Monday, 29 November 2010

A difficult clinical psychology session

I haven’t been feeling very inspired to blog lately. I think I have been in ‘function mode’. When in function mode I don’t tend to think or feel much for the main part, as I’ve talked about before; so it’s hard to even focus myself to write this much. When in function mode I’d rather spend my evenings watching TV, browsing the internet for Christmas ideas or pottering around the house than blogging about my feelings or thinking about, talking about, reading about or researching DID. Sometimes the latter are all I can do.

The last psychology session I went to was really difficult. I think I had been in function mode because I’d been having a difficult few weeks with my dad visiting and a few other stressful things going on. Normally if I’m in function mode I will try to come out of it before the session by reminding myself what we talked about the last time and by reading over things I’ve written in my diary etc. Sometimes that’s not enough to get me out of ‘function’ though. I guess I didn’t do enough to prepare myself for the session. My psychologist (T), launched in right where we had left off the last week when I had been altogether a different person: full of insight and reflections. Now I was jolted back to earth with a huge thud as suddenly I was being asked to talk about alters. I looked at the page of my own writing that she had handed me. It was a list I had made of all the parts I knew of. I had made the list a few months previously one day while having a moment of clarity and had given it to her along with a lot of pictures and other bits of writing that various parts had done and thought she’d be interested in. She was interested in the list and wanted me to place each person around a circular table (the ‘round table’ is a piece of work we have been doing for about a year: slow progress!). As I looked at my writing, it was familiar but I couldn’t relate to so much of what had been written on it. I remembered the piece of paper, I knew it was me that had written it but now it seemed as if it had been someone else. She was asking me questions about the list and I was answering them as though I was trying to remember what the person who had written it had told me about it; not as though I was the person. I felt more in the dark about DID and my alters than she.

I quickly noticed myself becoming very anxious. I felt my heart hammering in my chest. I wanted to run from the room and out of the building and jump in my car and drive away. I felt my head spinning. I felt awkward and exposed and I felt inside, the dreaded whirlwind commence as the internal voices started to wake up again. Those voices are quieter in function mode. Function mode is easy. Having several people inside who are all fighting for their say is not. I wanted to go back to my blissful ignorance. Someone was really upset, shouting at T (inside my head) to stop talking to me; to stop asking me questions. It felt like they had been woken from a sleep and were angry about their forced presence. They wanted to tear up the paper and throw it away. Another part was scared. I shifted about in my seat, pulling at the sleeves of my jumper and biting my lip. T asked me if some of my parts were active inside me at the moment. I felt relieved when she asked this; she is perceptive. It was a relief to be understood. I nodded. I tried to take deep breaths and internally reassure the parts that were upset. This seemed to help.

She asked if it was OK to continue with the ‘exercise’. I nodded but I was scared. I didn’t want to let my fears stop me. After all, one of the reasons I am in therapy is to help figure out the puzzle of Me. I need to conquer the fears that hold me back. Well maybe not ‘conquer’ but ‘tolerate’ anyway. We continued; T had asked me if I’d rather her read the information from my writings and me place each person around the table as we went through the list of alters or if I’d like to do the reading and her mark them on the table. I said I didn’t mind, so she gave the job of reading out the title and description of each alter while she marked them at the table according to where I thought they should go. I soon regretted taking on this task as it was very hard to read out what I had written. One moment I couldn’t connect with the writings; the next I felt my chest would explode at the emotions the descriptions were bringing up. My guess is that the alters that were being described were stirring as I read about them and some did not like to be highlighted so explicitly. I felt my anxiety levels soaring again. I was scared; I excused myself and went to the toilet.

When I came back I asked if we could swap over, with me marking on the table and T reading. She said she was about to ask if I wanted to do that and understood it could be difficult to read the descriptions aloud. I felt relieved again. It feels so good to be understood. Something I have never really felt in my life.

We made it through the task....just about. I felt so unable to decide who went where on the table when I was struggling to relate to some of the people on the table as being real people. T seemed happy with what we had achieved anyway. I felt...well a whole load of things at the one time... frustrated though. I always find myself getting frustrated and agitated when we work on this project. I had other things going on too though and this was distracting me...

You see, two of the most obvious alters to me are two child alters, who I have talked about with you in previous blogs. Little C is about 5 years old and the angry child part (who has a nickname but for now let’s call them ‘angry child part’) is maybe a little older. Anyway, they both want to ‘come out’ in the session. They usually come out when I’m at home. My husband is used to seeing these ones in control at home, but they now want to meet T. I have had serious ambivalence about whether this is a good idea or not but have come to feel that I can trust T and should not need to be afraid of her seeing me with another alter in control. So I had communicated with Little C and angry child and agreed that they could come out in the session. I think they had been looking forward to this, but when it came to it in the session, I was too scared and my instinct to hold everything in and control them took over. I couldn’t let them out completely, although they put up a good fight. Well, I think they did come out but I didn’t allow them to speak. T said at the end of the session that it seemed another part had been there but not speaking.

Unfortunately my struggles with my alters to not come out/come out meant a long period of time being spent with me in an internal fight which made me ‘go weird’ and which I’m sure was very confusing for T. She didn’t really seem to know what to do. I found myself dissociating in time as well, as in I sort of half felt as if I was still there but half as if I was a child and terrible things were happening to me. This is a horrible, horrible thing to experience, especially in the middle of a therapy session. I wanted to disappear and curl into a ball and cry but I was sitting in a chair with someone watching me. I wish T could keep a blanket for occasions like that and allow me to put it over myself so that I can be invisible. I know that sounds stupid but it would help me (or that child) so much. If I was at home I’d hide under a duvet and hug a teddy or suck my thumb.

It’s hard to know what can help me at times like this. T didn’t seem to know what to do. I heard her saying that she didn’t know if talking to me helps or not, or something like that. I don’t know really what I can tell her. I don’t know myself. I guess it’s good that she is patient with me. I guess when I dissociate in this scary way waiting for it to pass is all we can do. When it happens I am fighting myself for it not to happen. I am trying to calm myself and stop my body from panicking and I’m trying to stop my mind from shutting down. Maybe it would be easier if I just let it happen. I guess this is what I would do if I was at home; I’d just shut down. I’d curl up and let my mind drift away and I’d probably just wake up later. Or if I couldn’t do that, I’d self harm. The thing is, I can’t really mentally shut down in the middle of my session because I’m not alone and I need to be mentally there; never mind the time wasting aspect of it. And I don’t think it would go down too well if I just whipped a blade out of my handbag and cut my arm, although sometimes that’s all I can think of doing at the time.

So eventually I was back to myself and the panic had passed and I felt calmer although by no means OK. I felt like a shell of myself. I was sitting staring at the floor, kind of mentally popping in then zoning out while T talked about our next appointment. I remember her asking me if I wanted a drink of water and I was so thirsty that I was grateful for it. I remember her telling me to get my diary out and to write down the next date. I felt shattered. I felt like I had fallen into a dark hole and no one in the world would ever be able to find me. I felt like my chest was going to break and a tidal wave of pain would gush out and drown the entire world. But I sat still and my chest didn’t break and I got myself up and I think I said goodbye. I don’t know how normal I appeared but I got out the door and back to my car (just about because I couldn’t remember how to open the door release button on the main door out of the psychology department and had a bit of a fight and panic with it, even though it’s the same door I’ve been going out for two years). I managed to get my car out of the car park but I had to pull over and put my head down for a while. I couldn’t get myself back into reality. I felt like I kept disappearing. I was popping in and out of my life. I managed to ring my husband; I needed to pick him up but I didn’t know where he was and I couldn’t focus on the instructions he was giving me. I zoned out again and then I heard him saying: “Are you still there?”

I drove through the city, feeling like at any second I might drive straight into a wall without realising or through a red light or into a car. I was scared. I tried to focus myself; focus on the road. I made it to my husband and asked if he could drive. He seemed to realise pretty quickly that something was up. He said: “Are you OK?” I shook my head. He said: “Do you just need to zone out for a while?” I felt so relieved. I let my head flop down and my brain do what it wanted and soon we were home and I was in my pyjamas and hiding under my duvet.

The next few days were very difficult. A bad session can have a huge impact on my life. Dissociating like that reduces my ability to function drastically. After writing this I feel it will help me not to go to the next session as that person who can’t relate to any of this. But then again, the session isn’t for another two days. Can I maintain this level of awareness and do a good job at work?


MultipleMe said...

I'm sorry you hard a difficult session, they are always hard.

Might I suggest - if you feel safe enough - printing this post and giving it to your T? It may help her understand where you are coming from and help you figure out some strategies to make it easier next time. It could also allow you to approach the idea of having alters out during your sessions.

I know some people share their journals or blogs with their Ts. I personally cant do that - however I do print copies of posts or journal entries that I feel is something I want her to know about or if I think it be useful for her. I have found this really useful when I don't have the 'words' in therapy.

I also make sure I have nothing planned for the rest of the afternoon following any session. Even after a good session I need time to process and I often end up losing many of those afternoons to my alts.

Know it is okay to say in a session, "I'm not in the same place I was last week" or "I don't feel up to working on that today" - this doesn't mean that your fears are stopping your therapy - it just means that maybe you need to take a different approach this week.

I know if I become too anxious during a session, or if I am not in a good place at the beginning of a session, my T has me do 'sand play'. Basically this is a sand tray she keeps in her office, she has little toys, shells, stones - all sorts of things that can be added. It is a process I do without thinking about it. My T and I will talk about it at the end - we break down the parts of the sand play and usually I find so many symbols of how I am feeling or working through - if at the end of the sand play I don't feel like talking my T will take a photo and we will talk about it another session.

Another thing you could consider is taking a blanket or teddy to therapy. My t has a lot of soft toys and cushions but when Natalie is very upset I let her take ulfie (her soft toy dog) - this can be really good in those moments of anxiety - to have something familiar and safe.

Try not to miss your sessions but if you feel that your upcoming session might be just as stressful talk to your T about it in the beginning - see if there is something else you could work on together that would be less disruptive.

Take gentle care of yourself and your parts and know you aren't alone. Those bad days may feel like they are never ending but good days do come.

Candycan said...

Thanks for your advice. Sorry I didnt respond immediately, but I have been thinking about what you said.
I did paste the post and email it to my T but she hadnt had a chance to read it by the session. She read it at the start of the session but I felt disappointed by her reaction to it. Not that she said anything wrong, but I just sensed something that made me regret having shown it to her. I dont know, maybe she thought I was blaming her for it going badly or maybe she was just having a bad day. She asked me questions about my blog and what it offers me. I was telling her about other blogs (like yours) that I've found and how it helps to be able to read about others with similar experiences and she asked about what those experiences were and did these other people have child parts as well. I thought the questions were a bit odd. I didnt know why she asked me about the child parts and I felt suspicious. Then I got paranoid that she thinks blogging and reading other DID blogs is a bad idea or that I'm making it all up. She has reassured me that she believes it to be real but I sometimes worry she will think I'm just looking for attention. You know?
I dont know! Maybe I'll ask her next time.

I know it's probably a good thing not to have things planned for after sessions but sometimes I find myself intentionally planning meet ups with friends etc as a distraction and a way of forgetting about things that might have upset me. It's hard to get a balance between necessary reflection/rest after a session and overthinking/feeling bad and dissociating.

It's good that you can take Ulfie with you. I'd like to take a blanket but I am too scared to suggest it in case she says no. Lol