Saturday, 7 January 2012

New therapist: first session

I know I've been feeling good and by feeling good, I mean not feeling bad... which for me is good... but... and I am fearful to acknowledge this... I don't know if I am doing good. Or rather, I don't know if the others are doing good. I think I have shut myself off from them or vice versa, which is great because it means I'm getting on with life and not wanting to kill myself. But there are tell-tale signs that I've been trying to ignore, like the wanting to purge... and the out of control eating... and the song stuck in my head that tends to arrive when things aren't great... and the nightmares... and waking up at night and feeling freaked out... and the not being able to listen to music the last several days again... and today when Adam lightly stroked my forearm and the feel was so unbearably shocking... and the pains in my neck...and the fact that I have procrastinated about an offer from Adam to take me out and do whatever I want to do today because I don't seem to have it in me to get myself from the pyjama'd stage to the washed and dressed for outdoors stage (later edit, I did eventually manage to pull myself together and we went shopping).

I feel like it hasn't been me really here lately. I'm just on auto pilot most of the time. I've turned into my robot self who goes through the motions. 

I haven't allowed myself to feel any loss about T. I think that's why I haven't been able to tolerate music again or 'nice' feelings like a gentle touch on my arm. Music and touch are emotive and emotions are what I have been avoiding. Adam mentioned that he noticed I've just stopped talking about T since she left. Usually I think I drive him round the bend with “T says this” and “T says that.” I am doing the all or nothing thing again aren't I? So I thought, maybe I should sit down in a quiet room and consciously think about the fact that T is gone and allow myself to feel something and see what happens. Maybe if I did that I could avoid a crash or general decline in other areas. But I have been procrastinating about doing it because I am afraid of what it will feel like. What if it's too much? What if I fall into the grief and can't get back?

So anyway, I went to see new psychologist on Thursday so I want to talk about that. I will have to think of a name for her. I don't like that I picked 'T' for T. It's a boring and generic name for a therapist. Strangely, when I picked 'T' I wasn't picking it because it is the initial for 'therapist' and I didn't realise that other people call their therapists 'T' too. Maybe I will get round to picking a proper name for T oneday. I can't decide on a proper name or initial for new psychologist yet. I don't want to get it wrong again.

Before I went in to my appointment on Thursday morning I tried to envisage what I wanted my new psychologist to be like and what I wouldn't want her to be like. I wanted someone a good bit older than me. I know it's stupid but I think I'm a bit of a dick when it comes to young people treating me for health things. I think: 'what could they know?' I am a hypocrite because I am a 'youngish' health professional and I would not expect my patients to think that way about me, seeing I wouldn't be doing the job if I didn't know my stuff. I'm going to be a real bitch when I'm old. Anyway, I decided that a minimum age would need to be late thirties. I can't really describe the other physical criteria I had in my mind but I guess I just didn't want someone too young or too pretty. I don't care if someone is ugly or not but I guess I'd be put off a bit if it was a younger woman who is obviously into her looks a lot. I don't know why this is. I wanted someone more on the motherly side... but not 'motherly'... maybe 'auntily' (made up word, I know). I think T is kind of 'auntily'. Well, sort of. I don't know. She doesn't strike me as a motherly type person, but she has a good balance of everything I need from a psychologist. 

Anyway! I am not sure if new psychologist ticked the boxes or not. It was hard to tell her age. She could be anything from late thirties to fourties I guess. I didn't study her all that much to be honest. She's small... traditionally I have always been intimidated by small people, being that I am five foot ten... but most of the women in my life tend to be small. The women in Adam's family average at a foot shorter than me. Pou is only five foot and my few other female friends are all tiny too. T is not short but not tall as far as I can tell. Just average. I liked that too. So new psychologist is small but I guess that's OK. I'm getting used to having small people in my life. 

She looks kind of 'bookish'. Her hair is dark and possibly a bit greyish in places and I don't think she was wearing any makeup and she was dressed kind of casual, well not casual but not officey, which I was pleased about... the 'bookishness' that is. From her appearance I would say she definitely doesn't fuss too much about things to do with fashion and whatnot. Anyway, I feel bad going on about someone's appearance. By now I am learning that looks don't matter and although when I saw her I kind of thought 'Oh. She's not what I was expecting' I also thought 'She's not what I was hoping she wouldn't be either'. I have confused myself trying to figure out that last sentence I just wrote but I hope you know what I mean!

Anyway, too much talk about appearance. It was a bit odd being in T's office because all her stuff had been cleared out. I never saw it looking so tidy. T normally has piles of papers all over her desk. Unhappily, the boxes in the corner were still there. These are cardboard boxes that are directly in my line of view when I am sitting in the client's chair and every single week for the last three years that I have sat there I've had the urge to go over and move them about so that the designs on each box are all facing the same way. One has a lid that isn't on quite properly and I again hold back the urge to get up and try to fit it on and then I always try to visually assess the dimensions of the lid compared to the box, to see if it's just that it hasn't been placed on correctly at one side or if it is in fact a lid that is too small for the box. I seem to get annoyed by things like that in therapy. I guess when you're in that situation you sometimes need something to focus on. With my first psychologist I used to get really agitated by the table in his office which had black marks on it where a child must have been scribbling. These used to really upset me and I couldn't stop staring at them and in my mental state I would start thinking about the child that made those marks and what must have happened to them that would make them want to colour so vehemently in black marker and then I'd feel upset and weird and angry and want to shout at the psychologist to get some wipes and fucking clean the marks off the table! Therapists should consider these things. 

Anyway, I wasn't sure which chair to sit in. T always sits in her chair and I in mine but I noticed that the seat that was normally mine had notes sitting on the table next to it as though the new psychologist was planning to sit there, but it didn't feel right to sit in T's seat so I dithered for a moment and thought about asking her where I should sit and then just decided to go for my usual seat. And so we commenced.

She started by asking me how I coped over Christmas and with the 'transition' and seemed surprised when I said I'd coped well and she asked me more questions about that and I felt a bit weird just reflecting on things like that with her because I'd kind of thought she'd do some kind of introduction first of all but we were talking like I'd been coming for weeks... but not in a good way. I was struggling to explain my coping mechanism whilst wondering how much she knows about how I can split off parts of myself and can split off emotions etc. 

She asked then if I had anything I wanted to say to start off with and I mentioned my concern about not knowing how much she knows about me yet. We talked a bit about this and she said she knows about the 'structural dissociation' and had read a few reports about me from my notes but not my actual therapy notes. She wondered if I felt she should read them or not and I wasn't sure myself. On the one hand, it would be so much easier if she just already knew everything and could understand me but on the other hand, the thought of someone I don't know or trust reading my notes and then probably knowing more about me than I know about myself makes me feel uncomfortable, so I just said that. 

I also asked her about her background and she said she hasn't worked with many people with 'structural dissociation' before. She said she has seen people with dissociative issues but only a few who were 'very pronounced' and then she said: "but I think it's very rare..." I wondered why she said this and I started to have doubts. I wondered if she was thinking that there's nothing wrong with me and that I don't have DID or something. I know I'm just being irrational in thinking that. I also felt a little disappointed because I had been told by the other psychologists that it's not that rare and from my reading, it is thought to be more common than many people think. It's just not picked up on by many professionals. So then I was thinking, either she hasn't read that research (which suggests she's not that knowledgeable about it) or she doesn't agree with the research (which worries me). I know I am thinking into this too much. I'm sure T wouldn't have placed me with someone who doesn't believe DID exists. 

She wanted to know about if there were any techniques that T or I implement to help with grounding if I am struggling in the sessions and I tried to fill her in on this as best I could. She also wondered about what T would do if an alter came out during the session and I wasn't really sure what to say to this one. I said that I doubted if it would be the case that she would see me obviously switch and need to ask for me to come back out and I explained how I tend to be able to keep control and can dictate what others are saying if I can hear them sometimes. She asked me then if it had ever happened that another took over in the sessions and I had to admit that it has but I couldn't really remember how that was dealt with. She said she understood that it's hard to think back on these things sometimes and it's more experiential. I liked the way she said that because it put me at ease where I was getting in a muddle trying to think back. I also had to admit to myself that I can't guarantee that she won't see me switch. Who knows how things could be with her. T has seen it but I've felt it is something that will happen if we trust the person. 

New psychologist went on to say that she is not an expert in the field of 'structural dissociation' (I've never really heard it called that before and will have to look up what this means by definition) but that she would have supervision from the same person T gets supervision from, who is an expert. She also told me that she is an expert in 'treatment resistant depression'. She then asked me a lot of questions about the history of my depression and I started to worry that she would just want to focus on that and not understand that depression is only one symptom of my problem. She gave me a depression questionnaire to fill in as well. One where you think about the last week and tick how often you felt this or that. I really struggle with these things because I am so changeable that one week may not represent how things are for me in general at all. Take the last week for instance: I've felt better than I had in months. Not normal for me. Next week for all we know I could be curled up in a ball on the ground in a car park in the middle of the night again thinking I'm going to die of a broken heart.

Although I've sounded a bit negative here in my thoughts about how the session was going, I feel generally quite positive about her as a person, so far. My initial impression of her was that she seemed quite down to earth and open. She seems human and also had a few good insights to offer on some of the things that we talked about. I liked that. She seemed OK. I liked her way of talking and I felt OK with her. Of course, I was really, really anxious, but I'm like that with T anyway. 

The session focussed around an assessment which she wanted to do. She said she likes to fill this in otherwise she always regrets it and I said I didn't mind so she started off the assessment which consisted of questions like what I do for a living, who I live with and general things and the aforementioned questions about depression. She asked me about my parents and for some reason I ended up giving her an in depth report on both my sets of grandparents and very little information on my actual parents. I guess she might want to ask more about them next week because by that stage we had already run over time and had to finish off.
We talked about appointment times. I explained that I have been struggling with the morning appointments but that T had wanted to keep trying them and she agreed that she was happy enough to give me an afternoon appointment if I felt that would be better, so I was glad about that. It's so much easier for me if I can go last thing and then I have the evening to crash out at home, rather than going first thing and finding it a real struggle to get into work afterwards. I have ended up taking holiday leave on more than one occasion after morning sessions because I've been too dissociated to make it into work.


JustEliza said...

You did very well with meeting the new psychologist. Sounds like the psychologist did alright meeting you, too.

Structural dissociation is the more palatable interpretation of DID -- the terms I use (ANP=apparently normal personality, EP=emotional personality) come from that work. My first psychotherapist did not like it when I tried to use ANP/EP. Frankly, it seems like everyone has their preferred language. I wish therapists were less dissociated in their research knowledge so we could all have a coherent conversation.

Ellen said...

Could the new T help you with your feelings about T leaving, keeping it manageable...or do psychologists not do that kind of thing?

She sounds OK. Though I hate those 'intake interviews', they feel so cold and impersonal to me.

I'm like you with the depression - it's not the same as for people who suffer from depression as their primary problem. I switch into and out of it.

I guess the problem with insurance provided help is you don't get to choose who you see, so it's the luck of the draw. Good you like her as a person - that is really vital I think.

Ruth said...

Congratulations on making it out shopping. With so much going on that takes a lot of energy. I noticed that I describe things physically first. It is like getting the lay of the land. I thought your description is very understandable. I really get the challenge of 'naming' counselors. I tried to find a name for my new counselor. After a year I still call him NewCounselor. You'll get it sorted out.

CimmerianInk said...

I know that meeting a new therapist would freak me out, so I think you did very well considering. I think being "ok" with her is the most you can hope for in the very beginning stages of getting to know each other. I hope that you're able to build trust with her and I'm glad you were able to get out of the house as well.