
<p>It started, as far as C believes anyway, when he was late. He arrived in the building at 9.30am, which is the time I&#8217;m due to start seeing him &#8211; he stopped by me in the waiting room and apologised, saying he would just be a few minutes. That really didn&#8217;t bother me that much, so long as those extra minutes were added on at the end, but C seems convinced that he unsettled me by being late. I don&#8217;t think he did, but what do I know about my own subconscious? (For the record, that comment is semi-serious, not merely facetious. My subconscious <strong>is</strong> a mystery to me).</p>
<p>Anyhow, when we finally settled in the room together, he apologised again and said the traffic had been heavier than normal. I told him that I used to be late for everything and had become so neurotic about it that I was in fact now always early. He pointed out that I&#8217;d never been late for a session with him, and I said that that was my point; I&#8217;m always 20 minutes early now (which is actually probably a good thing, given my parking OCD ((Disraeli, the car, has to be <strong>exactly</strong> lined up in the middle of a parking space, on all dimensions &#8211; front, back, left, right &#8211; and I have been known to take a tape measure to ensure this)) which can take a lot of time to sate).</p>
<p>He then asked me how I was for time, and would I be happy just to add the 10 lost minutes onto the end of the session. <strong>Of course</strong> I was thus happy. That means there&#8217;s no bastard coming in straight after me, YAY! I had understood that the reason for psychotherapy sessions being 50 minutes long was to give the therapist 10 minute&#8217;s grace in the hour to prepare for the next client. With C this is clearly not the case, and it&#8217;s not the first time we&#8217;ve gone beyond the 10.20 limit. <strong>YAY</strong>. <em>C is all mine.</em></p>
<p>Anyway. Silence. What a bloody surprise. He gazed off towards the bookcase, I stared at his blank computer monitor.</p>
<p>He broke it by mentioning he&#8217;d received the <a href="/2010/04/26/pathological-dissociation-c-week-48/">dissociation questionnaires</a> on Monday, but he said he wanted to leave discussion of them until next week as, although he had scored them, he hadn&#8217;t a chance to look at them in considerable detail.</p>
<p>I told him about my concerns about how the questionnaires failed to articulate their frame of reference vis a vis the frequency of symptoms, and he admitted that he hadn&#8217;t considered that before he&#8217;d received my responses. I proceeded, then, to confront him on some of the points that had annoyed me, namely those questions that enquired as to whether or not you had faked or exaggerated symptoms in order to get attention.</p>
<p>Taking my lead from an astute comment <a href="/2010/04/26/pathological-dissociation-c-week-48/comment-page-1/#comment-2250">left</a> by <a href="http://crazymaking.wordpress.com" target="_blank">Wounded Genius</a>, I asked C, &#8220;is the questionnaire designed to incorporate BPD tendencies? You know, given that we&#8217;re all so <strong>hideously</strong> manipulative and all.&#8221;</p>
<p>He kind of winced a little but then admitted that this was indeed the case, in part anyway, and that there were also a number of PTSD strands to it.</p>
<p>I protested my innocence. &#8220;I&#8217;ve played up some medical problems, I&#8217;ll admit that,&#8221; I told him. &#8220;But only to ensure I have been given the treatment required, as opposed to doing it to seek attention. And I&#8217;ve never done it regarding my psychological problems.&#8221;</p>
<p>C looked at me shiftily. He said, eventually, &#8220;but wouldn&#8217;t you agree that there are maybe times when you don&#8217;t think your mental health issues are being taken seriously, and that you feel you need to scream at the top of your lungs for someone to pay attention?&#8221;</p>
<p>I pretended to think about this for a minute, and then denied it. Which felt sincere at the time but now sounds like a complete fabrication. I asked him to exemplify his perceived position.</p>
<p>&#8220;There was <a href="/2010/01/14/pointlessly-stupid-navel-gazing-repetitive-nonsense-c-week-37/">an incident</a> after Christmas,&#8221; he recalled, &#8220;wherein you said something like, &#8216;what do I have to do to get you bloody people to take notice of the seriousness of this illness?&#8217; Do you remember that?&#8221;</p>
<p>I did. Fuck. Caught-out. That was only a week or two before I tried (and sadly failed miserably) to <a href="/2010/01/17/suicide-attempt-epic-fail/">top myself</a>, which whilst done in the midst of a very serious depressive episode was also partly catalysed by his apparent determination to abandon me.</p>
<p>I think I said something to the effect of that having indeed taken place, but that it hadn&#8217;t meant I had made up or hyperbolised anything.</p>
<p>He did seem to accept this point in fairness to him, and went on to say that part of the reason for these awkward questions was to form a &#8216;validity scale&#8217; &#8211; ie. to catch out people who just randomly circle high figures because <strong>they</strong> want sympathy and attention. He basically refuted the idea that he felt that was applicable to me.</p>
<p>&#8220;Your dissociation scores <strong>are</strong> raised,&#8221; he continued (well, isn&#8217;t that a surprise). &#8220;But I want to explore them in detail before we discuss them. So are you OK to discuss this next week?&#8221;</p>
<p>I responded in the affirmative, and that conversation desisted. The silence returned.</p>
<p>It was C that once again interrupted it, by advising me that despite <a href="/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/">NewVCB</a>&#8216;s assertions that she wanted to talk to him, she hadn&#8217;t yet phoned him.  He wanted to know if I knew what it was that NewVCB had specifically wanted to ask him about.</p>
<p>[I had written an entire 900-word rant here about C cutting the therapy short; this was catalysed because I'd had a similar discussion with NewVCB when I saw here in the aforelinked appointment. But the rant is just a repetition of many rants I've had here and just takes up space on this post. I've saved it but there's no point in including it here. Essentially, when asked about what NewVCB wanted, I said that I didn't know, which was largely true, as she wanted to ask C about the flashbacks and psychoses, of which she was already aware.]</p>
<p>I went on to tell C that NewVCB had increased my daily dose of Quetiapine by 100mg (to a total of 400mg). To my considerable bewilderment, he seemed to be surprised by this.</p>
<p>&#8220;Why did she do that?&#8221; he asked, his brow furrowed slightly.</p>
<p>Christ on a fucking stick, C.  I <strong>wouldn&#8217;t have detailed</strong> my trauma-induced hallucinations to you <a href="/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/">last week</a> or anything, would I?</p>
<p>Through irritated gritted teeth, I explained NewVCB&#8217;s (surely rather obvious) rationale: that although she reckoned that the work that I need(ed) to do was primarily psychological, that she was concerned that I&#8217;d become floridly psychotic and/or distressed to the point where I&#8217;d be <strong>unable</strong> to work in that way with C. She has always insisted that my ability to do so is key to my prognosis, and such bothersome symptoms as I was having would, if left untreated, inevitably affect my ability to engage in active psychotherapy.</p>
<p>This explanation assuaged C&#8217;s inexplicable-to-me concerns and he nodded, which led to a lull in the conversation.</p>
<p>And so it began. Again.  A long, meaningless, drivelsome silence.  He once more gazes towards the bookcase, I choose to stare blankly at the noticeboard behind him this time.  All cogs of both minds almost palpably whir, and whir speedily at that, but nobody <strong>verbalises</strong> those cognitive processes, those deeply considered thoughts.</p>
<p>In my case, it rather predictably led to the boringly typical internal battle of Me vs Me:</p>
<blockquote><p><em>Speak.  Speak to him, damn you, speak!</em><br />
<strong>But what do I say?!</strong><br />
<em>Just something tangible about why you#re in therapy in the first place You <strong>need</strong> to engage with him.</em><br />
<strong>*cowers whines and whimpers*</strong></p></blockquote>
<p>Etc etc, blah blah blah. The usual pointlessly stupid bollocks in which two sides of my mind constantly engage. I kept thinking that I should be using this time to discuss Paedo, or my miserable years at school, or at least <strong>something</strong> about my mentalism, rather than getting into the usual navel-gazing therapy-about-therapy-as-seen-through-silence wankery. But I just couldn&#8217;t open my mouth to utter anything constructive whatsoever.</p>
<p>I believe that it was he that broke the silence, with the not-exactly-surprising “what&#8217;s going through your head?” question. A question that I&#8217;ve heard 350 million times before, on these frustrating occasions in which I seem all but helpless but to engage in this idiotic pursuit of uncharacteristic-in-every-other-walk-of-my-existence laconism.</p>
<p>I responded to C&#8217;s enquiry by laying into myself with a tonne&#8217;s weight of venom. I protested (<em>deja vu</em>, anyone?) by accusing myself of wasting both his time and mine. I was a useless, denomic bitch of Satan, I was moronic, stupid, idiotic, horrible, hateful – yadda yadda yadda.</p>
<p>C said, “what is it about silence here that terrifies you so?”</p>
<p>I said that I was not terrified but angry. With myself. And that I would metaphorically (and, quite possibly, literally) beat myself about the head for the next week for being such a time-wasting bitch.</p>
<p>“Why? And is there nothing we can take from that – from your silences, from your anger?” he persisted.</p>
<p><em>Oh here we go. The inevitable &#8216;what does the silence and self-berating actually reveal?&#8217; bullshit</em>.</p>
<p>He continued in this vein by saying that the silence was insightful, but I&#8217;m not so sure. What I didn&#8217;t reveal was that I would be notably less furious with myself if we didn&#8217;t have the stupid timeframe against us. I wouldn&#8217;t be <strong>happy</strong>, not at all, but at least I could accept that I was not under the pressure to resolve some of my difficulties that I actually <strong>am</strong>.</p>
<p>I don&#8217;t remember what I said to him. I certainly didn&#8217;t tell him the above, because the whole “you&#8217;re angry about the ending” thing was a dead horse that we flogged, flogged again and the flogged some fucking more around Christmas time, and it was a <strong>colossal</strong> waste of time. I did <strong>not</strong> want to go back there.</p>
<p>However I responded, I was interested to hear C then start blaming himself for unsettling me by being late. It certainly hadn&#8217;t <strong>consciously</strong> crossed my mind.</p>
<p>He went on, “and then I started rattling on about&#8230;um&#8230;<em>business-y</em>?&#8230;matters.”</p>
<p>“Housekeeping,” I corrected.</p>
<p>“Yes,” he agreed. “Housekeeping. Between being late and matters of housekeeping, I probably didn&#8217;t put you in the best frame of mind to commence this session.”</p>
<p>There followed a discussion about the inherent weirdness of the therapeutic setting. I pointed out that, when you really think about it, the notion of sitting down like clockwork one morning a week and pouring your heart out as if on some sort of cue was pretty preposterous.</p>
<p>“It&#8217;s alright for you,” I sighed. “This is what you do, you sit over there and you psychologise people [notwithstanding the fact that <strong>I am his only client</strong>. *clears throat* No one else but me. *whistles into fantasyland*]. But from the client&#8217;s situation, it really is bizarre to suddenly have to turn everything on, and 50 minutes later, turn it all off again.”</p>
<p>He <em>ever so astutely</em> observed that I evidently put great pressure on myself to talk in psychotherapy. Oh really, C? I had <strong>NO IDEA</strong>! You <strong>clever</strong> psychologist, you!!!</p>
<p>This reminded me of the old adage that rears its perennial head in job interview settings that stress and pressure are not always bad things. You know the situation I mean&#8230;</p>
<blockquote><p><strong>Interviewer</strong>: So, Pandora. You do know that this is a very demanding and busy role. Can you tell me how you would deal with the stress and pressure that you will inevitably encounter?</p>
<p><strong>Pandora</strong>: Why, yes, Interviewer, I most certainly can. My view is that working under pressure can actually be a highly <strong>positive</strong> thing. Pressure <strong>drives</strong> people, it spurs them on. It enables you to get the absolutely best results that you can achieve, but also within a demanding timeframe.</p></blockquote>
<p>Blah de blah. I quoted this example at C, calling it a “crap” situation (due to its intrinsic falsity)</p>
<p>He said, half-smiling, half-grimacing (or so I thought), “does that make me the crap interviewer then?”</p>
<p>That had not been what I had intended to imply at all. I had merely been trying to suggest that shit and all as the example had been, the idea that pressure could drive results had validity – and that that could be aptly applied to my interactions with C.</p>
<p>Instead of rationally pointing this out, I worked myself into a frenzied panic that I had offended him and started apologising like a ridiculously apologetic thing. “That&#8217;s not what I meant at all, I&#8217;m sorry!” I whined at him.</p>
<p>He said it was OK and seemed to dismiss it, but I was convinced that he thought I hated him and that he therefore hated me, so after trying to get over it for a few minutes, I started blathering again.</p>
<p>“I feel <strong>really</strong> bad about that, C, I&#8217;m sorry, that&#8217;s not what I think, not at all.” (Pa-<strong>thet</strong>-ic).</p>
<p>By this point he seemed slightly bemused by my reaction. He said, decisively, “Pandora, it&#8217;s alright. It was just a comment; I didn&#8217;t interpret it as some [waves his hands for dramatic effect] big transferential thing!” [laughs a little to show me it's no big deal].</p>
<p>Transference. Oh, <strong>transference</strong>. If only you knew, C. If only you knew <strong>a quarter</strong> of it.</p>
<p>Actually, who am I trying to kid? Two characteristics that are at the heart of C&#8217;s person (at least the persona that I know) are intelligence and, crucially, tremendous insight. He probably knows more about the nature of my transference issues that <em>I</em> do. He&#8217;s brought the issue up a few times in the past, quite subtly for the most part (although I <strong>too</strong> am intelligent and insightful, so I know what he&#8217;s doing), and there is no real problem from either side in the ensuing discussions, but of late we have been tackling such profoundly core stuff that (in part at my behest) we&#8217;ve avoided the whole him-and-me thing. That&#8217;s troubling in the sense that it&#8217;s going to be unresolved before therapy ends, but then what choice do I have? It&#8217;s that, or it&#8217;s the issues for which I am in therapy in the first place. I choose the latter.</p>
<p>Anyway, after some more silence, C said that he was aware that I was going on holiday after the following session and would be “on leave” as he initially erroneously put it for two weeks (as it happens, I&#8217;m now only going to miss one week – I am going on Thursday after all – but I&#8217;ll discuss that in the post about the next session). He said that he thought it might be useful for us to have some discussion in the following week about the abuse, but that he was concerned that I would have that left hanging over me whilst I was away, and that he didn&#8217;t want to put me through conversation about the topic in question if I did not feel that I could handle it.</p>
<p>I mused about this for a few moments, eventually concluding (mentally) that yes, I&#8217;d <strong>probably</strong> be OK, largely thanks to my increased dosage of Quetiapine. But then of course <strong>this</strong> led to worry too: I feel that if I say that medication has helped me that I am indirectly insulting him, and the last thing I wish to do is upset him or make him feel inadequate.</p>
<p>For once I was completely honest with him and admitted to that concern, and he was actually quite good about it.  I can&#8217;t remember the exact words, but he said something to the effect that just because I found medication helpful didn&#8217;t mean that I (or indeed he) felt that psychotherapy was ergo totally sidelined and useless.  If anything, he seemed to find my concern mildly amusing. Some people would find the fact that he occasionally expresses amusement at incidents like this quite irritating or patronising. I, on the contrary, find it reassuring. I have absolutely no idea why that is.</p>
<p>And thus arrived the end of the session. He said, “we&#8217;ll try and discuss some of that stuff next week then, if you feel comfortable with it, and we&#8217;ll add – I don&#8217;t know – 10 minutes on at the end to look at the dissociation questionnaires. Is that OK?”</p>
<p>*scoffs* “Is that OK”? <strong>Is That OK</strong>? Hahaha. A mere extra <strong>second</strong> of your time is a valued, longed-for second. So yes, C, it very definitely <strong>is</strong> &#8216;OK&#8217;.</p>
<p>He showed me to the door, opened it for me [nice touch, that], and told me that I wasn&#8217;t to be too hard on myself (re: my self-directed vituperations vis a vis my perceived time-wasting).</p>
<p>It&#8217;s hard not to do so – so desperately hard. I&#8217;m horribly acutely aware of the 10 (now nine) remaining sessions. It permeates the core of my being, every atom of my body, every neuron of my mind. And it&#8217;s fucking unbearable.</p>


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		<title>Pathological Dissociation?  C: Week 48</title>
		<link>http://serialinsomniac.com/2010/04/26/pathological-dissociation-c-week-48/</link>
		<comments>http://serialinsomniac.com/2010/04/26/pathological-dissociation-c-week-48/#comments</comments>
		<pubDate>Mon, 26 Apr 2010 22:45:36 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Sexual Abuse]]></category>
		<category><![CDATA[amnesia]]></category>
		<category><![CDATA[anxiety]]></category>
		<category><![CDATA[attachment]]></category>
		<category><![CDATA[attachment in psychotherapy]]></category>
		<category><![CDATA[bipolar disorder]]></category>
		<category><![CDATA[borderline personality]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[child sex abuse]]></category>
		<category><![CDATA[child sexual abuse]]></category>
		<category><![CDATA[clinical depression]]></category>
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		<category><![CDATA[countertransference]]></category>
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		<category><![CDATA[depersonalisation]]></category>
		<category><![CDATA[depression]]></category>
		<category><![CDATA[derealisation]]></category>
		<category><![CDATA[dissociation]]></category>
		<category><![CDATA[dissociation scale]]></category>
		<category><![CDATA[flashbacks]]></category>
		<category><![CDATA[hallucinating]]></category>
		<category><![CDATA[hallucinations]]></category>
		<category><![CDATA[major depressive disorder]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[multidimensional inventory of dissociation]]></category>
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		<description><![CDATA[So, here I am playing catch-up with the C sessions here, thanks to my recent laziness and endless forays into procrastination.  Let me add an advisory preamble to this post: I&#8217;m afflicted right now with a terrible dose of Blog-and-life-inertia-itis, so don&#8217;t expect this to be remotely scintillating, like several of you curiously found Sunday&#8217;s <a href='http://serialinsomniac.com/2010/04/26/pathological-dissociation-c-week-48/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>So, here I am playing catch-up with the C sessions here, thanks to my recent laziness and endless forays into procrastination.   Let me add an advisory preamble to this post: I&#8217;m afflicted right now with a terrible dose of Blog-and-life-inertia-itis, so don&#8217;t expect this to be remotely scintillating, like <a href="/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/#comments">several of you</a> curiously found Sunday&#8217;s update to be (thanks, by the way!  Sorry I&#8217;m toss at responding to comments at the minute but that&#8217;s the devious, underhand work of the Blog-and-life-inertia-itis again.  Is there medication for this condition?  Actually, yes, there probably is &#8211; Pro Plus, decent coffee and Red Bull.  But if I self-medicate with those, then I&#8217;m hopping back onto the insomnia merry-go-round that I&#8217;ve been trying to get off, requiring more and more sedatives.  So maybe that&#8217;s not as good idea.  Just like it&#8217;s not a good idea to ramble ((and ergo procrastinate)) endlessly within parentheses).</p>
<p>The Blog-and-life-inertia-itis is compounded by the fact that I&#8217;ve completely blocked out most of this session from my conscious memory.  I remember how things started, and I remember how they ended.  What happened in the &#8216;middle&#8217; portion of the meeting is frankly anyone&#8217;s guess; it&#8217;s almost like the chunk of my brain where the recollective (yes it is a word) neurons pertaining to those 30 or 40 minutes were stored has been cut out with a sharp knife.  Well, <em>así es la vida</em>.  On the bright side, I&#8217;ve always wanted a lobotomy.</p>
<p>As far as this session went, with the exception of a few minutes at the end, I&#8217;m not sure how much it really added to what had happened in the <a href="/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/">last meeting</a> and the <a href="/2010/04/07/admitting-the-extent-of-the-abuse-c-week-46/">one before that</a> &#8211; how could I be thus sure, however, when I don&#8217;t remember what the sodding hell happened.  We started with the usual crap of <em>silence &#8211; he asks where to begin &#8211; I say I don&#8217;t know &#8211; silence</em>, which in fact has almost become the subject a parody between us now.</p>
<p>C was the first one to cave in.  I&#8217;d noticed a couple of sheets sitting on the coffee table that sits between us (where the hateful, cheap tissues are housed for when mentals ((or rather, &#8216;mental&#8217; &#8211; singular &#8211; because of course I am his only patient *cough*)) start bawling their eyes out), and was interested to see him gesture towards them.</p>
<p>He explained that he had obtained dissociation scales to measure just how extreme my &#8216;general&#8217; episodes of dissociation, derealisation and depersonalisation were, as well to determine the seriousness of the dissociative psychoses.  He had two such survey things; one is a <a href="http://www.traumaawareness.org/id15.html" target="_blank">standard</a> dissociation scale, the second a much more <a href="http://www.informaworld.com/smpp/content~db=all?content=10.1300/J229v07n02_06" target="_blank">in-depth questionnaire.</a> He had apparently initially hoped I could fill them in during or at the end of the session, but given the length of the longer one (218 questions or something), he&#8217;d decided it was best if I filled them in at home then just posted them back to him.</p>
<p>He then mused about when he might receive them back, supposing it would be Tuesday (tomorrow).  I was surprised to learn that he does not work &#8216;there&#8217; on Tuesdays or Wednesdays; I missed the opportunity to ask what, if anything, he does on those days, but if I had to guess, I would say those are research days as I am aware that he has been involved in research in the past at least.</p>
<p>At any rate, he advised me not to sell myself short in the questionnaires; he feared I&#8217;d downplay the severity of my symptoms.</p>
<p>&#8220;On the other hand,&#8221; he continued, &#8220;you obviously don&#8217;t want to exaggerate them either, so&#8230;&#8221;</p>
<p>&#8220;So go with my first instinct,&#8221; I finished, to which he nodded.  &#8220;I&#8217;ve always been advised when completing psychiatric questionnaires that I should basically go with the first rating that my mind thinks is appropriate.&#8221;</p>
<p>He agreed with this and asked if I had any questions regarding why he wanted me to fill these in.</p>
<p>Of course, I did.  &#8220;Are you going to use these to bin me?&#8221; I enquired.</p>
<p>For some reason he initially smiled at this but, seeing from my facial expression that my question was serious, he desisted from that with very quick effect.  &#8220;Not at all,&#8221; he replied.</p>
<p>I asked what, then, he hoped to achieve through the exploration of my answers to the questions, and he said something about it being able to inform deeply the way we work together.  Apparently it could give him great insight.</p>
<p>I filled in the two questionnaires that afternoon, but found mysef to be somehwat irritated by the way in which they scale dissociation.  Both ask what percentage of the time you have symptom <em>x</em>; for example:</p>
<blockquote><p>Some people have the experience of finding themselves in a place and have no idea how they got there.  [<em>Thanks for not patronising me there, questionnaire, thanks very much ineed</em>].</p>
<p><strong>Circle a number to show what percentage of the time this happens to you</strong></p>
<p>0% 10 20 30 40 50 60 70 80 90 100%</p>
<p>(<a href="http://www.traumaawareness.org/id15.html" target="_blank">Source</a>)</p></blockquote>
<p>When it says &#8220;what percentage of the time&#8221; what exactly does that <strong>mean</strong>?  <strong>All</strong> the time?  Times when you&#8217;re unwell?  In the above example, how can that <strong>possibly</strong> be 100% of the time &#8211; surely that&#8217;s impossible.  If you didn&#8217;t know why you were somewhere every time you were somewhere, which is a state of permanence, then&#8230;no, fuck it, it&#8217;s too late in the evening to try to articulate what I mean properly.  Just&#8230;it&#8217;s odd.  I would have liked some proper context to these questions, and it wasn&#8217;t there.  So I added a note for C stating that, and advising that in the absence of such information, I was answering the questions at face value &#8211; ie. assuming that &#8220;percentage of the time&#8221; meant <strong>all the time. </strong>In all probability, having done so may well end up minimising my levels of dissociation as far as these scales go, but all I could do was be honest within the framework I was given.</p>
<p>Two things concerned me about the longer test (the MID) in particular.  Firstly, a cursory search online suggested that the MID is used to diagnose Dissociative Identity Disorder (DID).  Even though I&#8217;m all but certain this diagnosis is not at all applicable to me, I worked myself into a panic and convinced myself that<em><strong> C</strong></em> thought I had it.  Not that there would be anything <strong>wrong</strong> with having it, obviously, but given how much I don&#8217;t think it applies, it would create an incongruence between C and I if that were his opinion.  Fortunately, I now <a href="http://www.informaworld.com/smpp/content~db=all?content=10.1300/J229v07n02_06" target="_blank">see</a> that the scale is used more widely than just in relation to DID; it&#8217;s also applied to measure borderline and PTSD dissociation, which of course is me right off to a tee.  So hopefully C is on my wavelength after all.</p>
<p>The second thing to annoy me was that there are several questions that ask about how much you exaggerate your symptoms &#8211; either physical or psychological &#8211; in order to get attention (or variants thereon).  I know C didn&#8217;t <strong>write</strong> the MID, but I nevertheless took this as a personal insult.  Does he really think I am faking all of this?!  On a more logistical note, even if I <strong>were</strong>, am I really going to own up to that <strong>to him</strong>,<strong> </strong>the very person in front of whom I would be faking (at least psychic) symptoms?!  Now, in fairness, I&#8217;ve been known to exaggerate some physical issues, but never &#8216;for attention&#8217; &#8211; at least, not in the traditional sense.  I&#8217;ve done it only when I know a completely honest description of the problem would not garner the treatment required, as is quite typical throughout the NHS (at least in my experience).  To the best of my recollection, I&#8217;ve <strong>never</strong> done it in relation to my psychological health &#8211; if anything, the polar opposite is more likely to be the case.</p>
<p>C had thought we wouldn&#8217;t get to discuss the questionnaires this week as he reckoned they&#8217;d have arrived tomorrow (Tuesday) and he wouldn&#8217;t be back in that office until Thursday (at which point I am the first person, other than his secretary I assume, that he sees), but I ended up posting them in time that they may well have gotten there today, thus affording him the opportunity to study them in advance of this week&#8217;s session should he wish to do so.  We shall see if indeed that comes to pass.</p>
<p>Anyway.  I&#8217;ve diverged from a discussion about the session to a discussion of dissociative scales, so let&#8217;s move back to where we were meant to be.</p>
<p>Eventually, for reasons I can&#8217;t particularly fathom because it wasn&#8217;t relevant to anything we&#8217;ve been discussing in-session recently, I mentioned briefly to C that I had been out the evening before with A, as it had been the anniversary of my meeting him.</p>
<p>C asked me how things were with A, which was a curious question I thought; I don&#8217;t believe I&#8217;ve ever led him to believe that things were anything other than good between us.  Of course, as I was typing that last sentence I remembered that of course I&#8217;ve told C about what a cunt I&#8217;ve been to A at times (for example, <a href="/2009/07/01/attack-defend-submit-the-behaviour-of-a-lunatic/">here</a>) so I suppose it wasn&#8217;t such an odd question after all.  Anyway, I said that things were good and that &#8220;A takes care of me.&#8221;</p>
<p>Unfortunately, I <strong>literally</strong> said that &#8220;<strong>A</strong> takes care of me.&#8221;  Not his real name, but <strong>A</strong>.  I corrected myself and continued, thinking of it as nothing more than simple absent-mindedness, but C interrupted me and asked what I had meant by &#8216;A&#8217;.</p>
<p>&#8220;Oh, that&#8217;s what I call him on my blog,&#8221; I said dismissively.  &#8220;I suppose it shows what a big part of my life it is.&#8221;</p>
<p>I was ready to move on and discuss something that might actually have been vaguely useful, but C started harping on my apparent allegation that &#8220;the blog had taken over my life.&#8221;  He looked suspicious, which disturbed me considerably.  My paranoid mind is now convinced &#8211; especially in light of the exaggeration questions in the MID &#8211; that he thinks I make stuff up, or that I exaggerate and embellish to a significant degree, to make things sound interesting here.  I don&#8217;t think that&#8217;s true.  Is it?  I know I&#8217;m guilty of paraphrasing and perhaps not always describing things <strong>exactly</strong> as they happened, but isn&#8217;t that the nature of any subjective human experience?  Am I fucking things up?</p>
<p>And here we hit the brick wall of nothingness.  I don&#8217;t remember the next half hour to 40 minutes at all.  I could understand it if I just forgot little bits and pieces or nuances, but I literally remember nothing.  My supposition is that this is because &#8211; hurrah, you&#8217;ve guessed it &#8211; I dissociated it.  I&#8217;m almost certain that I didn&#8217;t reveal any <strong>specifics</strong> to him as regards our ongoing subject matter of child sexual abuse, because I remember having a discussion dodging that later.  But I don&#8217;t know what I <strong>did</strong> say.  I intend to ask him on Thursday, because I can&#8217;t tolerate this blankness, longed-for-lobotomy or not.</p>
<p>The next thing I recall was telling him that I hadn&#8217;t really discussed the <a href="/2010/04/19/death-of-sanity/">flashbacks</a> I&#8217;d been experiencing with him the <a href="/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/">previous week</a>, owing simply to the fact that we hadn&#8217;t had time (as the session was almost entirely spent discussing the hallucinations).  There was a bit of (largely un-recalled) probing from him, and a lot of humming-and-haing from me, though I think I admitted that the flashbacks occur as if they were my &#8216;present&#8217; and not my past.  I&#8217;m sure he asked me something on that point, but &#8211; wahey &#8211; <em>I don&#8217;t remember what it was</em>.  Well done, P.</p>
<p>Eventually, I admitted to the somatic symptoms that accompany my flashbacks and, indeed, that often stay put quite independently of them &#8211; the almost constant physical pain that has plagued me as part of this whole nightmare for the past few weeks.  I think he may have asked me similar questions to those he posed in <a href="/2010/04/07/admitting-the-extent-of-the-abuse-c-week-46/">this</a> session &#8211; namely, were the somatic symptoms in my genital region &#8211; but I don&#8217;t remember fully.</p>
<p>What I do recall is that eventually I told him my back hurt like blazes all the time, and that it&#8217;s especially pronounced during a particular recurring flashback.  He asked in what way it hurt, and I responded by telling him that I had been forced to sort of stand against a wall and that that was what had caused me pain in that area.</p>
<p>Cue a lot of investigation from him as to exactly <strong>how</strong> I was standing and a lot of attempted avoidance from me.  In short, this flashback is one wherein I was pinned to the (outside of) the garage wall, my knees bent forward considerably so that I was at the &#8216;right&#8217; height and angle to suck Paedo&#8217;s cock.  The pain emanates from the pebble-dashing of the wall pressing into my back, as well as being pushed against the wall with some force during each hideous thrust.</p>
<p>I managed to get out of telling C what went on, but he couldn&#8217;t understand what way I was standing during the incident in question, leading to much confusion.  I was about to act it out for him, but found that I couldn&#8217;t bring myself to do so, and told him as much.</p>
<p>He said, &#8220;could you <strong>draw</strong> it for me?&#8221;, pushing a pen and a bit of the bland Trust-headed note-paper towards me.</p>
<p>I was surprised at the request, and ever so slightly horrified, but made some gesture of reluctant acquiesence, and drew a stick-figure me contorted against a wall in the aforementioned grotesque fashion.  To my immense revulsion, C then went to the wall and physically depicted the stance I&#8217;d drawn myself in.  &#8220;Like this?&#8221; he asked.</p>
<p>I nodded, and looked away, suddenly &#8216;back there&#8217; for a minute or two.</p>
<p>Fortunately &#8211; or otherwise, depending on your perspective &#8211; this was at the tail end of the session and he couldn&#8217;t probe me deeper any further.  He said that his supposition was that this particular incident was a forced incident of oral sex (no shit).</p>
<p>&#8220;But,&#8221; he added thoughtfully, stroking his chin.  &#8220;I don&#8217;t think calling it &#8216;oral sex&#8217; is an accurate term.  It&#8217;s <strong>not</strong> sex; the word &#8216;sex&#8217; implies consent, not to mention the <strong>ability</strong> to consent.&#8221;</p>
<p>I stared at him blankly, determined to give nothing away.</p>
<p>And that&#8217;s suddenly reminded me of one thing that happened in the &#8216;lost&#8217; half hour: I remember repeating over and over again that &#8220;shagging one&#8217;s uncle at the age of <strong>five</strong> is <em><strong>disgusting</strong></em>,&#8221; and C reminding me that a five year old can&#8217;t consent, and my counter-protesting that I <strong>knew</strong> that, but that didn&#8217;t change my view on how <em>disgusting</em> I was/am and that no amount of evidence or rationalisation ever would.</p>
<p>Indeed, I now remember that I repeated the word &#8216;disgusting&#8217; in relation to myself and what happened over and over and over and over again, then went into a self-vituperation of epic proportions for failing to employ synonyms of &#8216;disgusting&#8217; in my speech, thus in turn failing to utilise the English language in a more creative fashion.  Very rational and helpful, I&#8217;m sure you&#8217;ll agree.</p>
<p>Anyhow, discussion of the forced-fellatio-flashback completed (that even <strong>sounds</strong> like a dubious sexual practice), I was feeling physically ill and as if I were about to explode with a doom-filled internal energy.  I joked to C that I was going to throw up all over him, and he joked back that he would dodge the vomit and catch it in the bin.  For some reason the gentle banter calmed me slightly &#8211; but I was still in full-on crazy-mode.</p>
<p>As a consequence, I held out my hand in front of me, in order that I could measure how much it was shaking.  This harks back to an incident when I was 15.  The day after I&#8217;d found out about my ex&#8217;s colossal betrayal &#8211; an incident about which I must write one of these days &#8211; I was sitting in school, literally shaking from head to toe.  At one point I noticed my extended right hand shaking up and down, like the Golden Gate Bridge shaking in an earthquake.  Ever since, I have used that as a benchmark to determine my levels of overt anxiety.</p>
<p>It was shaking a fair bit on Thursday, but not unmanageably so.  &#8220;That&#8217;s OK,&#8221; I muttered thankfully, mainly to myself.</p>
<p>I noticed C&#8217;s raised eyebrow, and explained what I was doing.  I was delighted when he said that he&#8217;d seen me doing it before.  <em><strong>I </strong></em>know he&#8217;d seen me doing it before, but it was the fact that <strong>he</strong> remembered such a small, meaningless thing about me that was so pathetically important.</p>
<p>I was further delighted when he described my facing up to the fellatio flashback with him as &#8216;brave&#8217;.  He&#8217;d also said I was &#8216;brave&#8217; in the <a href="/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/">last session</a>, and I have to say, the fact that he thinks this makes my heart and mind sing like something out of <em>The Sound of </em>fucking<em> Music</em>.</p>
<p>Clearly, though, C does not know that his endorsement (if that&#8217;s the right word) has such a positive effect on me.  He said, &#8220;you probably don&#8217;t like me calling you &#8216;brave&#8217;, do you?&#8221;</p>
<p>I nonchalantly responded that I &#8220;didn&#8217;t mind&#8221; the use of the adjective in reference to me.  Oh, what a belier of truth I am!</p>
<p>I went on and told him that although I appreciated him saying that, that it really didn&#8217;t &#8220;fit&#8221; with what I felt about myself.</p>
<p>&#8220;I&#8217;m not brave in my mind,&#8221; I murmured quietly.</p>
<p>&#8220;Well,&#8221; he responded, rather definitely and slightly authoritatively.  &#8220;<strong><em>I</em></strong> think you <strong>are</strong> brave.&#8221;</p>
<p>And for the second week running, I got an &#8220;all the best&#8221; as I left, which always makes my week.  I&#8217;m still desperate for him to actually like me, which I know rationally is probably a silly pipedream.  But his present extension of an arm of kindness comforts and reassures me, and I&#8217;ll continue to bask in its loveliness for some time to come.</p>


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		<title>Psychiatry and Psychotherapy: An Anti-Psychosis Army?  NewVCB and C: Week 47</title>
		<link>http://serialinsomniac.com/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/</link>
		<comments>http://serialinsomniac.com/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/#comments</comments>
		<pubDate>Sun, 25 Apr 2010 22:05:24 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Medications]]></category>
		<category><![CDATA[Psychiatry]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[attachment]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[child sex abuse]]></category>
		<category><![CDATA[child sexual abuse]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[dissociation]]></category>
		<category><![CDATA[hallucinating]]></category>
		<category><![CDATA[hallucinations]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[paedophilia]]></category>
		<category><![CDATA[psychodynamic psychotherapy]]></category>
		<category><![CDATA[psychoses]]></category>
		<category><![CDATA[psychosis]]></category>
		<category><![CDATA[quetiapine]]></category>
		<category><![CDATA[rape]]></category>
		<category><![CDATA[seroquel]]></category>
		<category><![CDATA[suicidal ideation]]></category>
		<category><![CDATA[therapeutic abandonment]]></category>
		<category><![CDATA[therapeutic attachment]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[trauma]]></category>
		<category><![CDATA[win]]></category>
		<category><![CDATA[zopiclone]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1458</guid>
		<description><![CDATA[I don&#8217;t really see a lot of point in going into great detail about last week&#8217;s (15 April) session with C, mainly as we spent almost the entire time together discussing my recent hallucinations which I have already detailed here and here. Furthermore, because I&#8217;ve been too lazy, too fuckwitted or too pre-occupied with other <a href='http://serialinsomniac.com/2010/04/25/psychiatry-and-psychotherapy-an-anti-psychosis-army-newvcb-and-c-week-47/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>I don&#8217;t really see a lot of point in going into great detail about last week&#8217;s (15 April) session with C, mainly as we spent almost the entire time together discussing my recent hallucinations which I have already detailed <a href="/2010/04/15/acting-the-hidden-psychoses/">here</a> and <a href="/2010/04/19/death-of-sanity/">here</a>.  Furthermore, because I&#8217;ve been too lazy, too fuckwitted or too pre-occupied with other inane, probably pointless shite, I have of course forgotten a lot of the session&#8217;s nuances and subtitles.  &#8216;Tis my own fault.  I should have written about it sooner, but I&#8217;ve been existing in a haze of exhaustion and combined Quetiapine/Zopiclone hangovers, so to my eternal disgust the blog hasn&#8217;t been as high up my priority list as it should have been.  It&#8217;s taking all the energy I have left even to write this rambling crap.</p>
<p>C opened the session by noting that it had been a fortnight since I&#8217;d last seen him, a meeting <a href="/2010/04/07/admitting-the-extent-of-the-abuse-c-week-46/">during which</a> I had apparently &#8220;taken a very brave step&#8221; in admitting that I was systematically raped as a child.  Brave.  He called me <em>brave</em>.  He <em>complimented</em> me, or at least <strong>I think</strong> he did&#8230;and my cynical little heart leapt with joy.  <strong><em>Pa-the-<span style="text-decoration: underline;">tic</span></em></strong>.  I hope I managed to hide my internal manic rapture; I know he knows about my attachment to him, but this is ridiculous!  (Actually, I think I must have hid it quite well because the next week, when he used the same word, he supposed that I would <strong>object</strong> to him describing me as such.  But more of that in a post or two).</p>
<p>He asked how admitting to the reality of things in session had been for me, and I told him that I was kind of surprised by how calm and measured I had felt as I&#8217;d detailed the extent of the molestation.  Encouraged by that, he then asked how things had been <strong>since</strong> that discussion.</p>
<p>I threw my head back and laughed out loud, in what was, on reflection, a hideously maniacal fashion.  Sensing his surprised bemusement, I stopped myself and said, quite definitely yet sardonically, &#8220;things have been just <strong>fine</strong>!&#8221;</p>
<p>He raised his eyebrow, as well he might have done.  He said, &#8220;your reaction to the question and your body language would strongly refute that.&#8221;</p>
<p>&#8220;Well,&#8221; I sighed eventually, &#8220;let&#8217;s put it this way: it&#8217;s a good thing I&#8217;m seeing the psychiatrist next week&#8221;.  Then I actually bit the bullet and volunteered the information to him about the ongoing persecution from &#8216;They&#8217; and fake-Paedo.  As I say, there&#8217;s not a great deal of point in getting into the minutiae of that conversation, but one point of note was that he decided he would &#8216;map&#8217; my mind on his whiteboard.  He did something similar <a href="/2009/07/02/he-may-be-attacking-but-my-shrink-is-not-resigning-c-week-17/">once before</a> in relation to my behaviour when I feel threatened and on the perennial abandonment anxieties, and the intellect inside me had found it quite fascinating.</p>
<p>C divided the map into two sections.  There&#8217;s &#8216;additional&#8217; &#8220;presences&#8221; in my mind (initially he asked if I wanted to call them &#8216;presences&#8217; or &#8216;parts&#8217;.  I went with the former because &#8216;parts&#8217; infers that they&#8217;re somehow <em>part of me</em>, and whilst I accept that possibility intellectually, that is not how it feels at all), plus there&#8217;s the very obvious internal sides of myself, several of whom keep up a running commentary in my head most of the time.</p>
<blockquote><p><strong>Presences</strong></p>
<p><span style="text-decoration: underline;">&#8216;They&#8217;</span> &#8211; multifaceted, malevolent, potentially harmful.<br />
<span style="text-decoration: underline;"><a href="/2009/10/01/hearing-the-voice-and-other-psychoses/">Tom</a></span> &#8211; benign and soothing &#8211; but does he still exist?<br />
<span style="text-decoration: underline;">Fake-Paedo</span> &#8211; though his &#8216;existence&#8217; is arguable as he appears <strong>outside</strong> my mind (as do &#8216;They&#8217; at times).</p>
<p><strong>Sides of Me</strong></p>
<p><span style="text-decoration: underline;">The Bitch</span> &#8211; (&#8220;I&#8217;m only using that term because you insist on it&#8221;, apparently).  Finds the other sides weak and pathetic.  Contemptuous of them.<br />
<span style="text-decoration: underline;">The Child</span> &#8211; scared, hurt, vulnerable &#8211; in need of someone to take care of her.<br />
<span style="text-decoration: underline;">The Intellect</span> &#8211; &#8216;everything can be rationalised&#8217; (though as I said, to C&#8217;s amusement, I am a walking quintessence of the ironic falsehood of that statement)<br />
Plus the <span style="text-decoration: underline;">healthy adult</span> and some others.  It harks back to our various discussions on <a href="/2009/12/09/countdown-to-abandonment-c-week-33/">schemas</a>, which he again acknowledged (and on which C has published research specifically on BPD!).</p></blockquote>
<p>The long and the short of this analysis was that C thinks the psychoses (or, as he perhaps more aptly seems to believe them to be, the dissociative presences) are caused by a splintering of my mind, thanks to having to deal with such graphic and enormous matters in therapy after having repressed them for so many years.</p>
<p>He said, &#8220;you are of course extremely intelligent, so I think you know that yourself, don&#8217;t you?&#8221;</p>
<p><em>Did he just call me &#8216;extremely intelligent&#8217;?  Why, I rather believe he did.  EPIC WIN, Pan, epic fucking win!  Another compliment!!!</em> Once more my perfidious heart nigh on exploded with delighted glee.</p>
<p>I admitted that rationally it was quite obvious to me that this bout of psychotic symptoms was caused by recent revelations in therapy, especially given the timing of the episodes.  &#8220;However,&#8221; I went on, &#8220;that doesn&#8217;t keep them from feeling utterly vividly and absolutely real.&#8221;</p>
<p>Apparently he had not intended to suggest otherwise, but merely wanted to explore the motivations for their manifestations.  The fact that their whinging (&#8220;slut, whore, bitch&#8221; etc) is in keeping with the whinging of The Bitch seems to provide further evidence for this position &#8211; it&#8217;s just that &#8216;They&#8217; have become a more extreme form of a similar thing.  In the absence of a compassionate side of myself, Tom had (temporarily, alas) fulfilled that function.  &#8216;They&#8217; are just sort of doing the opposite.</p>
<p>I said to C, &#8220;you know that &#8216;They&#8217; won&#8217;t like this analysis.&#8221;</p>
<p>&#8220;I&#8217;m sure they won&#8217;t,&#8221; he said automatically.  &#8220;They&#8217;ll probably think it&#8217;s a load of bollocks.&#8221;</p>
<p>For some reason this made me laugh a lot, probably because it was so completely spot-on.  I told C that they didn&#8217;t like him, and he didn&#8217;t seem surprised.  He didn&#8217;t say it the way A so explicitly does, but something in his body language intimated to me that he doesn&#8217;t like &#8216;They&#8217; either.</p>
<p>He never remembers their name.  He keeps calling them &#8216;Them&#8217; or something, then he ends up berating himself for not getting it right.  &#8220;It&#8217;s not <strong>your</strong> fault,&#8221; I exclaimed defensively at one point, &#8220;it&#8217;s their&#8217;s!  <strong>They&#8217;re </strong>the ones that are gramatically challenged, not you!&#8221;</p>
<p>I mean, what kind of sad tossers go around calling their collective selves &#8216;They&#8217;?  Do they think they sound hard or something?  Come on, &#8216;They&#8217; &#8211; it&#8217;s not like it&#8217;s the fucking Crips or Bloods, now is it?  Why can&#8217;t you at least assign names to each other?</p>
<p>Anyway, I digress.  I don&#8217;t know how we got back on to the sex abuse topic specifically, but at one point C said something about getting me to articulate some of the actual minituae of the incidents.  I (literally) recoiled in horror at the suggestion.</p>
<p>However, I knew that <em>I</em>, for once, had the upper hand; we had talked so much about the psychoses that I knew there could be very little time left for anything else, let alone something so difficult to address.  So I said, &#8220;you don&#8217;t seriously expect me to do that <strong>today</strong>, do you?&#8221;</p>
<p>I watched as his eyes shifted from me, to the strategically-placed clock behind my head.  He looked at it for a few seconds before conceding that no, he <strong>didn&#8217;t</strong> expect me to do it today.</p>
<p>And that was that really.  I got a &#8220;take care, all the best,&#8221; on the way out, which always brightens my Thursdays, pathetic as they and I are.</p>
<p><span style="text-decoration: underline;"><strong>The &#8216;S&#8217; and &#8216;H&#8217; Words</strong></span></p>
<p>So onward to the psychiatrist, on Wednesday 21 April (also the anniversary of the day I met A!).  In a stylistic homage to her predecessor, NewVCB kept me waiting for nearly 20 minutes after my allocated time.  I was interested to note that, before summoning me, she came into the waiting room and handed some old git an envelope (which I assume was a prescription, as she did the same for me before I left).  I didn&#8217;t care in any way that this occurrence took place.</p>
<p>Sounds innocuous, right?  Of course it does.  Why even mention it, Pan, you stupid, pedantic cow?  Well, the thing is, if <em><strong>C</strong></em> had come into the waiting room and interacted with one of the assorted mentalists in front of my face, I would have had a <strong>complete </strong>shit attack, and probably throttled him (and the relevant mentalist too for that matter).  I give you <em>Attachment in Action</em>, my friends.  C is not allowed to have anything to do with <strong>anyone</strong> but me, least of all some other bloody mental.  <em><strong>I </strong></em>am the focus of his world.  He has no other patients.  He has no other <strong>life</strong>.  It is only me.  C and me.  Me and C.  He exists only in those 50 minutes each Thursday, because <strong>he exists only for me</strong>.  <strong>That is the way it is</strong>.</p>
<p>Oh, what a LIFE FAIL as I have.</p>
<p>Anyhow, again I digress.  NewVCB showed me to her office and asked how things had been, and I just sort of collapsed in a wobbly mess in front of her.  No tears or anything, but lots of agitated, highly disturbed rambling.  Somehow, amidst the virtual delirium of my babbling, I managed to convey what had been happening to me.</p>
<p>The first thing of note was that NewVCB used the &#8216;s&#8217; word in front of me.  She had done once before, but on that occasion had absolutely refuted its relevance to me.  On Wednesday, however, she said, &#8220;in the past &#8211; the fairly recent past at that &#8211; you&#8217;d have been diagnosed with a schizophrenic illness.&#8221;</p>
<p>I had, at one point, decided that I had schizoaffective disorder (given my asinine tendencies towards self-diagnosis), but nevertheless &#8211; hearing this kind of comment from a consultant psychiatrist unsettled me greatly.  &#8216;Schizophrenia&#8217; is a <strong>big</strong> word to have thrown at you, even though I can see why I would once have been felt by the discipline of psychiatry to have it.  I don&#8217;t know why it sounds so daunting; after all, I am effectively medicated for it, or at least a sub-threshold version thereof.  Still, her use of the word struck terror in my heart (which by this point most assuredly <strong>wasn&#8217;t</strong> leaping with joy or threatening to explode with delight or whatever other sickly metaphor I used above regarding C&#8217;s quasi-compliments).</p>
<p>Anyhow, she continued: &#8220;but we now know, thanks to much research in the area, that there&#8217;s almost two types of psychosis.  There&#8217;s your traditional schizophrenic, firmly-believed and long-term psychoses, and then there&#8217;s this other branch that is often seen in severely traumatised people like yourself.&#8221;</p>
<p>Point of Interest II.  <em>Severely traumatised like [me]</em>?  <em>Severely <strong>traumatised</strong></em>?<em> Rid-<strong>ic</strong>-ulous!</em> Cue silly internal ruminative roundabout of denial-like idiocy: <em>What the hell is she talking about?  I&#8217;m not traumatised &#8211; I&#8217;m a little whore that got justly punished for the disgusting thing of fetid-ness that she was and is.</em> <em>Trauma.  Scoff!!!  lolz like innit</em> (all this notwithstanding the fact that I <a href="/2010/03/07/bpd-vs-c-ptsd/">diagnosed myself </a>with ((and gained <a href="/2010/03/10/psychiatrist-appointment-win/">confirmation</a> from NewVCB that I have)) complex post-<strong>trauma</strong>tic stress disorder.  Go figure.  I&#8217;m a walking contradiction).</p>
<p>Of course, the Me that was in control of my voicebox at the time didn&#8217;t make use of it, and I therefore found myself simply nodding every so often to acknowledge the fact that NewVCB was speaking.  She said at one point that her &#8220;instinct [was] to throw medication at [me],&#8221; but that she knew logically that this was stuff that, in the main, needed to be worked through psychologically.</p>
<p>Not surprisingly this led on to a discussion about the imminent-ish end of therapy.  I don&#8217;t remember exactly what she said, but the inference was that useful work can be done in the remaining &#8211; what?  Eight or nine? &#8211; weeks.  She said, &#8220;you have to stop viewing it as some sort of countdown.&#8221;</p>
<p>I laughed in her face.  I laughed in her face with barely concealed bitterness, contempt and irritation.  &#8220;Don&#8217;t you think,&#8221; I began, through gritted teeth, &#8220;that if it was <strong>possible</strong> to not view it as a countdown that <strong>I would be doing so</strong>?&#8221;</p>
<p><em>Some non-committal response.</em></p>
<p>&#8220;I have tried, NewVCB,&#8221; I told her, very definitely.  &#8220;I have tried, and I cannot <strong>not</strong> view it as a countdown.  I can still work well with C despite that, but that reality is not going away.&#8221;</p>
<p>To be fair, and to my surprise, she backed down and appeared to accept this.  Then she started rattling on about breaks from therapy which are only temporary.</p>
<p>Apparently what &#8220;quite often&#8221; happens is that patients leave therapy, for a matter of months, maybe even in excess of a year.  During that time they put their newfound self-understanding and training for &#8216;real&#8217; relationships and situations into practice.  Then, some time later, they&#8217;re referred back to therapy to build on the work they had previously done, both in and out of session.  How did that sound to me?</p>
<p>&#8220;In principle I have no strong objections, though it does seem curious to cut the process short when one is in the middle of something so important as this, especially given how rushed and forced into things I feel,&#8221; I told her.  &#8220;Whatever the case, though, what I <strong>could not stomach</strong> is being referred back to therapy, only to be forced into some wanky C- or DBT.  I promise you, that would be a <strong>very</strong> bad idea.  Any therapy with &#8216;BT&#8217; in the title will <strong>not</strong> work for me, and will only serve to make me very angry indeed.&#8221;</p>
<p>To my <strong>amazement</strong>, rather than defend the health service&#8217;s little alleged panaceatic wankeries of non-loveliness, she nodded in agreement with me.  Score.</p>
<p>I went on.  &#8220;Besides, it&#8217;s not <strong>just</strong> about the <strong>type</strong> of therapy; it&#8217;s an issue of personalities.  I <a href="/2009/09/02/a-half-life-in-therapy-the-fabled-post-of-therapists/">saw</a> <strong>Christ knows</strong> how many people before I met C, and he&#8217;s the first one that has been of<strong> any</strong> real help to me.  I know that literature on this matter agrees that the therapeutic relationship is absolutely fundamental to healing, insofar as healing is possible.&#8221;</p>
<p>Again she nodded.  &#8220;There are no guarantees; things change in the health service just like they do in any place of employment.  C could obviously leave his job here for another one.  But, assuming there are no such changes, we try to put people back with the folks that have previously treated them.&#8221;</p>
<p>Point of Interest Mark III.  That was <strong>very</strong> interesting.  C has made no reference to anything of this nature.   Additionally, it seems slightly at odds with a comment NewVCB made when I <a href="/2010/01/20/first-appointment-with-newvcb/">first met her</a> &#8211; she said something along the lines of her being sure that C would extend things now if he felt it was necessary.  C had, rather obviously, made no reference to that course of action either.</p>
<p>Part of me has wondered since C <a href="/2009/12/09/countdown-to-abandonment-c-week-33/">imposed</a> this ending if he has been doing it to force me into talking.  If he would change his mind later in the contract because he was getting somewhere &#8211; which he now <strong>is</strong>, of course.  I had always thought that what he wanted me to think was that the cessation of the process was about (a lack of) resources.  But if what NewVCB says is true, how can that be?  Maybe he wants to end things because of my attachment to him, an issue of which he is fully aware.  But surely the antidote to that is to fucking work through it <strong>with him</strong>, rather than find myself thrown out in the deep end that is the cuntified, horrible, real bloody world?</p>
<p>Anyway.  <em>Anyway</em>.  <em>Siiiiigh</em>.</p>
<p><strong>Anyway</strong>.  Eventually discussion with NewVCB centred around medication; she did exactly what I&#8217;d expected her to do and told me she would increase my dose of Quetiapine from 300mg to 400mg.  She warned, however, that she intended this to be temporary.</p>
<p>Her rationale for this dose and its probable temporary nature is primarily that she wants me to get through this particularly difficult period in therapy, of course &#8211; since the drug had had such a good effect in its 300mg dose, it would be hoped that once this current spell is dealt with psychologically, that that dose would once again be effective.  Secondly, though, she wants to leave herself &#8220;room to play with,&#8221; in case the dose needs to be increased further, which she suspects it eventually might.  She had already warned me that she&#8217;d be reluctant to take me over about 700mg, so she felt that she needed to leave a reasonable gap between that maximum dose and the present one.</p>
<p>And here she scared me.</p>
<p>She said, &#8220;I don&#8217;t want to over-medicate you [<em>fine</em>], but we do need to make sure you don&#8217;t go further downhill and that you can continue to do this work with C [<em>still fine</em>].  If I didn&#8217;t increase the medication, then that could slide [<em>OK</em>].  At the end of the day&#8230;[<em>dramatic pause</em>]&#8230;[<em>looks me straight in the eye, her left eyebrow slightly cocked</em>]&#8230;<span style="text-decoration: underline;">our priority is to <strong>keep you safe</strong></span> [<em>clears throat guiltily</em>,<em> shifts gaze</em>].&#8221;</p>
<p>Her euphemism, especially when accompanied by such powerful body language, is clearly psychiatristspeak for <strong>HOSPITAL</strong>.  Yet another point of interest, though in this case one I would rather not have had.</p>
<p><em>No fucking way, no way no way no way.  I will kill myself first.  I.  WILL..  KILL.  MY.  SELF.  Do you fucking hear me, you bitch?</em></p>
<p>Of course, rather than make any such protest &#8211; which may well have been interpreted as a borderline strop anyway &#8211; In-Control Me just looked at her meekly, and even fucking <strong>nodded</strong>.</p>
<p>I was, however, determined to steer her away from continued thoughts around this subject, so I took the opportunity to beg her for sleeping tablets.  She agreed, to my considerable satisfaction (and in hilarious defiance of <a href="/2010/01/04/the-latest-nhs-complaint/">Twathead GP</a>.  Interestingly, Twathead had accused me of insubordination vis a vis the consultant&#8217;s advice on Venlafaxine, but now the shoe&#8217;s on the other foot, Twathead; he refused to give me Zopiclone, and hey presto &#8211; look what <strong>the consultant</strong> is now doing!   Hahaha!  <em>Mwha</em>hahahaha!!!).</p>
<p>I actually got really lucky with the Zopiclone prescription, owing to an administrative mistake at the GPs&#8217; &#8216;surgery&#8217;.  But that, along with the entire comedy of errors that was obtaining my prescriptions, is a story to be told on another day.</p>
<p>In conclusion, I suppose there&#8217;s some encouragement to take from this appointment, especially re: the cessation of therapy issue.  I <strong>think</strong>, whether C will admit it or not, that NewVCB probably has <strong>some</strong> influence on how he proceeds &#8211; and if the courses of action that she has mooted are indeed possible, well, that&#8217;s better than the alternative of complete abandonment.  The question remains though &#8211; does C<em><strong> </strong></em><strong>know</strong> about any of this?</p>
<p>She was going to talk to him after my most recent appointment with him (blog upcoming) so we&#8217;ll see what, if anything, comes of that.  In the meantime, I&#8217;m a vertiable walking pharmacy and glad of it, and think I am ready to continue the anti-Paedo / anti-&#8217;They&#8217; fight with C.  All of the non-existent bastards are still hovering about for now, but Quetiapine has served me well in the past, and I have faith that it can do it once more.</p>


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		<title>Admitting the Extent of the Abuse &#8211; C: Week 46</title>
		<link>http://serialinsomniac.com/2010/04/07/admitting-the-extent-of-the-abuse-c-week-46/</link>
		<comments>http://serialinsomniac.com/2010/04/07/admitting-the-extent-of-the-abuse-c-week-46/#comments</comments>
		<pubDate>Wed, 07 Apr 2010 06:30:33 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Sexual Abuse]]></category>
		<category><![CDATA[Traumatic Stuff]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[child sex abuse]]></category>
		<category><![CDATA[child sexual abuse]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[countertransference]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[mental health]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[molestation]]></category>
		<category><![CDATA[paedophilia]]></category>
		<category><![CDATA[psychodynamic psychotherapy]]></category>
		<category><![CDATA[rape]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[transference]]></category>
		<category><![CDATA[trauma]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1332</guid>
		<description><![CDATA[I don&#8217;t know how to start this entry. I just wrote two paragraphs of completely pointless drivel that appears to have been designed to avoid getting to the point. It&#8217;s not that I found myself to be particularly upset at any juncture during the session that this post details, but there were so many gruesome <a href='http://serialinsomniac.com/2010/04/07/admitting-the-extent-of-the-abuse-c-week-46/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>I don&#8217;t know how to start this entry.  I just wrote two paragraphs of completely pointless drivel that appears to have been designed to avoid getting to the point.  It&#8217;s not that I found myself to be particularly upset at any juncture during the session that this post details, but there were so many gruesome words involved.  I hated them being said, I&#8217;ll hate to type them.  God.  Why are matters pertaining to one&#8217;s reproductive organs so difficult to deal with?  OK, so here I am talking about <strong>abuse</strong>, but I&#8217;m not sure using the terminology required would be much easier even if I was detailing <strong>consensual </strong>sexual behaviour.</p>
<p>The meeting started as they all do.  He looks at me, I look at him in the hope that he&#8217;ll ask or tell me something, then I shift my glance to the safety of the floor.  Except on this occasion, he said, &#8220;at this point, I usually ask you where you&#8217;d like to begin&#8230;&#8221;</p>
<p>He trailed off, and I made some mutterance of agreement.</p>
<p>&#8220;&#8230;and you usually seem a bit agitated and unsure&#8230;&#8221;</p>
<p><em>Flippin&#8217; &#8216;eck, guv, you&#8217;re quick, ain&#8217;tcha?</em></p>
<p>&#8220;&#8230;and then we sit in silence for a bit&#8230;&#8221;</p>
<p><em>Fail, Pandora, fail fail fail&#8230;</em></p>
<p>&#8220;&#8230;and finally you end up completely berating yourself as being a &#8216;stupid time-wasting bitch&#8217;, if I&#8217;m not mistaken.&#8221;  He rather drolly raised an eyebrow.</p>
<p>Well, that about sums it up C, yes.  I nodded in agreement, and in his aforementioned time-honoured fashion, looked silently away.</p>
<p>Eventually, against his better judgment I think, he asked me how things had been in the fortnight since I&#8217;d last seen him.</p>
<p>I genuinely considered this for a few minutes, but in the end was surprised to report that things had been mostly fairly stable.  I&#8217;m finding my trademark insomnia returning somewhat (thanks Quetiapine, you wonderful, dreadful drug), but beyond that I&#8217;ve been moderately sane.</p>
<p>&#8220;OK,&#8221; he said.  &#8220;And how do you feel about things here &#8211; in the sense that we didn&#8217;t meet last week, won&#8217;t meet next week and so only have this <strong>one</strong> week together for now?&#8221;</p>
<p>Of course, the truthful answer to that was, &#8220;<strong>it fucking sucks, how dare you not prioritise me above your bloody personal life, you cruel bastard</strong>.&#8221;  But I was hardly going to admit that to <strong>him</strong>, was I?</p>
<p><em>Shrug a bit, avoid his gaze</em>.  &#8220;I suppose it&#8217;s not ideal really &#8211; it&#8217;s a bit disjointed, isn&#8217;t it?&#8221; I stammered, finally.</p>
<p>He nodded, and admitted that that had been his feeling also.  I suppose that begged the question in my mind of why we&#8217;d even bothered to have this &#8216;in-between&#8217; session &#8211; but having said that, I <strong>was</strong> glad of it, as I am always so glad to see him after some sort of disruption in our shared little dance of therapeutic strangeness.</p>
<p>Perhaps my best bet in proceeding with this story is just to detail what I remember as it emerges from the tips of my fingers onto the page.  I don&#8217;t remember why some things were brought up, and I don&#8217;t remember properly the order in which some conversations developed.  So here we go&#8230;</p>
<p>I remember being pissed off about some stuff he&#8217;d brought up in the <a href="/2010/03/30/responsibility-c-week-45-and-other-pointless-drivelsome-bollocks/" target="_blank">previous session</a>.  That is to say, I wasn&#8217;t pissed off particularly <strong>at the time</strong> of the session, but upon later consideration, I became so.  The whole shite that I &#8220;played a tug of war&#8221; was especially irritating.  I told him I felt that that analysis had been unreasonable and unfair.</p>
<p>He claimed that he hadn&#8217;t meant to suggest that I deliberately fight against him, but just that both sides can sometimes become defensive over some topics (in my experience, usually the competence or otherwise of the NHS).</p>
<p>To me, there doesn&#8217;t seem to be a great deal of difference between a suggestion that I&#8217;m &#8216;fighting&#8217; him and what he said, but I let it pass, and just looked at him.</p>
<p>It led to silence.  He watched me.  I watched him.  Eventually I lost it with myself and said, &#8220;yes, you see I <strong>am</strong> a fucking time-wasting bitch, this exemplifies it!&#8221;</p>
<p>C asked if there were &#8220;alternative ways&#8221; of looking silences in therapy.</p>
<p>&#8220;Of course there are,&#8221; I spat.  &#8220;It&#8217;s irrelevant, because I don&#8217;t and won&#8217;t think them to be true representations of it.&#8221;</p>
<p>&#8220;Still,&#8221; he insisted, &#8220;what <strong>are</strong> those alternatives?&#8221;</p>
<p>&#8220;One is that silence gives us time to reflect on recently discussed matters,&#8221; I started uncertainly.  &#8220;A second is that it <strong>surely</strong> must be <strong>reflective</strong> of some psychological process, musn&#8217;t it?&#8221;</p>
<p>I noticed a smirk cross his face, and realised the potential connotations of what I&#8217;d just said.</p>
<p>&#8220;Did I just make a slight on your entire profession?&#8221; I asked, smiling sheepishly.</p>
<p>He laughed.  &#8220;I suppose something <strong>can</strong> be read into silences though, don&#8217;t you think?&#8221;</p>
<p>I assume this was the part where I was on the verge of being accused of &#8216;withholding&#8217;, which is no doubt exactly what I was doing.</p>
<p><em>Silence, not speech.  To withhold information is to deny its existence.  Then it is not real, Pandora.</em></p>
<p>&#8220;Well, I don&#8217;t know, C,&#8221; I smiled.  &#8220;<strong>I&#8217;m</strong> not the psychotherapist!&#8221;</p>
<p>He thought about that for a minute, but before he could respond, he was somewhat taken aback to see me laughing.  He asked what it was that amused me so.</p>
<p>&#8220;The very <strong>notion</strong> of <strong>me</strong> as a psychotherapist,&#8221; I howled.  &#8220;It&#8217;s utterly ludicrous.  I&#8217;m so devoid of sympathy and empathy for people that I&#8217;d fuc the poor sods up even more!&#8221;  Dreadful (though, I must confess, vaguely amusing) images of therapist-me landing into a pub blabbling all my clients&#8217; secrets to the assembled punters danced happily through my visual consciousness.</p>
<p>I laughed on, then heard the sounds of my amusement rather quickly fading, as I realised the territory into which I&#8217;d just unwittingly walked.  Empathy.  C&#8217;s favourite subject.  Specifically, my (alleged) need to empathise with and show compassion to myself.</p>
<p>I tried to avoid it.  I said, &#8220;do you remember when we first met &#8211; I couldn&#8217;t have cared less if people were lying about the place dead or in pain, but if I saw a mere scratch on a car, I&#8217;d break down and bawl my eyes out for hours?&#8221;</p>
<p>He nodded in response.</p>
<p>&#8220;That&#8217;s projection, right?&#8221;</p>
<p>&#8220;Well&#8230;&#8221;</p>
<p><em>Don&#8217;t let her intellectualise&#8230;</em></p>
<p>&#8220;Well, whatever &#8211; I don&#8217;t think it&#8217;s as bad as it was,&#8221; I pronounced triumphantly.  I exemplified by informing C that one of the cats had recently, for the first time, presented us with a dead mouse as a &#8216;present&#8217;.</p>
<p>&#8220;I didn&#8217;t end up cradling the mouse and weeping for its lost life,&#8221;  I said smugly.  &#8220;I <strong>was</strong> angry with the cat, but I didn&#8217;t lose it really; I just quite calmly asked A to dispose of the cadaver.&#8221;</p>
<p>&#8220;Um&#8230;OK..,&#8221; he said.  &#8220;And in what way are you now able to demonstrate the sympathy or <em>compassion</em> you&#8217;d have previously had for the mouse?&#8221;</p>
<p>I can&#8217;t remember what way I reacted to this, but C stopped me before I could speak and said, &#8220;I suspect when I say that word [compassion] you&#8217;re thinking, &#8216;oh, for <strong>fuck&#8217;s</strong> sake&#8217;, aren&#8217;t you?&#8221;</p>
<p>&#8220;I certainly wince every time I hear it, yes.&#8221;</p>
<p>He nodded.  &#8220;I really do think that developing self-compassion is a major necessity in our work.&#8221;</p>
<p>&#8220;I <strong>am</strong> trying,&#8221; I told him, thinking back to the <a href="/2010/02/17/ranting-about-mum-and-peace-making-with-c-week-41/">discussion</a> we&#8217;d had about a self-soothing book I&#8217;m reading.  Or read.  Or read <em>a little bit of</em>.  Hmm&#8230;</p>
<p>I said, &#8220;my current reading material is Judith Herman&#8217;s <em>Trauma and Recovery</em>, have you read it?&#8221;</p>
<p>&#8220;No,&#8221; he replied (to my surprise).  &#8220;That&#8217;s the book about complex PTSD, right?&#8221;</p>
<p>I nodded.</p>
<p>&#8220;That was quite controversial when it was released, wasn&#8217;t it?&#8221;</p>
<p>Well, given that I wasn&#8217;t taking the most profound interest in psychiatry in 1991 when I was <strong>seven</strong>, C, it may not surprise you to learn that I don&#8217;t actually know.  (Incidentally, a quick Google search does suggest <strong>some</strong> controversy upon the book&#8217;s publication, but I&#8217;ve yet to come across its exact nature).</p>
<p>My response was to say that Herman wrote from what I felt was a feminist perspective.  &#8220;I know 1991 was a good few years after second-wave feminism,&#8221; I sighed, &#8220;but sadly that takes us into the era of what I believe to be a form of post-feminism, so I suppose yes &#8211; it could <strong>indeed</strong> have been rather controversial in that sense.&#8221;</p>
<p>(He seemed quite impressed with my crude knowledge of feminist chronologies.)</p>
<p>He asked how I was finding the book, and I said, simply, &#8220;good.&#8221;</p>
<p>I was perplexed to see C smiling at this (lack of) analysis.  He kept smiling and looking at me, which although oddly nice in a way, kind of freaked me out at the same time.</p>
<p>I said, &#8220;why are you smiling at me like that, C?&#8221;</p>
<p>&#8220;Your perpetual detachment, your avoidance.  There&#8217;s a lot of&#8230;<em>relevant</em>&#8230;material in that book, and rather than discuss that, you merely pronounce it to be &#8216;good&#8217;.&#8221;</p>
<p>&#8220;Oh, OK, I hadn&#8217;t realised you wanted the <em>London Review of Books</em>,&#8221; I sneered.  &#8220;I&#8217;m reading the child abuse chapter at the minute.  It&#8217;s like reading an autobiography penned by me.  Do you see?&#8221;</p>
<p><em>And so it begins.</em></p>
<p><em>Subject shift, even if only subtly.</em></p>
<p>&#8220;You asked earlier if anything had happened since I last saw you,&#8221; I began, tentatively.  &#8220;I forgot to mention some sort of somatic symptoms I&#8217;ve been experiencing.  I haven&#8217;t experienced this kind of thing since I was a child &#8211; I don&#8217;t think I could have been more than about six the last time I remember it happening.&#8221;</p>
<p>&#8220;What sort of somatic symptoms?&#8221; he asked.</p>
<p>I stared at the floor and kept my mouth firmly shut.</p>
<p>&#8220;OK,&#8221; he said, reaching his arm out as if extending an olive branch, &#8220;stop me if this makes you too uncomfortable.  These sensations &#8211; are they in your vagina?&#8221;</p>
<p><em>Wince.  Why is that such a horrible, vile word</em>?</p>
<p>&#8220;Sort of,&#8221; I began, quietly, unsure of myself.  It&#8217;s a desperately uncomfortable sensation during which I feel like I need to go to the toilet, even though I don&#8217;t.&#8221;</p>
<p>&#8220;As in urinate?&#8221; he checked.</p>
<p>&#8220;It&#8217;s like I need to micturate, yes,&#8221; I confirmed.  I briefly raised my eyes from their default floor-staring position, to see more accurately his innate response to the word &#8216;micturate&#8217;.  He clearly wanted to laugh, but I&#8217;m not sure that a lesser reader of people than I would have spotted the tells indicating same.  He is clearly skilled in hiding his body language when he wants to do so.</p>
<p>&#8220;So is the bad sensation in your entire groin area?&#8221; he probed some more.</p>
<p><em>Eyes dart back to the ground</em>.</p>
<p>&#8220;Between my legs,&#8221; I replied quietly.  &#8220;The entire vulval region.&#8221;</p>
<p>&#8220;And why do you think this is happening to you again <strong>now</strong>?&#8221; he asked gently.</p>
<p>&#8220;I think material that we have been covering in therapy during the last few weeks has reignited old physical memories and sensations that I experienced as a child,&#8221; I answered simply.</p>
<p>&#8220;I would think so,&#8221; he agreed.  &#8220;I&#8217;m no anatomist, but it sounds like your muscles are tensing in that region and perhaps that has an impact on your bladder &#8211; maybe they press on it to some extent, leading to this sensation where you feel you need to go to the toilet.&#8221;</p>
<p><em>Nod.  Look away.</em></p>
<p>I don&#8217;t remember exactly all of what he then said, but he talked a little about the abuse for a few minutes, a soliloquy in which he admitted that he had his suspicions that penetration was involved, contrary to what I had allowed myself to reveal in the beginning of our therapy (and frankly to myself also, at least until fairly recently).</p>
<p>I looked at the clock.  About seven minutes remained.</p>
<p>He interpreted this as a sign of my desire to escape, but it was almost exactly the opposite.  &#8220;If we&#8217;re going to get involved in a deep-and-meaningful on this, I need to feel we have a fair amount of time to do so,&#8221; I told him.  He nodded understandingly.</p>
<p>Tension filled the room.  He <strong>knew</strong> I was going to talk.  <em>I</em> knew.  But how much was I going to say?  C seemed to literally be on the edge of his seat.  He&#8217;d angled his entire body towards me and was looking at me quite intensely.</p>
<p>I didn&#8217;t feel <strong>anything</strong>.  Nothing.  I don&#8217;t remember what I looked at; I just kind of stared somewhere blankly as if I was seeking catatonia, or perhaps another dimension.  I felt C&#8217;s eyes burning into me but I didn&#8217;t care.  I felt nothing.</p>
<p>I said, quite clearly, calmly and coherently, &#8220;he raped me, again and again and again.  He forced me to perform oral sex on him.  He performed oral sex on me.  He touched me in any number of inappropriate ways.  It started when I was maybe about five and it went on regularly for several years.&#8221;</p>
<p>Still perched on the edge of his seat, still with his head angled demonstrably towards me, C looked me in the eye and said, rather definitely, &#8220;what an awful thing for you to have gone through.&#8221;</p>
<p>I nodded wistfully and lowered my eyes from his once more.</p>
<p>My memory becomes a little skewed here again.  I don&#8217;t remember exactly the order in which what followed came, so I&#8217;ll try and follow it as I feels it flows.</p>
<p>We talked for a few minutes about how he felt making these admissions was &#8220;a big step,&#8221; as he put it.  We agreed, though, that whilst it&#8217;s a good start, using words like &#8216;rape&#8217; and suchlike don&#8217;t convey the physical agony, the terror and bewilderment, nor the psychological horror of the situation (as I tried to discuss <a href="/2010/03/22/putting-it-into-words/">here</a>).</p>
<p>He shook his head at one point and said something like, &#8220;I myself can look for words here in these moments, but none seem to quite cut it.&#8221;</p>
<p>I asked for clarification on what he meant.</p>
<p>&#8220;I can say what you went through is &#8216;awful&#8217; or &#8216;terrible&#8217; &#8211; and it <strong>is</strong> &#8211; but there are no words that sort of even come close to describing how dreadful it must actually have been.&#8221;</p>
<p>For some reason, that comment touched me.  He believed me, and he cared enough to think it was too bad to adequately be put into words.  I don&#8217;t believe that there was any sudden change in my demeanor, but I was moved nevertheless.</p>
<p>&#8220;Thanks,&#8221; I finally murmured, only just audibly.</p>
<p>He said, &#8220;you look like you want to cry now.&#8221;  He was actually correct, though I&#8217;m not sure if he was aware that it was more to do with his compassion towards my situation (<strong>he&#8217;s</strong> allowed to have it for me) than it was about the rapes.</p>
<p>I was well aware our time was all but up, so no tears were allowed to be forthcoming.  I shook my head at him and eventually started muttering, &#8220;no, no, no,&#8221; over and over again.</p>
<p>He asked what it was about crying that I so feared.</p>
<p>In this case, it was nothing more than a pragmatic matter of logistics.  &#8220;I can&#8217;t walk out of here in tears,&#8221; I said incredulously.  &#8220;People will see!&#8221;</p>
<p>He seemed a bit mystified by that for some reason, but let it pass and instead asked what I planned to do for the rest of the day.  He has been worried in recent weeks that exploring the abuse in therapy will fuck with my head out of therapy, and he wants me to engage in activities that minimise rumination on the matter in question.</p>
<p>I was concerned that <strong>he</strong> was concerned, and fervently sought to tell him that I was alright; however, he interrupted me and said that he actually <strong>wasn&#8217;t</strong> especially anxious, due to this being, again, &#8220;a very big step.&#8221;  I think he knew that, perverse as the subject matter is, that I felt a sense of achievement in finally telling him what had happened.  And he was right.  I did.</p>
<p>By the time I finally left his office, he&#8217;d let me overrun by nearly 10 minutes, about which I was felt very warm and fuzzy inside.  He told me to take care of myself as I left too, which is always a nice and considerably appreciated touch.</p>
<p>I really rather suspected that finally admitted the extent of the abuse would leave me a triggered, tattered mess of angst and mentalness between sessions, but I actually still feel really quite pleased with myself for admitting to how much went on, and I am pleased with his reaction of reassurance and gentleness.</p>
<p>The hard work is still to come.  The first step is taken, but the hard work awaits.  Will it be rushed and erratic?  I hope not, but one thing of which I am certain is that it will be bloody horrific.  But&#8230;I trust C, and I feel reassured by him.  So my hope is that he can, somehow, guide me through the worst of it.</p>
<p><strong>NB. I&#8217;m going to be <em>in absentia</em> for a few days &#8211; probably for the next week.  Don&#8217;t call the men in white coats, lovelies, I haven&#8217;t disappeared to search for a suicide spot.  I&#8217;m just having a few days away <img src='http://serialinsomniac.com/wp-includes/images/smilies/icon_smile.gif' alt=':)' class='wp-smiley' /> </strong></p>
<p>Love ya lovely people x</p>


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		<title>Responsibility, C: Week 45 and Other Pointless, Drivelsome Bollocks</title>
		<link>http://serialinsomniac.com/2010/03/30/responsibility-c-week-45-and-other-pointless-drivelsome-bollocks/</link>
		<comments>http://serialinsomniac.com/2010/03/30/responsibility-c-week-45-and-other-pointless-drivelsome-bollocks/#comments</comments>
		<pubDate>Tue, 30 Mar 2010 18:50:36 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Everyday Life]]></category>
		<category><![CDATA[Moods]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Sexual Abuse]]></category>
		<category><![CDATA[abandonment]]></category>
		<category><![CDATA[attachment]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[C-PTSD]]></category>
		<category><![CDATA[child sex abuse]]></category>
		<category><![CDATA[child sexual abuse]]></category>
		<category><![CDATA[clinical depression]]></category>
		<category><![CDATA[complex post-traumatic stress disorder]]></category>
		<category><![CDATA[CPTSD]]></category>
		<category><![CDATA[major depressive disorder]]></category>
		<category><![CDATA[mental health]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[molestation]]></category>
		<category><![CDATA[post-traumatic stress disorder]]></category>
		<category><![CDATA[psychodynamic psychotherapy]]></category>
		<category><![CDATA[psychology]]></category>
		<category><![CDATA[PTSD]]></category>
		<category><![CDATA[rant]]></category>
		<category><![CDATA[rape]]></category>
		<category><![CDATA[responsibility]]></category>
		<category><![CDATA[social anxiety]]></category>
		<category><![CDATA[the NHS is shit]]></category>
		<category><![CDATA[therapeutic abandonment]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[trauma]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1299</guid>
		<description><![CDATA[Walking home in the rain after meeting a friend for lunch today, it occurred to me how much responsibility is in my hands to not go completely doolally and get myself locked up, or to not end up in a fugue of a notably longer duration than the mini-fugues to which I am &#8216;used&#8217;. If <a href='http://serialinsomniac.com/2010/03/30/responsibility-c-week-45-and-other-pointless-drivelsome-bollocks/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>Walking home in the rain after meeting a friend for lunch today, it occurred to me how much responsibility is in my hands to not go completely doolally and get myself locked up, or to not end up in a fugue of a notably longer duration than the mini-fugues to which I am &#8216;used&#8217;.</p>
<p>If the police are ever involved in my psychiatric life, then all hell will break loose.  I will be <strong>fucked</strong>.  A &#8211; and possibly a range of others too &#8211; may well be forced to give out information about this blog and the history of my mentalness.  If that happens, not only will the peelers (Northern Ireland colloquialism for the cops) probably have to instigate a historical enquiry vis a vis Padeo, but they will have no choice but to contact social services about him, given his access to Marcus, Marcus&#8217;s baby brother and a couple of teenage grandchildren that hover about in his life from time to time.</p>
<p>It&#8217;s bad enough to have gone through sexual abuse as a child and to have to relive it all so vividly and painfully now.  But now I have to be responsible for not losing my mind, when my mind dangles so precariously on a precipice somewhere between semi-sanity and complete <strong>in</strong>sanity.  That is <strong>not fair</strong>.  Haven&#8217;t I gone through enough?  How am I meant to control that which almost by definition is uncontrollable?  And yet, the ramifications of not doing so are <strong>way</strong> too big &#8211; life-ruining and terrifying.  I am holding it together now, but I know it is by a mere fickle thread.</p>
<p>And, <em>mais oui</em>, I&#8217;m effectively being re-traumitised with all this abuse bollocks by psychotherapy, during the middle of which C will just up sticks.  How unfair can you get?  I know this stuff needs to be psychologically addressed, but it <strong>can&#8217;t</strong> just be done in a few short weeks; it won&#8217;t just be OK or even vaguely manageable<em> just like that.</em> Of course, that assumes that I <strong>can</strong> even talk about it at some point between now and June, and that&#8217;s a very big &#8216;if&#8217;.  I know from others &#8211; <a href="http://conversationswithmyhead.blogspot.com/" target="_blank">bourach</a> and <a href="http://splinteredones.wordpress.com" target="_blank">Splintered Ones</a>, most notably &#8211; that if specific discussion of these matters comes <strong>at all</strong>, then it simply cannot be forced.  So how am I meant to ever do this with C, given the short timeframe that remains of our relationship?  I resent the notion of going private, even though I recognise it as all but inevitable, because I have done (or at the very least have <strong>tried</strong> to do) my duty to the stupid, hateful Trust by working since I was 16, and happily paying my national insurance to its governing Department during that time.  Fuck them.  It would serve them right if I never worked again simply so as I could avoid paying them a penny more.</p>
<p>I&#8217;m not even going to bother giving discussion of my last session with C its own post as I normally do.  It was a complete waste of time; if he wants to play psychological academics, then he should have gone into full-time research, not clinical practice.  Not that I mind the psychological academics <strong>per se</strong> &#8211; but I do hate an inordinate amount of time being devoted thereto when there are very real and serious matters that must be addressed now.  Otherwise they never will be.</p>
<p>Apparently, I cling to &#8220;a tyranny of &#8216;shoulds&#8217;&#8221;, particularly regarding the sex abuse, meaning that I am convinced I <em>should</em> discuss the specifics of said rapes etc, I <em>should</em> resolve it in my own mind, blah blah blah blah de fucking blah blah.  He thinks I hinder myself by demanding so much of myself in this way, which is probably true &#8211; but the alternative is surely even worse.  As I told him, if I do not openly share this information with him, then it will remain unprocessed and unresolved.  It will only continue to haunt me should that be the case.</p>
<p>I told him that I pretty desperately <strong>wanted</strong> to talk to him, and he said that that was encouraging &#8211; but is it?  14 weeks (or 10, if you account for the four sessions to deal with the cessation of the process) is <strong>not</strong> enough time to resolve several years of systematic child sexual abuse of almost every conceivable description, not to mention all the other issues &#8211; the bullying, the ex, and the continued unresolved shite about my father &#8211; and even mother for that matter.  How can I be expected to continue to trust him in such circumstances?  I mean &#8211; I <strong>do</strong> trust him, but that&#8217;s because I am deliberately trying to fool myself into not realising the relative imminence of our last sessions.</p>
<p>C said, to my considerable annoyance, that some people enter therapy expecting to be cured and that that&#8217;s not necessarily what it&#8217;s about (or words to that effect).  I found this patronising in the extreme, especially because I have <strong>consistently</strong> told him that I don&#8217;t want or even believe in cures.  What I want, and I do not think this unreasonable, is to fully explore my considerable wealth of issues with someone I trust implicitly and that is trained to explore them with me.  This is in the hope that I can adequately process and in part resolve said issues, thus leading to <strong>an ability to fucking manage</strong> being mental in an everyday, vaguely normal-ish life.  Oh, and this can <strong>not</strong> be achieved using the abject fuckery of either DBT or CBT, which <strong>DON&#8217;T FUCKING WORK</strong> (for me) and are not the panaceatic solutions that the NH<em>bloody</em>S likes to pretend they are.  So if <a href="/2010/03/11/latest-letter-to-the-trust-with-a-giant-helping-of-screw-you/">Mr Director-Person</a> tries fobbing me off with that old dog-dirt-coloured chestnut, he&#8217;d better be ready for the ongoing fight to step up yet another notch.</p>
<p>C also accused me of playing a game of mental &#8220;tug of war&#8221; with him, all because I responded to him in some really rather subtlely pass-remarkable fashion.  It was a throwaway comment, but it&#8217;s not <strong>allowed</strong> to be throwaway in a psychotherapy session, is it?  Everything you say, do, even bloody think (so it sometimes seems) is subject to deep analysis by the alleged science of psychology.  Actually, I&#8217;m being unfair in being so bitter about that &#8211; the dark arts of psychology have helped me a little through C to date, and I do think he is skilled in them.</p>
<p><strong>However</strong>, it is a character trait of mine to be unnecessarily &#8211; and quite possibly inappropriately &#8211; flippant at times.  Maybe that means something in the grand scheme of things &#8211; I don&#8217;t know.  But I didn&#8217;t think it fair for one particular instance of it to be singled out, especially given that I really <strong>didn&#8217;t</strong> feel I was playing any sort of games with or fighting against C that day.</p>
<p>And that&#8217;s really all that happened.  A pointless session, just like the one <a href="/2010/03/17/empty-voices-and-empty-chairs-c-week-44/">prior to it</a> had been, except on this occasion it was mainly <strong>his</strong> fault, not mine.</p>
<p>What else?  I&#8217;m feeling <strong>alright</strong> &#8211; not great, but I&#8217;m managing.  Thank you, Seroquel, my favourite drug in the entire universe (even though I simultaneously hate it too, because rather like Venlafaxine it fucks with your head if you miss or come off it).  The recollections of the abuse prey on my mind, and the sense of yet another imminent abanodonment haunts my consciousness when I allow myself to think of C.  IBS troubles me, as do headaches.  I&#8217;m getting through <em>Trauma and Recovery</em> by Judith Herman quite well considering my poor concentration span, and find myself nodding with her analyses at most junctures.  Despite taking the drugs at the fairly tame time of 9pm, I&#8217;m rarely asleep before 2am, and rarely awake before midday as a consequence.</p>
<p>But for the meantime at least, I&#8217;m surviving, if only capriciously.  It&#8217;s the calm before another storm, I&#8217;m sure, but I&#8217;ll take the little I get.</p>


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		<title>Empty Voices and Empty Chairs &#8211; C: Week 44</title>
		<link>http://serialinsomniac.com/2010/03/17/empty-voices-and-empty-chairs-c-week-44/</link>
		<comments>http://serialinsomniac.com/2010/03/17/empty-voices-and-empty-chairs-c-week-44/#comments</comments>
		<pubDate>Wed, 17 Mar 2010 21:30:15 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
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		<guid isPermaLink="false">http://serialinsomniac.com/?p=1201</guid>
		<description><![CDATA[So.  Did I use this session to progress matters related to Paedo?  As if.  I was completely crap.  As ever C defended me on the grounds that sessions are co-constructs, and he claims that he is culpable for any time-wasting too.  But I don&#8217;t think he is &#8211; or at least he wasn&#8217;t on this <a href='http://serialinsomniac.com/2010/03/17/empty-voices-and-empty-chairs-c-week-44/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>So.  Did I use this session to progress matters related to Paedo?  As if.  I was <strong>completely</strong> crap.  As ever C defended me on the grounds that sessions are co-constructs, and he claims that he is culpable for any time-wasting too.  But I don&#8217;t think he is &#8211; or at least he wasn&#8217;t on this occasion, anyhow as he asked the right questions, he did the right probing, but I was just a useless twat that completely wasted the 50 minutes.</p>
<p>My ineptitude left me in a pretty awful frame of mind post-therapy.  One minute, I&#8217;d be quite happily getting along with whatever; the next, I&#8217;d just burst into tears.  I cried so much at one point on Thursday night that when I lifted my head, everything around me was covered in blood &#8211; the force of my tears had induced a major nose bleed (the worst I&#8217;ve had in years).  I also ended up driving home (and beyond) that evening in an unforgivably reckless fashion, in what I suppose was an attempt to weed out my frustrations.  I was in tears throughout most of the drive and at one point realised I was doing over 100mph.  Not good at all, for my car and for other road users.  It didn&#8217;t matter about my life, of course.</p>
<p>Anyway.  Enough of the &#8220;woe is me&#8221;.</p>
<p>Because Mr Director-Person hadn&#8217;t had the courtesy to copy C in on <a href="/2010/03/04/hilariously-and-predictably-shite-response-letter-from-the-trust/">the letter</a> he&#8217;d sent me, I took C a copy of it.  I told him that although it hadn&#8217;t been my intention in session the <a href="/2010/03/09/kind-of-discussing-child-sex-abuse-with-c-week-43/">previous week</a>, that I was now going to <a href="/2010/03/11/latest-letter-to-the-trust-with-a-giant-helping-of-screw-you/">reply</a>.</p>
<p>The discussion around this stupidly went on for maybe 15 or 20 minutes.  I admitted that my key motivation was to piss off Mr Director-Person and friends, and C kept asking me why I wanted to act in a manner as &#8220;destructive&#8221; as that.  There was the usual rant from me that if the bloody NHS had acted properly rather than throwing Fluoxetine in my face when I was 14, then maybe I wouldn&#8217;t have even needed to meet C (as my mentalness might have been adequately dealt with when I was a teenager, thus negating at least some of the need for therapy now).  There was a load of Trust-defensive rhetoric from him, plus a pile of questions designed to investigate my &#8220;true&#8221; motivation in replying.  He contended that I must want <strong>something</strong> other than to annoy Mr D-P.  He also seemed incredulous at my reaction to Mr D-P&#8217;s letter; what was it that I actually <strong>wanted</strong> from him?!</p>
<p>What I actually wanted was Mr D-P to take my case seriously and agree that longer-term psychotherapy was required, but what I told C was what I had wanted was <strong>something that actually fucking meant something</strong>, which is also true.  Mr D-P&#8217;s letter did not say <strong>anything</strong> in its 700 odd words.  It just threw a few dates at me and expected that to satisfy me.  Preposterous.</p>
<p>There was no animosity between C and I during this discussion, but I was pretty assertive and didn&#8217;t hold back.  I called Mr D-P &#8220;stupid&#8221; and accused him of &#8220;patronising&#8221; me.  I told C that &#8220;everyone but [him]&#8221; agreed with my decision to respond.  He was actually slightly amused by the fact that he was so outnumbered.</p>
<p>He eventually made the wise decision to cut that topic short, presumably with a view to continuing our discussion of the sexual abuse.  However, I butted in and started going on about my appointment with the <a href="/2010/03/10/psychiatrist-appointment-win/">psychiatrist</a> the previous day.  I babbled on for a bit about the medication issues then told him that NewVCB agreed with my assertion that I am afflicted with C-PTSD.</p>
<p>C was a bit annoying over this.  He pointed out that C-PTSD is not included in the DSM or the ICD nor is it going to be in at least the DSM&#8217;s next incarnation (facts that I knew), and that all the research he&#8217;d read on borderline suggested that people with that diagnosis had been abused as children.  He must have been reading different research from me, because whilst child abuse is common in those with BPD, it is not universal.  Anyway, the implication was that I had no need to seek a diagnosis of C-PTSD as BPD was perfectly adequate.</p>
<p>I protested saying yes, some people diagnosed with BPD were badly abused as kids, but that it was still the disorder that everyone loved to hate (he agreed that it &#8220;doesn&#8217;t have a very good rep&#8221;), and I went on to point out that at least having recognition of some form of PTSD was important to me as it shifted the focus to trauma, rather than personality.</p>
<p>&#8220;You mentioned trauma,&#8221; he said after a few minutes.</p>
<p>&#8220;Oh, here we go,&#8221; I whispered, rolling my eyes slightly.  A few minutes later I was aware of the physical stance that I&#8217;d taken; arms folded across my chest, head bowed, shoulders tense.  He commented on it, saying that it was in marked contrast to the assertive me of a few minutes previously.</p>
<p>We discussed the conversation we&#8217;d had the week before, and I told him &#8211; still omitting specific details &#8211; more about the flashbacks.  I quietly admitted that I&#8217;d been highly disturbed by the visions of what happened beside the old kennel particularly, as it had gone by the time I was five or six.  My conscious perceptions had always been that this stuff happened only much later in my childhood.</p>
<p>I&#8217;m not sure exactly how things progressed, but whatever the case he eventually asked if I would find it less difficult to start describing some of the more &#8216;minor&#8217; incidents.  I reckoned it would, so I agreed.</p>
<p>Wrong!  I kept thinking in detail about numerous times that Paedo had stroked my thighs in what I think he though was an alluring fashion (!), but I couldn&#8217;t even articulate <strong>that</strong> to C.  Fucking pathetic me.  Stupid bitch.  Every time I went to speak of it, something held the information in my throat.</p>
<p>&#8220;It&#8217;s almost like it&#8217;s somatic,&#8221; I told him eventually.  &#8220;I can feel a blockage in my throat that&#8217;s preventing me from telling you about it.  I feel like every nerve in my body is on end.&#8221;</p>
<p>&#8220;You can get up and walk about if you like,&#8221; he offered, which struck me as unusual as any time I&#8217;ve so much as stood up in the past, he has questioned me on my motivations for doing so.  At any rate, I shrugged and told him I&#8217;d be fine.</p>
<p>More silence ensued, and eventually C asked me what was going through my head.  Not that I could manage to tell him about the thigh-stroking bullshit, of course, but my mind was also engaging in its usual internal dichotomy of Me-That-is-Irritated-by-Me versus Pathetic-Child-Me.</p>
<p>&#8220;One side is saying, &#8216;it&#8217;s only words you stupid bitch, just tell him,&#8217;&#8221; I said.  &#8220;The other is whining, [cue childish voice] &#8216;noooo, I can&#8217;t!&#8217;&#8221;</p>
<p>&#8220;What if&#8230;&#8221; he began, standing up.  My eyes followed him in a kind of confused curiosity.</p>
<p>He pulled the chair from his desk away and put it in the middle of the room, then removed his bag from the spare chair next to me and pulled it towards the other.  There were now four chairs, including his and mine, in a nice little circle together.</p>
<p>He sat back down on his chair, and I raised an eyebrow at him.  The empty chair technique?  <em>Gestalt therapy</em>?!  When did this become part of our work together?</p>
<p>He asked me to imagine that Child Me was on the chair closest to me, and that the more Punitive Me was in the remaining empty chair.</p>
<p>&#8220;What would you say to them?&#8221; he asked.</p>
<p>I ignored the two empty chairs and said, to him, &#8220;I&#8217;d tell them both to wise the fuck up.&#8221;</p>
<p>C threw back his head and laughed.  It was the first time I noticed what nice teeth he has.</p>
<p>&#8220;Don&#8217;t worry,&#8221; I continued.  &#8220;The inherent irony in that statement is not lost on me.  I&#8217;m being punitive towards both of them, when I&#8217;m supposed to stop one being so punitive.&#8221;</p>
<p>&#8220;Can you think of another way to talk to them?&#8221; he enquired.  &#8220;And can you talk to <strong>them</strong> &#8211; not me?&#8221;</p>
<p>I faced the two chairs and eventually made some trite statement that the bully should see how difficult things are for the child, but that the child should see that maybe the bully had a point, even if she had an undesirable way of expressing it.</p>
<p>The two faceless chairs freaked me out.  That sounds ridiculous; they are <strong>chairs</strong>.  But somehow C had succeeded in getting me to project aspects of my personality onto them.  It was incredibly disconcerting, and I told him so.</p>
<p>&#8220;Why?&#8221; he pressed.</p>
<p>&#8220;They&#8217;re watching me.&#8221;</p>
<p>&#8220;And what are they saying or thinking?&#8221;</p>
<p>&#8220;They hate me.&#8221;  And I really felt that they did; the malevolence emanating from these two inanimate objects was, to me, hideously and suffocatingly palpable.</p>
<p>By this point, it was near the end of the session, and in fact C later pointed out that we&#8217;d overran (this delighted me as it meant he didn&#8217;t have another patient coming in straight after me.  I can thus maintain my wretched illusion of him being exclusive to me).</p>
<p>He said that he knew I found the empty chairs unsettling, but he asked how I felt about it as a useful aid to the therapy.</p>
<p>I didn&#8217;t like it, obviously.  However, I thought &#8211; as I&#8217;m sure so did he &#8211; that the exercise had been telling, even if only subtly so.  I therefore told him that I thought it had some merit.</p>
<p>He nodded, so perhaps that is something to look into again in the next few weeks.  He then turned the subject back to housekeeping-esque issues, telling me that whilst he knew it was important to me, he wondered if we could maybe focus less on the crap with the Trust in the next session.</p>
<p>&#8220;Sorry,&#8221; I replied mournfully.</p>
<p>As stated, he immediately leapt to my defence, reminding me &#8211; correctly, in fairness &#8211; that he&#8217;d fully engaged in that conversation too.</p>
<p>Whatever the case, he wants to use the next session (tomorrow) to go on about this sex abuse stuff.  Fuck.  I am horrified in two ways &#8211; one, it is my instinct to avoid this and two, tomorrow is <strong>week 45</strong>.  To negate the effects of one, I have printed out extracts from my post about the session a <a href="/2010/03/09/kind-of-discussing-child-sex-abuse-with-c-week-43/">fortnight</a> ago, in which I detailed the flashbacks of severe elements of the abuse.  I&#8217;d told him in this session that I&#8217;d considered bringing him such written information, but advised that I had decided against it as I thought he&#8217;d want me to verbalise the stuff.  He <strong>does</strong>, apparently, but thought working around written stuff would at least be a start.  Good.</p>
<p>As for point two, there is no way to combat it, excepting miracles from Mr D-P or someone.  I only have 59 weeks in total, and look how much time I wasted this session.  I was so raging with myself for doing that, but that rage pales into insignificance against the the dread I feel regarding the end of the relationship &#8211; a dread that threatens to completely and utterly overwhelm me.  I was telling one of my online friends during the week that thinking about the end of things with C is akin to contemplating the death of a loved one.  C will effectively be dead to me after week 59.  I will, in all probability, never see him again after it.</p>
<p>It&#8217;s too much.  I cannot cope with it.</p>


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		<title>Hilariously and Predictably Shite Response Letter from the Trust</title>
		<link>http://serialinsomniac.com/2010/03/04/hilariously-and-predictably-shite-response-letter-from-the-trust/</link>
		<comments>http://serialinsomniac.com/2010/03/04/hilariously-and-predictably-shite-response-letter-from-the-trust/#comments</comments>
		<pubDate>Thu, 04 Mar 2010 13:20:36 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
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		<category><![CDATA[hilarity]]></category>
		<category><![CDATA[manic depression]]></category>
		<category><![CDATA[mental health]]></category>
		<category><![CDATA[mental health advocacy]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[rant]]></category>
		<category><![CDATA[the NHS is shit]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1122</guid>
		<description><![CDATA[In response to this.  See also this update.  I have corrected a few minors errors in the author&#8217;s writing and have, as you will see, provided (italicised) annotated notes of the most rational and considered variety.  *cough* &#8212; Dear Pandora Advocacy in Accessing Mental Health Services Thank you for your letter dated 17 December 2009 <a href='http://serialinsomniac.com/2010/03/04/hilariously-and-predictably-shite-response-letter-from-the-trust/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>In response to <a href="/2009/12/17/the-advocacy-letter/">this</a>.  See also <a href="/2010/01/09/victories-and-failures-updates-on-those-letters/">this</a> update.  I have corrected a few minors errors in the author&#8217;s writing and have, as you will see, provided (italicised) annotated notes of the most rational and considered variety.  *cough*</p>
<p>&#8212;</p>
<p>Dear Pandora</p>
<p><strong>Advocacy in Accessing Mental Health Services</strong></p>
<p>Thank you for your letter dated 17 December 2009 about accessing our mental health services.  I am glad to note that you have developed a good therapeutic relationship with the clinical psychologist involved in your treatment[,] but am sorry that our services have not met your expectations.  <em>[My "expectations"?  My "expec-fucking-tations"?  No, you miserable old bellend, they are not my "expectations".  They are my fucking <strong>needs</strong> and <strong>requirements</strong>!]</em></p>
<p>I have received feedback from Dr C J confirming that he saw you for the first [time] on the 19 February 2009 and [that] after three assessment interviews an agreed treatment plan was drawn up that offered weekly treatment appointments and also an assurance that an end to therapy would be identified well in advance of a contracted completion.  Dr J <em>[he is <strong>not </strong>Dr fucking J!  He is <strong>C</strong>!  I don't care if this is an official fucking letter.  He is fucking <strong>C</strong>!]</em> agreed with your view that some modest gains had been made during your contact with psychological services <em>[aren't I the fucking lucky one]</em>.  He also recognised the complexity of your difficulties and so sought additional input in the form of a referral in May 2009 to [Old]VCB, Consultant Psychiatrist <em>[that should have gone through months <strong>beforehand</strong>, after a referral from my fucking GP.  Useless twats]</em>.  I understand that you continue to be seen by the psychiatric team <em>[yes, after more upheaval, and when they can be bothered, which is really rather infrequently]</em>.</p>
<p>At the time of your letter Dr J <em>[<strong>FUCK</strong>] </em>had made the offer of 24 additional appointments, which would bring your contact with him to an end at about the first week in June 2010, a treatment duration of about 16 months <em>[actually, that is incorrect.  There will be 59 sessions, three of which were assessments, and four of which will be to end the process.  This gives an exact total of 52 therapy-specific sessions, which surely even in your clearly deficient brain equals a total of <strong>12</strong> months.  Fuck you.]. </em>Dr J <em>[fuck fuck fuck] </em>expressed the hope that within these sessions, which would span approximately six months <em>[my God, I would never have realised]</em>, [that] further work could be done that would help towards resolving, dealing with or managing your ongoing mental health difficulties.</p>
<p>It is clear that you have a good knowledge of the NICE guideline[s] on the treatment and management of borderline personality disorder <em>[Hmm.  You are telling me that I know something that I know.  That was a productive use of your secretary's typing time]</em>.  Overall as the guidance states, the evidence base for individual psychological therapies in the treatment of borderline personality disorder is &#8220;relatively poor&#8221;.  Specifically, however[,] it recommends that brief therapies (under three months) should not be used.  Much of the guidance relates to provision within a specialist Personality Disorder Service.  The availability of twice weekly sessions, group psychotherapies and integrated team treatments <em>[what the fuck?]</em> are [sic] largely to be found within those highly specialist services <em>[oh really, I had no idea Mr Director Important Person, thanks for clarifying]</em>.</p>
<p>The &lt;Trust in question&gt; does not have such a service <em>[aha, and that's <strong>clearly</strong> the fault of the patient.  Nevermind the NICE guidelines saying in the absence of such a "service" that adequate generic therapy should be used.  Fuck you again</em>]<em>, </em>although we, along with all other local Trusts, are involved in the development of a regional approach to Personality Disorder services across Northern Ireland <em>[wowee, I'm so profoundly impressed]</em> and have recently interviewed for two specialist workers <em>[two?  A whole <strong>TWO</strong>?  That's extraordinary!  Congratulations sir!]</em>.  Therefore we are planning to develop our services to people with personality disorders <em>[I therefore assume that I can take this letter as confirmation that these "services" will be fully accessible by me...?]</em>.</p>
<p>As you state it is important that clients have access to a full range of mental health services appropriate to their needs.  We try<em> [and fail]</em> to ensure that needs are assessed in a collaborative way <em>[hahahahahahahahahaha!!!!!]</em> that involves both clients and mental health professionals <em>[well, then.  That has been an <strong>epic fail</strong>!]</em>.  I would encourage you <em>[who the fuck do you think you are, my father?  Fuck you in triplicate]</em> to discuss these matters with the two professionals that you currently attend<em> [yeah, because I haven't done that already.  Fuck you x4]</em>.  The Crisis Team provides mental health assessment and support outside 9am to 5pm hours in the working week, and can be accessed if appropriate through the out of hours primary care service <em>[well, fuck me sideways with a broomstick.  I had <strong>no idea</strong> what the Crisis Team did, thanks for providing me with a lit pathway to therapeutic enlightenment.  Fuck you mark five]</em>.</p>
<p>Dr J <em><strong>[F</strong><strong>UUUUUCK!!!</strong>] </em>has confirmed that you have continued to attend his sessions following the writing of your letter <em>[what was I meant to do?  Fuck a goat?  Oh wait, that's <strong>exactly</strong> what I was meant to do, right?  "The bitch is borderline, so she must be non-compliant with treatment and will instead go out and fuck anything to temporarily fulfill her emotional voids"</em>]<em>. </em>I would hope <em>[oh would you really?]</em> that despite their finite nature you could still use the upcoming sessions to make progress.</p>
<p>Yours sincerely</p>
<p>Abject Twatfeatured Spetum-Faced Tosspot<br />
Director of Mental Health and Disability Services</p>
<p>&#8212;</p>
<p>So.  He has succeeded in providing me with:</p>
<ol>
<li>A chronology of events.  Woohoo.  <em>Obviously the stupid mental couldn&#8217;t <strong>possibly</strong> know that she saw these individuals, nevermind know in which order she saw them, even less what they <strong>said</strong>!  Particularly when she&#8217;s an immature, manipulative borderline freak.</em> So thank you, Mr Important Director Person, you have made my life and mental health treatment complete!</li>
<li>A commentary on the fact that I know what I know.  A tremendously useful and productive use of his time and mine; after all, I couldn&#8217;t know what I already know unless he told me, could I?</li>
<li>Um&#8230;that&#8217;s about it.</li>
</ol>
<p>Altogether an epic success, I&#8217;m sure you&#8217;ll agree.</p>
<p>The letter is dated 17 February (how it took him two months to compose the above I&#8217;ll never know) and it actually arrived at Mum&#8217;s house a good while ago.  I made her read it down the phone to me, so I was aware of its content, but I only collected it the other day, and had (until now) refused to look at it.  I thought that due to its high degree of pointlessness and its utter failure to assuage my concerns, that it would upset me considerably.  After all, this is about the cessation of my relationship with C, which is an incredibly traumatic thing to contemplate.</p>
<p>However, when C asked about it this morning (blog to follow &#8211; big update on the beard!), I somewhat surprisingly found myself wryly amused as I reported a redacted version of its contents to him.  Therefore I&#8217;ve come home and written it up and am pleased to say that I <strong>still</strong> find it amusing rather than upsetting, probably because it doesn&#8217;t actually say <strong>anything</strong>.  OK, there&#8217;s maybe six or seven hundred words there, but it doesn&#8217;t actually &#8211; at any juncture &#8211; make any salient points <strong>at all</strong>.  It is a vacuum of a letter.  It is a <strong>nothing</strong>.  Empty space seems full relative to this page of black and white nonsense.  I&#8217;m glad it was printed on both sides of the sheet as I would have hated to see any more wood senselessly wasted on something so fruitless and silly.</p>
<p>Given the amount of money this moron is paid, I should really be rather angry, as well as disappointed and lost as to what to do next.  Instead, fair play to him, as he&#8217;s given me a laugh&#8230;and, in fact, some hope.  If someone with such poor (written) oratorical skills and an intellect clearly directly comparable to that of an earthworm can rise to such a lofty position within a large organisation, then <strong>my</strong> dream job is surely still within my reach.</p>
<p>In conclusion&#8230;<strong>FUCK YOU ONCE MORE, </strong>Mr Director Wankface Important Daft Person!</p>


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		<slash:comments>38</slash:comments>
	
		<series:name><![CDATA[The Mr Director-Person Letters]]></series:name>
	</item>
		<item>
		<title>The Answer to Life, the Universe and Everything?  C: Week 42</title>
		<link>http://serialinsomniac.com/2010/02/25/the-answer-to-life-the-universe-and-everything-c-week-42/</link>
		<comments>http://serialinsomniac.com/2010/02/25/the-answer-to-life-the-universe-and-everything-c-week-42/#comments</comments>
		<pubDate>Thu, 25 Feb 2010 22:26:56 +0000</pubDate>
		<dc:creator>Pandora</dc:creator>
				<category><![CDATA[C]]></category>
		<category><![CDATA[Psychotherapy]]></category>
		<category><![CDATA[Traumatic Stuff]]></category>
		<category><![CDATA[abandonment]]></category>
		<category><![CDATA[anonymity]]></category>
		<category><![CDATA[attachment]]></category>
		<category><![CDATA[bipolar disorder]]></category>
		<category><![CDATA[blogging]]></category>
		<category><![CDATA[borderline personality disorder]]></category>
		<category><![CDATA[bpd]]></category>
		<category><![CDATA[child sex abuse]]></category>
		<category><![CDATA[clinical depression]]></category>
		<category><![CDATA[mental health]]></category>
		<category><![CDATA[mental illness]]></category>
		<category><![CDATA[mother]]></category>
		<category><![CDATA[psychodynamic]]></category>
		<category><![CDATA[psychodynamic psychotherapy]]></category>
		<category><![CDATA[psychology]]></category>
		<category><![CDATA[rape]]></category>
		<category><![CDATA[resistance]]></category>
		<category><![CDATA[social anxiety]]></category>
		<category><![CDATA[the NHS is shit]]></category>
		<category><![CDATA[therapeutic abandonment]]></category>
		<category><![CDATA[therapeutic relationship]]></category>
		<category><![CDATA[therapy]]></category>
		<category><![CDATA[transference]]></category>

		<guid isPermaLink="false">http://serialinsomniac.com/?p=1072</guid>
		<description><![CDATA[Week 42.  Week 42.  How can this be?  I look back through this journal, and see prose referencing sessions as far back as week 10.  I read through said posts, and remember clearly the discussions, the facial expressions, the tones of voice to which I have alluded.  It all seems like yesterday.  How did we <a href='http://serialinsomniac.com/2010/02/25/the-answer-to-life-the-universe-and-everything-c-week-42/'>[...]</a>]]></description>
			<content:encoded><![CDATA[<p>Week 42.  <strong>Week 42</strong>.  How can this be?  I look back through this journal, and see prose referencing sessions as far back as <a href="/2009/05/07/c-week-10/">week 10</a>.  I read through said posts, and remember clearly the discussions, the facial expressions, the tones of voice to which I have alluded.  It all seems like yesterday.  How did we get so far, essentially without me even noticing it?  And now, with abject horror, I remember there will only be a total of 59 sessions with this man (unless there&#8217;s some sort of miracle), and four of those are about drawing things to a close.  That means a mere 13 weeks of actual therapy remain.  How &#8211; <strong>HOW</strong> &#8211; did things get to this point?  How is that even possible?  I don&#8217;t <strong>do</strong> anything.  My life doesn&#8217;t <strong>consist</strong> of anything.  How can time pass so quickly, through this sheer <strong>nothingness</strong> of an existence?  How can I now be teetering on this precipice of therapeutic abandonment, when it seems like seconds ago that I was settled in a stable and helpful, if asymmetrical, relationship with C?</p>
<p>He is off this week, which is why I&#8217;m writing about last week&#8217;s session on what would normally be my Therapy Thursday.  I miss him.  I miss him very much.  On Tuesday I had a moment (read: quite a long time) of utter desolation pertaining to his absence, accompanied by my old friends of depression, self-loathing and suicidal ideation.  If my inability to cope without him is so acute and all-consuming after a matter of days without seeing him, what &#8211; in all seriousness &#8211; are things going to be like when the 59th session has been and gone?  I can already see myself falling into an abyss of, at a minimum, abject depression.  I have contingency plans, of course, but can they ever be the same?  I&#8217;ve seen something like <a href="/2009/09/02/a-half-life-in-therapy-the-fabled-post-of-therapists/">nine therapists</a> over the past decade.  C was/is the first and only one with whom I really connected.  How long will I have to wait, how many more people will I have to see, before I can find a relationship with someone else that even approaches the quality of this one?</p>
<p>A doesn&#8217;t think attachment to a therapist is good.  I know some others, including mental health professionals, don&#8217;t either.  Personally, I don&#8217;t think it is &#8216;good&#8217; either (in the sense that it is a difficult position for the client to be in), but as a somewhat-proponent of the psychodynamic school of psychotherapy, I believe that some form of transference &#8211; and, if it is vaguely positive, therefore attachment also &#8211; is necessary.  As research consistently finds, the most important aspect of successful psychotherapy is the therapeutic relationship.  I have a good one, and yet it is on the verge of being brutally severed.</p>
<p>But enough with my pointlessly whiny ruminations.  42 is the answer to life, the universe and everything, <a href="http://en.wikipedia.org/wiki/Ultimate_Question#Answer_to_the_Ultimate_Question_of_Life.2C_the_Universe.2C_and_Everything_.2842.29" target="_blank">apparently</a>.  I&#8217;m not sure that <em>C: Week 42</em> was necessarily the answer to <strong>my</strong> life, <strong>my</strong> universe and <strong>my</strong> everything, but then &#8211; just like in the <em>Hitchhiker&#8217;s Guide</em> &#8211; I&#8217;ve never been entirely sure what the precipitating question was or is.  I merely have had and do have the awareness that many things have been afoot in my world.</p>
<p>Anyway.  The first thing that struck me was, once again, the beard.  It is <em>still there</em>.  I have nothing against beards &#8211; <strong>on people who suit them</strong>.  C suited his erstwhile goatee reasonably well (he looked a bit like Derren Brown), but this full beard makes him look like a walking statue of Christ.  What was of particular note last week was that it was <strong>perfectly</strong> trimmed.  It was so exact that it must have some mathematical or scientific use &#8211; perhaps it could be used to plot planetary movement around stars or something.  I longed to leave, drive to the nearest petrol station, buy some fuel, return, douse the beard in said fuel, and light a match.  I don&#8217;t want to cause him any pain, but really.  The beard needs to go.</p>
<p>As ever he tried to find out where I wanted to start our discussion, and as ever I stubbornly shrugged and claimed not to know.  Luckily &#8211; in a sense, at least &#8211; he had planned for this, and reminded me that in the <a href="/2010/02/17/ranting-about-mum-and-peace-making-with-c-week-41/">previous session</a>, we had agreed that we would spend some time talking about the various incidents that took place with Paedo when I was a kid.</p>
<p>In all honesty, I don&#8217;t remember a great deal of what we discussed.  In fact, in the end a lot of what we covered was related to my mother&#8217;s reaction to my revelations to her about the sexual abuse (see bottom of the page of the link in the previous paragraph).  I do remember telling him that I was absolutely able to be open and frank about what happened in writing (namely, here, on this blog), but that I simply couldn&#8217;t manage to get the words out to him.</p>
<p>Of course he wanted to know what I thought he would think about me if I did say what needed to be said.  I couldn&#8217;t think of the word at the time, but what I think I was trying to articulate is that he would be ashamed of me.  My own shame, my anxiety about uttering the word &#8216;rape&#8217; to him and my utter inability to actually eventually do so would seem to confirm that.  It was like there was a metaphorical stopper in my mouth; every time my lips tried to form the word, or my vocal chords tried to convey it, something stopped it from being enunciated.  Maybe some ethereal presence put its hand over my mouth and silenced me.  Utterance of <strong>that</strong> word, and the specifics of the incidents, was impossible.</p>
<p>Without putting it in so many words, I basically conveyed to C that I had a supreme difficulty in verbally declaring some of the stuff that I should be discussing with him.</p>
<p>He reminded me that a <a href="/2009/10/29/an-open-letter-to-my-therapist-c-week-28/">few months</a> back I had put together a range of material, largely garnered from my writings here, that I had wanted him to read.  He had refused, to my considerable disgust.</p>
<p>&#8220;What of it?&#8221; I inquired.</p>
<p>&#8220;I&#8217;m not sure exactly what that stuff consisted of,&#8221; C acknowledged, &#8220;but I believe that you were trying to reach out to me in preparing it, that you were trying somehow to tell me about this stuff.  But&#8230;[thoughtful pause]&#8230;but I think we need to get you to <strong>say</strong> it.  To say it out loud.&#8221;</p>
<p>I&#8217;d always suspected that at least part of his reasoning for refusing to take the myriad of pages I&#8217;d printed that day was related to the fact that he wanted to hear me actually <strong>verbalise</strong> this shit.  I still fervently believe that it was <strong>mostly</strong> about his refusal to have anything to do with me beyond my allocated 50 pathetic minutes, of course, but I did and do believe that his secondary motivation was to get me to actually <strong>speak</strong>.  I just wish he&#8217;d bothered to have told me that at the fucking time.  I would not have been so out-and-out furious had he done so.</p>
<p>Back to what I thought he&#8217;d think of me if I did speak of these experiences: I told C that I felt like a filthy whore and to that end provided him with the details of my complete knobbery from <a href="/2010/02/14/progressing-regressing-transgressing/">a fortnight</a> ago, where I endlessly castigated myself as a slut of evil (we both agreed that I need to take care vis a vis alcohol whilst taking Quetiapine).  I also confided in him that in huge, angry letters the word &#8216;SuzanneUT&#8217; is etched, permanently, across my lower abdomen (along with its kindreds of &#8216;HATE&#8217; ((the second <a href="/2009/07/15/self-harm/">incarnation</a> thereof)) and &#8216;DIE BITCH&#8217;).  &#8216;SuzanneUT&#8217; is the most dramatic, however, and seems to have been the deepest of the various mutilations (all garnered, if memory serves me correctly, on the night I tried to <a href="/2010/01/17/suicide-attempt-epic-fail/">kill myself</a> last month).</p>
<p>&#8220;It&#8217;s ridiculous,&#8221; I admitted, finally.  &#8220;Of course I&#8217;m nearly as far from a slut as it is possible to be [not quite perhaps, but largely]; I see that rationally.  But I still believe that I am one, whilst at the same time believing that I am not.&#8221;</p>
<p>He referred back to <a href="/2009/12/09/countdown-to-abandonment-c-week-33/">schema models</a>, about which we have talked on several occasions now.  He said that the part of me that felt that my belief that I&#8217;m a slag is ridiculous was, in many ways, an example of a healthy adult; she is rational, and can see things in a sensible, evidential sort of way.</p>
<p>&#8220;However,&#8221; he went on, &#8220;your healthy adult seems to have become rather merged with your punitive parent.  You can be very logical and whatnot, but when you do so, you&#8217;re very critical of the more child-like, emotional sides of yourself &#8211; not that you&#8217;d use the word &#8216;emotional&#8217; [he added dryly] &#8211; in this case, you use the word &#8216;ridiculous&#8217;, but on other occasions you&#8217;ve been even more disparaging.  You would agree that that&#8217;s punitive, I take it?&#8221;</p>
<p>&#8220;Yes, I suppose so.&#8221;</p>
<p>&#8220;So there <strong>is</strong> hope there, in the expression of the healthy adult,&#8221; he said, &#8220;but we need to separate that punitive side from her&#8230;&#8221;</p>
<p>&#8220;Well, as you know,&#8221; I interjected, &#8220;I don&#8217;t &#8216;do&#8217; self-compassion especially well.&#8221;  He has consistently told me that having some genuine compassion for myself would be a major breakthrough.  I have to say that in all honesty, this still seems as unlikely to me as it did when he first mentioned it <strong>months</strong> ago.  I feel sorry for myself at times, I think some of what I&#8217;ve gone through is unfair at times &#8211; but I never feel what I would call &#8216;compassion&#8217;, and frankly that applies to others as well as myself.  I have <strong>tried</strong> to develop some sense of it &#8211; I&#8217;ve read the stupid books and I&#8217;ve cried (admittedly rarely) under C&#8217;s watchful gaze.  But it still isn&#8217;t happening.  I don&#8217;t think <strong>years</strong> of psychotherapy can induce this supposed quality in me.</p>
<p>Somehow the dialogue progressed to an analysis of my mother&#8217;s response to matters with Paedo.  In particular, I told him how outraged I had been with her comments to the McFs in the immediate aftermath of my last therapy session (see the last few paragraphs of <a href="/2010/02/17/ranting-about-mum-and-peace-making-with-c-week-41/">here</a>).  Cue much questioning along the lines of the inveterate &#8220;how did that make you feel?&#8221; type.</p>
<p>I felt physically sick, not something common in my mentalness.  Struggled not to throw up.  Despondency followed.  Which was later subsumed by a raging inferno of anger.</p>
<p>I&#8217;m sure I&#8217;ve told him before (well, I know I have), but I felt compelled to outline again that my mother had initially said that I had &#8220;misinterpreted&#8221; Paedo&#8217;s actions, which &#8211; when I stupidly admitted the true extent of things &#8211; was later replaced by an accusation of outright lies, which were apparently fuelled by my desire not to see my family.</p>
<p>I didn&#8217;t get particularly angry in relaying this information, but nevertheless, the picture I painted of my mother to C was wholly negative, and at some point or another, I became acutely aware of that.</p>
<p>&#8220;I make it sound as if she&#8217;s a terrible person,&#8221; I sighed.  &#8220;She isn&#8217;t.  It&#8217;s just&#8230;this.&#8221;</p>
<p>(Actually, it&#8217;s not just &#8216;this&#8217;; I&#8217;ll have to introduce C to the tales of how she would viciously beat me up, leaving temporary but significant bruising, almost daily during periods of ((my)) intense depression when I was a teenager.  But I&#8217;ll leave that for another time&#8230;not that I have that many &#8216;other times&#8217; remaining).</p>
<p>He responded by saying that he was well aware that, broadly speaking, I presently have a good relationship with my mother and that I didn&#8217;t see her as a &#8216;bad person&#8217;.  He shrugged.  &#8220;We all have different facets to our characters, as well you know.  She&#8217;s made mistakes in this regard, but just because you&#8217;re highlighting them to me doesn&#8217;t mean that I necessarily think that that&#8217;s representative of her entire personality.&#8221;</p>
<p>&#8220;I wrote a rant about her behaviour last week on my blog,&#8221; I murmured, absent-mindedly.  He asked about the content of it, and I said that it largely mirrored the information that I had just relayed to him, except that it was furious and bitter.</p>
<p>He nodded thoughtfully for a minute, then asked about my audience here.  Was the blog open for everyone to read?  How many read it?  Who, broadly speaking, might my readership be?</p>
<p>I told him that I do password protect the odd post, though if I am honest I probably gave him the impression that I do it much more than I actually do (this is my 121st post; out of all those 121, only three are password protected.  Two of those three are about C, if that reveals any deep psychological insights).  I said that the majority of my audience seemed to be others involved in various mental health systems, mainly but not exclusively from my side of the couch.  And that there were, at that point, in the region of 20,000 hits.</p>
<p>&#8220;But it&#8217;s all anonymous?&#8221; he checked, which irritated the fuck out of me, as we <a href="/2009/06/18/i-hate-psychotherapy-and-i-hate-transference-c-week-15/">already had</a> this conversation, leading to a particularly fraught interaction between us and a horrible few post-therapy hours for me.</p>
<p>&#8220;Yes.&#8221;</p>
<p>&#8220;And no one in your &#8220;real-life&#8221; reads it?&#8221;</p>
<p>&#8220;Not &#8216;no one&#8217;.  There&#8217;s a few, but they&#8217;re a <strong>select</strong> few.  It&#8217;s definitely not for my mother&#8217;s eyes.&#8221;</p>
<p>&#8220;And maybe you think it&#8217;s not for my eyes either?  Maybe you&#8217;d feel uncomfortable about <strong>me</strong> reading it?&#8221;</p>
<p>Oh for God&#8217;s sake, C.  Not this crap again.  &#8220;Why, <strong>have</strong> you?&#8221; I challenged, looking him straight in the eye.</p>
<p>He too had been looking directly at me, but as he replied, &#8220;No, I haven&#8217;t,&#8221; he tellingly lowered his eyes.</p>
<p>I don&#8217;t believe he is <strong>lying</strong>, but I do believe the statement was a half-truth.  It would be hard for C <strong>not </strong>to find this blog, given some of the Google terms he is likely to be searching for in his line of work; therefore I believe that he&#8217;s probably come across it.  He would have recognised me after having read a mere few lines though, and in his defence he is a professional, so is unlikely to have read any further.</p>
<p>I told him I didn&#8217;t care if he&#8217;d read it or not, as there was nothing contained within these pages that I wouldn&#8217;t say to his face.  He was about to respond when I interrupted, saying that technically that wasn&#8217;t entirely true, as I was fully able to discuss the issues of child sexual abuse on the blog, but not with him. (Specifically, I can write &#8216;rape&#8217;, but not say it, at least not to him.  Look, see: RAPE RAPE RAPE RAPE RAPE RAPE RAPE RAPE.  The day I do that in therapy with particular allusion to myself is the day I eat the contents of a 14th century latrine).</p>
<p>&#8220;But you know what I mean, I hope,&#8221; I continued, and he confirmed that he did.</p>
<p>There was a lull for a few minutes, then C noticed that I was laughing softly.  Naturally he asked why.</p>
<p>I had been thinking about the fact I have an entire alter-ego here through this blog.  My material is searingly honest and intensely personal at times, and yet it&#8217;s a very tiny fraction of my readers that know to whom this intimate information really belongs.  As things stand now, that&#8217;s an unfortunate necessity, but it doesn&#8217;t keep it from being ever-so-slightly odd, and hence vaguely comical (at least to me).</p>
<p>We had a brief conversation about how the cloak of the internet allows one to accentuate particular parts of one&#8217;s personality.  In my case, in this guise at least, the accentuated part has been my madness.  I&#8217;ve had other guises related to other specific parts of my personality, of course, but relatively few that have been about &#8216;me&#8217; as a whole, whoever she even is.  Anyhow, this was part of the reason why I felt that I should consider giving myself an <a href="/2010/02/21/whats-in-a-name/">actual name</a> on this blog, even if it&#8217;s still not the &#8216;real&#8217; one.</p>
<p>This saw the end of the session.  C said that we have a lot of material to work with over the coming weeks &#8211; well, my friend, isn&#8217;t that a shocking surprise! We still won&#8217;t grasp it all, though; we <strong>can&#8217;t</strong> in the time we have remaining together. As I departed, he wished me all the best.  Little things like that make me feel pathetically good about our relationship, perhaps because it gives me the impression that he cares about me, however tangentially.</p>
<p>So, no strong revelations as to my life, my universe and my everything in week 42, but as he says, there&#8217;s material to work with for a while.  Can we find the ultimate question?  Moreover, can we find it in the small window of time that remains?</p>


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