Sunday, November 29, 2009

Home is a War zone

The house I grew up in was a warzone, and all of us casualties. Some of it was stealthy, guerilla type war fare, with acts of war carried out in a million silent, yet painful ways. One had the feeling upon walking into the house that they must be ever vigilant against attacks. Some of it was all out war, with guns and mouths ablazing. Usually it was alcohol fuelled, and after the bombs stopped raining down, and each side retreated to their corner to lick their wounds, there remained a certain 'shell-shock'. Although the explosions happened with regularity, one never became accustomed or innured to it. Each battle left you spinning around, frightened with a sense of doom. The brief periods of quiet, were much like that eeiry quiet between bomb shelter alarms. The quiet in the epi-centre of the storm.


Our house is like that now. My sister and her boyfriend (ex boyfriend?)  stuck in a war with neither able to make steps forwards to the future. To make decisions, to make peace. And whilst the periods of quiet guerilla warfare are stressful and tense (days without words), the raging battles like tonight scare the hell out of me. Particularly since the boyfriend has been drinking all day. I like him, but he is in a bad place right now. he doesn't want to break up. So he uses every weapon he can find against her. Including me. Today it erupted because a side door in the house was left unlocked when I walked directly across the road to the service station to get some milk. I was gone a maximum of 10 minutes. Sure, I made a mistake not checking the door, but I locked the front and back doors, and didn't even think to check the side door, as I never use it. But realistically, the fight is not about locking doors, even if he thinks it is. Its about communicating to each other, and at the moment the only way they seem to be able to do that is through screaming, threats and ultimatums. It takes me immediately back 20 years. I want to be here and support my sister in whatever decision she makes, but the heaviness of the house is helping to drag me further under, encouraging more anxiety, more flashbacks, more hypervigilance. I just want it to be over one way or another.

Saturday, November 28, 2009

Yes, The River Knows



Please, believe me,

The river told me
Very softly
Want you to hold me, ooh.

I'm going, but I need a little time,
I promised I would drown myself
In mysticated wine.

Free fall flow, river, flow
On and on it goes.
Breathe under water till the end.
Free fall flow, river, flow
On and on it goes.
Breathe under water till the end.

Sometimes it feels like even my ipod is against me....sigh...

A note to everyone in my head


I hear voices in my head. I refer to them as individuals. One, in particular, the one that is the most self-critical and critical of others around me, has a distinctive male voice, my stepfather's in fact. On the other hand, whilst experiencing them as individuals dependent of 'me', I am also perfectly aware that I am not experiencing a psychosis, that these voices are a manifestation of particular parts of my personality. Perhaps, parts of my personality that I don't particularly like to own, but nonetheless... when the voices speak, or scream and shout in my head, I am mostly aware that it is 'me'. In times of particular stress, when the voices are demanding and unrelenting in the idea that I should do something destructive... 'kill yourself, cut yourself, drink yourself stupid', I find it hard to keep in my mind that it is 'me' that is saying it and not some seperate malicious entity torturing me, and pushing me to the edge of the cliff. There are three distinctive voices I experience.. "The Voice" (my stepfather's), the child and "Game face", who feels like an older, firmer version of me that tells me to buck up, and barks orders at me, to get me through emotionally difficult situations without falling apart. And then there is a crowd of others that function only as a group, taunting, whispering threats. Sometimes, I feel as though 'me' is pushed completely out of my head, as one or another of the voices takes control of my body and voice, or when they start arging with each other. I dissasociate, either partially or entirely, and what happens in that time becomes vague and fuzzy. I am 'me' within myself to varying degrees throughout the day, week, month.

I used to think I was going crazy. I didn't want to speak about the 'voices' because I thought it would appear as though I had some kind of schitzo-typal disorder. But I have learnt that it is actually quiet normal. This happens to everyone to some degree. "I just heard my mother's voice come out of my mouth" is a common sentiment. It's just to a slightly more fragmented degree with me. The multiplicity of self, is essentially part of being human, but can sometimes go awry when parts of self have to be repressed or disowned, particularly in abusive households.  I was taught that I had no right to anger, and that anger in fact was very dangerous, so a part of me broke away somewhat and became the receptacle of my anger (ironically embodied in the voice of the one who made anger so dangerous in the first place) but it is still linked with in my mind to 'me', however tenuously. I would like the voices in my head to realise that they can all exist, that they can negotiate rather than wage war against each other, that they all have an equal right, space and place inside me. I know... a bit 'and world peace!' But that's my aim in therapy. So this is a shout out to the voices in my head, the day is coming when we are all just gonna have to learn to get a long.

Interestingly, my Therapist is Jungian oriented. I've not particularly noticed the presence of this orientation strongly in my therapy, I guess she is kind of one of those therapists that just engages whatever techniques and orientations are appropriate for the situation. But in the hours she spent in the emergency room waiting for my admission those many months ago, we were talking about what I have read, and when I mentioned Jung, she told me, that was her 'chosen orientation' or area of interest, I guess.

Carl Jung, was a Swiss psychiatrist and the founder of analytical (Jungian) therapy. His approach seemed to move away from the heavy 'scientific' bias, urging the consideration of the self in terms of spirituality and the collective unconciousness. One of his big things was the concept of psychological archetypes.  The Self (It signifies the coherent whole, unified consciousness and unconscious of a person), The Anima and The Animus (the unconscious or true inner self of an individual, as opposed to the persona or outer aspect of the personality. In the unconscious of the male, it finds expression as a feminine inner personality: anima; equivalently, in the unconscious of the female, it is expressed as a masculine inner personality: animus.) and The Shadow (part of the unconscious mind consisting of repressed weaknesses, shortcomings, and instincts). What distinguishes Jungian psychology is the idea that there are two centers of the personality. The ego is the center of consciousness, whereas the Self is the center of the total personality, which includes consciousness, the unconscious, and the ego. The Self is both the whole and the center. While the ego is a self-contained little circle off the center contained within the whole, the Self can be understood as the greater circle.(http://en.wikipedia.org/wiki/Self_(Jung) )
Jungian theory is pretty hard and somewhat nebulous to understand, and there is certainly a lot more ot it then my meagre little synopsis. But in it, intrinsically, I sense that idea of a multiplicity of self, and a goal towards unification (Jung would refer to it as actualisation and individuation. No doubt the idea of a multiplicity of self is inherent in a lot of psychological theories. CBT would have us conversing and renegotiaion thoughts and conceptions within our mind automatically. But I'm glad that the theory my therapist most relates to, is at least in mind, conducive to my major end goal. Everybody in my mind just getting along




We cannot change anything unless we accept it. Condemnation does not liberate, it oppresses.

Carl Jung

#On a good note, managed to get out of the house once again today. Still holding on.  Still fighting the urge to let go.

Friday, November 27, 2009

The enemy- how to start fighting???

Although our individual reasons, triggers and stressors for getting trapped in the depressive cycle are vast and multi-faceted, and at times indiscernable even to ourselves, the actual cycle itself looks pretty similar for everyone.



The results are often quite similar and predictable too, for example, low energy generally results in cutting back on daily tasks, activities and responsibilities, the inability to make decisions or to problem solve in any meanigful manner. In turn, this starts the nasty gremlins in our heads, confirming we are indeed pathetic, weak and ineffectual, leading to depressions favourite emotion: Guilt. It all seems so hopeless, like you won't ever be able to break out of it. It will just feed and feed on itself until it seems like it will consume you whole, and there is no other way out.

On top of the behavioural things, you are also fighting against a chemical warfare being waged on your brain. The three big guys that will either keep the boat afloat, or send it plummeting to the ocean floor are seretonin, dopamine and norepinepherine. Seretonin and norepinepherine are the two major players, they can work independently or together to bring you down. (Hence some people respond best to SSRIs - Seretonin Uptake Inhibitors and others to Tricyclic Antidepressants which will fight when the two of them are working in cahoots. Dopamine is kind of like a fair weather friend, who will only work well for you when reinforced, but will drop you in a red hot minute when lacking reinforcement (such as activity). Obviously if you get caught in the Behavoural cycle of depression (see above)  Dopamine isn't getting what he wants from you, and deserts, leaving you feeling even worse. (Much like some of the real fair weather people in your life, huh?) Worst still some of the things Dopamine likes to feed off are actually really bad for us (drugs, alcohol....chocolate :P )

So there you go, Ophelia's really simplistic understanding of the enemy. Now how to start fighting?

Today

- Ran the gaunlet of xmas shoppers and public transpot users to go to training fot volunteer work. Check.
-Caught up with friend for diet coke and chat. Check.
-Listened to uni lecture. Next on my list for today

-Made plans to meet up with a friend tomorrow at local pool...out in the big scary world again. Check.

Baby steps... but its more than I've accomplished in the last few days. I even showered (God, I'm pathetic!)

Thursday, November 26, 2009

In my little box of sad


Obviously life is just not a bowl of cherries for me at the moment. But I'm trying, I am really trying. Had a meeting with Case Manager (M) at my house yesterday which was somewhat unproductive, as I was having a really overwhelming day, and was frankly, just not up to trying to cope with anything other than keeping myself safe in the moment. She tried to engage me in a discussion about things that I could do to help get through this period, and distract myself from the gremlins in my brain. But I was just so exhausted and at such a heightened level of anxiety, I couldn't engage. Ended up withdrawing almost completely, as I tried to stave off a panic attack, and in the end she ended up leaving without me even getting off the couch to escort her to the door.  I feel such a sense of shame, when my emotions overwhelm me to the point where I cannot even behave in a civilised manner.  And I am sure that she left with not a small amount of frustration at my inability to engage as pro-actively as I normally would try to do. In the end, I did have to drag myself out of my self imposed hermitude to go to a GP appointment that I nearly forgot about, but that in itself felt like I was running through fire, having to be in such a crowded place, when all I wanted to do was be at home under my duvet hiding from the world.  I spent a good portion of the day just trying to resist the pull of the vodka bottle and the blade.

Sleep still isnt coming easily, but have had to try and pull myself together somewhat as I have training at the Ronald McDonald House tomorrow, and although I don't feel capable of facing the world or life in general at this moment, I know in my heart it is something I really want to do, and when (if) this passes I will be incredibley dissapointed if I screwed it up, in the midst of one of my plunges into darkness. The same goes for my uni work, although I am completely apathetic at the moment, if and when I do get through this I know I won't want to have backed myself into a corner where I have to start all over again.

That's the tricky part. At the moment life feels pretty shit, and there doesnt feel as though there is much hope of it getting better.  But I know from past experience that if I let everything slide, I will regret it in the future, fuelling the depression even more.

So, today, i have begun to try and pull myself up by the bootstraps and do what needs to be done. I've been trying to use my CBT bag of tricks. Self monitering isnt yeilding up much help. I don't know whether its a lack of insight or what, but I just honestly can't pinpoint the thought or event that are inducing my anxiety. It just seems to wash over me in waves, for no rhyme or reason. Sure there are mitgating circumstances at the moment, my therapists week off has left me feeling less contained then normal, the house is very tense because of the breakup, (Sisters ex is still living here, and nobody is communicating), and the holiday season is approaching, but specific triggers for the immediate emotion, well I just can't figure it out.

I am trying to cognitively restructure my negative thoughts. When I think of xmas, I keep telling myself that I am catastrophising an event that hasnt happened yet, and that even if there is the normal all out war, I can choose to disengage from it. When thinking about the house situation, I am telling myself that once again I can choose not to engage in the dysfunction, but continue as if everything is normal, and if and when we need to seek new housemate, I will deal with it. I am telling myself that feeling so abandoned with therapist away is a normal reaction within the therapeutic relationship and given my history of people letting me down when the going gets tough, but that (D) hasn't done that, and she will be back on monday, and she has repeatedly and steadfastly given her comittment to be there for the duration. I am telling myself that it is ok to have the thoughts of destructive behaviour and suicidal ideation because I have shown in the last few years an ability to resist the urge and reach out for help when things go to far. I am telling myself, that sleep will come eventually, and I just have to wait it out, the more anxiety I put into it the less likely it will be easily achieved........

Sigh... Anyway. Just taking a day at a time at the moment. Tomorrow I have three goals. 1) to make it to the training session, it is only a short bus trip and hour long session, I can pull myself together for that. 2) to catch up with friend (F) for a drink and a chat, because I know that social isolation is part of the downhill spiral for me, we will find somewhere quiet and out of the way. 3) to finish listening to this weeks uni lectures online, as I need to start preparing for the first test next week.

Baby steps.... I'll just fake it till I make it.

*Case Manager did not just walk out and leave me as a quivering wreck. She rang back later that afternoon to see how i was coping, which was still not very well. She is off for the rest of the week, but she did try to offer to get one of her colleagues to call me for the next few days to check in. I refused, as I know I cannot talk to people I don't know, and I would just lie and say I was fine and it would be a waste of everybodies time. She did however say, even though she isn't seeing clients next week that she would ring on monday to see how I am going. For all the issues I have with the 'system', and despite our somewhat rocky start, she is genuine and empathetic and I think she does try to do the best she can for her clients within the restrictions she is given... it must be a very hard and frustrating job.

Wednesday, November 25, 2009

Why Bother

I dream of snakes crawling all over my body, being tied up and unable to get away. I dream of being held under water until my lungs are on fire and I feel like I am about to explode. I dream of carpets soaked with blood, and blood oozing out of walls. Sometimes I dream about what actually happened. I am tired, but I don't want to close my eyes and dream these dreams.

I have voices screaming inside my head. Telling me I'm an abomination, unclean, a burden to everyone who has the misfortune of coming into my life. Telling me that everyone just secretly wishes I would just end it. Telling me its all my fault. Telling me I'm selfish for sticking around and poisoning everybody that I love. I don't want to hear that voice. I can barely think straight its screaming so loud. I want to drink myself into oblivian just so I can have some peace and quiet in my own head. I'm trying desperately hard not to, but the bottle is beckoning.

I hate what I have become, I am weak and pathetic. I am barely alive. I so desperately want to cut, just to feel that burn, the relief of the poison flowing from me, the blood reminding me I am still alive. But I can't, I can't go back to that.

I am where I always return. I can see myself returning to this place over and over again. Each time foolishly believing that maybe I've figured out the way forward, only to come plummeting backwards again.

And if my dreams aren't enough, if the flashbacks and voices and the very scars that crisscross my heart aren't enough to remind me. Now I'm told, my past has left a physical legacy inside of me. Puts a whole new spin on the 'scars you don't see'. I have been referred to a specialist, who may want to cut me open to peer at the damage he left behind... why bother... just look into my eyes and you'll see it. Why bother at all?

Tuesday, November 24, 2009

Counting Sheep


So, sleep seems to be once more spiralling out of control. At the moment, I am lucky to get 3-4 hours of broken sleep a night. I am exhausted, depressed, agitated and I have had a chronic headache for the past week or so. I have done the rounds of medications (currently I take Avanza-an AD with sedating properties, Clonazepam and Serepax.. I was taking Largactil as well, but for reasons unknown BabyDoc has ceased that one) But I can pretty much say I have tried almost any drug you can think of from herbal valerian types, over the counter restavit types, through to benzos and anti-psychotics. I practice relaxation techniques such as progressive muscular relaxation and I listen to a CD nightly that is aimed at restoring the correct sleep 'brainwaves'. (Sounds like water with a bunch of bell like bleeps, doesn't seem to work, but is quite soothing, so I listen to it anyway)

The effects of prolonged sleep deprivation has become somewhat of a pandemic in our modern world. For some like me, it is because of MH issues and anxieties, for others it is obesity induced apnea or simply the pressures of having too much to fit into a 24 hour day. Sleep is essential to the regeneration of parts of the body, particulalry the brain. Different stages of sleep are needed for the regeneration and stabilisation of different areas of the brain. Certain stages of sleep are needed for the regeneration of neurons within the cerebral cortex while other stages of sleep seem to be used for forming new memories and generating new synaptic connections.

The frontal lobe is the most fascinating section of the brain with relation to sleep deprivation. Its functions are associated with speech as well as novel and creative thinking . Sleep deprived test subjects have difficulties thinking of imaginative words or ideas. Instead, they tend to choose repetitious words or clichéd phrases. Also, a sleep-deprived individual is less able to deliver a statement well. The subject may show signs of slurred speech, stuttering, speaking in a monotone voice, or speaking at a slower pace than usual . Subjects in research studies also have a more difficult time reacting well to unpredicted rapid changes. Sleep deprived people do not have the speed or creative abilities to cope with making quick but logical decisions, nor do they have the ability to implement them well. Studies have demonstrated that a lack of sleep impairs one's ability to simultaneously focus on several different related tasks, reducing the speed as well as the efficiency of one's actions
http://serendip.brynmawr.edu/exchange/node/1690
It is pretty well known that sleep deprivation is a fairly effective tool of torture for interrogations. The Ancient Romans called it tormentum vigilae (waking torture). Prolonged total sleep deprivation (that is no sleep at all) can ultimately lead to death as the bodies inability to regenerate things such as white blood cells, create such a weakened immune system the body cannot sustain life. The longest a person has been officially recorded as going without sleep is 11 days. I personally, (without being under the influence of any illicit drugs which can enable a person to go sustained periods without sleep) have gone without any sleep AT ALL for four days. I know this because I was in a pretty bad place at the time and my friends and boss organised to have somebody with me 24 hours a day through that period. Finally my PsychDoc at the time prescribed some pretty heavy duty medications and I crashed for the next 16 hours. The next day, when my friends finally thought 'hey, she's got some sleep, we can give her some space, I overdosed on my medications badly enough to cause damage to my cerebellum and vestibular system, and end up in ICU on breathing support. I don't remember that week of non-sleep at all, I have only my friends recollections to go off, and I certainly don't remember the week after i OD'd. By the time I actually came to, I was in the midst of full-blown hallucinations, not helped by the pretty bad dose of aspiric pneumonia I contracted, by inhaling my own vomit.  What I do know is although not the primary reason for the overdose, I had been dealing with chronic suicidal ideation for a while, I fully believe it was the sleep deprivation, and the cognitive impairment of impulse control and problem solving that precipitated me actually to act on the ideation. Technically, I guess, my brain used sleep deprivation torture to nearly torture me to death. My own personal tormentum vigilae.

So, I am not in that place exactly. I am not getting a lot of sleep, but I'm getting some. I am having suicidal ideation, but I am able to control my impulse and make attempts at problem solving. But, given my past experience, such deteriations in sleep scare the shit out of me. Add to this the extra dimension of knowing the longer I go without good sleep the more likely my epilepsy will play up and I will seize. I am actually amazed I haven't so far, but would not be at all suprised if it were to happen in the next few days, so for now I'm sticking pretty close to home, and trying, trying, trying to get some damned sleep!

Monday, November 23, 2009

Things I do or have done when trying to fight gremlins

1. Challenging negative thought patterns (thanks CBT) but this can lead to you going round and round in circles, until your head feels ready to explode, so not entirely helpful at times
2. Distraction. I can't do benign mindless distraction, like reading a novel or seeing a movie. My distractions have to be hard core- brain straining activities so there is no room for the nasty gremlins to make their noise. Logic puzzles, reading Journal articles or hardcore 'thinking books', watching Documentaries, doing ridiculously long mathematical equations in my head, trying to name all the countries starting with B... the list goes on.
3. Cleaning. Not just general tidy the house type cleaning, I'm talking about taking to the clothesline with polish and a rag (Yes I have done that and Yes my housemate at the time thought I was nuts!)
4. Channeling the feelings- journal writing, painting, angsty poetry, blathery blogs.
5. Baking. I hate cooking, but I used to bake a lot when I was feeling off the wall... crazy amounts in the middle of the night, so my neighbours would all wake up with a container of freshly baked muffins on their doorsetp in the morning. Can't do it now, as is too noisy when housemates are sleeping, and I am purely a nocturnal baker.
6. Exercise- walking swimming classes, whatever is most suitable on the day.
7.Breaking glasses- I used to live across the road from a vacant lot on the side of a big brick industrial building. I'd go and buy a set of cheap drinking glasses from the $2 store and throw them against the wall. (And clean it up afterwards of course)
8.People watching- sometimes you don't want to interact with the world but youre not safe on your own. I'll go into the city and sit in the square, or the Botanic gardens or a coffee shop and just watch the world go by, making up little stories about people as they pass.
9. Music- make it upbeat, sing your lungs out, dance like an idiot- fake youre actually happy and maybe it will sink in.
10. Music- find the most depressing songs you can, and try to muster up a big cathartic cry. I don't cry much and sometimes I think that's part of my problem it just needs to be let out.
11. Snuggle with your cat (if she'll let you)
12. Go hang out with some kids. Preferably babies- that baby smell of talc and mik and the feeling of a warm, chubby little person grinning gummily back at you is a thousand times better than any drug I've ever been prescribed
13. Long, hot shower
14.Saying to hell with the diet and just eating whatever the heck I want.
15. Contacting people. Sometimes all I can handle is texting or msn, sometimes a phone call, sometimes its good just to muster up the energy to leave the house and meet for a coffee. Pick the person too. I have lots of friends who I love dearly, but at the moment the best person for me to meet/talk to in this state, is a girl who has had mh issues herself recently. We meet at the local pub, get our diet cokes (because neither of us can drink on our meds) and chainsmoke the afternoon away.

And when all of this is not enough... call upon the professionals. Although often there is not much point in that, as referenced in many previous blogs


For now, I've given this list a fairly good shot over the past few days (specifically numbers 1,2,3, 4, 6, 9, 10, 11, 12,13, 14, 15) And I'm still just trying to keep my head above water. I am rapidly losing my ability to give a shit, I am just too bloody tired. I hate this.

Sunday, November 22, 2009

I will let you down, I will make you hurt



I wear this crown of thorns

upon my liar's chair
full of broken thoughts
I cannot repair
beneath the stains of time

the feelings disappear
you are someone else
I am still right here

what have I become?
my sweetest friend
everyone I know
goes away in the end
and you could have it all
my empire of dirt
I will let you down
I will make you hurt


if I could start again
a million miles away
I would keep myself
I would find a way

The crazy equation...

Something that I came across (once more in the hours of sleep deprived stupor) that kind of blew my mind a little. I didn't understand it, perhaps a statistician could (I was never the maths girl anyway). But obviously they create a formula to decide how much funding mental health services in any particular region will recieve. I guess they have to have some way to figure it out and budget for it... but man, seeing the formulaic translation of how much help one can expect to recieve if mentally unwell, well it packs a punch!

D = a + ΣbjIj + e where D is the dependent variable of expenditure and I consists of a set of independent variables each with its own coefficient b. The other two terms are the intercept (a) and the error (e – the component not explained by the independent variables).
http://www.health.gov.au/internet/main/Publishing.nsf/Content/8456310414827A08CA2572060016012F/$File/need6.pdf

Tell me again that we are not just numbers?

Sorry, very tired, cranky, emotional and irrational. The gremlins are gnawing at my brain. Thats all I've got for today.

Friday, November 20, 2009

Late night reading


So, I can't settle tonight. Have been using a range of distractive techniques and relaxation to try and calm myself down, but to little avail. So I have ramped it up a notch, I try and go and find something to read either online or from the bookshelf, that really makes my brain work hard, or I try and do the advanced Kakuro puzzles, or watch a documentary on the Discovery channel. Anything that will make my brain work so hard, that there isn't much space for the voices that are shouting inside my head. Sometimes it works, sometimes it doesn't, I just can't block it out enough to concentrate. Tonight I have been reading Science Blogs online. I find neurology a particularly fascinating subject because of a) my mentalness and b) my epilepsy. The universe inside our heads still has so much unexplored and unexplained terrain. We make leaps of logic and faith when it comes to treating neurological disorders with medication, because we quite simply often don't know exactly why the treatment may work, just that it may.

I can look at my mentalness from a psychosocial perspective (which I am through therapy) and realise that the manifestations of my PTSD are quite logical. If the world has proven to consistently be filled with people who violate your trust, you find it hard to trust and relate interpersonally. If your world has previously been chaotic, unpredictable and filled with painful events, you grow cautious and wary even when there is no immediate sign of danger. If sleep has been a time, where consistently you have been violated either physically or metaphorically through nightmares, your body and mind are going to fight sleep. Its logical, and makes sense.

But then if you look at it from a purely scientific point of view it gets a lot more complex.
Fear arousal, initiated by an environmental threat, leads to activation of the stress response, a state of alarm that promotes an array of autonomic and endocrine changes designed to aid self-preservation. The stress response includes the release of glucocorticoids from the adrenal cortex and catecholamines from the adrenal medulla and sympathetic nerves. These stress hormones, in turn, provide feedback to the brain and influence neural structures that control emotion and cognition
When the fear arousal activation is consistent and prolonged enough, all these hormones that have flooded the brain begin to make structural and procedural changes to the functioning of the brain itself.

It begins to affect the very neural mechanisms underlying the acquisition, expression, consolidation, reconsolidation, and extinction of emotional memories
And it is somewhat comforting to then read articles such as this

http://www.scienceblog.com/cms/new-uab-study-sheds-light-brains-response-distress-unexpected-events-27095.html

To know that we are continuing to move towards a world with technology that allows us to better understand exactly what happens in the brain of someone with CPTSD, that we may be better able to understand and develop effective treatments. Just as the invention of the EEG, allowed those of us with epilepsy to move from the shadows of 'demonic possession' and 'madness', to a clearly definable and treatable physical malfunction.

I probably don't explain or understand the science that well. But reading articles like these a) helps to engage my brain in a way that goes some way to blocking the horrible recurrent thoughts in my head for a while and b) even if I don't fully understand it, gives me hope, that despite being a dunce student when it comes to the interventions thus far, that there might actually be something on the horizon that can help me.

Anyways, I'm off to watch a documentary on the parrallels between Ancient Mayan and Egyption civilisations.... yet another realm of unexplained phenonenom...not holding much hope for sleep tonight.     

A break from my life

Not doing so good. So I am going to take a little road trip back to the town where I lived before I moved to current city of residence. There is a good solid base there of people who know me and care for me, and all my friends little kiddies, who I love to bits and never fail to at least get a smile from me. Its just an overnighter, but hopefully will allow me to come back and have a bit more of a solid base to work off.

Sleep has been shite.  Not sure if that is a self fullfilling prophecy or what. But I'm edgy and emotional, and not dealing well with the tension at home. I'm just at the had enough stage. But my only option is to give myself a metaphorical boot up the backside and get on with it.

Just another number


So, in my self indulgent melancholy yesterday I didn't really chat much about my therapy session.  Therapist (D) is off for a week now, so it will be a week and a half before I see her again, which is a little daunting.  We spent a good part of the session talking about the Crisis Management Plan, that the Public Health system has written for me, to be CC'd to the hospital ect just in case I ever need admission. She seemed to think that the person they were talking about in the plan had very little resemblance to me. I basically think, its just a piece of paper, another piece of paperwork to pad up my file that noone will ever bother reading anyway. The only significance it had to me, was just a reminder that I am being pushed out of the nest, and as far as the extra support that was lacking back in August, its just going to be there again. Step forward one, step backward one. Case Manager said that she could try and get as much flexability as she could, but there was a lot of pressure to close files. I pondered whether this had anything to do with BabyDocs sudden decision to scale medication right back. Their final recommendation is that I find a private psychiatrist. As I am already paying for a private psychologist and private health insurance, I'm not quite sure where I am supposed to pull the money for this out.

(D) asked whether the situtation made me angry, and I replied, that I couldn't let it get to me. The girl with a background of trauma and self harm is already ear marked as a PD before she even walks in the door. Having an opinion, causing too much of a fuss is a sure way to ensure that diagnosis is stamped right across my forehead, whether my concerns are valid and rational or not.  Questioning BabyDocs medication decisions too much, will brand me as a drug seeker (which I am far from).When it comes to mental health it doesn't pay to buck the system, if you want to recieve any help at all. So you keep quiet. And hope that the path they are pulling you along doesn't lead to disaster. that's all you can do. (D) admitted that with her previous experience in the public sector, I had pretty much hit the nail on the head.

I never wanted to be back in the public health 'machine', but until my Private health insurance kicks in for psychiatric cover in May, its all that I can afford. And its necessary. As a solo practitioner there is only so much support (D) can be reasonabley expected to offer.and with the nature of the therapy I'm undergoing with her, there are going to be times when the therapeutic work coupled with life situations are going to pull the carpet from underneath me. So, as I said to her, for now, Public Health is a saftey net, one filled with gaping holes, but at least there is a chance with it, that if I fall, I may not plummet to the ground smashing to smithareens. The imminent loss of that saftey net terrifies me. And I have recieved some quite positive support from the public health system in the form of my Case Manager and the Consumer Advocate

And I don't even blame the people either. They too are part of the machine, pushed to reach certain targets ect. Its a result of the Australian medical system approaching the American system, where some bean counter arbitarily decides what amount of time they are prepared to allow for you to 'get better', and past that...no funding.

So where does that leave me, come the new year? Just another number.

Thursday, November 19, 2009

Change



Hmmm... So on top of everything else, it would appear that we are about to lose two housemates. Its all very nasty and tense, and there is no exact date for departure, leaving me worried that we will be left with not enough notice to get in a new house mate, and thus be stuck with footing double the weekly rent, until we do, which is a daunting prospect when you are on a limited income.  On top of that, the whole idea of having some 'unknown' person move in to the house is quite an anxiety inducing prospect for me. Studying from home, I spend a lot of time here, and it is my little sanctuary from the world.  I don't cope very well with strangers and have been quite lucky thus far to never have had to live with somebody I didn't previously know quite well. (Apart from College, many a year back, but that was a dorm, rather than a house, so a completely different dynamic, and even then I certainly had some major issues throughout the four years I lived there. I have lived with housemates who were friends which worked ok. I have lived in flats and apartments by myself, which is what I actually prefer, but is financially unworkable now in bigger city, and I am currently living with sister, her bf (looks like soon to be ex) and his brother, which has had its moments but for the most part has been a reasonably comfortable set-up.

Anxiety is really quite high at the moment, with therapist off for the next week, Case manager off for half of next week, Bachelor No 1 overseas for the next fortnight, Xmas and all that that brings approaching quickly, Changes to medication, sleep going completely haywire ect ect ect.  Add to the that the uncertainty of the New Year, with Case Management ending, possible new housemate, developing relationship with Bachelor No 1, Increased demand from uni, with practicuum element of the course for first Semester next year.... Its just all a bit too much.

On top of that, mood has hit quite a low. Am not sure if its the season, or another bout in the boxing ring of depression is imminent.

Why is it that everything changes at once? Why is it that just when you feel like you might have the shoreline in sight, another massive rip comes to drag you back out to see?

Wednesday, November 18, 2009

Confused

I am completely confused.

I had appointment with BabyDoc today, up at the Public Mental Health offices for my region (which lucky for me happens to be on the same road I live). To start off, he was running over half an hour behind, which meant 40 minutes of staring at the bleak surroundings of the waiting room. I'm sure the staff try their best with posters ect and it is very new, neat and clean. And I'm sure that some very important designer came up with the crisp, minimalist interior.... but seriously! Grey floors, grey paints, dark chairs, all encompassed in a purpley-grey building, that looks alike an amoebic representation of a depressive cloud settling on the hill. But anyway, I waited, because I understand that emergencies ect happen.

Then I walk into the tiny windowless airless office with BabyDoc. These offices alone are enough to get my heart racing. We spoke. I told him that I had good days and bad days, and that I was trying to concentrate on sticking to a good routine and reaching out for help within my crisis network when I needed it. I talked to him about the weight gain, and my attempts to lose the weight through diet and exercise. He pretty much told me that I had nothing to worry about, and that BMIs don't really mean that much in the end, and also made the 'incisive' observation that when patients begin to worry about the side effects of their medication, it meant they were starting to get better... which from my personal experience is just bollocks.

I mentioned that anxiety and panic attacks were still an issue, but I didnt really see the point in raising the serepax, because I think you need to find a balance between throwing meds at a problem and coming up with coping strategies. I told him my sleep was pretty damned bad at the moment. He asked if I thought the Largactil was helping. I said I didn't know. He suggested it would be possible to up the dose a little. He went off to get his prescription pad, leaving me stuck in this tiny room, all by myself. As I have mentioned in previous post, there is something about those rooms that just triggers me off. Its windowless, rectangular...much like being in the back of a closed in truck container. He was gone a few minutes, and I was focussing on trying to calm my breathing, and stop my body shaking, so I didn't go into a full panic attack.

This is where it gets confusing, he comes back in, makes a joke about the airconditioning being to high (I'm not cold, douchebag, I'm trying to convince my body not to totally flip out on me) And then all of a sudden, he says, that he is going to write a letter to my GP letting him know I'm on the Serepax, but to start the process of weaning me off, oh, and just as an experiment, lets cease the largactil all together and see whether it has any affect on my sleeping. I was still concentrating so hard on not flipping out from the panic, that I just kind of half nodded at everything he said.

I walked out of the Centre, and realised what essentially had just happened. I tell him I am still having issues with panic attacks, and that sleeping is pretty bad (about 3 hrs average a night) and he a)starts weaning me off my anti-anxiety meds and b)ceases my sleeping medications.

WTF? I hate that place, I hate the system, I hate being just a number and I am really not a big fan of Baby Doc at the moment. Plus I am Scared as hell, of what these meds changes might mean, especially heading into a time as hard as xmas.

Tuesday, November 17, 2009

BabyDoc visit


Appointment with Public Health Psych tomorrow, or as I like to call him BabyDoc. Fresh into the field and all Bambi-eyed trying to deal with all the crazies around him. Its not that I dislike him, he is.... benign. And in the scheme of the public system I don't really fit into the "high triage" catergory. I'm not psychotic or delusional ect. So, he sees me every month or so at the moment, and throws whatever drugs work with 'people like me'. Cos we're all the same you know. Tick box, tick box, take this drug a, and if that doesn't work well you're just not working hard enough! Maybe I'm being a little harsh. He does take the time to try and talk to you I guess, even if it does come off uber-patronising. I guess its just a different experience to having a private psychiatrist for five years. Tomorrow probably wont bring about any major change, and to be honest, I do kind of believe, whilst I need the meds as a crutch while I'm working this stuff out in therapy, meds are not the holy grail for me.

And, it is also partly my fault. I am not comfortable enough to be completely honest with him... so I am evasive. So I will probably leave the office without him knowing that:
1. The urge to self harm is particularly strong right now (although I am thus far, resisting that urge)
2. I am sleeping about 3 hours a night
3. The noise in my head is getting so bad it actually wakes me up, and sometimes when people are talking to me I can't actually hear what they're saying.
4. I must put on a damned good show of being together, cos everyone tells me how great I'm doing. Meanwhile I've still got a plan, and a date. And with every month that passes it gets closer, without any real progress appearing to give me hope.

In fact, my Case Manager and Psychologist don't know most of this either. Who am I kidding? I'm paving my own road to hell, and there is noone to blame but myself.

So, thats why I don't really expect much from BabyDoc

Monday, November 16, 2009

There is noone else to blame


I am sitiing staring at my pill bottles. I'm not going to do anything.  But the temptation is strong... I am weary, and right now there doesn't seem to be a whole lot of point. But I am staring at the note on my wall reminding me that this moment will pass too. This song came on my MP3 player, and I just began to cry. Tonight is a lousy night

Blowing in the wind



The wind was blowing a gale this afternoon as I walked home from my therapy appointment. The promises of a storm that never actually eventuated. And as I walked along bracing myself against the wind, I was noticing the trees all about me, swaying with each gust.  And I started thinking (probably over thinking once again) about that saying about a tree needing to bend with the breeze or else it will break. I'm not very good at that. I find myself constantly braced (emotionally and a lot of the time physically) at some percieved threat or imminent storm approaching. My therapist (and others) have noticed how my body will physically close up and go as solid as a rock when I'm feeling vulnerable or threatened (which is a lot of the time). And so when it does hit, I have no 'give', I will brace until I am so tired from the exertion that I break. So that's what I was thinking on the way home from therapy today, I need to learn to bend, so that all these little smaller storms just gust by me, leaving me relatively unscathed and with enough energy to weather the real storms.

Sunday, November 15, 2009

You'd better watch out!


The ornaments are out, carols are playing ad nauseum and Santa waits patiently, in the middle of every suburban shopping centre, as irate children are placed on his lap bawling and pulling his beard. (Does anyone else find it unsuprising so many kids are terrified of santa. Here, kid, sit on the lap of this complete stranger, who is wearing a fake beard and kind of smells like whiskey. Oh, and by the way, he'll breaking into our house on Christmas eve but don't worry cos its Santa! Yes, I was an over thinker as a child too. If Santa can get in through the keyhole (we didn't have a chimney....than who knows who else can?) Christmas is definately coming, they scream at us, even though its only early November


Is it weird that I am already starting to worry about taking a break from therapy over christmas? I blame the damned shopping malls! I've already had a little trial run by missing my Thursday session last week, which had its benefits (I am studiously avoiding talking about a particular issue with (D) at the moment, and so I kind of ran away to the beach for a week) But it was an unsettling experience to have such a gap between seeing her, and that's only a gap of a week. I seem to find a certain containment in not going any longer than 3 or 4 days tops without seeing her. Even when I was in hospital she rang me every couple of days. And the thing is, I am assuming my case manager will be off over the xmas period, and probably Consumer Advocate (K) too.... which leaves me with the PA triage line. And my family... at Xmas... when everybody gets hot, then cranky, then drunk, then resentful.....then sometimes ( most times) down right nasty. Is it strange that I am aready starting to stress about it... am I pre-empting it to turn out a certain way with my negative attitude? I don't know. What I do know is that I am stressed about the break from therapy, which then in turn makes me so angry at myself, because it is so pathetic and dependent. I need to build the resilience to weather these times on my own.


Christmas? Bah Humbug!

Sisters


My little sister (A) broke down in tears tonight. And as the tears welled up in her eyes she began telling me her story. It was a familiar story. The story of our mother, our aunt, our grandmother. She met her partner when she was quite young. 17, in fact. They've been together 6 years. She tried to break up with him last year by moving to my town to live with me. But after not so long, he moved down too and she took him back. She stayed with him because it was all she knew, she stayed with him because she didn't want to hurt him, she stayed with him because she was scared she wouldn't find someone else to love her, she stayed with him because she didn't want to be alone. But she told me tonight, as the tears began flowing, she has never felt as alone as she does now, with him. It's a generational thing in our family, the willingness to settle for unhappiness in a relationship rather than alone. That's what kept my mother with my abusive stepfather for so long. I have, in many respects, been rather the black sheep of the family in this respect. I would rather be alone, than be in a relationship I wasn't happy in. My willingness to stay single (although the roots of this willlingness are far too complex to delve into in this post) have always been somewhat of an bewildering concept for my family members. But, back to (A). Her partner isn't abusive, he can be somewhat emotionally manipulative but then she can be quite cold and incisive. She just feels as though it isnt working. As she told me that she was at the point where she was beginning to no longer see the purpose of life anymore, get up, go to work, home to a broken relationship, sleep and then do the same thing over and over again, ad infinitum, I began to hear another familiar story. My story. That point at the beginning swell of a wave of depression, where life just seems to lose its sense of importance and purpose. And it shook me. Its an over reaction. She is not suicdal, nor probably even clinically depressed. She is experiencing a situational depression, probably somewhat exacerbated by her inability to communicate her feelings very well ( her legacy from the house of horrors we called our childhood) But nonetheless it shook me. Because she is my baby sister, I would and have given my life and soul to protect her. I don't want this black demon on her back too. It has made me so proud to watch her grow from the turmoil of our past to turn herself into a driven, level headed and successful individual. I have often joked that I want to be like her when I grow up. But, now was the time she needed for me to be her big sister. I had to put my own irrational fears aside. I had to tell myself that she was ok, that this was an understandable period of unhappiness and then I had to do what she needed me to do. Listen. Simply listen. Not wrap her up in my arms and protect her, not solve the problem. Just listen. So I did. I asked how long she had felt like this, I asked what I could do. She has decided (to my suprise given her character) to see a counsellor, just to try and sort out what her feelings are, gain some perspective, and maybe (hopefully) deal with some of the issue she has from her childhood. She wants me to get a referral from my therapist to somebody she thinks would be good. And I can do this. I can in someways protect her again. And I'm glad. But still, worried, always worried, after all she is my baby sister and thats what big sisters are for.

Friday, November 13, 2009

Alone and angry


The problem with developing therapeutic relationships with your various peeps in the mental health teams, is that you come to rely on it a little too much. In many ways, its a wonderful thing to be able to rely on somebody to help you sort out those nasty gremlins or simply talk you down when you are spinning out. Somebody who is experienced, somebody who can help carry the burden for a little while, when you feel to weary to go on, somebody who you begin to feel (unlike your family friends) can handle it, without it being too much of an emotional infringement on them.


And why, is it not an enfringement? Simply... boundaries. The boundaries of time and space, the boundaries of a professional relationship. My crisis plan allows for me to reach out if needed to a variety of different people both on the public team and my private psych (D). And this works well if my little spin outs happen between 9-5, Monday-Friday. I can talk to Case Manager (M), try and get a hold of (D) between appointments or even try to get a hold of consumer consultant (K). Its still very hard some times for me to reach out to these people at times, I feel like I am being a burden. I feel like I should be able to buffer my own emotions and draw on my own resiliency in times of stress. But I have begun to, and benefited from access to these people in times of crisis.


The big issue for me is the times after 5pm or on the weekend. The plan wold have me call upn a crisis line that is staffed by mental health professionals. But these are not the people that I have slowly and delicately begun to build trust in. These are not the people who already know some of my stories. I try it, but it just doesn't work. Of course, I can always try (D) after hours but the few times I have done this, she has either been unavailable or else if available, I just feel so incredibley guilty for interrupting 'her time.'


So, relevance? Well its happening right now. Its late on a friday night, and I am panicing, I am having serious thoughts of self harm... I am so angry with myself, and I don't know what to do with it. So I want to cut, badly, even though I've managed to not do it in years, the urge is there, and the urge is strong. But I just can't seem to contemplate ringing the crisis line, and I don't want to ring (D) and interrupt her weekend.


So it time to pull myself together, draw on my own strength, and suck it up....

Thursday, November 12, 2009

Run and Hide


Ok...so when I said no internet access for a week, I forgot about the beloved Golden Arches. I am in McDonalds Cafe stealing their internets!


Reality check. There were a multitude of reasons I came to the coast, but the one that matters the most at the moment is that I was running away... running away from life, running away from therapy, running away from Bachelor Number one, running away from that nasty mess of gremlins, so I wouldn't have to think or do anything about them. Unfortunately, those damned gremlins packed themselves in my bag when I wasn't watching, and instead of gazing mindlessly at the ocean as I sunbathed on a towel, I was just doing the same thing I always do, wrestling my demons, just with more exotic scenery than usual.


So... Bachelor number one. Funny, sweet, respectful, interesting, and for some reason he seems to really like me. Even after I completely wigged out on him last thursday, by not being able to say this is too fast for me, by not putting my boundaries up firmly, by dissasociating, and freaking him out quite substantially. But he was a good guy. He stopped what we were doing, he gave me space, he waited for me to come back into myself and calmed down. He walked me to the bus, sweetly kissed me on the lips and asked when he could see me next. That's all he asked. Not hey, what the hell just happened, or what the heck is wrong with you, you freak, just 'when can I see you again?".


And still, I can't just allow myself to believe he might be a good guy. So, I am yelling at myself "What the heck is wrong with you, you freak?!"


And then therapy on Monday. Of course she wanted to know how it went. I stated firmly that things had not gone as planned but I didn't want to talk about it. She did her usual little attempts at trying to get to the issue through the back door, but I successfully fought her off (Checkmate!) Why? Because I am humiliated and embarrassed and angry at myself, and I just didn't want her to know. And I didn't want to see her again on thursday, nor did I want to catch up with Bachelor number one any time soon... not because of them but me... So when this opportunity came up, I grabbed it and ran with it. But, its nearing the end of the week, I have bitten the bullets and organised to meet (B1) on saturday, and of course I have therapy on monday. Time to come out of hiding and suck it up Ophelia!


It did cause me to think however on the multitude of things we hide from our therapists out of just sheer embarrassment, even if we know them to be pertinent to the therapeutic journey.

Sex, is just not something I talk about easily with anyone, including my best friends, let alone a therapist. But sex plays an integral part in how I came to be so royally f*cked up, why I continue to act in f*cked up ways, so I kinda need to talk about it.


Any suggestions on how to get this issue out in the open between (D) and I would be very much appreciated.


P.S. The beach was gorgeous...so lucky to live in Australia with beaches like that so close by... So I did get a bit of relaxation, and sleep was slightly better (I think its the sea air that does it)

Sunday, November 8, 2009

Taking a mental health week


Lots of things going on at the moment, therapy, relationships issues, family issues, sleeping issues, all swirling around trying to suck me back down into the vortex of despair. So I am doing what I am best at.... denial... I am off to the beach for a week to (metaphorically, of course) bury my head in the sand. No Internet access from tomorrow through till Friday. Catch you on the flipside!

Saturday, November 7, 2009

My new friend


Completely unmentally health related, other than the fact he makes me smile.... meet my new friend Koda the Triceretops.

Vain whinge


I am hungry.... really really hungry.


I have ranted and raved previously about the ridiculous amount of weight the new medication has made me gain. I have tried just making sure I was eating healthily, and getting a reasonable amount of exercise. But the kilos just kept on creeping up. And by Monday of this week I was just in tears over it.


So... I have done what I never thought I'd do and gone on a shake diet. I never really thought much of them, but I have a friend who lost a substantial amount of weight on this particular program. You are supposed to have the shakes for breakfast and lunch, and then three small low carb snacks and a small low carb dinner. And lots of water. The water and the shakes combined are supposed to make you feel full. But I am starving hungry pretty much all the time! I don't know how long its going to last. I am probably even crankier and more depressed than I was to begin with.


How do other people deal with anti-psychotic weight gain?

Friday, November 6, 2009




Ok, so obviously last night when I got home was not in the best of moods. Dating.... lots of baggage there.




But anyways... therapy yesterday.




Yesterdy the focus was primarily on my experiences as an infant. Yup... you wouldn't think that there would be a heck of a lot to talk about, seeing as I obviously can't remember what life was like as a new born or a 6 month old. I suppose, the idea is basically, to go back in time and find where the fissures in "normal emotional development" occured, and build me back up form the bottom upwards.




So we pretty much worked from what I've been told by family members.


1) My birth coincided with my parents divorce


2) My birth preceeded a lengthy and debilitating depression in my mother (probably would have been diagnosed with clinical post natal depression today)


3) My mother admitted to me that she did not feel as though 'I was hers' or that "I belonged to her at this time'


4) I was an incredibly placid baby


5) There is pretty much no record of my babyhood (photos, mementos ect) compared to my sisters who seem to have quite a lot.




So, what does this mean... well.. if you look at Erikson's Developmental stages, infancy is a stage of trust vs mistrust, (sound like a common theme in my life) and Therapist (D) highlighted how, without the security of knowing that my needs would be met (with a mother that was often unable to do so, at least on an emotional level) I never had the building blocks or foundation if you will, to start learning how to trust, and with each breach of trust throughout my life, that already fragile ability became more and more fragmented. So.... that was the session.




The only other thing that was a bit strange to realise, is exactly how much I am emotionally discontected to that, and other emotional experiences in my life. My therapist (D) experienced more sadness when talking about what life would have been like for that baby, whereas I just felt little connection before.

Not a great night


"Mistakes, afterall, are the foundation of truth, and if a man does not know what a thing is, it is at least an increase in knowledge if he knows what it is not" ~ Carl Jung


I am an idiot.


That's all I've got for tonight

Wednesday, November 4, 2009

Aha moment


I must admit although I have a lot of time to watch Dr Phil and Oprah these days, I find most of what they say tripe. But, there was a phrase on Oprah today that really resonated with me (which makes me cringe, God forbid, I might become one of those people who only read Oprah book club books next.)


The phrase was "You are only as sick as your secrets"


One for me to think about...


That is all.

Tuesday, November 3, 2009

Echos of the past

Here is an uncomfortable subject for me. And one that makes me glad that this blog is anonymous and my family will never read it. Recap on family make-up. My older sister (k) and I have the same parents, my younger sister (A) has a different father. And he, well he was an evil bastard, and much to blame for a lot of my issues today. I live with my lil sis and her partner. And for the most part we get along quite well (better than with older sis, for sure) But.... lil sis looks an awful lot like SF. Same colouring, same eyes... and to a certain extent same verbal temper. Don't get me wrong, she is nothing like the abusive bastard... she has cut off all ties after he and my mother divorced. And I'm sure underneath it all she has a multitude of issues related to having to accept she is genetically linked to the prick. But when she gets angry, she will yell and scream... and it just...takes me back in time to her father who used to do the same thing. Last night, she and her partner got into a rip roarer of an arguement, and it spun me out totally. Even though it wasn't directed at me, the way she can be so cruel and scathing, like you're just a speck of dirt... its horrible.

For the most part though she is perfectly fine. This afternoon for instance, she helped me pick some clothes out of her wardrobe that she has outgrown, because with the weight I've put on with the meds I cant fit into a lot of my clothes and I was feeling a bit depressed. She can be fun, and she loves fiercely. It's just a tiny, minute part of his personality that she has inherited, andis far, far outweighed by her better qualities.

I feel guilty for even thinking it. But last night I did. Last night scared me

Monday, November 2, 2009

Its time to have the talk...


No... not 'that' talk... at 27 years old I am pretty clued up about the birds and the bees (something about a stork and a cabbage patch, right? :P ) No, today, when I entered the therapy room, I knew something was different...that I was in for big session.


People have commented that the relationship that you have with your therapist is one of the weirdest relationships you'll have. This was not such a big deal in my previous, CBTish experiences. Although I was with the same psychiatrist for nearly 5 years, the whole relationship aspect was never too much of a big deal. But in this psychodynamic therapy it is kind of doing my head in. My previous PsychDoc (Dr B) didn't really self disclose that much about herself, I knew she had two sons who were a few years younger than me (they sometimes came to the clinic after school), I knew that she lived out of town (she explained that's why she didn't always get the best mobile reception on the weekend), other than that, I didn't know that much about her and I really wasn't that curious. No more curious than I was about say, my local GP. Sure it kind of creeped me out running into her in town on the two occasions I did, but no more than a blip of 'well that was weird'.


With new Therapist (D) I know pretty much nothing about her. I know she is probably in about her 30's. That's it. Which wouldn't be a problem, except that with this 'relational counselling' I am expected to form a therapeutic relationship with her based on trust. Trust with not just the surface type emotions, but the deep, delving into your inner psyche and unconciousness trust.

With someone I know nothing about. I don't even trust friends that I have had for over 15 years that much. I have to open myself up to be vulnerable to a complete stranger, really.


And the truth is, I do trust her. She has come through for me thus far, in basically every way I have needed her to. She sat with me for hours in an emergency room, while I was being admitted to the psych wing. But does that mean I can trust her for the future. My experience of relationships has been quite often that people who you put your faith in, whilst supportive to begin with, will eventually end up leaving you hanging, just when you have come to rely on them. And she is a professional... not a friend. Ultimately however altruistic her motives of choosing the profession are, she is being paid to help me. Thus the power balance is all screwed up... with me as the vulnerable one... her as the strong one. Me as the one who is supposed to be completely open and honest warts and all, her as the one who must constantly check with herself that everything she says is therapeutic (Unconditional Positive Regard.... there's another doozy to get your head around). Leaving me wondering, what of our interations, if anything are actually authentic.


Sigh.


So, we had the talk. She didn't use the word resistance.. she thinks it has negative connotations... I believe I was the one who actually labelled it for what it was. The therapeutic process is stagnating, because I am intellectuallising, holding back, trying to please her, because I am afraid if I say the wrong thing, if I am to needy a client, if I let her see the real me, then she will leave. And I'll be left again, alone, with all of this mess to sort through on my own. It's unproductive. I need to move past that block. And I guess today was the first step in really talking about it and acknowledging its existence


She told me she has every intention of sticking with me throughout this journey. I believe her. But I also no that there are no definites, things can change in the blink of an eye. she may not be able to follow through with that honest intention. She told me this is true of all relationships. I ask her how people deal with that... she said most people try not to think about it, or they go on faith that it will be ok. I asked her what you do when you've used up your life's quota of faith. She told me you mourn the loss, the knowledge that nothing is absolute. And that is what it is to be human.


Can I be human, or am I to far gone?


It was a full on session, and I'm pretty emotional tonight. But its out in the open. I'm sure this is not the last time it will rear its ugly head in this journey. But the elephant in the room was finally acknowledged.

Let the games begin...

Make me sane...make me fat

I have put on 16 kilos in two and a half months. When you stand at 5ft 2 inches, that is a lot of weight. I have never had weight issues like this before. If anything, I have always had trouble putting on and maintaining a healthy weight. So what has changed? Well, part of my new medication regime, in additon to the benzos, anti-epileptics and anti depressants they have had me on in the past, they have now added an anti-psychotic.

Denoon states in his article "Fighting anti-psychotic weight gain" that
Weight gain is one of the major reasons that people sufferin psychosis* have a lifespan 30 years less than than the average person.

Of course, there a whole lot of reasons that people with mental health issues have on average a more limited lifespan than their 'sane' counterparts. Suicidality, of course. The interactions of medication on the vital body functions such as liver function, disinhibited behaviour leading to dangerous behaviours. Alchohol and drug abuse to self medicate problems...and yes, that includes nicotine!

But weight gain brings with it more than just the effect on self esteem, of watching your body metamorphisise in front of you, there is also the other health problems inherent with obesity, ie diabetes and heart disease

Add to that, that in the midst of a depressive episode, the motivation to exercise or to carefully moniter diet it all but lost. In fact, at times with the overhanging 'fatigue' from the benzodiazepams, I have found it sometimes out right dangerous to undertake certain exercise at certain times of the year.

So, the drug makes me sane. But I'm going to be vain and whiney on top of it all right now, what point is that when even the sight of a mirror depresses the hell out of me at the moment.

Anyway, I'm off to drink my "yummy" diet shake, and then therapy

*I am not on the drug for psychosis, more for help with anxiety, nightmares and insomnia.

Sunday, November 1, 2009

Laser stare does not equal empathy.


Following on from my previous post, there were a number of things about this psychic that made me...well... a little uncormfotable. One of those being the intense I contact that she maintained, making if feel rude for you to look away.


This is an issue I've come across in therapy, with my case manager and definately whilst on the ward. I guess there is imbedded an idea that people with poor eye contact are deceptive or hiding somthing. The reality is, in a normal conversation, eye contact averages about 30-60% of the interaction. This is because usually those interactions are whilst in the middle of other tasks or activities. Thus eye contact is reserved mostly to demonstrate from time to time that you are still engaged and listening, or to get somebodies attetntion.


In the therapy room, or in the hospital consultation rooms, there isnt that extraneous activity, and eye contact seems to be regarded as a way mental health professionals can show they are really listening and hearing. We appreciate that. But when it is spooky almost non stop eye contact.... it freaks us out! And it seems.... almost...intrusive, there is no place to retreat and gather your thoughts.


Conversely, my eye contact, jumps from a steady holding gaze when I'm looking for an answer, to crazily bouncing around thr room, taking in paintings, furniture, lint on my clothes, when I am trying to give answers... because I'm flustered. I feel like a bug under a microscope. The hypervigilance from the PTSD doesn't help matters either.


So in conclusion, 'positive' eye contact, like 'unconditional positive regard'...isn't actually always positive. It makes us feel unsettled and it makes the health professionals seem specious and artificial. JMO.