I've had a busy week and it's only Wednesday. Other people probably wouldn't see it as a busy week, but as I rarely leave the house other than for my weekly psychotherapy session, to have been out for prolonged periods on three consecutive days has been almost unheard of for a considerable time.
I've already written about Monday's activities, so here is an update on what has been happening over the last couple of days.
Yesterday saw a return to psychotherapy after a two-week break while my psychotherapist was on leave. I have always suffered with terrible anxiety before my psychotherapy sessions but over the last month or so I have found Tuesday mornings less of an ordeal. I still leave the house far too early for my 11.15am appointment, but being early for any appointment is not something that I am really concerned about. On arrival at the hospital I got myself a cup of tea from the kiosk and went outside to the garden to sit in the sun while I drank my tea.
It was very apparent that Spring has finally arrived in the hospital's garden. When I was last there the trees were still barely in bud and only a couple of daffodils had managed to force themselves into bloom. Yesterday, the trees were covered in fresh green leaves and in addition to there being many more daffodils, there were tulips and several shrubs in full bloom.
Eventually it was time for me to make my way up to the 4th floor for my appointment. At this moment I was still calm but the moment that I took a seat to await my psychotherapist calling me to his office, the anxiety started to begin. I had a few minutes wait, all the time willing myself to relax and being partly successful. But it was all wasted because the moment that my psychotherapist said hello and I walked into his office anxiety swept over me in painful waves. And as I sat it my usual chair my therapist was aware by my body language and the pained expression on my face what had just happened.
What was to follow was even more difficult to deal with. After a brief discussion of how I had been since I had last been for therapy, the intensive work began. The probing, the answering of questions, the raising of emotions and being encouraged not to suppress them as I have done for most of my life but to allow them to come out was painful both mentally and physically. It was a hard session yet at the end of it there was a vague sense of success in that I had allowed these feelings out rather than having used them as a weapon against myself.
The session ended with a brief discussion of my feelings about the assessment appointment that I was to have today to find out whether I am a suitable candidate for group psychotherapy. I said that I wasn't particularly concerned about the assessment as I had been through this process before, but that I was aware that some difficult things could come up and that I felt that I would be able to deal with them.
Today arrived and after a bad night with only a couple of hours sleep I was very anxious. I arrived for my appointment about half an hour early and having reported to the reception desk I sat in the waiting area and attempted to read to take my mind off what was to come. Eventually the psychologist with whom I was to have the appointment came to meet me and after saying hello and shaking hands we went to her office for the assessment to begin.
I had been sent a very long questionnaire to fill in in preparation for this appointment some weeks ago, and armed with this, and all the other records that the mental health trust has on me, the psychologist had a lot of information, so some of the most difficult things in my past did not need to be gone over again. There is no doubt that this was probably the less emotional assessment appointment that I have ever had, and while there were tears when I was asked about the circumstances of my husband's death and at a couple of other points in the 90-minute appointment, it was not the traumatic experience that the first assessment appointments had been just over two years ago.
The result of today is that I have been put on the waiting list for group psychotherapy and hopefully in a couple of month's time I will be invited back for a couple of appointments with the psychotherapist in charge of the group before actually joining the group for regular therapy.
Showing posts with label psychologist. Show all posts
Showing posts with label psychologist. Show all posts
Wednesday, 21 April 2010
Tuesday, 23 March 2010
Letting Rip
I rarely sleep well on Monday nights because I am usually getting anxious about psychotherapy on a Tuesday morning. Last night was different; I still didn't get much sleep but it was my own fault because I just kept knitting rather than going to bed as I should have done. When the alarm went this morning I didn't want to get out of bed, but I did.
I was feeling very depressed, but I had been expecting that and was prepared for it. No matter how hard you try to not think about significant anniversaries they always creep into your brain insidiously and you just have to learn to cope with it. Today would have been my husband's birthday; he would have been 61. But even though I was feeling low, I wasn't feeling anxious. This was a first for me and I thought that I had the anxiety thing cracked. I was wrong; oh boy, was I wrong.
I got up to the 4th floor, pushed the buzzer, was admitted into the psychological services department, took off my coat and sat down on one of the chairs in the waiting area. And within seconds the anxiety started to build up. By the time my psychologist called me to his room I was suffering gut-wrenching spasms caused by the anxiety.
As I have mentioned before, the aim of this therapy is to stop me turning my anger in on myself; I need to express my anger, when it occurs, so that I no longer suppress it and cause it to fester inside me. As the weeks of therapy have progressed, I have had to learn to stop doing what I have done for most of my life. It isn't easy. Not only because I am having to unlearn the strategies that I have developed to prevent my anger spilling out onto other people, but also because my psychologist is such a nice person.
Today things went better than they have ever done before. It was not long before I was feeling angry; unfortunately I was more angry at myself for getting angry, than I was with my psychologist. Okay, it wasn't exactly what we were after, but it was a start. But things got better and it wasn't long before I was shouting at my therapist, and at one point I was ready to leap out of my chair, cross the office and hit him.
At this point, J decided that things had gone far enough for today, and we finished the session by talking about how I felt, what had been going through my mind as these actions occurred and why it was so important for me to stop the self-destructive practice of internalizing my anger. I told him that I felt really drained, and he replied that this was good because it showed that I had been engaging in the therapy properly and it was finally starting to show results.
I came back home and I could so easily have gone to bed to sleep. But I didn't, I want to sleep tonight, and I had an appointment with my GP this evening so I needed to make sure that I didn't miss that. Tonight I am going to have an early night, and hope that I can sleep the night through. However, saying I will have an early night is easy, actually making sure that it happens is a different thing completely.
I was feeling very depressed, but I had been expecting that and was prepared for it. No matter how hard you try to not think about significant anniversaries they always creep into your brain insidiously and you just have to learn to cope with it. Today would have been my husband's birthday; he would have been 61. But even though I was feeling low, I wasn't feeling anxious. This was a first for me and I thought that I had the anxiety thing cracked. I was wrong; oh boy, was I wrong.
I got up to the 4th floor, pushed the buzzer, was admitted into the psychological services department, took off my coat and sat down on one of the chairs in the waiting area. And within seconds the anxiety started to build up. By the time my psychologist called me to his room I was suffering gut-wrenching spasms caused by the anxiety.
As I have mentioned before, the aim of this therapy is to stop me turning my anger in on myself; I need to express my anger, when it occurs, so that I no longer suppress it and cause it to fester inside me. As the weeks of therapy have progressed, I have had to learn to stop doing what I have done for most of my life. It isn't easy. Not only because I am having to unlearn the strategies that I have developed to prevent my anger spilling out onto other people, but also because my psychologist is such a nice person.
Today things went better than they have ever done before. It was not long before I was feeling angry; unfortunately I was more angry at myself for getting angry, than I was with my psychologist. Okay, it wasn't exactly what we were after, but it was a start. But things got better and it wasn't long before I was shouting at my therapist, and at one point I was ready to leap out of my chair, cross the office and hit him.
At this point, J decided that things had gone far enough for today, and we finished the session by talking about how I felt, what had been going through my mind as these actions occurred and why it was so important for me to stop the self-destructive practice of internalizing my anger. I told him that I felt really drained, and he replied that this was good because it showed that I had been engaging in the therapy properly and it was finally starting to show results.
I came back home and I could so easily have gone to bed to sleep. But I didn't, I want to sleep tonight, and I had an appointment with my GP this evening so I needed to make sure that I didn't miss that. Tonight I am going to have an early night, and hope that I can sleep the night through. However, saying I will have an early night is easy, actually making sure that it happens is a different thing completely.
Tuesday, 9 March 2010
If It's Tuesday ...
... it must be psychotherapy. So this means that this crazy mixed up lady doesn't sleep well on a Monday night and wakes Tuesday morning with anxiety that makes doing even simple things time consuming.
I never eat breakfast on a Tuesday morning because I feel sick at the thought of it, just as I used to on a Friday morning when I was having psychotherapy before. I start to panic about making sure that I leave the house with plenty of time to make my appointment, allowing for problems with getting a bus that never materialise, and consequently arriving at the hospital long before my appointment time. I usually get myself a cup of tea at the little kiosk on the ground floor of the hospital, and if it isn't too cold or raining too hard, I make my way out to the hospital's little garden to drink my tea and have a cigarette.
The garden can be a tranquil place to pass the time for both patients and visitors. There are numerous squirrels that can be seen racing along the fences and onto the roof of the covered area in the far corner of the garden. A robin guards his territory from all comers and will ferociously attack any bird, no matter their size, if he thinks that they have come to take over his home ground. Sometimes the tranquility is broken by the squawking of parakeets that have become indigenous to the area.
Sometimes, and this morning was one such occasion, the tranquility is broken by shouting from the exercise area provided for the patients from the psychiatric intensive care unit; it is separated from the garden for the main part of the psychiatric hospital by the wooden fence of the hospital garden and the high wire fence around the exercise area. Today there was just one patient in the exercise area when I entered the garden and she was making sure that people knew she was there. The area behind the psychiatric and general hospitals is a park and is used as a short-cut by many people particularly those going to the hospitals from the local station and by others trying to shorten their journey to the local college and to a nearby comprehensive school. The patient in the exercise area spent about 10 minutes or more shouting to anybody that she could see, begging them to set her free or telling them to study hard. Eventually she was called back in from the area and quiet was again restored to the garden.
After having to race up to the fourth floor last week (which isn't easy for someone with an arthritic hip which plays up terribly in the cold) I was constantly looking at my watch this morning to make sure that I wasn't late. The consequence of this was that I arrived at the fourth floor 15 minutes early and then had to sit waiting for my psychologist to come to collect me and take me to his office. That meant 15 minutes for the calmness that I had manage to achieve sitting in the garden to disappear and 15 minutes for anxiety to take over; stomach-wrenching anxiety that was physically painful.
Today's session seemed to pass in a flash. My feelings changed from minute to minute; it was hard, it was painful, it was emotional, it was thought-provoking, I was frightened, I was anxious, I was angry. We talked about whether I saw it as a form of torture, for that is often what the expression on my face as I enter my psychologist's office seems to indicate. We talked about whether I felt that the therapy was working and we talked about why I find it so hard to stop turning my anger against myself.
There were moments this morning when I felt so angry that I felt as though I was going to explode, and one moment when I literally saw red. Yet, on leaving the hospital this morning I felt calm. I felt that although the session had been hard work that I had tried to engage in that work in a way that meant that I wasn't punishing myself. And at the end of it I had a sense of well-being that I don't think that I have ever felt before.
I'm sure that when next Tuesday arrives I shall be anxious as usual, but I also know that it is possible for me to work at the therapy and for it to help me to stop trying to martyr myself by directing feelings at myself when they should rightly be directed elsewhere.
I never eat breakfast on a Tuesday morning because I feel sick at the thought of it, just as I used to on a Friday morning when I was having psychotherapy before. I start to panic about making sure that I leave the house with plenty of time to make my appointment, allowing for problems with getting a bus that never materialise, and consequently arriving at the hospital long before my appointment time. I usually get myself a cup of tea at the little kiosk on the ground floor of the hospital, and if it isn't too cold or raining too hard, I make my way out to the hospital's little garden to drink my tea and have a cigarette.
The garden can be a tranquil place to pass the time for both patients and visitors. There are numerous squirrels that can be seen racing along the fences and onto the roof of the covered area in the far corner of the garden. A robin guards his territory from all comers and will ferociously attack any bird, no matter their size, if he thinks that they have come to take over his home ground. Sometimes the tranquility is broken by the squawking of parakeets that have become indigenous to the area.
Sometimes, and this morning was one such occasion, the tranquility is broken by shouting from the exercise area provided for the patients from the psychiatric intensive care unit; it is separated from the garden for the main part of the psychiatric hospital by the wooden fence of the hospital garden and the high wire fence around the exercise area. Today there was just one patient in the exercise area when I entered the garden and she was making sure that people knew she was there. The area behind the psychiatric and general hospitals is a park and is used as a short-cut by many people particularly those going to the hospitals from the local station and by others trying to shorten their journey to the local college and to a nearby comprehensive school. The patient in the exercise area spent about 10 minutes or more shouting to anybody that she could see, begging them to set her free or telling them to study hard. Eventually she was called back in from the area and quiet was again restored to the garden.
After having to race up to the fourth floor last week (which isn't easy for someone with an arthritic hip which plays up terribly in the cold) I was constantly looking at my watch this morning to make sure that I wasn't late. The consequence of this was that I arrived at the fourth floor 15 minutes early and then had to sit waiting for my psychologist to come to collect me and take me to his office. That meant 15 minutes for the calmness that I had manage to achieve sitting in the garden to disappear and 15 minutes for anxiety to take over; stomach-wrenching anxiety that was physically painful.
Today's session seemed to pass in a flash. My feelings changed from minute to minute; it was hard, it was painful, it was emotional, it was thought-provoking, I was frightened, I was anxious, I was angry. We talked about whether I saw it as a form of torture, for that is often what the expression on my face as I enter my psychologist's office seems to indicate. We talked about whether I felt that the therapy was working and we talked about why I find it so hard to stop turning my anger against myself.
There were moments this morning when I felt so angry that I felt as though I was going to explode, and one moment when I literally saw red. Yet, on leaving the hospital this morning I felt calm. I felt that although the session had been hard work that I had tried to engage in that work in a way that meant that I wasn't punishing myself. And at the end of it I had a sense of well-being that I don't think that I have ever felt before.
I'm sure that when next Tuesday arrives I shall be anxious as usual, but I also know that it is possible for me to work at the therapy and for it to help me to stop trying to martyr myself by directing feelings at myself when they should rightly be directed elsewhere.
Tuesday, 26 January 2010
Now All I have To Do Is Wait
Job interviews are horrible but waiting to hear whether you have got the job or not is probably even worse.
I managed to get up when the alarm went this morning although I would have loved to go back to sleep, get myself ready, and then leave the house in the time frame that I had set for myself. It seemed very strange getting myself dressed in a suit for the first time in about four years and I felt the cold as soon as I left the house to walk to the bus stop. During this cold winter I have been wearing thick tights and thick trousers on my bottom half and a T-shirt, jumper, and fleece on my top half and on top of all that wearing a nice thick padded jacket when I went out of the house. This morning it was just a blouse with my suit, although I did have some thickish tights on under the trousers, and my padded jacket. I forgot to pick up my gloves as I left the house so it didn't take long for my hands to get really cold and waiting for the bus, the cold really got to my core.
I knew the way to the GP practice where the interviews were being held having looked at the Transport for London website, but I find that it can still be very difficult to judge how long it is going to take you to walk from the bus stop to wherever you are aiming for. As it turned out it didn't take as long as I thought to walk that last bit of the way and I arrived at the practice building at just after 8.30am for my 9am interview. As usual I was there early, and after having reported to the reception, explained that I was there for an interview and then taken a seat in the waiting room, the extra time did mean that I could start to thaw out a bit before I was escorted upstairs by 'B' to the room where the interviews were being conducted.
As we climbed the stairs, 'B' told me that there were a couple of problems. The first was that 'M' who was supposed to be doing the interviews with him (she was from the PCT) was unable to be present so he had seconded a member of staff from the practice to be the second interviewer. that didn't seem to be much of a problem to me. The second problem could have been far more of a concern. 'B' said, "Have you brought your presentation on a memory stick, by any chance?" Well, of course I had. Didn't I say that I was a belt and braces person the other day? I was able to reply in the affirmative and 'B' was not at all surprised because he knows that I usually have my presentation on a memory stick when we go anywhere, even if we had already emailed them to wherever we were doing our double act.
The interview involved lots of questions, but then that is obvious. They ranged from what was your last/current job, what did you enjoy about it most and what did you like least. These were pretty easy for me seeing as I have really had only one job during my working life because I did the same thing both in the RAF and the Civil Service. Then the questions started about the job that I was being interviewed for. I have to be honest and admit that the questions probably played to my strengths and even the one about what I would do if I was at a practice and all the GPs except one were in favour of giving their patients online access to their medical records but as it was the senior partner who was against it they wouldn't say anything to try to persuade him to change his mind. This is where the gentle art of persuasion comes into play and I said as much. But if such an occasion was to arise, the final thing that can be used to persuade the recalcitrant senior partner is the fact that patients actually have a legal right to see their medical records and it would actually be easier to allow this to happen online than it would be to have patients regularly turning up at the practice to see them.
After about 20 minutes of questions I was asked to go through my presentation. This was the easy bit as far as I was concerned because I was only having to present to two people something that was a lot simpler than I would normally have to present. The fact that I am actually quite passionate about the subject probably helps, so at the end of it all I was reasonably pleased with how things had gone. As is normal at the end of an interview, I was asked if I had any questions for the interviewers, but I couldn't think of anything at the time, and I'm not sure that even now I can think of anything that I could have asked. The interview ended with me being asked if I was to get the job when I would be able to start. That was the easiest question of the lot. I said that I had psychotherapy on a Tuesday morning and that I was already booked to do the lecture at one of the London universities at the beginning of March, but really I could start any time that was acceptable to both parties.
'B' accompanied me back downstairs to the waiting room and we chatted a little about our visit to the House of Commons next week for the round table discussions. We still have not heard anything more about this so I may have to contact the Shadow Health Secretary's research assistant for details of where and who we have to report to.
After leaving the practice building, I made my way to the bus stop so that I could get the bus to the hospital for my psychotherapy appointment. I had time for a cup of tea before my appointment and I really enjoyed it as I was rather dry in the mouth after all that talking and nervousness. When my psychologist came to collect me for the session I commented on being a bit overdressed (in comparison to how I am normally dressed for my appointments) because of having just attended a job interview. When I saw him last week I hadn't received the invitation to the interview so he didn't know anything about it.
What was really great about today's session was that instead of dealing with my emotions and getting me to let them out as is the normal pattern of the session, we talked about how the interview had gone, about the fact that it is only a 6-month contract and if I got the job how I would feel when it was over, about my previous psychotherapy and how I had felt when it ended, and lots more things about my life and my feelings of abandonment. It was a good session and I think that it was just what I needed after the interview. I think that it allowed my psychologist to learn a lot more about me and how I can best be helped. He definitely feels that I need to be referred back to the main hospital where I had the earlier psychotherapy because I need long-term psychotherapy and if this is successful that it is likely to reduce my relapses into depression and should mean that I will never need to be be hospitalised again.
I guess that the only way that I can finish this post is to say a very big thank you to all of you who have sent me good luck wishes for the interview. I truly appreciate your comments and wishes and it only remains for me to say what a truly nice bunch of people bloggers are. I'll let you know whether I have got the job as soon as I hear anything.
I managed to get up when the alarm went this morning although I would have loved to go back to sleep, get myself ready, and then leave the house in the time frame that I had set for myself. It seemed very strange getting myself dressed in a suit for the first time in about four years and I felt the cold as soon as I left the house to walk to the bus stop. During this cold winter I have been wearing thick tights and thick trousers on my bottom half and a T-shirt, jumper, and fleece on my top half and on top of all that wearing a nice thick padded jacket when I went out of the house. This morning it was just a blouse with my suit, although I did have some thickish tights on under the trousers, and my padded jacket. I forgot to pick up my gloves as I left the house so it didn't take long for my hands to get really cold and waiting for the bus, the cold really got to my core.
I knew the way to the GP practice where the interviews were being held having looked at the Transport for London website, but I find that it can still be very difficult to judge how long it is going to take you to walk from the bus stop to wherever you are aiming for. As it turned out it didn't take as long as I thought to walk that last bit of the way and I arrived at the practice building at just after 8.30am for my 9am interview. As usual I was there early, and after having reported to the reception, explained that I was there for an interview and then taken a seat in the waiting room, the extra time did mean that I could start to thaw out a bit before I was escorted upstairs by 'B' to the room where the interviews were being conducted.
As we climbed the stairs, 'B' told me that there were a couple of problems. The first was that 'M' who was supposed to be doing the interviews with him (she was from the PCT) was unable to be present so he had seconded a member of staff from the practice to be the second interviewer. that didn't seem to be much of a problem to me. The second problem could have been far more of a concern. 'B' said, "Have you brought your presentation on a memory stick, by any chance?" Well, of course I had. Didn't I say that I was a belt and braces person the other day? I was able to reply in the affirmative and 'B' was not at all surprised because he knows that I usually have my presentation on a memory stick when we go anywhere, even if we had already emailed them to wherever we were doing our double act.
The interview involved lots of questions, but then that is obvious. They ranged from what was your last/current job, what did you enjoy about it most and what did you like least. These were pretty easy for me seeing as I have really had only one job during my working life because I did the same thing both in the RAF and the Civil Service. Then the questions started about the job that I was being interviewed for. I have to be honest and admit that the questions probably played to my strengths and even the one about what I would do if I was at a practice and all the GPs except one were in favour of giving their patients online access to their medical records but as it was the senior partner who was against it they wouldn't say anything to try to persuade him to change his mind. This is where the gentle art of persuasion comes into play and I said as much. But if such an occasion was to arise, the final thing that can be used to persuade the recalcitrant senior partner is the fact that patients actually have a legal right to see their medical records and it would actually be easier to allow this to happen online than it would be to have patients regularly turning up at the practice to see them.
After about 20 minutes of questions I was asked to go through my presentation. This was the easy bit as far as I was concerned because I was only having to present to two people something that was a lot simpler than I would normally have to present. The fact that I am actually quite passionate about the subject probably helps, so at the end of it all I was reasonably pleased with how things had gone. As is normal at the end of an interview, I was asked if I had any questions for the interviewers, but I couldn't think of anything at the time, and I'm not sure that even now I can think of anything that I could have asked. The interview ended with me being asked if I was to get the job when I would be able to start. That was the easiest question of the lot. I said that I had psychotherapy on a Tuesday morning and that I was already booked to do the lecture at one of the London universities at the beginning of March, but really I could start any time that was acceptable to both parties.
'B' accompanied me back downstairs to the waiting room and we chatted a little about our visit to the House of Commons next week for the round table discussions. We still have not heard anything more about this so I may have to contact the Shadow Health Secretary's research assistant for details of where and who we have to report to.
After leaving the practice building, I made my way to the bus stop so that I could get the bus to the hospital for my psychotherapy appointment. I had time for a cup of tea before my appointment and I really enjoyed it as I was rather dry in the mouth after all that talking and nervousness. When my psychologist came to collect me for the session I commented on being a bit overdressed (in comparison to how I am normally dressed for my appointments) because of having just attended a job interview. When I saw him last week I hadn't received the invitation to the interview so he didn't know anything about it.
What was really great about today's session was that instead of dealing with my emotions and getting me to let them out as is the normal pattern of the session, we talked about how the interview had gone, about the fact that it is only a 6-month contract and if I got the job how I would feel when it was over, about my previous psychotherapy and how I had felt when it ended, and lots more things about my life and my feelings of abandonment. It was a good session and I think that it was just what I needed after the interview. I think that it allowed my psychologist to learn a lot more about me and how I can best be helped. He definitely feels that I need to be referred back to the main hospital where I had the earlier psychotherapy because I need long-term psychotherapy and if this is successful that it is likely to reduce my relapses into depression and should mean that I will never need to be be hospitalised again.
I guess that the only way that I can finish this post is to say a very big thank you to all of you who have sent me good luck wishes for the interview. I truly appreciate your comments and wishes and it only remains for me to say what a truly nice bunch of people bloggers are. I'll let you know whether I have got the job as soon as I hear anything.
Monday, 18 January 2010
Anxiety Relieved
My walk to the bus stop this morning was not alone as would be the norm; just as I stepped off the drive my next-door neighbour (actually she and her husband and kids live behind my house because I live on a corner of the road and their house is in the road that joins my road) came out of the house on her way to the local newsagent to pick up a newspaper. It was nice to be able to have a chat with someone as I walked along the road. I was lucky this morning (or unlucky depending which way you look at it) because the first of the two buses that I have to catch to get to the CMHT arrived almost immediately and when I changed buses I had only to wait for a minute after getting off the first one for the second to arrive. The net result of this was that I arrived 35 minutes early for my appointment with the HTT.
I didn't see the usual nurse this morning although the one I saw today I have seen before. He is much better than the nurse I normally see at getting the information that they need to ensure that I am keeping well and it doesn't seem like answering questions by rote. It was actually much more like having a proper conversation. This meant that I probably gave more information because we talked around the subject. They are very pleased with my progress and I was told that I should give myself a pat on the back for all that I have achieved since leaving hospital.
When the appointment was over (I was in there for an hour and yet it seemed like five minutes) I walked down the road to catch the bus to take me to the hospital so that I could attend my psychotherapy session. By the time that I went into the psychologist's office I was suffering terrible anxiety and I really didn't want to be there. We got to work immediately and, though it was very difficult for me, it was a good session. I know it was a good session because at the end of it I felt as though I had been put through a wringer, but as I walked along the road to the shops after leaving the hospital I realised that all the anxiety had gone and I was much more relaxed. It really is just the anticipation of what I know is going to happen that makes me so anxious.
By the time that I got to the main shopping area I realised that I was very hungry; it was about 1.15pm and I hadn't had anything to eat since last night so I got myself some lunch and then did the little bit of shopping that I needed and then headed for the bus stop to get the bus home. The nice postman left my parcel at the back door so I don't have to go to the sorting office to collect it tomorrow so I now have a couple of knitting books and three new games for my Nintendo DSi to look at this afternoon.
After a night with only a couple of hours sleep and the rigours of the therapy session I am going to relax for the rest of the day. I shall probably try for an early night tonight, I will definitely take my sleep medication, but before that happens I am going to look at my new books and play my new games. Then tomorrow I must sit down and write the short story for my final assignment on my OU course.
I didn't see the usual nurse this morning although the one I saw today I have seen before. He is much better than the nurse I normally see at getting the information that they need to ensure that I am keeping well and it doesn't seem like answering questions by rote. It was actually much more like having a proper conversation. This meant that I probably gave more information because we talked around the subject. They are very pleased with my progress and I was told that I should give myself a pat on the back for all that I have achieved since leaving hospital.
When the appointment was over (I was in there for an hour and yet it seemed like five minutes) I walked down the road to catch the bus to take me to the hospital so that I could attend my psychotherapy session. By the time that I went into the psychologist's office I was suffering terrible anxiety and I really didn't want to be there. We got to work immediately and, though it was very difficult for me, it was a good session. I know it was a good session because at the end of it I felt as though I had been put through a wringer, but as I walked along the road to the shops after leaving the hospital I realised that all the anxiety had gone and I was much more relaxed. It really is just the anticipation of what I know is going to happen that makes me so anxious.
By the time that I got to the main shopping area I realised that I was very hungry; it was about 1.15pm and I hadn't had anything to eat since last night so I got myself some lunch and then did the little bit of shopping that I needed and then headed for the bus stop to get the bus home. The nice postman left my parcel at the back door so I don't have to go to the sorting office to collect it tomorrow so I now have a couple of knitting books and three new games for my Nintendo DSi to look at this afternoon.
After a night with only a couple of hours sleep and the rigours of the therapy session I am going to relax for the rest of the day. I shall probably try for an early night tonight, I will definitely take my sleep medication, but before that happens I am going to look at my new books and play my new games. Then tomorrow I must sit down and write the short story for my final assignment on my OU course.
High Anxiety (Apologies To Mel Brooks)
It's been another night with little sleep. I didn't dare take the sleep medication because I had to be up early this morning to go to see both the HTT and my psychologist. I know why I didn't sleep; it was the overwhelming feeling of anxiety that started to come over me yesterday evening. This morning I am like a coiled spring and I feel that I am likely to explode at any moment.
This complete irrationality about talking about how I have been feeling over the last couple of weeks to the HTT ( I chickened out of last Monday's visit) and what is to come later when I am with psychologist is what makes my mental health problems so draining on me both physically and emotionally.
The silliest thing about the state which I find myself in is that I know exactly what is going to happen. It's not fear of the unknown that worries me but anticipation of what is about to occur.
This complete irrationality about talking about how I have been feeling over the last couple of weeks to the HTT ( I chickened out of last Monday's visit) and what is to come later when I am with psychologist is what makes my mental health problems so draining on me both physically and emotionally.
The silliest thing about the state which I find myself in is that I know exactly what is going to happen. It's not fear of the unknown that worries me but anticipation of what is about to occur.
Tuesday, 12 January 2010
It's All About Psychology
Much as I am always very anxious before going for psychotherapy I know that it is the right thing to do. This morning I didn't want to get out of bed but I managed to get myself up and out of the house in plenty of time to be able to catch the bus to the hospital. I walked along to bus stop somewhat relieved that the thaw has continued and that much of the snow has now disappeared or turned to dirty grey slush so that there was no chance of me slipping over today.
I arrived at the hospital early (as usual but I can't help it) so got myself a cup of tea from the little kiosk and sat outside in the garden to drink it while I had a cigarette. It might have been cold outside but it was quite pleasant watching the squirrels running backwards and forwards along the fence. When it was time for my appointment, I made my way indoors and headed for the lifts. There are two lifts but only one of them goes to the fourth floor where the psychological therapies department is situated. I usually have to wait ages for the lift to arrive but this morning it was actually down at the ground floor when I pressed the button for it and the door opened immediately. It was straight up to the top of the building and into the department to await my psychologist.
Last week's session was different to normal in that we spent the whole session talking about how the devastating news about Mr Smiley had affected me. It was nice to be able to talk to someone about it and not just have it whirling about in my brain. This week, however, it was back to the usual work in the session and all that entails. I have to steel myself for what is to come and the effect that it will have on me and it is making a difference but I know that there is a long way to go yet.
We work at my emotions and in trying to stop me putting a lid on them all the time. I learnt at a young age that I had a temper and that I was likely to want to hit out if I got angry. The problem is that I have now been controlling these urges for so long that it is difficult to express them and this is doing me damage. It seems strange to have someone who is actually a very nice person deliberately trying to make me angry. This morning there were a couple of occasions where I could feel the anger rising in me to such an extent that it was causing me to shake as the emotion was overtaking me and for it to cause spasms in my body as the anxiety of the situation overcame me.
While I was in hospital I got angry and frustrated on a number of occasions and the only way that I could deal with it was to sit and scratch at my hands. The problem was that I kept scratching at the skin on the back of my hands until I had removed patches of it and I ended up with horrible areas of bleeding. Some of these got infected, somewhat unsurprisingly, and it took a long time for them to heal up. Even now the areas are apparent, particularly so when it is cold, so they are obvious at the moment as I sit typing this post.
As each week passes I find it easier to feel anger during the therapy sessions and I am slower to put a lid on it and bring myself under control. It may seem a strange thing to be trying to achieve but it is considered important that I should stop trying to keep myself under control as it is one of the things that is making it so much harder for me to deal with the depression. But it's very difficult to change the habits of a lifetime and learn new behaviour to a situation.
At the end of the session we talked about how much longer these sessions should carry on for. My psychologist is proposing that we carry on until Easter with these one-to-one sessions and he is going to refer me back to the psychotherapy services at the headquarters of the mental health trust (where I have already had a year of psychotherapy) for further long-term therapy. He is not sure whether this should be on a one-to-one basis or whether group therapy would be better. It will undoubtedly mean further assessment appointments to allow the decision to be made.
I was asked if I could change my appointment for next week to Monday at midday. This will actually suit me very well as it means that I can see the HTT at 10am and then instead of going home, head for the hospital for psychotherapy. I will be getting all of the difficult things over with in one day and then have the rest of the week to do whatever I want.
I arrived at the hospital early (as usual but I can't help it) so got myself a cup of tea from the little kiosk and sat outside in the garden to drink it while I had a cigarette. It might have been cold outside but it was quite pleasant watching the squirrels running backwards and forwards along the fence. When it was time for my appointment, I made my way indoors and headed for the lifts. There are two lifts but only one of them goes to the fourth floor where the psychological therapies department is situated. I usually have to wait ages for the lift to arrive but this morning it was actually down at the ground floor when I pressed the button for it and the door opened immediately. It was straight up to the top of the building and into the department to await my psychologist.
Last week's session was different to normal in that we spent the whole session talking about how the devastating news about Mr Smiley had affected me. It was nice to be able to talk to someone about it and not just have it whirling about in my brain. This week, however, it was back to the usual work in the session and all that entails. I have to steel myself for what is to come and the effect that it will have on me and it is making a difference but I know that there is a long way to go yet.
We work at my emotions and in trying to stop me putting a lid on them all the time. I learnt at a young age that I had a temper and that I was likely to want to hit out if I got angry. The problem is that I have now been controlling these urges for so long that it is difficult to express them and this is doing me damage. It seems strange to have someone who is actually a very nice person deliberately trying to make me angry. This morning there were a couple of occasions where I could feel the anger rising in me to such an extent that it was causing me to shake as the emotion was overtaking me and for it to cause spasms in my body as the anxiety of the situation overcame me.
While I was in hospital I got angry and frustrated on a number of occasions and the only way that I could deal with it was to sit and scratch at my hands. The problem was that I kept scratching at the skin on the back of my hands until I had removed patches of it and I ended up with horrible areas of bleeding. Some of these got infected, somewhat unsurprisingly, and it took a long time for them to heal up. Even now the areas are apparent, particularly so when it is cold, so they are obvious at the moment as I sit typing this post.
As each week passes I find it easier to feel anger during the therapy sessions and I am slower to put a lid on it and bring myself under control. It may seem a strange thing to be trying to achieve but it is considered important that I should stop trying to keep myself under control as it is one of the things that is making it so much harder for me to deal with the depression. But it's very difficult to change the habits of a lifetime and learn new behaviour to a situation.
At the end of the session we talked about how much longer these sessions should carry on for. My psychologist is proposing that we carry on until Easter with these one-to-one sessions and he is going to refer me back to the psychotherapy services at the headquarters of the mental health trust (where I have already had a year of psychotherapy) for further long-term therapy. He is not sure whether this should be on a one-to-one basis or whether group therapy would be better. It will undoubtedly mean further assessment appointments to allow the decision to be made.
I was asked if I could change my appointment for next week to Monday at midday. This will actually suit me very well as it means that I can see the HTT at 10am and then instead of going home, head for the hospital for psychotherapy. I will be getting all of the difficult things over with in one day and then have the rest of the week to do whatever I want.
Monday, 11 January 2010
A Bit Of A Thaw
I eventually managed to get out to get my parcels from the local sorting office this morning. I needed to get some food too, so I couldn't put it off any longer. I knew that it was still cold out so I made sure that I was well wrapped up and that I wore a hat and some gloves and equipped with my shopping bag and walking stick I set out. Most of the snow at the back of the house had gone but there was still much on the road and pavements at the side of the house.
As I stepped off the drive onto the pavement I put my foot down somewhat gingerly but I needn't have worried. The surface that last week had been so slippery was today quite soft. There had been a little more snow over the weekend but the real reason that it was much safer underfoot was the fact that the snow was actually melting. We are having a bit of a thaw at the moment and even though it is still very cold it is possible that by the end of the week most of the snow on the pavements will have disappeared.
I made it to the sorting office without a hint of a slip and then made my way to the supermarket for life's essentials. I now have bread and milk as well as a few other bits and pieces and I should be fine until the end of the week now. I decided to travel as much of the way home as I could by bus because the shopping was quite heavy and I really didn't want to come a cropper if I did mange to find a patch of icy pavement. In the end I made it home quite safely and once indoors I started to warm up a little.
I managed to get to sleep last night without the aid of medication and somewhat unbelievably actually managed to sleep in this morning too. I was supposed to go to see the HTT this morning at 10am, but I was still asleep then. I eventually woke at about 10.30 and knowing that I had other things to do that were far more important than going to see the HTT I decided to phone them to apologise for not being there owing to my having overslept. I had a brief chat and when asked when I wanted to go to see them I persuaded them that as I had a lot to do this week, especially having to get my assignment in to my tutor by lunchtime on Friday, that I not call in this week but go to see them next Monday. This was accepted by them and so I have a reprieve for this week.
Tomorrow I am off to see the psychologist again and I am already beginning to get anxious about it. Last week's session was less psychotherapy and more an opportunity to talk about how the news about Mr Smiley has affected me. Tomorrow it will be back to the real work and we will also be discussing how many more sessions I will be having and whether I am to be referred for long-term psychotherapy. I believe that this is quite likely, but the fact that I am being referred by one of the mental health trusts psychologists rather than by my GP will hopefully mean that I don't have to wait too long for the therapy to start.
Now I have to decide what I am going to do for the rest of the day. Do I have a go at writing the 1500-word story for my assignment? Or do I sit and do some knitting? Or should I sit down to write another post in the Tackling the Mental Health Minefield series. Making decisions is very difficult at the moment.
As I stepped off the drive onto the pavement I put my foot down somewhat gingerly but I needn't have worried. The surface that last week had been so slippery was today quite soft. There had been a little more snow over the weekend but the real reason that it was much safer underfoot was the fact that the snow was actually melting. We are having a bit of a thaw at the moment and even though it is still very cold it is possible that by the end of the week most of the snow on the pavements will have disappeared.
I made it to the sorting office without a hint of a slip and then made my way to the supermarket for life's essentials. I now have bread and milk as well as a few other bits and pieces and I should be fine until the end of the week now. I decided to travel as much of the way home as I could by bus because the shopping was quite heavy and I really didn't want to come a cropper if I did mange to find a patch of icy pavement. In the end I made it home quite safely and once indoors I started to warm up a little.
I managed to get to sleep last night without the aid of medication and somewhat unbelievably actually managed to sleep in this morning too. I was supposed to go to see the HTT this morning at 10am, but I was still asleep then. I eventually woke at about 10.30 and knowing that I had other things to do that were far more important than going to see the HTT I decided to phone them to apologise for not being there owing to my having overslept. I had a brief chat and when asked when I wanted to go to see them I persuaded them that as I had a lot to do this week, especially having to get my assignment in to my tutor by lunchtime on Friday, that I not call in this week but go to see them next Monday. This was accepted by them and so I have a reprieve for this week.
Tomorrow I am off to see the psychologist again and I am already beginning to get anxious about it. Last week's session was less psychotherapy and more an opportunity to talk about how the news about Mr Smiley has affected me. Tomorrow it will be back to the real work and we will also be discussing how many more sessions I will be having and whether I am to be referred for long-term psychotherapy. I believe that this is quite likely, but the fact that I am being referred by one of the mental health trusts psychologists rather than by my GP will hopefully mean that I don't have to wait too long for the therapy to start.
Now I have to decide what I am going to do for the rest of the day. Do I have a go at writing the 1500-word story for my assignment? Or do I sit and do some knitting? Or should I sit down to write another post in the Tackling the Mental Health Minefield series. Making decisions is very difficult at the moment.
Wednesday, 9 December 2009
A Nice Crispy Cos
After yesterday's session with the psychologist I felt like a limp lettuce. I managed to last until 10pm but then I decided that bed was definitely the best place for me. I fell asleep within minutes of my head hitting the pillow and slept through the whole night, not waking until about 7.15am. I got up, did a few bits and pieces, took my medication, switched on the computer to deal with any emails that had come in and wrote an email to Mr Smiley. By then it was about 9.30am and I couldn't keep my eyes open. So I went back to bed and fell asleep immediately not waking again until about 1.30pm.
How do I feel now? Pretty good really. My mind seems to be working reasonably well although I haven't managed to do any work on my TMA. So tomorrow I will get up early and head to library and I will stay there until I have written my three short stories (each 500 words), typed them up and sent the TMA using the OU's eTMA system.
Today I am not a limp lettuce; today I'm like a nice crispy cos.
How do I feel now? Pretty good really. My mind seems to be working reasonably well although I haven't managed to do any work on my TMA. So tomorrow I will get up early and head to library and I will stay there until I have written my three short stories (each 500 words), typed them up and sent the TMA using the OU's eTMA system.
Today I am not a limp lettuce; today I'm like a nice crispy cos.
Tuesday, 8 December 2009
Limp Lettuce
I'm feeling like a limp lettuce at the moment. I don't actually have a headache but I have a feeling in my head that is quite strange. It's the feeling that I have when I have spent the day crying and I just can't manage any more. All I want to do is curl up in a ball and wrap myself up in the duvet and not do anything or see anyone. This isn't depression creeping over me again; it is actually the after effects of something that should help me.
This feeling isn't new to me because I have experienced it before. Then it used to happen to me on a Friday. Now it is going to happen on a Tuesday. There is a possibility that it will also happen to me on another day of the week and the thought of it happening twice a week is more than I can bear at the moment.
Today I went to see the psychologist at the hospital. I thought it was going to be a second assessment-type session. These can be harrowing and last week it did have quite an effect on me, but nothing in comparison to how I am feeling today. My psychologist decided that he had got enough information from me last week (and I think he has seen the notes from my previous psychotherapy) so that today we would start working towards finding out how I feel about certain things and what that does to me. I don't want to go into too much detail here because I am very raw still from the emotional pummeling that I have been subjected to today, but I was made to feel emotions that I have spent all my life keeping under control.
Psychotherapy is hard.
This feeling isn't new to me because I have experienced it before. Then it used to happen to me on a Friday. Now it is going to happen on a Tuesday. There is a possibility that it will also happen to me on another day of the week and the thought of it happening twice a week is more than I can bear at the moment.
Today I went to see the psychologist at the hospital. I thought it was going to be a second assessment-type session. These can be harrowing and last week it did have quite an effect on me, but nothing in comparison to how I am feeling today. My psychologist decided that he had got enough information from me last week (and I think he has seen the notes from my previous psychotherapy) so that today we would start working towards finding out how I feel about certain things and what that does to me. I don't want to go into too much detail here because I am very raw still from the emotional pummeling that I have been subjected to today, but I was made to feel emotions that I have spent all my life keeping under control.
Psychotherapy is hard.
Thursday, 3 December 2009
The After Effects
One of Newton's Laws of Motion (I can't remember which) states that for every action there is an equal, and opposite, reaction. I believe that this goes for more things than just motion.
When I went to see my GP on Monday I was feeling pretty good. He has even written in my notes that I was the happiest that he has seen me for a very long time. When asked by him to what I attributed this improvement in my mood I said that I felt that the reason for this improvement in my mood was due to two things; first the increase in medication that had been decided upon while I was in hospital, and secondly the incredible visitor figures that my blog had started to have as a result of my having started to write about what had happened to me after he referred me for admission to hospital.
On Tuesday I went to see the psychologist and wrote a bit about it here. I was still feeling pretty good when I arrived at the hospital and I saw a couple of members of staff from one of the wards that I had been on and they both commented on how good I was looking. The session with the psychologist was difficult; these sorts of things always are. I found myself crying as he was asking me things and one of the things that I hate is being made to cry.
When I eventually got home on Tuesday evening (I'd gone to the library from the hospital so that I could do some work on my course) I was feeling drained. I couldn't face making anything to eat, so I just went to bed with a glass of milk and lay there reading a book. I'm not sure how many pages I turned, but I do know that I didn't take in anything that I was reading. By about 8pm I decided to take my night-time medication and try to get to sleep.
Sleep came pretty quickly, and although I did wake a couple of times during the night, I just turned over, snuggled further under the duvet and went back to sleep. Wednesday morning dawned and that horrible old feeling had returned. I didn't want to get out of bed, and I didn't want to do anything. I did try writing a bit more of Part 4 of Tackling the Mental Health Minefield, but although I knew what I wanted to say, the right words just didn't seem to come to mind. I decided that I should give Wednesday a miss and ended up watching a few videos and catching up with television programmes that I had missed.
It was another early night, again my sleep was interrupted with a couple of wakeful periods but I probably managed about six hours in total, which was pretty good because I had been getting only a couple of hours a night just a few weeks ago. This morning I got up early, got myself dressed and ready to head off to the library again. For some unknown reason the bus that I needed to catch has been a bit thin on the ground this last week or so. They are supposed to run every 10-12 minutes, but this morning I was standing at the bus stop for 40 minutes before one arrived. I eventually arrived at my destination and found myself a nice quiet corner in the library where I could sit down to do some work.
I did managed to finish the first block of material for my course. I had to read several bits more than once to be sure that I had taken on board the information, but I had managed to complete in three days the work that was planned for two weeks in the course calendar. My next decision had to be did I have a look at and start working through the second block, or should I have a look at the first TMA which is due in tomorrow. I do have an extension of a week for submitting it because of my having been in hospital when the course started so I don't have to struggle to throw something together for submission tomorrow.
In the end I decided that I would start looking at the TMA and I have started to draft the first 500-word story that is required for it. There are three parts to this TMA and each of them requires me to write 500-word stories or parts of a story. Five hundred words shouldn't be difficult for me to put together. Many of my posts on this blog are much longer than that, but they are about 'real' things and the course is about writing fiction. I realized that I couldn't think up things because there was so much real stuff going on in my brain. Going to see the psychologist has had a greater effect on me than I had thought possible. Suddenly as I was writing my notes and drafting the start of my first story, there were tears rolling down my cheeks.
I had deliberately chosen to write about a real event, but something that occurred before I was born. That way I knew that the story would not be in any way autobiographical. But just the effort of thinking about being the child who is telling the story of what they had seen in a street in a city started to bring things into my mind that I had wanted to keep well hidden away.
It seems that there are after effects from my appointment with the psychologist that I had neither expected or been ready to have happen.
When I went to see my GP on Monday I was feeling pretty good. He has even written in my notes that I was the happiest that he has seen me for a very long time. When asked by him to what I attributed this improvement in my mood I said that I felt that the reason for this improvement in my mood was due to two things; first the increase in medication that had been decided upon while I was in hospital, and secondly the incredible visitor figures that my blog had started to have as a result of my having started to write about what had happened to me after he referred me for admission to hospital.
On Tuesday I went to see the psychologist and wrote a bit about it here. I was still feeling pretty good when I arrived at the hospital and I saw a couple of members of staff from one of the wards that I had been on and they both commented on how good I was looking. The session with the psychologist was difficult; these sorts of things always are. I found myself crying as he was asking me things and one of the things that I hate is being made to cry.
When I eventually got home on Tuesday evening (I'd gone to the library from the hospital so that I could do some work on my course) I was feeling drained. I couldn't face making anything to eat, so I just went to bed with a glass of milk and lay there reading a book. I'm not sure how many pages I turned, but I do know that I didn't take in anything that I was reading. By about 8pm I decided to take my night-time medication and try to get to sleep.
Sleep came pretty quickly, and although I did wake a couple of times during the night, I just turned over, snuggled further under the duvet and went back to sleep. Wednesday morning dawned and that horrible old feeling had returned. I didn't want to get out of bed, and I didn't want to do anything. I did try writing a bit more of Part 4 of Tackling the Mental Health Minefield, but although I knew what I wanted to say, the right words just didn't seem to come to mind. I decided that I should give Wednesday a miss and ended up watching a few videos and catching up with television programmes that I had missed.
It was another early night, again my sleep was interrupted with a couple of wakeful periods but I probably managed about six hours in total, which was pretty good because I had been getting only a couple of hours a night just a few weeks ago. This morning I got up early, got myself dressed and ready to head off to the library again. For some unknown reason the bus that I needed to catch has been a bit thin on the ground this last week or so. They are supposed to run every 10-12 minutes, but this morning I was standing at the bus stop for 40 minutes before one arrived. I eventually arrived at my destination and found myself a nice quiet corner in the library where I could sit down to do some work.
I did managed to finish the first block of material for my course. I had to read several bits more than once to be sure that I had taken on board the information, but I had managed to complete in three days the work that was planned for two weeks in the course calendar. My next decision had to be did I have a look at and start working through the second block, or should I have a look at the first TMA which is due in tomorrow. I do have an extension of a week for submitting it because of my having been in hospital when the course started so I don't have to struggle to throw something together for submission tomorrow.
In the end I decided that I would start looking at the TMA and I have started to draft the first 500-word story that is required for it. There are three parts to this TMA and each of them requires me to write 500-word stories or parts of a story. Five hundred words shouldn't be difficult for me to put together. Many of my posts on this blog are much longer than that, but they are about 'real' things and the course is about writing fiction. I realized that I couldn't think up things because there was so much real stuff going on in my brain. Going to see the psychologist has had a greater effect on me than I had thought possible. Suddenly as I was writing my notes and drafting the start of my first story, there were tears rolling down my cheeks.
I had deliberately chosen to write about a real event, but something that occurred before I was born. That way I knew that the story would not be in any way autobiographical. But just the effort of thinking about being the child who is telling the story of what they had seen in a street in a city started to bring things into my mind that I had wanted to keep well hidden away.
It seems that there are after effects from my appointment with the psychologist that I had neither expected or been ready to have happen.
Tuesday, 1 December 2009
In The Psychologist's Chair
Sorry folks, Part 4 of Tackling the Mental Health Minefield is still being drafted so probably won't be available today. Writing these posts can be a bit of an emotional experience so I can't rattle them off as I do with my normal posts on this blog. However, I am posting about my return to the hospital today for appointment with one of the psychologists there.
As long-time readers of this blog will know, I was receiving psychodynamic psychotherapy until the beginning of May this year. This had lasted for a year, but I felt that it had not been brought to a proper termination given that new subject areas were opened up on the last session. It ended up with something along the lines of "well, you've had your year's worth of therapy on the NHS, I know that you never missed a session even though I didn't make quite a few, but anyway, goodbye".
Somewhat unsurprisingly this had quite a detrimental effect on my well-being, and I am not certain that it wasn't the trigger for my downward spiral into depression that eventually landed me in hospital. Anyway, the subject of this psychotherapy came up a couple of times while I was in hospital and my consultant referred me to psychological services situated in the hospital. I was persuaded to take part in one group therapy session while I was on the ward (there was myself, three other patients and one of the nurses from the ward along with the psychologist and his psychologist-in-training) but in the limited time available not much was really achieved in this session other than the psychologist getting to see me. Through a series of unfortunate circumstances beyond anyone's control (an appointment was made for me, but the ward staff forgot to tell the psychologist that I wasn't actually on the ward anymore, and then I didn't get the message about another appointment until after the event) my first appointment with the psychologist didn't actually occur until this morning.
As usual I arrived at the hospital far too early, so I got myself a cup of coffee from the WRVS kiosk and went into the garden to drink it and have a cigarette or two. Eventually I thought it was close enough to the time of my appointment for me to make my way to the psychology department and I soon found myself sitting on a chair in the corridor waiting for the psychologist to collect me.
We chatted inconsequentially as we walked to his office and on arrival he invited me to take a seat. His trainee psychologist was already seated on the sofa so I sat in the chair which was so obviously meant for me. I wasn't really sure what the purpose of this appointment was but it seems that the idea is that I am being assessed again to determine whether therapy is required, and if it is, then whether it will be carried out at the hospital or whether I will be referred back to the parent organization which was where I had therapy before.
After being 'grilled' for an hour and a half I was let free with an appointment for the same time next week and the knowledge that what happened in today's session definitely shows that therapy is indeed required. I left with the usual questionnaire about what my feelings about certain things have been during the last week and the request that I fill it in and bring it back with me the next time we meet. I've filled it in, and although I had thought that I had been quite reasonable this last week, especially having been buoyed up with the way that the posts about my hospitalization had been received, in answering the questions I realized that things probably hadn't been as great as I was telling myself they had been.
I'm supposed to be doing some studying this afternoon, but my mind is in such a turmoil after this morning's appointment that I am not sure that I could achieve anything meaningful. Perhaps I will have a change of plan and settle for a relaxing afternoon and get back to the 'creative writing' tomorrow. (I know that this is creative writing but the course is about writing fiction and this blog is definitely not fiction).
As long-time readers of this blog will know, I was receiving psychodynamic psychotherapy until the beginning of May this year. This had lasted for a year, but I felt that it had not been brought to a proper termination given that new subject areas were opened up on the last session. It ended up with something along the lines of "well, you've had your year's worth of therapy on the NHS, I know that you never missed a session even though I didn't make quite a few, but anyway, goodbye".
Somewhat unsurprisingly this had quite a detrimental effect on my well-being, and I am not certain that it wasn't the trigger for my downward spiral into depression that eventually landed me in hospital. Anyway, the subject of this psychotherapy came up a couple of times while I was in hospital and my consultant referred me to psychological services situated in the hospital. I was persuaded to take part in one group therapy session while I was on the ward (there was myself, three other patients and one of the nurses from the ward along with the psychologist and his psychologist-in-training) but in the limited time available not much was really achieved in this session other than the psychologist getting to see me. Through a series of unfortunate circumstances beyond anyone's control (an appointment was made for me, but the ward staff forgot to tell the psychologist that I wasn't actually on the ward anymore, and then I didn't get the message about another appointment until after the event) my first appointment with the psychologist didn't actually occur until this morning.
As usual I arrived at the hospital far too early, so I got myself a cup of coffee from the WRVS kiosk and went into the garden to drink it and have a cigarette or two. Eventually I thought it was close enough to the time of my appointment for me to make my way to the psychology department and I soon found myself sitting on a chair in the corridor waiting for the psychologist to collect me.
We chatted inconsequentially as we walked to his office and on arrival he invited me to take a seat. His trainee psychologist was already seated on the sofa so I sat in the chair which was so obviously meant for me. I wasn't really sure what the purpose of this appointment was but it seems that the idea is that I am being assessed again to determine whether therapy is required, and if it is, then whether it will be carried out at the hospital or whether I will be referred back to the parent organization which was where I had therapy before.
After being 'grilled' for an hour and a half I was let free with an appointment for the same time next week and the knowledge that what happened in today's session definitely shows that therapy is indeed required. I left with the usual questionnaire about what my feelings about certain things have been during the last week and the request that I fill it in and bring it back with me the next time we meet. I've filled it in, and although I had thought that I had been quite reasonable this last week, especially having been buoyed up with the way that the posts about my hospitalization had been received, in answering the questions I realized that things probably hadn't been as great as I was telling myself they had been.
I'm supposed to be doing some studying this afternoon, but my mind is in such a turmoil after this morning's appointment that I am not sure that I could achieve anything meaningful. Perhaps I will have a change of plan and settle for a relaxing afternoon and get back to the 'creative writing' tomorrow. (I know that this is creative writing but the course is about writing fiction and this blog is definitely not fiction).
Friday, 15 August 2008
Fridays Are Hard; It's Psychotherapy Day
I have mentioned several times in this blog that a significant proportion of the population of this country don't know how to deal with meeting someone with depression. In recent years there has been a lot of emphasis on the fact that depression is a form of mental illness, and it is mental illness that people are scared of.
My first encounter with depression was more than 25 years ago, when I suddenly started to suffer periods of unstoppable crying, night after night of being unable to sleep, a total loss of appetite, and a loss of interest in my work, which was totally out of character for me. I was serving in the RAF at that time, so eventually I paid a visit to the Station Medical Centre (SMC) and saw the Senior Medical Officer (SMO). The SMC acts as a GPs surgery for service personnel on the unit, and the SMO is the equivalent of the senior partner in the practice. I was prescribed anti-depressants and the SMO requested my boss move me to a less stressful job for a few months so that I could regain my equilibrium and pleasure in my work. It all worked, less than four months later I was back to my old self and the depression was something that I forgot all about.
Almost 10 years ago, my husband died very suddenly a few days into our holiday abroad. Fortunately, my parents were on holiday with us, and we were staying in a hotel where we had stayed many times before, so the staff knew us very well. We also had a number of friends who live on the island, and hotel manager phoned them to let them know what had happened.
The next few weeks passed in a bit of a haze for me. Some things I can remember as though it was yesterday, while there are other things that I cannot remember at all. About two months after my husband died, some of my colleagues began to get very worried about me. I would walk about as if in a trance, I would fall asleep at my desk, and they noticed that I was rapidly losing weight. They were ready to tell me to go to see my GP when something happened that scared me so much that I made an appointment myself.
I was diagnosed as suffering from depression caused by a grief reaction; something that was not unexpected considering what had happened. Anti-depressants were prescribed, at a very low level to start with but being increased over a period of a couple of weeks. I had to see my GP every week so that he could assess how I was doing. After a couple of months it was decided to change the anti-depressant as the first one did not seem to be having much of an effect. This change seemed to make a big difference and I started to look less haggard, began eating a little better, and being able to sleep at night rather than at work.
About a year later my last remaining great-aunt died, and her death was followed a few days later by that of her brother, my great-uncle. I hadn't been sure whether I would be able to cope with one funeral, but a double funeral was out of the question and my parents decided that it was best if I did not attend. At about this time, my GP decided to refer me to see a psychiatrist at the local Mental Health Trust.
This was the first time that I started to be really afraid about what was happening to me; after all, psychiatrists look after mad people, don't they? To this day, I really don't remember too much about this meeting with the psychiatrist, although I did find it disconcerting that the door to the building had an intercom entry system, and that I had to sign myself in and out of the building. The fact that it was a dark and dingy Victorian building, that in no way looked inviting, didn't help to alleviate my distress at the situation either. However, the psychiatrist turned out to be a very nice man, and although I can't really remember much of what I said in answer to his questions, he did tell me that he thought that I could benefit from counselling from a CPN.
A week or so later, I received a letter giving me a date for my first counselling session. I attended at the time requested and found myself being asked to fill in a questionnaire that seemed never ending. I can't remember how many questions there were, but it seemed that many of the questions seemed to occur several times, each time expressed in slightly different words. I might have been depressed, but I wasn't stupid. Anyway, after I filled in the questionnaire, the CPN asked me some questions and then asked me to start talking about myself and my life with my husband. It was difficult, but I tried. Further appointments were made for me to see her weekly, and I attended another three or four sessions, but a very close friend and colleague at work saw the effect that these sessions were having on me and after careful questioning decided that I needed to see my GP. An urgent appointment was made and I saw him less than an hour later; the result was that he decided that the counselling should stop because it was obvious that it was having a very detrimental effect on me and my depression was becoming worse. Although I saw the psychiatrist several times over the following years and always benefited from seeing him, counselling was not suggested again.
When I moved to London I registered at a new practice and saw the senior partner. After a slightly dodgy start, caused by him making a comment without realising the effect that it was going to have on me, we got along well. He was concerned that I had been suffering from depression for so long without any real sign that I was getting better. I seemed to have sunk into a depression after my father died that I just couldn't climb out of, so towards the end of last year he decided to refer me to our local MHT for psychotherapy. He told me that the service was severely stretched and that it would probably be some considerable time before I got an appointment for assessment to see whether they could offer me anything, and that it was likely to be a year or more before I started to receive any treatment.
Although so much of the population suffers from mental health problems and so many could benefit from the so called 'talking treatments' they are incredibly difficult to get from the NHS. There are many psychotherapists in private practice, but how do you choose one, how do you know what type of psychotherapy is right for you, and how much will it all cost? For most of us, this just isn't an option that we can afford to even look at, and I knew that it was impossible for me, so I resigned myself for a long wait for treatment on the NHS. Perhaps the most worrying thing about all this is that I live in London, and London is one of the few places in the country that you stand a reasonable chance of getting the psychotherapy without having been admitted to a psychiatric hospital first.
About 10 days after my GP referred me I received a letter from the hospital inviting me to make an appointment for assessment for suitability for treatment. So six weeks after my GP set the ball rolling I went for assessment, and after about an hour and a half talking with one of the senior psychologists he decided that another assessment appointment would be worthwhile and that it was likely that I would be offered psychotherapy. The next appointment was a month later, and at the end of the process it was decided that individual psychodynamic psychotherapy was the treatment that I was most likely to benefit from.
There are many different types of psychotherapy, some individual and some conducted in groups. Many people are offered short periods of cognitive-behavioural therapy (CBT), but neither this nor group psychodynamic therapy were considered suitable for me and my problems. Having been told that individual psychodynamic psychotherapy was what was being offered to me, the senior psychologist who conducted my assessments gave me details of what the therapy would entail and that I would probably have a long wait before a psychotherapist would be available to add me to their list of patients. One of the benefits that I had, was because I am unable to work at the moment, when a vacancy did arise, it would be possible to accept the time offered.
Having steeled myself for months of waiting, I was somewhat surprised, and my GP was absolutely stunned, that I was offered an appointment with a psychotherapist to discuss the possibility of starting therapy, just two and a half months later. I accepted the appointment, went to the hospital on the appointed day, and met the doctor who was to be my psychotherapist if that particular day and time were acceptable to me. As Friday at 10 o'clock was fine, without further ado the therapy started. It rather caught me on the hop, because I really wasn't expecting it to be so soon, and certainly not that day.
For those who don't know what psychodynamic psychotherapy is about, I will give this particular patient's view of what happens. Psychotherapists may be psychologists, some are doctors (in fact psychotherapy is now a compulsory element of the specialist training for psychiatrists), and some may be social workers who have undergone additional training in psychotherapy; mine is a doctor. My appointments are at the same time, on the same day of the week, and take place in the same room each time. Each session lasts between 50 and 60 minutes; the time varies slightly so that a convenient stopping point can be found. The relationship between the therapist and patient is somewhat strange, in that the patient is expected to reveal all about themself, while the therapist reveals nothing of themself. This may make the therapist seem remote for some people, but accepting that this is what the relationship should be is the first step to a good therapeutic relationship. For many, psychodynamic psychotherapy offered by the NHS is time-limited from the start; this means that it is decided that you will have a certain number of sessions, often 20 or 30, and that the therapist will move the process along so that certain stages in the process occur at specific times. I am lucky because I was offered psychodynamic psychotherapy that was not limited by time; in fact I was told from the start that I would probably be attending for more than a year.
At first the thought of talking about oneself for 50 minutes can be very daunting, and I found it particularly so as I had never been someone who let much out about themself to other people. Part of this was shyness on my part, and part a reluctance to talk about my work (which is the subject where many social conversations start) because I was not allowed to. This type of psychotherapy is not a two-way conversation; the therapist will often only speak if the silence at the start of the session is prolonged (and even after attending for three and a half months now, I can rarely start talking without prompting) or to suggest the possible reason for feeling the way that you do about some particular thing.
To start with the sessions are all about you, and your feelings; they are the way the therapist gets a feel for who you are, what your problems are, and hopefully what has caused these problems. They can be very traumatic, and can delve far into your past. You find out things about yourself that you never realised, and you start to understand why some things that have happened to you, occurred. Many things that occur in childhood or early adolescent years can be what sets the seed for mental illness in later life.
Some weeks ago, I had a particularly traumatic session. I found out something that had never occurred to me before. It has already helped me to understand why I am the way I am and it is helping me to talk about more things that have happened in my life, and how they have affected me, at subsequent sessions. One thing that you should always do is go with a good supply of tissues, for it is certain that the sessions will be emotional. I have actually managed one session so far where I have not cried, but it gets easier to talk each week as I bring out things that I have forgotten about or never realised before. To show how far I have progressed, I have been able to write this post without becoming emotional; just a few weeks that would have been impossible.
I hope this helps you understand why Fridays are hard for me, and that it gives you a little insight into something that you may have heard about but always wondered what it involved. Feel free to ask questions if you want, but be aware that I will obviously be quite careful how I reply.
My first encounter with depression was more than 25 years ago, when I suddenly started to suffer periods of unstoppable crying, night after night of being unable to sleep, a total loss of appetite, and a loss of interest in my work, which was totally out of character for me. I was serving in the RAF at that time, so eventually I paid a visit to the Station Medical Centre (SMC) and saw the Senior Medical Officer (SMO). The SMC acts as a GPs surgery for service personnel on the unit, and the SMO is the equivalent of the senior partner in the practice. I was prescribed anti-depressants and the SMO requested my boss move me to a less stressful job for a few months so that I could regain my equilibrium and pleasure in my work. It all worked, less than four months later I was back to my old self and the depression was something that I forgot all about.
Almost 10 years ago, my husband died very suddenly a few days into our holiday abroad. Fortunately, my parents were on holiday with us, and we were staying in a hotel where we had stayed many times before, so the staff knew us very well. We also had a number of friends who live on the island, and hotel manager phoned them to let them know what had happened.
The next few weeks passed in a bit of a haze for me. Some things I can remember as though it was yesterday, while there are other things that I cannot remember at all. About two months after my husband died, some of my colleagues began to get very worried about me. I would walk about as if in a trance, I would fall asleep at my desk, and they noticed that I was rapidly losing weight. They were ready to tell me to go to see my GP when something happened that scared me so much that I made an appointment myself.
I was diagnosed as suffering from depression caused by a grief reaction; something that was not unexpected considering what had happened. Anti-depressants were prescribed, at a very low level to start with but being increased over a period of a couple of weeks. I had to see my GP every week so that he could assess how I was doing. After a couple of months it was decided to change the anti-depressant as the first one did not seem to be having much of an effect. This change seemed to make a big difference and I started to look less haggard, began eating a little better, and being able to sleep at night rather than at work.
About a year later my last remaining great-aunt died, and her death was followed a few days later by that of her brother, my great-uncle. I hadn't been sure whether I would be able to cope with one funeral, but a double funeral was out of the question and my parents decided that it was best if I did not attend. At about this time, my GP decided to refer me to see a psychiatrist at the local Mental Health Trust.
This was the first time that I started to be really afraid about what was happening to me; after all, psychiatrists look after mad people, don't they? To this day, I really don't remember too much about this meeting with the psychiatrist, although I did find it disconcerting that the door to the building had an intercom entry system, and that I had to sign myself in and out of the building. The fact that it was a dark and dingy Victorian building, that in no way looked inviting, didn't help to alleviate my distress at the situation either. However, the psychiatrist turned out to be a very nice man, and although I can't really remember much of what I said in answer to his questions, he did tell me that he thought that I could benefit from counselling from a CPN.
A week or so later, I received a letter giving me a date for my first counselling session. I attended at the time requested and found myself being asked to fill in a questionnaire that seemed never ending. I can't remember how many questions there were, but it seemed that many of the questions seemed to occur several times, each time expressed in slightly different words. I might have been depressed, but I wasn't stupid. Anyway, after I filled in the questionnaire, the CPN asked me some questions and then asked me to start talking about myself and my life with my husband. It was difficult, but I tried. Further appointments were made for me to see her weekly, and I attended another three or four sessions, but a very close friend and colleague at work saw the effect that these sessions were having on me and after careful questioning decided that I needed to see my GP. An urgent appointment was made and I saw him less than an hour later; the result was that he decided that the counselling should stop because it was obvious that it was having a very detrimental effect on me and my depression was becoming worse. Although I saw the psychiatrist several times over the following years and always benefited from seeing him, counselling was not suggested again.
When I moved to London I registered at a new practice and saw the senior partner. After a slightly dodgy start, caused by him making a comment without realising the effect that it was going to have on me, we got along well. He was concerned that I had been suffering from depression for so long without any real sign that I was getting better. I seemed to have sunk into a depression after my father died that I just couldn't climb out of, so towards the end of last year he decided to refer me to our local MHT for psychotherapy. He told me that the service was severely stretched and that it would probably be some considerable time before I got an appointment for assessment to see whether they could offer me anything, and that it was likely to be a year or more before I started to receive any treatment.
Although so much of the population suffers from mental health problems and so many could benefit from the so called 'talking treatments' they are incredibly difficult to get from the NHS. There are many psychotherapists in private practice, but how do you choose one, how do you know what type of psychotherapy is right for you, and how much will it all cost? For most of us, this just isn't an option that we can afford to even look at, and I knew that it was impossible for me, so I resigned myself for a long wait for treatment on the NHS. Perhaps the most worrying thing about all this is that I live in London, and London is one of the few places in the country that you stand a reasonable chance of getting the psychotherapy without having been admitted to a psychiatric hospital first.
About 10 days after my GP referred me I received a letter from the hospital inviting me to make an appointment for assessment for suitability for treatment. So six weeks after my GP set the ball rolling I went for assessment, and after about an hour and a half talking with one of the senior psychologists he decided that another assessment appointment would be worthwhile and that it was likely that I would be offered psychotherapy. The next appointment was a month later, and at the end of the process it was decided that individual psychodynamic psychotherapy was the treatment that I was most likely to benefit from.
There are many different types of psychotherapy, some individual and some conducted in groups. Many people are offered short periods of cognitive-behavioural therapy (CBT), but neither this nor group psychodynamic therapy were considered suitable for me and my problems. Having been told that individual psychodynamic psychotherapy was what was being offered to me, the senior psychologist who conducted my assessments gave me details of what the therapy would entail and that I would probably have a long wait before a psychotherapist would be available to add me to their list of patients. One of the benefits that I had, was because I am unable to work at the moment, when a vacancy did arise, it would be possible to accept the time offered.
Having steeled myself for months of waiting, I was somewhat surprised, and my GP was absolutely stunned, that I was offered an appointment with a psychotherapist to discuss the possibility of starting therapy, just two and a half months later. I accepted the appointment, went to the hospital on the appointed day, and met the doctor who was to be my psychotherapist if that particular day and time were acceptable to me. As Friday at 10 o'clock was fine, without further ado the therapy started. It rather caught me on the hop, because I really wasn't expecting it to be so soon, and certainly not that day.
For those who don't know what psychodynamic psychotherapy is about, I will give this particular patient's view of what happens. Psychotherapists may be psychologists, some are doctors (in fact psychotherapy is now a compulsory element of the specialist training for psychiatrists), and some may be social workers who have undergone additional training in psychotherapy; mine is a doctor. My appointments are at the same time, on the same day of the week, and take place in the same room each time. Each session lasts between 50 and 60 minutes; the time varies slightly so that a convenient stopping point can be found. The relationship between the therapist and patient is somewhat strange, in that the patient is expected to reveal all about themself, while the therapist reveals nothing of themself. This may make the therapist seem remote for some people, but accepting that this is what the relationship should be is the first step to a good therapeutic relationship. For many, psychodynamic psychotherapy offered by the NHS is time-limited from the start; this means that it is decided that you will have a certain number of sessions, often 20 or 30, and that the therapist will move the process along so that certain stages in the process occur at specific times. I am lucky because I was offered psychodynamic psychotherapy that was not limited by time; in fact I was told from the start that I would probably be attending for more than a year.
At first the thought of talking about oneself for 50 minutes can be very daunting, and I found it particularly so as I had never been someone who let much out about themself to other people. Part of this was shyness on my part, and part a reluctance to talk about my work (which is the subject where many social conversations start) because I was not allowed to. This type of psychotherapy is not a two-way conversation; the therapist will often only speak if the silence at the start of the session is prolonged (and even after attending for three and a half months now, I can rarely start talking without prompting) or to suggest the possible reason for feeling the way that you do about some particular thing.
To start with the sessions are all about you, and your feelings; they are the way the therapist gets a feel for who you are, what your problems are, and hopefully what has caused these problems. They can be very traumatic, and can delve far into your past. You find out things about yourself that you never realised, and you start to understand why some things that have happened to you, occurred. Many things that occur in childhood or early adolescent years can be what sets the seed for mental illness in later life.
Some weeks ago, I had a particularly traumatic session. I found out something that had never occurred to me before. It has already helped me to understand why I am the way I am and it is helping me to talk about more things that have happened in my life, and how they have affected me, at subsequent sessions. One thing that you should always do is go with a good supply of tissues, for it is certain that the sessions will be emotional. I have actually managed one session so far where I have not cried, but it gets easier to talk each week as I bring out things that I have forgotten about or never realised before. To show how far I have progressed, I have been able to write this post without becoming emotional; just a few weeks that would have been impossible.
I hope this helps you understand why Fridays are hard for me, and that it gives you a little insight into something that you may have heard about but always wondered what it involved. Feel free to ask questions if you want, but be aware that I will obviously be quite careful how I reply.
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