Sunday 10 April 2016

Therapy, dissociation, progress, lack of progress

Hi everyone,
so I just thought I would talk a bit about therapy and how it's going. I've been seeing the same clinical psychologist for a long time now. It's been up and down I suppose but I think we generally have a good relationship. Always the aim has been for me to do EMDR (Eye Movement Desensitisation and Reprocessing) to process trauma. We have tried starting it in the past; I can't really remember at the moment what happened but I know it wasn't able to continue because of how I coped, probably because of dissociation and decreased stability in my life.

For a good while and because I was in a really bad place a few years ago, we weren't doing any structured work but therapy mainly involved helping me cope with whatever I was dealing with in my daily life which was about the most realistic thing to expect at that time. I don't really have a lot of coping capacity in general and talking to T is a huge support for me. I really notice the difference when I don't see her, like if she is off on holidays for a week. I start to get headaches and feel ill and if anything stressful happens I find it a lot more difficult to carry the stress. Usually I can carry it because I know I'll be able to talk about it with her and that helps me process things. I don't like that I need this support at all. Wouldn't it be much better if I had the capacity to hold my own stress and process things that come up in daily life without needing a therapist to talk about it with? Of course. It also frustrates me because I realise it's not exactly helping me with the big picture things that are holding me back.

I have a problem of dissociating during our therapy sessions if things get too stressful and sometimes I think it happens if another 'part' is putting pressure to try to show something or themselves, then I am trying to hold it in and I get so so stressed and can start to panic or shut down or zone out or I think maybe start feeling what they are trying to express. It takes a long time to get myself back to normal when this happens so it really fucks up the session or if it happens at the end, really makes it run late and then I get in a vicious circle because I'm zoned out or something; whatever is happening when dissociation happens. Sometimes I just can't move or communicate but I'm still kind of aware, but I lose awareness of some things and I can't tell that time has gone past. So then if I am hearing what's going on and settling myself and she tells me what time it is or reminds me I need to be able to leave, I get more stressed again because I'm frustrated with myself about how long I'm taking or that I can't control myself and then being more stressed makes me worse because then it's harder not to zone out again. She has been very patient with me. I worry that her patience will run out.

I really don't know what can help me to be able to stop doing this. It feels like a catch 22. I need EMDR to help me get better, but I need to be better in order to be able to do EMDR. Or you could replace 'EMDR' with 'therapy' in that sentence. And I don't have any ideas about how I can prevent myself from dissociating like this. As well, I am often too detached from my emotions in general, in that I can't really connect to what I should be able to talk about. I have drifted through my weeks thinking I'm not feeling or thinking anything, although I know that's not true, I just don't access it well. My T has been as helpful as she can be. She moved to a different office a while ago but she still makes a trip over to her old work place to see me each week because of the fact that I have trouble with dissociation so often after the sessions. Sometimes I can't drive home and need to leave my car and it would be very difficult to manage this if I had to travel to where she is working now.

When I'm getting dissociated I start to get really scared and irrational. Well, it's like I forget exactly where I am or that the reality is that I'm safe. I start to think someone is going to come in and hurt me. If I hear people walking about outside the room we're in I feel convinced they're coming in to attack me. T now locks the door and she puts signs up outside the room to tell people to keep quiet. It's funny because for the whole time I've been seeing her, I've always thought it would help so much if the door could be locked, but I never had the courage to ask because I thought she wouldn't want to do it and I'd feel bad for asking (seems silly when I write that now, what's the harm in asking?) but then she suggested it one day recently after we'd been talking about my fear. It does help, although sometimes if I'm getting scared I start to wonder if the door is really locked, but usually by that stage I can't speak to ask and then I don't feel safe anyway. Sometimes she'll remind me when I'm in a bad place, that the door is locked. It really helps me feel safer.

Another thing I use to try and help sometimes is smelling salts. It sounds awfully Victorian but because the smell of whatever is in it (ammonia?) is so strong, sometimes it jerks me back to reality. Sometimes it doesn't help. Sometimes I want to ask her why she can't do more to help me get out of dissociation. I don't know if that's a fair question. Maybe she thinks it should be up to me to work my way out. I don't know. I just have frustration of it happening and I think, she's the expert, surely she could come up with some more tools to help me. Maybe there is nothing more that can help me. I do feel pretty trapped in this cycle. It's strange though because when I'm not in that state, I find it very hard to imagine that it really happens. Often I've convinced myself that it will never happen again and that I obviously wasn't trying hard enough to stop it or didn't 'want' enough to get out of it, even though I remember how it feels when I start to get the whooshing feeling and my vision starts going and my head starts feeling fuzzy and confused. My heart sinks; I'm trying so hard to focus on the room, on being present, on what she's saying. I tell myself, it's OK, there's nothing to be afraid of. I'm fine. Keep breathing. Relax. You're here, you're an adult, you're safe. Stay here.

Another suggestion T made some months ago was that I could start recording the sessions on my phone. Funnily enough, this was another thing I'd wanted to ask about doing for a long time but was also nervous to ask. I don't know why I fear so much asking for something and being told 'no'. It would seem like a hard thing to take from her. I don't know why. Even though I have learnt to trust her in a way more than I can trust anyone else, in another way I'm more afraid of her than anyone else. I think it's probably something to do with her as a therapist, me as a patient thing. It's like I'm aware of how vulnerable I am. I've given her a lot of myself and in some ways that makes me so much more afraid of how she might hurt me than of anyone else to whom I give nothing of my true self. She has a lot of power to hurt me. I fear doing something to annoy her in case she rejects me. It's probably to do with how my relationship with my parents was, of course. Isn't everything? God knows, you had to be careful where you trod with mine. I'm probably projecting that.

Anyway, recording the sessions has been interesting and good for me for a few reasons but I may tell you about that another day because this is getting far too long as it as.

Therapy has helped me a lot though I think, despite the above complaints. I have no alternative to compare myself to you know, like I can't see how I'd be if I hadn't had it. Sometimes I wish I'd never started it because I feel trapped, not progressing the way I want but knowing I'm so reliant on it to cope. But I think that's over simplifying it. There were significant problems in my life that lead me to get started in therapy and I'd probably be worse off without it. Sometimes I don't believe that though, when I feel stuck like this. My relationship with T has helped me to look at people differently too. I think I have observed her attitudes and adopted some of them. Like, I'm a pessimist but I've learnt to be a bit more open minded about the outcome of things. Maybe not optimistic, but open minded to what may come and this helps. I can see that she has a generally positive view of people too and tends to think people do the best they can in their situation. I think this has helped me too. Other things, but not for reflecting on now.