Friday 30 March 2012

Arguing with my new psychologist... again

I have missed blogging. Unfortunately my laptop screen has broken. I can still link it up to the TV and use the laptop via the TV screen but there is little opportunity to do that with Adam about all the time and him wanting to watch the TV or play his PS3. He's gone away a couple of times this year for trips and although I didn't like him being away, I have to admit, I did enjoy feeling like the living room was mine. We don't really share the same interests when it comes to TV. Generally we end up watching 'compromise' programmes, which are ones we both enjoy but neither of us love. When he's away I can watch my sad programmes like 'Home and Away' and 'Supernnanny' to my heart's content without feeling guilty. I also really liked having a bed to myself. It's funny because when Adam's at home, I can't sleep if he's not in bed, which means if I want to have a good sleeping routine, it relies on him getting to be on time as well. Yet, when he went away, I realised that the quality of my sleep once I do actually fall asleep is so much better. No one pulling the covers off me or breathing in my face. Sometimes I get tired of him being around the house all the time. Sometimes I just want to be alone. Anyway, I digress. I didn't come here to complain about Adam.

You have missed out on two of my therapy sessions with New Psychologist, both of which have been ones worth talking about. Last week, I was just starting to relax after the rocky start we got off to and then we fell out again. Sigh. Remember before when I had emailed her and she didn't bother to reply and then lectured me about how I should 'bring things to the session' if I wanted her to look at them because she didn't have time to read things in between sessions? Well, I took on board what she had said and that was fine. She had asked me briefly three weeks ago about the stuff that has been going on with my dad lately. I haven't really talked to you about all of that; it's on the long finger. Anyway, she suggested that we would talk about it at the next session (two weeks ago). So between that session and the next I emailed her the emails that had been exchanged between my dad and I. I remembered what she said about 'bringing things to the session' so I just asked her in the email if she could print them off so that we could look at them during the session, as I don't have  a printer. I didn't think that would be a huge problem. I used to email stuff to T all the time and she had no problem with it at all.

Of course I was wrong. She confronted me at the next session by saying that I shouldn't be emailing her between sessions. I tried to explain that it was just so that she could print the things... but she talked to me about how it's a 'boundary issue' and that I should not have any contact with her between sessions other than in an emergency and that should be via telephone to the receptionists.

Well, I don't handle confrontation well, but I certainly let her know how I felt. I told her that she had agreed at the start when I asked her if it was OK for me to email her things and that she had then later changed her mind and said I should bring things to the session 'where possible'. I said that I try really hard to do the right things and that I didn't think I had done anything inappropriate in emailing her something to print because I wasn't able to bring it. Obviously, when she said that I should try to bring things to the session and if it was an emergency to contact her by phone, she hadn't been clear that she meant 'don't contact me at all unless it is an emergency'. It's not my problem if she doesn't have the balls to say what she means but expects me to understand anyway, is it?

She then tried to lecture me about it being a 'boundary issue'. She talked a bit about boundaries, which really pushed my buttons because if anyone hasn't been in the right about boundaries it's her: changing the goal posts all the time. I said: "I don't need you to tell me about boundaries! I have no problem keeping boundaries and if anything I worry about them too much!" I then repeated my reasoning about why I sent it. And it went on a bit like that. At one point she decided to also add into her argument that it's also not very easy for her to get things printed and that I should know, working in the health service and all, that resources are finite blah blah blah. I said in a sarcastic tone: "I'm sorry for asking you to print something." She responded kind of nervously: "Are you sorry?.. because you don't sound very sincere." and I replied: "No" and we both laughed: her nervously and me, ironically.

The discussion kind of ran in stops and starts over the course of the session, except that it was interspersed with sections where she tried to move on and I went quiet and refused to talk to her, which then forced her to have to re confront the issue. I was angry and I wasn't about to start confiding in her about my other problems when I felt angry about what had happened. That's just trying to brush things under the carpet and if our rocky start taught me anything it's that avoiding confrontation gets me nowhere.

So eventually, after coming back to the issue for the third or fourth time, or possibly fifth, I talked about how I always try to 'be right' and do the right things and that a lot of times in my life there were rules that you didn't know existed until you broke one and that I didn't think it was wrong what I did. She eventually also apologised and said that she hadn't meant to 'sound harsh' and that she didn't think I did anything unreasonable but that perhaps it's just difficult for her if she sees an email from me and she worries that it's something urgent that she may have missed etc. Sigh.

So I felt OK in the end. I think I stood up for myself and we both saw each others point of view and I was able to move on... again. Afterwards I thought about it and reflected that it was actually a pretty good thing that I was able to firstly even feel angry with someone else; then to be able to identify the emotion, sit with it without dissociating or reflecting it back on myself and telling myself it was me that was wrong and then after all that, to be able to confront the person about how I felt and defend my actions. I think that is pretty fucking monumental in the world of Candy actually! So in a way, it was a good thing for me.

That was two weeks ago. We got to talking about a few other things after that and I noticed she let the session run on for an extra twenty minutes longer than the usual strict hour. I wondered afterwards if that was because she felt the session had been 'tanked' a bit by the confrontation and she wanted to leave time for actual therapy. I refused to talk about my dad with her anyway. Although I was feeling OK that we had resolved things, I was by no means feeling open to confiding in her about anything and like I also told her, I didn't want to talk about it without having the print outs of the emails for her to see. I explained that this was because I wanted her to see that what I was telling her was actually what happened and not just my version of things. I talked with her about my dad once and maybe I was paranoid but I got the feeling that she was trying to decipher what 'actually happened' from what I said. That made me angry, but then that was when things were really bad and she was doing all the interrupting.

This week she asked me again if I'd like to talk about my dad and suggested that she could get the emails printed off if I'd like to talk about them. Perhaps I'm just stubborn, I don't know, but I said I didn't want to anymore. I reached out to her and invited her to share something that's so painful to me that I haven't even been able to tell you about it here on my blog where I can say anything and she slapped me in the face with a chastisement about boundaries. No thanks, I think I'll hold onto that story and share it with T when she comes back. I've survived my dad this far, I can survive a bit longer without someone to confide in. At least I know T will be on my side.

The strange thing about Dissociative Identity Disorder that I am discovering recently is how I can feel so angry and suspicious towards this new psychologist, where I trusted and liked T, yet it's so much easier for my new psychologist to get me to switch and for her to speak to the other parts than it was with T. This is a conundrum. It's also something I feel guilty about. T and I had been struggling through the issue of the parts wanting to come out to talk to her and me not being able to relinquish control for months and months before she left and then, within a few weeks of meeting my new psychologist, she already met Ebony and today she spent a good twenty minutes or so of the session talking to Pan!

I feel like when T comes back she's going to feel hurt that it was so difficult for me to let the others come out with her, even after nearly three years yet so easy with someone else. I think I know the reason for this though: I care so much about what T thinks of me. If she's freaked out by my alters and turns against me because of them it would be the most awful thing in the World... and I'd be stuck with her judgements. With New Psychologist, the risks are a lot lower. She's only going to be working with me until T returns, hopefully in the summer, so if she meets the other parts and that's a bad thing for her, it doesn't really matter does it? The first few months have already given her plenty of reasons not to want to work with me so a few more reasons won't make a difference. I guess what I'm saying is that it doesn't really matter to me what NP thinks of me, whereas with T it did matter to me, a lot. So with NP, I don't mind her meeting other parts so much.

I'll tell you about how it was to observe Pan meeting her next time. For now I will say goodnight as I have kept you long enough. I'm missing blogging and reading all your blogs too but don't forget me because hopefully I'll be back in full swing asap after I manage to get my laptop fixed. Take care. C

Tuesday 20 March 2012

Charting stress, dissociation and fatigue to assess the links

I'm pissed off with Blogger today. Why does it think it's OK to randomly change my blog url without letting me know? And where has the fucking 'edit' button gone at the bottom of the posts so that when I've posted my ramblings I can easily go back and fix it after Blogger has decided to spontaneously delete a chunk of my writing? Love hate.

I mentioned briefly last week that New Psychologist asked me to fill in a chart of everything I was doing every hour for a week and rate on a scale of one to ten: fatigue, stress and dissociation. I think she wanted to do some kind of statistical analysis on the data to see if there's any link between the chronic fatigue syndrome and the psycho brain. I only remembered half way through the week though that she specifically said, I could edit the scale or charts but to make sure I kept the hour by hour ratings going. Oops. For the first three days I was rating the parameters by activity e.g. 1300-1530: sitting on my arse watching TV... Fatigue = 6 Stress = 3 (Home and Away can be pretty nail biting at times), Dissociation = 5 etc.

Once I'd realised that I had fucked it up I had a look through to see how difficult it would be to fix it into an hour by hour chart but it was looking like it would take someone with a fatigue of less than 'two' and I was at about a 'six' at that point so I decided it was something she could do herself if she's that bothered.

Turned out, she was bothered because she has now asked me to do the ENTIRE task again. Sigh. It's quite a consuming task and as a few of you rightly pointed out, it's sometimes very difficult to rate dissociation. I'm just doing my best though. Generally dissociation doesn't really go below a five, because I rarely feel 'real' or 'alive'. Most of the time I feel like I am an observer sitting far back on the edge of my consciousness watching a robot going about my life for me. A six would probably be once I start getting visual disturbances or floaty feelings and a seven is zoning out etc. But even then, if I'm on my own, sometimes I'll zone out without realising it and so it's impossible to rate that. There have been a few hours I haven't been able to account for.


Anyway, NP did have a look at the first weeks charts and at the session last week she proudly announced that after reviewing my charts she felt there is a strong link between stress and dissociation... get that girl a medal! Who would ever have thought that dissociation might happen when I'm stressed? OK so she's new to this maybe. I nodded and let her continue. She said it was very clear that I 'use' dissociation as an avoidance technique when I'm in stressful situations or triggers arise. I know this, but from her explanation of her views, I got the sense that she feels it's something I consciously do. I don't think to myself: "I don't like the way this man is looking at me so I might just zone out now and come back to in a few minutes". It's not conscious like that. It just happens. She says that on some level it is intentional though. I get what she means but it doesn't mean that I can stop it from happening. It just happens.

I had also decided to rate 'pain' as a parameter as I've always felt sure that the recurrant varieties of pains I get are related to stress and dissociation. NP agreed with this theory and talked about somatic symptoms which can occur with dissociative disorders. Sometimes it's easier for the body to express it's reaction to trauma than for the person to feel the emotions. She was preaching to the choir with that one, but it's good that we're singing from the same hymn sheet (huh... she must also be in the choir).

She did have some other interesting insights though: she noticed that I tend to get higher levels of dissociation as well as 'flashbacks' and intrusive thoughts around bedtime and when I'm showering/bathing. She wondered if this might be something to do with the process of undressing and being naked. It's not something I'd consciously thought about. I do struggle with showers at times. Sometimes I find myself becoming overwhelmed with anger for no apparent reason and banging my fists on the walls in the shower, which brings Adam running up to see what I need. Oops. Sometimes I've found myself curling into a ball and crying or most commonly, scrubbing my skin raw like a maniac thinking "I can't get clean! Must wash off the badness!" But bedtime... well there's the theory of getting undressed... or the whole 'bed' thing. But really I think the main reason it happens when I get into bed is because there's nothing left to distract myself with. During the day, no matter if I have the energy of a normal person or of a person with chronic fatigue syndrome, there is ALWAYS something I can do to distract myself and prevent intrusions into my consciousness. I think I just spend my whole life doing that... avoiding. Then, once I get into bed at night, it just all comes flooding back in.

I expressed this view to NP and she must have thought of that herself because she whipped out a pre-copied diagram and gave it to me to look at. It showed a flow chart of a dissociative brain which suggested that there is avoidance, where the individual (so to speak) doesn't allow consciousness of traumatic material, then there is the other extreme, where they become overwhelmed and too immersed in it and then this either leads to dissociation or switching to an alter personality. Sigh... I'll look for it and give you a better explanation. She suggested that we need to learn to be able to tolerate thinking about the difficult things without dissociating, so she wondered if perhaps we might start with thinking about something more current that causes emotions and try to talk about that. She felt this could help me 'learn' how to be present with less painful things and so I could build up a tolerance so that I might get to the stage of being able to think and talk about the really bad stuff.

Something about how she explained that freaked me out and I ended up zoning out and getting dissociated right there in the session. I think in my head, it felt like she meant that this would happen very quickly and I was scared that I'd be asked to talk about things I'm not ready to even think about. She can be quite astute. She reassured me that this was not going to happen any time soon and that she didn't expect that work would be done with her (meaning, T is still due to return after six months) and that I should be reassured that I won't be rushed into anything. It didn't mean a lot to me at the time but I have found those words comforting this week. She's not so bad. She is trying.

I sense that she's anxious about working with me. I wonder if it's the 'label' of dissociative identity disorder. Maybe she feels ill equipped to deal with the condition and so is relying heavily on text book advice and research papers. I do think that those are important, however, I can't help but think if she relaxed a bit and got to know me she'd learn a whole lot more about the condition.

To finish with a final Blogger complaint: the spell checker is not working today (either that or I haven't made any mistakes, which would be a frickin first) so I apologise for any mistakes in this.

Wednesday 14 March 2012

Detached

The Titanic Signature building in the centre and Harland and Wolfe (the yellow crane is one of the two used to make ships. They are called Samson and Goliath)

The Titanic Signature Building. The Titanic sign at the front there weighs the same as one of the anchors on the Titanic.

Normally I write my posts with ease but get stuck on the titles. Anyone else find titles of posts really hard to come up with? It's just not my forte. Today however the title has been written before a word of this post was started and I'm struggling to know what to say. I guess that's because my title says it all. I am detached from my feelings and finding reflection difficult.

I thought things were improving for me a bit physically as I had a few weeks where I had more energy and fewer episodes of exhaustion. Last weekend I had some kind of stomach upset though and it seems to have knocked me back a bit. Last night I slept for thirteen hours! Well, I did need to get up about five times to pee and was awake for a bit during the night feeling anxious, but that's normal with an eight hour night so I must have really needed that sleep. I only woke up when Adam woke me after midday. I have been feeling rough today. Headachey, achey, faint, tired etc. That's how I had gotten used to feeling over the past year or so. I hope things will improve again.

I've been having a lot of urinary symptoms like the getting up to pee all the time in the night and some pain when I pee. I've also had a pain on and off on the right side of my back about half way up, which I was worried was my kidney. My doctor tells me it is unlikely to be my kidney, even though I do have a kidney problem which I am waiting to get seen for at the hospital. I've also been told the problem with getting up to pee all the time is because of anxiety. Who knows? It's annoying though. I find it triggering too. I was told the damage in my kidney could be from recurrent UTIs in childhood. I don't remember having any UTIs and my mum says I didn't either. It's hard to explain why this triggers me. I think I wonder what all was going on in my body as a child that could have caused damage and well, you know...

Moving on. My new psychologist asked me to keep a record for a week of what I was doing each hour with a rating of my stress, dissociation and fatigue on scales of one to ten. She wants to analyse it to see if she can find any association between my fatigue and psychological stress. It was quite a labour intensive task for me and it's surprisingly difficult to rate 'dissociation' especially since it's not just one thing. Dissociation includes alterations in senses in a number of ways and is variable in how it affects me. Feeling detached is a kind of dissociation, but so is visual disturbance, like tunnel vision and it's hard to rate everything on one scale. Sometimes I'm so separate from myself I don't know how dissociated I feel, if that makes ANY sense! I did my best anyway. I gave it to her last week and I guess we might talk over it this week. I wonder what her observations will be.

Today I went to the cinema with Adam and then for a walk around the Titanic Quarter in Belfast. It's starting to look really good with the new Titanic Signature Building which is due to open at the end of March, just in time for the 100 year anniversary of the Titanic, which as we all should know, was built in Belfast at Harland and Wolfe. These are a few pictures I took on my phone.

Thursday 8 March 2012

Time Out

Every cloud (Belfast): I just had to pull over my car to take this picture on my phone. It was so much more beautiful in the moment and it was shining directly onto the hill where I live.
Hi peeps! I'm still alive and I am going to write a blog post if it kills me!

It's been a while and my only excuse is procrastination. When I lived at home, my bedroom was never tidier than when I had exams to study for. Suddenly the need to reorganise every drawer and box was very urgent and pressing. Well, it's been a bit like that lately. My house is by no means clean and tidy but it's looking a hell of a lot better than its usual standards. Unfortunately, I'm the kind of person who'll spend an hour moving all my cups from one kitchen cupboard to another because that seems necessary when behind me there are piles up to my waist of laundry that need to be tended to and junk that needs sent to a charity shop. Ah well. On the bright side, I've had a bit more energy to procrastinate with lately, so I guess one might forgive me for making the most of being able to stand without feeling like I'm going to collapse.

In order to get myself to blog, I told myself it didn't need to be one that described the things I have been trying to avoid, but in short, I think I told you about them in the last post so suffice to say I am not any further forward with tackling those things. I guess in a way, I don't want to set myself back again by introducing changes that are potentially stressful, even though I know that in the long run I'll have more peace of mind if I deal with them.

I will need to stop procrastinating eventually. I still suffer from nightmares and when I get into bed at night I struggle to keep the thoughts at bay... the one's I'm trying to avoid. They are all just sitting there waiting for me to finish my time out. I wonder if some people go through their entire lives avoiding the real issues by keeping busy in whatever way: working, cleaning, sports, running, going out...

I'm still off work on sick leave. I have now been off for seven weeks, would you believe? My sick line is up tomorrow but I don't feel ready to go back yet. Things are by no means all better, even though there has been progress in the last few weeks. In a way, the 'progress' could simply be that now that I've had time to recover from the 'crisis' I went into in January, I simply have the energy back that would have previously been all used up by surviving the working day. The other explanation for the 'progress' could be that it isn't actually progress but just an emotional numbness which has been the result of avoiding thinking about anything other than superficial things like what room in my house I'm going to attempt to clean next. Or maybe the antidepressant I started is helping? I hope so.

Anyway, I want to make sure I'm ready before I go back to work.

Things have settled down over the past three weeks in my psychology sessions too after the unbelievable dramas that took place, thank goodness. I was happy enough to put everything that happened behind me after I had said what I had to say to my new psychologist and it seems that she has taken it on board and decided not to make outward judgements. She's also stopped interrupting me. She was good like that when I first started seeing her and then it all went pear shaped. Now that she seems to be back to her 'old self', I can work with that. I just hope she is going to stay this way now and not go crazy on me again. I doubt if I'll really learn to trust her, but in a way I think the negative experience I had with new psychologist has helped me, because it means I might not feel so bad when she stops working with me after T comes back. I'm not exactly sure why it might help at the moment, but somehow it just makes things easier.

It was also a huge thing for me to stand up to someone like NP and say clearly and assertively how I felt I had been wronged. Confrontation and assertiveness are not my strengths and this was a challenge. I feel like it was an achievement for me to speak out and not just try to pretend nothing happened and I'm proud of myself for doing that.

I still miss T, but I'm glad I miss her.