Saturday, 28 January 2012

New psychologist: fifth session

So yesterday I brought you up to date until Monday on the current crisis. There has been so much happening lately, I feel like there is no 'nutshell' way to explain it to you so instead I'll go about it by breaking it into bite sized chunks. I will have to hope that the next several days are very uneventful, otherwise I will never get you up to date.

So lets talk about Tuesday...

So I talked to new psychologist on the phone twice on Monday because I was feeling in a bad place and my thoughts were scaring me and she arranged for me to come to see her first thing on Tuesday. So I dragged myself out of bed four or so hours after nodding off and headed to see new psychologist on Tuesday morning, this time in her place of work, rather than at T's old office. I found that a little bit strange, but didn't really mind it. T had arranged with new psychologist that I'd see her in T's office for familiarity for me but as new psychologist was just slotting me in this time for an extra appointment, she said I should come to her workplace. I was a bit worried about bumping into family member X who works in the same place, as that would be very difficult to explain. I actually did see family member X as I was leaving but I don't think they saw me. I put my head down and shuffled down the road as fast as my little legs would carry me.

I was also nervous going to see new psychologist because I'd felt so bad after the last session and unfortunately, I was right to be nervous because it really didn't go well, in a lot of ways. The problem is that she sees that things are difficult for me and she wants to help me put in place lots of practical coping mechanisms such as deep breathing, having a bath, reading a book to help me sleep etc. She thinks I need a crisis plan to help me cope. She doesn't understand that if I just had someone to talk to about things and someone who understood and could provide a bit of reassurance, I wouldn't be having a crisis. All the while she is asking me what practical things I could fill my day up with and how Adam could further help me, she is taking up the time where I could be getting used to her and starting to feel a bit more secure and prolonging this period of feeling completely alone and unsupported since T left.

I miss T so much. I can't believe I was worrying that I'd not want to go back to T when she returns in six months because new psychologist seemed so nice the first few sessions. The last several have been really hard and not in a good way. She sends my head into a spin. I feel like we're clashing and not understanding each other. We're really struggling to get on the same wavelength. I feel a lot of dissonance and I feel her style makes me defensive; I find her constant suggestions patronising.

I also don't like the way she seems to interrupt me a lot. She interrupts me A LOT. I'm not the kind of person who stands my ground when people interrupt me. I grew up with a very dominant father who would constantly talk over me and shout me down (not that I would have dared shout back) and as a result I tend to clam up if someone interrupts me. I think it's rude as well. I put up with it a lot from people in everyday life, but surely a psychologist should know better? Surely a psychologist wants to hear what their patient has to say?! It seems to me that she doesn't want to hear what I have to say at all because a lot of times she just plainly talks over me or when I pause mid sentence comes in with a question or statement.

I feel confused by this. She wasn't like this the first few times I met her. I felt like she was listening and interested.

So we talked first about how my night had been, sleep wise etc and she asked me a bit about my sleeping patterns. I explained that I usually try to be in bed at a reasonable hour but that I can't sleep if Adam isn't in the room. I acknowledged that it's not his problem but that it's just a problem for me. New psychologist then suggested that it's not reasonable to ask Adam to get more of a routine because it's not his issue and could I try getting to sleep on my own. Err Hello? Did she hear a word I had just said? I said that I try but I can't sleep on my own and she asked me if I could try? This is about as helpful as my call to Lifeline. Sigh. I felt a little annoyed about this.

She then asked if I could try reading a book to help me settle down. I agreed that I like reading and do this sometimes and she asked if I have any books that aren't too heavy that I could read. This is OK; although I don't know that it's always realistic to get a book out when I can't sleep (e.g. if Adam is in bed), I will accept that I could try it more often.

She then asked me if I had spoken with Adam about how things are. I said I'd told him I'd been speaking to her a few times on the phone and that I don't normally do that so he knew things weren't good. She asked: “Did he change his behaviour at all?” I said that he'd given me a cuddle and tried to be reassuring but had also wanted to have a conversation about our relationship problems which wasn't helpful for me at that time. She asked how he normally is in terms of support and I tried to explain that I feel he is giving me as much support as I can expect at the moment. I said it wouldn't be fair to ask him for more at the moment. She expressed that it's not healthy that psychology be my only source of support: I've been saying this to T for years. At least she's on my side about that! The problem is, she seemed to think that Adam could be that missing support and that I should be asking him for more. Adam does a lot to help me on a practical level and I feel the way I am has a big impact on him already so I don't want to drag him down further by telling him every time things are really bad and scaring him. New psychologist seemed to have a lot of trouble understanding that... beacuse she said she was having a lot of trouble understanding it.

During this topic I also mentioned that I'd been losing time a bit recently (not a bad thing really if the time that you are aware of is filled with being distressed) and T wanted to come up with answers for how to fix that too. She asked if I could set an alarm to go off every so often to bring me 'to'. I agreed that I would try this if it continues. She said “Hmm, but it's already disruptive. You weren't in work yesterday were you?” She then said that yesterday I could have engaged in an activity with Adam. I think because we had just jumped from the middle of 'How can Adam support me more?' to 'How can we stop Candy losing time?' I felt confused and thought she was saying that Adam could have helped me by getting me out of the house if I had made better use of his support. I tried to explain again that Adam is happy to do activities with me but I need to be the one to make them happen, because his motivation isn't great either... but she interrupted me and said that yesterday it wasn't Adam that was the issue, it was me losing time. In hindsight I can see what she meant, but at the time I was confused about what we were talking about. One moment she was questioning me about how Adam can be more supportive, then half way through jumping to a possible solution to losing time and I had not made the jump with her. The way she interrupted me didn't help and I got more distracted with feeling annoyed that she wasn't letting me explain myself. It seemed to me that she wasn't listening to me saying that Adam helps me, but to her it probably just seemed that I was saying something irrelevant and she wanted to get me back to her point. My defensiveness was building.
She made some more suggestions about keeping present, like could I talk with Adam or ring Lifeline etc. I said I'd try these things. I was getting a bit annoyed about the suggestions. She asked if I could try to help to ground myself when I'm going to dissociate, by splashing water on my face etc. I started to explain that if I am going to dissociate at home by zoning out, there isn't a phase before it where I feel like it's going to happen where I could splash water on my face to help. It just happens. She didn't let me explain this though. She interrupted me saying: “Yes, but you're like that recently so it's these times that matter”. I felt annoyed. If she was listening, she'd understand that I wasn't saying it wasn't important. I was saying, I'm not aware that it's about to happen in order to prevent it. FUCK! I tried again to explain myself but she still wasn't getting me. I was by this point wanting to pick up my bag and run from the place. Either that or lie on the floor and kick my legs and scream that I wasn't going to stop until they bring T back immediately. She did kind of eventuakky start understanding me in and asked if I felt that at times zoning out was helpful. She then wanted to know how it affects me in daily life, for example at work. I said it wasn't such a big deal normally and then she said she had been under the impression that it can cause me problems at work. It does. It does cause me problems sometimes, but really, is that what we needed to be focusing our session on when I'm frigging in the middle of a crisis? I didn't want to get into it because I was worried she'd start trying to come up with practical solutions to how I could manage it on a daily basis.

Next she asked me why I didn't go to work yesterday. I felt like this was an attack. Obviously, it was just an enquiry, but I was already feeling defensive and I replied with a statement that I have tried hard to keep going for a long time and that I wouldn't take time off if I didn't need it. She said: “That's why I'm trying to encourage you to use your resources.” Aaaaarrrrgggghhhh!! I was raging at her saying this! This is what I've been trying to get into her thick head all along! I'VE BEEN USING ALL OF MY RESOURCES TO KEEP GOING EVERY DAY FOR THE LAST TWENTY EIGHT YEARS AND I DON'T HAVE ANY MORE FUCKING RESOURCES TO USE!!!!!!!!!!

I think my feelings at that moment must have been pasted on my face because she kind of paused for a moment then and asked: “How does that make you feel?” So I told her. I didn't say exactly what I just wrote here but I said I felt patronised because I think I use my resources every day to keep going; that I do really well and this crisis is because I feel my resources have run out. Her answer to that was to defend herself. She said she hadn't said I didn't but it was part of her job to ensure I was using them optimally.

I think I was probably already feeling fragile about the whole thing after my unfortunate conversation with the Lifeline lady and this is partly why her 'helpfullness' was not being well received. I tried to explain that and what I felt by saying “I got to bed every night, I try to go to work and come home and go to bed again and I try to keep a routine. It's not like I didn't think of the idea of going to bed to get some sleep so that I won't feel bad. The reason I ask for help is because I've tried all the things I feel like I can do and they're not working. I don't have anything left to keep doing those things!”

Did I make my point? No. New psychologist then felt that what I was saying was that I needed more advice than she'd already given me, because the things she'd already advised me weren't working so she tried to assure me that there was no more advice or other things she could tell me to do but that she could guarantee that if I do try these practical things it would help. Sigh.

I kept trying: “I feel like I just need support.” Surely you can't be more clear than that? She asked me what kind of support I felt I need. I said: “I don't feel like I need someone to tell me 'do this' or 'do that'. I just need to feel like I'm not completely on my own.” New psychologist responded annoyingly by saying that she hadn't been telling me what to do, but asking me how I've done it. She asked again what kind of support I need. ARE YOU THICK?!

I tried again by saying: “It helps to feel like I'm understood.”

New psychologist mulled this over for a moment and then the light bulb switched on as she realised that perhaps the girl needed some reassurance. She said: “I think it is very difficult at the moment. It seems like it's a difficult time. It's painful.” Unfortunately now it was clear to me that the only reason she was saying these things is because I'd practically hit her over the head with a demand for some empathy, so instead of feeling reassured, I just felt resentful and that she wasn't being genuine. If she really felt it was a difficult time, she'd be offering that information more willingly, surely. 
Feeling like she'd ticked that box, she then moved back to talking about what I could do to intervene at the moment while things were a bit more settled than they had been yesterday. She suggested that now was the time to build my parachute. Putting it back on me again. What can Candy do to prevent another bad day? She asked me about medication and plans for how I could fill my days and we went back to talking about things like bubble baths and watching TV while she wrote down each point on her notes, ticking the box that she had discussed these things with me. I resigned to this and just decided that it was best to agree with everything she was saying. 

Another half an hour later I left her office armed with a relaxation CD which I had agreed I would try at least once before Thursday and a checklist of other things to do: have a bath, watch TV, go to Tescos, do some crafts, set an alarm to go off on my phone every half an hour. I left feeling alone and distressed and missing T more than ever. I left feeling misunderstood and patronised. I left feeling like this person thought I was simple and was perhaps wasting her time coming to psychology when all I really needed was to pull myself together and start taking baths and getting out and about. I felt like she had no idea of how hard I try to live a normal life and do all the things normal people do. I heard T's voice in my memory reassuring me that I had been trying so hard to 'just get on' for my whole life and that maybe it was OK to need to stop once in a while and do nothing and acknowledge that things are really hard. Although T seldom stated opinions to me, I got the feeling she would have seen it as a positive that I was taking some time off work at last.

I try to remind myself that I am being over-defensive at the moment and that new psychologist is just trying to help me. I can't help feeling that she just doesn't get me though and is trying to stick a plaster on a third degree burn by suggesting I 'try to get to sleep at night' and such the like.


Pandora said...

Candy. I think you reacted remarkably well to this; I think I'd have screamed a barrage of abuse at her and stormed out. (I do have form on the first bit: I once told my ex-psychologist C that he was "nothing but a sadistic head-fucker". I later apologised, but frankly I don't know why; it was true).

I'm really not surprised you're pissed off. She may (or may not) mean well, and perhaps she's ultimately digging at something - but she's going about it in a ridiculously patronising fashion. In particular, I can so understand how you felt attacked about her comments on your sick leave; regardless of her intent, she phrased it quite aggressively it seems. I'm no psychologist/psychiatrist, but for what it's worth I think you absolutely made the right choice about work. You're burnt out. You need time to recover.

I wish I could say something more helpful :( All I can do is hope that (a) she starts to 'get' you more; and (b) things improve quickly for you.

Take care of yourself

Pan <3 x

Ruth said...

Your frustration with your conversation with your counselor reminded me of an early conversation with mine. It's a fairly long story and if you are interested I can put it on my blog. I come back and read your comments. Running out of resources is a good description of where you are at. It is a hard place to be in. Keep blogging and I will keep commenting. I hope I can do a little to validate how extremely frustrating living with DID can be. One of my medical doctors said I did this to get attention. I screamed at him in my head but out loud I quietly replied that there are easier ways to get attention rather than passing out. Take care. Ruth

JustEliza said...

I wonder if this new psychologist feels that her role is to support you in your self-care and resilience rather than work through the difficult feelings and traumatic memories (which should be done in the basis of a trusting and safe relationship).

Like you said before, she can't sweep in and take the place of your previous T (especially as T is coming back). It must be difficult for her to know what her role is in your life, for these few months. It certainly sounds like she's struggling with that.

I think that no matter what you two talk about, it will take time to suss out each other's expectations and needs. I hope you can find the strength to tell her directly how you feel about what she is asking, because without that feedback, no one can improve.

BTW, your session describes some pretty classic transactional analysis concepts in communication (crossed wires). I wonder if your psychologist will be discussing that with her supervisor? Either way, it's worth bringing it up next session.

Justine said...

Just reading it makes me want to scream! I agree with Just Eliza though that she is maybe trying to contain you and be practical but i don't think that helps you much does it? What made me really feel for you though was that the part of you that wanted to hurt you - wanted you to hang yourself seems so very untouched and cared about.Like you say a third degree burn with a plaster on ot. Lifeline and Psychologist seem to only be reacting to the actions, and going into stupid advice becos what? Frightened? overwhelmed? But how isolating for you and the part that lies awake so late. You also deserve respect for all the ways you manage your pain when you are at work. Don't feel bad for being off work. I had a therapist that never understood when i was off work - saw it I think as her failure to keep me well enough to work. Once said she thought my partner would be cross with her because I was off work! I was really shocked but realised then that she had her onw problems about it. You are more experienced managing you than your psychologist is but I imagaine that feels scary when you are in so much pain. All you write makes sense to me becos I understand the world you live in. But I'm really sorry you are hurting so much. If in your situ right now I would need to work out what's behind it all, the memories etc. For me that's more helpful than a warm bloody bath! I know there's a place for comfort etc, I don't mean to be glib but first you need a safe place to have your feelings out, with someone big enough to cope with it.
AS for the resources stuff- I echo your AARRGGHH! It's so hard when people who live relatively 'normal' lives think all the same rules apply to peopel with DID. if there were enough resources you wouldn't have DID in th first place. It wouldn't be necessary. You're having a time when you can't manage easily on shoe string resources by the sounds of it and taking some time off is a good and nurturing thing to do. If warm thoughts and sorrow for your pain helps at all then please fill yourself up on my warm thoughts and sorrow for you right now. And... from all I've read on your blog a belief in you and your strenght.

Meronym said...

Reading your last few posts about this T and then this one, it seems to me that you may have come into this session so frustrated that there wasn't really anything she could have said that would help at this point. Maybe you just needed some time to be angry and frustrated and vent. It sounds to me like that could be what you need the most at that point.

Candycan said...

Pan, thanks. Your comment was helpful. I'm glad I'm not the only one who feels her way of saying things wasn't great. It just seems so basic really. The more i think about it, the more i'm wondering if I've done something that has put her back up against me. LOL, I can't imagine how a psychologist would react to a comment like yours. It'd be hard to be a 'blank slate'. I'm sure they're used to it though. I'm sure they get called worse behind their backs; at least you were honest (that's what they want, isn't it?)!

Hi Ruth, I would be interested in reading about your experience if you posted it sometime. You're right; I can't understand why people would do that for attention. If I was 'just' looking for attention, I definitely would go about it in a different way. In my view anyway, if someone was to make something like DID up for attention, there must be something seriously wrong with them anyway so they probably need helped as much as someone who genuinely has DID. Either way, the person needs input.

HI Eliza, I agree that its important for us to realise what each others needs and expectations are. The problem is, I don't feel she listens and she often won't give me a chance to finish my sentences. How can she come to understand me if she won't listen? Can you tell me more about what 'transactional analysis concepts in communication' are? I find this interesting.

Archie, you're right, her aim of helping me practically is not helping me. "if there were enough resources you wouldn't have DID in the first place" This is so true! And if I felt supported and like I had someone I could talk through things with, I wouldn't be resorting to less healthy coping mechanisms. She's trying to get me to replace my less healthy coping mechanisms with less effective healthy ones, when a listening, empathic ear would take away the need for any coping mechanisms. I feel like this is just teaching me that I shouldnt rely on her for any support and that I can't trust her.

MultiMe, thank you for your view although I don't know that there wass nothing she could have said to help. I think some reflective listening would have helped. The key to motivating a client is to actively listen, empathise and ask questions in a way that the client comes to see their problem in a more rounded way and the solution comes from the client. Telling someone they have a problem and what they could do to fix it usually only increases defensiveness and I am no exception as a client when she does this... especially when I don't feel she has really listened long enough to identify what the actual problem is. You're right though, being able to vent would have been helpful. When I said I found lifeline unhelpful, she disagreed with me and said they were helpful. I felt invalidated. If she had just let me say what I thought and not disagreed I probably would have felt better.

Anonymous said...

I'm new to your blog and have had a read through of some of your posts. I am a counsellor in training but alas had some things trigger during my studies so training is on hold while I see a counsellor (oh the irony). I dissociate too but have rarely lost time, however I have an interesting 'team' of alters I'm trying to come to terms with. I just wanted to comment on this post. It feels like your new T is trying too hard, she sounds like a Rescuer. We learn very early on in training about our 'Shadow Side' those aspects of us that motivate us into becoming counsellors and one of those may be a desire to rescue people. It was one of my motivations, because I couldn't help my own mother. However, my awaremess of it allows me to stop trying to suggest things to make the client better but to actually listen to the client and hear them. She doesn't really sound like she has done that for you, she sounds like there is something frustrating her. Perhaps there has been some sort of transference, that you have said something or done something which has reminded her of some aspect of herself she has problems with and this is interpreted as a need to rescue you. We're not usually that 'helpful' with suggestions and advice unless you've opted for a cognitive behavour psychologist. Usually we try to establish Roger's Core Conditions, including trusting the client to get to where she needs to be by 'being' with her. This T needs to shut up, listen to you and start empathising. My suggestion? You tell her what she has been doing and that it is not what you want. I hope I would never be lost with a client, but we are all human so i would also hope that my client would tell me I got it wrong. Good luck.
p.s. I am finding Peter Levine's Unspoken Voice a real inspiration.

Ellen said...

New Psych sounds terrible and completely unhelpful. I would be angry also. What a time to start condescending, when you are in a crisis. Honestly. I just don't see the use of practical 'tips' - I'm sure you're bright enough to think of those yourself. You need an honest caring emotional response where you can express yourself freely and find some relief!

BTW I think it's great you're reaching out for help during this, more than I've heard you do before. Sad that the help isn't helpful though. Hope you're feeling a bit better by now.

HI Pan and Little C,
How are you? I am OK. There is snow here, which I like. It is piled on my windows. I'm happy you got an owl. I have a stuffed dog he is called Arnold Jones. Your friend Ellen

Ruth said...

Candy, I got it written tonight. One of the early situations that I had with my first counselor.
I hope it helps.

Candycan said...

Hi C, thanks for reading and commenting on my blog. I think you may be on to something with her being a rescuer, at least at the moment. Perhaps because things have gone so bad recently she feels responsible for this in a way as she is my new therapist and i've admitted that im struggling because of the change. Maybe she feels she's got to fix it asap. I'm trying to keep an open mind and just bide my time and hopefully she will come to.

Ellen, thanks for sounding cross on my behalf. I try to write my posts as they happened and say the bits that i think may be my perceptions so that the reader can judge for themselves if they think im just being a drama queen or whatnot, so its a relief to hear that other people would feel the same way.

To Ellen, you are lucky for snow. You could take a photo of it. It snowed a tiny bit here yesterday but [Candy] said she doesnt want it cos we get stuck on the hill. I have a cat called [xxxxxx] and he is real. I showed him my teddy the other day and he got scared and ran away. ha ha. i bet arnold jones must be a great dog. Did you go for a walk today and to the library? I like the library but we never go. i have to go now. Little C is ok too. We made a card for our new psychologist but now we dont like her anymore and wish we didnt give it to her before. [Candy] says wait and see cos we might like her again one day. I like you though. You are a nice friend. Bye

Ruth, thanks so much for posting that. I had a read and left a wee comment. Take care.

CimmerianInk said...

Wow, while I was reading this *I* felt annoyed and patronized on your behalf. New Therapist did NOT handle this session well at all!

One thing I've learned from my therapist is that when I don't like something she says or the way she says it, she listens and puts herself in my place to hear herself and she apologizes. A therapist shouldn't waste time defending themselves, but should try to hear how they may have come off.

I'm hoping time will improve the way communication happens for you.

I'm catching up on reading so I 'll read on to see what happened.

Candycan said...

That's great that your therapist can do that. I think some therapists think that they must never show any sign of being human and that if they admit they're wrong it will be like some kind of invitation for us not to have any respect for them anymore, whereas in reality it would have the opposite effect.