Mixed experiences of psychiatry

I know there are many strong opinions out there on the field of psychiatry, so I wanted to write down my own experience of being treated by a psychiatrist. For me there have been some crucial benefits (so far at least, 18 months in) as well as some downsides, and I want to give an accurate, balanced picture. Of course my experience is just that - my experience. It is not proof of anything either way and it's as valid (or insignificant) as any other individual's experience.

I came by my psychiatrist, a  woman in her early 60s, by way of a counsellor who thought I should have a full psychiatric assessment. I was highly functioning but really, really unwell at the time. I was working full-time, caring for my toddler on my own, running around 60 km a week, running our little household. But my mood swings were wild, my anxiety was through the roof, my urge to self-harm and suicidal thoughts growing stronger by the day and I felt I was going to explode. I was frightened of my threatening ex, frightened of men in the street, freaked out by loud noises or people shouting (especially at their kids), barely able to be around my mother but also desperately in need of her help, and I was in a mostly imagined, long-distance addictive relationship. Nightmares, night sweats, intrusive thoughts and memories that I found incredibly distressing. It was not a fun time.

When I went to the psychiatrist  for the first time, she immediately suggested I be hospitalised. But I resisted - it seemed to me that I was not only functioning but excelling at it. Working, cooking, cleaning, playing...I was doing it all, and clinging to it like a life raft. It took her about three months to convince me that I did need to be hospitalised. When I finally relented,  this step turned out to be a game changer for me.

Her reasoning for hospitalisation was that she felt I needed intensive therapy and to be in a safe environment because I was suicidal and self-harming. In addition, as an inpatient, I would be able to ramp up the medication much more quickly than if I was on the outside and not constantly monitored. This turned out to be true. We eventually settled on a combination of lithium and Venlaxine. I am aware of the withdrawal issues with these drugs, I have had a taste of them when I have run out, especially the Venlafaxine. But when I began taking them these drugs coincided with a major turning point for me. I don't think the medication brought this about by itself, although I do think the pills zapped most of the intrusive memories as well as the urge to self-harm.  I came out of my worst distress and began to work on my recovery.

Her decision to put me into hospital also exposed me to different types of help I could get, including SLAA. Along with my therapist, my psychiatrist actively encouraged me to go to SLAA and she still does. She was also supportive when I wanted to change therapists (twice in a row), until I settled on my current one. My treatment became and continues to be a multi-pronged approach: medication, therapy, SLAA, self-help. It has worked very well so far.

On the negative side, I had a few run-ins with her which made me extremely upset on a few occasions. This mainly revolved around the abuse my ex - I felt she wasn't taking me seriously enough and this made me feel unsafe. If she didn't understand, what chance did I have with the rest of the world? In retrospect I think she was trying things out, testing me a bit to see if I was ready to let go of my fear, but I just saw a repetition of what happened to me with my mother, who was ambivalent about the issue and who held strong sympathies for my husband in spite of what he had done to me. This along with other experiences had made me extremely sensitive. One therapist (whom I promptly ditched)  even suggested the abuse was my husband and my "way of having sex". That pushed me over the edge for a few days.

Anyway, I found my psychiatrist's attempts to talk more deeply to me about my emotions and problems pretty hopeless. I felt she was old-fashioned and while I could just ignore her advice on good days, on my bad days it made me really angry. I wanted her to just do what she seemed to do best: explore my symptoms and how they were developing, keep track of my overall treatment and tweak and manage my medication. This is pretty much what we have settled on, and I have gone from seeing her once a week to once a month. I know her much better now than I did at the beginning and I trust her a lot now as a person and as a doctor (with a very specific brief, as I see it). She got my whole recovery on the road and made sure it consisted of several elements.

Perhaps I am lucky with her but I also think it helped that I did not have to rely on her at all for emotional support - this would have been a disaster.

I would be interested to hear other people's experiences! Have a good weekend.
Rosamunde

Weak boundaries from childhood and parenting today

This morning, when I took my small son to nursery, I had a sudden insight about my upbringing and what I need to do differently with my own child. 

The incident was - thankfully! - just an everyday, harmless occurrence, but for me my reaction and the implications carry a wider significance.

This is what happened: For the past year my son has been very good friends with another boy in his class, who we will call Tim for the purposes of this blog. Both Tim's parents, me and the nursery staff have encouraged this relationship. We were excited that they were socialising so beautifully, their play and communication totally in sync. It was lovely to see. 

But recently, their relationship has hit a bit of a rough patch. There has been some mutual winding up and recently they fell out after Tim pushed my son, resulting in both of them bursting into heart-rending sobs and tears.  But they are still great friends. The nursery staff have had to sit them apart at activities, only to see them back to being as thick as thieves with each other moments later. It seems their issues stem from the intensity of their relationship - they have they grown a little weary of each other, which is understandable.   

When we arrived in his classroom this morning, Tim rushed up to my son, ready to start playing, trying to grab him. But my son ignored him, in fact he tried to get away from him as Tim attempted to hug him and get his attention. Eventually Tim gave up and, looking sad and dejected. I felt sorry for him, so I asked my son: "Why don't you play nicely with him?" To which my son replied, with Tim out of earshot: "Tim is not my best friend."

Now my immediate, involuntary response to this was to pull a face and to say: "Oh, don't say that! It's not very nice!"

But then I caught myself: Why on earth was I chastising him for just expressing what to him is a fact, a fact which reflects his feelings? Why am I denying him the right to feel whatever he wants? And I immediately knew the answer:  Because this is exactly what my mother would have done.  

It's not as if this is the first time I discover this aspect to my mother, but it has been a while since it has reared its head in my own actions towards my son. I am not sure if this was due to her strict Catholic upbringing, but as far as she was concerned, if we had an issue with someone, be it an adult or a child, teacher or friend, it was always because we were flawed, not them. If we got into trouble at school, it was undoubtedly because we deserved it. The general assumption was that we were bad and that we had to sacrifice ourselves, our needs and wishes, accommodate others, whose needs were more important. 

If someone had wronged us, she would defend them, never fighting our corner, never consoling us. It was as if she was ashamed of me, and I often felt dirty, flawed, wrong. This meant I never went to her with any emotional or relationship difficulties, not past a certain age anyway, I think at around 9 years old. This is also when her physical affection towards me stopped.  

Looking back, my mother threw me to the lions repeatedly, not least with my ex-husband towards whom she still has a degree of loyalty that makes me deeply uncomfortable. I have learnt just to live with it, but that is the subject of another post.

I guess it just did not occur to my mother that sometimes I, as a child and as a teenager, needed her protection, that  I needed my feelings and instincts validated by her so that I could learn to value and protect myself, to set my own boundaries. The message her neglect on this front gave me was: You are worthless. Other people are more important than you. 

This was difficult for me growing up but it became downright dangerous later on in my life, when I started getting into relationships and being sexually active. I had been taught to ignore and override my instincts at all times and I felt deep guilt if I wanted to be assertive or set limits with people. I felt I literally had no right to do so. Who was I to tell someone how to treat me or not treat me? Often it didn't even occur to me that setting boundaries was an option for me. 

I was quite bolshy in general, but I reacted to abusive and manipulative boyfriends by being submissive and accepting. Even with some friends I struggled to set boundaries, cutting them off altogether rather than going through the discomfort of being assertive when I didn't even feel I was entitled to ask for or insist on anything.

Anyway, to get back to the little conversation in the nursery classroom, I decided there and then that this was not a legacy I wanted to bequeath to my son, So I briefly took him aside and said: "Listen, you can be friends with anyone you like, that is okay. Just don't say this stuff to Tim's face because he might get upset."  

To me this is still not ideal -- I would have wanted to elaborate more on how to choose your friends and to speak out if you don't like the way you are being treated. But I was caught off guard and it was the best I could come up with there and then. I will definitely have another conversation with him about it layer today, a conversation in which I will not chastise him or deny his feelings, whatever they may be. 

How SLAA helped me to see that I was manipulative

I am enormously grateful to be able to say that working the SLAA programme along with therapy and all my other reading and recovery work has resulted in a drastic improvement in my self-knowledge and self-awareness.

One of the areas that I have seen the biggest change in is my behaviour in romantic relationships, in particular how I used to manipulate the other person. Manipulation was such a bad word for me that the mere suggestion that I was manipulative would previously have unleashed waves of terror, shame, self-loathing and ultimately denial in me. Surely I was a "good" person and would not do something as evil and selfish as manipulate anyone, let alone my lover? 

That belief about myself alone shows me what a warped self-image I had, how proficient I was at lying to myself, how blind and deluded I was. Because I manipulated all the time, sometimes expertly, sometimes clumsily. Sometimes the other person would become aware and try to call me out on it, but I would deny everything. Other times they would dance to my tune. But all the while, I was completely unaware of what I was doing, which was to twist and contort myself into a being that would make the other person a) pity me, b) admire me for my supposed courage and stoicism, c) make them want to rescue/protect/care for me, d) give me affection/love/any emotion at all goddammit. These objectives informed much of my communication in my relationships. I say I was unaware, but I think subconsciously there was some knowledge of what I was doing, and this would trickle into my thoughts. For example, I could not figure out why I had such radically different personas. Around lovers I would become needy, weak, and turn into a little girl, often with my voice too. In the rest of my life I can be quite ballsy and opinionated, and how I was inadvertently shifting in and out of those roles did trouble me somewhat. 

It was only through SLAA, which makes you look at your own actions and motives with complete honesty, without shame or blame, that allowed me to say: yes, this is what I have been doing. And I also had the explanation for why I had been doing it straight to hand - my childhood and loveless upbringing. This allowed me to be compassionate towards myself, rather than condemning and berating my person. It is a way of looking at yourself, your past and present, in a non-judgemental way, without any of the vitriol that would have distorted our perception of things previously. 

I think this is what allows for true healing. It's not that I thereby absolve myself of these past actions of mine. I am responsible for them and the harm I caused people. But I am no longer in denial, which allows me to break the cycle, to stop behaving that way. 

It is a process, and I still have some way to go. My hunger for the affection, overt love and affirmation I missed out on as a child, my desire to be validated and have my ego to be propped up and cared for from the outside, will probably always be there. So I have to keep an eye on myself, and check my motives before communicating. Often I find that as my mood dips, I reach for my phone for a quick boost of comfort or validation, or my mind starts thinking of ways to elicit an emotional response from someone. I have enough awareness now to stop myself, and often, if I just do something else, the urge or need passes. Previously I would flatter a lover, profess my supposed affection of love for them in order to get something in return, or even bring up a negative subject evoking jealousy or resentment. 

How do I know when I am about to fall back into old habits of manipulating for an emotional fix? It's not that hard to identify most of the time. My mood drops like mercury in an thermometer, so that is already a first warning sign. Sometimes I provoke myself into a negative state, thinking or seeking out information about previous relationships (my own included) on the Internet. That really is a trigger for most people I think and I try to avoid it. I become irrationally resentful or angry towards my partner, about his past, about his autonomy. 

How to let go of this kind of behaviour? Well awareness of it is the first step. Examine yourself honestly and without blaming or shaming yourself. Being compassionate, not critical, is the vital next step. You are not a "bad" person, you acted this way because of your past. It is not your fault. Luckily you can now take responsibility and manage this behaviour because it is damaging both to you and other people. I talk to myself kindly and ask: what is it that you need right now? Will reaching out in this way help you achieve that? Learning to self-soothe, to practise coping on my own has also helped me see that it is possible and not as dangerous or painful as it may seem.

I hope this is helpful. Please ask questions, express your agreement or doubts in the comments below. 

Poem: Weekend in Berlin

Pavement love 

Walking in step 

Flowers in a vase 

Open in my heart 

Chirp, chirp, buzz, 

Butter-yellow clicks, 

Drip, drop, tick, tick

Deep, furry hum. 

Not slick, not slim

Not the size of a brick,

Bigger than a car,

Bigger than a house,

We'll keep it in a hangar,

In rows and numbered blocks.

Grey boxes, blinking lights

Red green green orange 

Red green green orange

Red green green orange...

Relationship drama, relationship peace

Since leaving my husband after nearly 10 years together and going into recovery in SLAA, I have naturally given a lot of thought to what kind of relationship I want for myself going forward. 

I could see what had gone wrong before. There was a profound disconnect between my actions and my values and aspirations, one that I wasn't even aware of. I pursued, slept and went out with people I wasn't attracted to, who were too old, too different, unsuitable, unavailable, who treated me badly. 

All I wanted was someone to save me, to protect me, to make it all stop, and that is exactly what my then husband-to-be did for me. He was insanely jealous and controlling, but also there for me through every mood swing, every bad dream, every panic attack. He soothed me like a baby, nursed me back to health like a sick bird. As long as he was around, I was ok. He could protect me from my own mind, which appeared to be attacking itself. We fought a lot during this time, over my exes, my feelings, the boundaries of our relationship. My emotions felt dangerous to me, like a threat. I had moved from man to man without ever really getting over the previous relationship. I had much unfinished business, many regrets, many unresolved feelings.

He could not take this, and I tried to defend my right to feel what I wanted. Plates were smashed, laptops broken, tables overturned - mostly by him, but I began expressing myself like this too. Often I was desperate. I felt I could not survive if he left, and I think at the time this was not so irrational a thought.

Of course I would not have died but I was very young and very alone, and life would have been incredibly tough. I thought without him I would end up on the street. 

 I kept our difficulties and his controlling side secret from my friends because I knew I wouldn't be able to handle their disapproval. It would only destabilise me, I felt. Also I developed an extremely rigid sense of loyalty to him. It was us against the world and I could not say a "bad" word about him to anyone as this would be a betrayal. If I did utter a criticism or discussed our problems with someone else (which was extremely rare), I would not be able to face him again without confessing. Where did all this pressure on me come from? It's not like he ever explicitly told me to do any of those things. But I think he set the ball rolling, and then I ran with it. I knew if I didn't conform to his expectations - if I found someone else attractive, if I had unresolved feelings towards an ex, if I flirted with someone etc - he would leave me. Or so he always said. What would usually happen is that he would interrogate me for a couple of days, squeezing every last detail over my "transgression" out of me, asking me the same thing again and again and blaming me, berating me,  sometimes even depriving me of sleep. Now I see that he subconsciously (?) wanted me to break down, which after a while I inevitably did. I would cry helplessly, scratch my face and arms, and wish I was dead. Then he would scoop me up and "forgive" me, absolve me, tell me I was good and pure after all. Pretty sick. 

Anyway, needless to say, I don't want that kind of relationship again. And the person I am seeing now is nothing like this, thankfully. He does not hunt me, test me or interrogate me. He respects my right to privacy and an inner life more than I do his (I am trying to learn). Sometimes he felt too distant to me, but I am starting to see that this is someone whose self esteem is not entirely wrapped up in his relationship. He has other stuff going for him, other interests that sustain him and fulfil him. This helps me to do the same. 

I am not saying our relationship does not have its problems, but I am fairly certain there is no abuse towards me. Other dysfunctional aspects may arise or come to the fore at some point, and we will have to deal with them. Both of us had difficult childhoods and our fair share of trauma later on. 

But one thing that keeps me on my toes is the fear that, as a love addict, I am just with him for safety, for stability, so as not to be alone. That if I was stronger I would not be with him, that he is just "some guy". I don't entirely trust myself because of my past, when I was so unwell that I had virtually no choice who I ended up with. 

This insecurity in me is understandable but I don't want to let it sabotage my happiness. I want to take this relationship one day at a time. My dreams of another baby, of living together, they are for now just fantasy. That is okay, I am a woman in her early 30s and such wishes are only natural. And we make a good team, so I can see myself with him long-term. 

I just don't want to fall into that drugged sleep of someone in a relationship that doesn't suit them, for whatever reason. I don't want to be alive but dead on the inside, as I was in my marriage, denying my own life force, suppressing my spirit. 

For this not to happen, I have to keep going to meetings, keep working on my spiritual growth. I want to treat the relationship as a live thing with a soul, that must be nurtured and not taken for granted. And to live lightly, one day at a time, grateful for the chance to have a good time with someone so great. 

Enough therapy?

Today my therapist and I discussed whether I should stop having therapy, after more than a year of working together. I have been thinking about this recently because whereas I used to count the days between our sessions, but now as the appointment approaches I find myself thinking that I don't really need to go.

What has changed? I think the main development is that I feel I can cope much better with difficult situations and people than before. My moods are more even, my anxiety is almost gone, and my intrusive thoughts and memories are greatly reduced and not nearly as distressing.

It's not that I have "finished" anything - I am still healing from everything that happened and still have much work to do. But at least for now I can live in the present, and understand and take things as they are. I am more grounded, more realistic. Life as a whole feels much lighter, not so oppressive and dangerous, threatening.  I am no longer hostage to every passing thought or sight or experience. I have learnt that I canexercise choice over when to engage emotionally and when not to. 

Of course I am nervous that without therapy things could go awry. This could happen at any moment. What if my emotions start becoming volatile again, what if I have relationship problems and I am triggered into all the old places again, what if my ex starts acting up again and I become afraid....I could go on. But then my therapist cannot save me from life's knocks, from life itself. And I think now I am now more able to help and support myself - or I know where and how to access it. 

I have my friends, to whom I am closer than before recovery, largely because I am able to be more honest about myself and because I can listen and empathise better with them. I have a lot of resources - books and websites, blogs and so on, that I can read and get help from. 

Crucially I have SLAA. There is always a meeting I can go to, full of people looking honestly at themselves, bravely dealing with their difficulties, still alive and full of hope. I will keep going to meetings and doing the step work, because I need to for my recovery, but also because it allows me to stay in touch with my inner self. When I feel disconnected from myself, a meeting is the perfect remedy, better than therapy. It keeps me honest and non-judgemental of myself and others.  I am frankly in awe of many people in SLAA, I admire their strength and honesty, their willingness to share and to listen. It's like the very act of attending is an affirmation of humanity - yes, I am worth looking after, I deserve help, I deserve to get better, to heal and then to grow and thrive, and so do all these other people. 

I was fascinated at a recent meeting to hear people share about their relationship with their higher power. To an outsider it would have sounded odd, because the flexibility of the programme has when it comes to the definition of God/higher power is not immediately apparent.  You have to delve a bit deeper into the literature and talk to other members to find out how varied people's interpretation of this concept is. Everyone applies it in a slightly different way. I will write about this at a later date.

Getting back to my therapy, this last year has been eventful and much has changed. It's interesting to me that I feel strangely shy in front of my therapist, even though he must know me rather well by now. The sessions never felt like "home", they were always a temporary support, and I think I prefer this. It makes it easier - and in fact am exciting prospect - to let them go. 

My relationship with him has changed a lot. At the beginning I wanted him to protect me like a father figure, I wanted his approval and even some affection. But we spoke about this openly right at the start and after that it didn't bother me again. 

It's strange that I can't remember much of our sessions. It's like all the healing has been absorbed and assimilated in my brain resulting in an overall feeling of being better. A lot of tapping went on, and some EMDR, although not much, as far as I know.

Anyway, so it seems likely that I will stop therapy soon. This is exciting news and it feels like a big milestone. It means I am better, that I can look after myself - in theory. 

I still have a couple of sessions scheduled and hope to use those to help me with some of the memories and issues surrounding the abuse by my ex. The way it seizes me so completely when I have relationship problems now with my boyfriend is really quite disturbing.

Anyway, would love to hear from you if you have any thoughts or experiences to share. 

 

Nothing to lose

At the moment I am fortunate enough not to be in a crisis.  The situation with my ex has stabilised and I feel safe and supported. He has calmed down considerably and we have established a good routine to co-parent our child. His anger towards me is still there and bubbles to the surface often - but rather than fear for our safety I can mostly brush it off. His frequent attempts to control me are harder to handle because it feels like such an attack on my person, on my humanity. 

But again, I have learnt to handle my emotions around him better and not to let my mind spiral out of control with anxiety. 

My mental health has also improved. The wild mood swings are much, much reduced, and my anxiety - which came with a sort of parallel world of spooky shadows and terrifying creatures - has all but gone. 

There was a time I could barely tolerate being around my mother, even though I needed her desperately to help with my son and with my affairs, which I had abandoned when I became ill. She had not been supportive around the abuse, and appeared to side with my ex. This felt like an immense betrayal, and the rage and fear I felt towards her was overwhelming. I could not understand why she was throwing me to the lions, and coupled with my discoveries about my childhood in therapy, I felt I was living a nightmare. 

It's better now. I have not yet forgiven her for those times but she has sacrificed a lot for me and my son this past year, and I am able now to appreciate this more than before. 

Before, a few words from her could have me tumbling into an abyss of depression and distress that would take me days, weeks to recover from. A whole host of stuff would be triggered - memories from my childhood, teenage years, memories from the more recent past and the implications. 

Now her words no longer penetrate me so deeply. All that stuff is still there, but I can choose not to engage with it, not to stir it all up. I can say "not now, thanks" and walk away to get on with my day. I can also look at myself from the outside - where am

I right now? Can I hear my breathing? And I focus on the moment and how, right now, I am actually okay. 

I think these new abilities  have largely come from therapy, rather than SLAA. I have learnt that I am not at the mercy of my mind, my imagination. I can (mostly) turn it off and on. It is like a muscle I have to train, and I am still only at the beginning. 

Strangely I had to overcome some pride, some kind of 'sick person identity', to be able to slowly implement the new muscle, the handbrake, to stop the anxiety and wild thoughts. I had become used to being unwell, to being out of control and not taking responsibility for myself, and in a way this had become comfortable and familiar. Being well meant getting back to the real world and I wasn't sure I would be able to cope. Also my mind just didn't feel ready for this, it was like having to change gears and felt scary.  But once I jumped the first time, and then again and again, I saw that it was not difficult. I was lucky because I had excellent guidance, much support and I was educatin myself by reading voraciously, but most of all I had come to the realisation that I had nothing to lose by trying. 

Also, as I have mentioned before, I was and continue to be on a lot of medication, so that will also have helped.

I think SLAA provided me with the hope I needed that things would be alright. Contrary to group therapy at the hospital, there was at least as much sharing of success, gratitude and newfound happiness as there was of people's chaos, fear and distress. The members of the fellowship lead all sorts of lives. They are artists, businessmen and -women, medics, lawyers, journalists, students. Some are single or in relationships, many have children, and ages vary massively too. 

It showed me that someone with my kind of issues could carry on, and be happy and fulfilled again. 

Anyway, today I am incredibly grateful that I am not in a crisis. I am going to meet my friend from recovery Marilyn for lunch and we will no doubt talk about how drastically our lives have changed in just one year.