Still In Limbo

I feel too humiliated to go back to Jen. I didn’t get a response to my email telling her that I felt hurt and unsupported, and the thought of her reading it, going ‘Eh – delete’ and then not giving me another thought is so much worse than the original hurt of her not contacting me after Anna quit. This is what you get when you expect people to support you. 

I do know that I have no real idea of what is going on for her. Maybe if I went and saw her she would be supportive. But it’s humiliating. Being ignored and going back anyway feels desperate, and that’s humiliating. The very real possibility that she’ll tell me, gently and kindly, that I overestimated our relationship and that her support is only available on her terms, when she offers it, is unbearably humiliating. Imagining being back in her office makes me feel exposed and ashamed and so desperate to hurt myself.

Thinking that I was worth more than I really am is horrible to realise – not only because of the impact on my relationship with Jen, but because it feels like I’ve been tricked, that I trusted in connection and reaching out and my trust made me pathetic.

No response from Aisha to my termination email. No surprise there.

But I do think that I will go back to Jen at some stage. As much as I hate bodywork, it’s an important part of my therapy, and probably not one that can be achieved by working with a psychiatrist. Before I started seeing Jen, I literally had no idea that I had body-related triggers, not even the obvious ones, like things in my mouth or having someone holding and moving my head. I didn’t know that I can’t lie on my stomach because you can’t put your hands up to defend yourself and it takes longer to get up and get away, and it never would have occurred to me that it’s fine to be touched by strangers because if they hurt you you only have to endure it once, but being touched by people you know isn’t okay because even if they hurt you, you still have to keep seeing them and keep being hurt.

So far this knowledge hasn’t helped me a whole lot, I guess. Maybe I was better off ignorant, or maybe I’m just making it up. But it feels important to know.

With all the intense pain and emotion and anger at Anna and Jen and Aisha, it’s been hard to really stop and think about me. I know that sounds stupid – this whole situation is fundamentally about me – but I get caught up in those thoughts of ‘no decent professional would ever act this way’ and ‘how could she do this to me?’, which are focused on her and what she’s doing. I forget to stop and think about what I’m feeling, about why I’m so hurt and what need isn’t being met.

So when I eventually faced the question of whether to go back to Jen and Aisha, I worked through the following questions:

Zanifesto - decision tree

With Aisha, the answer was no – our relationship has too many barriers to be able to meet my needs – time zones, her schedule prohibiting ability to be responsive when I need support, her travel cutting us off for 9 straight weeks a year, her inability to connect me with other services because she isn’t local and isn’t aware of them, and just the physical distance.

With Jen, I think the answer is a maybe. If she is completely unavailable out of session, then I think that could be functional. If that had been our understanding from the start, I don’t think I would have had any issues with it. The challenge is in adapting. She gave me her mobile number soon after we started working together and has repeatedly told me to contact her whenever I need her, and she’s initiated calls and texts to check in whenever things are bad. She was the second contact on my crisis plan, which meant being available for contact 24/7 for the 12 weeks of my DBT course. (I contacted her once, while Anna was on holidays, because I had to take Everest back to the shelter to be adopted out the next day, and I desperately wanted and needed to keep her but my lease doesn’t allow pets.)

This feels childish and petulant, but I don’t want outside contact unless it’s consistently okay for me to contact her and she can consistently be responsive. That feels like such a ridiculous overreaction, and so unrepresentative of real life – people aren’t consistent. But our relationship isn’t representative of real life either and I would prefer to just call for an emergency appointment if I really need to see her or talk to her.

So that sounds pretty settled, right? Why haven’t I gone back to see her and start figuring some of this out with her? Well, because I don’t have any other sources of support to fall back on right now. I feel guilty and wrong for using that as a reason, because most people only have one practitioner and they have no choice but to make that leap and deal with it if it goes badly. But that hasn’t been my experience. My very first week in therapy I started with both Aisha and Jen, and steadily (though reluctantly) added more and more, to the point that at the end of last year, I saw 5 professionals weekly plus a DBT group. When I’m having difficulties with one provider, I’m used to having at least another one there as a secure base. That’s going to have to change, now that I’m looking for one psychiatrist only, and I’m glad it will, but I’m not there yet.

Of course, that’s assuming I actually manage to find a psychiatrist. Today I resorted to trying to sign up for an online psychologist through BetterHealth, but that failed because I don’t have a credit card (and they don’t take PayPal). One of the psychiatrists on my short-list returns from overseas tomorrow, so maybe that will go somewhere. Honestly, I don’t really want to see anybody. Part of me is afraid that I won’t self-harm so they won’t be that invested in helping me, and part of me is afraid that I’ll be so triggered I’ll escalate into severe self-harm and more suicide attempts. At the moment I’m kind of passively suicidal, in that All I’m doing is trying to get through each day so what’s the point of being alive? way.

But I’m doing okay. I’m still here. I may not be happy, but I’m still here.

Still In Limbo

Three Down, None to Go

* Trigger warning for thoughts of self harm

I replied to Jen almost straight away last night. Before I lost my courage, before I lost my mind from sitting with the pain, and (I hoped) before she went offline.

“No, I am not seeing the new psychiatrist and am not seeing Aisha any more either.

You’ve been a great support over the last couple of years and I really appreciate everything you’ve done – thank you.  But I am feeling very hurt and unsupported by you and am not sure when or if I’ll be back.”

I don’t regret it. It was honest, and as skillful as I knew how to be. I didn’t get a reply, and I’m not waiting for one.

I thought about cutting myself. I could see the blood, pooling around me while I sat in the bottom of my shower, and that triggered another thought – maybe I should overdose, too. I could already hear exactly what I’d tell myself: Jen hates you, you stupid bitch. She thinks you’re needy and clingy and too demanding and she wants you away from her. You’re a pathetic whiny little piece of shit and she doesn’t.fucking.care about you. I hate you, you bitch. You deserve this. You deserve this. 

I stopped, though.

Do you really want to hurt yourself? 

I pictured drawing a razor across my arm, and inwardly recoiled.

No. But I don’t want to feel this feeling and hurting myself will push it away. 

Already I don’t know how, or why, but I decided to stay with the feelings. It was probably Rachel’s fault. I sobbed until I was gasping, and I let myself feel all the rage and the hurt and the disbelief – how can this be happening again? why is this happening again? what did I do?

An hour later, I got another email in my inbox; from my friend R to Aisha, my last sort-of-remaining therapist (and his), with me cc’d. He and I are fighting, and he’d taken a screenshot of our text conversation and sent it to her. I was instantly diverted from my hurt over Jen to fury with him, and I decided it was time to terminate with Aisha.

I did hesitate, wondering if I was being reactive to Jen’s rejection and I’d regret it in the morning, but I felt very strongly that this was the push I’d been needing. I’ve been reluctant to contact her because I was scared of the feelings. I still am; I know there are a lot more to come. I love Aisha. I’m crying now, writing this. She’s given me so much unconditional affection that even with all my fears and insecurities, I really believe every part of me is accepted with her. I want her, so much. But that doesn’t mean she’s good for me. And while I’m already feeling crushed and devastated about Jen, I might as well get it over with.

So I typed out a quick email, Goodbye and thanks, and I sent it. The malicious part of me hoped that when she first opened her email, she would see the subject line and think it was a suicide note.

***

Hi Aisha

This [R’s email] has prompted me to write to you to formally terminate our therapeutic relationship.  It’s been 6 weeks since we spoke and 4 weeks since I got in touch to let you know Anna quit and you haven’t responded.  I feel very hurt and abandoned and it has brought home to me that I need a much higher level of support than you are able to provide.

I really regret that we are parting under these circumstances but I’m trying to remember that it’s not about right or wrong, just the reality that our relationship isn’t meeting my needs.  That said, I so appreciate all your patience and kindness and all the humour we’ve been able to share.  I’m very lucky to have had the opportunity to work with you; I’ll miss you and I wish you all the best. 

Everest also sends her regards – or she would, if she wasn’t busy trying to eat one of my pens.

Rea

***

I haven’t got a response, of course. If I do, it probably won’t be for weeks.

So this month has been a series of cascading failures. Anna, then Jen, then Aisha. I’m swinging wildly between emotional states – numb to angry to sad to relieved to self-loathing and back again. I don’t know what I did. It feels like it can’t be a coincidence, but I don’t know what I did. I’m trying to tell myself that even if it was because I’m too much or too hard or too something, that doesn’t mean that I’m bad or they’re bad, just that we aren’t the right fit for each other. It’s not helping much.

I was awake until 4am last night, restless, idly playing fetch with my kitten, but woke at 7am feeling okay, and determined that I have to start moving forward. I texted my GP, and asked her to call the psychiatrist I’d picked as my preference and see if she was available.

She’s not. I don’t even remember why, but she doesn’t feel she’s a good fit for me. She recommended a psychologist in my area she thinks would be perfect, and S pushed me really hard to do it, but the reality is that I can’t afford it. I’ve found 5 psychologists I would love to see, but even with the private health insurance that costs me $55 a week, it would cost another $400 to go twice a week. With what I earn, even if I went back to how I made it through law school, living in a condemned house and dumpster-diving/boiling pet bones for food, I couldn’t do it. Seeing a psychiatrist will cost me $40 – $80 to go twice a week. I know how lucky I am to have access to any level of care, but I’m still angry that my options are limited.

But I stayed calm, and gave her the number for my second preference. She got an international dial tone, and no message bank.

And then I started spinning out and catastrophising. There’s nobody else I can see. I can’t go to another male psychiatrist. Nobody is going to be able to help me. I should just give up. The universe hates me. Why do I even try when nothing ever works out? 

Being activated is full of contradictory states, for me. My head feels empty, but so heavy. My stomach feels like there is a rock resting at the base, but I feel the urge to eat, to fill it. My arms and legs can’t move but they want to flail and kick and lash out. I need to be very quiet and still but the silence feels blurry. I don’t know how silence can feel blurry, but it does.

I’m trying to be kind and gentle with myself. And when that doesn’t work, I play fetch with Everest. It has become apparent that the pen lid needs to be subdued with all possible force.

Three Down, None to Go

(My Therapist Says) I Am A Dog With Cancer

I think I’m going to stop seeing Aisha.

She was the first psychologist I ever saw. I’d been self harming for over a decade by then, but had never spoken to anybody about it, and she patiently sat through session after session of silence, waiting for me to feel comfortable enough to talk. It’s been over 18 months now, and when my emotions are so overwhelming they start spilling out in snark and snippiness with other people, she’s the only safe person I can break down and cry with.

But she isn’t here. She’s literally on the other side of the world.

I only started Skyping her because she was my friend/boss/surrogate father R’s therapist, and R was the one who talked me into trying therapy – it was just convenient to set me up with her because he knew she was good, I guess. By the time we realised I really needed to see someone on the ground who could work with me more fully, I was too attached to just snip the apron strings, and instead it became a case of finding a local psychologist and then slowly weaning off Aisha. Very slowly – I’d been seeing Anna for 8 months and nobody was anywhere near thinking it was time to transition away from Aisha.

But right now, I’ve got a knife and I’m hacking at those strings. I can’t tell whether this is coming from a wise place, or whether I’m being reactive because I feel abandoned, because she didn’t reach out to me after Anna quit and I’m hurt and sad.

Back when Aisha had been seeing me for a few months, she told R to think of his relationship with me as adopting a dog with cancer – to treat me with love and compassion, but not get too attached, because I’m probably going to die. I’m not supposed to know that, but I do.

To be clear, she has never, ever let that thought show in our therapy. She has always been optimistic and encouraging and told me to have hope for the future. But knowing that she thinks (or thought) that I’m not going to make it just makes everything seem disingenuous. It hurts, and it makes me angry, and I don’t really know why. I should be glad that she recognises how profound my emptiness is, that she can see how much I hurt and struggle. But only a very small part of me is glad.

I think she’s amazing at her job, and I love her. But I have some reservations. Like when she went away for four months last year with less than two weeks notice (even though it’s scheduled travel that she does every year), at a time when I was self-harming so badly I needed surgery and had lost other personal and professional sources of support. Like the fact that it generally takes upwards of two weeks for her to respond to simple (e.g. scheduling related) emails.

And I wonder about how much she discloses to me. This was a huge difference between Anna and Sue – I knew virtually nothing about Anna, so I couldn’t ease into session with 5-10 mins of small talk about her life the way I do with Aisha. It has definitely made me more comfortable with Aisha, but I do wonder if this is sidestepping part of the work by taking the spotlight off me.

In addition to what’s happening in her everyday life, here are some of the things Aisha has told me:

1. Her first husband was emotionally cold and didn’t express any feelings when his mother died. She left him when he started hitting her kids, and then later called Child Protection on him to restrict his custody of them – he suspects it was her but she’s never told him.

2. She started therapy when she was 28 and used to have major troubles saying no, so much that she’d white out in session when her therapist would get her to say it. In her early 40s she woke up with a body memory of what had happened to her. She’s had bad personal experiences with psychiatrists and she doesn’t trust them.

3. After her first children were born she had major postpartum psychosis and had recurring thoughts about killing her babies. Her three children are all autistic.

4. Her mother had very unrelenting standards and she has a terrible inner critic.

I feel uncomfortable about sharing this with anyone, even anonymously. I just want to work through all of my confused thoughts. I feel honored and proud that she shares with me. A lot of me loves it. But it also makes it harder for me to trust her judgment, because sometimes I think she sees so much of herself and her kids in me that it’s hard for her to see me. And I wonder whether the advice she gives is biased by her history. For example, she’s the one who set me up with Anna. At the time, I was looking for a psychiatrist who did psychotherapy, not a psychologist, and I made it clear I didn’t want to see Anna, but Aisha had connected with her and R pressured me into it so I went. Was the resulting shit storm influenced by her personal dislike of psychiatrists? I don’t know, but I wonder.

Earlier this year I woke to the sounds of a furious man yelling, banging and crashing and a woman screaming. I ran downstairs (in my pyjamas) to physically intervene, without calling the police, who fortunately arrived just as I stepped in between him and his girlfriend. I was, and still am, horrified that of an entire apartment building of people, most of whom are not 125 pound women with the upper body strength of a soggy bowl of cereal, I was the only person who showed up. I asked around and was even more upset to find that every one of my friends, family and colleagues said to call the police and not to intervene. So I asked Aisha, and she said I did the right thing, and that somebody has to step in and do something. That’s the answer I wanted. But I wonder. Her answer was so starkly opposed to everyone else’s, including Jen’s – is that influenced by her own experience with domestic violence?

I know that every therapist is going to be influenced by their own history. I’m never going to be able to take anyone’s opinion without examining it myself. Really, knowing something of her background is helpful because it helps me be aware of where some of the pitfalls might be. But it’s hard, sometimes. I don’t want to second guess her, but I do.

The care she has shown me is so humbling and has really touched me so many times. She used to cry after every session with me because she was so worried about me. Maybe she still does. I love that she cares so much, even though it feels weird, too. Even when I’ve been furious with her for repeatedly cancelling sessions, not responding to me, going away on short notice, I’ve felt secure in knowing that I matter to her.

I feel special. She’s told me that I’m the only person she breaks the rules for. She tells me she’s proud of me, and she signs her emails with “Hugs”, or sometimes, “Love”. She cries for me during sessions and she gets angry with my parents. No matter what I bring to therapy, she’s always calm and always accepting – if I’m cutting during session, if I’m completely silent for an hour, if I get up and walk away or ignore her and start texting – it’s okay. She has never got defensive and never been frustrated with me for not wanting to try something.

So why would I want to quit? Well, I don’t, really. Part of me wants to be able to crawl into her arms and hide my face in her neck and stay there. But at least I feel mostly numb about it right now. There’s pain and fear and need underneath it, but the numb goes pretty far down. It has to happen at some point, so why not now, when it’s going to hurt less? In a couple of months she’ll be going away again anyway.

I don’t know. I don’t know what to do.

(My Therapist Says) I Am A Dog With Cancer

Fuck Everybody

tumblr_lw5lgnKcNt1qg1up1o1_250.jpg

It’s been over three weeks since I saw Jen. Over four since I talked to Aisha. That’s my choice, and I’m so mad at them for it.

The day Anna sent me the first termination email, I forwarded it on to Aisha and Jen, with a simple ‘FYI’ at the top. I didn’t want to talk to either of them, felt angry and oppositional at the thought of even being near someone who would want me to talk about my feelings, but I wanted some empathy and caring in a safe, contained way. I wanted an email that said “I’m so sorry, Rea. I’m here whenever you’re ready.” Just that.

It’s been 11 days, and neither of them have responded.

Mostly I’ve been ranting inwardly about how there’s absolutely no possible excuse that could justify Aisha not getting back to me because no competent therapist could possibly not realise that after being abandoned by another practitioner, their client absolutely had to receive affirmation that the therapist cared for them and was still here for them. But that argument is really just avoidance. I’m trying to skirt around owning my feelings by saying that it’s always wrong in every situation and therefore the impact on me is beside the point, she’s clearly a monster, case closed.

It hurts. I feel like I’m a little girl who fell off her bike and is on the ground wailing, blood dripping from both knees. I could get up and hobble over to my mother and tug on her sleeve and she would probably give me some affection, but I don’t want that. I want her to come over and pick me up. But I’ve been sitting alone bleeding for too long now. If she comes, all I’ll do is hit and scream because there’s too much hurt for her to comfort.

I just don’t understand. I know they both care about me. Why would they just let me disappear for weeks? Part of me feels stupid – maybe I thought they cared more than they actually do. Part of me is terrified and devastated that maybe they understand me so little that they don’t even realise how upset I am about Anna quitting, or they think they should just give me space until I decide to come back to sessions. Part of me is furious that maybe they’re trying to train me to directly ask for help, that they’re choosing this moment to withhold any response until I tell them exactly what I want.

Fuck them. Anna has her faults. Too many of them. But if Aisha had quit, and I’d sent her on the email, she would have been in touch within hours.

Fuck Everybody

I’m So Lucky (And It’s Still Not Enough)

TW for non-specific mention of self harm

I have been given so much support over the last week. (Originally that sentence said “more support than I deserve this week” so I had to go back and rewrite it – I wish someone would invent the therapy equivalent of a spellchecker that would automatically correct invalidating and self-deprecating statements to positive self-affirming ones.)

It’s been a hard week, and frustratingly, half of what’s been hard is completely in my head. Yes, the crisis plan finished last Tuesday, so I no longer contact Anna when I’m intending to act on self harm urges, but that doesn’t mean that anything in my life that would trigger me to self harm has actually changed. In the four months we had the plan, I only contacted her three times anyway, and all three ended with her calling the police. A bunch of uncomfortable men in uniforms standing in my bedroom asking me where I bought my artwork is really something I can do without.

My trip home to see my cousin and her kids last week was taxing, though not quite in the way I expected. I knew the kids would cling and cry when I left, and ask me why I couldn’t stay. What I didn’t expect was the honest, connected conversation with my cousin about her social phobia, about the way her parents spoke to her when she was a child and how her mother shamed her father for his depression, about how isolated she is and how frustrated she gets with my oldest niece. There are probably two people in the world she’d have that conversation with, and the other is her husband. Her trust in me brought our connection alive again, and the more connected we are, the more guilt I feel about betraying her. She still won’t get help from a psychologist, even if I pay, even if I go with her, and I had to do something to protect the kids, but I’m doubting whether it was the right choice.

And my army has rallied. Last Wednesday, I spoke to Aisha in the morning, and then spent most of the rest of the day barricaded in my bathroom, telling myself I wasn’t allowed to come out until I’d harmed myself severely, but struggling with the physical pain in a way I never have before, to the point that I ended up screaming. I reached out to Jen via text that night, and despite having four kids, two dogs and a new puppy, she got back to me just before midnight, checking if I needed medical help or support and asking me to touch base with her the next day. Which I did, but not in the way she expected. I’m experiencing major inner cringe as I write this – my friend had an appointment with her in her capacity as a chiropractor, and suggested I come along, so I did. A whole new level of gatecrashing. I sat in on their appointment, then my friend basically demanded that she see me before her next patient, and she was incredibly gracious about it and did. It wasn’t that helpful in the “wow I feel better” sense (unsurprisingly since at the time I was having a bad reaction to a new medication I’d forgotten I’d taken) but it was really reassuring to see her and know she was still there. I felt a little like a child sitting on the floor playing nearby while her mother chats with friends. I didn’t really want to talk to her, I just wanted to be with her.

From the same friend who took me to Jen, Aisha heard that I was struggling, and sent me an email on Thursday to say she was thinking of me and sending me a big hug, and then reached out again to offer me an extra session on Saturday, which I took gratefully. Again, it wasn’t so much about the content of what we discussed as it was about reminding myself I’m an adult now, I have support now – I’m having experiences which are scary but I can talk about them with someone now.

I saw my GP on Friday, and she was the same lovely mix of completely unhelpful advice and totally warm support that she always is. She’s just not good at talking to me about emotional issues, but while my injuries were being dressed, she sat next to me on the bed, bumped her shoulder playfully against mine then leaned her head against me and said “You can come every day if it helps“. When we walked back through reception, she called out cheerfully to her receptionist “Who can we cancel so Rea can come again on Monday?“, then stood rubbing my back while we made another appointment. After I left, she texted me to say “it was really good to see you today – didn’t realise I’d missed you until you left“. Her level of affection for me does make me anxious, because I feel like I always have to be “on” to make sure I keep it, but I feel very cared for with her.

I am so lucky. And it still doesn’t stop me dramatically spiraling when I get a response that isn’t what I hoped for. Last Wednesday, the awful day, I texted Anna to ask if we could set up an appointment for the next week (the good old scheduling excuse), when really I just wanted contact with her. Thanks to Rachel, I at least considered just saying I was struggling and wanted some kind of nurturing from her, but the whole point of the crisis plan ending is that we don’t have an agreement for that any more and I just couldn’t. She texted back three options, two of which were impossible (which you SHOULD KNOW, Anna, why don’t you have my schedule memorized?) and the other option she knows I hate (we refer to it as the Devil’s hour). And I totally flipped.

Why didn’t she check in on how I’m doing when she knows this is a bad day for me – hell, two weeks ago she wanted me on 24 hour watch today! Why is she offering me session times she knows I won’t want -is she trying to stop me coming in next week? She doesn’t even care about me. I hate her. I hate her! 

She asked whether my appointment with the new psychiatrist had been scheduled for that week, and then asked if I was going to follow up with them or if I wanted her to do anything about it. By now, I was petulant, but still passive-aggressively reaching out.

Thanks, but not right now. I can’t cope with anything else at the moment, I’ll think about following up next week.”

A couple of hours later, she responded “Really sorry to hear things are tough. If you need me to ring that Dr I will.”

Of course, what I read was: “I am not providing any support other than calling the psychiatrists office. End of conversation“. I felt so angry at her for abandoning me and fell into that place of despair mixed with rage, and immediately turned it against myself: “Anna hates you. Anna doesn’t care about you. You’re such a stupid bitch.” And plenty more.

Even at the time, I knew (again, thanks to Rachel) that I wasn’t communicating in a way that was going to get my needs met. And yet I was still triggered as hell when they weren’t. I think this is the negative side of having so much support offered by Aisha and Jen and my GP – when it’s not forthcoming from Anna, it feels even more punitive. Which isn’t fair to Anna, because everyone gets to set their own boundaries.

And then I was in tears tonight. I thought I was so secure in my relationship with Jen that I couldn’t be triggered by any perceived rejection, but I was wrong. This morning I took Everest to my appointment with my GP (at her request), which made me think that maybe Jen would be open to me bringing her too. Tomorrow morning I’m taking Everest to my office and will have to go straight to Jen from there, so I texted her to ask if Everest could come too. Why not, right? The worst thing she can do is say no.

Turns out the worst thing was harder than I expected. When I read her reply I felt like the breath had been knocked out of me: it was a moment of pure shock.

Hi Rea. Apologies, but no pets in the clinic. Thx. Jen” 

Innocuous, right? BUT IT’S NOT. She never uses my name in texts – she always opens with “Hi there” or something similar. And she never signs off with her name and it feels weird and distancing and the whole tone just seems off. So I’m spiraling into a mess of criticisms for texting her last week (even though I checked and I’m allowed), for showing up without an appointment, for being too much and inappropriate and crossing boundaries and needing to be put in my place.

Part of me knows that this is crazy. That I’m talking about a woman who offered to come to my house last year to throw out my pills to make sure I wouldn’t overdose. Who has offered for me to stay at her practice all day when things are really bad so she can keep an eye on me and make sure I stay safe. Who texted me back on Christmas day even though she was in the hospital with her teenager daughter who had just broken her leg. That she has four kids and an incredibly busy practice and that even if she is or was frustrated with me, it’s temporary and it’s okay. But it’s not okay. It hurts. And it’s so frustrating that even though my army prove time after time that they care and they’re there for me, it only takes one little perceived misstep for me to fall off the edge.

I’m So Lucky (And It’s Still Not Enough)