I wrote what follows back in early 2013. I’d recently stumbled over the writing I had done in 2009 Old Patterns: Part 1 and Old Patterns: Part 2 which recounted the time of the big breakdown and the scary interventions and decided to start writing again having not put pen to paper, or fingers to keyboard in the whole intervening period. I was in therapy and beginning to feel ‘all the things’ with Em 😉 and so this leads up to June 2013 which saw the end of a 16 month period of psychotherapy on the NHS.
This is the last long blast from the past instalment on the blog. Loads has been going on in the here and now lately and I have just started the summer therapy break so I will get to catching up on 2019 soon!
Anyway, here goes!:
Nearly four years have gone by since I wrote here and rereading what I have written makes me so sad. Sad because right now, all this time down the road, I feel totally out of control again. It’s like I’m still circling the pit of doom. I know this isn’t completely true. I have not been stuck in a consistent state of depression since dad died- far from it – but I seem to find myself back down in the depths of despair wondering how, once again, I find myself in such a mess after so much time has elapsed?
How on earth can I be here again?
I have done the therapy – but it’s not enough, I know there is so much more left to process and I do not have enough time.
Still, let’s bring things up to speed before I get to what’s happening now.
After the seven month long nightmare with the breakdown Dr M wrote to get me put on a waiting list for psychotherapy in the NHS. I knew the wait would be a reasonably long time and so in the interim I had been recommended a private counselling service to try. I didn’t really know what I was looking for in a therapist I was just desperate to not feel so bad and went with the suggestion.
I went religiously to weekly sessions with my therapist N for two years but really made no progress on the big big things, not because I avoided talking about them (that’s progress right?!) but because I was told that my issues were too complex for her as she was just training. You would think I would have jumped ship then and found a more suitable match but after so long I didn’t feel able to kick my crutch out from under me. I liked her a lot and just being in the room each Monday night felt helpful. I think the ritual of going and talking for an hour was at times all that kept me going, even though I didn’t really gain anything other than stability. Not that I am underestimating the need for stability.
I terminated the therapy in the end. I was doing okish. Good enough. The eating disorder was quiet. The grief was still there but I had sort of learned to live with it. I was functioning! Life felt pretty good, really. I was back at work full time and enjoying it. I’d moved house. I’d travelled a lot. I’d got married. I was doing ok at adulting and still not yet 30. Win! I had kind of accepted that maybe the stuff I carry around in the shadows was always going to be there and I should just learn to live with it.
To be honest by the time the letter finally came through inviting me to attend 12 months of psychodynamic psychotherapy (30 months after the initial referral!) it came as a bit of a shock. I’d almost forgotten I was on a waiting list!
About six months after my GP had made the initial referral I had two appointments with a Clinical Psychologist in the Psychotherapy Department in the same scary building where I had seen the psychiatrist that wanted to put me on lithium. Same god awful waiting room. The bright yellow woodchipped walls still giving off a luminous glow of doom. Ugh!
When I went to these sessions I didn’t know they were only assessment interviews, no one had told me and it certainly wasn’t clear from the letter. I thought it was the therapy starting. I didn’t really like or warm to the therapist but given there’s not much choice in the NHS I thought I should seize my opportunity and start PROPERLY talking especially as N couldn’t help me with the ED. It would probably take a while to warm to this new therapist because she wasn’t N.
At the end of the second appointment the therapist told me that she definitely thought I needed psychotherapy and that I would now go on a waiting list for long-term therapy. I felt like I had been hit by a bus. What did she mean, go on another waiting list?? I had just spewed some serious bits of a lifetime of shit at this woman and now I was left hanging again. For fuck’s sake! Still, I’m good at shoving traumatic memories down into boxes and pretending they’re not there (you should see my loft!) and so that’s what I did. I went off and got on with my life – and I still had N even if she couldn’t help me with the anorexia.
So skip to January 2012 – As I said, A LOT had changed since my breakdown. For the first time ever I felt pretty grounded, happy, excited about the future. Now really wasn’t when I needed the therapy but I was wise enough to know that the issues that I’ve been struggling with since my teens hadn’t gone away, they were just dormant. And so I arrived at my first psychotherapy appointment 37 weeks pregnant and feeling quite on top of things.
It must have been a shock to Em my therapist. I suppose reading my notes she might have reasonably been expecting an anorexic falling apart person to show up in the room and instead she got a blossoming heavily pregnant woman…how did that happen?!
The moment I met Em I liked her. It was a completely different response to the therapist I had seen for the assessment. I felt comfortable with her from the first session. I don’t know what it was…I just really liked her. She had a nice face and smile, her body language was open. I dunno. I can’t explain. BUT it was good news all the same. I hadn’t really thought much around the logistics of therapy with a baby on the way but Em said that we could wait to start the sessions til after I had the baby and as soon as I felt able I could ring and let her know and start coming to see her.
She said that of course it was fine to bring the baby as she’d be little and need feeding etc. Basically she made the whole thing feel really easy – I didn’t lose my place on the list because I couldn’t start that week. So two weeks after my gorgeous little girl arrived I found myself in the room talking and breastfeeding. Turns out my baby needed feeding EVERY SESSION for the first four months.
So.… skip forward again.
I’ve been going to my sessions for a year now and I have made some good progress and uncovered some issues and set a few of them at rest. But despite Em being really great there have still been things I have felt unable to address with her. Some of this is because I know my therapy must end soon and I feel like I have run out of time.
It’s taken me three months of mentally psyching myself up to tell her that I am really struggling with my ED again – it’s been especially bad since I have gone back to work after mat leave. I think I have passed the glow of having had a baby and now feel like the baby weight is just fat.
For months I have skirted round the edge of this issue, repeatedly being lost for words or filling my session time with insignificant garbage…. I am distracting myself from what is really important and something that is slowly taking over my life again.
Well, I guess it’s for many reasons. After giving it a lot of personal thought time- the time when the lights are out and the demons take root in my mind- I think I have reached the conclusion that I haven’t felt able to talk about my eating disorder because I am embarrassed and ashamed about it.
I am ashamed that for 15 years I have been secretly starving myself, on and off, when I can’t cope with my life. I am scared to admit that apart from my pregnancy, I have never achieved a healthy BMI and that I consider anything close to 18 fat whilst still knowing that it is at the bottom end of the healthy.
Part of it is that I don’t want Em to judge me.
I judge myself harshly enough already.
But today I realised with only a few sessions remaining I had to say something otherwise I will be 45 and still battling with these issues which doesn’t even bear thinking about, especially when my daughter will look to me as a role model.
I need to change.
I know it’s going to be really hard.
I know I cannot do this on my own.
Today, I sat down in the chair and soon realised that I couldn’t even speak. I felt myself getting angry with myself. How could I have mentally planned what I wanted to say, dreamt it every night for a week, and yet again find that I was mute? What was stopping me just telling my truth? Why is it so hard to open up and trust someone with this stuff?
I know she could see I was struggling again and, thankfully, I just sat there and she filled my silence and led me along. She told me that she felt like I was holding back and that the need to cry was really strong and that she could see that everything was too much.
She was right.
Somehow, I falteringly began to get my words out. I told her of how I hated myself and how I had become really self destructive and how I didn’t see the point of being here. She asked me if I felt suicidal. I said yes. She asked me if I had thought about ways of ending it. I said yes. She asked how. I told her: crashing my car, overdosing, cutting myself. She asked me if I had ever done any of those things before. I told her yes. She asked what stops me from acting on it, and I pointed to my baby girl. And from there the words kept coming, albeit messily and not always coherently.
I told her about how people have told me I look ill, that I am too skinny at work. I told her how I felt like I am losing it. I told her how I feel I am battling with myself all the time. I never know if I want the part that wants to be well to win or the critical self-attacking part to win. I told her that I struggled to talk because I have been in the situation before and been told I did not have an eating disorder after skilfully answering questions that meant the end score did not add up to ‘anorexia’.
She seemed to understand and acknowledged that I am skilled at letting people see what I want them to and understood hard it must be. I told her how I was sick of always falling into similar patterns, how every time things get overwhelming I start hurting myself rather than helping. She asked what I want to look like and I told her I didn’t know, only that I can never see how bad things are at the time and it’s only afterwards when I look at a picture that I can see how thin I am. I told her that the more weight I lose the less I see how thin I am and focus on the areas I perceive as fat and the number on the scale.
I was inarticulate and confused but I did it. I FINALLY told someone what I am carrying around and now the door is open to deal with it…. I feel nervous and exposed and know that next week I will have to keep myself in check and stop myself from playing what I have said down in a defence and actually let myself remain open. The embarrassment is ebbing away and I feel finally like I might get the help I need with this….I just hope I have enough time. That’s what really frightens me. For the first time I have opened up, but I think maybe I’ve left it too late.
I am scared of being left hanging in June, in crisis and having to leave the security of the room and the weekly safe space I have to unburden myself. I am worried I will not cope. Things are bad already without the only support I have being removed. Truthfully, I am terrified.
A week on, another session, and another mild failure in my ability to build on what I said the previous week. I am so painfully aware that in a few sessions my safety net is going to be completely removed that I think I’m probably withdrawing into myself a bit trying to protect myself from another loss. I have lots to say but don’t think there’s time now and as such I think I am wisest trying to put my armour back on and get ready for life ‘out there’ without my weekly check in.
Interestingly, today, Em commented on how I seemed different today than last week (where I was completely flustered and anxious but just about able to talk). I was behaving differently, but actually, in the last week, nothing much has changed for me. I am feeling anxiety about leaving my job, my brain is in a million places and actually what’s happened is that I have ejected my emotions out into space to allow me to function. I have been obsessing about my weight, I even found an app that allows me to track exactly what I am eating and how this will or will not impact my desired weightloss.
I now spend time inputting what I eat into the app and watching the calories go down….I’m aiming for 1000 a day at the minute which is manageable and won’t draw any attention. It also allows a steady weight loss. I am currently 7st 5 which gives me a BMI of 16. I am not happy with my body. I am not happy with myself. I never am. I guess next session I should address this deliberate food restriction. Oh but the shame. God.
I wondered today about something she said to me. She commented on how despite everything, I’d still been able to function and things hadn’t fallen apart and I should be proud of that. Why would I feel proud? I’ve succeeded in reigniting my fiery eating disorder, I’ve taken sick days when I’ve felt unable to cope, I’ve been struggling to sleep, on more than one occasion I’ve had suicidal thoughts, but I haven’t fallen apart. What does that even mean? I haven’t physically harmed?
In the build up to termination today she said that a year of therapy is not a long time and that there are organisations that I can use to find another therapist in the future if necessary. It felt like the rug was being pulled out from under my feet. Something inside felt really painful, like I had been kicked in my solar plexus and my chest went so tight. I felt sick. It felt like I was going to fall apart. I sat there still and tried not to look affected.
I really am going to lose her in a few weeks. I can’t even go there. The loss feels too huge. She is just my therapist but for some reason this ending feels immense- so much worse than ending with N. It was never my intention to let Em matter to me. I knew this was a relationship that had a time limit and yet here I am faced with the reality that somehow or other she does matter to me, I do need her, and oh the fucking irony I can’t stay.
After years of therapy at different intervals, I really can’t envisage starting over again with another therapist. Let’s face it, it takes me an eternity to truly open up and I don’t want to start the process with another person in the future. Maybe she isn’t allowed to promote her own private therapy practice (I looked online this week to see if she exists outside that dingy room!- and she does!) but I would really like to continue working with her if I could.
The PCT dictates that the maximum time available for therapy here is a year, and I have already had this extended by two months because things have got so shit lately, but I know that realistically, had I been in private therapy, we would not be terminating right now.
So school is finished. I cannot believe I have walked away from teaching but I know right now this is what I need. I need to regroup and rebuild. I want to spend time enjoying my baby and focusing on my family.
Today I had another therapy session. It always takes me by surprise on a therapy day how I wake up buzzing as though there is an electric current flowing through my body. It’s not a pleasant feeling. It’s as though I am adrenaline filled and there is no outlet for it.
I noticed, as I sat in the waiting room that my hands were shaking. This was not due to low blood sugar, but rather, nerves. Was I nervous? I suppose so. I worry sometimes that she’ll think I am wasting her time. I always feel like I am waffling my way through and not saying what I should be. I feel like I am boring.
We talked today about ending work (school not the therapy) and how I don’t ever feel calm. I mentioned how I so easily forget positives about myself and fill myself with doubt. I talked about the tutoring that I have been approached about and how I have felt unable to respond to the email despite knowing it will generate income. I know it is because it feels like work is still there and all the negative associations I have about being judged and failing despite never having performed badly in my work.
She broached the subject of food today. I didn’t build on that opportunity but did talk about obsessive behaviour patterns like running at 5am and how I have had to reign myself in, knowing that one run will become alternate days, then daily, then add in a bike ride etc. I suppose I could then have talked about the food and the app – another tool for me to berate myself with.
I have 4 sessions left now, one of which will be closing up and I have to address this fucking albatross ED. I know it’s tied to self-esteem, perfectionism, sexuality, lack of control….the list goes on….the thing is I need to unload it. Perhaps if I can let this secret out it will make it less of a monster and more of a mouse?
Something else that’s new: I feel more in my body lately. I feel more. I’m not stuck in my head or dissociating. That scares me a bit because what I feel in my body is horrid and overwhelming.
I talked today about remaining firm when people ask me what I am doing and telling them that I don’t know, and that it’s ok not to. She said this is known as ‘negative capability’ where a person can challenge the norm or go against convention and that it can be really healthy and shows that I can assert myself.
Oh man. I like her. I think maybe, if I am honest, I love her. She sees me as I am and doesn’t run away. To feel accepted as I am is novel and addictive. The more time goes on the more worried I feel about the termination of therapy. I really don’t want to be the tortured anorexic but I don’t feel able to be any other way at the moment. I don’t feel like I have the coping strategies to deal with what feels to me like another enormous loss and not eating is a way that I have always coped with emotional pain. I feel like I am losing H and Dad all over again and added to this, someone who has not flinched when I show them who I really am.
Walking into my session today I felt like I didn’t know what I would say or where it would go. I sat down and immediately felt the loss I am beginning to grieve before it has even happened. I could barely look at Em. I did, however, outline just how bad things feel right now. I told her how I take to my bed when little girl is asleep and lie under the duvet just to hide away from the world. She totally seemed to get the need to feel safe and she understood how I never feel soothed.
I explained that hiding in bed allowed me to be safe and not to harm myself. I told her about how I worry about hurting myself and I haven’t done that in years. She asked how and I told her about cutting and burning. These methods have been running through my head for a few weeks now. I have been looking of self harm websites. I guess that is a visual outlet rather than actually hurting myself.
Towards the end of the session more and more came out, as it always does and she picked up on that. I wish it didn’t take so long for me to get to what I need to say. We talked about the impact of ending and how I felt. She suggested that maybe I would feel angry or let down. I don’t feel either of those things, particularly. I just feel lost and sad that I don’t have more time to really unpick this….this self-destructive part that rears its head periodically. I didn’t say this.
I came home and tried to cut myself. The knife wasn’t sharp, though, so there are only superficial lines. No real damage done. I also heated a metal spoon and burned my skin. That really fucking hurt. Neither of these acts makes me feel like I have been able to find an outlet for how shitty I feel, though. I almost feel like I have failed and can’t even damage myself successfully. I feel pathetic.
I had no idea when I started this process that I had so many attachment issues. Em has suggested I have trouble with intimacy – well duh! I had no idea that so much was tied up in abandonment issues and dependency. I guess what has happened in the therapeutic relationship is that for a long time I have held back from allowing myself to get close to Em because I knew that the relationship would come to an end and I didn’t want to feel like I was alone and abandoned when the time finally came.
Fortunately or not, in December I guess I began to experience transference with her and then began to shut down a little for fear of frightening her and replaying issues. As it turns out this has happened anyway. It feels a lot like H, not being able to tell her about how I feel. I suppose what happened last week was the bit that I was terrified of, suddenly being so needy and dependent that I feel like I can’t function without that safety net. Argh. I know I have a lot to work through now about how this has all come about and why. We have a month break now and then it is the last session.
I decided to send Em an email to her private practice email asking if I could see her privately when we finish. She replied that she’d be happy to work with me but that she’d have to find out what the rules are and will let me know in our next session.
June 5th 2013
So today was the last session with Em. I went with a feeling of dread and nervousness after the email and also knowing it was the last session. I was worried that I had overstepped a boundary contacting her. She thanked me for my email and quickly told me that I could see her again but that it would have to be in 3 months or so in order for there to be ‘an ending’ with the NHS and fresh start with her privately. As much as I don’t want a gap, I do understand the theory behind it.
The session today was a bit bizarre as after a month away I felt like I couldn’t just open up and do it, particularly knowing it was the end and I would have to manage. I did talk through some superficial stuff and tried to remain upbeat and together – my outer world persona. I talked about how I have been trying hard to look after myself but that I don’t find it easy and it is easy to be critical. I know that that is the big thing I need to work through next time. I can’t avoid it anymore.
I have come away from today feeling numb – I know I am just shelving how I feel because I know I can’t deal with the idea of being alone with myself for a quarter of a year.
So – that was way back in 2013. I didn’t end up going back to Em until three years later (June 2016). When I finished the therapy I had six solid weeks of horrific nightmares and then one night I had dream where I was night swimming in a lake. I was feeling suicidal. I was cold and tired. I decided to drown myself. I calmly put my face down in the water and floated on my front. I waited. Just as things started to go black someone pulled me up and out of the water and into a boat. It was Em. She quickly wrapped a blanket around me. She said ‘you don’t have to do this to yourself anymore’ and held me close. And that’s when the nightmares finally stopped.
I picked myself up after that dream. I didn’t contact Em when the three months wait was up. Part of me wanted to but part of me was scared of ending up back in that dependent, unsettled place. I had another baby in 2014 and life actually was really very good until I got cancer in 2015 and then had to go through a year of treatment…cue a complete meltdown when that had all finished! The wheels really started falling off. All the old stuff started to become live again. So I approached Em and since then we have been working together solidly for the last three years working on so much shit. We’re still not done yet! But I am so glad I have her reliable, calm, non-judging presence in my life. And even though I am still trudging through trauma I can really see how far I have come.