My CAMHS notes state that ‘therapy with Alice is a challenge’. My private therapist howled with laughter when I told him. He more than agreed. And I have to concede, it bloody well is.
I don’t mean for it to be- or want it to be, and I don’t really understand why it is. But it is. Always has been. And it frustrates me to no end. For years, I’ve arrived with something in mind that I want to talk about. And for years I’ve left therapists offices kicking myself for having spent the hour in stony silence. It may have something to do with the fact I’ve had over a dozen therapists over the years, half a dozen more doctors, and have seen endless endless duty workers, crisis workers, mental health nurses, general nurses, SHOs…So it gets a little tiring repeating your ‘story’ over and over, and more than a little difficult to actually open to these people, when, in the past, just about every time I begin to get comfortable, my treatment is switched around again, a therapist leaves the service, falls sick, decides after a few sessions- or a few months, that the service won’t be beneficial, or that uni will get in the way, or that I had a private therapist and too many people would complicate things.
Mostly though, I think I’ve just built my walls too high. I can be honest about how I’m feeling on a superficial level- ‘I’m really suicidal’ or ‘I’ve been very dissociated’, but I can never get to the why I’m feeling those things. I avoid questions like ‘what’s your number on a scale of 1-10’, ‘do you have any thoughts of LNWL?’ (an infuriating abbreviation that litters my psych notes), ‘how are you’ like the plague- I can’t answer them. I can’t pinpoint one thing, or one thought, or sum up the complexity of my brain with a single number or concise explanation. What goes on in my head is more complex and confusing than could possibly be summed up in a few words, in a way that someone else will actually understand. And perhaps more importantly, I’d rather not walk down the street, bumping into people who know the most intimate details, the innermost working of my mind, the dark thoughts that have plagued me since childhood.
My former therapist understood it though. And I guess he got pretty close to learning the deep, dark thoughts that kept me trapped at the bottom of the rabbit hole. But it took hundreds of mugs of milk coffees, years of Friday’s at 4pm, and for a time, twice weekly appointments, that ran well over the allotted 1 hour, for him to understand it, me. I was with him for four and a half years. In our first meeting, he promised he wouldn’t give up, that when therapy ended, it would my decision. At times, he faltered. I was exhausting, a challenge…but he embraced it.
In the beginning, I stared pointedly at the floor, would drum my fingers against the arm of my chair for the duration of the appointment, legs jigging up and down. I answered everything with ‘I don’t know’ or ‘shit’. Until I was no longer allowed to answer ‘I don’t know’ or ‘shit’. I played games. It wasn’t a conscious thing; in fact I didn’t even know I was doing it until he pointed it out. One by one he picked apart my defence mechanisms- regression, splitting, projection, acting out, compartmentalisation, intellectualisation, denial and jumping to extreme conclusions, refusing to think rationally. I did these things a lot. And spent sessions talking about movies or other trivialities. And deflecting. And trivialising. And storming out of sessions. And double bluffing him. But that’s the thing with J- if I was one step ahead of him, he was always two ahead of me. He bluffed my bluff, caught me out at my own game. Nothing got past him- no matter what I did or said or refused to say, he could always guess the end of my sentence, or the start of it, he always got it out of me in the end. And when he did, I would say (ranging from meekly to full on yelling) ‘YOU’RE SO ANNOYING.’ Or I’d smirk. And he would know we’d Got To The Bottom Of It.
Days I would arrive and refuse to talk. So he might try to challenge me, or he might simply say ‘that’s fine.’ and sit in silence with me. And eventually the whirring of my thoughts would get the better of me and I’d spill them all out, panicked, in the final ten minutes. ‘Doorknob moments’ he called them. But there was one thing I refused to budge on, shot down every time it came up. I could speak to J about anything, but not this.
During my first admission, the nurses felt there was something I wasn’t sharing. They asked questions, insinuating, eventually flat out asking me. I left the ward, my lips sealed. In the interim between my first and second mission, the symptoms surrounding It grew and swelled and swallowed me whole. I approached a nurse during my second admission which set the ball rolling for an assessment for a type of therapy I didn’t know existed.
By September 2015, I’d begun the therapy. A clean slate, a female therapist this time- and someone brand new to get to know, start to trust. I’d been seeing her for assessment since March, and although I felt I’d be able to trust her/click with her, it’s been difficult to adjust. I felt at such ease with J, saw him for so long, that starting over with someone new is…hard.
In theory, it should be easier this time. I’m aware of my defence mechanisms, know that I’ll do anything and everything to avoid getting to The Point. It’s not that I do it deliberately, and that’s where the difficulty lies. I round up whatever detour I’ve managed to take, drop a bombshell as we’re wrapping up- whatever, and then I realise ‘oh. I’ve done it again‘. And I drive home screaming ‘DUMB BITCH’, slamming my foot on the accelerator, tears of frustration burning down my face.
The type of psychotherapy I’m reciveing now is pretty tailored. And I think it’s what it’s tailored to that is stopping me- more than usual- from being able to engage. From the minute I opened my mouth about these symptoms, I’ve regretted it, berated myself for it. I’ve backtracked. I’ve been trying frantically to convince myself that I don’t need the service, that I’m blowing this all out of proportion, that really, I’m just being dramatic, it’s dumb, nothing at all. Mostly though, I think I feel like I don’t deserve it, that someone else would benefit from it more- someone who’s actually experienced it. And I guess I know that all this is part of the problem- all these feelings I have about the therapy are a symptom of the very thing I need to address. I’ve brought these feelings up with my new therapist (I’ll call her H), and she tells me it is a further attempt to avoid the issue.
So every week I shuffle in and curl up on the chair and the session unfolds. I distract her when she asks me one day if I am Safe to Go Home, begin ranting about something or other going on in the news. For 3, 4 weeks running when she asks me what number I am on the mood scale, I tell her 3.5. Even if I’m not. When I’m asked to fill out a safety plan for homework, I give one word answers, tempted to copy word for word the example one she has given me to see if she’ll notice. Conveniently, my mood takes a shift upwards, which means we spend a few sessions focusing on that, ignoring, to my glee, the REAL reason I am sitting in her therapy office. I spin her in a different direction any time we touch on something I don’t want to talk about. I’m only aware I’ve done it once it’s done, and I leave feeling full, eyes brimming at the thought of another week with this all in my head. Occasionally, she’ll notice that she’s ‘lost’ me, but honestly, I know I am taking advantage of the fact that she doesn’t know me inside out, can’t read me the way J was able to after all those years.
Until one day I arrive and my thoughts are racing, the familiar buzz of elation coursing through my veins. My mouth, filterless, spills this all out, reveals all.
I think this is a good thing. In November, I write that I am afraid that H might give up. I am well aware that the NHS doesn’t have time for ‘difficult’ patients, that budgets don’t stretch to allow months of deference, deflection, mind games, while a client gets comfortable with therapist. And so each week when I leave therapy, I feel a little more panicked, knowing that time is running out, that I am sabotaging this. And I think that’s half the point- or rather the whole point. It’s the ol’ ambivalence kicking in again- I know I need/want this, I’m just bloody petrified. So I’m teetering along that thin line, giving just enough to get by, while not really engaging- all the while hoping she’ll just give up, make the decision for me and terminate the therapy so I have someone else to blame, when 5, 10, 20 years down the line I still feel the same.
Today though, time runs out.
I drive to therapy, the winter sun casting a haze across the sky. I sing along to Paloma Faith. I wonder if Serbia is in Siberia. I will google it when I get back…it makes the worms in my head squiggle faster in frustration that I can’t find this out NOW.
When I curl up in my chair, she tells me she has spoken to a supervisory panel something or other about my ‘presentation’ (read: mood) the past few weeks and the things I told her about therapy (read: refusal to engage). She tells me she is setting boundaries, that there will be no more deflecting or distractions or games (‘and it is a game’), that we WILL talk about what I am here to discuss, that, after all, I was the one who chose to do this therapy above a few other options I had, and this is her specialisation. She tells me that if I don’t want to be here, or won’t engage, that there will be no point in carrying on sessions.
I talk a little about my thoughts- the usual ‘I’m just wasting time’ stuff, and she tells me it sounds like I have already made up my mind. And half of me is screaming ‘YES!’ and half of me is screaming ‘NO NO NO!’ And it is all very confusing because I know what I perhaps need, but it is entirely different to what I want. Which is to continue burying my head in the sand.
But I go with it anyway. She wants to know about my first hospital admission, what had led me to self harm, which led to the admission. And suddenly we are talking about It All. The symptom stuff, and she is pushing for answers, and I don’t have answers, and I very much wish I did because talking about it all and having to search for the answers is very uncomfortable and is precisely why I have been playing the game for so long- years intact.
I’ve been running from myself for almost a decade, and I think, I think, I am learning that I cannot run forever. GAME OVER. I need to wise the fuck up.
When I get up to leave, I ask her if she knows if Serbia is in Siberia. She asks: ‘are you deflecting again’. I grin.