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

Tedium

Tedium: The quality or condition of being tedious; tediousness or boredom.
[Latin taedium, from taedre, to weary.]

Therapy was ok today. Unsuprisingly, some of the content focussed around the conversation we had about Borderline Personality last session, and the feelings this aroused. We spoke a little about the split between the purpose of the Public Mental Health team (my PsychDoc and Case Manager) and her, my private therapist. She purported that there should be no split, and anything that was impacting on me re: Public Health, was important to consider in therapy as well. More specifically, I had stated that I wasn't really all that interested in discussing the Borderline diagnosis with her, as I didn't feel that it impacted in anyway on the therapeutic process... PH was the place where diagnosis, medication and day to day coping skills were paramount, and therapy was more for understanding the motivations behind behaviours. I kind of felt like we were wasting time talking about it.

As the conversation continued, evidently I let out a rather large sigh. Cue thera-speak... "I wonder what is going on for you right now, behind that sigh?" (Sidenote: Why can't they just talk normally? How often do you say to the average person "I wonder why you chose this movie"? Just ask directly...I can take it, and its a little less irritating) Anyway, I told her that I was just feeling a bit fed-up. Not with her particularly, just with therapy in general. Walking into the room three times a week, and talking about things that more often than not recently, feel pretty unimportant. It felt tedious, and I didn't particularly, in that moment want to be there.

This resulted in an examination of what tedium was, was it felt like and when I had felt  it before... a conversation that in itself felt pretty tedious.

The thing is... I don't feel like it is that important to look at in any great depth. For any human there comes times whether it be in relationships or work, where the act of doing the same or similar thing over an over again created a tedious feeling. It's natural, but it passes. Something will happen, that will break the monotony and spark a new engagement. In therapy, sometimes it is just the tedious task of poking around and hitting all the boring, non-painful areas for a while, until you hit a raw spot... and then the tedium breaks and there is room for growth or new insights. The only time I think the feeling of tedium is particulalry worriesome is if it persists and nothing sparks that break, or if you react to the tedium in a maladaptive way ie. this therapy is boring and wearisome in this exact moment, so I'm going to quit and never come back.

Sure the feeling is certainly a signpost in the therapeutic space that we're a bit off track, but if we keep pushing on eventually we'll get back on track again. IMO. Not a big deal. But everything must be examined within an inch of its life, whether important or not... so we'll be continuing this conversation in therapy tomorrow, no doubt, as we ran out of time today.

Re-reading this post it has a slightly snarky quality... but you know, I'm just a bit fed up. It will pass.

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

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

Not such a great day

Yesterday was hard. And I guess a little bit of a shock to the system after a period of relative good moods. We so quickly become accustomed to it: the good moods, the lack of agitation, the good sleep, that when things take a bit of a slide, even if it is nowhere as bad as it has been before, you kind of feel it even worse because of the contrast. But I am trying very hard not to let it turn into a snowball effect.

I was up early for the ultrasound appointment, making sure I had enough water to drink and taking the higher dose of anti-anxiety meds to get through it. Having (S) come along proved to be a good thing, not just as a safety thing with the increased meds, but also just as a bit of distraction. She did offer to come into the consulting room with me, but I refused... taking our friendship just that step to far into the intimate, methinks. But it was nice of her to offer. I was pretty lucky with the tech that I got. I explained without going into much detail that this was a difficult test for me to have due to past trauma, and she was very good about explaining things step by step, taking it very slow and offering to stop if it got too much. She also tried to engage me by talking throughout the test, although this was not very effective as I found (as a coping mechanism, I think) that I was drifting in and out of the moment. Not full blown dissasociation, but certainly it was there to some degree. Probably exacerbated by the medication. It did trigger a lot of flashback type episodes which continued on after the appointment.

I got home and headed straight off to bed for a little bit, but found that I was pretty damned agitated and resting was pretty impossible. I felt quite disconnected, emotional and fuzzy. (Medication? Flashbacks? Probably a combination of both) I wasn't sure how I was going to handle catching public transport to get to my therapy session. After the brouh-ha a few months ago about missing sessions, I find it pretty hard to justify missing sessions, I never know if its a good enough reason. In the end I called (D) my therapist and she pushed the appointment back a little for me, (S) came to the rescue once again and drove me across town for the appointment. In my eyes it wasn't a very productive session. I spent the majority of it wrapped up in a blanket, and to be honest I don't really remember that much about what we talked about.

It's time to be proactive. The girls stayed last night which was a good way to get me back into the present and stay there. We had a girly night chatting and laughing and then woke up for bacon and eggs this morning. (M) my case manager and I had a phone meeting, which went pretty well. She's pretty pleased with my progress in general, as am I. She is going to make a referral to the employment officer in the service. We also touched briefly on creating a proactive plan for how I am going to deal with "D-Day anniversary" in September. I'm going to have a think about it ( but not dwell!!) Whether I want to just try making it through with a little extra support (phonecalls etc) or whether we should do a planned admission. A lot of it will come down to how I do in general over the next 6 weeks or so. If things remain as stable as they are, perhaps this year the anniversary wont be as much of a struggle.

(D) is going to do a check in call this afternoon, as I wasn't doing so great yesterday. (S) and I are going to catch a movie tomorrow and then I have a shift at RMH on sunday. I'm determined not to let htis hiccup ruin my good streak.

Peace and Love
Ophelia

Over share....sorry!

Starting with the nice stuff first... I slept right up to the alarm this morning and even hit the snooze button! Loving this sleep stuff!! Off to therapy and a GP appointment, and then shopping! And I didn't even freak out in the crazy school holidays crowd. I bought some warm, casual clothes...(as I am too fat to fit in last winter's clothes) including a cute shirt with two penguins on it that says "Melt hearts not ice caps". Very sacchrine, but I will ony be wearing it as a bed shirt, so won't be too embarrassing...and I just couldn't resist it. Also got an awesome pair of black knee high boots. I have been looking for boots for well over a year now, but current fashion trends seem to lean towards tall stiletto ones, which I cannot wear due to my vestibular system, so when I found these, on sale even, I was stoked.

Tracking back.....therapy. It wasn't horrendous, but wasn't exactly a laugh either. We started off talking about self protection. (D) knew that I had a late shift last night and that I planned to catch the bus home. Because the Busway is behind a shopping centre and the shops are obviously closed at that time, you have to walk right around the poorly lit perimeter, before you get to the better lit main road that I live on. (D) asked why I didn't ask lil sis to pick me up and I told her that lil sis goes to work at 5am so she is usually in bed by 9ish. (D) then contended that I felt lil sis's sleep was more important than my safety and basically insinuated that I leaned towards more risk taking behaviour than the average joe. I don't think that's a fair assessment. I very rarely am out at that time of night, I try to schedule things so I am home before dark. But once in a while a situation comes up where I can't avoid it. It's only a 5 minute walk, and I keep alert (heck, I have PTSD, I am HYPER-alert) towards my surroundings. I have taken self defense. The fact of the matter is, the epilepsy prevents me from driving, so I am reliant on Public Transport. And my independance is very important to me.

I was starting to get quite annoyed with her nagging me about, and told her as much. And then.... the conversation I had been waiting for, but surreptitiously avoiding since I got back from prac. "Our relationship'. Specifically, how I find it incredibly uncomfortable when she shows any sign of care or concern about me ( but paradoxically, feel comforted and validated....grrr) She (with her annoyingly perfect memory of everything I have EVER said in therapy) reminded me of a comment I made right back when we started, referring to peoples reactions to me. I said "Disgust is horrible, but empathy is even worse". So all in all an awkward, yucky session. BUT. I was proud of the fact that rather than shutting  down the topic, I let it unfurl, to see whether anything came of it, rather than give into my panic and discomfort. Yay me! We ended with a kind of heavy feeling in the air, and (D) was worried about whether I would be ok to leave. But I thought about it and felt I would be. And in reality, I walked out the door, and was able to pretty much leave it in there, to pick up next session. Something that I have struggled to do in the past. :)

After that I had a GP appointment, and she reminded me of a test that I have needed done, and been putting off for weeks. ***************Warning: Personal Overshare of an intimate nature following, feel free to cease reading especially if you have a Y chromosome*********************************************************
Basically, I have a lot of gynaecological problems, as a result of the trauma my body has undergone.... and they are quite insistant that they want me to get this ultrasound done. Unofrtunately, this particular untrasound is nnot done externally. UGH! Aside from the fact that for anybody this is an embarrassing proposition, because of my SA history and the PTSD, I can't make it through a papsmear with my own very lovely female GP, without a buttload of aanti anxiety medication. The prospect of some ultrasound technician I don't even know, sticking something up my whoo-ha..... well to say I am freaking out, is putting it mildly. Suggestions from any of the gals out there with similar fears and how they get through it are appreciated.

So that's my day. Still all in all a pretty positive mood. I was reading Pandora's post today over at Confessions of a Serial Insomniac, and I guess she was defending (?) her particular approach to therapy and mentalism in general. And it really got me thinking. How sad it is, that with a good portion of the so-called normal population judging and misunderstanding mentalism, that we ourselves would want to attack or criticise each others approaches. Personally, I don't care if you make the journey kicking, screaming and cursing every step of the way, or frolicking along gently spouting inspirational sayings and personal affirmations. The fact that you are making your way through is what's important. And, myself, I actually like me a little sarcastic, black humoured, 'the glass isn't half empty, its smashed on the floor in a million pieces after I tried to glass the last person who told me to Let go and Let god' type approach. And I love Pandora's raw and unflinching honesty. So even though I seem to be drawing rainbows and smealling flowers at the moment, I'm still on your side, sista! I can be happy, sad, angry, downright going off my brain, but as long as I'm moving I don't care.

Frocks and Fascinators

Therapy on Tuesday continued much in the same vein as Monday. The anger, the rage. We went back and tried to pinpoint exactly when the feeling started to overwhelm me, and concluded that in some ways it did come down to me feeling judged, and inadequate. But also, because I know inherently, it is not D's natural inclination to judge, the fear that arises from the vunerability and exposure of being with somebody who will regard me with unconditional positivity makes the "voice" very angry. D asked whether she could be privy to the conversation going on in my head between the "voice" and I, and I replied no. No from the voice, and no from me. She asked if I was trying to protect her or me? Both really. The "Voice" is a manifestation of a part of me I'm not too proud of, and it thinks some very nasty things about her (from my perspective). And the "Voice's" job is to keep my guard up and protect me from anyone who might hurt me, so he doesn't want her to be privvy to ANY information (from his perspective). It creates quite a quandry. She said quite firmly that if she could not be privvy to the conversation, then the "Voice" was going to have to quieten down so she and I could have one. (Is very strange to have somebody else see the "Voice" the same way as I do... intrinsically a part of me, yet distinctally individual of me) Well, of course that got the "Voice" quite het up... and sent me into a bit of a dissociative state, or at least deeply internalised and unable to deal with outside factors ie her. I actually don't really remember getting home.... about 4 hours I can't really account for which is incredibly scary, but has happened before, in extreme stressed out states.  Unfortunately due to Easter Long weekend, and a missed session tomorrow (only time I could get into Dentisit) I won't be seeing her for a week, which is the longest in between session break we have had, outside of time spent in hospital. She will be phone contactable and encouraged me to ring, but I am heading back to small rural town to spend time with family for the long weekend and phone reception is quite dodgy.


Had group this morning, which is going pretty well. Haven't said much about it on this blog because really, it is a collective experience and thus confidentiality does come into it, but aside from the first session (when I was quite mentally unwell to begin with) I have actually quite enjoyed it and gotten some positive effects out of it. Even if it is just a collection of "Ah, I thought it was just me that.....etc etc". And just the effect of having to get out of the house one more day per week has been positive. Will be quite sad when it is over to be honest.

As I said, Home for the long weekend. Off to the country races, so I found a fascinator to go with my frock today, now I just have to find shoes... I really hate high heels, but its a frock so....hmmmm

Down to the lowest dose of Avanza now, change to effexor tomorrow. Haven't noticed it soo much with the mood, but physically, have a pretty bad case of the shakes etc. Hope this attempt turns out better than the last try

Looking forward to Sunday, when all the chocolate comes!

Time to make good choices

Today's therapy session was craptastic less than ideal. I'm not really sure what was going on with me, but I spent the whole session quite defensive and a little bit sulky, if I am to be honest.  I blocked (D) at every possible turn, preventing her from really being able to dig into any subject, and behaved, generally in a narky and antagonistic manner, because I'm mature like that! I don't know whether it was because I knew I had the whole weekend to get through by myself, or maybe, with some of the stuff swirling around my head about the suicide attempt anniversary, coming up next week, I just really didn't want to dig into anything to confronting.

I started the session, telling her I was fine, everything was fine, FINE! And that pretty much was my catch phrase for the entire session. Bad dreams? Not important. Weird crazy issues with bio dad? Not bothered! I'm fine, and nothing you can say or do is going to make me admit otherwise, woman, so get up and outta my grill! Word.

But the truth is, I'm not fine. And when I got home, and started contemplating the weekend stretched out in front of me, with all the temptations that come when lil sis goes away for the weekend, I realised I was heading towards danger zone. As much as I am trying to push anniversary stuff out of my mind, and pretend it doesn't matter, it is still starting to worm its little gremlin way into my psyche.

So, (fairy claps for me) I decided to take a action. I rang my friend (S) and told her what was going on, cos I'm proactive like that! :P Together we devised a plan. Tomorrow, I am going to busy myself cleaning the house, and catching up on some other errands I've been putting off. (S) has banished her bf to a boy's night tomorrow night, and she is going to come over after work for a girly sleepover. Chick flicks, chocolate, face masks and a mattress on the living room floor, just like high school. On Saturday, we are hopefully going to go for a trailride at some stables just outside the city. (K) was talking about having done it at our coffee yesterday, and it reminded me of how much I enjoyed it last time (S) and I went back in September. Something very zen and peaceful about, sitting atop these giant beasts, and meandering your way through the Aussie bushland. On Sunday, I'm working a double shift at the Ronald McDonald House. By Monday, Uni will have started up, and of course therapy will have rolled around again.

Obviously, I need to come clean to (D) about what next thursday represents to me. I shut her down today when she spoke about a contact call on saturday afternoon, but maybe I should take her up on it.

Its hard work. *Yes, that's kind of whiney, but still....* Its so much easier just to let the bleurghiness take over and pull you down. It takes so much energy to make sure you are doing these tiny things to combat it. But I can't keep crashing. Even though there is a lot I have no control over, I still have to take responsibilty for my own choices. So today, I am feeling a little ashamed of my juvenile behaviour, but proud that I finally pulled it together enough to make healthy plans to support my well being.

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.

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.

The therapeutic relationship.

Ok. I know that there are a lot of much more informed and better blog posts out there in regards to this subject, and this will probably be a very boring post to read. You don't have to. But I just had a very 'wiggy' session and I need to process, and this blog is my place to do it.

So, today I had my make up session for the one we missed yesterday, because of (D's) conference. I was in a much better place for discussion this week, than I was last week, as some of the 'other people's drama' has calmed down, and also, I would hazard a guess, because of the increase in my Serepax dose. So, (D) began the session by asking how the last few days had gone. I rambled on about lil sis's ex finally moving out etc, and she let me ramble for a bit before saying, what she really wanted to hear about was me. How had those five days been for me? I kind of giggled at that point, because she had a point, I was not paying her to sit and listen to my sister's relationship issues for an hour. Ok, so moving onto me. I told her that I had handled it ok. I also told her about my little meltdown on Friday at lil sis, and the residual anger/agitation/irritableness that I had not been able to shake since.  I told her about the incredibly uncomfortable physical reaction that I had to it on Friday (shaking uncontrollably) and aboutt my frustration with myself for not being able to get control over myself in regards to this irritation over the weekend. We spoke about why I was so uncomfortable with anger. She zeroed in on my use of the phrase 'cracked up'. Enter various interpretations...the cracks that allow bits of me to be visible and allow bits of other people access in, the cracked egg etc. Cue my response that the cracked egg in the carton is the one that goes bad, if we are going to indulge in this over-analysis of a throw away phrase. Cue her, if some what predicatable comeback, that the cracked egg allows the chicken to be born. Well played (D), well played. I really don't know why I let myself be drawn into these debates over the deeper meaning of words and phrases, that I am pretty sure really don't much have a deeper meaning. I said cracked up, were I from a different locality I may have said "Had a barney" "Chucked a tanty" "Did my block" or any one of many other meaningless and trite phrases. I guess maybe it's that, if I can engage her in these trivial debates, it is more time deflected away from uncomfortable subject matter.

Finally, she just out and out asked me what it was about anger that made me so uncomfortable. Which of course, made me extremely uncomfortable. To the point where I did what  swore to myself previously I wouldn't do, and let a little too much of my crazy show, by jumping up and straightening her mat. I recentered myself, and answered that anger made me uncomfortable a)because it is unproductive b) because I feel like once I allow myself to get angry I can't contain it and stop it (not like the Incredible Hulk, or anything, I just feel like once I give myself permission to be angry at one thing, a whole plethora of things come pouring out that I am angry about and c) I was uncomfortable talking about it with her, because I knew we held diametrically opposed ideas about anger and it felt too much like a confrontation. (D) considered all this and replied to b) that "it would eventually stop, that is the nature of it" or something along those lines. Then she considered "diametrically opposed. I clarified. I have a firm position in my head that anger is completely unproductive, particularly with my family, as it makes no impact on them, nor does it get them to change their behaviour (see lil sis's lack of help or understanding on the weekend), so all that it does is make me feel horrible and hateful. And she of course, holds firmly to the idea that anger (when contained and appropriately directed) can be a productive thing. I hate situations like this, because I really feel like there is nothing she can say to change my mind... and it just feels confrontational and makes me feel like a recalcitrant child, who won't listen to reason.

So, we moved onto a) anger isn't productive. I tried explaining to her that in my family, my anger is not heard. It wouldn't matter how loud I screamed they would not hear it or accept it. I could get angry at my family's inability to allow me to break out of the role of passive peacemaker who will always give in, or I can just accept that I can't change them, and if I choose to have them in my life (which I do) then I just have to accept that. I came to this conclusion after being told by them repeatedly post-od in 2006 that I had to be more honest about how I was feeling, only to be shut down completely everytime I tried. She asked me how my family had reacted to my 'pitching a fit' on friday night, and my general crankiness and agitatedness over the weekend. I told her that big sis had tried to have a word with lil sis about it, but I just don't think it sunk in. Other than that, I said, they mainly just made a joke of it. She asked me what they said, and I cringed inside knowing how bad it would sound to her. She said that it was not about blaming anyone, just trying to figure out the communication dynamics within the family. So, I gave her the example "Be good, because your Auntie Ophelia is on the edge, and she might crack it, then we'll have to take her back to the nuthouse". I felt so ashamed saying that out loud, becuase I know how it sounds. I think (D) was a little speechless for a moment. I tried to explain that that was just the way they all talked, and that I just had a thinner skin than the rest of them, but she told me not to 'minimise' it. I know, some of the things that my family says could be considered inappropriate, but that's how we've been brought up, to make a joke of things so we don't have to discuss anything unpleasant or requiring emotion. And, yes, at times it feels incredibly invalidating, but I also tend to make a joke of everything, to make other people more comfortable with things. Sigh.

I checked the clock. She smiled and asked me whether time was going a bit too slowly for me, or whether I had something I was wanting to say before the session ended. But it was less about that, and more about the growing feeling of agitation, that I was coming into therapy, and getting these thoughts all messed around in my head, I got to 'feel' these feelings that I apparently have a right to feel and then go home to my very real, very imperfect, invalidation world, and try to manage. I didn't think it was fair to bring up this giant mess of emotions when I had to walk out the door after 50 minutes and deal. Which is stupid, because essentially what therapy is all about. Sigh. Anyway, I told her my thoughts. (D) replied that we did need to work towards getting more containment as we approach some of the more difficult stuff. She said that therapeutically, she actually thought I would benefit from more contact (I currently see her twice a week!) but she realised financially this would be difficult for me (she already charges me a sliding scale rate, which creates bif issues around money and power balances for me) She mentioned looking into some organisations that may subsidise the cost of therapy. But I vigorously shook my head. Seeing her,even for one more session a week just brings to head the ugly issue of dependence for me. Ugh! She talked about the possability of daily phone check-ins, which I also rejected. She asked whether this was because of the dependence issues or because I was worried about being a burden to her. Both really, but mostly the former. She told me that a certain level of dependence is expected and somewhat necessary for the therapeutic relationship. But that it is something that we both keep in mind and moniter. She asked me to think about it and asked if she could call me tomorrow to check in. I shook my head. She asked if this was because I was worried about the being a burden issue. I shrugged. She told me she would call tomorrow. Sigh.

It is a weird, weird, weird relationship the one between therapist and client, particularly in pyschodynamic therapy The reality is, the last few weeks have shown I am dependent on her. And I hate it! And I am fighting desperately against it, whilst at the same time needing the support to anchor me. Arrrrrrrrrrrrrrrgh! How do i know when it crosses the line from healthy (in the therapeutic context) and unhealthy? I guess I trust her judgement. And I do. Some of my family seem to think she is trying to rort me, suck me into staying in therapy, keeping me unwell. Not only is this laughable, as I don't think they fully understand what mental illness really is.  But is also, this is laughable because I am not exactly a cash cow. She sees me twice a week, say 50 weeks a year, so 100 sessions. Of these, medicare pays for 18. Private health pays for 7, but only $65, so (D) cuts the price to $80, so I pay a $15 gap for those. Once those 26 sessions are used up, the next 74 sessions are all down to me. (D) has cut these sessions down by $130 to $30. Do I feel guilty, do I hate this ? Yes. Am I under any illusion that she is trying to keep me in therapy to milk me dry? No. If that was her intention there are plenty of people who could fill my slot and pay her a lot more.

I hate this
I hate this
I hate this

Pummelled. stabbed, stretched and electrocuted

I am pretty bloody tired. I did not sleep at all last night, and I'm just kind of hoping now that a big seizure will come along and knock me right out. Taking another's advice, I decided to give myself some treats today, so I went and got my hair cut, along with the lovely head massage they give with the hair conditioning treatment, went and got some acupuncture and a massage done, and then finally went and got a manicure with (F). To be honest I haven't really done anything to deserve such treatment, but it helped to reduce my anxiety a little.

The acupuncturist was different from my normal guy, and attached me to this machine that fed electric pulses through the needles, which was actually quite painful, but I must admit a little pain was kind of relieving. Nonetheless my muscles are feeling a little less tied in knots than they were before.

So, starting from the beginning, Case Manager (M) came around yesterday morning. We spoke mostly about the insomnia, and some of the unpleasant consequences of it. We spoke briefly about my sleep hygiene, but there was really not much there that I could change. She did query whether perhaps backing off on the therapy for a little while might help, but I guess I kind of think, eventually I have to go through it all, and its going to have the same negative aspects to it whether I do it now or later, so I don't really see the point in putting it off. We tried to work out if there were any particular unusual stresses or triggers that were exacerbating the problem, but to be honest, there isn't really anything that can account for it.  She did a quick suicidality assessment, and realised, I think, the depth of how low and helpless I am feeling underneath it all. This line of questioning is always difficult. There is not much point in being dishonest, that is not going to do me and good, but there is also I reluctance to share particular details as far as planning and dates, because it feels safe (in a f*cked up way) to have that little plan that you, and you alone are privy too. So its always a bit of an internal arguement when trying to decide how much to share. She did ask me about timeframes, and I did not answer at first. But then she quite firmly reminded me that it was important information for her to know in order to do her job properly, so I quite reluctantly shared the date with her. (Which I am not going to put on here, as I don't think that is very fair of me) Our plan of action for now, is to make it through Xmas etc, and reevaluate in the New Year. She did mention the idea of hospitalisation at a later date if it is needed, but I think she realises that I am not going to do anything over the Xmas period, as I couldn't do that to my family. I really quite bulk at the idea of hospitalisation and don't think its particularly helpful, other than to immediately save me from myself, but I don't think it has any real long term benefit, but I guess we'll cross that bridge when we come to it. The other option is to go with the Private clinic that therapist (D) has suggested previously. It apparently has a better program, actual inpatient therapy and a more individualised approach to inpatients. Hospitalisation in a private hospital would only cost me a $250 excess, but I would have to become a patient of one of the Gap Cover Private PsychDoc's who have admitting privileges. And that's where the expense comes in, if I leave the Public system, I will have to pay out of pocket for a Private Psych, probably once a month, and Health insurance doesn't cover that, and Medicare only covers a portion.  But then, in my experience the private PsychDocs tend to be a bit more flexible and creative when it comes to meds, and perhaps a private PsychDoc could come up with a solution to help support through the sleep issue, until the underlying issues exacerbating it are resolved through therapy (if it is possible for them to be....sigh) But, I'm putting the cart before the horse, hopefully it doesn't come to that.

After that I had my appointment across town with Therapist (D) We skirted around the issue of my 'visual disturbances' which I really did not want to talk about. We also, of course went over what happened in the session on Monday, when she notice me baulk when she started to talk about me being angry with her. She asked if I could share with her what the voices were saying inside my head at the time, which of course I couldn't. It was a long and pretty fruitless session (through no fault of hers, I was just finding it really difficult to speak)We did talk for quite a while at the end about trust and expectations. I explained that I found it really hard to believe that she truly was as universally supportive and understanding as she attempts to be, and that eventually, she was just going to get frustrated at my inability to meet the expectations. She espoused, that she didn't think I was failing to meet expectations. After some direct and slightly agressive questioning about what her expectations were, she finally answered that "I show up, and I try my best to share as much as I can". They are some pretty flimsy expectations. I'm not going to get very far if all I do is show up and talk...you know, unless it gets a bit difficult, and then its ok, to sit in silence and waste her time! I was taking quite a frustrated tone with her, but to be honest, I was more frustrated and angry with myself. I know that I am hanging on by a thread, and I know the only way to move away from this place I keep returning to is to push myself to enage more in the therapeutic process and sort this mess out once and for all. I don't have the space or time to twat about! And yet, I seem to be incapable of doing this, no matter how I berate or beat myself up over it. And I know the ONLY person who can change this is me.

So after therapy I had a date with Bachelor Number 1, which given my current frame of mind I would have gladly cancelled, only he had organised a suprise for me. He also asked whether I would stay the night at his place, so we could wake up together....arghhhhhhh! This is the last thing I wanted to be dealing with at this time. So, I called for some back up support, and the gentle kick up the arse that I needed from (K). There was no doubt about it I was just going to have to suck it up and go. And, I was going to have to really suck it up and have a conversation with him explaining about my sleep difficulties and some of the other issues that were making the idea of spending the night so terrifying. We went to a lovely Turkish restaurant and had a really nice dinner. And then he took me back to his apartment, where he had done the very cliched but sweet rose petals throughout the apartment, candles and chocolates and roses on the bed. (Double arggggggggh). Ok, breaks on. I took him outside and we had a discussion, but he convinced me to give the whole sleepover thing a chance. So he drifted off, and I spent the next hour lying next to him wide awake, worrying, amongst other things, that if I went to sleep I was going to have a nightmare and wake up screaming...way to freak I guy out. I needn't have worried, because I didn't have a nightmare... I didn't sleep full stop. He on the other hand slept like the dead. So after an hour or so, I extracted myself from the bed, and I went out on the balcony, where I spent the whole night, surfing away on the computer and watching the city lights dim and the sun come up over the river. I really should have taken a taxi home. I had told him I might have to. But I didn't want to dissapoint him. So instead I just stayed awake all night, and slipped back in beside him at about 6.30am. Sigh....I am pathetic.

So, thats my world in a nutshell....

Everybody wants control of my brain

Therapy this afternoon. We spoke briefly about the work that I'm doing at RMH, and how I can gauge whether I'm dealing with the emotion of bearing witness to some pretty sad events in an appropiate way or whether it is becoming a case of taking the sadness in too much, to the point that it begins to impact my own mental health in a negative way. I think at this point I am handling it pretty well, and it is not a major issue. But I am aware of the fact that I have to keep an eye on this. Speaking to my mother last night, she expressed similar concerns, and whilst she acknowledged it doesn't seem to be an issue at the moment, she urged me to be careful, explaining that in her experience as a nurse (and a number of year working in a nursing home.. which by nature is steeped in death) that the effects of bearing witness to death, can be culmative, and sneak up on you. She stopped working in nursing homes, because she began to burn out emotionally, after years of developing relationships with patients only to have them pass. And she pointed out that at least in that situation, one could derive comfort from the fact that it was an inevitable part of the circle of life, and the majority of the deceased had led long lives. At the RMH, it is children who are dying, and that will never be natural or acceptable. I think it will just be a case of having to carefully moniter myself to ensure that I am balancing the need to 'be there in the moment' with the residents, against the need to protect myself from the trauma of repeatedly being exposed to the sadness and unfairness of children passing. And I am only volunteering a couple of times a week, it makes me wonder how paediatric and neo-natal nurses manage to be immersed in it, and not burn out, or lose faith in the Ol Guy upstairs who allows such things to happen time and time again.

We then went back to the issues with lil sis, and more specifically to my inability to express anger or even to comfortabley allow myself to feel it. At this point 'The Voice' and some of his auditory comrades began to grow louder in my head, and when she suggested that perhaps I was angry with her, and that was ok, they began to make so much noise, I was finding it hard not to be pushed completely out of my own head. She went on to assure me, that it was ok to feel angry towards her, and that relationships can survive anger. In fact it was impossible to have a true relationship without it. She tried to explore my explanations that I felt anger was pointless and not productive... but must have noticed that I was having trouble trying to stay present in my head, with the entities that were trying to fight me, and each other for control. She stopped, and took a minute to try and assess where I was at, and who was talking inside my head. She asked me to share what they were saying, which I was promptly told (by them) not to do. To be honest, even if I was allowed to share, it would have been hard to, as it all becomes tangled up, and there is just so much competing din, that I find it hard to really here what each individual voice is saying.

The gist of it was a) "She is only saying that because she has to", "This is supposed to be about fixing up your fucked up behaviour, not getting angry at other people, you are the one to blame", "People only just manage to keep on caring for you, because you demand so little from them... most of them are just looking for an excuse to cut all ties... so go ahead, get angry, see how quickly you end up all alone" "Nobody wants to hear your pitiful  complaints, you are nothing... less than nothing, you are not worth the effort etc etc.." (The Voice) b) "She is trying trick you, just shutup and let me take over" "Do not speak. DO NOT SAY A WORD" (Game face) c)"Get up and walk away" "Go on then, if she wants to see Angry, show her how mad you can get" (The Others) There was in fact, a lot more than that screaming around the corridors of my mind, arguing back and forth, but it gets to a point where it is so loud and so simultaneous, that I only hear brief snatches of it, the rest just blends together as a general din. And on top of that, I experience being 'pushed' out of the way and to the side within my own head, so everything begins to take a kind of disconnected, fog like feeling. A new one, (which now I write about is sounds really crazy) is the Paranoid voice, which has long been a member of the chorus within my head, but this was the first time he really showed up in therapy (with D anyway). He quite often will tell me that people are trying to catch me out. They can read my minds, they have cameras set up, they are accessing my computer etc etc. I can usually just dismiss this as paranoia, all though there is a persistant uneasiness that follows it, and I must admit it is a fairly pervasive thought... particularly about reading my mind. I suppose to honest, that has come up a little bit in therapy, especially since (D) tends to be fairly perceptive, and can often guess quite accurately at whats going on in my head, or at least is able to tell when something changes, like the voices ramp up. But Paranoid Voice, as a seperate entity to myself, has not really shown up in therapy till today. Today he was claiming that D was secretly filming me, and wanted me to crack up and get angry.. I don't know to what purpose she would be doing that, it obviously made no sense on so many levels. But there it was anyway. As I have mentioned before, these voices are obviously just seperate parts of myself that I cannot reconcile or 'own' as my own feelings, so they have been separated into discrete entities, masculinised or feminised. I really wish that I could experience these as what they are, MY thoughts and feelings, it would be a lot easier to reason with something that doesn't seem to be running its own agenda or battling me for control.

Anyways, I guess (D) must have decided to back off a little bit and give my head a chance to quieten down... I'm not really sure what we talked about next, it all gets a bit blurry. The next thing I became aware of, does not bode greatly for my sanity. I experienced a brief hallucination. I saw a snake slide its way from under her desk, and dissapear under the table beside me. Now, normally this would have probably caused me to gasp, or show concern like any normal person, but the fact is that this is the third such hallucination that I have had in the last week or so. I attribute it to being most likely a result of extreme fatigue from the prolonged bout of insomnia that I am experiencing write now (its been well over a month since I slept more than 3 hours a night) So, having experienced this little visual blip, I managed to keep what I thought was a fairly neutral demeanour. But once again, (perception? esp?) D managed to tune into the fact that something had just happened and asked me about it. I brushed her off saying it was nothing. To which she replied, "Its not nothing. You look so worried". Desperate for escape and not really wanting to talk about it, I looked over at the clock and realised ou time was up, so I told her I had to go or I would miss my train.

Oh, now I remember, I think we talked briefly about my appt with BabyDoc on wednesday and more specifically about my appt with BossDoc (the consultant psych who actually makes the decisions regarding treatment, and when to discharge a 'client' from the service) This will be at the beginning of January, and I mentioned to her I am feeling quite nervous about the whole thing. I'm not quite sure why other than the obvious not wanting to talk to yet another person I don't know and the anxiety I have relating to being trapped inside the rooms in the giant purple amoeba of a mental health building. I think some of it comes down to not knowing if I can adequately describe my concerns, worrying that he will brush over some of the more difficult symptoms I am experiencing. Like the insomnia. I am not by any means a drug seeker... I would love to cut all psych meds out of my daily regime altogether. But when a person is getting 3 hours sleep a night for a protracted period of time, it needs to be treated. Obviously, the most appropriate treatment is therapy, as there is no medical reason why I can't sleep... it is pure anxiety. But that is a longer term project, and I need help immediately, with the increase in seizures and now these little pseudo-hallucinations (I say pseudo, because in my mind, a complete hallucination would be a detachment from reality, I see the hallucination, but am cognitively aware in the moment that it can't be real, and that it is just my brain throwing something that is not real out there) Anyway, am not quite sure I want to tell Boss Doc about this, as I dont want to appear nuttier than I already am. My concerns from a medication standpoint, is that my general baseline of depression is not too bad with the Avanza, its there, and I deal with it, but its not that breathtakingly low black place at the moment, I am better with my ADLs generally, although there are days when I find it hard to get motivated and self-care. But in general not a major issue, right now. My anxiety is fairly constant and at nighttime or times of particular stress ie lil sis and bf screaming shoots through the roof, and the occurence of flashbacks and panic attacks, is on par with the way it was before I was hospitalised. And with that, and the sleep deprivation my concentration is shot to hell, and my school work is suffering. On top of that, my anxiety causes me to worry that everything I do write is rubbish, so I rewrite it and rewrite it, until eventually it makes no sense at all, but the deadline has come and I have to hand it in anyway. And the final thing i've noticed is that since I was taken off the Largactil, the voices are more constant and louder, which kind of worries me, as that would indicate if an anti-psychotic quietens them, that is might be a psychotic feature, which doesn't make a lot of sense to me, as I have insight enough to understand that they are not real, and if they were a result of psychosis, I wouldn't be in touch with reality, right? This is something I really do not want to tell the psychiatrist about, and I kind of wish there was a way that I could make him see that I need th seroquel or largactil without having to say anything about the voices.

Anyway, (D) suggested that we need to talk about the upcoming appointment, so we could find a way that I could comfortabley share the pertinent information (but not ALL of it). She thinks it is a priority to ensure that I am not discharged from the service just now, and as i have mentioned in previous posts, I kind of agree with her. I hve this sense at the moment that things are beginning to teeter on the edge. The culmative effects of the insomnia and anxiety are beginning to make it harder and harder for me to hold things together, and I am expending so much energy into fighting to maintain my responsabilities for school (and failing) and holding myself together for work, and for lil sis and just because I know its my responsibility to do so. I have a range of professionals supports who are willing (at present) to be there for the moments when I cant keep it together, that I feel obligated to make sure I am doing whatever I can to control, modify, self soothe what I can and to use the techniques and tools I've been supplied with. But when you are sleep deprived the energy you need to do all of things....school, work, self-maintinence begins to wane. That's the tightrope I'm trying desperately to walk at the moment.

Anyway. So I pitched my excuse about trains and hightailed it out of me.... dragging the voices along with me, and although they have quieten some, they are still there and arguing with every thought that I have. It is a horrible feeling when you are trying to write a blog entry having one voice decry that 'that's not what I said' another voice laughing hysterically and saying nasty things about what I'm writing and what a loser I am, and another voice telling me that we are alone and we need to call somebody to talk to us, even though its midnight and I'm trying to reason with 'the Baby" that we can't call somebody at this time of night.

Well, I'm going to leave it there... the entire post probably makes no sense, as my mind is a bit all over the place. Sorry bout that! 

Shite days

Cartoons by Andertoons

So, today has been a pretty shite day. Well, its been a pretty shite couple of days. Lil sis and her (ex)partner, (who I live with) had a horrible screaming match on Tuesday night, and I was of course dragged into it... he told her that she was making him crazy, and that it was no wonder her sister (me) walked around wanting to kill herself all the time. Which was a bit of a shock a) because it was a nasty thing to try and insinuate that she is responsible for my MH issues, and b) because I thought I was doing a damned good job keeping my suicidal ideations and other struggles from her, only to figure out, I've been expending all of that energy for nothing, because I've been fooling noone. But it did confirm that she doesn't want to hear about it or deal with it, or she doesn't know how to deal with it, because she has not once asked me about it, or even acknowledged in any manner that she knows I am struggling. Aside from all that, as mentioned in previous posts, the screaming just transported me right back to childhood, and I spent the night pretty upset and shaken up by the whole thing. And of course I didn't get any of my assignment done.

So, after next to no sleep.. (on top of everything when he left the house he let my cat out, so when I did finally fall sleep in the wee hours of the moment, I was woken up to the sound of her fighting outside, and she wouldn't come in, so I couldn't settle back down to sleep) I got up early wed morning to head off to the Ronald McDonald House where I volunteer. It was xmas party for the kiddies, so I passed the day doing crafts with the little munchkins (a good distraction), but by the time I got home at 2pm, I had to work flatout to get my assignment finished in time to hand in at 5pm. My brain was fried by the time I submitted it at 4.45pm.

So, after another night of fitful sleep (although better than the night before) I headed off to a specialist appointment this morning, where I was told surgery could be put off for at least another couple of years most likely (good news), but the whole appointment was just very horrible and triggering.

Off after that across town to see (D) therapist. This was a weird, and not incredibley pleasant subject. (D) was a lot more forceful, and almost...confrontational than I have ever experienced her in the past. I could understand (intellectually and logically) where she was coming from but.... The gist of the session was pretty much that by staying in the house, where I am obviously exacerbating my stress, depression, anxiety etc, I was not 'protecting myself'' but instead focussing on 'protecting my family' as I had already done. And that my inability to stand up and say 'hey guys, this is really affecting me badly, could you leave me out of your fights, and try and have them a little more privately' was once again, me sacrificing my needs to keep the peace and not rock the boat. Basically she said, that I am scared to let my needs be known, as to do so would make me visible, and I expend so much energy making myself invisible. I just am to braindead right now to go into the long history that makes me unable to even contemplate doing this. And whilst on one level I logically accept her points, and I DO recognise, that as an adult I am making a choice, by remaining in the situation, emotionally I am not willing to live with the consequences of moving out or trying to make lil sis understand what it is doing to me mentally. If I was to acknowledge what is obviously (I see now) the great purple elephant in the room, my mh issues, lil sis would be forced to acknowedge too, and she DOES not cope well with the idea of my mentalness. In fact the last time I had a major crisis period (in 06) she did not talk to me for 6 months, and it really took till 08 when she moved in with me to really begin to regain the relationship that was lost. It is the same to different degrees with all of my family. Whilst many of them (lil sis not included, she just blanked me from her life) expressed to me in 06 after the OD that they wanted me to 'be honest and tell them what was going on before it got out of hand', when it came to the pinch they just couldn't actually deal with the uncensored truth, and in fact, got very passively or aggressively angry with me. What they actually meant is, we want you tell us your OK, we want you to BE ok, because we don't know how to deal with the emotions that you 'not being ok' or not living up to the expectations of your role within the family is. And so after several months of attempts to follow their overt message, I finally got the message and listened to that implicit message instead. Because I would rather deal with my MH issues on my own (with the help of professionals) than lose the relationships I do have with my family. I can't change how they are, and I either have to give up and walk away (not an option in my book) or figure out a way to just deal with the inherent stress they all bring into my life. So, its not just a case of fear of confrontation or standing up for myself ( although they are intrinsic issues, it is a matter of having looked at the options available, and chosen the one that I am least unhappy with. Which was frustrating, apart from her unwillingness to let it go and move onto another subject, her confrontational attitude, which was a bit of a shock.... there was also the realisation that as unhappy and stressed as this situation is making me.... I did and continue to still, choose it.

Anyways, I only had about half an hour after that to pull myself out of the bleurgh that the day had plunged me into before I had to head off to my volunteer job. But I manage to muster up the required smile and calmness required and completed mmy first solo shift tonight... which was quite daunting, being in charge of the whole house. It was, once again a good distraction, a great deal of the shift was spent just listening to the parents, giving them a friendly ear and a shoulder to lean on. There was lots of good news... this baby putting on weight and off the CPAP, that child finally scheduled for a much needed op... and therefore a forseeable end date in sight. I did have my first really emotionally confronting conversation with a pair of very young parents who just lost one of their very premmie bubs. I wanted to cry, and had tears welling in my eyes for them, but the situation required someone calm, who would just listen as they talked through their experience, the funeral arrangements and their grief. And that is really the most important part of the job, and although sad, also fulfilling, because you know that just the little task of listening, helped them in some minute way, in this horrible experience. Luckily, there are also so many wonderful and miraculous stories, it balances out somewhat. I find it amazing, that babies born at 25, 26 weeks manage to fight their way through and survive.  And I find the parents resiliency and fierce love awe-inspiring. I met a little toddler yesterday who weighed less than a coke can when born, and now is this beautiful little girl, with next to no long term damage done.

So I finished there at about 11 and caught the bus home. I'll just make a note hear that after 6 months as a disabilty bludging student, I haven't had to wear closed in shoes since I quite my previous job in June. I am quite the minimalist when it comes to shoes, and much prefer a pear of thongs or sandels to closed in shoes. Thus the shoes I wore to work yesterday gave me the most remarkable blisters on my heels, and although I elastoplasted them up and wore a different pair of shoes today, the heat made the elastoplast slide off, and by the time I got off the buss to walk home, the back of my heels were covered in blood, and quite painful. So I took my shoes off and walked home barefoot, which resulted on me standing on a small piece of glass that I have now had to dig out of my foot. Minor injury, but a bad end to the day. So I am home... but it is hot, and the last few days have just left me feeling quited deflated. But I think the best plan is to just keep staying as busy as I can, pasting on a smile, and faking it till I make it.

NB: I got a letter in the mail from Public Mental Health, saying that I have an appointment with head honcho- consultant psychiatrist in January, so Case Manager (M) has come through with that. It still remains to be seen what he will personally make of my current state of being, or really to even know what state I might be in come January, but it is a hopeful sign, that maybe they will hold off on completely discharging me from the service, if it is indeed still needed in January... which therapist (D) feels it will, and on this point I tend to concede she is in all probability right.

Back on the couch

Its been a while since I talked about what was going on in therapy, which was of course what this blog was intended for in the first place. So, today I arrived at therapy two hours early (a combination of the heat and insomnia fuelled fatigue mushed my brain to the point where I got my times mixed up) so I spent two hours sitting in the air conditioned pub next door, drinking diet coke and reading a book that was loaned to me by Consumer Advocate (K). How I kept myself alive when my brain was trying to kill me (definately a post on that one when I've had a chance to read a bit more. I'm pretty damned exhausted, and I guess wasn't feeling up to a big, messy session, so we had a bit of a therapist/resistant client duel going on. Sidestep a question here, answer another question with a question there, and the proverbial favourite answer of all avoidant clients 'I don't know'. We talked a little bit about 'Game face' and how I used it to get through the weekend, and my date on thursday night with Bachelor number one. And then she asked if I had Game face on right then in therapy, to which I answered honestly, yes. Trickily, she asked if I was to leave Game Face at the door, what would that look like, to which I answered (aha! Don't think you can get me that easily!!!) "Now what would be the point of me using all my energy putting Game face on today, if I was to answer that question?" (Off the cuff defense!!) She laughed, and realised she wasn't going to get to far with anything heavy today, so changed tacts. We talked a little about a hallucination that I had a few days ago... I thought that maybe it was something to be worried about, but she told me not to be overly concerned with it. That given my current level of fatigue, it is not unexpected, and that these things can commonly happen as people are about to drift off to sleep, which I think I was, until I 'saw' a snake slither across my bed and scared the beejeezus out of myself! So that was comforting to know, that I'm not slipping into some new level of madness. We talked some about an idea that sprouted in a converstion with (K) this morning, where I mused if there was a scale of fucked-upedness, would where I placed myself along the spectrum, differ from where other people would put me. I came to the conclusion that yes, objectively people would see me as 'coping' a lot better than I subjectively see myself. She asked (one of those magic 'if' questions) if I could choose where I sat along the spectrum where would I put myself. I answered that although I know the expected answer would be somewhere towards the top, but not right at the very top. The whole, your negative experiences can help to shape you in ways that someone who does not experience many obstacles is not, you need to experience the dark to appreciate the light and all that. But that if I was to be honest, I would prefer to be right at the top living a completely calm, neutral, content life with no gremlins in the closet to bother me. I went on further to elaborate how much it can irk you sometimes when people talk about all the things your experiences had taught you, and how they have shaped me into a more insightful, empathic person. Said at the wrong time, it can ring of platitude.... and in reality, I would far rather have come by insight and empathy a different way, thank-you very much! We spoke briefly about how the relationship was going with Bachelor Number one, and she tried to get me to tell her what happened all those weeks ago when I had my complete flipout in front of him, but I promptly erected my red light, no go there zone. All in all, was a session with interesting conversation on an intellectual level, but not much on a purely emotional level, which was actually pretty good for me today, as I have been a bit of a depressed amoeba for the past few sessions, and not even up for discussion on an intellectual level, let alone an emotional level. So at least I actually did a reasonable portion of the talking this week. The resistance is an issue, because eventually I am going to have to allow myself to be a bit more exposed and vunerable if I am to effect any change. But as today it was, a deliberate self preservation resistance, rather than the usual "I'm trying really hard to move past this block, but I just can't make myself let it go, and its very frustrating', I wasn't too bothered. Sometimes I think, its just not the day for 'therapy' as such, but the act of going and keeping up with the consistency of it, and even just touching base to confirm there is someone there to listen and who cares, is all that you need for that given moment. I will try harder on Thursday.

I have done a few volunteer shifts, and they rang me to do a further five in the next few weeks, so that has been some good distraction and much needed time away from the navel gazing. Uni work is slipping behind and I must catch up on assignment that is due on wednesday tonight and tomorrow. But as I was challenged by (K) today to try and practice beeing kinder to myself and not such a hard task master, I am going to temper the drudgery of assignment writing, with some kind of treat for myself if I can get a reasonable amount done in the morning. Haven't decided what yet though! :) Case Manager (M) will also be dropping round for a catch up. Haven't seen her since the panic attack last fortnight, and am kind of stomache churningly embarrassed at the though of seeing her again. But she is a professional and will have seen a hundred people freakout worse than I did, so I just need to get over myself a little.

Am a little worried that there may be some tension between her and therapist (D), as (D) is not very happy about their plan to discharge me from the service in January, and I think, said as much to (M) over the phone. But really, there is very little I can do about it, the decision has already been made, and I need to just get as much as I can out of the last few weeks of support, and worry about finding a new private PsycDoc, and establishing new safety net contacts in the New Year when it all goes ahead. Its not really my place to get in the middle of professional disagreements, even if they are about me. And as I said to (D) it doesn't pay to rock the boat too much in the Public sector, as you will quickly find yourself being labelled a difficult client, and then getting any kind of help is made a hundred times harder.

Sleep is still a major issue, and clouds so much of what goes on in my life... I'm riding somewhat of an exhaustion high at the moment, after the craziness of the weekend, but am aware that it is all somewhat of a facade, and the likelihood of a crash back to amoeba status is reasonabley high.... just going to keep up the 'fake it till you make it' routine as long as I humanly can before I crash. The voice, and the gremliny thoughts are still there chugging away pretty strongly in the background, but (fortunately, in some ways) I've just got too many commitments at the moment to allow them to take over completely.

Well, that's life in a nutshell. (no pun intended)

Its time to have the talk...

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

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

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

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

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

Sigh.

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

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

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

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

The Dunce

I have a meeting with Case Manager (M) tomorrow. But this is going to be one wwith a twist... she is introducing me to a former 'mental health consumer'. They have some fancy title for them which slips my mind at the moment, but they are basically people who have been in the system before, have had mental health issues, and found ways to make successes of their lives. They come and talk to current clients through request by Case Manager, to share their stories as, I dunno... I guess a beacon of hope? Sounds great in theory, and in some ways I am interested in meeting her. I have often found it to be the case that those who have actually experienced mental health issues themselves can be of more help than the "professionals".

But there is also another part of me that is resistant to this arranged meeting. I guess, it comes from Case Manager basically saying to me last week that sometimes they label people Borderline Personality when they have been in a few different types of therapy with limited or moderate success. Basically those of us that fail the goal orientated behaviour therapies like CBT. So I kinda feel like the dunce student being shown the A-plus student. Kind of like, this is what you could be if you just put a little more effort in. Probably the wrong way to think about it, and I'm trying not to, but it hurts you know? Especially, since, being an inate people pleaser, I actually was the A student at school, who never got in trouble, no suspensions, no skipping school, not even detention. Basically if I could humanly do what they want me to do, what would make my family and friends happy and get 'better' I would. I try really hard to follow whatever advice, rules, medication regimes ect have been put in front of me. I don't skip therapy. I don't show up late. The few times I have rebelled against 'whats best for me', its been at times when I was just too damned tired to keep the enormous effort of what they ask from me going.

Sigh.

Anyways. Will see how it all pans out. Have decided to have a chat with Case Manager tomorrow anyway. She sees (I believe) my distractedness and aloofness as a form or resistance or challenge to her, and I want to try and explain that a)it takes me a while to trust and get comfortable with new situations/people and b) the room we meet in at the clinic totally freaks me out. Its really small, because they have so many offices crammed in, you can hear all the noise from around you which triggers my hypervigilance, and doesn't really assure me of the confidentiality of what I am saying and it locks and unlocks with a swipe card, which makes me feel trapped. I hope that if she undestands this, she might be able to understand me in context a little and not take these things on face value.

In other news. Toe is almost definately broken. Its purple and black and quite sore. So have been off my feet for most of the last few days (I know... I am such a wuss) But in the good news, has given me a chance to learn how to play Bob Marley's Three Little Birds on the guitar. I'm sure my beginner attempts at the guitar are driving the neighbors to distraction, but it gives me something new to focus on and sink my teeth into. :)