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“.

 

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

18 thoughts on “Better Than A Poke In The Eye With A Sharp Stick, I Guess

  1. I hope things get easier soon. First sessions are always hard. Maybe things will improve once you get to know one another a little bit more. Also, I wanted to tell you about my blog, I wanted to know if you want to request access, it’s Private, I write about therapy and psychiatrist appointments and other things related to did and PTSD I’d like you to become a reader, if you want to I mean http://therapybits.com/

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  2. Sirena says:

    I understand your reservations. This one seems astute though and very forthright. I wonder whether that’s something you need to get you moving? It’s all very well having the soft fluffy therapist but it’s much easier to avoid things and not progress in that environment. If it helps, when I first met Sienna I was a bit scared of her, she was a no nonsense, cut through the bullshit type of person and that scared me because I knew my defences wouldn’t intimidate her. After meeting her for the first time it took me weeks to make and appointment and a further month to turn up.

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      1. Sirena says:

        Yes a bit. But in a tough love kinda way almost. “I care but I’m not going to allow you to self sabotage” kind of way.

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    1. Getting a bit more of a kick up the butt could be really good for me, and I think she is pretty astute. I’d like a bit of fluff to soften the no-nonsense, but I’m feeling pretty hopeful that we will be able to figure it out. (Knock on wood.)

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      1. Sirena says:

        Yeah but once u get to know each other and relax into the process you’ll find there might be a softer side to her. And remember the next four sessions are for u to suss her out too.

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  3. I hear so much fear in reading this. Fear of opening up, showing yourself, after being rejected and scorned many times before, for the very parts of you that are in so much pain and in need of comfort and acceptance. I can understand why you didn’t want to answer her questions. It makes a lot of sense to me, why you’re resistant to risk trust with her. You have no guarantees, after all, that she will stick with you after those 4 sessions. And that is so scary, to not know, and risk anyways. It is such a sensitive place, and Anna really hurt you. And Anna was so comforting, in many ways. Other ways, the inconsistency, not so much.

    Not that you asked for it, but my initial reaction to this doctor is that she knows about trauma, she is not afraid to get in there (her direct questioning), and is not going to be intimidated by anything you say or do. I don’t like some of her statements “that isn’t normal” (uh, self-inflicted violence is a pretty normal response in complex PTSD), but maybe overt expressions of compassion aren’t her strong suit. I think she sounds strong, and steady.

    It won’t be like Anna, anyone else you see, because no experience will be exactly the same. And there is grief to that. I remember, after I left Delaney, I cried a lot about how I would never be able to connect to another therapist in that way. It felt so personal. And sometimes, I still think about her, and compare my current therapist. And what I’m learning and seeing, is that the bond I have with my current therapist goes much deeper, than the one I had with Delaney. It is different, and I grieved that loss, but I wouldn’t go back. Even if I could. Therapy is not friendship. Therapy is not surrogate parenting in the way we might wish for it to be. And when it blurs those lines, things tend to be less therapeutic, on that deeper level. It might be too early in your process to see that, but I wanted to offer my thoughts. Mostly as an encouragement to say “this is hard, I get it. It hurts. It really fucking hurts. And it is scary to open back up.”

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    1. I always value your opinion, and I’m reassured that you think she seems solid. The more distance I get from the session, the more I think so too. Though I didn’t like some of her statements, I’m also not too bothered by them, because she’s very Russian and we’re operating across different cultural contexts, and because I got the impression that if I told her I didn’t like something she’d listen.

      Next session she is going to tell me the rules I have to follow if we’re going to work together, and I’m nervous not knowing what they are, but I’m relieved that she has some. It seems like a good sign.

      I decided very soon after Anna terminated that even though I liked her flexibility in the way she did things, that didn’t mean it was therapeutically helpful, and that there are other people I can look to to visit me in the hospital, text with me etc. But knowing that doesn’t stop me missing it. It’s more about feeling like I mattered than the specific things she did.

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      1. I think when we are just learning boundaries, we have to learn what healthy boundaries feel like and look like. And it gets so confusing, because we really want that comfort and nurturing and it feels good in the moment because we have been so deprived. But in the long term, as you found out, it doesn’t actually feel good when the relationship isn’t sturdy and boundaried and fostering our own inner self-efficacy and compassion and soothing. It is hard, this is really hard learning.

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  4. I just want to say you did so well. I imagine you think about what you should’ve/could’ve done differently but don’t let that draw you away from the accomplishment. Like me, you seem to be able to communicate clearer when you have time to reflect and write. You gave her the list of previous providers (was it like the one you wrote on here?) Do you think you could share with her portions of this one? To see if maybe with her you can develop a way to communicate?

    This is so hard and painful. But I see potential here too. I liked this “I prefer humility in confusion to arrogance in certainty.” yes! and “but I’m trying to look past the phrasing to the intent.” This is hopeful to me. That you feel that there is enough potential to look past the surface stuff. Sounds like she will do that for you too.

    I agree with Rachel. The loss and grief is there and no wonder. It is sad and not ok that this happened to you. all of it.

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    1. This is very insightful – I hadn’t really made the connection, that she’s looking past my “whatever, I don’t know” surface the same way I’m looking past her slightly unfiltered surface. Thanks E.

      The list I gave her was just names. Part of me does want to share some of my writing with her just to prove I give it serious thought and do have some insight, but I’d rather stay away from emailing and texting if I can. It seems healthier for me to keep it in the room if possible.

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      1. I think it is wise to stay away from emailing and texting, but bringing these writings into session could be valuable. And awesome. Sometimes I can be clever and funny in my writing or honest and articulate and I’m usually just a quivering mass of nerves pretending to not have nerves in session so I feel better about not being a total derp. And you write way more awesome and funny and clever then me so I think being able to bring that and communicate to your providers in session would be pretty cool. Just my two cents.

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      2. Taking it to session literally hadn’t occurred to me – I just went straight to email/text because they are more distant and minimize vulnerability whereas sitting there while she read it would be super uncomfortable. But it could be helpful, you’re right.

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      3. I don’t like her to read it although that has happened (she reads it out loud and I just can’t stand how she reads it so carefully and with feelings, ugghh!). So when I have brought something in, I just read it out loud to her which allows for some editing too. I feel my skin tingling, face turning red, ears getting hot as my hands shake holding the page, but that is still easier/better then to try and communicate (or not) with no paper cheat sheet.

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  5. It sounds like a promising first session. You did GREAT! You shared a lot with her (past experience with providers, absence of support from your mom, the driving thoughts to self-harm) and yet at the same time you also protected yourself by not over-explaining everything. You are waiting to see how much you can trust her. That’s a completely reasonable response to past experiences.

    She sounds like she is fairly insightful, if a bit clumsy/overly direct in how she phrases things. But you’ll just have to see. I think the “you’re a funny girl” comment was a bit strange. Does she say that to all her clients? Because aren’t we all a but “funny”??

    I know you feel like you are “on trial” more than she is, because it’s harder for you to find other options than it is probably for her to find other clients. But really, you both have to decide if it feels like a possible match. You have power in this decision too. I don’t know how it works for you, but it always helps me to remember that.

    You’re so brave. I get that you hate this. It is really hard, unbelievably, sometimes unbearably hard. But you are so, so worth the effort.

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    1. I had no idea how much I needed to hear that until I read your message and almost cried. Thank you. It feels like somebody quite sad inside me just got a hug and affirmation that her best is good enough. It’s easy to focus on all the things I didn’t say, but I DID share a lot. And I was brave enough to risk rejection and ask if I could take Everest, which is huge for me.

      I don’t much trust my ability to assess whether or not she’s a good match. I thought Anna was great, and that didn’t turn out so well. I’m not sure if I’ve ever had a really skilled therapist or what that even looks like. But you’re right, I can tell a NAPIWET when I see one and I can run for the hills if she turns out to be really unsuitable.

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