Perspectives from the Mentalist's Best Friend

Good afternoon, loveliest readers. Following the success of A’s series of guest posts for Confessions on daily life with a mental, my best friend Daniel asked if he could add some thoughts of his own. Clearly I jumped at the chance to have these insights, so I fired him off a couple of questions, which, along with his answers, now follow. Enjoy ūüôā ~ Pan

What was it like growing up with a mental friend? Did you know how mental she was? Did you ‘get’ some of her weird behaviour? What, if anything, did you feel you could do about it?

An interesting question, because as a teenager, rather than consider my friend to be mental, I considered her to be interesting; as such, I chose to emulate her behaviour.

I remember running up and down streets carrying a curtain pole. I recall parading around people’s living rooms with a cushion on my head, making stupid noises. I was there when we walked home, unable to afford our bus fares [Pan – having spent our money on alcopops, if I recall], from the near-ish-but-far-to-walk-from large town (approximately eight miles, if my memory serves me correctly) – all the while pretending to be German, talking to every person we met in broken English. They were helpful in offering us directions and admitted that they had forgiven us for “the war” when we insisted on apologising for it (and yes, I’m still laughing about it now, perhaps 15 years later). [Almost literally pissing myself at that one. Ah, memories…].

Oh, almost forgot: we phoned teachers in the middle of the night pretending to aroused horses, cats and vampire bats. Good times.

This seemed to me to be completely normal, acceptable behaviour – and if I am brutally honest, it still does [agreed]. This is how we chose to spend our time and was what made us laugh as children. Of course, society may judge young people behaving like this as being weird, unbalanced and perhaps even dangerous – but this is certainly not how it seemed to be at the time.

But, in saying all that…I was also there the night Pan took her first overdose (I think we were 16). I recall watching her take the pills and I helped her mum force her to spit them out. I was still there that night in the hospital, when Pan informed the staff that if she were allowed to go home, she would kill herself. A sanctimonious A&E doctor curtly replied, “no, you won’t. Manics don’t want to kill themselves”, to which Pan calmly (bearing in mind she’d been hysterical only moments before) explained, “oh that’s interesting, because I do”. [I don’t remember this bit; I hadn’t realised I’d talked back to the supercilious bitch. Good.]

And in a moment of what should have been horror for any young person, that wry smile – infectious when around Pan – spread across my lips; here we had this suicidal teenager who, despite her suffering, still had the audacity and quick-thinking to look a doctor in the eye and calmly tell her that she didn’t understand a word of what she was talking about (though Pan’s mum was naturally mortified).

Who doesn’t love a bit of black humour?

But in all seriousness. I just went with it. When Pan got out of the hospital, we did talk through the issue that had upset her. But we never psychoanalysed her decision to overdose (on ibuprofen? [yes. That makes me cringe now.]). It wasn’t the sort of friendship we had then – again, because it was just normal for me.

If you knew me, you’d know I judge everybody. I can’t help it. It’s a cold part of an unashamedly bitchy streak of mine. I judge people on their clothes, their hair, their reading habits, what music they like, their accents, and the things they say.

With that in mind, the following may be surprising. I think Pandora’s the only person in the world other than my partner that I love unconditionally. As such, she’s one of the few who’s been immune to this cult of judgement – back in school, throughout university, and still today. For her part, she has never formed an judgemental opinion of me, despite supporting/counselling my countless foolish decisions. Perhaps these acts have been made because of some undiagnosed mentally interesting characteristic in my head, I don’t know; as such, either way, I have never formed any judgement on the way she thinks and what she does. Ever. And I never will. I can’t understand the exact thoughts in her head – and again, I probably never will – but I ‘get’ why she has them.

So – growing up with a mental friend? Every day was an adventure. Most days were fabulous. On a daily basis, Pandora painted my dull life with beautiful colours. No one has ever made me laugh as much as her. She knows me inside out – in ways that, almost terrifyingly, I do not know her [you do, my dear. Believe me, you do].

Did I know how mental she was? Yes. Definitely yes.

What could I do about it? Not a lot. But I hope I was one of the things in her life that at least didn’t exacerbate the problem. Although thinking about it…curtain pole/teacher stalking/rollerblading late at night/”Shinobi”-wise – I totally did, didn’t I? [Indubitably. But in the most hilarious and uplifting way possible ūüôā]

To what extent has a physical separation impacted upon your friendship with the mental, if at all?

I don’t like it very much. But I know “the mental”, as she so eloquently puts it, very well in different ways. Her blog outlines in detail what she is up to, so on a very cosmetic level I know how she’s getting on [or did, until I took an unannounced hiatus. Explanations and more for that next week]. And I understand a lot better now what she’s thinking. So that’s nice.

Fundamentally Pandora has always behaved exactly the same with me, so when I see her, we click back in. Since I have been away she has developed her relationship with A, who is now also a good friend, so it’s been great to get to know them as a couple and have – to an extent – a more traditionally ‘civilised’ friendship.

Mental wise? Her condition certainly seems to be to be more complicated now – but then, I read about it on a screen. If she were to talk to me about it face to face – and we have done so, on some issues – it is/would be no different to how she communicated things to me when we were children/teenagers. Still, this blog certainly allows us to have a ‘conversation’ (about mental health) that is often made more difficult in person. But I imagine that’s because of the context, therapy, drugs, triggers etc etc – inevitably, analysis of such difficult issues is more easily tackled in the written word, no matter how close the relationship.

How do you reconcile the teenager you knew with the depths of the person you now do?

Right – I have touched on this a little bit. But she’s very, very similar. Pan has always been deep, though perhaps she is much more considered now in how she speaks. I don’t witness her highs or lows, since I see her maybe only three times a year, usually in a public setting – so she comes across to me as the same girl. And often we will reminisce, so we talk a lot about us as children.

But now, what’s interesting to me is how rather than reacting angrily to her mental health difficulties in the way she might have perhaps done as a teenager – she actually uses them for something constructive. It’s quite inspiring actually.

Perhaps some of the people who read this blog have a certain schadenfreude about the terrifying thoughts that go through Pan’s head and how she reacts to them…But she’s really not a dramatic person. She’s calm, caring, thoughtful, considerate and although she does like the occasional bit of recognition for a job well done, this blog doesn’t exist to win awards or amass some sort of international recognition, or whatever. Rather, it’s to help three groups of people.

  1. Pan – to keep a diary of her progression and an archive of how she is feeling after certain therapy session and/or drug cocktails
  2. To help people like me who are ignorant about mental ill health understand that sufferers are ordinary people leading extraordinary lives
  3. To provide information and a forum for people who are suffering – so they know they are not alone.

She wouldn’t have had the balls to do this as a teenager – no one I knew would have, and most wouldn’t now. To take something like mental illness – something that can be so powerful and destructive – and harness it into something that has been described by influential types in the mental health sector as “beautiful” is, in my mind, the mark of an exceptionally gifted woman.

This side to her, although I knew it was there in ways…well. I don’t think I could have ever imagined from knowing her as a teenager that she had all the facets and experiences that led to the persona we all now know as Pan…Does that make sense? [very much so. I didn’t know this…entity, I suppose, of Pandora existed until relatively recently either]. The Ang Sang Su Chi/Eva Peron/Catherine the Great of the Madosphere? We’ll see [don’t be so melodramatic!!!].

The mental is, of course, mental. As a writing professional yourself – knowing that the mental narcissictally proclaims herself a writer – do you that think she has any realistic occupational prospects in this arena (be honest)?

Ok – she has won more awards than most well-known or full-time writers, and turns in copy that is tidier and requring less editing that the majority of journalists I work with.

But writing is a big job description.

The issue here is in confidence. I can only speak for myself in my own job. I have to attend networking events in rooms with dozens of suits I don’t know, attend dinners and sit at tables with people I’ve never met – and talk to them. I have to interview executives in their offices, over the phone, speak to PRs and have hideous corporate lunches – daily.

Pan would hate all of this shit. [I would…most assuredly, I would].

I had to write a 3,000 word feature once on bio-degradable microwavable packing (I can send you it to read if you want [I cracked up at this. Please send it. It sounds incredible!]) as a freelance piece when I was looking for a job – and I can’t imagine her ever doing this.

But, and I really don’t want to sound patronising here, she has a hell of a lot of raw talent and will dedicate herself to something – but only if she’s passionate about it.

I would LOVE to see her have a regular column in a paper or magazine, edit a serious mental health journal, or – dare I say it – write a book.

This is probably where the future lies – but I know she’s already talking to editors, making strides and breaking into the wider arena. I think there is a lot to be hopeful about. It’s just about planning a strategy and working to it, and I’m learning that Pan doesn’t necessarily tend to let things she’s terrified of stop her from doing what she wants, if she really wants something (although she doubted herself…MIND awards anyone? She was petrified of attending the ceremony, yet she threw caution to the wind and just went). [Very true – I was genuinely terrified of attending the event (fucking anxiety), but knew it would be a travesty, both personally and professionally, not to. I’m so glad now that i forced myself to go, of course – but I managed to get through my agitation and enjoy the night, in part, with Daniel’s help ūüôā].

And that, boys and girls, is a rap.

Can I just add here that I am touched and flattered and have a warm fuzzy feeling inside after reading all that Dan has written here. I know he loves me, but it’s always nice to be reminded of it. I love him too ūüôā With a friend like Dan, and a partner like A (whom, obviously, I also love very much), I really have much to be thankful for. You two rock. ~ Pan

Perspectives from the Mentalist's Partner (5): Thwarting the Downward Spiral

I should preface the following by noting that this post has not been written by Pandora. Rather it is a guest post by her partner, known to regular readers of this blog as A. The views expressed, needless to say, are not necessarily those that are held by the Serial Insomniac herself. Now, with that disclaimer out of the way, I’ll proceed.

Over recent months, I have sometimes found myself wondering to what extent worklessness, quite independently of Pandora’s mental health issues, breeds the kind of motivational collapse that this blog so often and so effectively chronicles. The question seems particularly apt with the Coalition government taking forward very significant changes to disability support and out of work benefits.

Let’s get something straight from the outset; in raising this question, I’m not for one moment suggesting that Pan is in any position to work at the moment or that she isn’t deserving of the support that she currently receives. What I am asking is this: is being away from work for such a long time a contributor to the difficulties that now stand in the way of Pan resuming a ‘normal’ life? (Cue all the usual reservations about the word ‘normal’.)

In speculating on the life-deadening impact of worklessness I speak to an extent from personal experience, albeit not a long stint of same. When I completed my university education some years ago, I naturally went job hunting. I didn’t think I’d get anything quickly, and in the interim determined to enjoy myself, drink in (sometimes literally) the freedom that being away from full time study could bring. Without a care in the world, I could begin on any number of projects I’d always thought I’d like to do – writing some short stories, composing music, improving my guitar technique, learning to program a computer in a much less amateurish manner, honing my understanding of the world and its most important issues through wider reading. Sounded good. And yet I’d been warned that prolonged exposure to the dole could be psychologically debilitating. A friend of mine, a long term doleite, told of the fact that he had come to the stage where he couldn’t even be bothered getting up or having a shower on many occasions. I dismissed such thoughts; that was him, I was me. Nothing like that would happen to me.

Well, for my first four or so weeks of freedom, I was right. I had a whale of a time. No commitments. No pressures. I could go out when I wanted. I could stay up as late as I wanted for some deeply interesting all night philosophical conversations. I could catch up on series upon series of the good TV shows I’d missed, read good books, experiment with writing, compose bits and pieces on the computer, and so on. I could pursue what I wanted to pursue, all the while job hunting, attending a few interviews – not having much success – but oh well, time would sort that out, wouldn’t it?

Week five brought a niggling feeling that things were starting to veer off course. I’m obviously an impatient person, because by the time I’d reached this stage, the boredom had subtly, insidiously started to set in – and with it, the transformation of my motivation into molasses. That morning shower? Bah! Showers were for losers! [Pan – yes, they are. I’m actually scared of them, and since I am soooo awesome, anyone who thinks that showers are cool is wrong. Matter closed]. It could wait. Going to the shop to get milk? Black coffee would do just fine. Tomorrow, maybe. Getting up? Well, surely past midday was perfectly respectable. Maybe I could even practise some lucid dreaming! In short, postponement and procrastination gradually became the order of service, and with this development, the ebbing of creativity marched dolefully in step. Days blended into other days. Weekends were the same as weekdays. Friday afternoons weren’t the great escape they once had been. Time to do stuff was, well, just more time. And I had plenty of that, so why rush?

By weeks six and seven, my brain was beginning to atrophy. By week eight, I was finding it an achievement to force myself to take a daily walk into town – I’d even set this as a bloody goal, so pathetic was my motivation by this stage. That was the height of my ‘achievement’.

Luckily for me, I’ve always been driven by some sort of guilt trip which prevents me from giving up entirely – so far, at least. I continued the job hunting, somehow, and eventually secured a position.

But enough about me. The point I am trying to make is that worklessness – or so it seems to me – creates its own challenges which are generated separately from, or at least contribute in a separate way to, the challenges brought about by what I will call, for want of a less generic description, clinical depression.

I’ve now had this conversation with Pandora on a number of occasions. What part of her is unable to get out and about, to find motivation, to look for work, etc, as a result of her condition? And what part of all that is the result of being in the situation she has been in – without work, without what one might call external responsibilities – for around three years?

This thought process of mine should not be interpreted as a suggestion, as some would have it, that people struggling on benefits are necessarily work-shy and simply need a good kick up the backside. Do such people exist? Certainly. Are they typical? I doubt it. The long term unemployed who have lost hope need help back to work – a carrot and a stick, probably – but at the same time there are plenty of mentalists who, for various reasons, are unable to work, who want to work but are simply not currently in a place where they can do so at this moment. Let me put it like this: would you want your colleague having paranoid delusions, or bursting into tears/storming out of the office or off the building site because they can’t cope with what might seem an ordinary task? I have an acquaintance who sees conspiracies everywhere and who is working. Or was. Until he was fired. For threatening colleagues. On more than one occasion. Even after formal warnings. Because he erroneously thought that people were engaged in a conspiracy against him. He needed help. He ultimately couldn’t stay in work. He needs help now to get him back to a place where he can resume work. (That he fails to acknowledge this [I’d say ‘doesn’t realise he needs it’] does not negate the fact that he needs it.) I’m sure about this: a person like him should be nowhere near a workplace until he has had an opportunity to deal with – and be helped to deal with – whatever conditions afflict him.

I’m somewhat worried that the proposed changes to the system will fail to recognise cases like this; the medical assessors, as I understand it, won’t be specialists in the field they are assessing. Does that make sense? Not to me.

To return to Pandora’s case, and I can’t and won’t generalise about others, I still wonder how much her chances to get back to a ‘normal’ existence are constrained not alone by mentalism but also by having become stuck in a rut – through no fault of her own – for so long. Adjusting again to the concept of work, after the passage of a long time sitting in the house, will almost certainly be very difficult. It would be difficult for most people, I’d venture. For me, definitely.

So what’s the point of this post?

I’m not sure, really. I suppose I want to reassure myself, and Pandora, that a return to work will be possible, but I need to acknowledge that, independently of mentalism, it will be a gradual process, perhaps starting with some very light voluntary commitments and working its way up to some part-time, low pressure role. Eventually, of course, the objective will be a return to a full-time and, ideally, fulfilling career. You may have observed that Pandora is a smart cookie, and I think she’ll do very well for herself as a professional, provided she is able to reach a sound level of stability and find something that she really doesn’t mind (or, dare I say, enjoys) doing [which is all I’ve ever really wanted out of life].

I don’t have the answers, but would certainly be interested in the views of others on the ‘worklessness breeds worklessness’ theory.

You can follow A on Twitter at @TheNyarlathotep.

Them and Us

A few weeks ago, I made very¬†brief allusion to the (highly unlikely) question of being seen by random people whilst in a therapy session. ¬†The point also applies to the issue of waiting¬†for or leaving such a meeting; given the nature of the department, building or clinic you’re in, people can¬†immediately¬†make huge assumptions about what you’re there for, whether they are accurate or otherwise. When I was seeing C on the NHS, I almost never saw anyone before the session commenced, but afterwards, the corridor would suddenly be laden – sometimes extensively, sometimes less so – of elderly people; there was a hearing clinic next door to Psychology, specifically catering to this demographic. ¬†As such, given the signage about the place, all of these old people would have known that I was in the building for being mental, as – old as I feel – I’m a few years off pension-age yet.

On¬†one occasion at C’s, there was another young-ish woman waiting before the beginning of the session. The atmosphere was as awkward as fuck, meaning that it was almost inevitable that we’d have to start talking to each other; we both knew we were there for psychotherapy, though a direct confirmation of same was never entirely verbalised. ¬†She made assumptions about me, and I made assumptions about her. ¬†Depression, I reckoned. ¬†Isn’t it the usual catch-all term that GPs dish out when they’re making a referral, regardless of the accuracy thereof?

I wondered what the assumptions she’d made about me were. ¬†Inevitably, “complete fuck up” would have come in there somewhere, as I accidentally intimated to her that I had been “seeing this bloke” for over a year.

In Nexus, my current centre of psychotherapy, this sense of assumption is even more amplified: the entire point of the organisation is to counsel those that have been raped and sexually assaulted. ¬†Although you can’t tell exactly what has happened with a client of their services, you know – as opposed to assume – in general terms why they’re there.

As most of you will know, over the past month the weather in the UK has been very snowy, and because we lack any sort of normal and adequate infrastructure for dealing with same, people end up being¬†sucked into the centre of the of the Milky Way’s central super-massive black hole late for appointments. ¬†Because I do not have the shocking audacity common sense¬†to be petrified of a bit of snow, I have not been late for my appointments. ¬†This late/on time confluence of circumstances has resulted in that most dreaded of things: encounters with other in-therapy clients (actually, it has now resulted in that other most dreaded of things – a session cancelled by the allegedly snowed-in therapist. ¬†I may rant about that, I may not, but it will come in another post if so. ¬†Perhaps in my review of Week 10 ((ie. last week, 13 December)), which I really ought to try and write tomorrow, because cunting, fucking, wankshaft, bollocks Christmas and its inane miscellany of shite are monopolising my fucking time for the rest of the fucking cunt of a week).

Anyway, meeting other Nexus clients. ¬†Perhaps needless to say, I haven’t exchanged words with them – I mean, what the fuck are you meant to say? ¬†“How’s it going there, lovey? ¬†So…who was it, then? ¬†Your ex? Father? ¬†Cousin?” ¬†No. ¬†Sexual abuse does not lend itself well to polite smalltalk – however, for a split second, you lock eyes with the other person and, in a weird, intangible, unquantifiable sort of way, you know each other. ¬†You could be polar opposites in terms of character, outlook, political persuasion and so on – but somehow this similar sort of tragic shared history forgives any such differences. At the risk of sounding insanely pretentious, for that second, you are united.

Then you both remember that society rarely allows itself to openly acknowledge what has happened to you, and you look away from each other.

The particular branch of Nexus that I attend is quite a¬†surreptitious¬†building – a deliberate choice, I am certain. The sign denoting the name of the building is tiny, in stark contrast to some of the other properties in the area. ¬†I am in fact convinced that the name of the organisation – though probably symbolic in some way – was chosen mainly because¬†it’s so anonymous and dull. ¬†Inside said branch, there are two waiting rooms; one for those there for training, or interviews and the like – and another one, tucked quietly round the corner, for¬†us.

I am grateful for this.

I resent myself for being grateful for this.

Why shouldn’t I sit with non-client attendees?! ¬†It’s not like I have some sort of infectious disease or something, unless Nexus somehow have paranormal-like powers in the arena of medical classification. ¬†I’m not a walking case of dynamite or airbourne poison.¬†¬†The charity would no doubt claim that they arrange the rooms as they this for the privacy of the client, and I would not doubt this assertion for a nanosecond. ¬†As I say, I have only gratitude for their thoughtfulness in this regard. ¬†But should it¬†have to be this way? ¬†What have I, or any of the other abused clients, done to deserve a sort of¬†pseudo-banishment from ‘ordinary’¬†society? ¬†Why should we be hidden away from the world, like things to be brushed under the carpet? ¬†And, maybe more importantly, why should we want to?! ¬†(Yes, yes, yes – I don’t speak out because of my family situation, and I know I’m highly unlikely to be the only one – but in a way, that’s part of the point. My family would disown me and probably me my mother. ¬†Why should they do that?¬†¬†I didn’t fucking systematically rape my-fucking-self! ¬†And why would his claims of innocence be more convincing that my recounting of reality? ¬†This is exactly my point.).

I should note that I am not criticising Nexus in the least. ¬†They’re only implementing a policy that all their clients want. ¬†What I am doing is asking why we want it, and let’s face it – isn’t it in large part because sex abuse is still such a taboo subject? ¬†Society, whilst peripherally acknowledging its existence, turns a blind eye to the harsh reality of the phenomenon; it always has. ¬†In the modern era we are more aware that it happens, certainly – but have we come far enough?

I have so much admiration for those victims of the Irish Catholic institutional abuse.  Many of them have waived their rights to anonymity in order that they could openly raise awareness of the issue, and indeed of child abuse in general.  And nobody blames them for what happened, rightly reserving their antipathy for the horrible perpetrators instead.

I do wonder though if we as a society are really ready to accept that families and “ordinary” people do this to each other – in some cases, to their own children. ¬†Moreover, can we accept this without unwittingly excusing it? ¬†I know my little corner of the world can’t cope with such recognitions. ¬†My mother simply cannot believe that incest occurs, for example. ¬†“Parents couldn’t do that to their children,” she claims: because she feels maternal love for her offspring, so it must be for every single parent in creation. ¬†She has come to ‘believe’ in the afore-referenced Irish scandal, as if it were something that somehow warranted doubt to begin with, but opines that if the Church allowed priests to get married, then it would never have happened. ¬†Her childlike naivety and wilful disregard for evidence staring her in the face still has the power to shock me.

Why is the default setting of many people to deny the existence of this stuff? ¬†Why is it society’s default setting to ignore it? ¬†Why do only a single-figure percentage of rape cases taken to Crown Courts result in conviction?

It’s not just sex abuse that I’m ranting about either. ¬†It’s general discrimination faced by people who have experiences the world is scared to try and understand – mental illness, indeed, though such attitudes are by no means limited to these two arenas.

Even as recently as the latter half of the last century, cancer was a big taboo.

Oh, yes, my sister’s ill. ¬†[Nervous pause] ¬†Er…well…it’s…well [whispering] it’s cancer.

Oh… [backs away] ¬†Oh right. ¬†Well, it was nice to see you. ¬†Cheerio. [Practically runs away]

In this stigmatic sense, mental health problems are today’s cancer – but then again, these forms of illness have always been regarded in demeaning or horrific fashions. ¬†From ignorant cunts claiming that mental illness doesn’t exist, to things like enforced¬†electro-convulsive¬†therapy – mentalists amongst us are still under attack with little hope that I can discern of ceasefire. ¬†True; no one really fully understands the mind and its parent organ, the brain – but nonetheless, mental health problems are still subjected to a complete Cinderella of a service in terms of accessing meaningful treatment.

Why?  What is it that this stupid fucking planet is so scared of?  It fears the unknown, certainly, but it has overcome its prejudice in that regard on a multitude of previous occasions.  Various organisations are trying to help it overcome this one, but I really wonder sometimes to what extent they are succeeding.

In this little corner of teh interwebs in which people like me write – the little part of the blogosphere that has become known as the Madosphere – there is no stigma, no horrified and urgent backing away, when you discuss the finer (or even the general) points of your illness. ¬†But, if you ran into an old friend today (that had not studied Psychology, Medicine, Nursing or some allied professional) and said to them, “I have borderline personality disorder,” do you think they would even know what you meant?¬†¬†If you said, “I have schizophrenia,” would they automatically assume that you have 17 different personalities and/or are, by your very nature, violent and deeply dangerous?

Would you even tell them you had a diagnosable mental health difficulty? ¬†If not, why not? ¬†It’s none of their business, is it? ¬†You’d tell them if you had gall stones, would you not? ¬†How is that any more their business than your schizophrenia?

On the point of the erroneous assumption that schizophrenia is¬†dissociative¬†identity (or multiple personality) disorder, would they know that cases of multiplicity are almost always connected with severe and chronic childhood trauma – or would they simply be of the view that it was some bizarre, at times even amusing, quirk of the mind of those thus afflicted? ¬†If they’d even heard of borderline personality disorder, would they know that in a notable majority of cases, an abusive history is present?

Would they care?

Of course, everyone would claim that they would care deeply – how could one not feel repulsion and compassion for a mistreated child, blah blah blah. ¬†The problem is the person with the mental health problem is no longer a child, and in¬†ageing¬†for some reason seems to have lost the side with which one is allowed to have sympathy. ¬†One’s bad experiences – if indeed there even were any, because they might have ‘imagined’ it to their psychotic madness, or lied about it owing to them being a useless malingerer! – should be resolved by now; if one remains mentally ill, then it has nothing to do with either brain chemistry or trauma, and is merely a fault – a deficiency – in you, the person afflicted. ¬†Either you should get off your arse and get on with your life, or you should be sectioned.

I am simplifying, and of course a lot of people do recognise the existence – in theory, at least – of a middle ground,¬†but I really don’t think I am grossly overplaying this hand. ¬†It is easy for us in the Madosphere and, if we’re lucky, our friends and family, to ¬†universally accept that mentalism is understood and accepted, because that is what we’re used to here. ¬†Experience, however, has taught me that as soon as you deviate from an inner circle, you see the views of the rest of the world – and they are the reason for the very existence of this rambling, meandering post. ¬†And it’s sad to see – from my own point of view, yes, but more so from the perspective of those people whom it prevents from seeking help. ¬†They suffer alone or, in especially tragic cases, end up committing suicide, feeling they simply have no outlet for their misery.

The problem is, of course, ignorance – at least in the main. ¬†As noted, that widespread setting is being challenged by the likes of the Time to Change project (or – here in Northern Ireland – um…er…well…nothing). However, these organisations can’t reach everyone, try as they so steadfastly and admirably do. ¬†At some point do individuals not have to take responsibility for their own lack of awareness (they do in court – not knowing that something is illegal, or that that person you slept with is a minor, is an illegitimate defence in British law)? ¬†I’m not saying that every single person across the space-time continuum should drop everything right now and start Googling the finer points of the academic discourse on mental ill health. ¬†That would hardly gain us any points! ¬†But when a non-disordered person encounters (I originally typed encunters, which also works) mental health difficulties in others – at work, school, the gym, or even through entertainment such as film and music – would it really be so much to ask that they took a few minutes to (a) understand that they don’t understand, (b) accept that they cannot therefore judge those affected, and (c) do at least a little research? ¬†Is modern life really that full and frenzied that 10 minutes out of a person’s day can’t be devoted to this, at least when there’s a clear catalyst for it?

Deary me. ¬†Trauma and mental illness, and the sometime correlation between the two. ¬†Can those of us affected ever be entirely integrated into normal society like, say, those with cancer largely have (rightly) been? Or will the issues always remain taboo – someone else’s problem, not something that happens amongst one’s direct friends and family? ¬†Will it always just be a case of them and us?

/overlengthyrant

(NB. ¬†Questions are rhetorical (though discussion is, as ever, welcome); nothing in particular precipitated this gurning except my annoyance at the waiting rooms issue at Nexus; I probably perpetuate stigma and a Them and Us culture in using some of the terms I do; I am just a mental freak with bells on and you should not listen to ((read)) a word I say ((write)); the Earth is flat and orbits around a giant tombstone with a statue of a banana on top; blah blah blah, yadda yadda yadda, etc etc etc, ad infinitum ad infinitum ad infinitum, la la la, meh meh meh…)

Memories

Memories have been bothering me this weekend. ¬†Some are of the more obvious variety, though perhaps not in the way you might think – not in the sense of constant rumination of the¬†minutiae¬†of sexual abuse – but I’ll get to that.

My First Flirtations with Mental Health Problems

My best friend as a child and early adolescent was a girl named Louise. ¬†She led me astray in terms of rules laid down by my mother (and grandfather) more than once, not that I required much persuasion on the majority of such occasions. ¬†Her mother let her do essentially as she pleased and her father appeared uninterested in his family. ¬†So freedom was by and large her’s – and, for those fleeting periods that I was granted time with her, it was by extension mine.

We had immense fun together. ¬†We would talk and laugh for hours on end. ¬†We’d make up ridiculous lyrics to established songs, record them, then fall about laughing at the results. ¬†We would talk about boys (or, more usually, men) as girls of that age are of course wont to do, and we’d piss about with hair dye (a tradition that stayed with me; I get bored easily. ¬†It’s presently blue/purple).

I don’t remember when things changed, or even if they did – perhaps I simply didn’t notice before, or remember a lot of our relationship through rose-tinted glasses. ¬†Even if a shift did take place, it was insidious and spread-out. ¬†I didn’t just wake up one morning and see a difference.

Her first diagnosis was the same as my first, but at that point in-the-future, illness was said to be. ¬†Clinical depression. ¬†Apparently with somatic symptoms in Louise’s case, though I don’t remember that term being used the time; I merely remember that she had a zillion physical illnesses that would keep her off school for weeks. ¬†Perhaps they were her cover story for episodes of depression, rather than being ‘real’ per se – who knows. ¬†It doesn’t matter. ¬†The point is, Louise’s illness was my first proper awareness of and exposure to a mental health problem. ¬†Hindsight dictates that I was probably quite doolally myself well before this, but because my childhood hallucinations and inherent weirdness hadn’t bothered me unduly, or at least hadn’t seemed abnormal, I hadn’t taken much notice of them.

I don’t remember much of how I reacted to her diagnosis, which I think she received when she was about 12. ¬†I do recall her telling me when she’d be back at school after a lengthy absence, and of my waiting eagerly at the window of the Music department, which overlooked the main pupil’s entrance, in order that as soon as she arrived I could rush down to greet her and welcome her back. ¬†My peers were very unkind; they sneered and spat about her absence(s). ¬†I didn’t care; she was my friend, and in whatever way it was, whether it was obvious and visible or not, she had been unwell.

However, what I’ve been struggling with today was a later memory. ¬†It must have been in the summer before I was 15, because my ill-fated relationship with my hideous ex forms part of it. ¬†I don’t remember what I – or she, as they’d met – had told him about her depression, but he must have been aware of it, because I remember using the word ‘another’ in conversation with him about it.

Louise’s mother and grandmother had taken us on ‘holiday’ for a week to a wee apartment in Portrush, a seaside town in the North-West of Northern Ireland that falsely and rather¬†grandiosely¬†believes itself to be the province’s answer to Blackpool (not, I’m sure, that Blackpool is anything particularly extraordinary either). ¬†It had started off extremely well; we sat up half the night chain-smoking, listening to music and pissing ourselves laughing at God-knows-what. ¬†We went skinny-dipping at about 3.30am one of those first nights. ¬†Ridiculous, ill-advised and probably frankly stupid – but it was fun.

The week went on, and with it came a change in her demeanour. ¬†I remember distinctly that she was point-blank refusing to take her Fluoxetine; her mother tried to insist that she swallow it over but Louise literally threw it out the window in an rage. ¬†Her mother asked me, a medication-compliant individual, if I could persuade Louise to at least try them. ¬†Reluctantly, I did – but as you might imagine, it didn’t go down well. ¬†To be fair, I think she eventually apologised to me, but in the¬†immediate¬†aftermath of her scornful outburst, I told her mother that I was going out for a walk to clear my own head.

As someone herself suffering from depression, I understood the extreme depth of feeling and¬†indescribable¬†desolation that it brought, but the thing was that I never took it out on my friends, and even then I was very, very skilled at acting and pretending that everything was OK. ¬†So things about Louise’s condition that at the time I didn’t understand included (but weren’t limited to) her vicious outbursts and abject refusal to take her medication.

Off I went on my walk. ¬†This was in the day before mobile phones were widespread (God, I’m old…) and also in the day before the worst of the development of my phone phobia, so I stopped at a phone box on the main street and called Hideous Ex.

I’m finally getting to my point (900 words later. ¬†Why don’t I have this ability when I’m trying to write stuff that pays me?!). ¬†After a desultory conversation about the weather in Portrush, the subject finally eased its way into being about Louise, and I finally said to Hideous Ex, “she’s had another mood swing.”

She’s had another mood swing. ¬†What an awful thing to say. ¬†What a truly horrible, stigmatic, ‘victim’-blaming way to describe the situation. ¬†No “Louise is depressed,” or “she’s having a shit time of it.” ¬†She’s had – yep, her fault. ¬†Well done, Pandora. ¬†Another – yep, yet again. ¬†Sure that’s all that happens in her sorry life, isn’t it? ¬†Mood swing – yep, spot on. ¬†Her life is defined by mood swings, isn’t it? ¬†Except that it wasn’t of course – she was funny and interesting and¬†charismatic, and was not defined by having depression.

Besides, I used the term ‘mood swing’ to mean depressed, or distressed, or however else you might have described her mood. ¬†The phrase ultimately means nothing, and is furthermore so often used by ignorant or discriminatory members of Joe Public to demonise people with mood disorders – they’re not sick, don’t be stupid. ¬†They’re just a moody fucker.

I was young and naive to matters pertaining to mental health issues, despite my familiarity with Louise and my having recently been slapped with a diagnosis all of my own. ¬†It was a throwaway remark, one that probably seems innocuous to many people reading this. ¬†Nevertheless, in the last year or so¬†I’ve been on such a crusade to attempt to eradicate the stigma of and raise awareness on mental illness that to recall that I was once so horribly dismissive of my best mate’s distress makes me feel tremendously guilty. ¬†I’m a hypocrite. ¬†I find myself furious about the average person in the street’s lack of knowledge or lack of sympathy, or of their downright disdain – and yet in one small statement I exemplified all those things and more myself.

For those interested, Louise and I eventually drifted apart as we progressed through school.  She left the hovel after completing her GCSEs; I stayed and did my A Levels.  We lost touch altogether.  I ran into her one day in the early days of my relationship with A Рabout seven years ago Рand she seemed genuinely pleased to see me.  She told me that she was studying to be a hairdresser and was off to see a rock band that night.  I was pleased that her life seemed to be on track.

Another few years passed. ¬†I was maybe 23 or 24 when my mother ran into Louise’s mother outside the corner shop, and it transpired that her life was anything but on track. ¬†She had never wanted to leave home (and hadn’t). ¬†She had never had a job, nor completed any education beyond her GCSEs. ¬†Her days were spent sitting alone in her room, staring at the wall – perhaps with a bit of musical accompaniment if she was in a ‘good’ mood.

So things were worse than ever. ¬†And she’d recently received a new diagnosis: that of schizophrenia. ¬†Manageable, in most cases, yes – but nevertheless chronic, pervasive and incurable.

I’ve experienced psychosis. ¬†It isn’t pleasant. ¬†I just hope that she is having a better experience with the health service than I have had, and that she is getting the treatment she needs.

Ah Yes…My Psychoses

Yes indeed. ¬†Remember the craic with hallucinating Paedo and all that cal? ¬†Well, it’s not back – thankfully. ¬†Nor are the flashbacks any more intrusive or frequent than normal – thankfully. ¬†However, something has seduced me back into obsessive thinking about what happened with Paedo – or, rather, what didn’t, as my mind would have me believe. ¬†A opines that the fact that I am intending to see Nexus, an organisation specifically in existence to deal with the consequences of sexual abuse, has brought on this current bout of self-doubting nihilism. ¬†I don’t know what I think.

When I was in the process of recovering my ‘memories’ of these experiences, I wrote a post here about False Memory Syndrome. ¬†My mind echoes the concerns I expressed therein. ¬†If memory serves me correctly, I eventually concluded in the post that I couldn’t be imagining things or engaging in a particularly cruel and twisted fantasy.

But I’m not so sure. ¬†How can it be true? ¬†How? ¬†It’s just fucking inconceivable. ¬†Why did I remember parts of it and not others, at least until more recently? ¬†Why are parts still hazy and pixellated? ¬†Why do I apparently ‘know’ some things, but not actually remember them clearly (if at all)?

How can I accuse such a pathetic, pointless, boringly innocuous human being of such acts? ¬†I mean, they’re disgusting, to be sure, but they’re…I don’t know, they’re something. ¬†Paedo isn’t. ¬†He’s a vacuum of characterless nothing. ¬†One is only ever peripherally aware of his existence, because to any meaningful intents and purposes he doesn’t fucking exist. ¬†He doesn’t only not live, he also doesn’t exist properly. ¬†He just sort of is, like I imagine a ghost might be. ¬†He is a half-being. ¬†He can’t be responsible for something that requires effort and, let’s face it, a certain amount of skill (which prevented his ever getting caught).

I still can’t fully grasp the notion of dissociation, which seems ridiculous given that it’s so much a part of my life. ¬†I understand it from an objective perspective – the textbook discussions of it, the technicalities. ¬†But it just feels so…I don’t know, wrong? ¬†Inappropriate? ¬†Untrue? ¬†Whatever the correct adjective, I can’t work out how it fits for me. ¬†Traditionally, I have a good memory. ¬†It’s a large part how I got successfully through school and university with¬†minimal¬†effort – I simply remembered everything I’d been taught. ¬†So how can I have amnesiac bubbles like this? ¬†I know I do have them, thanks to all the times I’ve ‘woken up’ in random places with no idea at all of how I got there. ¬†But it doesn’t make sense regardless.

How do people lose time?  What happens?  I understand the psychological reasons underpinning the phenomenon, but how does it actually physically happen?

Fucking sex abuse. ¬†I can’t remember all of it, so it can’t have happened. ¬†What I do ‘remember’ has been created by my own twisted mind: it’s the only answer. ¬†What a despicable human being I am to create such evil…and from such banality too!

Of course, Rational Me jumps in at this point and cites 7,392 reasons as to why it fucking did happen, but I cannot really convince myself of it despite the ample evidence to the contrary. ¬†Yes, I remember this, I remember that – but I don’t remember everything, and I didn’t even remember a majority of it until recently. ¬†We can bandy about terms such as ‘dissociation’ or ‘fugue’ or ‘amnesia’ or whatever other medical terminology is deemed appropriate, but the key point of this issue is that I forgot. ¬†I forgot something as massive as this. ¬†Children live in strange realms of consciousness, but still. ¬†How can you simply forget a major, formative, immense part of your life like that?

Paedo is a nobody and I forgot.  So how can it be?

Perspectives from the Mentalist's Partner (4): The Hidden Reaches of Therapy

Q:

I’m obsessed with a man that isn’t you. Discuss.

A:

Short, sweet and to the point, I see, and a most frank admission. Not that you’d choose to disguise it, of course, given this blog’s ample testimony to your obsession.

It’s a strange one, I must admit, and I might have cause to be jealous but for the fact that you have made it clear that there is nothing of a romantic or sexual nature in the obsession. I understand that some therapeutic relationships tend in this direction, but luckily for me, yours does not, and I am satisfied that that is a true account of how you feel. I must admit that this does not prevent the odd stab of perplexity (read: minor jealousy) from time to time. Here you are, sharing your deepest, darkest secrets, or a good number of them anyway, with someone who is in many ways a stranger. I learn of these secrets on occasion not from you beforehand, but afterwards through the medium of your blog or during one of our regular Thursday night trips to our local coffee shop. I’ll have a cappuccino please, a scone – oh, and some dark revelation about sexual abuse. Do I want jam with that? Of course I do. Silly question.

Why my mystification/baby green-eyed monster? C, in essence, remains a stranger to you. The therapeutic relationship seems to me, from my knowledge of your case at least, to be fundamentally asymmetric. You talk. C listens. C utters the occasional ‘wise’ or ‘understanding’ comment. You play with your hair or your phone or look out the window. C sits in silence. You spout something angry. C says “so how do you feel about that?” You laugh, bitterly, because you knew that was what he was going to ask. You talk. He listens. “Have you thought about it like this?” You probably have. On rare occasions, you haven’t, and he thereby brings something new to the table. On most occasions, though, your therapy seems to have become a circular dance of frustration. There were occasional good weeks throughout the process, but most that I have observed have either been about as effective as a chocolate fireplace, or else actively damaging to your mood for the following days/weeks.

Why then, I ask myself, are you obsessed with a man who gives so little and asks so much of you? Clearly, the relationship is designed to allow you to talk about certain issues, to get them out of your system, to engage with an expert who may be able to help you deal with the issues. That’s the theory, and doubtless sometimes it works. You undoubtedly ‘click’ with C on a personal level, and yet the number of times you’ve come away from therapy angry, hurt or bemused makes me at times incredulous at your apparent liking of him, your relentless desire to know what CDs he listens to, what he does on his ‘off’ days, what his e-mail address might be, and so on […um…for those not in the know, you might need the password to this. It’s the usual password if you already have it. ¬†If you are C, then you can’t have it: please fuck off].

What you have is by no stretch of the imagination a friendship, though of course you admit as much. Perhaps had you met under different circumstances, it might have been so, but the imbalanced power relationships and the need for C to maintain his professional role mean that it is impossible for this to be anything more, in my view, than a doctor-patient engagement which, regrettably, is failing because an arbitrary time limit has been placed upon it. That being so, I fear that your obsession sets you up for crushing disappointment when the whole thing, in a few mere weeks from now [two from today], comes to its premature end.

In that sense, I resent C because he will very shortly reward your clear attachment to him with what you will perceive as abandonment. But then this all comes back to attachment. They say attachment to your therapist is necessary to get you to open up, but clearly this is a two-edged sword. If issues are not properly addressed during your therapy and the relationship is severed in an unsatisfactory manner, then the amputated pseudo-‘friendship’ leaves a gangrenous wound that will fester. Thanks, NHS.

This process, in fact, seems to have actually required you to obsess, and I resent that tremendously, because the result is clearly going to be highly negative. Is that C’s fault? Probably not, but he could have handled things better, made it clear that the end of therapy was not ultimately his call. Do I blame him? Somewhat. However, the system is what is at fault in the end. I ceaselessly harp on the idea that the NHS would never do this to someone suffering from a physical illness. Yet that is precisely what the NHS is choosing to do to you. Because it can. And it has more important things to spend money on. Like managers. Grr.

Jealousy, then, isn’t my main reason for disliking the obsession. I’m not jealous, mostly. What I dislike is the damage that is being done to you. For transference to work (and I’m still not clear on the theory of how), attachment is necessary. In attaching yourself to C, you have grown to care about him, but unfortunately that care is misplaced in a relationship that can be ended at any time because someone wants a nice shiny annual report showing how efficient their psychotherapy service happens to be. It makes me angry, but that’s not a whole helluva lot that can be done.

Perspectives from the Mentalist's Partner (3): Impact on the Partner

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

Q:

On a day to day basis, what’s it like living with me? Like, really. Be honest. Be brutal.

A:

A difficult question, I fear. One might well ask, ‚Äúwhat’s it like living with anyone?‚ÄĚ 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.

Perhaps a different approach, then. To be frank, it’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’re both in the mood, that is exactly what happens. I don’t imagine that is any different from what most people in a relationship experience, though I can’t proclaim myself any expert.

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’s…well, ‚Äúchallenging‚ÄĚ might be the word. That said, I realise now that on most occasions there is probably little I can do to ‚Äúfix‚ÄĚ 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’t mean I will seek to ignore you at times like that, but I try not to interfere.

Q:

So, there are certainly some times when I appear vaguely normal?

A:

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 ‚Äď or indeed both ‚Äď I am not sure [it is, for the record, both. ¬†Mainly the former, but certainly both]. Perhaps I should be interviewing you! ¬†[Be my guest!]¬†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’t get any misunderstanding from me on that score.

Q:

OK, but I think it’s inevitable that my sicknesses has impacted on you, probably in ways I can’t even understand. Could you outline the effect they have had on you, and how have you dealt with that?

A:

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’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 [huge, in my view]¬†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 ‘work-shy’. 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 ‚Äď like you ‚Äď face difficulty in communicating what this all means to people who are ignorant (wilfully or otherwise) of these issues.

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’ve not changed substantially from the person I was ‘before’. Well, actually, I’m not the best judge of that. You’d probably have to ask a neutral observer. I feel like me, anyway, and I’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.

Is it frustrating at times? I’d say so. However, we’re dealt imperfect hands by life (and I should know that as you beat me at poker all too often! [almost always these days, my dear… ūüėČ]) and we just have to get on with it. No point in my crying over what can’t be changed. Let’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’ve tried to knock some sense into the NHS to little avail. That isn’t to say we’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’t exist in respect of some of your conditions. Answers that will assist, in whatever small way.

Q:

I suppose there’s an issue here too about the extent of my history of sexual abuse. You knew bits ‚Äď just like C, a few close friends and my blog readers knew bits ‚Äď 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’t fully disclose things to you? ¬†How does the reality make you feel¬†overall?

A:

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.

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’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 ‚Äď if I believed there was a hell.

Do I feel hurt that you didn’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 [as do I]; things you maybe haven’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 anybody, and I commend your for your blatant honesty to date, particularly in this blog.

Q:

I’m going to explore this more in a future post, but briefly ‚Äď your thoughts on my experiences in psychiatry and, especially, psychotherapy? Have these processes impacted on you in any way?

A:

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 ‚Äď 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’m not saying the therapy is to blame for the black mood¬†per se, 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 ‚Äď 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.

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 ‚Äď would the benefits outweigh the drawbacks?

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 December/January lows, both in terms of keeping away the voices and in terms of mood.

We shall return to this subject, I would imagine, in more detail. However, I have pontificated enough for most people’s sanity by now, so I shall beat a hasty retreat.

Perspectives from the Mentalist‚Äôs Partner (1): Understanding that Mental Illness is Real

I deal with a set of symptoms representing the diagnoses of BPD, C-PTSD, clinical depression and social anxiety on a daily basis. I fall victim to the nefarious antagonists of psychotic and dissociative episodes with more frequency than I would care for (although I must hat-tip the efficacy of Seroquel in decreasing the former, having said that). I’m occasionally and essentially without warning flung into states of exuberance that are largely uncharacteristic and rather OTT, leading to a question mark of manic depression. I’m also fairly sure I could be diagnosed with agoraphobia these days.

Me me me. I have this, I experience that. Me. I. Yours truly. Myself.

But it’s not just about me…is it?

For some time I’ve been thinking about ‘interviewing’ A on his experiences of living with a woman with mental illness. It’s of interest to me both intellectually and as a girlfriend, and I hope that it might be of interest to you, my dear readers, too – particularly if you are in, or are hoping to be in, a relationship. So I give you the first in a series I am going to call Perspectives from the Mentalist’s Partner (PMP): how through his relationship with me, A has developed a greater understanding of what mental ill health really is.

Q:

Let’s start at the very beginning. You knew I had a mental illness before we even met [I was diagnosed with severe clinical depression at the age of 14, and corresponded with A for nearly a year before we met when I was 19], but that didn’t completely manifest at first. When it did, you will recall that you viewed that mentalism fairly unsympathetically, though your mind has clearly been changed, as over the course of this present breakdown, you have been extremely supportive.

So I suppose I’m wondering – do you remember when you first saw evidence of my mental health problems, and how did/do you feel about that incident or period? Can you explain your reasoning for your evident lack of sympathy at the time – and what was it that modified your opinion into what it is today?

A:

It took me a very long time to realise what mental illness actually is. Sure, I was peripherally aware of depression as an issue, and you made it clear that you had suffered from it*. However, I probably wouldn’t have perceived it as a ‘mental illness’. I associated the term ‘mental illness’ with, well, very extreme conditions involving padded cells and the like. A very stereotypical view, for which I apologise to readers of this blog; however, I simply didn’t think much about it as it had not really affected me or others I knew. Granted, I’d experienced what I considered ‘depression’ at the age of 15-16, and I therefore assumed that what you suffered was some variant of that. Not at all a pleasant phenomenon, but something that would nevertheless gradually recede, with time. (In my teenage years, I think my own experience of ‘depression’ was one of those ‘growing up’ type problems, though I never have been and never will be a cheerful or optimistic type). Anyway, I am digressing.

When we first met, you seemed far from depressed. In a recent post [this], you talked of the dichotomy between Pandora and the ‘other’ you, the everyday person whose name I shall not utter here. The person I met was essentially Pandora; sociable; intellectually agile; opinionated (in a good way); lively; challenging; interesting – a person with aspirations and apparent self-confidence. Of course, we all package ourselves in similar ways, or try to, in order to impress those we wish to impress, especially in the first flower of a relationship. Sure, there may have been a bit of that, but it was certainly more than that, and indeed that part of you continues to exist now. When others meet that part of you in person, they are extremely taken aback to learn that you suffer from ‘depression’ (to use the generic term that most of us who are not informed might use).

As we got to know one another better, and the first flush of spring faded (it always does, as I know you agree), I started to see your occasional black moods. However, as I’ve said, I have not been a stranger to such in the past. ‘Depression’ was something that I felt, with time, one could ‘get over’. That will undoubtedly seem insulting to some, but it was how I felt.

I was also very much opposed to attempts to control depression through medication, believing that the solution lay in rethinking one’s approach to life (somewhat DBT-ish, you might say). I’ve never taken many pills myself, although I’ve been fortunate in my health for the most part. You’ll recall that I was no fan of you taking medication, and eventually made the drastic error of persuading you to come off Prozac**. Bad mistake. I suppose it was at that stage, several years into our relationship, as you really began to spiral downward, that it began to dawn on me that this was not something that would go away easily, without some form of concrete assistance.

My realisation grew as time passed and a pattern started to emerge. You were unable to hold down a job. You’d start one, seem to enjoy it at first, but gradually find it more and more difficult to cope, lying awake at night worrying about what might go wrong the next day or week. Of course, you were not helped in that by some of the horrendous managers you have had the misfortune to work for; still, even somebody as insensitive as I began to notice A Problem. Nonetheless, on my more cynical days I wondered whether it was just that you needed to find ‘the right’ job, and that you needed to foster a greater sense of ambition and commitment to achieving this. I have always been somewhat driven in the work sphere, if not elsewhere in life, and I suppose I expect the same in others. So, yes, at times I still thought less about illness and more about ‘what I would do’. Obviously, I couldn’t possibly know what I would do, given that I don’t suffer from mental illness. However, I didn’t always think like that at the time.

Really, then, although my realisation was dawning, I believe that it’s only in the past two years that I have really started to grasp what mental illness is, and the extent to which you are afflicted by it. Gone now is my illusion that you simply had ‘depression’ that you would ‘get over’, or that you could will yourself to cultivate a greater personal drive.

Just as an aside, thinking about my prior attitudes, I have come to believe that ‘depression’ is a horribly overused term, as in popular usage at least it can signify anything from a bad few weeks to serious clinical illness. I am not saying that those who actually understand mental health issues talk of depression in this way, but the word has become seriously devalued by its more general societal usage, whereby it can connote practically any bad feeling a person may have for a sustained period***.

Anyway, I suppose my first lesson in the seriousness of your illness, which came long before the realisations mentioned above, came from your occasional black moods. I remember in particular one Sunday evening where you did not really wish to speak or interact. You exuded a aura of bleakness, and no matter what I tried to do or say, there appeared to be nothing I could do about it. It left me wondering things like, “What have I done? Is this my fault? How can I fix this? Why is Pan behaving like this?” I didn’t know how to handle it. Your illness seems to have changed, and your black moods are subtly different now. I’m not sure I have figured out how to deal with them, from my own point of view, but I certainly know more about what to do and what not to do than I once did.

I might add that much of the understanding I have gained of your illness has come from you. As you have educated yourself about the issues, you have educated me. In that respect, Confessions of a Serial Insomniac has been a tremendous help. You write cogent, coherent, insightful and moving accounts here that you are often unable, due to the difficulty of talking about these issues, to express to me or anyone in person. I started writing ‘real life’ there for ‘in person’, falling into the dangerous delusion that the written form is somehow less real. Far from it. In fact, it allows one to be more revealing in some ways. I suspect that the closest you come to being able to communicate as you do on here, in verbal form, is when you meet C.

Anyway, next question please…

* Through our 10 months’ email correspondence prior to meeting face to face, I had shared a lot with A, including the fact that I had depression and that I took Fluoxetine (Prozac) to treat it it.
** This was during my postgraduate course – I would have been 21 or 22. I was taking, I think, 60mg daily, and initially cut it down, before I stopped taking it altogether. It was partly because I’d been feeling fairly good and fell into the trap of thinking I was ‘better’, and it was partly due to A’s encouragement. It – in part, at least – led to my second biggest psychological collapse (after the present one) to date.
*** One thing that A hasn’t mentioned here is that he has in the past said that he felt that my receiving a proper, psychiatric diagnosis was of great benefit. As I recall (and I welcome his correction(s) if I am misreporting him), he felt that saying, “I have borderline personality disorder” as opposed to “I’m depressed,” allowed one brought up with the views he had formerly held to note the presence of a real, tangible medical condition, rather than expressing their ‘having a few bad days’ erroneously. I would point out that I feel, have always felt, and that A now feels, that depression is a ‘real, tangible medical condition’. However, we are dealing with stigmatic stereotypical societal views here (how alliterative), and I would agree that most people probably do misuse and, indeed, misunderstand the term.

Next interview with A to follow soon…