What I hear vs What is said: Communication in therapy.

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I’ve been in therapy with my therapist a good long while now; in fact it’s been six years since I first wandered into the rather cold and depressingly decorated consulting room in my local NHS Mental Health Hospital (after a three year wait no less!) to begin a year of psychodynamic psychotherapy…at least I think that’s what we were doing!

Picture a small room with a tiny window at one end, two not particularly comfortable brown chairs (the kind where the back isn’t high enough to lean back comfortably and the sides are so tight that you are forced to keep your feet on the floor – no curling legs up underneath yourself!), a fluorescent strip light in the ceiling a la Girl Interrupted, woodchip wallpaper and durable office-style carpet (again brown) and you’d be in the room.

It was a consulting room like many others in the NHS I guess, nothing homely or that in any way reflects the therapist that works inside it – because many therapists use the room. It was as blank a space as the blank screen that my therapist was to me at that time. I’m not really moaning, though. I will always look back fondly on my Wednesdays in that cold little room in the grey stone building because it was there that I met my  therapist by complete chance.

I could’ve been allocated to anyone in the Psychotherapy Department as a space became available on their caseload but somehow fate decided that she would be my therapist and I am so glad it was her because when I had had a couple of assessment sessions in order to go on the waiting list I hadn’t warmed to the therapist AT ALL. I really didn’t like her and dreaded the thought of having to possibly work with her.

The moment I met my therapist I liked her. In fact looking back over my diary after the first session I wrote ‘Uh oh, I really like this one. She seems really nice’… ha!…wakey wakey attachment issues I knew nothing about at that point!!

Little did I know when we met back in 2012 that (after a too lengthy break – damn Cancer!) I’d now be seeing her privately in her home, in her very lovely consulting room by the sea. It’s a medium sized room but feels homely, with neutral – but not bland- soft furnishings, cream carpet (she must be mad!), a pale blue leather sofa and her IKEA therapist chair (you know the one!), chunky style natural/driftwood wooden furniture, several completely filled bookcases (and not just therapy books), art work and a wooden Buddha watching over proceedings. It’s lovely.

It’s amazing how a nice environment can help make things feel more relaxed. Ok, perhaps ‘relaxed’ isn’t the right word here but I do find that the familiar environment is a place I (mostly!) look forward to spending time each week; it’s a little oasis of calm where I can bring my storm and try and get settled and grounded before venturing back out into the real world. Of course that space, just like the little room in the hospital, would be nothing without the person that sits opposite me from week to week trying to help me navigate my way through my almighty mess.

Yes. I can see how this is getting a bit gushing…but that’s because tonight I am feeling nothing but love for my therapist. I would not, however, have been writing in this way on Wednesday about the therapeutic relationship! I haven’t seen her or communicated with her since our session on Monday and yet how I feel about her, and where the therapy is going, is a world apart from earlier on in the week when I was hurt and raging and devastated and considering terminating… and that is why I have chosen to write this particular post about what I hear in therapy sessions.

I trust my therapist (well the adult part of me does), and for the most part our in session communication goes ok – good even. Of course sometimes she says things that immediately hit a nerve or piss me off, but more often than not sessions go fine. I can see and feel that she is making an effort with me – and frankly I am not easy to work with. My window (letterbox!) of tolerance is minute and I can swing into a dissociation with no warning whatsoever. All through that she is with me and as steady and patient as a….what? Can’t think of a decent simile. She is patient!

Generally I leave therapy feeling ok and sometimes I feel very connected. And yet I keep stumbling over the same issue again and again and that is, as if by clockwork, the moment I leave the room and start driving home, things start to shift and morph into something else – something negative. What was a good session suddenly becomes terrible and I feel like she doesn’t care about me and before too long I’ve had enough of therapy, am angry and want to terminate.

I really feel for a couple of my friends who week-in week-out listen to me rant on about how ‘terrible everything is’ and how ‘I am done with this’ and how ‘unfair it all seems and why can’t she just give me what I need?’ and ‘why doesn’t she show me she cares?’ and they patiently coach me through my fluctuating emotions. It’s hard work being in my head on Tuesday and Wednesday and they must feel so bored by now!

The problem I, like so many of you, have is that is what my therapist says to me in session hits so many different trauma parts: Little Me, Four, Seven, Eleven, The Teen and not just my adult self. Communication, therefore, is really complicated between me and my therapist. She has frequently commented that it is hard to say something that is adequately soothing and talks to all the different parts of me. What the little ones need is very different to the teen and sometimes it is hard for her to know exactly who she should be talking to because I give very little away at times. And we all know that the littlest ones don’t really want to be talked to at all and nothing but physical holding will feel enough for them.

I can hide behind my adult self and she’d be none the wiser that the tiny two year old girl is crying inside. I actually think the coping adult front I bring to session is more damaging than when I shut down in a dissociated silence or the protector parts put things on lockdown. At least when I am like that she knows something is up and can try and connect to whatever part is having a hard time. When I (adult) go in, am articulate and talk about things (but not necessarily the things I really need to talk about) she has no clue that I am not telling her what I need to or that I will leave feeling uncontained and spiral in the week.

I am getting better at telling her how things feel but sometimes it doesn’t go well or sometimes, like last week, I leave what I really need to say to the last minute and we don’t have adequate time to discuss it and then I feel like I am left with loose ends and not quite clear communications. Ugh. Must do better at this.

I doubt you’ll be surprised to hear that I didn’t ask her to sit closer to me or tell her how much her moving closer to me the other week had impacted me – AAAARRRRGGGH! I can’t remember what we actually spoke about during the session, now! It was ‘stuff I needed to talk about’ but it wasn’t #1 on the list stuff that eats away at me!

With ten minutes to go I decided I needed to ask her about wtf was going on with the pebbles:

Why, when we came back from Christmas break, did you say that you felt like I was trying to script what you needed to say in the text messages and yet for such a long time you’ve been asking me what I want you to write on the pebbles? It doesn’t make any sense.’

I mean launching into a discussion about the text communications that caused the rupture and the failing effort at a transitional object with only ten minutes remaining wasn’t exactly a genius plan was it? The thing is, sometimes it takes me that long to build up the courage or feel safe enough to bring these things up – so in some ways it’s better with ten to go than not at all…

We talked a surprising amount and whilst she didn’t say anything explicitly hurtful or unempathic (adult knows this to be the case and can hear it on the recording that that’s not how she is EVER) once I had asked that question I felt a shift in myself. Adult may have appeared to be fronting the show but actually all of a sudden the most vulnerable traumatised parts switched their ears on and were listening intently to everything that was said, analysing every word and subtle nuance, projecting a narrative onto the conversation. Inside was a running monologue: ‘What is she saying? What does she really mean? Does she like me? Does she care? This feels rejecting. No she doesn’t like me. I hate that I need her and love her when she clearly feels nothing…’

I’m struggling to articulate clearly what I want here, but basically the moment I asked the question there was a part of me, if not several, that was automatically searching for confirmation of my deep held belief: she doesn’t care and no one loves me because there is something inherently wrong with me. To be honest no matter what she had have said I doubt I would have heard anything vaguely positive because I am so conditioned to hearing this negative narrative – even when it is nowhere near the case.

My therapist said that she often feels that whilst a part of me wants to be told affirming things and to be loved there is another part that is absolutely terrified of that and wants to run away from it or rubbish and reject it as not being genuine.

Every time she says that it drives me mad inside. Whilst she is right (I recognise this more and more now) it feels really rejecting to the part that does want the affirmation and clear displays of love and care. It feels like she is saying ‘you can’t handle what you want and so I won’t give it to you’. I feel like shouting at her ‘I’m not going to die if you give me more warmth or clear demonstrations of care and maybe if you do it enough I’ll stop doubting you and attacking myself for needing you and convincing myself that you clearly don’t care about me’.

It feels really like a Catch 22 situation. I feel like I need her to be more demonstrative in how she feels towards me and yet she feels like it would send me over the edge if she did. It sends me over the edge as things are so what’s the answer?

We left it that we would work more actively with the pebbles especially as there is the Easter therapy break coming up shortly – nooooooooooo!!!!!!! And so that is a good thing, I guess. I am a bit reluctant about how it’s all going to go. It feels like something simple has become unnecessarily complicated. My therapist said she felt that perhaps I thought she had been too pedantic or pernickety about it but that she wanted it to feel right and genuine. I, of course, heard that as ‘I don’t want to write lies on the stones and therefore have not done it because I don’t want to say anything positive about this relationship when I don’t feel it’.

Anyway, yet again I have navigated my way through the emotional rollercoaster that is the week between sessions. It is Saturday night and I feel quite stable and content in the fact that my therapist is out there, cares about me, and that she will be there on Monday and we can talk – who knows I might tell her all the angst I’ve felt this week about the conversation we had and about the one we didn’t have (proximity).

It’s strange. I always feel quite motivated and able to take these things to session at this point in the week. Monday morning at 10:30….a whole other story!

Ugh!

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Letter to my seventeen year old self.

Dear Seventeen,

I’ve just read your diary. Please don’t be mad. Wait and hear me out a minute. I know how angry you were when you woke up to find dad reading your diary on holiday in Mexico and how violated you felt back then; but please know that I am not deliberately prying into your private life or being nosy. I’m just trying to understand you better. And honestly, I am good at keeping secrets, in fact I’ve been holding onto yours for the last seventeen years of my life. I’m not here to judge you and I promise that you can trust me.

We haven’t met before. Well, I know all about you (more than you realise) but I don’t think you are aware that I even exist. I’ve been watching you stuck in your own private hell for a long, long time now. It’s like Groundhog Day for you in the year 2000 isn’t it?

Too often I have turned away from you when I should have reached out to you. I have ignored your pain and your suffering because I haven’t known how to help you. Sometimes I have wondered if you even want to be helped.

I don’t know if you know it, but sometimes you take over my body in the present (which, by the way, is 2018 and means you’re often roaming around a stretch-marked 34 year old bod’ – yeah I know, it’s not great – and to think you hate your body now is incredible!) and react to my current day issues as though you are being hurt again in the way that Mum and H hurt you. It’s like my life triggers flashbacks from your life and you (and I) are reliving the pain over and over again.

I can feel your anxiety and fear coursing through my veins. I can’t speak and I go numb. I shake. I feel your frustration. I haven’t know what to do and neither have you. I’ll admit that I have felt overwhelmed by your feelings. I know you have things to say but I also know that you are very very frightened. I understand how desperately alone you feel. It broke my heart reading your account of the pain you feel inside. I know how hard it is. I remember it well.

You feel like you have no one to listen to you and that no one cares. It feels so difficult to trust anyone. You fear getting close to people and letting them in because you think you’re going to be rejected or abandoned or ridiculed – and you don’t think you can survive it again. This year has been the hardest one yet, for you, and I am not at all surprised that you just want to run away from everything and anyone that might hurt you.

So you isolate yourself in order to avoid being hurt but you can’t be alone forever. In your heart, deep in your soul you know you need love and connection. We all do. I know it feels risky seeking that out. I know you fear annihilation. I get how scary it feels to consider opening up again after what’s happened. You are still heartbroken but the only way your heart is going to mend is through letting someone heal it with you; currently you have a handful of shattered pieces and no glue.

There is no shame in wanting to be loved. You needn’t be embarrassed for feeling love either.

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You probably won’t believe me (who can blame you after all you’ve been through); but if you can find a way to trust me, I think that I am the person that you have been waiting for. I can help you, listen to you, and love you…if you’ll let me. I really want to make things better for you – for both of us- because right now your pain is my pain and it’s crippling the pair of us.

I’m so sorry, so very sorry that circumstances have made you feel like you are not worthy of love and care. How things have been with mum are not a reflection on you. None of how she has been with you is your fault. You are not unlovable or untouchable even if that’s how you’ve been made to feel over the years.

How things have been for you growing up isn’t normal. I think you know that but really acknowledging that is devastating. You have suffered emotional abuse and neglect at the hands of the person that should have loved you and protected you the most. I assure you that there is absolutely nothing you could have done that would have changed how things have been for you.

I know that’s hard to hear, but I think you need to hear it and try and take this in. You carry the weight of the world on your shoulders. You feel responsible for everything. And darling, some things are simply beyond your control. No matter how good you are or how much you achieve, there are some things you cannot change or control. You can only be responsible for you and not for the actions of anyone else.

What I will say, though, is this: it won’t be long until you are able to start getting away from some of the horrid stuff. Next year you will leave home and go to university, you’ll fall in love (really!), and things will start to get better. I promise you it won’t always feel this bleak. Until then, though, I’m afraid you’re just going to have to hold on tight and keep putting one foot in front of the other like you always have. I know it feels impossible sometimes.

Despite everything that has happened you are still here. You are a fighter. I know there have times when you have been very close to the edge. I know there are days you have thought about driving your car into a wall or overdosing or paddling your surfboard out to sea and never coming back. I felt the pain of each cut you made, and every burn on your skin. I know how you starve yourself. I see how regularly you purge everything from your system. You are punishing yourself over and over again for something that is simply not your fault. I don’t hate you. Why do you hate yourself?

You’ve lost sense of your value – or maybe, more accurately, you have never felt valued or loved. You feel worthless. Don’t get me wrong, I know why you feel this way. Steady and systematic emotional abuse does this to people. Now you feel like you are acting your way through life. You have little idea of who you are because you’ve spent so long trying to be what everyone else wants you to be that you really don’t know how to be yourself. You’ve struggled so hard against yourself for the last couple of years not wanting to disappoint anyone but inside you were dying.

I am so unbelievably proud of you. Coming out was massive. I know right now it feels like the worst thing you’ve ever done and you feel more lonely than ever; but those people that walked away from you, called you names, and bullied you were not your friends. I am telling you that even though it was scary and is still having a huge impact on your day-to-day you have made a huge leap forward into living authentically as who you really are. I know it takes a huge amount of courage to stand up and speak your truth but six months from now, you’ll be surrounded by people who love and accept you for exactly who you are and those people will become lifelong friends – chosen family.

I also want to say thank you. What for? For looking after the little ones. You are a force to be reckoned with, for sure! They are very lucky to have you as a protector. I know it’s difficult living your life when you continually have distraught children demanding your attention. It is not your job to hold them. It was never your job to look after them, but in the absence of an adult to care for them, you’ve done a brilliant job.

I have children (a boy and a girl). I see a lot of you in them because I remember you as a child, too. You were innocent and vibrant and full of life. You had so much love to give and then something happened and you started holding everything inside and that light you exuded steadily faded until it is now barely a flickering flame inside you. I know right now you feel bereft because, to you, coming out equates to you never having children and you so desperately want to be a mum. I’m not a time traveller but I am telling you this – children are going to be part of your future and that flame will burn brightly again in the love you have for your babies.

You are incredibly strong and I recognise just how much effort you put in to surviving. Sometimes the best you can hope for is just to keep on keeping on. You’ve done amazingly. Don’t roll your eyes! I mean it. The fact that in the face of so much pain you have still somehow held it together, passed your exams, can drive, and are alive is testament to your spirit. You are so driven and this is a good thing. It’ll take you a long way in life. But do you know what? You need to learn to relax too.

You need to let your hair down every now and again and have fun. You are so serious – so grown up- because you’ve had to be. As I said earlier, I am here now, for you and for the little ones – if you want me to be. So I am giving you permission – please relax and start to heal. The adult you all need/ed is here now. I’m not super woman but I promise you that if I can be there for you when it starts to feel scary then I am going to be there – and I am not going anywhere.

Things aren’t going to feel better overnight, I think we both know that. If things are to improve then we are going to need to work together on this. And so there’s something I need to ask you to do for me. I know you know about the therapist that I see each week because sometimes you hijack my session and stamp your feet a bit; or sometimes sit there silently raging and planning how you’re going to hurt yourself when you get the chance. Between you and the little ones there’s not a great deal of space for me in the sessions. I am, in no way, complaining about this, but I was wondering something.

I know you really like therapist but it feels risky to have feelings for her. You are attached to her just like the young ones are, ok perhaps in a slightly different way, but you do love her. And that’s ok. You want to be known by her. The idea of her really seeing you is both appealing and terrifying. Sometimes you let her see you, the real you, and other times you shut her out. When you feel close to her the alarm bells ring and you instantly back away.

Look, I’ve known this woman for six years now and I’ve been in therapy with her for three. I trust her but it’s not me that needs to talk. I’m ok. Do you think that maybe you might tell her how things are for you? Or if you can’t, do you think maybe I could tell her for you?

You’ve been holding onto this pain for such a long time, and I have been sitting on your secrets for as long as you’ve been alive and I think it’s time for us to move on.

What do you think?

Sending you so much love,

X

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