Insert Witty Title Here – CPN and NewVCB Appointments

I was writing this as a combined post of this week’s entire set of mental appointments – ie. these two and Paul – but the Paul stuff has completely taken on a mind of its own and needs to be separated from these, which are broadly factual, rather than introspective and ‘deep’. I’m feeling very belligerent tonight, and that shows in the following, and in the stuff on Paul (which I intend to publish on Friday, after the intervening two sessions tomorrow). So beware of ranting, bitchiness, cursing, nostalgia – but there’s a little hope thrown in there somewhere, too.

I’m not going to proof-read this yet either – I need to keep my flow up with the Paul stuff – so apologies if it’s complete and utter wank fodder.

This is still quite long, so here – have some clicky links 🙂

The CPN / NewVCB / A Random Encounter of Which I Epically Failed to Make Use in Which You Are Probably Not Interested

TUESDAY – First Meeting With Christine, My Newly Allocated CPN

The short assessment of this is that she’s actually quite likeable. I’m not really go greatly into the details of the appointment – not because it wasn’t useful necessarily, but it would simply be pretty repetitive. The meeting seemed mainly for her to get a grip on me, and take a proper, verbal history, as opposed to relying on the (fabricated) notes that are in the (fabricated) file.

She is short, fat (she makes me look slim, and that’s quite good going) and has spikey red hair. My guess is that she’s well into her 40s. She has a local working class accent, and ergo does not exhibit the middle-classness of the other members of the CMHT that I’ve met. I liked this; it made her seem more down to Earth. She called me ‘love’ a few times, which normally irritates me – but in this case, she wasn’t doing it in a patronising fashion. It just seems to be part of her demeanour.

She was rather surprised that given my history of command hallucinations etc that I’ve never been hospitalised. I was surprised that she was surprised. I said that no one within services had ever taken enough notice of me to feel hospital was a necessity, or even vaguely desirable. She had the grace to blush slightly.

Another point of interest was when she said, “…and how are things when you aren’t suicidal?”

I sat back in my chair in confused aghast. “Sorry?!”

“You do have times when you’re not suicidal?” she checked, raising an eyebrow.

“I have times when my finger isn’t hovering over a ‘buy’ button for a helium canister,” I said. “But there’s no such thing as ‘not suicidal’, is there? I mean – everybody wishes they were dead, don’t they? They just don’t don’t have the bollocks to go through with it.”

“No,” she said, firmly. “The vast majority of people do not want to die.”

I’ve read such contentions once or twice, but apart from A once saying so (and my assuming he was saying it to disabuse me of the idea of suicide), I’ve never heard it verbally. This is truly an absolute revelation to me. People actually, actively want to live?!!! Seriously????????? Why?

Anyhow, eventually she filled out a risk assessment form. This is another thing that’s entirely new to me. Christine said, “we have to do this as you know,” then upon seeing my confusion, she added, “you have had one of these done before, right?”

“No,” I said. “Never.”

I’m not saying being asked if you’re going to go out and knife the living fuck out of some poor stranger is fun. It’s not. But if these things are so fucking standard, why haven’t I experience them before?

I blame C. I absolutely, completely blame C. I’ll write another post explaining this in more detail some time. For now, let’s just say that my perennial suppositions that he didn’t take me seriously seem to have been proven. I noted with passing interest that a number of his files were to be seen in the filing cabinet in the room. As I idly eyed the documents, I wanted to take my lighter to them and watch them burn to ash. Fucking cunt of cuntishnessfuckerywankshafthatefulness. But anyway…

Christine quizzed me on suicide, and it was instantly evident to her that if I was going to do it, that I would succeed. They find that terribly frightening. Hahaha! They think people will say, “oooh, look at me and my overdose!” and that they can breathe collective sighs of relief as it’s unlikely to be seriously dangerous, so when she asked me if I had any ideation about taking ODs, I laughed right into her face. She didn’t need to ask me why, but I nevertheless said that I would only even consider taking a suicidal overdose if I could acquire the complicated ingredients that are fundamentally necessary to be peacefully fatal. Since I can’t – legally or otherwise – I’m sticking with my party box.

That said, I’m not actively planning anything, and may not do so for some time. Possibly ever, but I don’t believe that. Whatever the case, in short: I’m still not sure exactly what I’ll be doing with Christine, nor how long I’ll be seeing her for. But based on Tuesday’s meeting, I do think that maybe – just maybe – she can be useful to me.

WEDNESDAY – NewVCB

The appointment went pretty well, despite my being irrationally terrified. I’ve known NewVCB for over a year now, and she’s generally been quite supportive of me, but for whatever bizarre reason, I have developed a terror of psychiatry.

She was very nice to me today. She’s usually pleasant enough, but occasionally lacks sincerity in my estimation. On this occasion, I found her to be thoroughly genuine – this is a breath of fresh air in mental health services (particularly in psychiatry), as I’m sure so many of you can appreciate.

I could go into a lot of detail about the appointment – wank on about the dialogue, the subtlety of the non-verbal communication – but I don’t see the point. The essence of it was this: I told her about how I became hugely upset last night, in relation to the Paul session that I was originally writing here, and she opined that therefore my therapy with him must be going well as that demonstrates that I’m starting to experience “emotions” in an “appropriate, constructive way.” She asked if I agreed.

I told her that crying was a sign of weakness and that I thought my behaviour had been pathetic. I said that I was meant to be an aloof, calculated, analytic droid.

She asked me to look at it from her perspective, and I was forced to admit that of course, rationally, it is progress. That objective knowledge doesn’t stop me from fully believing at an I Feel It Like This level that crying and emotions are a pile of fuck. She laughed and said that she didn’t expect me to change my view quickly, but that the fact that I could even look at it logically without flying into a self-flagellatory rage was encouraging. Broadly speaking, I agree with this. Sympathetically, she said, in what I think was an attempt to reassure me, “crying is not a sign of weakness.” Hmm.

We discussed Venlafaxine, as you might imagine. I suggested that maybe I had been too quick to condemn the drug the last time I’d seen her, and said that I understood from some sources that it came into its own at higher doses. NewVCB agreed, stating that its operation on norepinephrine was more pronounced from about 300mg.

I essentially asked her would she increase it again. Things are much better since I’ve been taking 300mg, but I think they could be better again. When I was at sixth form school and on a laughably high dose of Fluoxetine, I functioned fairly well. To that end, I am quite happy to take a laughably high dose of something else if it can assist me in re-achieving such a state. I’m aware that Venlafaxine is a nastier drug than Fluoxetine, of course, but if it works at higher doses – well, then it does. I’m prepared to accept the (numerous) negatives that go with it.

She said that I would need to have an ECG, for which she would refer me; apparently it’s worth having whilst I’m taking the 300mg dose anyway. All being well with that, she agreed to raise my dose of the horrid-but-seemingly-useful stuff to 375mg next time I saw her. “That’s as far as I’ll go, though,” she added.

Hmm. That’s potentially unfortunate, but I do understand the medical rationale for it.

We had a brief conversation about Nexus. Obviously, I’m now into week 18 with Paul, and judging by the discussion I had with the secretary when I first approached the organisation, that only leaves a matter of weeks left. NewVCB seemed unaware of the time limitations. I was interested to note how she phrased the relevant question:

Are they going to give you a more appropriate timeframe than we [scrunches her face in dismissal at her use of the word ‘we’] gave you here? [Dismissive hand gesture in C’s general direction].

I told her how long was left, and said that whilst it concerned me, I felt that if anyone was likely not to play by a silly rulebook, it would be Paul. I hope that assessment turns out to be the case. This kind of complexity cannot be solved in 26 weeks.

As I wrote the other day, an appointment letter for NewVCB had arrived stating that she wanted to see me on 6 April. I asked her, given that this (ie. Wednesday’s) appointment had been organised as well, if she wanted to keep the later one. She said that she did, because she still wanted to keep an eye on me. It might have been nice if she’d seen me within the fortnight she originally proposed, but I’ll forgive her. Just this once 😉

As I was leaving she said that she knew things weren’t ‘good’, but that there was clearly a change in my demeanour since last month. And I think there is. It’s weird, and I don’t trust it. Epically severe depression is seemingly my default setting. I’m not not depressed, of course. But I am a little better. Is the simply the drugs, or is it them plus therapy? Or just the latter? I don’t know. Either way, I cautiously welcome it, but again, I don’t trust it. I’ve had stable-ish periods before, and they always fall flat around me eventually. So I will leave presumption on the issue for another time.

An Odd Encounter

Something really interesting happened when I was waiting for Christine yesterday. I mean, it won’t sound interesting to you probably, but it was for me. As I walked into the CMHT building/Old Bin, I caught the eye of someone in the waiting room, and did a fucking double-take. It was the mother of my long-lost friend, Louise, that I discussed here. As I noted in the post, she had been diagnosed with schizophrenia when I last heard of her.

We (A and I) reported to reception, then proceeded to the waiting room ourselves. I walked past Louise’s mother (Brenda), terrified to speak to her. I saw out of the corner of my eye that she looked up at me, but I withheld my own gaze and sat down as far away as possible, my mind racing.

For the sake of context, my address is at Point A, my alma matter about six miles west at Point B, and Louise’s last known address about six miles further west from that. I tried to figure out why her mother was there, then, at my CMHT. It’s nowhere near their house.

Of course, in supposing that she could not attend the same place that I do, I made (given my experience) the fundamentally stupid error of assuming that this fuckhole country has adequate mental health services. Louise’s house would be equilaterally between this CMHT and the next one in the Trust. Ergo, her possibly attending my local bastardhole is an entirely feasible eventuality.

I stared at the floor until a blonde woman poked her head round the door. Brenda got up to talk to her, and I leaned forward to gawk. I was hoping that Louise may emerge from an appointment or something. If she had been there, I would have spoken to her. Of course, I thought, it was entirely feasible that Brenda was there for her own reasons. Caring for a schizophrenic daughter is bound to present its own set of mental challenges.

However, the blonde woman sort of touched her sympathetically on the arms, uttered a few hushed words to her, and led her further into the building. A few minutes later, Brenda left alone.

It is daft of me to speculate, but still – I am supposing Louise went mental, and Brenda had to take her to the CMHT…and leave her there (for assessment and possible admission – there is no psychiatric ward at this hospital, but of course they have contacts with others). Brenda and the blonde woman seemed to be on familiar terms, so I’d guess it’s unlikely that this was the first visit.

Fuck my social anxiety. I so wish I’d just spoken to Brenda. What was she going to do, fucking punch me? I still think about my old friend a lot, and have tried desperately on many occasions to find her on Facebook or at her old email address, or whatever. I had the most obvious fucking opportunity in creation to re-establish contact the other day, and I blew it. I mean, even if Louise was completely psychotic, her mother knew me, and could have passed on a message when she was a bit better. Stupid, stupid fucking cow!

I even considered asking NewVCB about it today. Obviously she would not be allowed to tell me anything, but I considered telling her what I’d seen, and asking her if Louise was somehow under there care, could she pass on my email address (without her confirming or denying Louise’s presence or otherwise within the system). But, nice as NewVCB is, I thought it was most likely a futile request, so I kept my mouth shut.

Alas.

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10 thoughts on “Insert Witty Title Here – CPN and NewVCB Appointments

  1. I don’t want to sound cynical all over a fairly positive post, but in my experience,

    it was instantly evident to her that if I was going to do it, that I would succeed

    is the kind of suicidality that they care least about, because it won’t result in extra costs for the NHS, or bad PR.

    A few individual workers aside, they don’t care about what’s best for the individual, just what’s best for the system or for the collective whole.

    I hope for your sake you have a helpful CPN 🙂

    • Funnily enough, that’s part of what I was discussing with Paul on Monday (part of the session I was planning to include with this). Both he and I have a certain amount of cynicism regarding my very referral to a CPN – is it Trust arse-covering if I do off myself? Well, we tried to help her, but she decided to top herself instead – we made every reasonable effort, blah blah blah.

      I don’t think my psychiatrist is like that, to be fair to her. Christine remains to be seen, but first impressions are vaguely encouraging. Only time will tell, I suppose.

      Thanks hun x

      • Shite, I’ve just realised I took my own quote out of context – duh! Yeah. I think you’re probably right in many ways. It’s convenient for them as you say. In my case, because I’ve kicked up such a massive fuss, they have to be seen to not wish me dead, or they’ll get done! If I hadn’t bothered, then my helium fixation probably would be music to their ears.

        xxx

  2. RE: social anxiety, i can completely empathise because i am fairly certain, had i been in your situation with Brenda, i would have completely refused to so much as make eye contact let alone actually talk to her. I dont know if i would even be able to do that with the mother of a close friend. But then i also invariably kick myself HARD for it later on wondering why the fuck couldnt i have just sucked it up and opened my stupid mouth! I hope Louise is alright, and perhaps one day you may be able to reconnect. Obviously, because you were so blindsighted, forming the words to talk to Brenda was going to be near impossible… but perhaps you can consider “psyching yourself up” to talk to her if you ever happen to bump into her again?
    *big hugs* xx

  3. I hope Louise is OK. *hugs*

    Christine sounds like a Good Thing.

    I have to say I cried a bit for you (please don’t get cross with me! Or is it only yourself you get cross with for crying?) when you talked about assuming most people are suicidal most of the time. You were so young when Paedo started abusing you. And even before that, your dad left.

    It’s been three and a half years, ish, since I’ve actively desired life for more than a couple of rare hours at a time, but at least I have 19 years of sanity prior to that. It’s odd – I don’t really remember how that feels. But I at least know that it exists. I have experienced healthy mood for sustained periods. You never have, really. That’s horribly sad and unfair.

  4. Forgive me for my amusement but I had to smile as I read all of this, my mind was filling in your vocal style (odd only as I’ve never heard your voice). It was a rapid fire delivery for sure. Suffice to say, from the style of writing and from what you say, that (assuming you are bipolar) you’re on a high. Don’t get me wrong, I’m not saying this is a bad thing or anything but it’s interesting to see the changes within you when this state hits (for whatever reason).

    • Last night (when I wrote this) was really weird actually. Random ranting just seemed to fall off my fingers as I typed, and I was listening to heavy rock music so was feeling a sense of ‘fuck yeah!’. I certainly felt…I dunno. Not ‘high’ (in the traditional, euphoric sense at least) – as I kept bursting into tears every five minutes – but perhaps ‘fired up’? I ended up writing all evening (from about 6pm to 1am), which is something I haven’t done in a very long time owing to depression, lethargy, the usual bullshit.

      I wonder is it the Venlafaxine? When I was first prescribed it back in June 2009, I was cognisant of two things. One, starting it sent me completely and utterly mad (see this post) and two, I was confused as to (Old)VCB’s train of thought in prescribing it, as it’s notorious for inducing manic symptoms in relevant individuals.

      I think that having Seroquel as a mood stabiliser (as well as an anti-psychotic) is probably a good thing here, if indeed there is bipolar disorder running through my blood somewhere. A certain amount of ‘highness’ I can deal with, but not too much. It leads to odd behaviour and, moreover, when you fall, you fall hard.

      Still, I’ll take what I get for now 😉

  5. Hey Pan,
    It sounds like there has been some positive advancement in several areas and I’m glad for it. I completely understand your cautious attitude, I feel the same way when things get “good”, good being a realtive term in our world. Having people in the mental health system who actually do there jobs is essential. They have to see you as a person and not just a name on a page. I’m glad that someone actually talked to you instead of just making notes in a file. The very fact that you saw a process with Christine that you’ve never seen before like the risk assessment form, tell me that you weren’t being fully treated before and obviously you’ve dealt with an incompetent ass before.

    It’s ok to feel cautiously optimistic, sometimes things really do get better. Better can mean different things for different people, but it does happen.

  6. Hi Pandora,
    I went mental about a year and a half ago when my dog died, but the mental health folks here blame EVERYTHING on the fact that I was sexually abused by my father as a kid. Don’t agree with them. Anyway, as the months have passed I, too, have developed a fear of psychiatrists. I find them ( after 4 admissions) to be scary, intimidating, domineering, evasive, and (they think) all powerful. We’re not on the best of terms right now either. In regards risk assessments, I’ve had two -as we call them- forensic evaluations. I can tell you that you are taken a LOT more seriously when the risk is to someone else. Yea, yea it’s one thing to threaten yourself but “concerning” to threaten another(father). Take care, Lori

  7. Yeah – honestly, the vast majority of people don’t want to die.
    I’m glad you’re feeling some improvement. I truly hope it lasts – you deserve more than stable-ish.
    That must’ve been weird seeing Louise’s mum – I hope they are both OK.

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