I got a call back from De’s old supervisor today. We actually ended up talking for quite a while (We both apologized simultaneously for taking up so much of the other’s time). We ended on me trying with another clinician there one more time. At first I was a bit relieved to have a trauma therapist again, and to be able to work on the trauma stuff almost exclusively, but now I am hesitant.
I don’t want to take the slot from someone who may need it more, I don’t want to take advantage of the system, and I don’t want to be an exception to the rule. Also, I don’t want to know that I will have to switch therapists again in 4 months if I don’t move… Looking back on my history with therapy, most of my progress was made with therapists I was able to see for more than a few months at a time (and who had more trauma experience). It takes me SO LONG to trust someone, the constant change makes it difficult to progress.
The positives about seeing a clinician at the s.a.c. center would be knowing that I am talking to someone who has more training around trauma, specifically sexual abuse. It might be easier for me to jump into the trauma narrative knowing that my time is very limited. They also have all the notes from De. Oh, and I made it a point to mention to the supervisor that I am aware of my tendency to distract from the focus of therapy and would like help staying on track. She agreed that it can be a lot easier to talk about the day-to-day stuff or deal with a crisis than to deal with the realities of the trauma. If I do end up there (so still up in the air, as I know I can back out even after speaking with the new therapist), I think I will underscore to her that I know my crises and self-harm are distractions. I will ask that she keep pushing me through all the other stuff that I am supposed to be there for in the first place. I know it was a huge relief when De did that a few times. She would have a plan in place for the session, and kinda just spring it on me when I got there. It was helpful in keeping me from getting too anxious, and in getting me through the material… I actually left those sessions feeling like I accomplished something (or at least felt that way as the week progressed). I wish she had done more of that, but we digressed easily.
Anyway, sorry. I got lost in writing up things to tell the new clinician (wherever I end up). Hoping that if I can write out those “quick & dirty FAQ’s”, then maybe the “getting to know you” phase will go a bit faster at least on her end. In talking to the supervisor today, I realized that I am kinda getting sick of therapy (at least the inconsistency) so if I can make this next round count enough to get me ok with a break, then all the better. I don’t know if I want to do therapy again when I get back up north if I won’t get to see Dr. C. At least if I can get a bunch of this trauma stuff out of the way down here (where it all happened, where all the huge triggers are), then maybe I won’t be so desperate for support. I’m just so tired of having to start all over again with the trust and the story… also, it’s difficult to find therapists who “think outside the box” in terms of treatment options. Most just regurgitate the same old things tried a million times that ended up not working for me.
The supervisor was explaining that they can adapt the TF CBT method for adults, and that it might be helpful. It’s still in the testing phases, but this center was chosen as a site to implement it and report on the results. If we end up using it with me, the data will be reported anonymously and with notation that it was adapted for an adult. Heck, at this point, I’m willing to try most anything (NO ECT or anything invasive though, never). Who knows… If it works, maybe I can move on with my life finally… That would be nice.
My other options are to 1) stay with TL’s agency and hope I get someone versed in trauma, 2) try D’s agency again, or 3) hope that one of the three EMDR therapists I emailed tonight takes my insurance…I guess I will see what it’s like talking to the therapist from De’s agency. If that doesn’t work, and the three EMDR clinicians don’t take my type of insurance, I will try out whomever at TL’s agency. If even that doesn’t work out, I will contact D’s agency and get more info… If all of that doesn’t work, then I will just take a break from therapy and try to do some self-directed work on it all (pretty difficult with trauma, especially since I feel the need to finally be able to share it, but if I have no choice, I have no choice). Here’s hoping whatever works out, does so for the best.
A friend from college did this activity with her son. I think it can work well for adults too… it’s a good reminder that we are not our poor choices. I would probably use the shredded old script in an art piece that represents strengths. Hmm, there’s an art journal class coming up this week doing a page on 5 of our strengths. If I write out and shred the “old script” before the class, I can use it in the piece. I’m a believer that even the more negative things in our lives can be used as foundation for the positives. The cutting and dissociation got me through a lot. The breakdowns allowed me to look at some ickier stuff from the past that I was not facing. The isolation helped me understand that sometimes people need others to reach out to them, even if they are pulling away…
I guess keep an eye out for Friday’s post. It might be a follow-up to this.
A comment from Patricia on my previous entry mentioned that having the control around when she attended therapy gave her a sense of ease around building the relationship. That got me thinking. I don’t think I’ve ever felt in control in therapy. It’s not given me a sense of having any power in the relationship lately until this termination with TL. The first ever official therapist I saw (not counting my guidance counselor in high school) was 1) a requirement of the work-study program at school, 2) was assigned to me, and 3) refered me to another therapist in the program by the 2nd session because of countertransference. 18 therapists later and I’ve only voluntarily initiated termination with 2. All others were either time-limited by school terms (internship guidelines), or I was terminated for “liability”… Oh, and one was ill for an extended period so I saw someone else in the interim. When the original therapist returned, I took the option to stick with the one I had been seeing while she was out… so really only felt in control of major decisions a small handful of times. I guess you could also count the two therapists I never got past the intake with. One was atrocious in first five minutes of the first session, and the other took 3 sessions to cement that we were not going to click (neither handled self-harm or suicidal thinking well).
Aside of not feeling in control of the relationship all that often, I rarely feel like I dictate the path of the sessions (though in reality I do that almost every session. I wonder what keeps me feeling not in control of it?). I constantly defer to the clinician’s focus after an initial overview of what’s bothering me. If they narrow in on something that I don’t necessarily think is more pressing than something else, I don’t often try too hard to change the focus back to what I consider important. Yes, there are times I will insist on addressing something, but it usually takes a huge amount of effort and time to attempt to assert myself. I don’t feel like I am the expert in my life. It’s weird…
On the flip side, I have never felt the need to dictate where a client’s session should go or what they should address. In my professional role, I had aways believed the client was the expert in what needs addressing, and what direction therapy should take. They are paying me to be a sounding board and to offer support through difficult times, but what we addressed was always totally up to the client. Also, aside of scheduling logistics, the frequency of contact was pretty much up to the client. They controlled when and how often they showed up for appointments, and would have controlled when they terminated (for the most part… until I fell apart and ran away. Then they were S.O.L… and I still feel pretty shitty about that).
How can I hold those both true? How can I as client feel the therapist has all the control, and as therapist always feel the client has the control? Maybe it has been my experiencing of the therapeutic relationship early on. Maybe being indoctrinated into having no real control over choice in therapist or choice in termination time perpetuates my inability to feel in control over it all. As a clinician, I could not and would not force my clients to see me. As a client, I could not dictate the end of therapy until relatively recently. Things with JG didn’t click well, so I was ok with my then-wife insisting I stop therapy. I hadn’t become attached to JG, so walking away was easy. I simply did not reschedule one time after having to cancel because of weather… With Dr. C, I was moving across the country so I was the one to say I’m leaving. The termination with TL did not start out in my control (because I had not planned on switching therapists again so soon if I wasn’t moving again), but I ultimately took control. I know it was her intent to have me feeling like I had a choice in it, like it wasn’t a forced and sudden termination happening on her time-line. At the start of therapy with her, I had talked about how difficult it had been to terminate with De. I had also brought up that D before her had sprung immediate termination on me about a month earlier than planned. TL had the flexibility, so she did her best to allow me to set the pace of our termination… It’s been the easiest ending to a therapy relationship in a long time. It certainly has not been easy, but it has also not been as devastating as the others have been of late. I’ll have to remember to mention that to the new therapist, so they can get a message to TL to say “thanks”…
There’s definitely something to be said for feeling in control of your therapy. I keep trying to remind myself that I hire a therapist, so in that respect, I am more of a “boss”. My client self has only recently remembered that I can hire them or fire them as I see fit. It’s not necessarily that simple, but I need to remind myself I have more control than I think. When you grow up with others always in control (and no safe way for you to gain any), you forget that it is even a possibility. (attachment can also make it feel like there’s no control, but that will be a topic for another post some day…)
Anyway, that’s not exactly where I wanted to go with this post, but I have lost my original direction… Maybe I need to start creating outlines like I used to do for major papers in school. That way, when I go off on a tangent, I have something to refer back to in order to keep on track. Who knew my h.s. writing courses would come in so handy later in life?
Oh, I know. I meant to touch on having trust issues, which makes it difficult to open up in therapy. Lately, by the time I acknowledge trusting the person I am talking to, they are headed out the door for new adventures. I never really pictured opening up to someone because I could choose to never see then again if I wanted to. I know that there’s a measure of safety in speaking with someone you don’t see daily (their judgements won’t impact your life as strongly as those of the people around you day in and out), but I never realized I could walk away from therapy. Aside of feeling that the clinician is in control, my desperate need to have a safe person/place for all the ugliness keeps me feeling a slave to it. There’s something very validating and comforting in knowing someone is professionally required to be accepting and trust-worthy…
I ended up at the beach last night. It was nice. I will really miss the beach after the move (it’s a mere 20 minutes from here, but will be about an hour from where we will be living… and there will be no palm trees or wading in the winter months). I really needed the time away. I needed to think and drown in my music.
I can’t remember which blog turned me on to Angel Haze, but I am in love. She’s inspirational, positive, and kicks ass. I can’t pick a favorite song because I like almost all of them. Dirty Gold is my current obsession, but there’s also Battle Cry (ft. Sia), Angels and Airwaves, A Tribe Called Red, Same Love (remake)… and ok, just about all of them…
I have been fighting strong self-harm urges since the TSA line back up north. I guess it’s a good thing they no longer allow sharps in the airport because I would have shredded my arm and leg in the airport bathroom before boarding, they were that intense (and I had that little resolve at the moment). Music has been my centering tool. I have not picked my art up again yet, but the iPod is glued to my side, with earbuds wedged into at least one ear. If I don’t have my iPod on, I am playing music through the computer or my phone. I am sure I will run through the gamut of coping skills in my repertoire before De returns from vacation. This weekend is a long weekend and most people already have plans. M and I will be spending more quality time together. It’s not a bad thing, but we have forgotten how to interact. We don’t have simple casual conversations, it’s only ever stuff that lights one of us on fire (if not both). I wish I remembered how to talk to her. I wish I knew how to rekindle that close relationship we had back in the day (or at least I think we had). We are both lost in our own drama. When we meet, we tend to collide because the spinning arms of the drama hit before we meet causing sparks to fly and fires to light.
I volunteered for a research project on reporting sexual violence. I’m not 100% sure what they are looking into, but I believe De had said they are looking into how to improve the reporting experience, and what causes barriers to reporting. I was supposed to meet the lady tomorrow at De’s office, but they will be closing early for the long weekend. The lady will be coming here later on this afternoon. I hope the dogs don’t maul her while trying to get her attention (they LOVE people SO MUCH they are not quite sure how to contain themselves. I also suck at keeping up with their training, and they don’t get out as much down here. They do better when they have seen other humans recently). The questionnaire should take no longer than 15 minutes she says, so it shouldn’t be too painful. I don’t think it will be too triggering either, so it should be well worth the money I get from it… I miss research opportunities. While I was never a fan of writing the papers, I did enjoy coming up with the ideas for the papers. I love expanding the knowledge base on things that we don’t quite know too much about. I love education, and helping people understand things. I wish someone would do more research on the after-effects of sexual violence. There’s so much anecdotal stuff out there, but so little “official” understanding of a lot of it. I recently found a blog entry on a topic I have never really seen discussed in print. I know I have been told that it is not uncommon for assault/abuse survivors, but I had not seen anything even remotely close to educational about it anywhere before. It is also one of the few places to write about it as a function of coping with the abuse vs a pathology simply deemed psychotic. I wish medical professionals had access to that information. I think I may have gotten some more effective treatment earlier on had the doctors seen it as something that makes sense in the context of my trauma. I’m fighting with the thought of posting a link to it here because I don’t think it’s something I’m ready to admit to anyone outside of a few select people. I know it would have helped me immensely seeing it before now. It helps ease some of the shame to know (other than just hear one or two professionals tell me it is not uncommon and it makes sense) that others struggle with it. I was surprised to see the number of comments on that post (well over 200?!) from people all struggling with it in one form or another. I’m just not ready to go public with that aspect of my struggle. I guess I could post a link to the blog itself, and let you wade through the posts to find the one I’m talking about… I just… I can’t say it right now. Not yet. It’s still something I’m working on with De (and eventually with whomever I see up north)… Anyway, the blog is called Blooming Lotus. She has not written recently, but there’s a ton of good stuff on there (at least stuff that can help you feel less alone). I hope, if you struggle with anything she speaks about, you will find some peace in knowing that it really is something others struggle with… and that’s coming from people who know it first-hand, not just through trainings or clients…
On a totally random note (random because I’m not 100% sure what train of thought led to this) but how can you hold two completely opposite and contradictory ideas as true at one time? I know DBT covers some of this, but I am allergic to DBT, so I don’t really remember the concept behind the “dialectics”. I’m talking about such opposing ideas that they should not be able to be held as true at the same time because they virtually cancel each other out. If I tweak one idea, it’s a little easier to understand how I can hold them both true and correct at the same time, but they are not tweaked, nor do I wish to tweak them. One is the concept of “never, ever give up.” The other is the right to “bow out” as each individual sees fit. Suicide is seen as giving up, so how can I hold that sentiment with the belief that everyone has a right to give up if they choose to do so? How can I advocate for life at any cost in one breath, and the freedom of choice to end your own life in the next? I am not currently suicidal, though the freedom to have that “escape route” is calming to me. I hold at once the obligation to fight any and all demons, and the option to give in to the desire for peace and an ending. How is that even possible? Maybe it’s that I understand the pain on both sides. I have felt the desperate need for relief, and I have felt the devastating black hole born of the death of someone I care for deeply. I grew up with the women in my family (and possibly even the men, but I don’t remember that as explicitly) lamenting about death being around the corner. My grandmother said that she would die soon (should die soon, needed to die soon) since before I was born. My mom would always say she wanted the right to kill herself should she ever be incapacitated (she wanted to make sure we all understood and agreed with her right to choose to end her life if she could no longer live it the way she was used to living, be it physical or mental). I think I recall my father saying similar things. No one ever expected to “get old”, yet the only person who did not speak regularly of death died at a young age. My grandmother was 94. Both my parents are still alive (despite saying neither of them wished to reach the age they are currently). Bitch is still alive in her late 70’s (all of us wish she wasn’t). But K is gone, and has been for 20 years this year. She was 52 when she died, but she was the only one who wanted to grow old… I was indoctrinated to believe that every human has the right to decide to end their own lives. But I’ve also felt the loss, and had the training that ingrained in me the instinct to preserve the life of others (and maybe even my own)… so I hold those opposing truths at once. Sometimes it’s a mind-fuck.
pass almost 2 hours: The lady for the research study came and it took me an hour and a half to complete the survey. Her computer was slow, but I also think I kinda spaced on some of it. it was only supposed to take 15-30 minutes. Clearly, I did not fit that time frame. It was ok. I thought it would ask more about any history, but most of the questions revolved around the last 12 months. I remembered an incident I had not thought anything of because of where it happened and the circumstances surrounding it. It was during a hospitalization last year. It happened on a locked unit, by another patient, and in front of staff. It wasn’t anything major, he was having a psychotic episode (or so they said) and tried to grope me after another patient mentioned that I was a lesbian. I pulled away. I was able to re-direct him in no uncertain terms, and staff told him to stay away from me (and really everyone). Despite the fact that I was in there due to my PTSD reactions over past assaults, I was never spoken to about the incident, no one asked if I was ok. I simply stayed out of the common areas for a while, and later had some really bad body memories that ended in an uncomfortable verbal incident with another staff member. The thing is, you lose all rights when you are hospitalized for psych issues. You lose your personhood. You become a thing without feelings, needs, or any control over anything. They treat you like prisoners (though I tend to think prisoners may be better off in some respects). If you don’t do what you are told, you are lectured and called “defiant”. Things slide that would never slide outside those locked doors. People (other patients as well as staff) can treat you like crap, violate all sorts of boundaries, order you to do things, and you just have to accept it. You have no rights, you have no decision-making capabilities, and anything you say is clearly an exaggeration due to your mental instability. I was expected to have no real reaction to this man invading my space and trying to invade my body because he was a patient and so was I. It’s counter-intuitive that a patient’s reactions and feelings are not taken into account on a psych unit, but it’s true way too often. The minute you step foot onto that floor, you are no longer a functioning, reasonable human being who is simply having a difficult time, you are a crazy person that needs containment (even if you are there for depression or anxiety). With or without a psychotic diagnosis, you are treated as if you are actively psychotic. At least, that is how the hospitals in this state are. Up north, I felt a bit more human, a bit more sane.
Anyway, I digress… the survey took longer than I had expected, but I did get paid, so that’s good.
One of the cats had moved out. He really just runs when he sees us, and spends all his time at a house down the street. I’m trying to be ok with it, but I miss him. I wish he’d come home. I wish I knew what we did to have him run and not return… I miss him a lot. I got him shortly after I started seeing L. Then he ended up going to live with her when our little dog proved he’d kill a cat if given the chance. We ended up moving in together and Danny came with the package. We got Alex training to get him over his cat attacks. When we moved, he got worse again. I wonder if that is helping contribute to Danny’s leaving… I don’t want to torture the cat, but I also miss him a lot. He’s the first “kid” that’s ours’ together. Others have come since, but he’s just our baby… I want to find a way to bring him home, but I don’t want to trap him if he’s miserable. He hates being indoors here even though he has more space than he had since he came to live with us. Clearly we are doing something wrong and I’m heartbroken. This sucks. Where do you draw the line between what you want and what someone/thing else wants?
I’ve done it again; ignored something until it’s too late… now there really isn’t much of a choice. J’s fire that she’s been looking for is firmly lit. We will be moving back up north sooner than expected and under a lot more pressure. This sucks… I’m kicking myself for putting off the asking for help for this long. Now we just have to suck it up and move on. It looks like we will have to re-home two of our pups (one of mom’s and one of our’s), which is totally breaking my heart. I knew we wore out our welcome, but now it’s also our grace period. The house needs to be sold and we will be left with nothing to show for it but more debt. I just want to hide from everything right now (lot of good it’s done so far). Trying not to panic, but not sure how to make things happen. We either find roommates that can cover half the mortgage and stand living here, or we throw in the towel and lose what we have. Pretty shitty choices since I don’t think anyone would want to live here (too many critters, too much stress, too little space)…
lots of things I can relate to in this, and I really like the way some of it is said (I do not think English is a first language for the writer, but they get their point across well).
“for me it felt humiliating to be hospitalized. It was almost impossible to keep my dignity in those periods of time. Sometimes I did not even feel human anymore. We had to ask for everything, the medicine (we had to stay in a line to receive them), the food, going out and getting back to the ward. It felt really degrading when all the power was taken off from me. One can say, maybe I was not able to take care of myself anymore. But many times, I felt that what I wanted to say was not heard at all. Of course, in those periods of time I could not express myself so well. That is true. But when people are not willing to listen, talking becomes extremely difficult. Maybe it is dangerous to say, but I think psychiatry felt for me like the environment I lived in as a child. Neglect, silence and disrespect”
” I begged to be heard and for guidance to get out of trauma land. This was not honoured at all. Therapists and psychiatrists thought what was right for me. Many times they said that I had to stabilize, but it meant literally loads of sedative medication, and nobody asked me what had happened to me in my childhood.”
I have just been on two course-days about dissociation, and was happy when I discovered a news-letter from ESTD (I am a member now). There I found the following post about how hard it is to become a patient dealing with abuse. I have so much respect for people who want to live a better life after abuse, since this is no easy task. I hope this can be a reminder of just that
Nina
By Esther Veerman
THE CHOICE TO BE A PATIENT
Being a therapist for patients with chronic childhood abuse and neglect needs a conscious choice. Not a lot of colleagues will do the same, and sometimes it is quite a lonely voyage that one starts to make. Becoming a patient with a history of chronic childhood abuse and neglect demands a conscious choice as well. It is not logical to start exploring the traumatic past, once…
both sides of the wall 