CPN Appointment

***Possible Self-Harm Triggers, Blah Blah Blah***

Saw Christine on Thursday afternoon for the first time late December. Explained all that had happened in the first few months of 2012 and how things are very, very shit. She seemed to be of the view that this is a depressive episode more generally, because of the self-harm in which I engaged before Maisie’s death (she views it as serious because I was trying to dig out the veins in my hands, and seeing if I could sever the tendons in my wrists. When I shrugged it off, she said, “you do realise that this isn’t…normal, don’t you?” I said that I didn’t know). All that has happened, of course, has not exactly helped me claw my way back up the slippery slope I’m currently navigating.

She was horrified to hear that, as I spoke, Paedo was sitting in my mother’s living room. I explained that the reason for his presence was my mother and the McFauls’ over-compensatory just because the matriarch is dead doesn’t mean we’re not still family! routine. Christine opined that this must have been very difficult for me. I said that I didn’t care, but I don’t think she believed me.

Complained about either losing her or losing NewVCB; went on a rant (well, insofar as I was able to speak) about how much the health service has failed me in the past, and just as it had started to get things right, it was cunting them up again. I must have looked particularly distressed at some juncture because she appeared to think I was about to burst into tears – “that’s really hit you hard, Pan,” she said, adding that the entire CMHT is furious about the changes – at which point I said that I do not do tears and that even when I’m sitting alone in the house and feel the ‘need’ to cry, I do not permit myself to engage in said activity because someone will be watching me through the clandestine cameras that follow me about.

Naturally, this remark piqued her interest, and she asked if I really believed it, or if it’s just a feeling. I said that I knew it was ridiculous – “maybe they were right when they diagnosed me with a personality disorder, it’s just that they got the specifics wrong; it’s not borderline, it’s narcissistic” – but that I believed it nevertheless. Cue the usual questions about voices and visions, of which I was able to truthfully say there are none.

Either way, she was extremely concerned about my levels of depression. I laughed (if one can call such a hollow, cynical sound ‘laughter’) and said that this was nothing. I know how bad it gets, and this isn’t it – even though it’s heading distinctly in that direction, and has been for weeks. Christine said that in a sense this was good – might I be able to ‘get it in time’, she wondered, if I wasn’t yet at rock bottom?  I shook my head. “By the time it’s got to this stage, it’s still gone too far to prevent it from getting to its worst. It creeps up on you so slowly and insidiously that when you get to ‘now’ – the realisation you’re spirally into the abyss – it’s virtually written in stone that the very worst of depressions will be upon you anon. Like a fixed variable in space-time.”

She kept asking me over and over again if I could “guarantee [my] safety”. I kept trying to make non-committal responses, but she wouldn’t let it drop. Eventually I said something along the lines of expecting to be alive at the time of our next appointment. She accepted that, but added that she wasn’t just concerned about my trying to top myself; she was also worried that I’d engage in more self-harm, and this time actually succeed in doing myself some proper damage. I stated that I couldn’t guarantee I wouldn’t do anything of that nature, but that I thought it was highly unlikely. As I told her, you need at least some mental vigour to engage in self-injury, and with each passing day I have less and less of such commodities available. Depression sucks out your very soul.

Christine nodded, but kept prattling on that my safety was the most important thing. Meh. Fuck my safety. Don’t fuck my safety. I don’t care either way. I was just glad that she let me leave without a shiteist crisis team assessment.

She wants me back in two weeks rather than the usual month. In the meantime, I am to contact her urgently if things get notably worse or if I’m running helium cannisters through price-comparison websites again. I said, “I know you always say I can contact you, but can I actually do so? Do you mean it?”

She seemed surprised by the question, and emphatically told me without breaking eye contact (which was odd, because I’d spent the entire appointment trying to avoiding looking at her – mental health professionals love it when you don’t engage in eye contact; it’s always splattered over your notes) that of course she meant it, that she wouldn’t have offered it had she not, and indeed that she wanted me to contact her if things get worse. ‘Get worse’ is a stupid phrase in context – of course things will ‘get worse’. But I think she means ‘really bad’.

I might take her up on it, assuming I can get out of bed.

End of terrible post, and of pathetic pity-party. Can’t be bothered to proof-read, for which you have my apologies. Love to all. xxx

You Know You're a Self-Harmer When…

A little vignette for you.

I’m wearing the same black dress tomorrow to Maisie’s funeral that I wore to the awards ceremony back in November (what a varied experience that dress will have had in its short life). Unfortunately, I didn’t have a jacket to go with it, nor did I have an appropriate pair of shoes (I don’t get this ‘thing’ women are alleged to have with shoes. I wear a comfortable pair of boots for almost everything. Still, they’re tatty and would not go down well at a funeral; nor, indeed, would the preposterous high heels I wore to the awards, not that I can stand on those fuckers anyway). I ergo drove to the shops this evening in an attempt to procure these apparently requisite items. Having succeeded in said endeavour, I finally went into Boots to obtain steri-strips and scar-reducing plasters, thanks to an as-yet-undiscussed-on-this-blog incident of self-harm last weekend (I blame my GP’s “surgery” for completely fucking up my Lamictal prescription. Wankers).

As I was dithering in the first aid aisle, I spotted this:

I was alone in the area, which is fortunate, because, initial head-cocking completed, I visibly started at this product. “Pre-cut knee application”, it said. What the fuck?!

I crouched down and examined it more closely. I even squinted at it to make sure my eyes weren’t playing tricks with me. But yep, it really did say “pre-cut”.

I was aware that my facial features were contorted into an expression of complete and utter astonishment. I mean, I liked the idea – but I thought it was shockingly niche at the same time. Too niche, surely, for a mainstream, walk-in shop.

My mind asked the following questions:

  • Could a well-known and respected pharmaceutical giant such as Boots really allow themselves to stock – and therefore endorse – a product designed specifically to aid a self-injurer in advance of an act of self-injury?
  • The knee thing. Why were the manufacturers so sure that you’d want to cut yourself on your knee? I’ve never self-harmed on my knee. Have you?!
  • The bandage is suitable for “two to three day wear”. Surely you’d need to take it off sooner than that to attend to the wound you’d inflicted upon your poor knee?
  • As I left the shop, I wondered why it was called a “bandage”. Surely anything you would use in preparation for an act of self-harm could not be a bandage? Are you meant to wear it for “two to three” days in advance of an act of self-harm, so that it does something fancy to your skin to stop scarring/bleeding/dying/vampirism/whatever? Is that what they meant when they alluded to the “two to three day wear”?
  • Assuming that the bandage were to be worn in advance of an act of self-harm, aren’t they catering to a even more niche market? I mean, I know a lot of us do plan cutting and other injuries – but two or three days in advance?! Surely there can only be a very small demographic of cutters to whom that would apply?

I got into the car, where A was waiting for me. I apprised him of the details of the bandage, then raised my afore-listed concerns and queries about it.

Imagine my surprise when he threw back his head and started laughing.

“Well, I suppose it is kind of darkly funny to have such a thing on the market, but…” I started.

“No, you idiot,” he laughed. “It’s pre-cut!”

“Yes, that’s what I said…”

“It’s a bandage that has been pre-cut in advance of your fucking purchase! It itself has been cut by the manufacturers to a certain size to support existing knee injuries!”

Oh.

For someone with a high IQ, I can be remarkably ditzy. DUH!!!

As noted sagely in the title, this is when you know you’re a self-harmer.

As noted briefly above, it’s Maisie’s funeral tomorrow. Perhaps unsurprisingly, I’m not looking forward to it, and – entirely selfishly as usual – I’m particularly concerned about seeing Aunt of Evil (who arrived surprisingly quickly, which is the reason I managed to stay at home, rather than remain comfortingly at my mother’s, for the last two days). I’m not sure when I’ll be able to detail tomorrow’s events (should they merit detailing), or discuss the back-story to her death, but I’ll update you all as soon as I can.

Thanks to all of you that have commented here, tweeted, emailed or whatever. I know I’m toss at responding but I do read everything and I appreciate it all greatly. Thanks for being there for me. xxx

Dermatillomania: Do 'Normal' People Pick Scabs?

***Possible Triggers for Self-Harm***

I’m sitting here on my sofa, contentedly watching A play Saints Row. Legs folded comfortably over one another, relaxed, comfortable. A perfectly ordinary way to while away a dark and rainy November evening.

Except for one thing. As I sit here with my lower legs bared, I cannot help but be drawn to gaze upon one of them. You see, I’m mesmerised by a deep, beguiling, dark flow of blood pouring out of my shin.

I’ve not started self-harming again, in case anyone finds this a perturbing state of affairs. Or rather, that is to say, I didn’t sit down consciously with my scalpel or a knife, and inflict a gaping wound. I have no idea how the gash got there, but that part doesn’t really matter anyway.

What does is that the wound was healing – until I pulled the scab off it, and re-opened it to the air and all its multitude of dangerous impurities.

I pick every scab on my body. Regularly, and compulsively. I have some fairly hardcore eczema in my ears, and I have the most disgusting, lurid habit of digging scabs of dead skin out of both aural cavities with hair grips (I know. I know! But if it’s not hair grips, it’s my nails – so should you ever encounter me in person, make sure I have one of the former with me ;)). And as for spots – I squeeze the few of the fuckers that I get without exception, and in fact actively go in search of others – usually non-existent – to burst. In that way, I end up picking random bits of skin; in doing so, I frequently and unwittingly scar myself.

I have always engaged in these anti-social behaviours, much to the repulsed chagrin of my manner-minded mother and, to a lesser extent, A. When, historically, Mum would call me up on an incidence of same, I would simply say that I couldn’t help it.

I continue to hold to that prerogative. I truly feel that there is no way to control any of this mistreatment of my skin; frequently, the actions are unconscious, but they are always compulsive.

So anyway, I never really thought much about the nature of the phenomenon until recently, but if I had, I suppose I’d have termed it nothing more than a bad habit – and one that was not, at least to some degree, particularly unusual. Since my descend into utterly chaotic madness (as opposed to ‘mere’ clinical depression), though, I’ve come across the term dermatillomania.

According to the linked Wikipedia article, in order for compulsive skin picking to be deemed dermatillomania, one has to experience anxiety in relation to it. Whilst in my case, that doesn’t commonly precede picking, what does happen is that – should I be stopped from scratching – then I’ll start panicking.

Arguably then, I suppose I could say I had this ‘condition’, being as it is compulsive, and obsessive. But perhaps I’m just over-pathologising myself – it would hardly be the first such time, would it?

Either way, I can’t imagine not skin-picking. It’s one of those things that just cannot compute in my tiny, limited brain. So, bad habit or dermatillomania – do other people really not do this, or is it just that they have enough self-control to avoid indulging the practice when they’re in polite company? I can logically accept that it’s the former, but I cannot truly believe that the latter is not the more accurate picture when fully painted.

Is this yet another manifestation of my wide-ranging madness or it just…meh? Do you do this or do you honestly, truly not?

Later

A side note: A and I are off to Laaaahhhdahhhnnn in the morning. Tomorrow, to my delight, we will finally meet bourach for the first time. Yay yay! Sunday sees a lunchtime meeting with my best mate Daniel, and (hopefully) his partner Craig, then drinks in the evening with the lovely CVM. And – Jesus Christ almighty – Monday night sees the long-awaited awards ceremony. GAH! I know I was banging on last week that I was excited rather than nervous, but I’ve just lost a mission on Saints Row six times in a fucking row and packed, so now I’m in an apprehensive rage, which has led to a still-excited-but-OH-FUCK-I’M-ACTUALLY-GOING-TO-THIS-THING sense of…well, oh fuck, I’m actually going to this thing.

Wish me luck as I take my worried strides in the unknown…

Bye, by the way! See you next week. I’ll try and post about how the awards went on Tuesday (or, as I probably more accurately mistyped, Ruesday. Rue because I’ll no doubt feel slightly deflated at not winning anything, even though I already know that’s going to be the outcome. Well, no one ever said I was rational). Love you all, lovely people. Take care. xxx

Semantics, Psychosis and Severance – Paul: Week 24

As any of you who have followed my accounts of my sessions with Paul will know, I have a lot of time for the man. I both like and respect him. However, there are a few criticisms that could be justifiably levied in his direction:

  • He almost always reads something into everything. I appreciate Dr Freud’s input into therapeutic theory and practice, but some stuff – just some – is just that: stuff.
  • He is a vehement opponent of the medical model of mental illness (presumably the term ‘mental illness’ would in itself offend him. I’d actually prepared a post ages ago, in which I confoundedly asked why this description is so offensive to some people – I just don’t get it. But I’ve gone and lost my bloody notebook, so that’ll have to wait. Well done, Pan!).
  • He keeps blaming people around me for not ‘noticing’ my abuse. Yeah, because it’s fucking standard for each family in the entire universe to be intimately acquainted with the warning signs, isn’t it?
  • His constant use of the phrase, that little girl. So saying that I have a mental illness offends Paul? Well, saying that I have a ‘little girl’ inside me offends me.

I think the palpable irritation of the foregoing probably sets the tone of this session quite well. Indeed, it makes me think that perhaps I was being slightly disingenuous in recently so vocally applauding Paul in comparison to C (though, that said, I stand by my assertion that the former has been more help to me than the latter – I spent many sessions in C’s company wanting to punch him, and only a few such occasions arose with Paul). At any rate, from the offset in this appointment, he irritated the hell out of me. Also, although towards the end there was finally some useful work being done, I felt a bit out of it for most of the session (I had been up to 3am the previous night trying to stop a good friend of mine from killing herself, and had not slept for ages after retiring either) and the whole thing felt a bit disjointed. So, I’m going to go through it in bullet points. Of course, my version of bullet points is everyone else’s version of a protracted essay with a few random, indented dots thrown in for no clear reason, but what else would you have come to expect? Beware of triggers for self-harm and child sex abuse, though the latter is not especially graphic.

  • We discussed our relationship briefly at the start of the session. He proffered the view that one thing that had not really occurred during our time together was any trace of him trying to “rescue me”. Apparently, he’d seen some “scary stuff”, mainly in relation to my erstwhile tendencies towards self-harm (‘normal’ cutting did not, I think, faze him especially. However, my particular modus operandi was often to carve words into my flesh or, latterly, to stab myself with a scalpel. I’m actually shrugging as I type this – such actions really are no big deal to me. They must be to him, though). I opined that his reactions were “refreshing”: C, for example, would often have seemed perplexed by and disdainful of my self-injurious behaviour; A would groan every day it happened; Mum was abjectly horrified. Paul’s dislike of the activity was certainly evident, to be fair, but he never tried to actively stop me from engaging in it, knowing that destructive as it was, it was an important coping mechanism for me at the time. Anyhow, as I noted to him on this occasion, I hadn’t self-harmed for ages. Medication was partly to blame – not that I dared to tell him that – but, to his credit, so I think was therapy.
  • You may recall that around the time of our holiday, A and I had been invited to ScumFan McFaul’s 21st birthday bash. I’d had this out with Paul before – A and I were making excuses to avoid the event, whereas Paul’s stroke-of-genius solution was to say, “well, I don’t want to go because [Paedo] used to rape me all the time.” He reiterated this point in this meeting, which annoyed me intensely. The McFauls, for the most part, and my mother, definitely, do not deserve to have their lives ruined by this information. Does no one give a shit about altruistic utilitarianism any more?!
  • I added, in relation to same, that even if I did confess, that no one would believe me anyway (which is probably true). They’d probably think I was making it all up for attention or something, but the most flattering scenario would be if they held the view that my beliefs and recollections pertaining to Paedo were psychotically inspired. “In other words,” as I said to Paul, “they’d think the mental illness causes the idea of abuse rather than the abuse causing [in part, I’d stress, not in its entirety – not that Paul would agree with that] the mental illness.”
  • He said that in his view I didn’t have mental health problems. Apparently, insanity is where nothing makes sense. He claims that everything I experience and do makes complete sense when considered in context. That’s all very well – I do concur to a large degree – but Paul is a trained psychotherapist, and I am a mentalist that has become very well informed about all the issues surrounding my conditions. The McFauls are laypersons; they aren’t going to know any of the psychosocial connections at play here. If someone tried to explain it to most of them (Suzanne and StudentMcF possibly excepted), it would rush right over their heads and vanish like Willow the Wisp. In any case, “coping mechanisms” versus “mental health problems” is a purely semantic debate, to my mind. You could call it Bouncy Fluffy Bunniness and the nett effects would be identical, so why do the fucking words matter so much to him?
  • Paul wondered why I’d never demonstrated any overt psychosis in session with him (query: why is it OK to use the word ‘psychosis’, but both ‘mental health problems’ and ‘mental illness’ are teh sux0rz?). He was distinctly unimpressed when I made a reference to Seroquel, which further irritated me. Regardless of what he thinks, I think Seroquel has helped me immensely – and surely, when it comes to one’s health concerns, one’s own observations are of pivotal importance? Anyway, he instead ventured that perhaps that particular brand of mentalism hadn’t been “needed” in the room with him. Was it that I was safe there, he mused? I was willing to entertain that notion, but added that although I felt safe with him, that I didn’t necessarily feel ‘safe’ psychologically. A lot of the work had been challenging and extremely intense. He agreed, then said that, based on my previous experiences, that perhaps I unconsciously feared that I would be judged.
  • This led to a conversation around my mother and her refusal to believe my claims about Paedo, when I tried to bring them up at the ages of 14 and 17 (or thereabouts). I defended her, however, on the grounds that she was engaging in “a quintessential pattern of psychological avoidance.” Paul sighed, and asked me for the non-intellectualised version, and I (rather reluctantly, because I felt my first answer had been fine) declared that I was perhaps insulted. My mother had, on the second occasion I think, accused me of making up my allegations of rape because I didn’t want to go to Hotel California. (Of course I didn’t want to go to Hotel California – rape was why!). I was insulted because I find women who make up stories of rape and/or domestic violence to be abhorrent individuals; not only do they dilute the genuine pain and trustworthiness of actual victims, they also make (generally) men look worse than the poor sods really are. I don’t want to be seen by anyone, least of all my fucking mother, as such a person.
  • Apparently Paul detected anger in my voice, which surprised me as I had deliberately feigned nonchalance. The problem is that if I express – or even if I just am – anger/angry with my mother, then she will die and it will be my fault. I said so to him, then launched an invective against myself for thinking and feeling something so patently fantastical. He leapt to my defence, saying that this was another thing that made sense in context – apparently, because I became the vehicle for so many heinous things, I (to my subconscious self) became a walking nuclear reactor, capable of bringing great evil and destruction to all. A reasonably fair assessment, to give him his dues.
  • At one point, for some reason (I think I must have been defending my mother again), there arose a comparison between my father, V, and Paedo. V was a complete twat, and everyone knows/knew it (apart from Aunt of Evil and her cunts). Paedo, ostensibly, is a nice enough old bloke (though in my view he’s a supremely boring imbecile, but when I have said similar to my mother she accuses me of intellectual snobbery, which I suppose is a reasonably fair charge). I exemplified the surface differences by stating that Paedo had never knocked seven bells out of Maisie. Then, to my eternal disgust, I muttered, “though I don’t know how he hasn’t, I’d have gone for her countless times.” Unsurprisingly this led to more self-castigation. Naturally, he defended me again, asking why every caustic comment I made had to be retracted. I responded by saying that I had just condoned domestic violence, which was repulsive. Apparently not, though – the issue of my taking the remark back was “much more complex” and I was using a reference to domestic violence as “an excuse” to “withdraw at the first sign of feeling”. “So,” I mocked gaudily, “I’m brimming over with resentment about Maisie’s failure to protect me and that comes out in throwaway bitchy comments?” His response? “Yes. Exactly.” Whatever. What-the-fuck-ever, Paul.
  • He monologued about how bad the abuse had been and how Maisie had “stood by [Paedo]”, not exercising a due duty of care towards me (and, he through in as an addendum, neither had she acted out of the unconditional love she is for some reason meant to have felt for me). As I witheringly picked my nails, bored of this endless psychobabble, he asked me to see it from that [fucking fucking fucking] little girl‘s point of view. Children don’t analyse and rationalise, apparently (wrong. I may not have a clear, linear recollection of my childhood, but I do remember doing just that), so my reaction to the family’s non-reaction was purely visceral. For instance, “I’m in pain, waaah waaah waaah, please help me, waaah waaah waaah…oh, look you’re not helping me, waaah waaah waaah waaah waaah.”
  • The conversation meandered towards an incident in Fuerteventura. A and I had been sitting at this lovely beach bar, looking out over the bay and enjoying a cool beer. All these little kids were running around mad, splashing in the water or jumping about in that pointless, irritating way that only children do. Aloud, I randomly mused, “I wish I’d had a happy childhood.” After a second or two, I was completely aghast at this out-of-the-blue, out-of-character remark. A seemed – I don’t know, moved? – by it, and when it was duly relayed to Paul, he in turn pronounced it “very poignant”. I was reminded of another occasion in Fuerteventura when yet more children were running around on the beach. Some of them were naked. I am not joking, readers, but this horrified me. Part of me was so disturbed that she could barely look away, thus cementing my belief in that old theory of the compelling car crash; part of me then forced myself to look away, because I felt like a paedophilic voyeur even noticing these youngsters. He said, “most people have a happy ignorance about child sexuality, and therefore have no issues with child nakedness. Unfortunately, you’re not one of them.”
  • He said that I have a lot to grieve vis a vis my childhood and that in conducting my mourning, I turned everything upon myself. I was told that when cutting is not enough, I “degrade” myself. In response, I rearranged my features to reflect bewilderment. Degrade? “Yes,” said Paul. “You sometimes write words when you cut, degrading words like ‘whore’, ‘slut’, ‘bitch’ and so on. None of which you are.” I shrugged, reluctantly but truthfully stating that “they’re not normal terms applied to a child.”
  • Paul raised the subject of the photo of the baby. He proclaimed my reaction to it to be a “wonderful moment”, it having been a single image that cut through all my defence mechanisms and psychological barriers and yadda, blah, and meh. “I saw real sadness in you that day,” he said, “and moreover, you didn’t push it away. It’s hard to pin all that hate and blame on a baby, isn’t it?”
  • This was true. However, as I pointed out, pictures of myself as a five or six year old don’t only not have this effect, they have the opposite. Young Me leaves me nauseous.
  • Blah blah blah, twaddle and waffle for a bit.
  • Eventually he came back to the subject of words like ‘slut’ or ‘bitch’ and remarked that those were Paedo’s words. Although as I said I don’t remember Paedo saying anything much at the time, I reflected that he wouldn’t have had to. Paul agreed, stating that his actions and attitudes spoke louder and intimated the same.
  • Ever defiant, I insisted that I still didn’t like the child, regardless of who actually proscribed her a whore. “Not liking her doesn’t mean I can’t absolve her of blame, though,” I added thoughtfully. And I don’t think it does either. He replied by stating that that was a good start, and that eventually, as he helped me build bridges between her (Aurora, let’s just say again) and me, I would “grow to” like her. (This is complete bollocks. I really, really don’t like children and, in fact, am generally rather scared of them. Of course, he thinks I don’t like children because I specifically hate Aurora and the legacy of madness she’s left me. I do not concur. I think that I don’t like children because I fucking don’t like children).
  • I disputed his assertion that I would like her, but not on the aforementioned grounds, valid as they are in my view. What I told him instead was that (as noted elsewhere) I don’t have a linear path of memories of my childhood. So, if I cannot access Aurora’s personality in the form of her thoughts, feelings, ideas, experiences and so on, how can I ever get to know her? Without those she is, in effect, dead (occasions of which she tries to invade my mind notwithstanding). I am not her, even though I occupy a body into which she grew.
  • For what I’m pretty sure was the first time, Paul deflected the point away (C did this infuriatingly frequently, but familiarity breeds contempt, as the old adage goes: Paul doing it once irritated the shit out of me). Rather than respond specifically, he said that in demonising Aurora, I was “shooting the messenger”.
  • For some reason, the conversation turned to a very brief article I had published some months ago in a national periodical, in which I whined about how terrible NHS provision for psychotherapy can be. I happen to know that C reads said publication. That’s not why I published it, but I did take some satisfaction in knowing that he may well have read it. “It was basically ‘fuck you’ in 150 words,” I told Paul. “Isn’t that really bitchy?” He laughed, and said that “bitchy is good sometimes.” I went on to add that occasionally I allow myself some slack for bitchiness in this area – I mean, the NHS therapy thing was a ridiculous debacle for which I was not responsible. Paul nodded his agreement, but added that all too often I “take the slack back.” True enough.
  • He alluded to the fact that, as well as not showing psychosis in session (mentioned 23 miles back up the page), I also rarely demonstrated anger. This is curious in a way, because I frequently ranted and raved at C, which was sort of a back-handed compliment to him; it denoted total ease in his company. In that way, not being angry with Paul (or, at least, not demonstrating anger) could be construed as vaguely insulting. Not that I said any of that to him, of course, but in any case he wondered if I felt that he would not “accept” my anger. I don’t know; I have never got beyond irritated with him (as I did in this session at points), so it’s hard to say. But why can’t (or won’t) I express that irritability, then? I have simply never felt comfortable doing so, yet I otherwise feel contented in his presence and, as this blog has amply testified, feel that he has helped me a great deal. Anyhow, I made some comment about “being very well aware that I’m my father’s daughter” – by this I meant that I felt that I had to be careful with anger, just in case I ever went into a dangerously blind rage (though, I should note, this was and is not my expressed reasoning for not exhibiting anger in front of Paul). I exemplified by telling him about the events that precipitated this post, though I’m still not going to say what they were here. Paul examined the incident in question against some of my father’s behaviour, and all but dismissed my concerns. I am most assuredly not like my father in any way, in his stated view.
  • As the end of the session approached, he noted that the one following it would be our last together. He lamented that fact because he felt that whilst we had achieved quite a bit in six-ish months, that realistically we had only begun to start scratching the surface of the tiresome iceberg that is my so-called trauma. “In the last few sessions especially,” he said, “we’ve covered a lot of very deep stuff. It’s frustrating to have to end it here.” I agreed that the timing was unfortunate, but brought up a point that NewVCB had made – that a break isn’t always a bad idea. Paul actually agreed with this, which is probably the first and last time that his opinion and that of a consultant psychiatrist will ever meet (and hark! The Earth wasn’t subsumed by the sun, and the galaxy wasn’t pulled into a super-massive black hole by this unlikely confluence, once-every-parsec of events!). Nevertheless, despite my insistence on the issue in the previous session, he asked me if I felt “abandoned.” I said ‘no’, citing the upfront-ness of Nexus on how short-term their therapy had to be. With the NHS, there had been – as far as I was concerned – an implicit understanding that my therapy would be relatively ongoing, at least until such times as I was socially functional. It was only after an attachment had been allowed to be formed that I was advised that that would not be the case. So, I told Paul, in comparison – and given the charity’s very reasonable issues of resource limitations – I felt quite OK about the ending. The fact that I could eventually go back gave me a further buoyancy about the whole thing. “I know we can’t start exactly as we’ll have left off,” I continued, “but at least we can dispense with the whole ‘getting to know each other’ formalities, and just get to work.” He agreed: he remarked that the time between the stints of therapy would be useful for me to consolidate the work we’d already done, and that I’d come back to the process with an increased understanding of myself, Aurora and ‘our’ situation.

As you know, I am in fact going back soon. I really don’t know to what extent I have reflected on everything we did before – not in a discretely contained gap-in-therapy sort of way, at any rate. But I know that I have a much greater awareness and understanding of myself through the therapy as a whole, and I’m still hopeful that I can build on that in the weeks and months yet to come.

Silence is Dolescum – Paul: Weeks 19 & 20

Week 19

I have lost every last word of my notes on week 19. Fuck! This has caused me considerable frustration, but it could be worse. I do remember the session as being a rather frustrating one – it was characterised by a lot of silence and little discussion. If you’ve been reading this blog for a while, you may remember that this happened a lot when I was seeing my previous psychologist, C, and it used to do my head in. In my interactions with Paul, it had not seemed anywhere near as common – but in fairness, I suppose it’s inevitable from time to time.

Paul doesn’t think that this economy of verbal expression is necessarily a bad thing. I know that when I vituperated against myself for same in this session, and the following one (below), he defended me. From a psychodynamic perspective, which I suppose this therapy broadly speaking is, there is, he holds, a lot to be drawn from sitting quietly, just experiencing whatever one is experiencing.

It doesn’t make for a particularly fascinating blog post, however, and even if it did, devoid of my notes and with five sessions in between now and then, there’s little I can remember specific to that day anyway. So I bring you, instead…

Week 20

He opened the appointment by asking me to fill in one of those wanky questionnaires that therapists routinely present to clients – you know, scales of depression, anxiety, that sort of bollocks. Apparently he’s meant to do them every six weeks, but the last time he’d done one with me was either in our assessment session or in the first week or two of actual therapy. He says that their main function, unsurprisingly, is for Nexus’ statistics; it keeps the funders happy, but Paul himself thinks it is “a load of old toss forced on [him] by [his] manager”.

This exercise completed, he asked me if it had been “intrusive”. I responded by stating that no, it had been nothing of the sort – but I did wonder, “why now?”

“I’m quite conscious of the fact that when I first approached this organisation, I was advised that I would have therapy of about 26 weeks,” I told him. “This being week 20, y’know…”

“Yes,” he nodded, resignedly. “This is about the time that I start thinking about this with clients.”

He asked me how I felt we were getting on when measured against the reasons that had brought me to Nexus in the first place. What were those reasons?

I hate it when therapists ask this kind of question. Surely the answer, simplistic and uncomplicated as it is, is to feel better. I said so to him.

“And are you?” he asked me.

I shrugged, which was perhaps not an entirely appropriate response, and gave him my usual spiel about not believing in cures, etc etc. I added, though, that I believed that things could improve; life will never be easy, and what happened will always have happened, but perhaps it can be made a little more ‘in the past’.

He agreed, but did note that much more could be achieved if we had longer than 26 weeks in which to achieve it. Ideally, he stated, we’d work together for two or three years.

“But we do have to stop after those 26 weeks,” Paul sighed. To my own surprise, I felt great sadness as I let this statement sink in. It was partly about the relationship that’s been established, but it was more about regret that the progress being made would now be struck down. As things stand I don’t think there will be a regression [at the time of publication, the therapy has ended, and there’s no regression yet], but there could be a lot more moving forward if the opportunities were there.

But wait! Perhaps there could be some opportunity?

“You can always come back,” he said casually.

I felt my brows furrow. “Can I?”

“Yeah. You’ll have to wait a few months between leaving and returning, and you’ll have to go through another assessment and all that shite, but then I’ll just pick it up again anyway.”

Splendifourous! In the weeks that have passed since this appointment, my current relationship with Paul has been and gone, but I confirmed with him several times that I wanted to come back, and he himself confirmed that he would be happy to work with me again. So, in a way, it’s a win. I get a break for a few months, then get to pick up largely where I left off.

I used the ensuing pause to consider how things had changed in the time since I first met him. One key issue is that I mostly know now that everything I’ve said about Paedo is true. I mean, I always knew that some of it was, but as well you know, o my little brothers (and sisters), I doubted myself on many of my memories, despite their vividness, despite their striking detail. This is no longer true, and I really think Paul has helped to guide me to this position. His faith in me, his explorations of my child self (Aurora, whatever) have been strong and in-depth, and that has in turn given me the strength to face the truth and stop running away from it with allegations of False Memory Syndrome and similar wank.

Another issue was that my self-harm had “improved”. Writing this now, reading the word “improved”, kind of makes me laugh at myself. I haven’t self-harmed in months, and it reminds me just how far behind I am on writing about these sessions. I must still have been doing something self-injurious at the time, though I note with interest that I haven’t scribbled the specifics of that down on my nigh-illegible immediate-post-session ramblings. What I have noted is that I then stated to Paul that I still fail to see why self-harm is so inherently bad. Even though I’m not doing it right now, and don’t have any particular inclination to do so, I still largely agree with my stated take on this.

He said, “it’s not bad compared to what?”

I looked at him curiously. I hadn’t considered it to be somehow comparable to something else. Eventually, I shrugged and said, sincerely, “boredom.”

Then my intellectual mind kicked in, and realised what he was trying to get at. “Of course,” I continued, “that doesn’t work from a psychodynamic perspective, does it?”

Used to this kind of inappropriate interruption, Paul immediately returned with, “let me worry about that. What does boredom mean to you?”

I shrugged. “Self-harm is something to do. Blood is something to watch.”

“Isn’t it about feeling something?” he asked. “Don’t you see the repetitive nature of what you’re doing? Stabbing? Penetrating?”

Well, I do, yes. I also see the repetitive nature of this particular conversation with you, Paul, but let’s not get bogged down by pedantry, eh?

I was silent for what felt like forever. The fact that we’ve had this particular exchange so many times frustrated me, and I didn’t want to confess that to him, but at the same time, Aurora was faffing about in the back of my mind and I kept, internally, telling her to shut the fuck up. She wanted her say, as she often does. I didn’t (and don’t) want her to have it (as you might imagine Paul finds this particular issue to be unhealthy, but that’s a story to be told in more depth on another day).

But she kept on and on and on and on and fucking on, until I could bear listening to her no longer. So I tried to speak for her, but each time – for ages, over many attempts – the words stuck in my throat. So I instinctively resorted to a more standard version of communication, and berated myself (whilst beating myself and Aurora about the head) for my inability to verbally convey the matters in my mind.

I was biting my thumb, I remember, during the moments of silence that preceded and indeed followed this childish outburst. Acting out, anyone? Paul observed at one point that the transference emanating from me was “very childlike.” Funny that, when I’ve got this fucking infernal brat in my head trying her damndest to take over my body as well. You folks with DID and multiplicity of other descriptions – fair play to you for coping with that kind of thing all the time. Dealing with one alter on an occasional basis (at least, as far as I am aware it’s occasional) exhausts me entirely.

Eventually he said, in that time honoured fashion of psychotherapists the world over, “how do you feel?”

I made a non-committal facial gesture in response.

“You looked angry,” he prompted.

“Of course I’m angry,” I spat, the vitriol in my tone almost palpable. “I sit here and waste both my time and yours by being unable to open my stupid fucking mouth. What’s the point in that, Paul? Of course I’m angry. I’m angry with me [and, not that I said this aloud mind you, I was angry with her too].”

“OK,” he replied, “you mentioned psychodynamic work earlier. In psychodynamic work, silence can be useful. A lack of words can say an awful lot. You know that.”

What can it say?” I begged him, sounding pathetically desperate for answers.

“Usually I come to your rescue at about this point,” he said. I waited for him to follow this comment up with the rescue itself, but he didn’t.

After another infernal millennium of no speaking, I blurted out, in a laughable squeal of apparent anguish, “please help me here! I’m stuck!”

Eventually, he began to respond, carefully. “One of the hardest parts of my job,” he said, “is having to sit here not having answers, nor knowing what to say. I have to sit here and let my clients suffer at times. The reason is, they were damaged as children and need an adult to be with them who won’t tell them how to think, what to say, how to feel. Sometimes they just need to sit with the pain.”

Another pause.

“OK, but what do I do?” Reading this comment back has amused me somewhat. He had already said that he wasn’t going to prescribe my comments nor my words, and when he responded with a simple, “I dunno,” I shouldn’t have been surprised.

He added, a few minutes later, that perhaps there was some value in not knowing what to do.

“And how does that achieve anything?” I enquired witheringly, looking out the window behind me at the frustrating normality of life outside the therapy room.

“It enables us to have a comfortable, honest relationship.”

“Right, that’s good and everything, but how does it advance matters?”

“It allows a unique relationship. It’s different from your psychiatrist, wouldn’t you agree? Does she ever not know what to do? Does she allow you not to? It’s even different from your relationship with A [well, I’d like to bloody hope so, yes]. You have to, at least on occasion, live in the real world with him. You don’t in here.”

When I didn’t answer, he went on: “the disorganised part of you is allowed in here, yet it’s the part you fervently fight to keep out. What can that tell us?”

“Well, I’m obviously uncomfortable with that side of myself,” I conceded.

“Yes – but why in here specifically?” he pressed. “I think there’s enough trust between us [yes] that you know that you’re safe here, that you won’t be judged or hurt or whatever, but yet you push it away nonetheless. Is it that it’s not needed in here?”

“It’s very destructive,” I responded, avoiding the question posed. “Sometimes I want to kick and punch the living shit out of things…wait, I haven’t done that have I?” I cried, suddenly panicked. “I didn’t dissociate and kick the fuck out of that wall [the wall has some paint peeling off it in a curious fashion]?”

He shook his head whilst suppressing a wry smile. “What brings those times about?” he asked me.

“It’s just…it’s just so profoundly un-fucking-fair. And that makes me angry.” I cleared my throat. “But so what? Life’s not fair; shit happens.”

“I think you’re allowed a bit of leeway on that,” Paul responded. “Most people thankfully don’t have to go through what you’ve gone through. That’s more than mere ‘life’ – that’s having shit kicked in your face and then some.”

“But I’m not angry with him,” I whined. “The anger is there, it’s just…not pinned down to one specific person. I don’t like him, but I don’t wish him ill.”

“Why?” (Inevitable).

“I just don’t,” I said pathetically, looking intently at the non-descript carpet. “I just…don’t.”

More silence befell the meeting, but I uncharacteristically broke it without it going on for 18 chiliads. Instead, a few minutes later, I admitted that I had lately been torn between feeling sad, and feeling bollock-bustingly furious.

“The problem with either anger or sadness is that neither gets you anywhere nor does anything,” I lamented with a philosophical sigh. “I mean, other feelings serve as uncomfortable but nonetheless useful catalysts or warnings, just like physical pain. Look at anxiety, for example – it’s horrible but it’s there to protect you, or scare you into a fight or flight response. Anger and sorrow do nothing.”

I went on to tell Paul that, a few months prior to this meeting, especially early in our acquaintance, the primary feeling I experienced was one of a low-lying but paradoxically paralysing terror. Or perhaps horror. Or dread. Or a curious alchemic mix of all three at the same time. See this post, for example. But as I said to him, that really isn’t true any more – or, rather, I don’t have that constant horrordread hanging in the air wherever and whenever I walk.

“What scares you now, then?” he queried pragmatically.

I thought this through out loud.

“Family? No. There’s just…well, again, there’s just a sort of sadness there [which is weird to read back as, aside from my mother, I mostly don’t much care about any of them]. Let me see…well, crowds. Obviously. Don’t do crowds well at all. And…work. That scares the absolute living fuck out of me.”

“What’s frightening about a job?” Paul asked.

What’s frightening about anything? I never said any of this was rational! As I said to him, it is just a vague, unspecific sort of anxiety that overwhelms me whenever I consider it. However, I did attempt to pick it apart for him.

“I’d theorise that my fear of failure is so profound as to be debilitating. I’m petrified of failing others, of letting them down. I’m scared of people, and in the vast majority of jobs there are – regrettably – people.

“More practically, there’s my pathological phone phobia. My concentration, whilst better than it was a year ago, is still rubbish. There’s no point in doing a job if you can’t concentrate, as it simply won’t get done or, if it does, it will be shoddy, and that is unacceptable. Also, I can’t deal with confrontation, no matter how civil it may ostensibly be, and in my experience even the best job in the world carries the risk of that arising occasionally. So, in summary – there are a number of practical concerns, and a few more abstract ones – but whatever the case, the anxiety about it is crippling.”

“Overwhelming,” he added, apparently having garnered that word from the fear he heard in my voice.

“Yes. But then, I hate myself for not being at work. I hate it. I just don’t want to go back into work, not be ready for it, have another breakdown and be back on benefits again. That would be no good for either the employer nor myself, and would probably set the progress I’ve made mentally back about a decade.”

I sighed. “But then, that makes me feel guilty. I should be able to return to work and just be able to fucking do it. I measure myself so strongly by the concept of a career. I have no idea why, because I’ve never had a career – only jobs.”

I told him about my abject rage when I hear of people I went to school with – stupid people, nasty people, whatever people – doing law degrees and being lawyers, doing computer science degrees and being computer scientists, doing engineering degrees and being engineers. Or the ones who had the bloody sense to jack school in at the age of 16 and become plumbers or electricians. God, if I could live my life over again, I would surely choose that path.

“So you describe your former classmates by their job titles. How do you describe yourself?”

“Dolescum.”

“Dolescum?!”

“Dolescum, yes. Oh yeah, I may try and re-invent myself as a writer [ha] or whatever, but really – ‘dolescum’ reigns supreme.”

“Isn’t ‘dolescum’ a little harsh?”

I ignored him, and went off on some impassioned rant about how I wanted to change my ‘dolescum’ status, but that I couldn’t, not yet, not now.

“Everything makes sense in context, as you know,” he said, which I initially found to be quite cryptic. “An interview panel, a set of colleagues – they’re all judging you, in your eyes…”

Of course they’re judging me,” I interrupted. “That’s the point of interviews.”

“…they’re judging you as adults. You feel like a demeaned kid in front of them – who can you trust? What will they do to you? It seems perfectly natural to me. The problem is, you judge yourself far more harshly than they will judge you. Do you think a colleague of yours is going to carve ‘bitch‘ into your stomach?”

Well, it’s a funny old world, Paul. Who’s to say there isn’t such a colleague out there, just waiting for me? I responded by saying, simply, “it feels like it.”

Time for another self-directed rant. “It wasn’t always like this! 10 years ago when I was first properly applying for jobs I was confident, cheerful, even charismatic in interviews. It came naturally to me – none of it was an act. Now all that comes naturally is stammering and floor-watching.”

“Is that how ‘Dolescum’ [he made a gesture denoting that he was, with irony of course, referring to me] has handled interviews?”

“Dolescum can’t have done that badly. Dolescum went back to work after breakdowns before.”

“How is ‘Dolescum’ dolescum, then?”

“Because Dolescum isn’t working again. It was all very easy when I was off for six months to make up some bollocks on my CV that I’d be travelling. I can hardly spin that yarn over three years.”

“OK,” he said, trying to ‘ground’ the conversation. “I don’t think it’s about unemployment, to tell you the truth. It’s about you. You don’t work now – you’re dolescum. If you were sitting behind a desk right now, you’d be office scum. If you were in a factory, you’d be factory scum. Etc etc etc. It’s the ‘scum’ bit that’s entrenched.”

“That seems reasonable,” I admitted, which led to the inevitable narcissistic whinge about the just-sort-of-Mensa-level-IQ bint with qualifications flying left, right and centre out of her arse who ended up as a receptionist or glorified typist* (though admittedly, my typing speed is very good – I can usually rack up about 90wpm, which is a bit unfortunate for you, a reader of my blog, as it helps facilitate the ludicrous verbosity of these self-obsessed ramblings).

(* Actually I should state that my last job in particular was a lot more than this, but it was not considered so by my superiors – but let’s not go down that route again. Past is past and everything, yadda yadda).

“Well, it’s my own fault,” I sighed. “I shouldn’t have done the courses I did.”

Pause. Then: “it’s his fault I don’t have a doctorate.”

Paul peered at me over his glasses. “Who said that?”

I shook my head in self-surprise. “I have no idea. It just came into my head.”

“Is there any truth in it?”

“It’s my fault I don’t have a doctorate,” I clarified.

“But did he [there was an implicit understanding that we were referring to Paedo] have a role in it? Didn’t he have a role in everything?”

I avoided his gaze.

“Your mental health issues,” he offered. “Whose fault is that?”

“It depends who you ask,” I said evasively.

“I’m asking you – you’re the only one that counts. Oh and please – don’t give me any bullshit from the medical model.”

I rolled my eyes a little, but shot him a wry smile.

“OK then, you’ve lain down the gauntlet. It’s not just him. There’s some residual issues with my mother, there was a whole pile of fuck with my ex, I still haven’t got over the death of my grandfather. But mainly – well, I attribute most of my mentalism to my father and Paedo, yes.”

“And to what extent did your mental health difficulties prevent you studying for a doctorate?”

It’s impossible to know the answer to such a question, of course, but I replied by stating that I reckoned they severely impinged on my failure to achieve one of the few things I ever really wanted in this world.

I saw Paul glance at the clock. “Shit,” he muttered irritably. “Just when we’re getting into some really meaningful stuff, we have to end the session.”

For some reason this took me right back to therapy with C, and his weekly mantra of shit of “we’re going to have to leave it there.” Shit-tinted glasses show me a glint of satisfaction in his eyes, as if he enjoyed throwing me out of his room like dirty dish water when I’d got into the midst of something gritty and murky with him. Of course, I know rationally that this is absolutely horse shit. But it was how I felt, and I responded accordingly.

“Am I game-playing?” I said, genuinely concerned.

Paul tilted his head and studied me, as if to look for clues as to where my odd comment had arisen from. “No,” he said finally. “If you’re ‘playing’ at all, then you’re safe-playing.” Before I could counter this, he went on: “it’s interesting that you put so much blame at your father’s door [it’s not interesting to me. It just is]. It underlines his failure to provide safety and security for his child – both in the context of your life as a whole, and in the context of allowing the abuse to happen.”

He sighed and looked contemplative for a minute, as if he were taking on the guilt that my father should have carried. Then he turned to me reassuringly, made some non-verbal gesture of, “we’ll pick it up next week,” and then it was – for another week – a meeting consigned to history.

marketing

Bye, Bye Borderline!

These are the criteria, at least five of which are required to be met, in order to be diagnosed with borderline personality disorder. Apologies if this is too much of an echo of my year-old post called ‘BPD vs C-PTSD‘ – but there’s method in the madness, I promise 🙂

But what is that method?

I realised something last night, when I commented on Frankie’s blog, The Sunshine Diaries. I was saying to Frankie (who has both schizophrenia and BPD, the former being an illness that she is managing well, the latter being something she still struggles with at times) that I had felt so much better lately, showing that (contrary to a lot of uninformed but sadly popular opinion) there is hope for people with the disorder. As I typed, the following words seemed to roll of my fingers

I’m not sure I meet the required five criteria any more and if so, only just.

I hit the ‘reply’ button largely without thinking…then I realised what I had said, and the possibly enormity of it. Could that possibly be true? Honestly, literally true? That I might no longer meet the criteria for BPD? Really?! Surely not!

Well – this is not official in any way, but stilll…as it turns out; yes, it could be true. I no longer meet the diagnostic criteria for BPD!

😀 *does a happy dance* 😀

Let’s examine it one by one.

[BPD is a]… pervasive pattern of instability of interpersonal relationships, self-image and affects, as well as marked impulsivity, beginning by early adulthood and present in a variety of contexts, as indicated by five (or more) of the following:

  1. Frantic efforts to avoid real or imagined abandonment. (Note: Do not include suicidal or self-injuring behaviour covered in Criterion Five)Me? NO. I’m not even that anxious in terms of abandonment issues any more, never mind going to extreme measures to avoid it. I don’t suppose I ever really went out of my way to prevent rejection, other than to make the complaint against the Trust about the end of matters with C – but really, that was more about morality and rights within the system than it was about me and him per se (not that that wasn’t part of it, admittedly. It just wasn’t the whole story).
  2. A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealisation and devaluation. Me? NO, and this has never been true. I have had issues with splitting in fairness (although this is increasingly less true as time goes on), but it’s very rarely been the case in the context of my close relationships. A and I will have been together for eight years this month. My two best friends from school are still my two best friends. Aside from the normal ups and downs any lengthy connections go through, all of these relationships have been pretty stable.
  3. Identity disturbance: markedly and persistently unstable self-image or sense of self. Me? NO. Not significantly more than anyone else anyway, I think. In the last few months my self-perceptions have been stable, or at least consistent with an ongoing mood. When severely depressed, I don’t like myself – who does?! When I’m feeling euthymic – as I think I am at present – I am reasonably content with myself. So yeah, it changes occasionally – but it’s not some sort of yo-yo disparity at all.
  4. Impulsivity in at least two areas that are potentially self-damaging (eg. promiscuous sex, eating disorders, binge eating, substance abuse, reckless driving). (Note: Do not include suicidal or self-injuring behavior covered in Criterion Five)Me? MAYBE. The binge eating thing still applies, though in fairness that’s only really gone out of control since I started taking such a high dosage of Seroquel. Even if we can assume that it is a BPD symptom, is there (at least) a second such trait? It’s hard to say. I used to do a lot of stupid shit when I was driving, like seriously exceeding the speed limit. In the past few months, I’ve actually noticed myself being exceedingly boring whilst ensconced behind the wheel. I haven’t even gone beyond 60mph on the motorway in the last few months. *zzzzzzzz* Oh, and – assuming we’re talking in terms of consent (*coughs*), then I’m about as far from promiscuous as you can get without being one of those no-sex-before-marriage people. Yeah. I should vote Conservative.
  5. Recurrent suicidal behaviour, gestures, threats or self-injuring behavior such as cutting, interfering with the healing of scars (excoriation) or picking at oneself. Me? YES. Not threats and gestures; I’ve actually never been guilty of that. And I haven’t attempted suicide in well over a year, though I have seriously toyed with the idea since. Suicidal ideation is still a very big part of my life, and I can’t see it ever going away. However, it’s about degrees; right now, it’s fairly low by the standards to which I am used. As for self-harm, I’m perennially guilty of the whole ‘interfering with scabs and picking at self’ thing, and I do self-injure with my old friend the scalpel from time to time. 18 months ago, though, I was doing that at least once a week. I find it hard to average out its frequency in terms of today, but it would be less than once a month anyway – perhaps not as often even as that.
  6. Affective instability due to a marked reactivity of mood (eg. intense episodic dysphoria, irritability or anxiety usually lasting a few hours and only rarely more than a few days). Me? YES, but also NO – not in terms of the specific criteria detailed here. The DSM says that people with BPD have reactive moods, and that said moods last a few hours or days, and only ‘rarely’ longer. This is not me at all. My mood ‘episodes’ last for weeks, quite often months actually, and – in an opposite to the DSM criteria – only rarely last for shorter periods than these. In this way, any affective ‘instability’ is much more consistent with major depressive disorder and/or an anxiety-related difficulty.
  7. Chronic feelings of emptiness. Me? NO. No! I don’t feel empty at all. One can feel hugely depressed, anxious, traumatised or whatever without feeling empty. I have all those issues and more, but no – no emptiness. Not any more.
  8. Inappropriate anger or difficulty controlling anger (eg. frequent displays of temper, constant anger, recurrent physical fights)Me? NO. I rant and rave on this blog all the time, but as I discussed somewhere else (I can’t be arsed looking for the link, sorry), that’s often because I’m really pretty submissive in ‘real life’. I have occasional tiffs with my mother and with A, but – shock! horror! – that happens in such relationships. Big wow! All that said, my types of ire can alternate – but even when it’s internally explosive, my old skills at acting allow me to behave, mostly, in a measured fashion. I am not constantly angry, and the one, solitary physical fight I’ve ever been in was when I was being bullied at school and had no choice but to defend myself.
  9. Transient, stress-related paranoid ideation, delusions or severe dissociative symptomsMe? YES. This is still the main criterion that applies to me, though things are a lot less severe in this regard than they used to be. They could also be explained by other illnesses with which I am diagnosed, but I accept that they could certainly still be BPD ‘traits’ too. NewVCB has told me on a couple of occasions that, in her observations, there are two main strands of people with BPD: you have one bracket of folks who are (to use her phrase) “classically emotionally unstable”, then another who tend more towards dissociation and psychosis (which is much more in keeping with Stern’s original observation of the phenomenon, ie. that it was on the ‘borderline’ between psychosis and neurosis).

So! There you go. I have two of the main symptoms, and a couple of others remain arguably applicable. That’s probably still enough to see me considered to have ‘borderline traits’, but by the definition of the full-blown disorder, I can no longer have its ‘complete’ version.

It’s weird to write this, you know: in a way, it even feels uncomfortable. Waaaaaay back just after I started writing Confessions, I debated the issue of whether or not if, if given the option, I would flick the fabled switch to bring me to sanity. I said that I wouldn’t, and I still hold to that largely. Yet here I am, effectively devoid of an entire set of insane-ish personality characteristics that seemed such a normal part of my apparently abnormal life for so long. Someone once accused me of being obsessed with the diagnosis, which I don’t think I ever was; I did, however, embrace it in many ways – in terms of learning how to be able to manage it, of interacting with others in similar boats, of advocating and trying to fight that ridiculous stigma that permeates it.

I am not ashamed to have been diagnosed with borderline personality disorder; the stigma is unfair, and the histrionic, manipulative stereotypes are blown out of all proportion and are in no way representative of the majority of people that have the illness. You can’t base everything on what you see in an A and E department on a Saturday night, and if you’re stupid enough to think that you can, then you’re not worthy of further words on the subject from me – aside from screw you.

So no, I’m not ashamed, but at the same time, I’m relieved that it’s seemingly no longer with me too. The diagnosis will never leave my medical notes so it’s not about that aspect of things; no, it’s about progress. If I can no longer be diagnosed with BPD, then I have moved forward considerably – and, maybe, returning to work is not a million miles down the road. That is still my ultimate benchmark of ‘wellness’ and ‘recovery’.

All that said, perhaps oddly I still meet the criteria for the similar psychiatric problem of complex post-traumatic stress disorder. I won’t bother to go through the whole thing with it like I did with BPD, but perhaps the reason that it could still be applied is that it puts more emphasis on dissociation than the BPD definition does, or that some of the more specific sub-criteria are applicable to me in a way that the BPD symptomatology is not. Since NewVCB first told me that I “couldn’t not have” complex PTSD, I’ve tried to embrace that diagnosis much more than borderline – not because I was ashamed of the latter, as I’ve noted, but because it seemed politic, wise and even affirming to acknowledge the trauma partly associated with my illnesses.

Furthermore, it’s evident that I still have major depressive disorder, (social?) anxiety, psychotic and dissociative episodes (potentially part of C-PTSD or a BPD trait, but possibly independent thereof too), plus arguable issues with agoraphobia, panic disorder, yadda yadda. But still. It’s progress. I’ll never be rid of everything. I don’t believe that for a second, as well you know, good readers. But if I can manage some of it, eliminate other bits – then maybe I can go back to work and stop wasting my life like this.

How did we get here, this point of non-borderline-ness? Intense, in-depth therapy, with a competent, vaguely integrative (but non-behavioural!), caring and demanding therapist. Someone with whom you’re comfortable – but not obsessed. Someone who cares about you and not targets or looking good to his or her colleagues. Someone who asks a lot of you but is willing to give a lot back in return.

However, therapy is only one part of the equation. I have to say that Quetiapine and, in its higher dose, Venlafaxine, have both worked wonders. It pisses me off that NICE strongly recommend against the use on medication in BPD – the right combination, under the supervision of a good psychiatrist, has made my life better. Simple as, end of. I don’t think therapy would have improved things so much on its own – not in less than six months, anyway. And would I have been able to even have undertaken such intensive work without the relative stability the medication gave me in the first place? Probably not.

In fact, although I think therapy with Paul has been incredibly useful (and will continue to be), the timing of my positivity* is consistent with starting to take the higher dose of Venlafaxine. Placebo? Given that I formally thought it was a useless pile of wank before and had no expectations of it, higher dose or otherwise, whatsoever? Placebo my fucking arse.

* Well. There we go, readers. I’m bored with the newfound positivity of this blog. This is not me, is it? I mean – don’t get me wrong – life is still shite and everything…but it’s a little less shite. Tolerable. Acceptable and passable. This is new and different, and is less bollocks than it is normally. That’s good, but I feel like I’m becoming some sort of saccharine fucking cherub here, and that makes me want to vomit all over this screen.

So…

As I said to my CPN yesterday (blog on her tomorrow, I hope), it’s all going to go tits up again before long. This is probably a calm before a gargantuan cunt of a storm.

Random rant to prove I still can: the human race is an out-of-control fucking virus of much disgusting-ness and David Cameron and friends are cunts who need to have their smug, wanky faces beaten in by ASBO yobs. And, whilst I wish both concerned parties well, who in the name of all that is HOrwell (geddit?! Holy Orwell! HOrwell?!!!1!!!1!!11! No? Sigh :() gives a damn about the Royal Wedding? And this fucking post has taken me about three hours, not because the content is so amazingly refined – it certainly isn’t – but because WordPress is shit. gah. I feel sorry for WordPress now; I didn’t mean that, I’m sorry. I do actually love Wordperss, but honestly – they really, truly, honestly need to revise the user’s ability to create bullet points and so on. This has been eminently frustrating to format.

Bla. Blafuck. Fuckblah. Fuck. FUCK! FUCK!

There’s more to say and more to rant about, but I have a more general update planned for tomorrow so it’ll go there.

I’ll sign off with this. tai has been creating some collages based on her perceptions of her blog readers and commentators. I was pretty chuffed when she did this one of me:

Pan by tai

Isn’t that class, and isn’t it a brilliant idea? I love tai’s creativity, both in her art and in her prose, and feel very privileged to have been part of this project – so thank you, tai, very much indeed! 😀

‘Night everybody. x

Smoking (and its Possible Relation to Mentalness)

I quit smoking, after about a decade of engaging in it, on 1 January 2007. The smoking ban was coming in here in April that year, and I thought that would give me plenty of time to adjust to being a non-smoker before everyone was (in my view justifiably) forced outside to practice their lung-destroying habit.

It was a success. What worked for me really well was being absolutely decisive and certain that I simply would not smoke after that New Year’s Eve, to the point where I didn’t need any of the traditional aids that are recommended. I had bought some of that nicotine chewing gum, but (a) it was absolutely bloody rancid and (b) I was surprised to find that I almost never craved a cigarette at all. That led me to the conclusion that, in my case at least, smoking was more of a habit than an addiction.

I had had a smoking routine prior to quitting, that depended on whether I was at work or not. If the former, I got up, checked my email with tea and a fag, went to the bus-stop, smoked a fag there, got the bus, went to the coffee shop and smoked a fag there, went to work, went out for a smoke break with the others at 11am, went back to the office, went out for lunch smoking between one and three cigarettes, went back to work, smoked on the way back to the bus-stop, went home, had dinner, smoked a fag, went on computer, smoked a fag, had a cup of tea, smoked a fag. If I was not at work, I got up and sat at the computer for hours, with smoke after smoke on the go. Etc etc etc.

Yet, if I came to stay with A (I lived at Mum’s at the time), I would go for days without even thinking of the things. Mum and I even went to America for a fortnight once, and as we were staying with Aunt of Evil, we didn’t smoke the whole time…well, until we got back to the airport to go home anyway, at which juncture it all started again.

So yeah, it seemed like a habit, and a potentially controllable one at that and furthermore, one that I got very easily out of by determination alone.

Until late last year.

I don’t remember how I got back into smoking precisely. I could sit here and whine that therapy (and, in particular, the end of therapy with C) was difficult, and whilst that’s true, I don’t think it serves as an adequate excuse for lighting up again. I did it because…well, I don’t know why entirely. I think I just felt like it. Which is indubitably bad.

It’s funny; when I quit in 2007, I didn’t notice all those supposed health benefits people wank on about, such as being fitter and whatnot – but now that I’m back on the heinous things, I notice losing fitness. I have regained a smoker’s cough and am not particularly good with hills (which had been something that had been improving since I’ve lost some weight).

The weird thing about my recent re-foray into smoking is that there’s no pattern to it in the rote fashion that there was before. Some days I might smoke a lot, others I may only have one (or even none at all). This may sound more encouraging than sitting here chaining all day, but I don’t think is. I think I’ve developed a sense of complacency that I’d much rather I didn’t have; the unconscious thought process seems to be, “bah, sure you don’t smoke much anyway – why bother quitting again?” I don’t rationally think that, of course, but there’s something blasé at the back of my mind. When I was a frequent and/or heavy smoker, no such pseudo-ambivalence existed.

Of course, I have no money. In fact, I have less than no money – so the finances from the bastarding things come mainly from my ever-expanding overdraft. This, more than the health thing, is my main impetus to stop again – I mean, it’s through no fault of mine that I’m disabled from working at present, but I still think it’s a travesty that public money is going on this grotesque pursuit.

So, in light of this and related concerns, I had determined that I would quit again on 4 April – ie. Monday coming. Rather than celebrate this in the way I had when I had planned on giving up fags before, I’ve been sort of nervous about it. I know that the claim that smoking relieves stress has physiologically been proven to be false, but I think that in certain circles it is accepted that people psychologically gain relief from it, in much the same way that one might do with a placebo drug. And I have been under some stress recently – not much by comparison to times in the past perhaps, but not insignificantly nevertheless. Poor A has been under immense pressure at work lately, and it’s hard not to worry about him. Psychotherapy, whilst productive at present, is fucking hard work. I’ve also been completely obsessed that my mother is about to die, and have now got it into my head that the McFauls will find out the truth (not that they would believe it as the truth, of course), and that Paedo’s life will be ruined. I mean, as stated a million times, if the McFauls never speak to me again, that may be very vaguely unfortunate for me personally, but I’d get over it. I’m not their biggest fans, after all, even if one or two of them are OK. However, I don’t particularly wish to tar him with the brush of paedophilia this late in his life. I don’t like him, but I don’t wish him ill either.

So, I’m led to wonder – is this odd sort of “oh well” about quitting smoking related to my tendency to panic about not very much? When I quit in 2007, life was pretty reasonable. I had just recovered from a major breakdown (not at all as major as this one, but the most significant one to that point) – so much so that I was going back to work. Things were fairly good, insofar as existence can ever be said to be good. Now – life is not abjectly, unspeakably awful in the way it was a few weeks ago, and my mood feels stable-ish – but “what ifs” and a sort of low-level agitation can be quite independent of mood, I’ve found. I’m still on edge a lot, and up to my usual old tricks of perpetual catastrophising.

I went to see Mum, newly tanned from a holiday, yesterday – and was quasi-horrified to find that, instead of buying me some sort of tourist tat as she normally would have done (she and I tend to exchange crappy fridge magnets from our respective foreign trips), she’d brought me a big packet of cigarettes. Enough to do me for the next month, or maybe even more.

My pointless little story gets particularly pathetic here. I don’t want to not smoke them, because that would apparently be insulting to her given that she put the money, time and effort into buying me the bloody things. Rationally, I know that’s preposterous – she’d rather see the fuckers binned and her money lost than me not give up as intended (though apparently my intended date has skipped her memory, but she’s nearly 70 now so we can forgive her that). But I have this nonsense in my head now. It reminds me of certain circumstances that commenced way back before I started this blog: I’d randomly feel sorry for Any Old Thing, and then want not to “reject” it. In this case, it feels like I am vicariously rejecting my mother if I reject her present, which was purchased with every goodwill.

I am glad to be an idiosyncratic person in general, but I often wish I wasn’t in this sort of domain. What possible reason do I have for this stupid sort of – as bourach once put a similar phenomenon – dilemminating? In this specific instance, it’s particularly counter-productive and idiotic.

So will I actually stop smoking on Monday as intended? I hope so, but I’m really angry with myself that my intentions feel so vague, so wholly different from last time. It’s a disgusting, filthy habit – and as discussed in the comments of a recent post I wrote, it’s ultimately a more destructive method of self-harm than that which we traditionally associate with such actions. I am ashamed of it, more so than many things that are generally much less socially accepted. I keep worrying about Paul smelling smoke from me – yet I am quite happy to call myself a dirty whore and talk intimately about sexual issues to him.

I did get a “help with quitting” kit this time, and will indeed purchase additional aids as required (pricey, but cheaper to me and the British taxpayer in the long-run). I just can’t guarantee it’ll be this week, as planned. And now that I’ve admitted that, of course I feel like the big fat failure of fuckery that I am.

On an unrelated note, there’s very little to report. Monday’s therapy session was not one of those conversational ones that for some reason some of you seem to find enlightening; it was very introspective, but there’s probably something good in that. I’ll write about it in a day or two. Mood-wise, things are alright-ish – in fact A and I have have just been crying with laughter at this…

:D

…but still, as observed above, a bit of anxiety and worry. Part of me is vaguely concerned that my increased dosage of Venlafaxine might be inducing a mild mixed state, but on the other hand, there’s lots of exhaustion – ah, insomnia, how I hast not missed thou. Boring all round, really. Part of me almost regrets getting so up to speed on all those weeks of therapy reviews, because now I only have one thing to write about. So I thought I’d do one of those weird speculative filler posts, ie. this one, that I sometimes write when I have nothing to say 😉