Balanced Precariously At The Edge Of A Ledge, Trying Not To Fall Off (Send Help)

Things aren’t going so well with Nikki at the moment. Or maybe everything is completely normal and I just have unrealistic ideas of how things are supposed to be after too many therapists with unhealthy boundaries. Or maybe my constant over-analysis is fucking things up and it’d all be fine if I didn’t examine every little thing with all the intensity of Animal from the Muppets playing a drum solo.

I’m feeling pretty mixed up at the moment.

Our session on Tuesday was probably the biggest waste of $200 I’ve ever spent (and I once bought the complete collector’s edition box set of Xena). And that’s completely my own fault – a couple of things went kind of wonky, but instead of using that as an opportunity to work through things and share and grow as a person (you know, the POINT of GOING TO THERAPY), I just sat there.

The afternoon of my appointment, Nikki texted to see if I wanted to come earlier since she was free until my session. When I replied to tell that I was still at work and was likely to be a bit late, she replied “That’s cool but I can’t stay after 7.30 I’m afraid. See you in a bit.”

The idea that she would ever have to tell me that our session needs to end on time seems beyond ridiculous to me. Of course it does. It should be a given that we’ll end on time, though it’s not, because she always start at least 5 minutes late and usually ends at least 10 minutes over. At the time it just registered as a mild discomfort, probably because her setting a boundary seemed to imply that I wasn’t already completely aware that it existed, and I’m always more reactive to perceived rejection of something I didn’t even ask for in the first place, because it feels unjust as well as embarrassing.

I raced home to pick up Lily, my new foster baby (everybody, meet Lily!), skipped getting changed and rushed to her office…then spent almost 20 minutes in the waiting room. The receptionist said she was with someone, and I figured she must have got a crisis call or something, so I texted her to let her know I’d arrived and then settled in to focus on pretending I didn’t have a cat turning somersaults in my handbag.

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Lily crashed out taking a nap on Nikki’s lap

 

 

As it turns out, Nikki had actually been talking to the psychiatrist I was meant to see two days later, and my control/independence issues came rising up with a vengeance.

Psychiatrist #10 kind of browbeat me into going back and doing DBT again, but that means I have to transition to another new psychiatrist, because you have to be seen by one of the people affiliated with the private hospital that runs the program.

I hate seeing new psychiatrists. I hate it. My biggest rupture with my last therapist, Anna, was over her lack of understanding of how much I struggle with seeing new psychiatrists. The worst self harm I’ve ever done was over a first appointment with a new psychiatrist. I hate seeing new psychiatrists. 

So I picked Psychiatrist #11 on the basis that:

  1. I’ve already seen her once before, and I didn’t love her, but I know she’s not awful.
  2. She works at the same consulting rooms as Nikki, so I don’t have to deal with any anxiety about where do I go? am I going to get lost? how do I get in the building? if there’s an intercom what I do I say when they answer? do I turn left or right when I come out of the elevator?
  3. She works at the same consulting rooms as Nikki, so it’ll be easy for them to connect if there’s a crisis.

But when Nikki finally called me in, she said she hoped I didn’t mind but she’d just met with #11, because she wasn’t sure if the intention was for #11 to just assess me for the group, and so she’d asked #11 there were other psychiatrists I could see. #11 had given her two names of male psychiatrists, and one of them is experienced with complex cases.

“So I probably should have asked you if that was okay, but I said ‘That sounds really good! That sounds really good! Call him! Call him!‘”

It did not sound really good. Suddenly I’d gone from a set appointment with a relatively safe person at a safe place to seeing a male psychiatrist (I never see male clinicians) at an unknown place and time, and it’d all been taken out of my hands. She didn’t know that I’d been planning to keep seeing #11 after the intake assessment…because she didn’t ask. But Nikki was so excited, and she’d been trying to help and I couldn’t bring myself to trample all over her good intentions, so I summoned a wan smile, and said “Great!“.

That was pretty much the last thing I said for the rest of the session. I wasn’t angry or upset, but I felt kind of helplessly despairing and numb, and like there was no point in saying anything and I didn’t have the energy to anyway. Nikki kept trying to safety plan, because it was only two days until November 24, and for the past two years I’ve taken overdoses and ended up in hospital on that date. Last year I overdosed then slashed my arm, and if my psychologist hadn’t called the police rescue squad to break into my apartment and carry me off to the hospital half-unconscious, I would have died. But I really didn’t care about safety planning. I cared a little bit about the difficult position I was putting Nikki in, but not enough to summon the willpower to be helpful and constructive.

When she found out that I’d been waiting for more than 15 minutes, because the receptionist is new and didn’t know she should interrupt her conversation with #11, Nikki was incredibly apologetic, and much more upset about it than I was. And she immediately offered another 15 minutes.

I hated that. She’d made a point of telling me she had to leave at 7.30, and now suddenly she could stay until 7.45? I hate the inconsistency, and I felt like she’d lied to me – lied for the purpose of making sure she wouldn’t have to spend any extra time with me, which I don’t expect and which wouldn’t even come up as an issue if she would just manage session time properly. I flat-out refused to stay, and made a point of checking the clock and scooping up Lily to leave right on 7.30, against her protest of “No, Rea, honestly, I’m going to feel really bad if you go“.

I was standing at the door of reception, and she called out to me “Come here. What’s wrong? What’s wrong? Tell me what’s wrong.” 

I looked at her and wavered for a second, but time was up, and I’d chosen not to talk to her in session, so it wasn’t okay to talk to her now. I walked away without saying goodbye.

 

I’m such a shitty, shitty client.

On Thursday, the dangerous anniversary day, I decided to text her. My instinct was to shut her out completely, to just show up for session the next day all casual and ‘oh yeah no big deal I have everything under control without your input‘. That seemed like a bad idea, and if I’m honest, I kind of wanted a small point of connection. So I texted to let her know that Kim had picked me up for work, and a friend was staying the night – in my tiny studio apartment, that means sleeping on the floor right next to my bed, so I couldn’t get up in the night to overdose without literally stepping on her face. About as solid as a safety plan can get.

I know I didn’t communicate much on Tuesday so wanted to make sure I didn’t leave you in the dark.

She sent a nice reply, insisting I get rid of the pills I have stockpiled just in case, telling me to look after myself and that she was free for the next couple of hours if I needed to talk. All nice and all good, and no need to reply, so I didn’t.

Then a couple of hours later, she sent another message that she’d received from #11 about arrangements for me to see the male psychiatrist she’d recommended, and tagged on the end “Good news! I’m hoping this one will be a good one!”

Everything overflowed. Hoping this will be a good one, she says, the unwritten implication being but oh well, if he’s not then we’ll just find another one, no harm no foul. Only it is harmful and I hate it, I’ve told her how horrible it is for me, why is she so fucking goddamn blasé about it? I was angry, and suddenly I hated her.

Good news for you – I would literally rather die than see another psychiatrist, though I suppose that’s not saying much. This is what I was so upset about on Tuesday. Thanks for the info though.

Her response threw a whole fucking shipping container full of fuel onto the fire.

Please don’t judge too soon. He might be exactly right for you. Hope you’re feeling better now that you have people around you.

Nikki is the least validating psychologist I’ve ever had. Any time I say I’m upset about something or struggling with something, there’s always an ‘Oh, but what about this?‘. She always argues with me. I just want her to listen and be affirming, but instead she makes me feel like my feelings are wrong. And I know I’m not taking one incident and blowing it out to encompass her whole personality, because this complete and systemic failure to ever respond in a helpful way was the entire point of this email that I sent her a month ago.

Here are the responses I didn’t send:

Fuck you.”

You’re such a cunt.”

What the fuck is wrong with you?

Here is the response I did send, after two minutes and a lot of deep breaths.

I’m not judging. Whether he’s good or not it’s fucking shit that I have to go see my 11th psychiatrist. I fucking hate it. No, I’m not feeling better.

Would you believe it got worse? Yeah, it got worse.

Ok. Maybe you should get your friends to take you for a walk. Forget about psychiatrists for now!

I was crying pretty hard at this point, and angry enough to want to throw my phone at the wall. Minimising? Check. Completely ignoring what I’ve told you about throwing basic strategies at me being unhelpful, further proving that you don’t listen to me? Check. A completely stupid and inappropriate response to being told that something is so upsetting it makes me want to die (‘how about you go for a walk and just forget about it?‘) – Check. Especially fucking stupid on a day where I have a greatly increased probability of committing suicide? Check, check, check.

I’m happy with the response I sent. Overall, I think I was able to be reasonably effective through this conversation, considering I was at a pretty massive level of distress. We wrapped it up with this:

This is one of those times you’re not listening. Don’t give me information like that over text if you don’t have the attention or ability to deal with it.

I’m sorry that you feel I’m not listening to you. I had no idea that you were upset about my making an appointment for you with a new psychiatrist as you didn’t communicate that at the time. As I said in my last text, I’m free over the next hour or so if you want to call me for a chat.

“I’m upset about seeing a new psychiatrist – that’s not about you. I just don’t get why you never just say “Yeah, that sucks, I’m sorry”. Banal problem-solving really sounds like you’re either not listening or don’t get it, and if you’re not listening and you don’t get it then why would I share anything with you?”

“You sound really angry and we should talk about that when I see you tomorrow. It’s not really appropriate to have this conversation over text as things can too easily be misconstrued.”

‘Appropriate’ was a stupid word to pick. She should have said ‘Not a good idea’, or something like that, instead of making it sound like I was doing something inappropriate. I texted back a little tongue-in-cheek, telling her I really wanted to reactively cancel my session, but that since I don’t do that, I’d fucking goddamn see her tomorrow.

Then I pulled myself together and went to see a movie with a friend, but I cried myself to sleep that night.

Our session on Friday was, again, a total waste of time, but this time Nikki colluded with my avoidance.

We’d agreed to have a park session, and I texted her beforehand to ask if she could just meet me there – I didn’t want to do the awkward walk from the office to the park with her, trying to make small talk at traffic lights with strangers clustered around us. She said that sounded good, but pointed out that it would eat into our session because she needed to leave on time, and since I still understand the basic concepts of time and space and was completely aware of that before I suggested it, I agreed that that was fine.

We hadn’t set a clear meeting place beforehand, and she couldn’t find me, so we ended up starting more than half an hour into the session. I was lying in the grass reading a home decoration magazine when she finally found me, and while she flipped through it we chatted idly about her landlord refusing to renovate her tiny apartment – she seemed nervous and awkward, probably unsure of what the hell she was supposed to do with the 15 minutes we had left. She commented about our city being so expensive you have to marry a banker to be able to afford to buy a home, then rambled straight on to:

“Oh, dear, self-disclosures all over the place. I didn’t marry a banker – I’m not married.”

I had no idea what to say to that. I was glad that she wasn’t pushing to talk about the rupture, and I was happy to talk amiably and superficially, but I was only happy on a surface level. Underneath, I really wanted to process the rupture we’d had last night, so I didn’t have to keep imagining the conversation in my head all weekend.

Again, after telling me via text she had to leave on time, she changed her mind and said she could stay longer and she didn’t have to pick her son up until 6pm (AAAAARRRRGH  JUST BE CONSISTENT), but I was pushing her to go, and it didn’t give us the space to get into anything. Instead, we both just touched on it in passive-aggressive, indirect ways.

Nikki: “Do you ever call people up on a Friday night and say ‘let’s go to the pub?’

Me [very flatly, having told her 5 minutes earlier that I mixed codeine and vodka for the first time on Monday and cut the worst I ever have]: “I don’t drink.

Nikki: “Sorry. That’s a good thing. Banal and inappropriate problem-solving.”

Me: “Good to see you’re always improving.

Nikki [after telling me that I had to text her a safety plan by 6pm or she’d call the crisis team, and me refusing]: “You seem to be more agreeable when I’m not here…actually, no, not the other day. HA HA HA HA HA.

She kept saying ‘okay, I need to go‘ and then not actually leaving, and eventually I pulled the magazine back over to me, said “Bye, Nikki” and started pretending to read.

Okay. I’ll hear from you at 6. Okay? See you.” She started walking off, then walked back and said “Say goodbye, because it feels weird otherwise.

I’m such a shitty, shitty client.

I need some help, guys. I mean, I’m stubborn as a rock and I’m going to do whatever I’m going to do no matter what anybody says, but I’m way too embroiled in this and I need some outside perspective. I’m wondering if maybe we should set some therapy ground rules, for her and for me, the first of which would be STOP FUCKING TEXTING ME AND TELLING ME YOU NEED TO LEAVE ON TIME.

I don’t want to find a new psychologist. I want this to work. But I’m not completely sure why it’s not working, so I don’t know what I need to fix. Is it all me? Is it both of us? I see her again in two days – what do I do?

Balanced Precariously At The Edge Of A Ledge, Trying Not To Fall Off (Send Help)

Part I: Back in the Hospital, and the Mamas Find Out

After Nikki told me she was pregnant, I lay awake all night.  I was not being mindful, and I was not finding a calm centre, and I was not regulating my nervous system by shoving my face in a sink full of ice. I was ruminating about how I was going to have to find yet another therapist, and start all over from the beginning again, and I might as well just die. I was crying and despairing and I was not ready to even consider trying to approach the situation in a healthy way.

I slept most of Saturday, and that night I fell back into the cycle of rumination and despair.  About 3am, I snapped.  I was counting out pills when I remembered that when I was released from hospital on Tuesday, I’d promised the doctor that I wouldn’t attempt to kill myself for at least a week.

Well, fuck.

For the first time, I walked into the hospital and told them I was suicidal. I couldn’t stay home and keep my promise, and integrity is important to me. It was an awful night, though. I was feeling fragile and scared, and the intake nurse was verbally aggressive with another patient, then grabbed him by the arm and started yanking him around. It was triggering and too much, and when he told me I had to take my headphones out I refused.

It was completely irrational, but I’d latched onto them as a sense of security, kind of a barrier I guess, and the idea of removing them was like removing my clothes – it made me feel vulnerable and bare and panicky and I knew I was being ridiculous but I just couldn’t do it and I didn’t understand why he was making such a big deal out of it. I told them that I wasn’t listening to anything, and I just wanted to leave them in, but another man came along and asked me sarcastically:

Do you want to see a doctor?”

Yes.”

Then you’ll take the headphones out.”

I don’t deal with reprimands well at any time. This time, I burst into tears and tried to leave, at which point I was involuntarily detained, until another doctor came along and yanked the headphones out while I tried to stop her, scolded me for being inconsiderate, then wrestled my phone from my hands and took it away.

It wasn’t a good night.

Maybe it was the push I needed, though. I knew I had to get back to work if I was ever going to start feeling better, but I knew I wouldn’t get there unless somebody made me. So I called Kim, one of my self-titled ‘Jewish mamas’, and told her everything, and asked her to pick me up the next day, even if she had to literally pick me up to get me out of bed.

I am the most unbelievably lucky person. The flexibility and care that my colleagues give me is more than anyone could ever hope for. For the past two weeks, I’d failed to show up when I said I would, missed deadlines, ignored their emails and screened their calls. And they met me with nothing but compassion.

Monday morning, I did the rounds of the managers, and told each one I’d been suicidal and in hospital, after choking myself and slicing up my thighs. Sarah told me she loved me, and my wellbeing was more important than work. Polly had tears in her eyes, and got up to hold me, one of those long, close hugs with my head tucked into the bare crook of her neck, those incredibly rare hugs where there’s no time limit, and they will stand there until you decide to let go. When I told her about hanging myself, she pulled me back in again. Carol, the HR manager, cried and told me I’m a beautiful person, and that I could call her any time and she would come to the emergency department with me. Kim hugged me, called me “bubs” and “my love” and “precious”, and I soaked up every word.

Even the people I didn’t share with know something is up, and they’re reaching out. A girl from another team that I’m kind of in awe of called me over to tell me that she’d had a dream about teaching me to fly. The accounts assistant, who I barely interact with, came and gave me this post-it note quietly, then started chatting about the new café down the street.

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It was intense, and uncomfortable, and overwhelming. At times, it triggered an intense urge to bleed. But being surrounded by so much love made me feel like I didn’t really need Nikki anyway.

The next day, I had my regular weekly session with Nikki.  I was quiet at the start, but the kind of quiet that has an edge to it.

We’d decided to go for a walk to the park, but before we left, she took me into her office to show me she’d bought me some scented Play-Doh and a colouring book, because I’d started getting bored with the watercolours.

I had no idea what to say. I couldn’t really say “Great, looking forward to it!”, because I’d already decided this would probably be our last session, but it also seemed too abrupt to just say “Nope, actually, I’m devastated and repelled by this pregnancy you’ve been desperately wanting for years, so I’m not coming back”.

I probably should have bitten the bullet, though, because I didn’t even manage to tell her I’d been in hospital over the weekend until we were already returning from the walk.

I started off mostly with angry frustration (“I was distressed because now I have to find another fucking therapist”) but it quickly shifted to sadness (“I don’t want to quit, but I just cannot cope with this”).

I couldn’t explain it, because I don’t really understand it. The thing is, even my reaction to her pregnancy is weird. I’m not all that worried about a two or three month break, because I know I’ll miss her, but I have other options – I can go back to see Jen, or Aisha, and I know I can get through it. If she was taking the time off to go on a holiday to Hawaii, I wouldn’t have even considered quitting. And I’m (maybe naively) completely convinced that she will come back. It’s not a fear of abandonment.

At least, not that kind of abandonment. Not the direct kind. I’m a little afraid of her leaving me mentally, that she’ll be too distracted by thoughts of the baby to actually listen to me, too tired from sleepless nights to focus on what I’m saying, too frazzled by ‘baby brain’. I’m already using it as evidence that she doesn’t really care about me (it’s just the hormones that made her feel maternal towards me). And there’s the fears around how her availability will change when she has an infant, how I won’t be a priority any more.

But mostly, it’s this kind of internal recoil from her physically being pregnant. Normally I have no issues with it – in fact, I’m the kind of person who’s desperately keen to put their hands on a friend’s belly and feel the baby kick – but Nikki having a swollen belly feels really not okay and really not safe. Like, to the extent that I feel as though I can’t be in the same room as her. If she was adopting, I wouldn’t be freaking out anywhere near this badly. Is it a boundaries thing, feeling like she’s bringing too much of herself into the session (in a very tangible kind of way)?

At the same time, though, I know it isn’t just about the physical aspects of it, because my level of distress also depends a lot on whether it’s a girl (catastrophe) or a boy (only a moderate disaster).

(I really hope that coin toss comes up ‘penis’.)

I picture having a session with her in a few months’ time, and the imaginary Nikki in my head is unpredictable, and I’m afraid to talk to her because she might lash out at me. Is this some kind of object permanence thing? That if she looks different I can’t hold onto the fact that she’s still the same person?

I hated talking to her about it. I was so upset, and I wanted her to know how upset I was so she’d feel bad about just dropping it on me. She kept telling me that we could figure it out, that we still had five months, we just had to take it one step at a time. She wasn’t getting it. She wasn’t hearing that it was about the pregnancy, not the absence, and I just kept telling her I couldn’t do it, that it was too much, at the same time that I desperately wanted her to hold onto me, and tell me there was no way I was going anywhere.

Eventually, she offered to give me some referrals, and I told her I’d already looked into it over the weekend and picked a couple of possibilities. I felt heavy, and empty.

By the time we made it back to her office, I’d mentioned dying enough times that she was worried, and she asked me if she should drive me to the hospital. I thought about it – really, the answer was yes, but I had a $3 million proposal due to the CEO that night, and I didn’t want to let him down.

She asked some more risk-type questions, but I was lost in the turmoil in my head, and I didn’t answer. Eventually, she looked at me and said “If you’re not going to talk to me, then there’s nothing I can do for you”. Her voice was flat, and it stung, so badly.

Yeah, I know. I’m going to go.”

I got up, and she stood too. I don’t remember exactly what she said, but it was something about it being a pity, and a wasted opportunity. I couldn’t look her in the eye when I mumbled goodbye. And then I walked away.

Part I: Back in the Hospital, and the Mamas Find Out