Steps.

Standard

I saw R tonight. We’re seeing each other monthly at the moment, and tonight was the first time that I felt okay about the length of gap either side of this session. Our work is more mentoring than counselling, but our last session, I was a complete mess. Things were awful with T, I was so suicidal and struggling to fight the urges, and perhaps most importantly I was unbelievably exhausted by work. I’m unable to think rationally when I’m in that dark place, so our last session was mostly me crying and whining and fruitlessly begging for someone, anyone to save me. R was brilliant but it wasn’t what I am hoping our work can be.

Tonight, it was.

I find her breathtaking in her ability to just get it. Two sessions ago, we had talked about a sort of resources scale. At the moment, my emotions go from 0-10, and I’m so volatile I’m usually at either extreme. I almost never feel like I’m in the middle, and this means that I pretty much always feel like I’m in a crisis. This can be why T and I get into difficulties – my crises are so frequent that we speak a lot, but when she cannot reply (because she is working, or busy, or away, or sleeping….) I can’t cope. She feels like my only option, or certainly the only one that will comfort me (or Little). When we cannot connect (and sometimes this happens because I haven’t messaged her because I know I shouldn’t, but this triggers the same abandonment reaction, I still feel alone), I resort to harming. Immediately. There are never any shades of grey with me – I am only ever black or white. Coping or not coping. And my fear is that soon, I will be alive, or dead.

So today we came back to the list. T2 and I, years ago now, made a ‘Relentless Self Care’ list. That was a classic case of great therapist, resistant client though, as her list got very little use – she pretty much wrote it for me and I was very unwilling to give it any substantial effort. When I did use it, it was helpful though, so I am sort of keen to reinstate a list that is made up of positive coping strategies, and on some sort of scale, to try and give me a sense of the shades of grey in my moods, and the beginnings of self-compassion.

I was really nervous before the session today because I knew this was the plan, but part of me is incredibly resistant to putting anything positive in place. R and I spent a lot of today’s session talking about why I feel this way… it was probably the first time that I was that honest with someone about why I feel so resistant. R has an incredible way of holding me as an adult in our sessions, she is more capable of this than anyone I have worked with. The ‘adult part’, who T regularly talks of but I feel is non-existent, is finding an integrated voice with R. It has the effect of me seeing things with a more birds-eye view than often happens in my sessions with T, and today I even felt very slightly protective over all the younger, more broken parts. But the list was still bloody hard to think of.

The main reason seems to be linked to my inability to be self-compassionate. Yesterday’s session with T was so shocking to me because for the first time, I was unable to blame myself. I cannot look at that tiny baby and blame her. I spend my life blaming myself, believing that I am a fraud in this world and that inside, I’m rotten through. ‘Being kind’ seems like such an alien concept when I hate myself so much. I’m not stupid, I have lots of good ideas about how to be kind – but mostly, I want to be punishing myself. The relief I find in cutting, the pain giving way as the blood pools then runs over my skin… that relief is because it’s a tangible punishment. Look at how bad I am… I’m so bad that bleeding is the only thing suitable for me. Why would I be kind?

Thinking of being kind to myself when I have been so bad triggers a really painful trauma response. Her voice in my head screams I’m sorry I was bad I’m sorry I was bad. She repeats it like a mantra, over and over, progressively more desperate. It’s easier to silence her with blades than it is to consider where she was taught to say that phrase, to make her whole self into one big apology.

Another reason is that I am not sure I truly want to get better. I can feel, deep in the pit of my stomach, that being able to acknowledge my emotions, regulate them through self compassion and then choose to support myself with positive strategies is the next huge step for me in therapy. It feels like this might be the biggest of all the steps, actually – this is why I started therapy in the first place. If I could have written an agenda at the beginning, it would have looked exactly like this. But now I’m here, I’m terrified. ‘Getting better’ means leaving therapy, and leaving therapy means leaving T, and R, and all the other professionals I have worked with or might work with. Leaving T is the big one – I finally feel securely attached, I finally feel loved, I finally have that relationship Little has always needed. Getting better means stepping out of the safety zone, where I am guaranteed that relationship. It’s only for a few hours a week, but it is invaluable, and because I am only ‘loveable’ when I’m paying someone, leaving her means losing this feeling. Forever. I feel like people only care about me because I am broken (or because I give them what they want – money, sex…). The professionals who work with me, only know me because of the scars I bear and because it’s their job to fix those scars. The other people in my life… I have some brilliant friends, but I also keep company with a lot of people who only care about me because I am broken. I am ashamed of the ways I have allowed myself to be used, and I am ashamed of the ways I have played to my weaknesses to allow people to feel like knights on noble steeds, sweeping me off my feet. I feel I am only cared about when I am broken, weak or unable to care for myself. If I’m making steps to make myself strong, I risk throwing these relationships away.

T and I have gone around this conversation so many times. We always get back to the same place – she cares about me as a human being, not purely as a client. She will always see me, for as long as I need her to, and she reassures me every single time that I will be the one to leave her, not the other way around. And even when we do finish, she reassures me that we won’t lose contact – clearly it will change dramatically, but unless I wanted there to be, there doesn’t have to be a time where she is completely removed from my life. When talking to R today, I had a real sense of weighing up this fear of abandonment against the unbearable agony of the emotional place I’m always either in, or hovering just above. I said today that I don’t feel like I have a choice but to risk trying to get better, and hope that the people around me still stay. My god, though, I hope they stay.

Which brings me to my worry that I am nobody without my history and my issues. I went to Barcelona last week, and I’m going on holiday again tomorrow – but in the three days in between, I have journaled, attended three therapy sessions, struggled with food, and slept. I’m building a life for myself, working my arse on developing my ‘identity capital’ (see this woman and her book for more details!), but I am still fundamentally terrified that I will drop off the cliff at the end of therapy, and become a nobody. I started therapy because I had my whole life ahead of me, and I was ruining it because I could not cope. The secrecy was fundamental to the life I was trying to build, but it was destroying me. The first step for me in therapy was breaking the secrecy – telling someone, week after week, about the things they did to me and the way I felt then and now. In the last year or so, I have really found my voice in this sense – I blog now, I go to support groups, I am more vocal in public about eating disorders and mental illness. I have friends who I speak openly with about what is going on for me – friends who I ring so we can dissect therapy sessions together, friends who have the same nightmares as me. Even my parents are aware of my eating disorder and I talk to them about sanitised aspects of treatment. I’m singing freely now, and suddenly starting to package all my trauma and drama back into a box, making it become something not all encompassing, feels like being told to make it all a secret again. Little is absolutely manic about this – the idea of putting her back in a box feels scary, and not something I want to do.

R reminded me today of a model that T2 and I spoke about when we ended therapy together (original post here). The Tonkin grief model suggests that grief is initially all-encompassing, but eventually we grow around it. R described it today as a fried egg – the inner circle is initially almost filling the outer one, but eventually the outer one grows. What I remember feeling comforted by when T2 and I spoke about this (in the context of grieving endings) was that I wasn’t being asked to squash my feelings down, or make them smaller – they were not being stifled. Instead, I would grow around it. It has the illusion of the inner circle being made smaller, but in reality it is the positive part that is growing. No shrinking happens at all, no stifling. Being reminded of this today has helped me feel a little braver in making a start on that list.

We started at the bottom, with ten minutes to go. The list has to be fluid and open to adaptation, and I trust that R won’t be cross with me if I cannot stick to it or if it takes time. I trust that T, who is the one stuck in the middle of this with me, is standing by me until I can manage this in a more acceptable way. The benefit of the last month of intensity between us is that we’ve come out the other side of it – and I do trust her when she says she isn’t leaving, no matter what.

The bottom of the list is ‘go to A&E’. This really would be my very last resort, as I would lose my job. But, if I really cannot keep myself safe and alive, that would be the last option. Next up is a suicide respite centre – confidential, a time out with some peace. Again, a real last resort as it would mean time off work… but again, if I really cannot be safe then I would go. Then I put T on the list, about halfway up the page. I ummed and ahhed for a bit about where to put ‘ring Samaritans’ – at the moment I would only ring them after trying T, but I think they should maybe be before. There are levels of contact with T, though (text, email, phone call, crisis message), so I could maybe adapt the list to include those options (certainly emailing her is preferred and okay whenever I need to). With a few minutes to go, I wanted to put something at the top – just to get a vague skeleton in place before a 5 week break. At the top, I wrote “tell someone”. I put a friend’s name next to it, but I want to leave some flexibility to be able to reach out, in a crisis, to whoever feels safest. R wrote underneath it challenge the beliefs!. I am always so scared of telling when things aren’t good – I shut down until I get to such a point that I cannot reach any of my other healthy strategies. So that’s the skeleton. I am going to spend the next five weeks trying my damned hardest to tell someone at the beginning, before things get bad – and I guess being aware of when I cannot, and writing about it maybe.

I hate leaving R, there’s always a really panicky moment on leaving, but this feels like a really good place to be left in for the next month. What a therapy week! I feel like T and I struck gold yesterday, R and I examined things from a bird’s eye view today, A and I are ending therapy but with next steps planned. I feel like I’ve made the first step in this next really big step. And driving home after our session, I realised I don’t feel scared tonight.

I think maybe I’m ready.

x

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2 responses »

  1. Wonderful progresss on all fronts! I am sure, with time, you can learn to be much more self-compassionate and to work through the list when times get hard.

    I think tgst n one will love you any less when you are better: they will be pleased for you, and inspired full of hope for anyone else they know on a similar journey 🙂

    A fab note to go on holiday on: enjoy! 🙂

  2. Hi plf, I was both sad and hopeful reading all of this. The list sounds very rational and I think it’s helpful that it’s fluid and subject to change. You are envisioning a time when you can wave goodbye to therapy, to T and R and the people who feed off your misery. I am glad that you go to support groups as well and therapy and blogging, because this seems like a ‘real world’ approach rather than the more insular support mechanisms of the online community and talking to a paid professional.

    I hear your very real fear that you might drop off the cliff at the end of therapy. This is totally understandable because you can’t see a ‘future you’ that doesn’t have that crutch, that safety blanket wrapped around you, especially at a time like now when you are making breakthroughs every session you go to. I can’t tell you not to worry or just to have blind hope, because honestly no-one, not even you or your therapists, know what is going to happen next. It’s kind of self-evident advice but… take one day at a time.

    On a subject that I know is on your mind, it is tempting to treat our issues like a pet and nurture them. To feel that we have nothing without our own brand of madness & our issues. I have been guilty too of making issues bigger than anything else in my life and not letting them go. It’s a safe cosy place to hide and that’s the truth. I wonder if I am still doing it now. It all feels so real to me but this is the real world and our actions and even our thoughts affect other people too.

    I hear you sister, when you talk about playing on your weaknesses and allow others to help you only when you feel so low you can’t help yourself. I have used my friends as props to help me feel better and have burdened various friends and partners over my lifetime with my Big Problems, whether they are about identity issues, loneliness, drinking, depression, inadequacy, communication difficulties, fear, abuse (both giving and receiving)… the list goes on. Real people in your life will care about you whether you are broken or not. And those that don’t, that are only hanging around in order to prey on your vulnerabilities, will soon disappear. But only if you start challenging what lurks in the darkest recesses of your mental landscape, and making changes in the way you interact with these people.

    It would be too much to start making lots of changes all at once and it only becomes overwhelming when we discover that we can’t keep them up. We fall back into our old ways because they are comforting. If you can promise that you won’t beat yourself up if this happens, maybe that is the basis for change. That and mental preparation for change which it seems you are doing with your list of whom to contact, your thoughts about leaving therapy and changing your relationships with those that you allow to prey off your abandonment issues.

    One thing I was curious about though was why you believe going to A&E would mean the end of your job. Excuse me if I am prying here, perhaps you’re not at liberty to say in which case I am sorry for asking a personal question. My understanding was that it is private and a hospital is authorised to inform your employers or other healthcare-givers without your express permission, but maybe I am mistaken.

    I hope that you have a good holiday and see you on the other side. Above all, take care of yourself. X
    therapyjourney

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