Becoming a group person

Like a lot of people with mental health problems, I lean towards isolation. The energy it requires to put on a good 'public' face is just sometimes a little too much. I also am not much of a "group" person. One on one, I do ok, but too many people, I can get anxious and overwhelmed. But I am doing reasonably well at the moment, and really trying to be proactive from a recovery standpoint. (M), my Case Manager took me to visit a Mental Health house with a Peer Support slant last year, when she first started seeing me, but it was just not the right time for me. But, (with further gentle encouragement from M) today I went along to one of the group sessions, to see how I went. And it went suprisingly well. The group was quite small, and they were very welcoming without being pushy. Just "glad you came, hope we see you back again". There are a variety of interesting groups including Art, Music, Women's and Under 30's. And it was not as I had feared (and experienced when I tried one of these places in a different city many years ago) all centred around talking about illness, or worse, competing to see "who had it worst". The focus seems to be about providing social opportunities to those of us who struggle with it, something that gets you out of the house, particularly when all your sane friends are working 9-5. Providing support that is Peer support, from people who have a lived experience of mental illness, and outside the medical framework. Which is a real attraction for me... as I feel like I spend most of my life in either a Doctor's or a Therapists office. A real chance to meet people of similar age and experience, who will accept you as you are at that moment in time. Time will see if the experience continues as well as it did today I guess. I particularly liked when one of the PS workers was talking to me about how they didn't focus on diagnosis, as that didn't define the person, their day to day experiences and general personality were more important. It wasn't denying the impact of the mental illness, but rather looking at it in a broader sense.

I'm quite proud of myself for actually going. The support I recieve through blogging is great, but to be able to get some of that IRL would be good too. And as much as I love ya'all, we can't sit down for a coffee, ciggie and a chat, ya know? So, I guess I kind of achieved two things today...a possible addition of support, socialisation and activity, and a sense of achievement for being able to stepout of my comfort zone and face my fears....

I'm working quite hard on the isolation thing at the moment... taking the opportunity while I feel well to reconnect with friends and increase my volunteer work. My friend (S) and I are going to a Farmers Market tomorrow morning, which I am looking forward too, especially picking up some oh so yummy bannana bread and cheap fresh flowers. The parentals are also coming to stay for the weekend, which means Big Sis will probably be over a lot.... which can create a lot of tension... but I'm going to try not to get drawn into it and just enjoy the time with my mum.

In other news, I am on the third day of my Serepax tapering down. We've just removed the midday dose at this time, but I guess its going well. Mostly it's just a physical anxiety in the afternoons, not really worrying about anything mentally, but the body is responding like I am. Trying to use a combination of relaxation techniques and distractions, reminding myself that its my body's reaction to the medicatio withdrawal and will pass, rather than 'true anxiety'. I've found bubble gum and blowing gum bubbles is a handy trick for redirecting the physical frenetic energy when I am stuck in a place where I can't move about, or when I am trying to concentrate on TV or something.

Peace and Love
xOphelia

Driving under water ain't right!

I discovered today that I don't like tunnels. I mean, I really, really, truly despise tunnels!

See, we ventured over to the northern suburbs today. My lil sis ( also my current housemate), her bf (soon to be my new housemate) and I. Our journey across the river was to look at some of the suburbs to determine where we will be moving to when our lease runs out in a few months.

Now let me say here, I don't actually want to move. I like where we live. I like the freedom I have from me close to a major shopping centre and fantastic public transport into the city. I am comfortable with the people who work with me from the Mental Health district that services the south-eastern suburbs. I like my GP. I like my pharmacist. (When you are on as many medications as I am, and they are dispensed weekly, you develop quite the relationship with your pharmacist!) I can get to my volunteer job easily. I can visit my friends easily. It has become familiar and comfortable and workable. Sigh. But I also like (for the most part) living with Lil sis. I can't afford to live by myself and I would not cope moving into share accomodation with strangers. So, the time has come for compromise. She wants to move in with her bf. He works on the coast. He is prepared to move to the city to live with us, but in order for his work commute to be reasonable that means we need to live on the other side of the city. At first, they wanted to move to one of those "Lifestyle" gated communities, pretty much as far north as you can go and still claim to live in *our city*. You know the places, where they advertise how you'll rollerblade around the fake lake, and take walks every evening... blah blah. As if a physical move suddenly turns you into a fitter, healthier, relaxed, more active person. As if that's all it takes. Problem being, it would take me well over an hour just to get into the city centre.

So we are working on a compromise. Far enough north that bf is closer to work, and can get on the motorway avoiding too much heavy traffic in the morning. But closer to the city and public transport, so that I can stay independent and not totally isolated. It means I will have to move to a different Health District (but maybe by then I'll be discharged from the Mental Health service anyway?), find a new GP/Pharmacist, and getting to work and visiting friends will take a little longer. But it's a pretty fair compromise I guess. I just don't adjust to change very well. Sigh. The good news is that it is actually on the same side of town as my therapist, so if we get somewhere on the right busroute, the travel time there might be reduced.

Now I said we had to venture across the river. Thats not strictly true. Lil Sis had the bright idea that instead of taking the bridge, we should take the new, you-beaut tunnel they have built to bypass the city, that takes you under the river. It was horrible. My skin got clammy, I started hyperventilating, I felt totally trapped. Ugh. They spent a fortune on this tunnel bypass, but hardly anyone uses it, even though they've dropped the toll to try and increase the traffic. And now I know why. It's just not natural, driving under all that water. But lil sis thinks its great, because its cheaper than the bridge and you avoid the traffic. So on the way home we took it again. Ugh! It was not a phobia I was aware of until today, but its easily hit the "Top 5 Things that freak me the fuck out!" list.

I think therefore I resist....

I am a person of reasonable intelligence. Some have said above average intelligence... I don't really know, there always seems to be people out there that are smarter... but my brain has certainly been a strong part of my identity and day to day functioning.

But is it getting in the way? Certainly, I have always known that I have a tendency to over-intellectualise issues as a way of calming the not so rational world of emotions. And in many ways, that's been a saving grace. I am able to rationalise away when people's actions hurt me, rather than acting out from a purely emotional stance, which enables me to save relationships. I am sometimes able to rationalise away unpleasant feelings or moods if they are making functioning in life difficult. It gives the distance needed to react in ways that are productive rather than destructive, ordered rather than disordered and chaotic, fair and rational rather than unfair and irrational. It's part of the grease on the wheels of civilisation, I feel. To act from the evolved, thinking part of the brain, rather than the animalistic instinctual parts, or the slightly more evolved, yet largely unconcious emotional parts of the brain.

But as an annoying American TV therapist would say..."How's that working for you?" Obviously not so well, (see multiple hospitalisations, bucket loads of medication, and three therapy sessions a week) There are things that can't be held in check by rationality and intellectualisation. I have to admit so much of what goes on in my mind has little to do with that small, evolved, intellectual part. And in order to deal with those uncontainable, unrationalisable little gremlins that are running about, I need to be able to talk about them in therapy in their native language... the language of emotions. I am book smart but my emotional intelligence is lacking, to be sure.

Obviously, this came up in therapy today. And maybe it does have a lot to do with why therapy has stalled a little or to reference my previous post become a little tedious. Because there isn't anywhere to go until I learn to speak from emotions. Ugh. I hate emotions. I often will sit there in session and think, I should be feeling something about this, and underneath it I am, I just often can't access it, or identify what it is. When (D) asks me "I wonder what you might be feeling right now?" and I say "I don't know" I am not being difficult, I just can't quite put my finger on it and name it. And then the one of the two basic feelings that I do see to be able to identify 'panic' and less often 'anger' flood in and override the more subtle emotions... sadness, despair, vulnerability, shame.... an endless list.

I seem to have gotten better at identifying the physical elements of the emotions and with (D)'s help linking them to a named emotion. Sadness sits around the jaw, tight and wound. Shame creates a bodily feeling of disconnection... a rejection of the physical self really. But still there is an inherent disconnect between the naming and basic somatic reactions and any deep understanding of what the emotion actually is.

Looking back at therapy sessions this evening, I have come to realise how much I employ intellectualisation as a defense mechanism. Arguing semantics, being pedantic as a form of deflection, looking for the flaw in each persuasive arguement my therapist makes, much as I used to try and tear apart the opposing teams position in High School debate. Not really caring so much about the position I am taking, but more about negating the position she takes. Deflect, deflect, deflect. Anything to keep her, and more importantly myself away from peering at the primal wounds. And so often I haven't even realised I am doing it.

But what do I do? How do I make myself drop this defence? Recognising it is a good first step, admitting it to (D) and allowing her to call me on it another good step. But beyond that... how do I speak this language I just don't understand? I don't know how to communicate these things. Even this blog post... entirely rational and intellectualised.

Let's give it a try... At the moment I feel... pretty tired (ok, so that's more physical)... hmm, a bit anxious... but my mind immediately jumped to rationalising that as the fact its late at night, which is the worst time for me so I generally feel a bit anxious at this time of night. Ok...why anxious? Nights are a time where I feel vulnerable, like I am open to attack, I feel quite childlike like a little kid terrified of the boogie man in the cupboard, 90% of you knows its not there, but the other 10% can't be that certain. Ashamed, because I am a grown woman who is still afraid of childish things like the dark and the monsters that inhabit it. Fearful... it always sits in the pit of my stomach until dawn breaks or I fall asleep. Sigh. I don't know. Is that the way you do it? Maybe typing them isn't the way to acknowledge the feelings. Maybe I would be best to just lie quietly and let them come, yep thats fear, that's what it feels like, now let it flow on and feel what comes next? Maybe thats one way to start learning this language in a way that's more about understanding then just knowing the words. Does that even make sense?

I am so confused right now... and I really don't know how to start chipping away through this so we can start doing the things we need to be doing in therapy.

Peace and love
xOphelia

Itty Bitty Tanties

Ok, so maybe I threw a little, eensy, weensy, tiny tantrum in therapy today. Highlights included telling her to back off, stop patronising me, screwing up my fists and lasping into a sulky, scowling silence for the last 15 minutes or so of the session. And yes, it probably is still a good thing therapeutically, working through transference issues and having the chance to experience and express (however clumsily) anger in the safe containment of the therapy room. But ultimately I'm left feeling like quite a prat, and am feeling quite embarrassed at the prospect of going back. And I maintain, for today at least, THERAPY SUCKS BALLS.

Had my PsychDoc appointment, and it went pretty well. We're going to put off the benzo withdrawal for a fortnight or so. With the current little slump I'm experiencing, its just better to wait until things stabilise a little. But then hopefully, we'll start a slow withdrawal process, and sometime (in the hopefully near future) I will be completely off the Serepax.

Other than that I'm just trying to focus on keeping a positive attitude. Its just a little slump and it will pass. It doesn't mean that things are spinning out of control. I will sleep again. And I will feel happy again. This too will pass.

Spoke to Case Manager (M) and she said to give her a call if things continue to be a bit down, otherwise I will see her next week. I guess a part of me just doesn't want to admit to them how low I am feeling, because I want to be able to handle it myself, there isn't really any particular problem that they can help address, and probably a little bit of pride as well.... I was doing so well, I hate that I wasn't able to keep it up.

Anyway, Lil Sis and I got some boxed sets...so we'll be watching Outrageous Fortunes, True Blood, and the first season of Glee for the forseeable future.

Peace and love
xOphelia

I don't wanna and you can't make me, so there!

So feeling much better. Sleep seems to be slowly improving which is fantastic. Had a bit of a funny converstion with Lil Sis this evening:
Me: Why is it that the "Woman's Day" (an Aussie Magazine) is only released weekly and the "Woman's Weekly" is only released monthly?
Lil Sis: Well, it wouldn't sell very well if they called it "Woman's Monthly"
Me: Touche, Grasshopper, Touche....

Therapy was interesting today. We got talking about my little irrational crying jag on Saturday night. I mentioned that I knew what had triggered it off (a movie I was watching) but that wasn't really the reason I kept crying. The crying jag was completely out of proportion with what I had seen. That being said, I really wasn't entirely sure of what was behind it... but it was more than what I had seen on the TV. Here is where it got a bit tricky, because obviously her next question was what I had been watching that upset me. And I didn't want to tell her. She assumed it was because I was embarrassed and I let her think that. But it was actually not that at all. The truth was, I knew if I told her what it was, she would read way more into it than was necessary, and we would be caught up in a conversation I didn't want to have. I'll share it with you, my dear readers. The movie I was watching was "MASH- the movie", quite an oldie. The scene that upset me was when Hawkeye was in a bus, trapped behind enemy lines, and they were trying to keep as quiet as they could so the soldiers wouldn't know they were there. But there was one Korean woman with a baby that wouldn't stop crying and was putting them all at risk of being found. So in desperation, she smothered the baby to death. It was really quite horrible. And of course if I shared this with (D) than what direction do you think the conversation would take. Mother who sacrifices her child for her own survival. Easy to see where that would lead to in a therapy situation.

So, I didn't tell her. Which she accepted, but of course then we had to examine why I didn't want to tell her. Sigh. I felt myself digging my heels in even harder, which was not helpful and really, I was starting to annoy myself. I felt like a petulant child. But I also didn't feel like I could do anything about it. I knew I was being childish, but I couldn't stop myself. So I did the next best thing. I talked to (D), she pulled the old therapy chestnut "what's going through your head right now". And I answered honestly, that I felt like I often was behaving like a petulant child, and that I didn't know how to stop myself, and be open and less stubborn so that we could actually have productive session. We spoke about it for a while, and she posited that when a child behaves like that it is away of them creating that seperation of self from a parent, and maybe I was doing it to create that seperation of self from her in the therapeutic process. Which annoyingly, made sense. Freaking transference. If I was to talk about this process to any of my friends, they would just think its bloody weird. And it is. But it is helpful. Sigh.

Anyhow. I'm applying to volunteer in the children's ward across from the RMH, which I think is a good step toward filling my life with productive and meaningful stuff. Job Hunt 2010 still goes on. Hopefully I should hear back from the Disability Employment Ofiicer soon. Tomorrow, I've got therapy again and then an appointment with Psych Doc. And then in the afternoon Lil Sis and I are going to go shopping for new DVD BoxSets to keep us entertained. Any suggestions?

Peace and Love
xOphelia

Musings on dependency

I have spent a lot of the last 12 months in therapy terrified of becoming overly dependant on (D)'s support and the therapeutic process. The psychodynamic therapy we are undertaking is somehow a lot more confrontational in this aspect than my previous therapy ever was. Whether this is indicative of a different type of therapeutic alliance or the difference in therapeutic orientation, I'm not sure. Perhaps a little form column a and a little from column b?

Trust and attachment are intrinsically intwined with dependency in my mind. If I allow myself to be open enough with a person, to share parts of myself and allow myself to accept and derive comfort from the relationship between us, if I allow myself to believe, that maybe, just maybe... I can trust that this person is going to stick around and not turn from the 'darker' aspects of me and my life... if I can believe that any of this is possible, than certainly I would want it, need it even and I wouldn't want to let it go. Always that belief that I would overwhelm people with my needs if ever I was to allow them to show.

Dependency, of course has developed a bit of a bad rap. Even amongst some of the MH professionals who really should be able to look at the issue a little less simplistically. Dependency is for infants and children, as adults we should apparently be able to look out for ourselves. At least this is the message we are given. In the public health system, "service users" may find themselves fighting and (sometimes losing) to access the services that they feel they need. The MH system creates an atmosphere of fear, fear of dependency on hospitalisation, fear of too much dependency on individual professionals, fear of dependency on medication, fear of dependency on benefits... the list goes on and on. And some of them are valid fears in certain situations. But the blanket, knee jerk reaction to these, and the suggestion that any form of dependency is regressive and not mentally healthy is unhelpful.

Yes, for some people and it some situation hospital can foster an unhealthy dependence on an 'unreal' world.  I think that's a possibility for anyone who is hospitalised. The world outside can feel scary and unsafe and full of decisions, that to suspend those responsabilities and know that you are at least physically safe for a while is certainly tempting. And it can be hard to know when you are actually 'able' to handle these things in the real world on your own. And of course, we have all heard the blanket dictate that anyone with a personality disorder will not benefit from hospitalisations (never mind if they have co-morbid depressions, suicidal ideations, psychosis etc) It's such a simplistic approach.Each situation should be looked at individually, rather than unbendable policies being enforced because of the bad rap of dependency. I myself have never had any issue really with accessing hospital care, but I read all the time about blogger friends who do, because of their labels, and it just seems so stupid to me.

Whilst I have not had much trouble accessing hospital care, my fears around dependency spring up in other areas. Dependency on medication. Now this is a funny one. Because whilst the MH professionals seem to make such a huge deal (rightly so) about the addictiveness of the benzos, it doesn't prevent them from dosing me up with them, and everytime that I have started to try and reduce my dosages, it has been at my suggestion rather than theirs. So on the one hand they help to create this fear of dependency, but on the other hand they continue to hand me medication, at times (not so much lately) it feels like hand over fist.

Within Case Management in the Public Mental Health system, I did undergo a little bit of stress at the end of last year in regards to being discharged from the service. The accepted thinking of the service is that they want to a) develop the individual's ability to soothe, contain and problem solve themselves and b) create a system of support that is community based rather than based on the mental health system. Fantastic in theory. But what I have found is that even while focusing on my ability to soothe, contain and problem solve myself, there are times when I am able to do this and times when it is a bit harder. In relation to developing community support, its great in theory, but the reality is that the average 'everyday' person is just not equipped with the skills, experience or ability to distance themselves as MH professionals are. So, some dependency on the service is necessary, and unless my MH issues disappear, potentially this dependency will exist for quite a while. But it waxes and wanes. I don't feel the need to pick up the phone and ring my case manager for every little issue (or even some of the big issues), we have cut contact back to once a fortnight, unless something comes up and that will probably reduce even further as things continue to go well. So, I think I am dependent on their being their as a safety net, but I don't feel its an unhealthy dependency.

Then we get to therapy, ah....therapy. The dependency that can be fostered in therapy is probably the scariest, because (D) has so much information I have trusted her with, so much insight into my thought processes and feelings, that she really has the potential to hurt me big time. She is a person who consistantly supports, holds (emotionally) and cares about me. Encourages me and helps me to learn. Sound familiar? Yup, as much as I hate to admit it, she has taken on a somewhat motherly role in my life.  And what happened with the last mother in my life? Let's see... I was a dependent infant, and she was emotionally and physically absent due to her PND. She entered into a realationship with a violent alcoholic and allowed him to physically and emotionally hurt her babies, once again failing those who were dependent on her for protection She then (as a way of coping) withdrew entirely from those dependents abandoning them into an environment where secrets and darker, traumatic abuses could take place. So.... yeah.... feeling dependent + a person who acts in a motherly fashion = big fears of reenactments of past traumas and let downs for me. I do a dance with (D) of throwing up my cast iron shell, and letting in tumble and letting her in. Is the dependency I'm experiencing with her a bad thing? From a psychotherapeutic aspect of course all the transference issues that are brought up allow for great opportunities to explore, reexperience positively and grow. But she is not my mother, and I am no child. What kind of dependence is reasonable and sustainable? I guess this is where the boundaries come in. And (D) is pretty good at making those clear and keeping to them I guess. Sessions are consistently within the same frame. Time, structure, she's never late, always dependable. Contact outside of session is thoughtful and purposeful, whilst still flexible enough around times of crisis. The other big hurdle was me. Accepting that I need this woman, that I rely on her and thats ok. But I still keep my eyes open, still put all information and suggestions through my own validity tests and don't rely on her for *all* of my emotional needs, because a) she is only human and b) as important a part of my life as she is at the moment, by very defination she will not/should not be around for ever, and will never be a solid presence in my real day to day life. And that ,I am beginning to realise, is a healthy dependency

Why I'll never use a face mask again!

Therapy has been interesting. (D) and I were talking about how I have been able to contain the unpleasant stuff that's being brought up in therapy to the therapy room. Part of the problem with therapy in the recent past is that when things were brought up in session I have carried them into my outside life, ruminating and growing more depressed and anxious because I become overwhelmed with it all. I had thought that this new ability to contain it could only be a good thing, as it allows me to work on what I need to work on in a safe place, but not carry it with me to a place where I don't have that safety and support. (D) however, queried whether I might be repressing or avoiding the issues outside of therapy. For some reason this caused me to become extremely agitated. I think maybe because I felt a) like "shit, I thought I was doing good... obviously I can't do anything right" and b) annoyed because why does she have to go and mess with a good thing? (D) expanded saying that she just wanted me to be aware that whether I was doing well or not so well, she would not turn away from the parts of me that remembered the distress and hurts, and she didn't want me to either. I'm not really explaining this very well, and to be honest, I found it all a bit confusing myself. The conclusion we came to in the end, is that for the moment I need her to hold that distress for me within the therapeutic frame, because I cannot hold it by myself outside of session and still retain any semblance of balance. So maybe its a little avoidance/repression, but it's working for now. The analogy that comes to my head is that its kind of like keeping a child safe. When they are very young to keep them safe you have to attend to them all the time, leaving you no time to do anything else. Which is why parents will employ safety pens. Still interacting and keeping them safe, but with the ability to turn away and attend to other things, and know that it will still be safe for them. Therapy is the safety pen, and that distressed part of me is not yet able to be left unattended. As I mature emotionally, like the child, the distressed part of me will be able to venture out of the pen and spend less and less time needing to be constantly attended to and monitored. Anyway. Interesting session. Then in todays session we broached the subject of my "being unseen" as a child. Particularly within the mother-daughter relationship. And the way that affects me today. In particular, my automatic assumption that I am doing something wrong. (see above) Basically, she posits that as a result of my mothers post natal depression, my father's abandonment of me as an infant, and my sister's complete ambivalence about my existance (she tried to get rid of me by hiding me behind a wood pile as a baby) that I have come into this world feeling "unseen" and trying to remedy it by being the 'perfect child' and when this failed to make me visible to my family assuming that I was doing something wrong to be unworthy of acknowledgement. The whole idea that family dynamics of my infancy could really have any impact on me today seems a little odd to me still, but as (D) pointed out the dynamics have become set and remain to this day. My sister would certainly try and hide me behind the wood pile today if she could get away with it and she's 29 years old! Lol. And, whilst I think my mother really did 'see' me for the first time when I was in the ICU post overdose (not a great way to be seen and not something I wish to repeat!), I think as time has passed, we've slipped back into those old comfortable dynamics, where I am invisible once again. Anyway, we left it there and will pick it up again on Thursday. Gosh! Therapy makes my brain hurt sometimes, but I feel like we've finally scraped passed the first few superficial layers, not to the core yet, but its progress.

I got a call today from the mother of the kids I've been babysitting, to let me know they've come up with chicken pox. Sigh. First, this means I'm out two days work, because I was supposed to look after them until the end of this week. Second, I have never had chicken pox, so gulp! I've been exposed to it a few times through my work with kids though, so I doubt I'll catch it this time, if I haven't caught it so far. But it has reminded me that I do need to go and get the vaccine. If I catch it, it could take up to 21 days to show up. So, I promptly texted (D) to ask if she had had it (weird conversation to have with your therapist) but sitting in close proximity to her 3 days a week, and not knowing about her life (if she has regular contact with infants, pregnant women or people with suppressed immune system) I figured it was best to ask. I'm pretty sure I won't get it, but I'm going to be a little careful about where I go for the next few weeks, as the most contagious period is apparently before you get the rash.

That being said, I do have a Neurologist appointment and an Ultrasound appointment this week that I can't miss. Neuro is tomorrow. I'm not expecting much out of it. Seizure control not the greatest over the last two months, but this is pretty much directly proportional to fatigue so not suprising. That being said, since I got back from prac seizure control is pretty good, so obviously the medication works, just not in the face of crazy insomnia. Anyway will get the results from the sleep deprived EEG. And PsychDoc wants me to check with Neuro about the possible ramifications of reducing my Serepax (anxiety  med) on seizure threshhold. I still have that niggle in the back of my mind after all these years that possibly some of my seizures are pseudoseizures. I have been definitively told by specialist that at least some of my seizures are genuine epileptic seizures. There are certain things I won't go into that help them make that diagnosis. But, as my seizures are at times still medication resistant and as I already know well, I'm a bit of a nutter, I wonder whether some of them may be psychosomatic or stress induced. I can never get a straight answer from Neuro Doc, maybe because they have no real way of telling other than 'catching' a non epileptic seizure whilst EEG monitoring. I don't know why it bothers me, other than the fact that if the breakthrough seizures were pseudoseizures...well then there is a chance I could get rid of them, as medication doesn't seem to be the answer. I don't know, grasping at straws I guess. I try not to let it get me down, but the seizures are disruptive, exhausting and really make me feel out of control, which is not a feeling I deal with well.

I've recruited (S) to drive to me to my ultrasound on Thursday, as I'm planning on taking a lot of medication to get get me through it without a freakout. So probably not a great idea to be on public transport. God, I am cringing just thinking about it. I do have a good friend there though, willing to get up early on her holidays to drive me across town to the hospital for this extremely embarrassing and anxiety provokign test. Thursday night our other friend (SC) is coming into town and the three of us are going to watch the season finale of Glee and have a sleep over (yes, I am 27 and not 14....but meh!) This means the girls will be here when my Case Manager comes around on friday morning (if she still comes, have to check her chicken pox status first) but they can hang out else where in the house for a bit.

All in all still in a reasonable mood. Sleep not perfect but still far better than normal. Biggest disruption at them moment is (you can laugh at me, its pathetic) I did a face mask last friday and had an allergic reaction, which I've never had before. I got it off pretty fast, but I have this welt on my left cheek bone, requiring ample amounts of make up each day, and the top layer of my skin has kind of burnt off on my forehead, cheek bones, under my eyes etc. So, have been using lots of moisturisor and taking make up off as soon as I get home.... but its getting to that itchy stage of healing and driving me nuts at night! Sigh, the stupid things us girls do in the name of beauty! Luckily its not all that noticible under make up....embarrassing much?

Anyway... off to slather on moisturiser and attempt to get some sleep.

Peace and Love
Ophelia.

Lokking hot!

Successful day. Managed to amuse myself quite well. I am particularly pleased with my new hair colour. A really nice chocolate brown colour, perfect for winter! Plus I did a treatment on it, so its all shiny and healthy and purty! I tend to be fairly lax with my appearance for the most part, can't muster up the energy to care... but at the moment I am feeling quite good about myself, inside and out. I look hot! Well....apart from the excess kilos from the anti-psychotics, but we won't talk about that!

I spoke with my mum on the phone this evening, and she is quite happy to hear how well things are going. However, she has been helping out financially for the last three months, paying for my third weekly session. And now that I am doing a bit better, she is questioning whether I still need the third session. I kind of agree with her, and really would prefer not to have to take their money... but I think maybe I need to have this stability for a few more weeks before we go changing things. I'm lucky that she has been able to help out with that extra $120 a month, but I get the feeling from my family a lot that they just don't see how I possibly NEED to see a therapist 3 times a week (or even twice or once). They just don't understand that stability doesn't necessarily mean everything is fixed now. Obviously I don't plan on being in therapy forever and certainly not at this frequency. Sigh. It just puts a lot of pressure on. And I guess that was why I was reluctant to accept the money in the first place. To allow somebody else to have a stake in it, and feel as though they have a right to an opinion on frequency or effectivenss. She is going to put in money for another month. But I think if after that I still need it, I am just going to have to find the money myself.

Anyway. Therapy tomorrow. And this week I have a meeting with PsychDoc, one with Case Manager, one with Neurologist, one for an ultrasound and of course my other two therapy sessions....so chock-block appointments. Blah!

Peace and Love
xOphelia

Back in the saddle

So after a blissful week of lying on the couch stuffing my face with chocolate and watching crappy daytime television relaxing, today I ventured out into the world. A good chance to take this happiness for a ride and see what it can do for me. I smiled at strangers on the bus, and they smiled back. Sent a warm tingle down my spine. I kind of feel like the fog that veiled me from the rest of the world is lifting. Dramatic much?

I had my first shift back at RMH and it was great. Very easy shift with lots of time to chat with the parents and play with the littlies. I was also given a bit of a project, cleaning out the playroom cupboard and making a list of toys, books etc for the house manager to buy. And we all know I love me some organising! My OCD tendencies had a chance to shine as I not only divided the books into age appropriate groupings, but then grouped them according to genre and alphabetical genre! Lol. They have already roped me into doing an extra shift tomorrow.

I called home and found out my mum's hubby got the job he was going for, which is fantastic news, as it was beginning to look like he might have to move away to find work... not great for a newly married couple. But he got the job, so they can stay settled and living close to my grandparents. He was also really sweet about the decision I've made regarding uni, and told me that he was really glad that I was sounding so good.

On the way home I swung by Grill'd, this gourmet burger franchise that I am totally in love with! The Zen Hen burger is to die for. I ran into and old work colleague and we had a little catch up which was great. He could always make me smile.

Tomorrow I have a full day, babysitting all day, straight to therapy and then straight to RMH to work the evening shift. It will be exhausting, but all fun... well apart from therapy, but its been ok recently...guess it just depends on what direction she decides to push.

I'm listening to Jason Mraz at the moment, which is beautiful and quite upbeat too, and soon I'll head for the comfort of my doona and pillow. Sleep is still remarkably good. Yay!

Peace and love
xOphelia

Just plain scary

I guess "normal" is a subjective thing in any context, but probably especially to mental health professionals. In the last few months I have definately had some experiences that fall outside the realm of normal for me. Things that make me feel like I may actually be losing my mind. In particular, hallucinations (though these do seem to be linked to periods of extreme deprivation and seem quite benign when one considers what a hallucination could be.... its more shadows in my peripheral visions, strange patterns dancing off the wall and carpets ect) and dissociative states. Up until today, I would have said that I have experienced dissociative states beyond that which an average person would...we all do it, some of us just do it better than others I guess. Particulalrly in periods of real stress, ie after a horrible session, i would have no real memory of how I got home or what I'd been doing...it was like a mist I would slowly emerge from. But if I thought really hard, i could pinpoint the pertinenet details. Maybe not conversations, but yes, I saw that person. Maybe not how long, but I was in the Park for a while stuff like that. Until today. Today I blacked out an entire hour and a half, and I honestly have no recollection of what went on. I have evidence. (A new tooth in my mouth and an appointment for next month) but I went from lying in the dentist chair, beginning to panic, to being at home sitting on my bed, with an aching jaw and no idea how I got there. Just Blank. I even checked my medication to check i hadn't taken something. And frankly it scared the living shite out of me. Because I must have appeared normal-ish to the dentist or they would have kept me there. Or called someone. So "me" can leave my mind for an hour and a half and have some other seperate part of me take over, and no one notices?

I spoke to (K) and finally to (D) and (D) reassured me that everyone dissociates and whilst this was an extreme example it didn't mean I was going nuts. In fact given my fear of dentisits (not the pain, just feeling trapped and having things shoved in my mouth....flashbacks...enough said), given that I was alreasy under a wee bit of stress because the new attempt with efexor was not going to plan (same reaction, vertigo, but we're going to push on and see if it abates) and given that in general it has been a stressful few weeks, and there are a lot of changes coming up... it is quite understandable that it would happen. Rationally, I see her point, just as I did about the hallucinations, just as I do about the 'voices'.

But there is another part of me that thinks voices+hallucinations+losing periods of time is pretty much just leading me toward a nice cosy padded cell. It may be normal, expected or understandable to them, but to me it is just plain scary

Weird or what?

Health related, not mental health related. So, living in Australia, land of skin cancer, and being a fair-skinned red head (at least I think that's my hair colour, I have been dyeing it since I was 14, so am a little unsure as to what the natural colour really is now....) I have to keep an eye on moles etc. My Aunt had a very nasty melanoma cut out years ago, so we have had the whole sun safety thing drilled into us. I get them checked once in a while by my GP. However, I noticed about a week or so ago, my body seems to have "eaten" a mole. That is...there was a mole on my chest, and now there is just a white circle where the mole used to reside....Hmmm... does this constitute a change requiring a checkup? They say if they change shape or colour...they don't say anything about if they just fecking dissappear on you! Maybe I should make appointment with GP just in case.

Mental Health related. Well, kinda shite. Lil sis, off to the coast for the weekend. Me, alone in the house with cats and thought gremlins....and liquor. Got a little drunk last night, just to mute the voices in my head a little. Wee bit of self harm... Not good. Up today. Did housework, gardening, headed off to BBQ. Spoke with (D) Worried about being home alone again tonight. Spoke through my options and decided to give it a try, with some caveats. No drinking. Check in via phone with a friend later tonight. Brunch still on for tomorrow. Am being well behaved. And the thought gremlins are kicking my arse for it!

Am off to read some blogs, drink my milo and cuddle my cat

Showering

Lil Sis turned to me this afternoon and said "You know, Crazyboy is going to be here soon...." Crazyboy, is her new...erm...Bf? Fling? Bit on the side?... its all still a bit unclear. He lives on the coast, about an hour and a half away. She has been heading down there every weekend recently to spend time with him. I guess, after four months of living with her ex AFTER THEY HAD BROKEN UP, she now feels free to pursue something different. I can just hope that she doesn't rush into things. Anyway, I've only met CrazyBoy once when he came down the other weekend to go to the waterpark with us. I'm sure he is a nice guy, but he is soooo full of energy, its drives me insane. He never stops talking. He acts and speaks on impulse. Its like he is the re-incarnation of a Golden Retriever. But.... he makes her happy, and its been a while since she has been happy. And anyways, she usually goes to stay with him.

But this afternoon he was on his way to spend the weekend at our house. Sigh. She tried again "He's going to be here in 15 minutes..." And left that hanging in the air, as she looked me up and down meaningfully. I paused, and did inventory. Last shower, two days ago. Hair stringy and pulled back with a headband. Attire, pajamas with a chocolate stain on the top. "Right, so you want me to have a shower then?". "Well, maybe even just put on a bra?" she replied hopefully. Grudgingly, I made my way to the bathroom to human-ify myself again.

I get it, I do. I mean, that's one of the good things about living with family. When I'm not at my best, and schlepping around unwashed, in pajamas, she accepts it. When I am incommunicative and lying in bed for hours staring at the well, she knows its because I'm having one of my bad days. On the days that I HAVE to go out and face the world, I have to make some effort, but at home, I can just schlep if I don't have the energy. But Crazyboy doesn't know me. And in the bloom of a new relationship, slovenly, depressed sisters aren't high on the romance scales.

I get it. And really, showering and wearing day clothes is not that much of an ask. It's what normal people do. But there is a tiny part of me, that is ever so resentful that for the near future, I am going to have to put on "Game Face" in my own home.

I'm not very good at psychotherapy

I am a thinker. By no means the most intelligent person in the room, but I appproach the world analytically. I have an innate need to find reasons and explainations. I thrive on finding the rational and logical reasons behind other people's and my own actions. In some ways, it has been my greatest defense throughout my life. As a child my intelligence protected me on two levels. First, as a precocious child, who learnt the rudiments of reading and writing at around age 3 (according to family history) I used these skills to escape from the turmolt of my early life. I wrote stories, and later discovered the catharsis of poetry and journal writing. I read ferociously (easily plowing through the 15 books we were allowed to borrow from the library each fortnight) to escape into worlds that were anywhere but mine. Second, I used my ability to analyse situations in order to predict what was going to happen, in a very unpredictable home. I was highly in tune with my surroundings, people's emotional states and motivations. And thirdly, I used this understanding to allow myself to retain relationships, I could find a reasonable and rational explanation to excuse any behaviour on others behalf, so that I could accept and live with those behaviours over which I had not influence. This pattern continued well into adulthood. I am doing it right now! :)

This defense was, like most defenses, bothe protective and destructive. The need for rationality and logic got in the way of my ability to just experience life as it was. To feel and accept emotions, without considering whether they were valid or not.

I'm not very good at psychotherapy. I was very good at CBT, in some ways. I was able to dissect my thoughts like a scientist dissects a frog, to identify and label each thought and its purpose. I was even able to integrate some of the ideas at times. It helped, somewhat. It was exhausting though. I felt dragged under by the past, and what I managed to control in my day to day consciousness, through extreme hypervigilance, always having to be ready to pounce on that next cognitive distortion, I was unable to keep at bay when my unconscious took over during sleep or horrific flashbacks. I felt like I was barely managing the symptoms, but underneath there was an untreated infection of 'feelings' just waiting to go septic and kill me.

So, I started psychotherapy. And I suck at it.

Feelings throw me through a loop. They are neither logical, nor rational a lot of the time. They don't stand up to close examination. They are maurauding rebels without a cause, determined to occupy my brain and do whatever the hell they want. In psychotherapy, I am to accept these feelings, to embrace them, to try and understand those parts of me, not analytically, but empathically. I am finding this incredibly difficult.

I went into therapy today, nervous, but reasonably sure that I had managed to find a logical reason for my behaviour in the past couple of sessions, and why I thought therapy was stalling. I was validated by discussing this earlier in the day with my Case Manager (who seems to use more CBT/DBT orientated interventions) that I was showing good insight, and showing signs of things starting to click into place. Therapist (D) was somewhat less affirming. She did congratulate me on my ability to step away and think about the way my mind was processing things, and acknowledged I made some very valid points. She has two major issues with it. First, she felt that I had found away to analyse away any responsability on her behalf. That she had made mistakes within the conflict too, but that I was too scared of the emotions that came with that (fear, dissapointment, anger) to allow them in. So I bludgeoned them to near death with logic and over analysis, so I wouldn't have to deal with them. Second, as much as she was interested in what I thought intellectually about what was going on, she was more interested in how I felt about it. I found that incredibly difficult to answer. Emotions are just not a strong part of my personal vocabulary. I don't know how to speak of them. Sigh. I've got a long way to go. I'm not very good at psychotherapy.

We also had a brief but horrifying talk about the therapeutic relationship. At one point I was focussed on breathing shallowly to prevent myself from throwing up. She explained that due to the nature of the relationship I was going to have feelings for her "the therapist". I was going to feel hatred and dissapointment. I was going to feel love and sometimes just like. Arggggggggggggggh! I just kept quiet hoping she would get this little talk out of her head and move on. Thinking about it now, I have to acknowledge (stomach churning again) I do have feelings that reside somewhat closer to love (platonic) than like. And it horrifies me. She is somebody who knows more about me than most people, who has shown herself to be consistent and trustworthy, who appears to care about me, who I can share a laugh with, she is nuturing and protective.... it is much like the relationship between best friends, or even approaching a maternal type relationship.... but its not. I remain aware of the limitations and reality of what it is. But still, there remains this strong attachment, that the very thought of her leaving sickens me. I hate it. And yes, there are times, when my feelings move beyond annoyance with her, to a deep, visceral rage that I have yet to fully understand.

We spoke at some length (rather she spoke) about how it was not my job to protect her from any of this. Link back to her (forced) admission that I could be exhausting. She stated firmly, that if she was beginning to experience feelings of exhaustion or burn out, it was her job to be mindful of this and remedy it...not mine. My only comment was, that it scared me to not be aware of this, because if I didn't know where she was 'at', I couldn't be prepared. She reflected that this is how I must of felt growing up in an environment where one had to constantly, be in tuned, to be prepared. How difficult a responsability for a little girl, how heavy a burden. She reported counter-transference feelings of immense sadness. I wasn't ready to go there today.

On the way out the door, she told me she would call on the weekend and she had put aside a third session for me on Tuesday. I paused. "Haven't you had enough yet?". She replied gently, "No, Ophelia, I haven't.

On the ward and out of my mind- Therapeutic or Babysitting?

Continuing on from here, here and here

One cannot expect to go into a mental health ward (at least in the public system) and experience any real therapy. There are several reasons. The focus on providing treatment in the least restrictive environment (and lets face it, also the lack of financial resources to have enough bed space) mean that all but the most severe cases of psychosis or the forensic cases are discharged in quite a short amount of time. In my experience, most people are there between 2-14 days at most. The emphasis is quite heavily on containment whilst the worst of psychotic symptoms/ suicidal ideations pass and medication adjustments.

I was first admitted to Ward B in 2006. My first admission was quite a lengthy one, in part due to the additional medical issues I experienced as a result of my overdose. I was in hospital for about 2 and a half months. Over the next two years, I was admitted on four other occasions, for periods ranging from 5 days to two weeks. Whilst in hospital there were a number of people I could theoretically talk to, in order to process what I was going through and experiencing.

Consultant Psychiatrist
Generally, I saw this guy maybe once a week at most. Usually it would be him, a Student, my assigned nurse for the shift and I. Occasionally members from my medical team were invited to participate. Not quite like the horrible ward rounds that you guys in the UK have described. But still somewhat intimidating. The focus of these meetings was primarily to establish where I was at, mental health wise and to adjust medications. They usually only lasted five minutes or so, and there was generally no suggestion on how I might deal with some of the symptoms I was experiencing, other than to suggest I ask my nurse for a prn when needed. The consultant changed over the two years that I was in and out, but the one thing that did remain the same was that he was male, usually quite authoritarian and foriegn. I found myself getting quite upset when having to go through my history with these guys, as a) I wasn't really comfortable with men b) several things on Doctor said to me about my family made me feel quite judged (I think it was due to significant cultural differences in the ideas surrounding parents and respect) and finally, as English was not their first language, it was near impossible to talk in the idioms and metaphors, we would generally engage to soften the impact of telling a trauma. They simply did not understand. Language had to be clear cut and brutally to the point. Raw and stark. Being the passive personality I am, I usually just accepted it, but one occasion it got too much for me and I got up and stormed out of the treatment room. Unfortunately, anyone who has ever needed a walking stick before can tell you it is near on impossible to "storm off" and I ended up going arse up in front of the nurses station and all the patients. I then promptly burst into tears, which the nurses responded to quite quickly, as I am known to be a non-crier. Bundled off to my room, the nurse could do little more than pat my shoulder as I howled for the next 15 minutes. That's why I don't cry. Once I do, I can't stop. Anyways....
Nurses
As I mentioned, you got an assigned Nurse at the beginning of each shift, who was supposed to check in with you for that shift, and if you had any additional problems you were to find them. The one thing all the nurses had in common was that they were OVERWORKED. The bulk of their time by necessity had to be spent caring for the geriatric patients. They weren't normally sitting in the office ignoring us (it was a cramped, uncomfortable space anyway), they were working hard. That's where the similarities ended. Some nurses were so burnt out from the demands of "general nursing" on the ward that they had no energy left for mental health nursing. A brief "How are you today?" was sufficient to their requirements and if you did approach them with an issue, they would try to listen but you could see that harried look in their eye of someone who knows they have 1001 things to do before their shift ends. Some were burnt out by the demands, but made the effort anyway. Spent the time developing rapport with the patients. Back in the days before somking restrictions came into full force, they may sit in the courtyard and have a smoke with a group of patients, always observing, in a non-confrontational way that is so much better than "How are you today?". They may be too busy to deal with you straight away but they will tell you when they can see you, and they will keep their promise. They had the skills to turn subjects that we had in common into ways of exploring the patients issues. For instance one nurse, who was also a professional photographer, would always want to see what was new in my portfolio, and we would discuss how it was representative of the way I saw the world..... and finally there was the last kind of nurse....relatively rare, thankfully. The ones who hated mental health patients, thought we were all just lazy sods who were bunging it on for attention. Mind you, the community had its share of acopic personalities that made their way to Ward B, but no excuse for the nastiness these women exuded. If its not a field you want to work in, that interests you...then why the hell work there!  I met some wonderful nurses in Ward B. As a gimpy, little long term patient, who wasn't violent or particularly demanding, I was out of the ordinary for them. Most patients were gone too quickly for them to develop rapport and the ones that remained (in Ward B at least) were pretty far gone to dementia. So, I guess in a way I became their little mascot. But for those majority of nurses who did the best they could in an under-resourced area, there were 3 or 4 nurses, whose callous actions or words remain with me today
Case Manager
I didn't get introduced to my first Case Manager until I was about a week away from discharge. Their focus is generally Ccmmunity Care. My first Case Manager (Y) was fantastic. She found away to relate to her clients, she made sure to make the meeting spaces somewhere comfortable, whether it be a park or a coffeespot, and she firmly believed in talking and doing.. in other words, by all means talk about what was going on, but at the same time go for a walk as part of my PT or go and check out a second hand book store. Anyways she was my Case Manager for most of the time I was in that area... and whilst I was in hospital she did check-in on me, she would drive me to and from my private psychiatrist appointments, when I had permission to leave the hospital. She was less of presence than out in the 'real world', I guess because she knew while I was in there I was relatively safe and contained.
Patients
Anyone who has spent time in a mental health facility will know that it is the patients that you spend the most time talking to. And often the ones you turn to, for advice or comfort. There are some inherent difficulties in this. You have to be concious of the fact that a) some of them will not be entirely truthful with you, and b) some of them will have issues that may end up impacting on your own mental health. This is particularly important to keep in mind if you decide to keep in contact outside of the ward. But the benefits are they are usually extremely judgmental, and even though no person has exactly the same experiences as you they do have a greater understanding than the average person. The other thing they bring to the table is some comraderie and humor in a dark time in your life. There is a suprising amount of laughter in a Mental Health Ward. The downside to this, is many of the 'acopic' patients, went from this comraderie and support back to their isolated and lonely existences, felt the void, and so would make a suicidal gesture just to be re-admitted for a few days to a world where they felt accepted.
Other hospital staff
Being a longer term patient, the housekeeping staff got to know me quite well, and would often stop for a quick chat. It was all very light, but it was always nice for them to compliment me on how well my walking was coming along, or as one old duck said to me "Some meat on your skin and those dark circles away from your eyes, you're starting to look quite bonny" :) In addition, (S) my physiotherapist was a fantastic support. She worked really hard to keep me goal focussed on the future, to give me hope, but on the few occasions I did fall apart, she was lovely too. I guess she didn't have to adhere to boundaries as strongly as the MH professionals do, and in those times when I was wondering if I was ever going to walk, read and talk properly again, she would take my hand and let me cry. She also provided me ample opportunites to get out the pent up anger inside me and direct it into my rehab sessions, knowing when to push my buttons to get me to push myself just that little bit further out of anger. She was a big reason why I recovered physically as well as I did, but I also believe she was a big reason why I made the steps forward with my mental health too.
Private Psychiatrist
By this stage I had been seeing Dr B for a little over a year. As soon as I was allowed out on leave, I began to go to my appointments with her twice a week, first on escorted leave with either my mum or Case Manager, and then by myself. I found it quite surreal that I was signing out of a psychiatric hospital to get psychiatric help, but the reality was, in order to get the containment I needed to go outside of the Public System.

There were some differences and some similarities at Big City Hospital.
Consultant Psychiatrist
Usually there was just you, him and  the junior doc. Not quite as confronting as at Ward B, but also it meant that there was no nurse to explain things to you when you left. I often found it hard to absorb what was being said. The consultations were the same length, about 5 minutes, but seemed to be more regular than on Ward B. Every 2-3 days. He is also the guy who heads the team the Junior Doctor and Case Manager assigned to me in community care are apart of. This means he is kept more regulalry apprised of what is going on with me, and is generally consulted in CM thinks I might need an admission. So there is a lot less repeating myself. And quite often they will do a direct admit rather than make you endure a horrible A&E admit.
Nurses
Now this is one that I do get quite cranky about. I understand that we live in a world of paperwork, back-up paper work and back up, backup paperwork, but the amount of time the nurses spent even out of the office, let alone actually engaged with patients was abysmal. They did not have the same geriatric workload as Ward B nurses. WHAT ARE THEY DOING?? I believe a small part of it can be attributed to the system of medication hand outs. In Ward B, three times a day you lined up outside a window for your medication, this took two nurses about an hour to do. Of course, they had to track down the odd non-compliant patient, but it worked pretty well. Assigned nurses gave out any prns or the odd medication that fell outside these times. In BCH, each assigned nurse, prepares the meds for each of their patients and then runs around the ward like a headless chook with a dixie cup of pills and another of water, trying to find their patient. As there is a bunch of nurse all trying to do this at the same time, the tiny meds room gets quite jammed up, which slows the process further. I've watched an individual nurse take two hours to get through all her meds. It seems to be a waste of time that could be better spent with patients. In BCH, I quite often went an entire shift without talking to my assigned nurse, or even knowing who is was until they came to give me meds. A common phrase was "Ive been measning to come and see you. Just let me finish these meds". And then you never see them again... I am not a squeaky wheel in hospital, so I am easy to overlook. Additionally, I have had a nurse tell my private psychologist who rang, that I was doing very well, and that she has spoken with me that morning....and she had not even seen me! Most of them are good nurses I think, but there is a culture of inefficiency and a tendency to migrate to the nurses station where its comfy. The nurses station in addition, is nowhere near the middle of the ward, so they had no idea what was actually going on (i.e patients smoking dope in the corner (I witnessed this!), there was gossip about patients getting it on in the laundry (not sure if that's true) If you did need to see your nurse, it would take a lot of banging on the door just to get anybody to respond. Massive Fails in my opinion.
Case Manager
Unlike in Ward B, my Case Manager in BCH was housed in a separate location from the hospital. I think she only came to the hospital once, when I was first admitted to introduce herself. However she does always make sure to let them know if I am coming etc and checks on me when I am discharged.
Other staff
Consumer Advocate (K) came and saw me twice during my last incarceration   admit. She also arranged for her counterpart to check in on me on my birthday, which was sweet.
Patients
Similar to Ward B, but have had a few bad experiences this time round. One of the girls I befriended in there ended up taking me on a bit of a roller coaster ride outside of the hospital. But I will always be grateful for the few months of friendship we did have. And I truly hope she manages to work through her issues. Unfortunately, I had to distance myself to preserve my own mental health.
Private Psychologist
I began seeing (D) about two months before I landed in BCH the first time, over the next 6 months I had two subsequent admissions. I cannot emphasize how much of a support she has been when i have been hospitalised, and I really need to remember that at times like now, when I am pissed off at her. I was really reluctant to go in my first admission. I had stayed out of hospital for nearly two years, I didn't want to go back to that. I didn't want to admit to how far things had gotten out of control. She did not push hospital, in fact she is in many ways anti-hospital, but eventually we both had to admit we were out of options. The first admit, she sat in the ER with me for hours, waiting for admittance. She also did a lot of the talking (background history stuff) that I was unable to do. I don't think I would have stayed and waited if she hadn't have been there. She also rang me pretty much everyday to check how I was going. At the end of the admission, the Consultant Psych told me, that if I was admitted again, (which I think he suspected I would be, with D-day anniversary coming up) that I was to go to my bi-weekly session with her, for continuity. So on the subsequent stays, I was faced with the surreal prospect of leaving a mental health ward on leave, to go and get mental health help. Seems ludicrous! But it helped.

Ultimately, I can see that Public Mental Health Facilities are not meant to be therapeutic communities, I can see the arguements for least restrictive environments etc BUT if the patients are going to be in the hospital anyway, you would think that there should be some attempts to provide an environment more conducive to processing whatever emotions etc they are feeling. I don't know exactly what the answer is, but I suspect a big part of it, particularly in BCH is getting the nurses off their arses, out of the nursing station and into the messy melee that is a psych ward. That's what they signed up for after all.

The second thing I have become aware of in retrospect, is how lucky I have been to have other people, (private practitioners, physiotherapist, auxilary staff ect) step into to fill the void left by the lack of involvement of behalf of the nurses.

Three times a week!!!

Therapy today. Sigh. I began the day by catching up with (K) for coffee. Entertaining and thought provoking as usual. No BS, which is nice. I always seem to walk away from my catch ups with her with a few different ideas rumbling their way through my mind. Is always good to have a different perspective from somebody who has been in a similar place before.Among the many things our little chat through up (what is the opposite of hope? I say resignation.. she respectfully disagrees) she said something about how you can't tell everything about a person, just because they have a sunshiney demeanour... they may have become that way as a reaction to a not so sunshiney past. It made me think about one of the major discomforts I have with MH professionals. They always seem to have it so together. And you imagine from the way they are able to pull apart and analyse your problems and come up with healthy solutions etc that they must have it all together. But the reality is, I'm a client, they can't really bring their baggage into the room like in a normal relationship. So you get a skewed view. Maybe somedays their life is just as shite as mine. Maybe they are able to empathise and give good advice, because they are talking from their own experience. And I need to keep that possibility in mind, before I dismiss what they have to say. Is very easy with MH issues to become very ego-centric...nobody could possibly understand, wah wah wah, I need to keep in mind they are human too, not perfectly turned out robots.

After that we chatted for a bit about photography, and (K) asked me to bring some of my photos to see next time. I really must follow through on my plan to go to the botanic gardens and potter about with my camera. Its something I have enjoyed in the past, though I am not that great at it... and as (D) has pointed out I need to be "doing things"

Anyway, after (K) I jumped on a bus and then train to get to therapy. (D) commented that I seemed outwardly to be a lot calmer. (Which I attribute mainly to meds and ex moving out of the house...finally!) But was somewhat concerned that I had become a bit disconnected. I don't seem to be able to find a happy medium, either utter out of controll-edness or complete disconnect. She started talking about increased contact again, and pointed out that while I might feel that since I am disconnected rather than a shaking, gibbering mess, I don't need it, she actually feels that I probably still do, maybe even more so.

We spoke for a little while about anger again (flogging a dead horse). She pointed out that even if I can't do anything to change the way my family reacts to it, I can still work on finding ways to be more assertive and say no, in other relationships. To learn how to protect myself from others who would seek to exploit me. And if I feel confidant in doing that, I might not just cut people off out of fear of what they might do....

Which of course led to.... Bachelor Number One. No I have not broken up with him yet. I've tried, but I jsut can't seem to make myself. Argh. I sent him an email explaining everything thats been going on, half hoping that he would just go "Ooh, that bi-atch is crazy!" and back off. But he didn't. He sent one back asking to see me. I haven't responded yet. I know in my heart now is not the right time for a relationship. And I do not want to explain the state of my hacked up legs to him... but I can't seem to make myself cut ties either. He is a great guy. Sigh. And of course, if and when he does reject me as a nutter, deep down I'll be devastated..

Finally, we moved back to the "increased contact" discussion. Still haven't made any headway. I'm going to think about adding a third session and how that might make me feel. The other choice is the phone checkins. I think she realised how worked up I'm getting about it all, because she is only going to call me once over the weekend (on saturday) and then I'll see her at my normal time on monday. She pointed out that she thought, part of the reason the "Horrible Thursday" went down the way it did, was becuse she pushed me a bit too hard and then I left the session with all of this crap still going nuts in my head, but was not going to see her again for four days. And I'm not the greatest at reaching out for help on my own at times. I don't know if that's true, but I guess it kind of makes sense.

Anyway, I left therapy with all sorts of (you guessed it) crap floating around my head, and just really needed to go home. So I skipped my blood test at Big City Hospital, which means I'm going to have to travel half and hour each way to go and get it drawn tomorrow afternoon. Sigh. I also NEED to call the uni.

Not an incredibly exciting session, but still, gave me a bit to think about.

Found my anger..didn't know what to do with it, so lost it again..

Lost my temper and very nearly lost the plot this afternoon. Lil sis just pushed me to far with her inconsideration and unhelpfulness in getting the house ready for prospective tenants. Plus I was on edge from lack of meds...Finally got the call that my script was ready and so removed myself from the house. By the time I reached the Mental Health Building, I was shaking with agitation. Was so bad that when (M) handed me a cup of water I could barely hold the cup. Chatted with her for a few minutes, which centred me a bit. Although she was of the opinion like therapist (D) that it is good for me to get in touch with my anger. Which I understand in theory, but practically, me losing my temper is not going to help the situation. Walked back down the hill to the mall to get script filled, still shaking so bad that the pharmacy attendant was giving me strange looks as I tried to sign my name. Thought I would want to get in and out of mall as quickly as possible, but strangely did not find it as claustrophobic as I would normally. Plus it was airconditioned and 10 000 degrees outside. So stuck around for an hour or so and did some frivilous shopping. Didn't spend much and I had some birthday cash left, so it was a nice splurge. Bought some cushions and a shoe rack and a new mat for the doorway. Also bought a big bag of pick and mix lollies as a treat. Ignored phone calls from sisters. When I finally got home I think lil sis was trying to apologise, as big sis had basically told her, if you don't cut it out then Ophelia is going to crack completely. But didnt realise that's what she was trying to do, and was too pissed off to bother listening. She still didnt really help me clean the rest of the house. So I finished tidying and vacuuming. Aunt arrived with two little cousins and my big sis went to pick up her son, so we have a full house ready for our trip to the water park tomorrow. At first found the infringement on my space a bit tricky, but had a 'good' chat with aunt and sister re: past history, and why therapy is good for me. They see me going month after month and don't think its helping, which I understand, but they don't understand the complexities of it. Besides they don't have a better plan, so.....Is now 2 am and I have to be up in a few hours to leave, so I should try and get some sleep. Sigh. Ex is pretty much all moved out, and has tomorrow while we are out of the house to get the rest. Anyways....longer post tomorrow.

Echos of the past

My older sister has come to stay with us until the end of the week, when little sister's ex is supposed to be leaving. Safety in numbers. It's a familiar feeling. Three sisters, carefully monitering the tension in the house, waiting for the next outburst, waiting for the blow. We are wary of making too much noise, drawing too much attention. We stay mostly within sight of each other, especially watching little sister, trying to protect each other.

Last night was an onslaught of screaming and intimidation, punctuated by brief, but strangely agonising patches of silence. Agonising because you knew it was just a prelude to the next onslaught. We fall into familiar roles. Big sister steps in, deflects the aggression towards herself to protect us. I mediate, defuse and attempt to deescalate. Little sister remains stoic, doesn't give much away, pretty much pretends to herself that it isn't happening, though I can feel her exhaustian under the constant barrage of verbal assaults and physical intimidation.

It has not turned 'violent' yet, in the most general sense of the word. The abuse is mostly verbal and emotional. But the presence of violent threat looms through standover tactics and words screamed directly into one's face. Things seem absurd. His actions are on the face spiteful, but have a malaevolent undertone. We laugh that he woke up in the middle of the night to dismantle the wireless, as he didn't know about my purchase of a pre-paid wireless modem for my laptop. We laugh that he disabled my little sister's car and cancelled her RACQ membership, because older sister was able to drop little sister at work, and then figure out how to get the car started. We laugh that his attempts to lock little sister out of the house, were thwarted because he didn't realise older sister had a set of keys for the other door. We laugh that he wakes in the night to shift things from the house to the shed so we cannot use them, dryer, washer, ect. We don't care about things, take what you want, stuff can be replaced. We laugh because his attempts fail to cause the discomfort intended. But we are also perfectly aware and wary of the intent.

It's a familiar feeling... not wanting to go home, not knowing what the night will bring.  We find ourselves laughing hysterically over stupid things, over serious things.... but we are all aware that scratch beneath the laughter, we are all bundled up with anxiety. My stomache aches, my head throbs, my hands are constantly moving. My therapist commented on it today in session... my hands, that flap and pull, tug and pinch, startle reflex honed into supersensory mode. "The body remembers" she said. Cliched, but true. Old patterns repeated, old coping mechanisms reengaged. Fight or flight response constantly on active standby.

My energy is low. Neither older sister or I slept much last night, as we listened to him creep around the house, doing his nasty little tricks. We saw him attempt to go into little sisters room, unobserved, only to realise, that we were both awake, watching, on standby. I feel to fragile to withstand this standoff, but there is little choice. She is our baby sister, if you try to hurt her, we will come after you, motherf*cker!

We have all the information we need to get a Domestic Violence Order place, we know his behaviour meets the criteria. But little sister holds off for now, and we have to respect that. Instead we spend the day planning, making lists, ringing real estates and shopping to replace items he has taken or destroyed. Tomorrow, we will make sure all the items he wants are ready to go... we will make it as easy as possible for him to leave. Leave, just leave for God's Sake.

Tonight has been by comparison quieter. He has been out most of the night. But the tension remains. And the vigil goes on. He could return at any minute and we need to be ready to step in if needed. We need to be on guard. Hopefully whereever he went, it wasn't to go on another bender.... the alcohol makes it much worse.

Same story. Three scared sisters. One large, angry, drunk man. 20 years on. Same story.

I don't know how much more of this I can stand.

Deadline passes...... and nothing...

Sunday. Deadline for sister's ex to move out. He is still here. They have spoken and she has agreed not to take out the AVO and give him till the end of the week to find somewhere. He has agreed to behave. So I am home after a turbulent, homeless weekend. And not feeling to secure about the living situation. Tension could be cut with a knife.

I went and stayed with friend (F) for two nights, but as it turns out she is dealing with her own demons at the moment. Spent most of friday night, trying to keep her out of trouble, as she drank and took more tablets then she should have, and then passed out in the hallway. We were to go over and feed the cat on Sat arvo, but I didn't realise she had continued to take pills throughout the day. Got in the car with her completely unaware that she was pretty much off her head on prescription meds, so ended up in a low-speed head on collision. Pretty stressful and scary stuff. Am very angry with her for putting me in this position, and also feeling quite helpless, as I have too much going on in my own life to try and save her, so have had to take a big step away and let her family and fiance deal with this. Hopefully now the full extent of the problem is on the table, she will be able to see she needs help. But I just can't be a part of it right now. I don't know if this makes me a bad friend? The accident actually caused me to go into shock. I couldn't stop shaking, was breathing really fast and speaking a million miles an hour for a few hours afterwards. Ended up going to stay with friend (B) for the night, which was a much calmer environment.

Managed to go and do my volunteer shift today, which was ok...pretty low-key. Not to much personal interaction mostly just paperwork ect. Therapist (D) has been calling everyday to check in, which really has been the only thing anchoring me over the last few days.

Still dealing with a lot of anxiety and intrusive thoughts. Gremlins still lurking. Therapy tomorrow, which I am both grateful for and dreading simultaneously. May have to book into acupuncturist as well, I think just the jolt from the crash has given my neck and shoulder a bit of strain... has stiffened right up today.

Still here. Sigh.

Still here

I'm still here. Just too much going on in my head to write a proper post.

Will give you the highlights and fill in the details later when I can get my thoughts straight.

-Discharge on Wednesday afternoon. Still pretty unsure about this whole living thing. Some regression to SI as a coping mechanism to get through till session with (D) on Thursday. (Very dismal attempt, not much damage one can really do with a broken up pink lady bic razor)
-Call from Case Manager (M) Thursday morning, I was not very talkative. Arranged to meet with her at the horrible Mental Health Clinic as she doesn't have time next week to make it out to my house. So meeting arranged at the centre for Tuesday
-Session with (D) went very, very, veeeeeeeeeeeeery badly. Her new approach is to try and work on buffering other things in my life ie uni, volunteer work, gym ect, so that my whole life doesn't get flooded with the gremlins. Good idea in concept. She said she knew that I would feel frustration and anger at her, because it would all seem a bit pointless, but she reminded me once again that she 'could' not give into my sense of hopelessness. She was right, I felt an impotent rage towards her, unlike I have ever experienced in therapy. The one person who is supposed to 'get me', is just not getting me at all.... its gone too far for a plan of distraction to help in any way. I wanted answers, a direction, a glimmer of something,. Fuck! I don't know what I wanted from her.... but I didn't get it. Of course with my fucked up inability to express anger, I just told her I had to go, and walked out of the session. I've never done that before...just walked out... I'm too much of a good girl.
-Waited for the train... thought about throwing myself on tracks, but then thought that seemed overly dramatic and somewhat narcissistic way of ending ones live. A big Fuck You to the world had never been my plan before.
-More darkness, hopelessness and Gremlins. Got to the city, and found myself in a chemist buying shiny new razor blades. The ones I knew from my past more successful days as a SI'er', before I (thought) I grew out of it. And of course the requisite gauze, bandages and steri-strips as a repair kit. Figured maybe if I could just bleed a little of the blackness out, I might find some space to breather.
-Walked out to bus depot to make my way home, but found myself in another chemist filling all my scripts. Mind started thinking, why waste your time with this SI bollocks? Just frikkin do it already! Next stop bottle-o for a bottle of vodka. Pills, Blades, Booze.
-Started looking for a hotel, but realised quickly I wasn't going to get into most of these establishments with just a canvas bag filled with booze.
-Good girl kick in and called friend (B) who works in the city. Told her I needed to not be alone. She met me after work, and sat with me in a cafe for a couple of hours.
-Anxiety and gremlins start kicking up a gear. Need to get away from (B), she is standing in the way of my release. Convince her I am ok, and get on the bus headed home.
-Call around hotels in local area. None of them have bathtubs (Some very weirded out hotel receptionists out there I am sure!) Hmmm... flaw in my perfect plan...
-Sit outside hotel with no bath, trying to figure if the pills and blades were fullproof enough without the third element of drowning............ decide to down bottle of vodka while I ponder this.
-Good girl kicks in again... call friend (F) to come and pick me up to sleep off booze..
-Friday morning awake with less of a hangover than I deserve... and no seizures from alcohol intake (very odd) Return Therapist (D's) phonecalls. Very non-committal. Talk to Case Manager (M) Very non-commital. No, will not consider going back up ER.
-Also discover, am temporarily homeless, as sister's (ex) bf who has still not moved out of the house, apparently started smashing things up in the house and cornered her in the room. He didn't  hurt her, but his behaviour was erratic enough to frighten her. She has left to stay with some friends on the coast, and called me to tell me to find somewhere else to stay for the weekend. She has given him an ultimatum to be gone by the weekend or she will go to the police and get a DVO. Went with (F) to pick up some clothes and my computer so he wouldn't smash it, and am now squatting a (F's) temporarily.

Mood black. But am still here, so somewhere in my brain something is still fighting. Will wait and see what happens in therapy on Monday. (Yes.. the same therapy I was swearing never to go back to again yesterday afternoon).

10 signs I am heading for a fall.

Life is shit. For a variety of reasons I'm just not going to go into right now. But there are a few quite obvious clues that my mental health is circling the drain. 10 Signs, that are historically, harbingers of doom for a complete and utter, to hell in a handbasket, dropping my bundle, breakdown approaching.

1. Sleep. As you would have picked up from my blog. Insomnia is something that I have battled with for many, many years. As a direct result of PTSD induced anxiety and hypervigilance, I have trouble getting to sleep, I am frequently awakened from sleep due to horrible, covered in sweat, screaming, hyperventilating type nightmares, and then if and when I manage to get to sleep, I wake up early, and can't go back to sleep. It cycles, sometimes its worse, sometimes its better. Occasionally, I have found a medication that will allow me to get a semi-decent amount of sleep for a time, but inevitabley, it will stop working. And sometimes its just spirals so ridiculously out of control and there is nothing I can do to bring it back into line. That's where I am at the moment.
2. Mess. When reasonably well (by my standards anyway) I am quite particular about the way things should be in the house. Dishes are done nightly, the house is tidied away nightly, laundry is done every day or so, bathroom cleaned at least once a week ect ect. At the moment, I have been making the occasional brief foray out into the house to clean when I know somebody is coming over ie Case Manager or mother, but in general I just really don't care. Looking around my room now, there are several obvious signs that a crash is coming..
*Beside my bed there are, count em, 11 empty diet coke cans (caffiene free, of course!). This has been pretty much my staple diet for about a week now. And leaving my bed, to go and dispose of them in the trash... just not going to happen. There is also an array of crumpled tissues, and several empty pill blister packs. (Not from an OD, normal usage, just slovenly disposal of the packaging when finished)
*On my bed there are, two teddy bears, one childhood doll, three plastic bags, one handbag, one bag with the materials to start my friends wedding invites (untouched), two weeks worth of unopened mail (bills?...meh!) Three photo albums (necessary for depression inducing trips down memory lane) One air perfume insert, still in its package (I bought it the other day to try and stave off the stale smell that permeates a room when one settles down into a depressive hibernation, but thats as far as my motivation went, actually moving the bed to plug it in...way too much effort).... lets see what else? Five separate articles of dirty clothing that hasnt made it to the floor yet, 9 hairbands, 4 booby pins, an empty chocolate buttons packet, one sleeping cat, and me.... in desperate need of a shower, stringy hair, pjs with a stain on the front, nails bitten to the quick, and an ongoing hand tremor which is telling me that I am due to have another seizure, probably sometime in the next 12 hours.
*On the floor at the foot of my bed... The rest of my dirty clothes, one bag still unpacked from my christmas trip home.
3. Time spent in bedroom. I would estimate I have been out to go to the bathroom four times in the last 24 hours, to the fridge to get a diet coke, probably about 4 times as well. Timing each of these trips at a generous 3 minutes each.. ergo (4+4x3=24min) I have been laying my bed for about 23 hours and 36 minutes. I have only been a sleep for 2 hours and 45 minutes of this time. The other 20 hours and 51 minutes has been spent crying, blogging and reading blogs, staring at the ceiling, thinking, over thinking and then for a change thinking some more, debating calling the crisis line, debating taking all the drugs in my possession and then taking a nice warm bath into oblivian ect ect. That's the last 24 hours, the previous week or so has been pretty much the same, other than the fact that occasionally I *have* to leave the house for a few hours, with appointments, one shift of babysitting (4 hours) and one dismal failure of attempt to be a good girlfriend (2 hours), but other than that, yeah mostly bed. The mattress has hollowed out to quite a nice little hollow where I lie and the sheets are...well, they could be cleaner.
4. Food intake- has pretty much slowed to nothing bar what is put directly under my nose by somebody else (and even then....meh) and the occasional crackers, cheese and vegemite combo to keep me from fainting... which luckily is not much of an issue seeing as I am expending next to no energy
5. Self harm... nuff said.
6. Mobile phone, email, facebook ect are filled to the brim with people trying to contact me. People I will not be contacting back anytime soon. In fact pretty much the only *real life* people I am communicating with are those who will instigate full on intervention methods if I drop off the radar too long- my mum, my grandma, and the mental health people. I give them enough of a response to satisfy them..no more, no less.
7. Alcohol consumption. I am epileptic. I am depressed. I am on a lot of medication. For my own safety I am not allowed to drink. I am usually pretty good about this. At the moment, I am hiding a couple of empty wine bottles under my bed, until I can find a way to sneak them into the trash without my sister noticing... pathetic, huh?
8. Damage Control... involves pulling out the paperwork on my funeral insurance to make sure its all kosher, trying to figure out how to withdraw from people so they won't feel guilty, bad when you are gone...how to do this? Cut contact entirely? Make them hate you? Haven't figure this out, so it runs through my head constantly.
9. Uni work. Yeah, I'm enrolled, that's about as far as it goes. I don't know what is due, past due, due to be due, and I just don't really care, I haven't logged on in over a fortnight, I haven't really touched a book since before Christmas. Setting up a nice little mess for myself with my apathy.
10. Most obvious sign of all..... when I think about the days,weeks, months and years ahead of me, my mind can see nothing good. Nothing good at all.

And I am sick of trying to manage this, to put Daily living and Crisis plans into action. What is the point? Even if I pull myself out of this hole, I'll just cycle back to here in a few days, weeks, months or years time. Better to just let myself crash, and see what's left at the end... whether there is anything worth resurrecting. Let nature take its course.

Bah... fuck it all.

Yes. I know. Its my choice and my responsibility. And this kind of thinking and this kind of apathy is not going to help me.  I should try and pull myself together. I should be reaching out to people rather than isolating, I should be sticking to a routine, I should be doing a lot of things.

Sigh.