Greetings, strangers, and welcome. Please beware that because I’ve been too crap to update this blog properly for ages that this post is frustratingly long.
This is sort of continued from here. I considered splitting this into two posts but since when I write entries called ‘Blah Yakka Meh – Part One’ a ‘Blah Yakka Meh – Part Two’ doesn’t often seem to transpire, I decided against it.
I am indeed still in the land of the living, not that anything about the pursuit of living my life is particularly interesting. Which is partly why I haven’t written anything substantive in forever – though most of it is down to anhedonia. Or laziness. Whatever. I don’t feel especially depressed as of this writing, but the weird thing about depression, as I’ve found it at least, is that you can be in an episode without realising it. In fact, I’m going to (sort of) empirically test that contention…
I like things to be measurable and easily analysed. So I periodically take online tests to get a grasp on how my mental health objectively appears. As I said, I don’t feel depressed – but low mood is only one symptom of a complex phenomenon. As such, the following results have failed to surprise me:
- PsychCentral Depression Quiz – 59 (54+ is a severe depression)
- Beck Depression Inventory – 32 (31 – 40 is severe depression; 41+ is extreme depression, so at least things aren’t that bad)
- Hamilton Depression Scale – 25 (moderate depression, apparently, which at least is a hell of a lot better than last time I took this)
- Burns Depression Checklist – 58 (51 – 75 is severe depression; 76+ is extreme)
- Modified Scale for Suicidal Ideation – 16 (9 – 20 is mild to moderate suicidal ideation; 21+ is considered severe.)
In short, things are better than the last time I took these – but my mood was very low then. A lot of my stronger responses to the questions on the above scales are based on motivation, sleep disturbance, ability to work and engage with people and suchlike, rather than mood as such. But I believe those disabilities to emanate from the same source.
Also, I may as well admit it since The Man has worked it out anyway – I engaged in a wee bit of (superficial) self-harm last week. The reason is simply that I was bored. Or, at least, that was my conscious reason at the time. Presumably your average mentally healthy person alleviates boredom via alternative means, but I’ve never claimed to be anything approaching sane.
Anyway, that was a tangent. This post was intended to update on things with my new CPN and the status of my current tenure in group therapy.
This woman is excellent. It is well worth going the extra 20 odd miles to my new ‘base’ up at the specialist psychiatric hospital to see her. The first week, she came to my mother’s house, but I asked if I could see her at the hospital; I don’t feel I can speak freely in my mother’s house, even though I very much doubt that my ma is standing in the hall with a glass to the door. Anne, the CPN, was very glad to accept my suggestion of seeing her at the funny farm, mainly because it would “at least get [me] out of the house.”
On that note, she has, over our hitherto three meetings, expressed concern about my not going out of the house. I pointed out to her that I’m an anthropophobe (and probable borderline agoraphobe) and cannot deal with being around people, at least when by myself. With The Man, I can go out okay as long as the place we’re visiting is relatively non-busy. With my mother, a little less than that. The only places I feel comfortable going to myself are established appointments, such as those with my GP, the shrink or (now) with Anne herself. I have avoided other important appointments (such as the follow-up to the colonoscopy, the barium meal thing) and run out of basics such as milk and bread due to my inability to leave the house.
Anyway, were I to ever get to the point, this concerns Anne. This concerns Anne to the point where, even at our first meeting, she suggested getting me a support worker to help me get out of the house. To my own surprise, I not only agreed to this but actively welcomed it. It turns out that after she spoke to my psychiatrist that they agreed that it wouldn’t be a support worker, but an occupational therapist instead – but either way, I’ll get that form of help. The OT apparently operates on a graded exposure basis, and whilst I maintain a cautious level of cynicism about how much this will aid me in my ultimate quest – to be sane enough to go back to work – I am certainly open to it, and will try it to the best of my ability. Anne anticipates it starting around the end of January.
The mere fact that she suggested a further form of input was astonishing to me. NHS Psychiatry and Psychology have not been kind to me over the years, and to have someone actually suggest extra support on an unsolicited basis is a completely new thing. The surprises didn’t end there, though. When I told her I’d been in and out of the system since the age of 14, when I told her how much school I’d missed and how I had to leave my Masters degree with a PgDip due to losing the plot, when I told her how Psychiatry had initially told me to get lost and Psychology prematurely discharged me, she was disgusted. Normally, whilst some of them acknowledge that the system isn’t perfect (masters of understatement), they try to defend their employers. Anne didn’t. She said that I should have been with CAMHS straight away when I first presented to my GP with mental health trouble. She was especially horrified when I told her that I didn’t even know what CAMHS was, or that it existed at all, until about 2010 or ’11, thanks to the online mental health community.
In relation to NHS debacles more recently, she was equally annoyed. In relation to Psychology, she stated that she felt that long-term therapy was something the NHS should invest in, in much the same way that it invests in long-term (sometimes for-life) medication. As she said – and as I have told my local Trust ad nauseum – it’s ultimately better for the health service itself; if I receive long-term therapy and deal with pertinent issues properly, then I am less likely to need long-term/life-long treatment. Having to dip in and out of services is not cost-efficient in the least.
She felt that perhaps I’ve not been taken as seriously as I should have been because, in her words, I’m “intelligent and articulate” (that alone makes me like her!)
It’s just as bad for you having mental health problems as it is for someone who is less intelligent. In fact, in many ways it’s worse for bright people, one reason being because they are less likely to simply accept their position – they think over it, analyse it and so on, and end up feeling even worse than they already did.
She went through a few other reasons as to why she thinks it’s even more difficult for smart people to navigate life with mental illness, though to be honest I can’t remember what she said exactly. Nevertheless, I agree. I also agree that it makes you less likely to be taken seriously, because being able to articulate yourself well does not ‘fit’ with traditional tropes of those with severe mental health difficulties. Sadly, in part thanks to personal experience, I’m firmly of the view that a lot of professionals still fall into the trap of viewing individuals through the lens of a stereotyping kaleidoscope of pre-conceptions.
So that was all good. At the second appointment, I approached a few issues with her that have been bugging me about my psychiatric ‘team’ for a while – since I started reading and writing mental health blogs, anyway. I have never received a care or crisis plan, or risk assessment. Again, before I met people online, I had no idea such things even existed. This was another thing to annoy and surprise Anne. It turns out that a care plan does exist, but that no one had bothered to show it to me (despite the fact I was meant to have signed the thing.) It was completed almost two years ago, which would be funny if it wasn’t so unreasonable.
There isn’t a crisis plan as such, but for the first time since I entered the psychiatric system, Anne explained to me exactly what I should do in a crisis. Obviously you have to see the heinous Crisis Team, but I had no idea how to access them before. Each Trust seems to be different. Anyway, I finally know now.
Finally in relation to Anne, she is just generally nice. My psychiatrist, Debbie, had once described her as being very much like my first CPN, of whom I was very fond, and so far I’d agree with this. She appears to genuinely listen, to genuinely care, and to genuinely express warmth with her parting words: “take care, m’dear.”
I can’t go into an awful lot of detail about this, for two reasons. Firstly, and most importantly, I obviously have to respect the confidentiality of the others in the group. Secondly, whilst it’s very much psychodynamic-based therapy and although it helps treat them, it’s not for mental health problems per se. The organisation at which it’s based deals with people who’ve been through very specific experiences and I have no intention of going into the minutiae of those here. Most of you are already familiar with the circumstances, I’m sure. Those that aren’t are welcome to enquire privately if it matters to them.
There are four of us: one man, and three women (no cats, though I’m sure Therapy Cat is there is spirit. Thank you for this picture, Susan!) Originally there were meant to be eight of us, but for various personal reasons, the other four either didn’t start coming at all, or have dropped out. One poor sod did so in part because it turned out he knew one of the other attendees, which is a nightmare scenario in my view. She has stayed on, though.
I dread going to it every week, as I actually admitted to them last night. Therapy is inevitably hard work, and the prospect of expunging oneself in front of several others feels like climbing up an even steeper hill. However, when I’m actually there it’s surprisingly okay and – dare I say it – rather cathartic. The four of us, the ‘core group’ as I’ve taken to calling us, seem comfortable around each other by this stage. The man and one of the other women tend to do most of the talking, and end up apologising for it – but I think I and the other girl are happy enough, as if the first two start the conversation, we can bat off that; take a lead on general themes, and speak of how they relate to us too.
Questions of each other are welcome, though of course you don’t have to answer. People generally do, though; I think we trust each other enough now to know that the answers will be treated sympathetically and confidentially. The facilitators – my former one-to-one therapist and a woman – tend to take a back seat, but when they do speak up, you can see the different approaches they’re taking. My therapist will analyse the object relations between us, the underlying psychology and the senses of transference and projection – though that said, any transference there has been thus far (and my observations have been that there hasn’t really been that much, surprisingly) has been completely non-hostile and non-invasive. The woman will look at things more from a ‘feelings’ angle, if you understand the distinction.
I think the key thing, and this always was the point I suppose, is the level of empathy. Each of us ‘gets’, to a point anyhow, where the other is coming from. If one person is having difficulties in an interpersonal relationship now, for instance, we can see how similar themes have come up in our own lives – and, crucially, consider as a collective the ‘whys’ of those issues.
Personally speaking, two things really pleased me. In a way that sounds perverse, because it’s like being pleased about other people’s suffering, but it’s a sense of relief, I suppose, that other people are or have been in the same boat. One of these things is that one of the others is also an educated type, and although she was able to go on and complete her post-graduate degree, unlike me, I did feel some vindication when she said that she’d had a major meltdown whilst undertaking it. It doesn’t change my feelings that I totally failed in that endeavour, but it does feel like I’m not completely alone.
The other thing is that the other woman really ‘gets’ dissociation. She was sitting there discussing how she was talking to someone one day, when that person innocently made an allusion to something – and bam! Her mind was flooded with memories she didn’t know she had. Without going into detail, that’s exactly what happened to me in relation to some stuff.
The thing is, I read a lot of DID-related blogs, so have certainly never thought this was a phenomenon exclusive to me, but she’s the first person I’ve met offline who’s experienced this influx of dissociated thoughts. (I have met several other bloggers who have dissociative tendencies, but that’s after following their writings or talking to them on Twitter first.) What was particularly ‘nice’ about this interaction was when I explained to her that my experience was very similar, she felt less alone. Apparently she’d never realised this was quite a common psychological issue, and I’m the first person she’s known that has also gone through it.
The same woman has, like myself, experienced long-term mental health problems, and hasn’t worked for 16 years. The other two do work, and have no diagnosable conditions, but are completely non-judgemental about us being unemployed, unlike a lot who seem to believe the ongoing and fallacious societal rhetoric about ‘scroungers’. I am (by far) the youngest of the four of us, so my fellow member’s long-term unemployment makes me feel slightly less shit about my own.
So I suppose one might say that it’s strange, spewing out your darkest history to five other people – but considerably less strange, and much less intimidating, than I had anticipated. I don’t think it’s going to completely eradicate the effects of what happened (I remain unsure that that’s even possible), but I do feel that it will have some positive outcome. My main aim in going to the group was simply to go to a group; as stated both here and in other posts, I am positively terrified of people, and my obsession with not being in work dictates that I am also obsessed with ceasing to be terrified of people. I don’t think group therapy will get rid of that entirely either, as the circumstances are obviously highly divergent – but it might help ease the tension a little (perhaps especially now that I am to try this graded exposure thing.) If nothing else, I feel a slight sense of hope I won’t always feel so isolated.
The #flegs nonsense is still ongoing, which is completely driving me mad. It’s not keeping me in the house like it is for some poor people, but I’m fed up hearing pathetic defences for inexcusable acts of aggression. Seriously, if these dickheads don’t stop their idiocy soon, I am sincerely concerned that history will repeat itself. In inoffensively expressing my disappointment on Fuckbook that parts of my beloved home city are seemingly war zones again, I inadvertently started a war between one fella who supports this bollocks and about 14,000 reasonable human beings. My fear of confrontation drove me away, but I’m pretty sure that overall sense prevailed. Although yer man was tenacious, his arguments – at least, as far as I could tell from a spy on Twitter – were (unsurprisingly) weak. It’s worth noting that the man in question is actually a really decent bloke in general, but he has some qualities that are unattractive and this blind so-called loyalism is definitely one of those. Loyal to what? British democracy, when people are throwing petrol bombs at the police? Whatever. All these twats are loyal to are dissident republicans, who are bound to be lapping every second of this up.
I still haven’t been on @mymorevividlife for a very long time – well before Christmas, I’m pretty sure. I’m presently pretty active on my personal Twitter account, perhaps because I’m ‘happy’ to simply be ‘me’ at the minute. I go through phases when I tire desperately of anonymity – or, in the case of this blog, semi-anonymity, and such is the case at present. Usually I then tire of being me (!), but I can’t necessarily guarantee that in this case. So if you would like to follow me, feel free to email me and I’ll give you the other Twitter handle.
Speaking of email, I owe loads of people responses via that medium. Some from five or six months ago. I’ve always been an appalling correspondent, but this is ridiculous. I’m genuinely sorry, and genuinely intend to respond properly – but when? I wish I could say. What I can say is that I’m a twat, and that I’ll try to get over this anhedonia as soon as I can and get back to you all. On a similar note, I haven’t been commenting on blogs, nor have I responded to comments left on this blog, for ages. I am actually still reading, but I can’t seem to think of anything remotely coherent, supportive or useful to say. It’s not that I don’t care; I really do. I’m just crap. And, again, I’m sorry.
And that’s about it. Well done to those of you that got this far! I hope you all had a pleasant Christmas (or at least a relatively non-shit one), and that this year will be a good one for you. Much love across the bandwidth to everyone. xxx
Forgive me; I haven’t proofread this at all, so apologies for any spelling/grammar/syntax/other errors.
Picture credits: the second picture is my own work. All the others come from the sites they link to.