Margaret Burke Is Not Fucking Around

If you were walking down the street looking for someone to interview about their first-hand experiences of World War I, you would immediately hone in on Margaret Burke. She is old. She shuffles along, bent over and leaning on a walking stick. When she reached out to pass me a depression inventory, her hand was shaking violently.

Margaret is no soft, cuddly grandma, though. She takes no bullshit.

In the first five minutes, she’d asked a question, I’d answered, and we were sitting in silence, looking at each other.

I feel like you’re looking to me for something,” she said. “You want me to take responsibility for you, and I’m not doing that. I won’t do that.

I struggle with talking sometimes,” I said.

You mean you’re resistant to talking,” she retorted.

Later, I shared that I used to play sport every day and that I knew it was good for me, and I said I’d look into joining a gym to find out how much it’d cost.

I don’t think you really want to do it,” she said dismissively. “If you did you’d just commit to it. You can pretend it’s about money, whatever.

There will be no excuses with Margaret Burke. She called me out every step of the way. Sometimes very legitimately, so I couldn’t help but laugh, and sometimes in ways that seemed to leave no room for depression or anxiety and the barriers they put up.

Like Alina, she pointed out the incongruity of my half-smile and casual tone while I talked about the “horrific things you’ve done to yourself,” and I tried to explain, a little.

I’ve just done this so many times,” I started, and she cut me off, telling me that this was more evidence that I’m resistant and not interested in changing, that I’ve self harmed for years and I’m going to just keep on doing it. I tried to interrupt to explain that she’d misunderstood me, that what I was trying to say had nothing to do with self harm – I was talking about having done “this” (giving my history to a new mental health professional) so many times (more than 30 times in the last year) that it’s lost impact for me, that it’s just reciting things like they happened to another person. But she just raised her voice and spoke over me, then went directly into another question without giving me a chance to respond.

I’m pissed off about that. I get that she’s not afraid to argue with me, and that’s pretty refreshing, but she has to let me speak too.

She was very clear about what she’s offering. “I’m not going to stick around forever,” she said. “If you’re not making progress, you can find another therapist.” I loved this candour, the refusal to make false promises, but it makes her a bit of a wild card. I don’t want to be adrift again in another couple of months because I wasn’t meeting the goalposts.

There’s a lot to like about her. I found it incredibly challenging and confronting, though,so much that I was on the verge of tears pretty much all session. When I walked out of the door and down the street, I suddenly realized my whole body was aching, and realized I’d been tensed tight with my jaw clenched for the last hour. But I’ll always know where I stand with her, and she won’t let me pretend that a spade is anything other than a spade.

I don’t know, yet. I could make a lot of progress with her on a more superficial level, I think – eating better, working out, trialing more medications. But the part of me that likes her is the critical bootcamp part that says “See, you’re just being a lazy shit, you need to stop making excuses and fucking around, if you’re depressed it’s nobody’s fault but your own“. I approve of her approach because it feels like what I deserve, and I felt a lot more need to hurt myself last night than I did after Alina. My instinct is that I could make short-term progress but maybe not long-term change with her, but I don’t know. Maybe that’s just another excuse.

Margaret Burke Is Not Fucking Around

Better Than A Poke In The Eye With A Sharp Stick, I Guess

I couldn’t get up. My alarm went off, and I stayed in bed. The bus I was supposed to be on left, and I was still in bed. I felt frozen, and like there was something squeezing my chest. When I finally got up, my knees were shaking.

In the back of the taxi, I watched Timon dress in drag and do the hula (Arrrrre you achin’ [yup yup] forrrr some bacon? [yup yup]) over and over, imagining the psychiatrist as the hyenas, trying to make myself laugh. But when we arrived, a whole new source of dread struck me – when I tried to pay the driver, my card declined. I was already a few minutes late, but I stood outside the building trying to decide whether to go in. It wasn’t like I didn’t have the money – I’d just got a new card the night before and they’d cancelled my old one – but the idea of explaining to the psychiatrist or the receptionist that I couldn’t pay today was so unbearably shameful I almost turned around and went back home. I went in, but the anxiety clung to me.

I was right to be afraid I was going to cry. I didn’t, but I wanted to. Alina is pretty shrewd about abandonment pain; the moment I handed over the list of psychiatrists I’ve seen, she zeroed in on the number who’d referred me on after a single session, and questioned me about how painful that had been. (“A bit frustrating” was all I was willing to admit to, but she saw the truth on my face.) Later, when Anna came up, she poked the sore places again.

“Twice a week for 8 months, and she sent you an email saying she doesn’t want to see you, she can’t help you. Do you think she was angry at you?”

The question I heard was ‘Are you one of ‘those’ BPD clients? Were you too demanding? Did you burn her out?’

No,” I said, but with a slight upwards inflection that betrayed some uncertainty.

Why can’t she help you?

Because she cared too much and she tried too hard, I think. Because she liked me and she wanted to help me, and when I didn’t get better she was frustrated and lost and she couldn’t separate herself from my own sense of hopelessness, and it overwhelmed her. Because she was always reaching for me, asking me to text and email and I almost never reached back, and she was afraid I was more attached to Jen and Aisha than I was to her, and she felt useless and insecure about what her place was. 

She just felt stuck, I guess,” is what came out. Alina wasn’t satisfied, but she moved on.

“I don’t think I have ever seen anybody who overdosed at 13.”

I shrugged. “I don’t think it’s that uncommon.”   

What I was saying was ‘There is nothing special about my pain’, but she seemed to hear ‘You don’t know what you’re talking about’.

“Probably not, I’m just saying I haven’t seen anybody. Or maybe I did, but usually the people that started that early, they don’t function that well later in life. But you finished school very well, you went to university, you are working, you have good friends…so I’m just a bit sort of puzzled I guess.”

I didn’t really know how to respond. Normally I feel proud that I’m resilient, but the way she was talking, it didn’t seem like something to be proud of – just another way I’m different, another reason I’m hard to treat. And I felt torn, because part of me felt frustrated and disappointed that again I’m a puzzle, that she couldn’t understand me, but the rest of me knows how much I hate psychiatrists assuming they know me after one session, and I know that I prefer humility in confusion to arrogance in certainty.

It was inevitable that at some point, the topic of my wrist was going to come up.

“Why did you break four of your bones?! That’s not normal, you know.”

“I don’t know – the thought just popped into my head, and…” I started to trail off, and she interjected immediately, strongly.

“What do you mean?!”

“I don’t know – the thought came into my mind, and I couldn’t stop thinking about it until I’d done it, so I did it.”

She looked down at her papers for a moment, shaking her head. “Listen. It puzzles me, the way you talk about what has been happening to you. I need you to start feeling and thinking about all this stuff. It’s almost like you’re telling me ‘You know what, I don’t want to think about it, I’m just doing it, and I have been doing it for a very long time and I probably will continue doing it, but I’m not thinking about it’. What do you think is wrong with you?” I sat silent, not liking the question and not knowing where to even start answering it, and she interpreted: “You’re not telling me that.”

“Mmm.” I felt stormy, misunderstood, outraged – I do think about it! – but I knew I wasn’t giving her any reason to believe there was anything deeper behind my bland, monosyllabic responses.

“Okay. You are a difficult case – you know that, don’t you?”

“Yeah,” I agreed immediately, confidently, owning it so I could pretend there was no shame in it.

“Why do you think you’re a difficult case?”

“Well, I’m not that great at communicating, so that makes it more challenging.” 

“Well, I think you’re communicating. You might not be talking, but I think you are communicating.”

Touché. She definitely won that round.

 

Later, she circled back to my broken wrist, and my parents’ reaction.

“Did mum cry? Did they give you a hug?”

“No,” I said with an incredulous half-laugh, giving her a flat, warning look.

“Did they say ‘oh my god, what happened?'”

“No.” I upped the intensity of the stare, and she conceded.

All right. Okay.” She stopped, took in a deep breath. “Whew. You’re a funny girl.”

Her tone wasn’t unkind, exactly – it felt impersonal. Like she’d already given up on trying to understand why I might be reacting that way, and had concluded that I didn’t have any feelings she could hurt.

So. She goes on holidays in three weeks, and she offered to see me 4 more times before she decides whether she can work with me or not. (I took this as “You’ve got three weeks to start talking and start showing some insight or you’re out, kid“.)

I prickled at some of the things she said – like when she described my (beloved) schizophrenic uncle as “disabled” and summarised my foster brother’s home as a “bad family” – but I’m trying to look past the phrasing to the intent. She’s blunt, but I didn’t sense disrespect or dismissiveness. The way she spoke to me in general wasn’t overtly compassionate, or exactly kind, but I heard some gentleness in her tone.

I don’t think she will ever be the kind of psychiatrist who will sit with me on the floor, take me to the park or blast rock music during sessions. I can’t picture her holding my hand, or sending me a text, and I don’t think there’d be much laughter or banter between us. I feel grief about that. Seeing Alina made it very real; I am never going to see Anna again. And with Alina, I feel very much that it’s my job to convince her, win her over. I feel like I’m on trial, and I miss the safety of Anna. Her priority from the start was to make me feel comfortable, to do whatever she could to win my trust. That was uncomfortable, but this is harder.

I’ll go back next week, and I’ll try to share more, and I’ll hope she’ll be kinder. But I hate this. I hate it.

Oh, and – no big surprise – when she asked what I want to achieve in therapy, I said “I don’t know“.

 

Better Than A Poke In The Eye With A Sharp Stick, I Guess

Great Idea, Rea, Go Ahead And Make Some More Dumb Decisions

Two more days until the appointment, and I’m afraid that if she asks me about what happened with my last therapists, I’ll cry. It feels very important that I not cry.

One option is to cut myself, soon enough before the appointment that it’s still fresh, but long enough that I don’t bleed through the bandage and onto my clothes. Somewhere that my hand naturally rests, the top of my thigh maybe, or the side of my ribs, so that I can press into it, hard, when I start feeling emotional.

My preference would be a chemical burn. To soak a cloth in bleach and tape it to my skin, so that it hurts throughout the appointment, keeps me sharp and clear. It’s risky, though; I can’t think of a good explanation for the smell (removing nail polish?) and it might bleach through my clothes. Plus chemical burns are usually too superficial to really help, and they itch like crazy.

I don’t want to do this. I don’t want to be calm and detached and pretend I don’t care if she can’t help me. And I don’t want to be honest and vulnerable and open myself up to hurting myself badly when she decides she can’t see me (see psychiatrist #4 below). I’m frustrated with myself for “making this into such a big deal“, but it is a big deal for me. It probably wouldn’t be for other people, but that doesn’t change the fact that it is for me. And I’m being stupid, because I wouldn’t be anywhere near so anxious about this if I could take Everest with me, and one of the other practitioners at this clinic has a therapy dog, so it quite possibly wouldn’t be an issue. But I can’t make myself ask my brother to call and check, because I’m convinced that I’ll seem impossibly high maintenance and ruin any possible chance I have of her seeing me again.

She asked me to bring a list of the psychiatrists I’ve already seen, presumably so she can cross them off the list of possible referrals. This seemed like the right moment to reflect on 2015 and the 6 experiences it brought me.

#1. After 5 minutes, he decided it would be more productive if I went and sat in the waiting room and he took my history from R instead. For the whole 50 minute consult. I went out obligingly then thought “wait…what the fuck?“. Even then, I still went back for a second appointment, during which he repeatedly told me he was only a baby psychiatrist so I couldn’t expect too much from him, and informed me that he would need to speak with my parents about their perspective of my issues. (I was 24.) I did not go back.

#2. To borrow a phrase from La Quemada, a NAPIWET of the highest order. We were late and she got into an argument with R in the waiting room over the (apparently ridiculous) suggestion that perhaps the receptionist had given us the address to a different office where she also consults. Her tiny office had a huge desk between me and the door (panic panic panic!) and she was cold and clinical. At the end of the 50 minutes she informed me that I definitely had borderline personality disorder because all people who self harm do (not true) and that I needed to get into a DBT program that would teach me that the rejection I was perceiving from medical staff wasn’t really happening and was all in my head (Really? Comments like “You need stitches but I’m not going to waste my time because you’re just going to cut again anyway” were just me reading too much into things?). She referred me on to #3.

#3. I still feel bad about cancelling my second appointment with her. She didn’t do anything wrong – she listened, didn’t show any signs of exasperation when I didn’t share much, and she really thought about what other resources she could refer me to (like a low-cost psychotherapy program). Probably I should call and find out if she could see me again. The reason I didn’t go back is because she often didn’t understand what I was saying, and asked me to repeat myself or asked questions that made it clear she’d misunderstood. This may have been partly because English is her second language, or because of my style of speaking – I’m a sesquipedalian and tend to use very formal, rigid English when I feel uncomfortable (which is probably why my third psychologist, Gemma, told me I came across as arrogant in my first session with her). 

#4. I was so excited about her. She was a psychiatrist who did psychotherapy, and I’d spoken to her on the phone when I made the appointment and really liked her.  Things felt a little off during our first session, but I really wanted to believe that she was the one, my therapy soulmate, so I kept stretching myself, and I told her more than anybody I’d seen before. Towards the end of the session, she told me – in a tone that indicated it should be obvious – that she couldn’t see me on an ongoing basis, but if I wanted to make another appointment in a month (a month!) she could call around and see if she could find someone who would see me. I barely made it through the rest of the session, and when I got home, I burnt myself beyond my body’s capacity to heal. I believed that there had to be something truly, fundamentally wrong with me for so many practitioners to reject me and I was so distressed I could hardly feel the flame touching my skin. A week after I got out of the hospital, from surgery to fix the burn, she called me and said she was sorry to hear about my injuries (the hospital had called her to confirm that I had an upcoming appointment), but that she hadn’t been able to find anybody who’d take me on so there was no point me coming in next week. She wrote a letter to my GP, and S offered to print me a copy then took a look at it on the screen and said “Oh, wait…better not“. I still wonder what was in that letter.

#5. He was lovely and he tried really hard to connect with me. Our first session wasn’t great; as usual, he assumed I have borderline personality disorder, and started telling me not to go home thinking that he’s terrible because things aren’t black and white and he’s not all bad. Which made me angry, because that isn’t how I think, and there’s such arrogance in the assumption that you can predict anybody’s thoughts after knowing them for less than an hour. But I was sick of searching and he seemed okay, so I kept going. Honestly, (and this is embarrassing), if he had been a woman then I would probably have been able to connect with him, and would be happy to keep seeing him. But he wasn’t the mother figure I wanted, so I never warmed to him, and I wouldn’t share anything with him. 

#6. I liked her dog? I very reluctantly went to see her shortly after being released from hospital following a suicide attempt because #5 wanted a second opinion. No idea what happened with that – I never heard from her.

Anna was so different. At the very start of our first session, she observed that she could tell I wasn’t feeling grounded and that was okay, admitted that she was feeling nervous too, and told me that she’d warmed up a heat bag in case I wanted something to hold onto to help me stay more present. (I didn’t, but the care and thought in that gesture…it still amazes me.) She asked me if I was happy sitting on the chairs, or whether I would prefer to sit on the ground, or on the desk, or stand. I felt uncomfortable (holy shit, so uncomfortable) but she was really attuned to me in a way that was more comforting than scary.

Still, though, I have to reluctantly admit that my history with psychiatrists is not as bad as the story I tell myself. Two of them were objectively terrible. One was horribly disappointing, but because of how I reacted to her, not because of her. I wrote one of them off too soon, and the other just had the misfortune of being the wrong gender. All in all, not sufficient reason for the total terror I have about seeing another one.

But really, the reason I’ve calmed down a little is because I’ve decided to make an appointment with one of the psychologists I’ve found online who look empathetic and a good fit for me. This is probably a stupid decision. I have two appointments this week with two different psychiatrists, and with a third later in June. Should I really be adding another person I can only (and barely) afford to see for 10 sessions? Shouldn’t I at least wait and see how it goes with the other people first?

Fuck. Of course I should. But I’m desperate for some empathetic connection. Desperate is such a dirty word, to me, but I am. I feel like I have to sit in a room with someone who understands the pain and fear and overwhelm I’m experiencing and cares about it, or I’m going to self-destruct. In my experience, psychiatrists don’t do that. I don’t care about making progress or learning new skills, I just want to spend an hour a week feeling less alone.

Stupid. Pathetic. I think I’m going to do it anyway.

Great Idea, Rea, Go Ahead And Make Some More Dumb Decisions

So, What Are You Hoping To Get Out Of Therapy?

It’s virtually inevitable that I’ll be asked this question next week. And it’s a good question – there’s no point in two people going into business together if it turns out that one is an expert in smoking bacon and the other is vegan. But in the 6 psychiatrists and 6 psychologists I’ve seen, I’ve never managed to answer it.

My biggest problem is that I mostly see therapy as a participation sport, where I get a ribbon just for showing up. Maybe I’ll make more progress if I have a clearer idea of where I want to go.

Emotion regulation and distress tolerance

I’ve got tools galore. I’ve got colouring books and exercise games and stress balls and voodoo dolls. I’ve done DBT and I have worksheets and plans. And when I get upset, I still really believe that the only way to feel better is to hurt myself, and that hurting myself doesn’t matter. I need to work on that.

Shame, self-hatred and compassion

Shame stops me doing a lot of things I’d like to do – like surfing even though I’m bad at it, going to the gym when there are other people there to see me sweaty and ugly and panting, dancing at a concert even though I gave up ballet at 5 because my body rarely cooperates with what my brain is telling it to do. Shame keeps me awake at night remembering that stupid thing I said in high school. And self-hatred makes me punish myself for all the shameful things I see in myself.

I’d like shame to quit running my life. I’d like to look at a photo of myself as a child without being overtaken with the desire to hit my child self in the face. (I’d also like to understand why I have such violent urges towards the smaller versions of me.)

Boundaries

I’d really like to be able to say no to having sex with anyone I don’t want to have sex with. I’d like to stop feeling like I’m responsible for the happiness of everyone I know. On a more prosaic level, my workload would be greatly improved if I could learn to politely refuse when coworkers ask me to draft that document for them.

Mostly, I’m afraid that if I do have children, I won’t be able to set boundaries to protect them. My mother is unable to handle any sort of confrontation, and I’ve followed in her footsteps. For example, when I was 3 a man she knew grabbed me and threatened to break my arm for stepping on his garden, but she wasn’t able to say anything to him, so I took myself into the (stranger’s) house to hide alone. Don’t get me wrong, I wasn’t in any actual danger, but it’s not the kind of parent and not the kind of person I’d like to be. If my niece was in that situation, I would like to be capable of asking the person to take their hands off her and not to speak to her that way. Right now, I don’t know if I could, and I hate that.

Empathy

When my brother C was barely 20, he needed surgery on his hand. When he woke up in his hospital bed, disoriented, I was standing beside him with my parents, and I joined them in mocking him for being a wimp over the canula in his hand, and rolling our eyes at each other when he wanted help holding a glass to drink from.

I am kind, most of the time, and I am caring, most of the time. But I struggle with a belief system that says that people who have trouble enduring physical pain are somehow lesser. Inferior. It’s often hard for me to summon compassion for somebody who has been scratched by a bush, or has a sore throat, or got knocked over at basketball last night.

I don’t like this, even as I can feel myself holding onto it. Pain is pain. It’s not my job to try to toughen people up by telling them that what they’re experiencing is wrong, that it’s not as bad as they think and they’re just being pathetic.

Food

It’s kind of bizarre that I never developed an eating disorder. Most of the women in my family have a tortured relationship with food, and my mother, who was obese, projected her issues onto my teenage self, calling me a pig and pinching my hips. And like any neurotic teenager, I internalised that, embellishing a little – my usual refrain is fat disgusting pig. I overeat to drive away uncomfortable feelings, and even though I know that objectively I’m slightly under the “ideal” weight for my height, I always feel overweight.

But the most disruptive part of my relationship with food is my issues with other people eating it, another heirloom handed down through generations. My grandmother has a favourite threat – “if you’re going to eat like that, you can go outside and eat on the mat with the dog“. She’s not joking. In turn, my mother was very strict about table manners with me and my brothers. C and I both have almost a phobia of watching and hearing other people eat, especially crunchy food. Somebody could sexually assault me and I’d still smile at them on the street, but eat an apple next to me on the bus and I will disembowel you.

It makes being with other people challenging. The rage that rises up in me is completely inexplicable and barely controllable, and my hands clench into fists under the table. I can hear the judgments that arise – are you so greedy you have to eat that right now? jesus christ, slow down, why are you shovelling your food down your throat? – and I can hardly breathe through the urge to hurt them and make them stop.

Work

I graduated from law school with first-class honours, and was the highest-achieving student in my state in my Aboriginal Studies degree. And I am so terrified of having a real job with real responsibility that I didn’t apply for a single graduate job, and went on to do two unpaid internships instead, and begrudgingly took a job when one of my intern organisations offered it to me. The idea of making mistakes and being reprimanded is so anxiety-provoking that every day of work is a struggle.

I have to learn not to crumple and cry every time I’m scolded for forgetting to insert page numbers on a document. If I can’t grow enough resilience and self-confidence to be able to handle the normal stresses of working, I don’t know how much longer I can stay alive.

Gratitude and remorse

I am a disaster at thanking people for Christmas presents. I’m also a disaster at apologising for accidentally breaking other people’s new expensive Christmas presents. Expressing gratitude is too vulnerable and gives other people too much power over me, and my shame at fucking up is so overpowering that if I admit to doing something wrong by apologising, I’m afraid I would actually drown in the wave of shame.

Emergencies

I’ve been taught not to get help in an emergency. A few years ago, at my brother C’s birthday party, my father collapsed, clutching his chest, unable to breathe, crying and making a kind of gasping, moaning sound. I thought he was having a heart attack and said I was going to call an ambulance, but my mother told me, sharply, “No!“. C and I both stood there, frozen, looking at each other for guidance but both unsure of what to do. I repeated a few times that I was going to call an ambulance, but each time I was told not to, and each time, I obeyed.

In hindsight, it seems so simple and obvious. The worst possible consequence of calling an ambulance is that it turns out to be unnecessary and I’m shamed by my family and possibly the paramedics for overreacting. The worst possible consequence of not calling an ambulance is my father dying on our kitchen floor while I watch and do nothing. No contest. But if the same thing happened again, I would do exactly the same thing, because in that moment of panic, that ingrained it’ll be fine don’t be a drama queen overpowers any capacity for logic.

On a broader spectrum, I guess this is mostly about wanting to have a better handle on what’s ‘normal’. Sometimes my family thinks something is hilarious, and I feel unsettled about it, but I don’t trust my judgment. An example is a favourite family story about my grandfather and my mother, when she was 4 or 5. They would go walking through the paddocks every day, and each day, Papa would offer my mother his hand. When she took it, he would touch the electric fence, sending a shock through her body.

Everybody thinks this is so funny: that she was so guileless she would keep taking his hand, every time, even though she kept getting shocked. But I think of that little girl, trustingly reaching out for connection and being hurt and mocked, and it just seems sad. I think about Rachel’s experience of attachment and pain being wired together, and it seems like such a literal personification of that.

But even though I’m sure, I’m not sure. Am I making it into a bigger deal than it really is? I want to know. I want to be sure.

Body

It would be a distortion of the truth to say that this is something I want to work on. I feel triggered just thinking about it, and I’ve had to stop, close my eyes and take a few deep breaths. But I can acknowledge that the situation isn’t ideal. My mother had gynecological cancer with a high fatality rate, and she only survived because it was caught so early. Despite this, and despite having a few (minor) symptoms, I’ve never had a pap smear. I know this cancer kills – a friend my age died from it less than 2 years ago – and I do think about it, sometimes, but I would literally rather die than have anyone anywhere near my genitals.

On the other end of the spectrum, creating life rather than losing it, there is no way I could handle being pregnant. I’m happy to look into adopting, but it’s expensive, and I’d like to have a choice.

Money 

A few months ago, my teenage cousin came to stay with me, and we played a game called Scruples, which poses real-life scenarios and asks what you’d do. It quickly became apparent that I would lie, cheat, steal and do pretty much anything short of setting a puppy on fire in order to save money, or hold onto money that wasn’t even mine. I grew up middle-class but with parents who both grew up in poverty, so I understand it, but it’s also not a great way to be.

Of course, I won’t tell her most of the things on this list, and certainly not any of the details. That’s the paradox of shame – the only way to move past it is to talk about it, but shame is a powerful silencer. I’m ashamed that the list is so long, and a little ashamed of basically saying “please help me stop being a shitty person“. I’m afraid that I’m wanting too much, afraid of the shame I’ll feel if she says “those are good goals, but they’re really out of the scope of what psychiatrists and psychotherapists do – my role is really just to help you get the self-harm under control“.

 

So, What Are You Hoping To Get Out Of Therapy?

Too Long, Too Soon

On Thursday, I finally got a call back from the psychiatrist’s receptionist, almost two weeks after I’d called to make an appointment. My GP had called to let her know that I’d broken my wrist and asked them to please get in touch with me, and they did, but the appointment they offered was 5 weeks away.

I accepted, then crawled into bed in tears. How was I going to hold on for another 5 weeks? I felt frantic, thoughts swirling urgently – which bone could I break next? How would I do it?

Everything seemed hopeless. I’d tried over 20 other psychiatrists, even those who weren’t suited to me, and none of them were taking new patients. I wasn’t suicidal, but only because of Everest. A couple of weeks ago, I was sitting on the floor of my bedroom, tying a chain around my doorknob and testing to make sure it could hold my whole body weight, ready to choke myself. And Ever came over to me, curled up on my bare feet and went to sleep, breath tickling my ankle. I couldn’t bear the thought of her in the room with my dead body. Bringing her monkey over and dropping it in front of me, waiting for me to throw it for her. Patting my face and trying to wake me up. So, I’m not suicidal, right now. But I needed to hurt myself.

The next day, my brother C told me that my first choice of psychiatrists had agreed to see me. Originally she’d said she wasn’t taking new patients, but he’d called four times and told the receptionist that we’re out of names on the list and my sister needs to see somebody, so I need to talk to the goddamn doctor. I could never be that forceful, but it worked. The psychiatrist called him back and agreed to assess me with the possibility of seeing me regularly.

She specializes in BPD, so she must be experienced with self harm. She’s ranked #7 of #578 psychiatrists in my state, and she admits to the best private psychiatric hospital in my city. And when I called to make an appointment, she offered me one next week.

For a few minutes, I felt pure relief and excitement. And then I felt terrified.

It’s too soon. I’m not ready.

Now that I’m finally past the first hurdle, I remember how much I hate seeing someone new for the first time. How sick and nervous I feel and how hard it is to cover that up. How hard it is to stay resilient against whatever judgments they come up with about me, and the near inevitability that they’ll refer me on elsewhere to keep running like a hamster on a wheel. When I spoke to her on the phone I had real trouble understanding her accent, and felt embarrassed and ignorant when I had to keep asking her to repeat herself.

It’s more than that, though. When I first found her, she seemed like the holy grail of psychiatrists. I’m afraid of losing that hope. The idea of her was a safety net for me. I was resigned to maybe having a psychiatrist who wasn’t great, for now, but she was there as a shining beacon in the future – one day I’d reach the top of her waiting list, and all I had to do until then was find someone who was good enough to keep me relatively stable. If I don’t like her, or she doesn’t like me, that light at the end of the tunnel is gone.

Last night I dreamt of taking a wild wolf – boy foster child, who had four vicious dogs. He was burning them and branding them and beating them, and they were biting me, sinking their teeth in and not letting go. I was his aunt and I was committed to keeping him, but he took one of my comments as evidence that I was going to abandon him, and emerged from his bedroom with a knife, carving four deep gashes into my arm.

I don’t want to go to work today.

Too Long, Too Soon

Keep Going, Mr. Meatballs

I feel far more settled and at peace today. But it’s hard to really embrace it when I know it’s only happening because I hurt myself.

My father happens to be in the area this weekend, so I took a train to meet him for a hike in a national park. It was a beautiful day and I was happy to be outside, listening to the birds and the waves and remembering how it is to be part of the world. I was also assessing every cliff edge for whether or not a jump would result in death, but that’s just habit.

The only thing that put me off balance was, oddly enough, a fat little corgi named Mr Meatballs. We’d done the best part of a three-hour walk when we got stuck behind him and his owners on the track, and he was obviously exhausted. He was walking slowly, but with the air of somebody moving briskly and with purpose, and when his owners (who were largely ignoring him) got too far ahead, he’d put on a short burst of speed, trying vainly to catch up to them before his energy wore out and he dropped back to a slow, effortful walk.

Something about that really hit me. He was so tired and trying so hard but they were just walking off and leaving him. I wanted to pick him up and carry him, but I was quelled by the impropriety of picking up another person’s animal without their permission. I wrestled with myself, but settled for stroking his head and encouraging him quietly, until I could feel dad getting impatient and we walked on ahead.

Visiting the Hand Clinic yesterday was unsettling. After my experience with the Burns Clinic last year, I’ve come to learn that ‘clinic’ is code for ‘sit in an open uncurtained room with 20-30 other patients and doctors, your arms, scars and wounds exposed, answering questions about your history of self-harm, some people completely oblivious to you, some trying very hard to pretend they see and hear nothing and some leaning around the person next to them to openly stare’. It’s kind of like the dream where you show up to school with no pants on – you’re awkward and embarrassed but trying to act cool while you inwardly wish a teacher would show up and usher you into an empty classroom.

 

Since my hand still looks like a squished tomato, the doctors were concerned enough to send me for more x-rays and a CT scan. Even now, I’m pleased with the results, and ashamed of myself for being pleased. I broke 5 of my bones. They offered me surgery, but I wasn’t interested in even discussing it as an option, and I’m letting that be okay.

(I hate having surgery – when I had skin grafts to fix my full-thickness burns last year, they promised the surgeon was going to come and talk to me about where I wanted him to take the skin for my grafts from. And then they knocked me out, and I woke up with searing pain in my left thigh. I’d wanted it taken from my back, for a number of reasons: I didn’t want my upper thigh being regularly touched and checked; I live on the third floor of a building with no lift and could barely walk let alone climb stairs; and now I can’t wear shorts in summer, my only reprieve from the heat of long sleeved shirts. And I hate being in hospital – the last time, a male nurse got frustrated that I was frozen and couldn’t stand up, and took hold of both my thighs and tried to uncross my legs while I was panicking and sobbing and trying to curl into a ball, then hauled me to my feet and told me I was being inappropriate. It took me a month to stop feeling guilty and angry and twisted up about that.

So: no surgery, thank you.)

So instead, I have a temporary cast that will be replaced with a proper one once the swelling goes down. As expected, the responses I got from my family reinforced my belief that the worse the injury, the better. (“You have done a good job!” my mother texted back. “That must have taken a concerted effort,” my aunt replied.)

I got home from the Clinic around 1.30pm, to an email from R that sparked a furious response from me, and resulted in me sobbing hysterically while I scrolled through job ads. I decided that this was the last straw, that I don’t deserve to be treated this way and I don’t have to put up with it, and it felt terrible. My distress tolerance needs some work, but I just am not a person who enjoys being angry. It feels like swallowing poison and hoping my enemy will die.

So instead I’m trying to replace it with love. And all those spaces inside me that feel empty and lost and confused about how I feel and what I should feel; this isn’t the time to stare into the abyss, so I’m trying to fill them with love too. It just feels better.

I’m choosing to love R, by focusing on the many good things he’s done for me instead of the many hurtful things. I’m choosing to love my family, who don’t always say things that are helpful, but who are interested in what is happening in my life and almost always mean well. I’m choosing to love S, my doctor, who wants to know where I got my x-rays then tells me the details of some personal issues she’s having at the moment and says she’s ‘checking out with ethanol’ for the night, whatever that means – she’s out of her depth, but she’s still here and still trying. Loving Anna is beyond my reach right now, but I’m choosing not to send her a text: Five broken bones. Still hate you.

Hardest of all, I’m trying to give myself permission to love the care and attention I’m getting from the Jewish mamas and, more surprisingly, the two new female supervisors at work, all of whom want to bring me food and drive me to the hospital and pick me up and take me home to their families for dinner. I feel wrong for enjoying it, and fraudulent for getting it, because I did this to myself so I don’t deserve any help – I have to face the consequences myself. But I do love it, and there is no point pretending that I don’t. I can get mad at myself, and remind myself that I’m a 25 year old woman, an an adult who can take care of herself and is too old to be looking for a mummy, and I have a perfectly good mother anyway. And I can hurt myself more, to punish myself. Or I can step back, and let the little 8 year old girl step out, the one with bruises and trouble breathing and probably a few cracked ribs who never got to go to the doctor. And I can let her feel cared for. I am finally learning, too, that letting people help makes them feel good. That instead of making them respect me, turning down support just makes them feel rejected, and distant from me.

(Last year for my birthday, my mother wrote some little notes on the things she loves about me. It was such a beautiful gesture, but most of them hurt. I looked at ‘I love how independent you are‘ for a long time before I threw it away.)

Radio silence from the psychiatrist’s office, so I am going to start making calls again next week. I feel spoilt and petulant, but I am unhappy that instead of choosing someone who seems suited to me, I am basically in the situation of having to accept anybody I can get to see me. That will have to be okay. I want to find the right person now, and start getting better now. But sometimes you just have to wait.

Keep Going, Mr. Meatballs

Terrible, Horrible, No Good Very Bad Day

* Trigger warning for self harm *

I broke my own wrist today.

Sometimes once I decide to do something, it’s like it’s already happened. I have one of those brains that thinks through every step in every activity, whether that’s a trip to the grocery store or snapping one of my bones. And once I’d figured out how I would do it, and when, and what I would tell people – hell, even what I’d write on this blog – it felt too late to turn back. Even though I knew that I didn’t really want to do it.

I lay awake two nights ago, reasoning with myself.

I’ll have to miss out on going swimming with my nephew at his birthday party next week.

I won’t be able to drive.

How will I get dressed and do my hair? What can I wear that will fit over a cast?

How will I work?

And just one small voice, on the other side. If you get it over and done with now, you won’t have to think about it any more. 

I understand self-harming when it’s the result of intense emotional distress. That makes sense to me. And because it makes sense, it doesn’t frighten me. This did, a little.

Last night was my first attempt. I went upstairs, put a load of laundry on, went out to the rooftop, counted to eight, and then did it. It hurt intensely at first, and my hand immediately bruised and swelled, but I was relieved – I could see the bone looked out of place. For a couple of minutes, I paced, taking deep breaths, feeling sweat starting to bead on my neck. Then I went back downstairs, tidied my room, vacuumed and did the dishes then commented on a few blogs before returning to the rooftop to hang out the laundry one-handed. It was all very calm. Just part of the routine. Nothing to see here.

I don’t know how to regulate these intrusive thoughts, because they aren’t emotional. I mostly felt numb. Resigned. Scared of the pain, because I’ve never broken a bone before and didn’t know what to expect, and a little scared that I’d fail, that I wouldn’t be able to do it and I’d be a pathetic little sook. But mostly numb.

That all flipped when I went to my doctor this afternoon. She told me she didn’t think it was broken – it might be, but we’d wait a few days and see before doing any x-rays.

I’m finding it hard to identify how I felt, hearing that. In some strange way, it was like being knocked down yet again. Another thing that hadn’t gone right. More pain I’d suffered for no reason. More pain I’d have to suffer, because I’d decided I was going to break my wrist and so I had to break my wrist. I was fighting back tears, without much success.

“So how will I be able to tell when it is broken?” I asked.

And she told me. Not only that, but she told me why what I’d done hadn’t worked and explained the way this bone is usually broken. She didn’t ask why I’d done it, or whether I was planning to do it again. She just sent me home in tears.

The next attempts were so much harder. I was up on that rooftop for hours. Crying, pacing, laying my hand out but losing my nerve at the last minute and pulling it back. Scared. And feeling so much grief over all the time I spend reluctantly inflicting pain on myself. Over the nights I’ve lain awake worrying about having to do this, and not having anybody to tell who could help me. It was a choice – doing it was a choice – but how many people have to make decisions like that?

The fear was much worse than the pain. As soon as it was done, I took myself to the walk-in clinic on my block, and a couple of hours and five x-rays later, the doctor confirmed it – I’d broken my wrist. But my hand was so swollen that he was worried I might have compartment syndrome, and he wrote me a referral letter and told me to go to the ER.

And then the terrible, no-good very bad day got worse. I went home to plug in my phone, anticipating hours waiting in the emergency room, then went out while it was charging to buy a drink to take with me. Without my keys.

Deep breath. Okay. This is annoying, but okay. My spare keys are at R’s – he’s sulking and mad at me and told me I had to ask permission from his PA Anne before I go over, but we explicitly agreed that my spare keys could stay at his place. So I just have to walk over there (broken wrist still uncasted and not even in a sling), grab the key from the concierge, go up and get my spare keys, then get my phone and my x-rays and go to the hospital. Deep breath. It’s okay.

But it wasn’t okay. When I asked the concierge (a nice guy; I always stop to chat with him) for the key, he looked intensely uncomfortable.

“I’m sorry, Rea. You’ve been taken off the list.”

I felt humiliated. I’ve paused, writing this, because I just can’t find the words to explain the shame I felt, that this place I used to live was now sealed off to me, that I no longer belonged, and that I couldn’t stop the tears that came to my eyes.

Voice shaking (bite your cheek, hard, until it bleeds; get yourself under control), I asked him to call Anne and get her permission to let me in. He did, and things got worse.

I’m sorry, Rea,” she said, hesitant. “My instructions from R are that you’re not allowed in the apartment.”

In the end, she called R and got permission for me to go in, then drove the hour’s journey from her house to retrieve my keys when it turned out he’d locked them in the safe and I couldn’t get to them. In the meantime, I was sobbing but furious, taking down my photos from what used to be my bedroom in his apartment, gathering my pot plants from the window sill in the living room, taking my Sprite from the fridge, collecting any trace of myself I could find. I’m angry with him for agreeing to keep my spare keys without telling me I wasn’t allowed to access them, but mostly I am boiling with rage that he has had such a childish fit because I dared to request that if he wants me to work after hours, on a Friday night when I am sick but have still worked 12-hour days to get papers ready for him, when I told him the night before I wouldn’t be working more than 8 hours on Friday because I also had to work through the weekend, that he ASK me to help instead of texting and TELLING me to check my email. That’s it. That was my crime. (I checked and answered the email.) That tiny piece of respect I wanted is why I have endured weeks of silent treatment and snappiness and petulance, and I am sick of it.

You could say all’s well that ends well. It took over 2 hours, during which time my hand ballooned even more, but I got my keys and I got to the hospital. My arm has been put in plaster and I have an appointment with the specialist team tomorrow morning. I’ve called my mother and fed her a cheery lie so she isn’t surprised and suspicious about the cast when I go home next week.

But I feel sad. The kind of sad where you can’t think of anything that would make you feel better. The kind of sad that makes you wonder what the point is anyway.

I called the psychiatrist’s office on Monday to make an appointment, and they told me they’d check her schedule and call back. It’s Friday tomorrow and still no word.

There are wars, and famine, and deaths, and none of it is happening to me. But I still feel sad, and lost.

Terrible, Horrible, No Good Very Bad Day