Feeling Abandoned

It is now five weeks since my last psychotherapy session and I still cannot sleep properly on a Thursday night.

I understood the reason for my not sleeping when I was actually going to therapy; I often started to become anxious on a Wednesday and that feeling just increased as the hours passed and by Thursday night I was often in a real state. Sometimes I managed two or three hours sleep, sometimes none, before I had to get myself ready to go to catch the bus to the hospital.

I can perhaps understand why I continued to have problems sleeping on Thursday nights for a couple of weeks, but to still be suffering in this way is starting to concern me.

The problem seems to be with the way that the therapy terminated. There seemed to be no proper ending. The resulting feeling of abandonment seems to have left me in a permanently depressed state where I find it difficult to do anything meaningful.

I seem to manage to pull myself together sufficiently to make the presentations that I am asked to do occasionally, but the recent cancellation of one of these, and the cancellation of the summer course that I was to be lecturing on, seems to have made the feeling of abandonment worse. I'm back to crying for long periods of time, finding it difficult to do anything that requires more than a minimal amount of concentration, and wondering why I bother carrying on with life.

I Will Not Panic; I Will Not Get Anxious

In less than 48 hours I will be setting off for my last psychotherapy session. I have often written on this blog how difficult I find it during the days before each session, though at the moment I am quite calm. But Friday morning may be a slightly different matter.

The termination of psychotherapy should mean the end of my sleepless Thursday nights but it also means the end of the one routine item in my otherwise empty life. Friday mornings have meant a regular opportunity to talk to another human being, and most importantly to be able to talk to someone who genuinely wants to know how I am rather than the question just being a platitude.

Yes, I have a couple of friends with whom I correspond by email on a daily basis, and both of them (and they know who they are) do much to encourage me and to help me get through my dark periods. But they are both many miles away and so actually seeing them and talking face to face is a rare thing.

I am telling myself that the psychotherapy has made a difference to me. It has helped me to see that it is not my fault that I am ill, that I am not responsible for how I feel, that things in my past have made it difficult for me to deal with how I am today. Medication helps with the panic and the anxiety, but it does not help with the loneliness and the empty feelings. Talking has helped with them, but I now have to see if I can cope with them on my own. And that is the most difficult part of depression to deal with; the isolation and emptiness. The end of therapy feels like I am being abandoned yet again.

One More Session To Go

Today was my penultimate psychotherapy session. It was difficult; in fact, it was very difficult. I know that I am not ready for it to end, but end it must because that is the way of things on the NHS. There is never enough of what is needed.

As a former manager myself (though not in the NHS) I am well aware of the necessity of management of some kind, but I wonder how much more could be done for the patients' benefit if the multiple levels of management and the ridiculous amount of paperwork, results tables, protocols, and sundry other government and management requirements were to disappear overnight.

Mental health has always been a poor relation. It is not glamorous, nor is it seen as being of significant importance to this country. Yet the fact is that approximately 25% of the population will suffer with mental health problems at some time in their life, and a significant proportion of the population is unable to work because of mental health problems means that is should be seen as important. It is likely that the proportions will rise over the next couple of years because of the global financial crisis which has resulted in so many losing their jobs and the uncertainty that so many others feel.

As with everything else, this government has promised to do something about mental health provisions and yet their solution is far in the future and a least cost option. There is much evidence to show that psychotherapy can do much to make a change to the lives of those with mental health problems, particularly depression. But it is necessary to ensure that the right sort of therapy is provided for those that need it; and it needs to be available from the start, not when the situation has become so bad that the sufferer cannot work and their life has fallen apart. The government plans for there to be 10,000 therapists offering CBT in the next few years, but the Layard Report which brought about this decision by the government actually said that 30,000 were needed and that was before the financial crisis which is likely to increase the number of those needing help.

And CBT is not the global panacea that many seem to think it is. I am sure that it does help some people, but what is not widely reported is the number of people who are made well for a few months but then regress and have to rejoin the waiting lists for treatment of some kind. There is no point in offering a treatment that encourages people to change their thinking about the here and now if it is the long-distant past that is the root cause of their problems.

I know that I have been lucky. I have been receiving psychodynamic psychotherapy for a year now and it has made a significant difference to me. I have started to regain some of my self-confidence, and my weekly appointments have meant that there has been a little bit of routine in my life which has helped me get some structure in my life. But I know that there is still much work to be done to deal with the problems that led to me becoming ill. I need to understand how things that happened to me long ago and of which I had no conscious knowledge can be put behind me and I need to be helped to move on with my life. However, that is not going to happen because next week I will be saying goodbye to my therapist and I will be left on my own. I am being abandoned. Not because I am 'cured' but because the resources are not there to help those who need help.