We came along this road

The journey back isn’t a Hollywood blockbuster. There are no explosions. No world-destroying earthquakes. Denzil Washington doesn’t turn up with a cartload of braille Bibles to point out the right way to go. There are no maps. No signs. You are entirely alone in the quiet, unassuming task of getting back on your feet, and the act is nothing spectacular. It doesn’t warrant any fanfares.

In Terry Pratchett’s Discworld, there is a Dark Desert, with miles and miles of “brilliantly-lit black sand, under a black sky studded with cold bright stars, stretching away to distant mountains (where judgement awaits).” Thousands of souls pass each other, all walking the same desert, but they never see each other. They just keep walking towards what they hope will happen, locked in their own time.

For a while now, I have been, metaphorically and physically, taking that long walk back home.

walking-home

It began with Autumn arriving. Almost overnight, the leaves on the horse chestnut tree next door began to turn a bright, yellowy-orange, and the fir in the front garden began to turn blue in preparation for winter. Red berries briefly appeared on the bushes near the driveway before being eaten by fat woodpigeons, and the nights began smelling of leaves and bonfires; the sea air feeling chilly in the dead of night, a cat cuddling up to my dressing gown for warmth.

After a successful cortinsone injection into my ankle joint, walking has become much easier. This is the second one which has worked; and it’s worked miracles. Today, on the way to the back garden, I kicked through some leaves to entertain Stimpy. This time last year that wouldn’t have been even close to possible, and I’m very aware of the difference both cortisone and Methotrexate have made to my life.

I’m not running marathons; I still need the stick for balance and still struggle to pick things up. S still has to do most of the cooking, although I’m helping more and have cooked a few meals alone recently. I still have bad days. My health is currently compounded by Methotrexate doing the exact job it’s supposed to do; suppressing my immune system, reducing the white blood cells and calming the inflammatory response when my immune system attacks the joints.

That side of it has worked very well and I have far more movement in my fingers, neck and wrists than I did even a few months ago, however, lowered immunity means bacteria and infections have almost free reign and infection can be very difficult to treat. I’ve found this to be the case for a while now, with repeated infected cysts and tooth abcesses – which require constant antibiotics as the infection returns as soon as they’re stopped – as well as mouth ulcers, swollen gums, losing clumps of hair to the shower drain, and difficulty urinating.

It has increasingly been a case of weighing up the pros and cons of taking a disease-modifying anti-rheumatic drug, but so far the ability to walk and go outside (the wheelchair was causing me too much anxiety; I left it at my mother’s house) and have that small shred of indpendence back is more than worth dealing with anything Methotrexate can throw at me.

methotrexate

So. Slowly, the road is leading me back. It’s a little scary to know how long I’ve felt… muffled by life. With hindsight I can see how the combination of moving in with S after living with my mother – albeit with brief breaks – in the same house since I was born, the psoriatic arthritis symptoms becoming chronic, difficulty getting diagnosed again, so many tests and hospital appointments I lost count, all built up to set a sequence of events in place which, really, I should have seen coming. I have never dealt well with crisis.

Moving away from my mother was emotional in a few ways; my time at the quiet suburban semi was often fraught, she and I fought like cats, refusing to budge on any subject until I became uncontrollable and set to destroying whatever I could get my hands on (my early teens) or saying the worst things I could possibly think of (my later teens) and the majority of the time I lived there was spent sequestered in my bedroom like a hermit, refusing to come out except to go to the bathroom, binge, or, in the later years, smoke. Sneaking down at night to use the phone to call whoever I happened to be dating at the time, trying to break into my mother’s bedroom – she installed locks – to find my confiscated medication.

I slept all day and tiptoed around like a ghost at night, flicking through Teletext at 3am, smoking out of the window, eating everything I could get my hands on and purging silently in the garden.

Despite our lack of relationship, I was nevertheless hugely reliant on my mother even if I didn’t believe it at the time. Without me knowing, she steered me through the important parts of life; albeit in a way which wasn’t always right, but she always tried. A few years ago my mother stopped speaking to my brother, C, after he never repaid her a large debt despite being able to, and yet she has never given up on me despite the years of carting me to psychiatrists, sitting in the ambulance with me on the way to A&E after overdoses, the shouting, the ignoring, sitting up all night waiting for me to come home as the police helicopter passes over me, never stopping.

She says the difference is that I try to fix things.

bamboozle

I am back in therapy. Somewhere along the road was a stumbling block and I was too busy enjoying my new-found freedom to notice before walking straight into it. Overnight, agoraphbia strolled back in and set up camp without so much as a greeting and, as a result, I am back to sending S on small errands I could do myself and staying indoors for days if no appointments are due; however, I’m adoring being outside once I get through the front door. This is new for me, and I’m not sure how to make myself go outside even though there’s nothing I want more than to put my boots on and crunch through the piles of fallen leaves down the street into the village.

Despite this, the future looks bright. Or brighter, at least. For the first time since I can remember, thoughts of a possible future are beginning to creep in. Reading has become pleasurable again after being used as a distraction from unwanted thoughts and crippling boredom for a long time. S and I bought a new mattress and we’re back to sleeping in the same bed every night; he kisses me in the morning while putting his shirt on for work and I wonder how I didn’t go crazy sleeping in the spare room without him, with just the cats for company. I suppose I did in a way.

sleeping-alone-black-and-white

I had a meltdown. That’s why I’m back at therapy, really; my GP referred me after seeing the cuts I’d made on my right arm with a scalpel and hearing from my mother – I couldn’t find it in me to talk and needed somebody by my side – how I’d “spiralled downhill” since a difficult hospital appointment and overhearing an argument between S and a friend in which my so-called friend called me “lazy” for being unemployed; despite him having witnessed the illness at its worse on a number of occasions. There was more to it than that, but… I flipped. Took a scalpel and  harmed myself for the first time in, well, a long time, and certainly the first time since moving in with S. I have never self-harmed with him around, and when he came inside and saw me sitting on the bed with a bloody towel inexpertly wrapped around my arm and mascara everywhere, he panicked and we argued. We both said terrible things.

We made up and the relationship actually feels even better, but ever since that day I’ve been struggling in a number of ways. Friendships are becoming difficult again; S and I are invited to a close friend’s wedding on Monday and I’m terrified of having to cope with, well, other people. Even those I know. I worried I won’t pull it off. It’s a long time since I did anything truly social and since I stayed away from home for the night (we’re staying in a hotel) and I suspect I may be more nervous than the bride.

nerves

I don’t  know. I’m just trying to grab any shred of confidence and push along the road, because what’s the alternative? Another year in bed, on the sofa? Another year of sleeping through the day, seeing S only briefly in the hallway? That was never what I wanted, and nor was hiding inside my flat day after day, week after week, nervously emerging only for appointments and to see my mother once or twice a week.

It feels better to be on the road than off it.

The snappy biting black dog

Last night, I realised something. That in itself isn’t special – I realise a lot of things at night – but I finally understood why I’ve been so reluctant to update this, and it’s a reason which makes me angry. Angry, because I allowed myself to feel scared and worried. Angry because I lost the trust I spent years building – the trust which eventually led me to feeling able to write everything down in a blog. The trust which said, ‘I don’t care what people think’.

It turns out I did care, more than I could have known. It’s not lack of time or energy, it’s not a lack of something to write about. It’s simply… I still feel broken in ways by somebody sharing this blog when they know I write anonymously. When they surely knew that the subject matter was incredibly personal and if I’d wanted it shared I’d have done it myself. Every time I have sat down with the intention to write, I find myself becoming paranoid and shutting my laptop down.

 Image

It all comes back to paranoia. Part of me wants to shake that person; scream in their face. However, I know it’s pointless because the damage has been done and they will never, ever understand how I think and feel, and clearly have no desire to. Personally, I would never share anybody’s mental health tale, but is that just me? Has social media made it so that everyone has a right to poke and pry? I always knew there was a chance somebody would find this blog but I assumed it would be a family member or friend; somebody I knew well, who already knew about my past and would understand at least some of how I communicate and respect that. I never suspected it’d be a virtual stranger who barely knows me, somebody who shouldn’t even have an interest in what I’m doing or saying. It feels horrible; every time I sit down to type there’s a squirmy black worm wrapping itself around my words and reminding me that I’ll never be safe. Since safety is what I’ve always craved and fought for… it’s difficult. I want to ignore it because it’s none of their business what I say, but my brain just doesn’t want to accept that.

I had almost forgotten. I decided to let this blog and the hours of work and difficult words go, and move on. However, maybe I don’t want to move on. Maybe this has always helped me, and I should be doing what’s best for myself regardless of fear.

ImagePart of my need to write regardless is down to an utterly wonderful woman – M – who has been my therapist for a while now. Last week we had our last session and a relapse prevention, and part of the prevention comes down to not letting things build up and explode in panic and irrational behaviour and my way of doing that has always been to put my feelings into words. M has been encouraging me to bring back helpful things into my life and discard the useless; to believe that I’m capable of doing so. When I was first referred, things were… difficult. I had developed full-blown agoraphobia. My flat had become my prison and I only went outside to attend hospital and GP appointments. Stepping out of the front door was the most terrifying thing I could possibly do, and it’s not that I didn’t try; I did, over and over, but just didn’t seem to have the ability. Agoraphobia is a frustrating condition, because there’s absolutely no logic to it. Logically, I knew nothing bad would happen. Logically, I knew that having fellow humans see me wasn’t the end of the world. I like logic and despise anything which is entirely illogical, and so I grew to despise myself and my inability to do normal things like buy a pint of milk. M helped me see that I was reacting to an impossible situation – physically I had been forced indoors by the arthritis, and that gave my brain plenty of time to create fear which didn’t actually exist, so when I became more mobile I found myself stuck between wanting to live a normal-ish life and wanting to hide from everything which seemed so horribly unbearable. It’s a silly thing, really. The world isn’t that scary. My street certainly isn’t. Yet for the longest time I couldn’t even look out of a window without feeling sick at the thought of stepping outside.

I’ve had agoraphobia in the past, but never at this level. I always managed to cope somehow before, putting my mental blinkers on and just barrelling through life as best I can. This time… this time, I found myself leaning against the front door after S had left for work, banging my head against the glass and wanting more than anything to be able to follow him into the world, yet totally unable to. Opening the door was like throwing myself off a high cliff; my body and mind simply said ‘nope’ and shut down.

ImageSlowly, over time, things have improved. I can now go outside alone, although walking to the shop down the road is still difficult and I’ll make excuses not to. I haven’t been near public transport since last Summer. One of the main goals I currently have is to get on a bus; such a simple thing, yet I still don’t feel brave enough. M has helped me understand why I find it so difficult, but it’s still frustrating. I live close to the railway and could go anywhere if I wanted, but all that seems so far away, so impossible. I spent an hour in the garden today, and that was pushing it.

Even now, as I write this, I’m trying to censor myself despite knowing it shouldn’t matter. After all, what’s the worst that can happen – people know I have a personality disorder? It’s not as though I’ve been murdering anyone, I haven’t done anything wrong. That’s what I keep trying to tell myself, but there is always that split part of me laughing at my paranoia and pushing my buttons. I suspect some people will never understand the concept of true paranoia and unrelenting fear and just how horrible it feels; otherwise they’d leave me be.

Heck. I doubt they’re even reading this. I know that in reality I’ll have been long forgotten. If someone were, would it really matter? What are they going to learn about me – that I have a mental illness? That’s nothing special, plenty of people do.

Still. Just typing ‘I still want to self-harm every day’ scares me. I want to be honest. With myself and with the readers who have been incredibly supportive. I know some of you are still looking in, and I appreciate the comments asking if I’m okay after such a long period of silence.

I owe myself that honesty, it’s just difficult untangling it from the snappy biting black dog.

 

So why don’t you slide

Earlier, S asked if I fancied a takeaway – curry from our favourite restaurant – and I agreed. Later he went out with a friend to buy some tools. They’re working on the basement beneath our flat, as technically that’s included in the rent. It’s currently filled with the last owner’s belongings; stacks and stacks of paintings, canvas, frames, lamps, chairs, books… Bob was a hoarder, and a painter. His work’s pretty good actually. Now he’s dead and his wife is in a nursing home (she went downhill very rapidly when he died), somebody has to clear it all. The basement is pretty big, taking up most of the floor space of the house, so it’s a mammoth task.

Anyway, while they were out I got a call from S. He asked me if I wanted to go to the restaurant with his mates instead of getting a takeaway.

Did I do the right thing when I said, “it’s okay, I’m not up to it. You can go along anyway”?

I wasn’t lying. I’m truly not up to it. I tried going for a short walk earlier, and by the time I returned, I was struggling to breathe and sweating like crazy. It’s been so long since I’ve had ‘proper’ exercise. That walk used to take me five minutes. Today, it took thirty.

Straight away S’s tone changed; the first time I’ve ever really heard it do so. He said, “oh. Okay. But we were going to have a takeaway.”

I shrugged him off, “it’s fine, I’m really, really not up to it. We can do it another time”.

He agreed, but… he didn’t sound happy. It’s only when I ended the call that I began to feel that familiar twinge of panic.

Image

Oh god. Oh god oh god oh god you fucking idiot oh god oh god.

I have never once done something (to my knowledge, anyway) to make S angry or disappointed. Unlike my relationship with O, I’ve managed to keep my irrational emotions in check; at least until I’m alone. I’m so determined not to fuck this up. I know it’s classic BPD to say, “oh, I love him so much, he’s my everything, I want to be with him forever” but all that’s got me in the past is a string of disastrous relationships and far too much bitterness. I almost have my head around that now, and the medication certainly helps me keep the more extreme aspects of my behavior in check. So while I know that these feeling might be BPD tricking me and that mental illness has a habit of making me cling to somebody like fuck… I want to believe this is real. I’m pretty sure I know, deep down, I love S with all my heart; how could I not? He’s the only man who has never condescended me. Who has never given me reason to suspect him of wrongdoing. The only man who I’ve felt comfortable enough with to let the mask slip.

I know I love him.

And now I’m scared.

scared-woman

So what did I do? I went straight for the Tramadol.

I’m now sitting at the kitchen table, trying and failing to calm myself with a joint. The urge to crawl into bed and hide under the duvet is overwhelming.

A letter to my consultant

Current medications:
Propranalol Hydrochloride (80mg daily) – for anxiety and panic attacks
Lansoprazole (30mg daily)
Etoricoxib (60mg daily) – for inflammation
Pregabalin (300mg daily) – for fibromyalgia
Duloxetine (90mg daily) for pain, depression and anxiety.
Dianette – contraception and treating polycystic ovary syndrome

Recent medications:
Cipralex – for depression and anxiety
Celebrex – for pain
Omeprazole
Prednisone (12 week course to treat chronic eczema)

Past surgeries:
Four wisdom teeth removed
Laparoscopy (to investigate painful periods and bleeding) (2007). Laser ablation done at the same time to treat inflammation in cervix.
Cholecystectomy (2008)

Current diagnoses:
Synovitis in left ankle and inflammation of tendon at side of foot (originally misdiagnosed as achilles tendonitis 18 months ago), diagnosed approx. 6 months ago.
Pompholyx eczema/dyshidrotic dermatitis (diagnosed in 2012)
Polycystic ovary syndrome (diagnosed in 2001)
Fibromyalgia (diagnosed in 2006)
Irritable bowel syndrome (diagnosed in 2002-ish, originally treated with Mebeverine but currently under no treatment due to side-effects)
Depression and anxiety (first diagnosed at the age of thirteen) and Borderline Personality Disorder.

Current symptoms:
Pain and stiffness in fingers, knees, upper neck/base of skull, hips, feet/toes, lower back and wrists. Fingers, knees and toes most affected, although neck is becoming much worse. Pain and stiffness much worse in morning/after sitting still, and takes at least 2-3 hours after waking to begin loosening. Gentle movements seem to help the pain in most joints.
Unable to bear weight on heels for 2-3 hours after inactivity.
Swelling in fingers, toes, ankles and knees after waking/inactivity, especially in joints closest to nails in fingers and toes.
Clumsiness, especially in morning. Unable to grip items with confidence, especially pens and cups.
Fingers and toes have become misshapen over the past 18 months.
Weight loss. This is a particular concern for me as I haven’t dieted, although my appetite has decreased dramatically, again over the past 18 months. Since September 2012 I have lost almost three stones in weight, which is very unlike me as I have always struggled with keeping my weight down and I love food.
Recurring cold sores.
Itchy eyes and very dry mouth, which seems unconnected to medications.
Lack of temperature control. I have suffered from this for a number of years, but only at night. Recently it has become an issue throughout the day also, leaving me either far too cold, or far too warm. Fingers and toes always feel painfully cold regardless of weather or environment.
IBS has become much worse in the past 18 months, with constant diarrhea, cramps and loss of bowel control.

I have been referred to orthopedics, physiotherapy, rheumatology at SDGH, and to the local mental health team all regarding my symptoms. Because the pain and swelling in my left ankle was misdiagnosed as achilles tendonitis, they have only concentrated on that area of my body, and not taken the whole range of symptoms into account, which I feel are connected somehow as all my symptoms either appeared or became worse around the same time.
Emotionally, this has had a huge impact on me, and my life. I am no longer able to live independently as I need somebody around to ensure I have help with basic tasks (like cooking, taking a shower, and walking), as co-ordination and balance are something I struggle with a lot now. I am no longer able to go outside on my own in case I fall or am unable to bear weight on my heels. As a result I am now almost entirely housebound and even though I have bought a walking stick (after physiotherapy claimed I didn’t need help with walking), this only causes pain in my hips and neck as I try to balance with it.
I feel that if I could at least have a name for what is happening to me, I would cope a lot better, and possibly find a treatment which may help. Currently, I have lost all hope of ever leading a normal life, of being able to work. My hobbies all involve movement (walking, sewing, knitting, photography) and I am no longer able to do these things, and the rapidly increasing pain in my joints leave me unable to do the most basic tasks such as hold a pencil (I am also a writer) or comfortably type on a keyboard without wrist pain.

The show must go on.

All alone, or in two’s,
The ones who really love you
Walk up and down outside the wall.
Some hand in hand
And some gathered together in bands.
The bleeding hearts and artists
Make their stand.

And when they’ve given you their all
Some stagger and fall, after all it’s not easy
Banging your heart against some mad bugger’s wall.

- Outside The Wall, Pink Floyd

The smell of rose and amber shower gel. Cupboards full of donated plates, huge bags of pasta, Christmas leftovers and fake Pimms I can no longer drink. Twinkling lights on my mother’s Christmas tree, now placed between S’s desk and the huge Marshall amps; decorations passed down from my childhood, now belonging to me. Fudge cake in the fridge, and a shiny new Morphy Richards coffee machine sitting on the worktop. The ridiculously ornate mantelpiece covered in Christmas cards and candles, the bedroom lamps illuminating our Ikea bed and my beautiful dressing table. Roses and mistletoe arranged in glass milk bottles, and shelves filled with Discworld books.

My mother cried. She said this is what she always wanted for me. She admitted she never believed it would happen.

DSCF0002

Christmas was wonderful; quiet and easy, without the usual stress of arranging the tree lights absolutely perfectly to calm my mother’s slight obsessions.

This is all so new to me, and I confess it’s a strange feeling, knowing I’ve reached a major life goal. Where was the fanfare, the confetti, the slaps on the back and heartfelt congratulations? Of course, life doesn’t work like that, and in a way I’m glad. It’s no secret that it’s taken me far longer to reach the basic life-targets than usual, and in a way I’d much prefer nobody knew that, at 28, this is the first time I’ve ever felt safe. The first time I’ve been able to have a relationship without ripping it apart at the seams. The first time I’ve moved out of my mother’s house and known I’ll never go back. Known that I’m not doing it just to escape. The first time I’ve been independent without breaking down and ending up in hospital or riding home in a police car.

In a way, it’s like losing your virginity. That first time you see yourself in a mirror afterwards, and you check your face for signs; of knowledge, of growing up, of, well, sex – finally reaching this point in my life should change me physically. There should be something in my eyes, some sort of peace. A difference. But there isn’t, they’re still the same ice-blue, and I’m almost disappointed by that. I’ve wanted this from the day I realised life wasn’t going to give me a smooth ride, shouldn’t something feel different?

Woman Looking at Reflection

You see, I’m worried I’ll take all this for granted. Becoming too used to a situation is… a problem of mine. Considering how terrified I am of losing everything I hold dear, I have an ability to forget to try. I stop making the effort, because it’s scary thinking of making the next step up. I’m very aware that what I have now – the flat, S, independence – all relies on me not going batshit crazy. For someone who breaks down at least once a year, it’s hard knowing that I have to put the effort in this time if I’m to keep what I’ve worked so hard to achieve. I can’t just sit back and let life pile up around me; it’s never worked in the past, so why would it work now?

I know; I’m analysing too much.

“I wouldn’t be buying plug-in air fresheners if I didn’t want to live with you, would I?”

We’re nearly there. Empty boxes are beginning to outweigh full ones, and the hallway carpet is finally visible. S spent today sorting tools and electronic bits into drawers, while I painted the underside of some shelves I started yesterday, and a shelf S build from some scrap pieces of wood to attach to the blackboard I made from the backing to an old painting I found in the basement. We’re putting them up in the kitchen; I’ve accepted that my piss-poor memory isn’t going to improve any time soon, and any tools to help me remember the most basic things would come in pretty handy.

We’re finishing off tomorrow, and putting the Christmas tree up. After years of making sure my mother’s collection of decorations was in her will – I’m not kidding, I really love those decorations – she announced a few weeks ago that I could have them. Neither S or I are particularly big on Christmas, or public holidays of any kind, but I sort of want a tree and some sparkly lights for our first Christmas living together. We went to Tesco tonight to pick up some essentials, and ended up getting excited over festive food; something I never thought would happen.

lights

 

I confess, my first solo-ish Christmas combined with finally unpacking has brought the BPD out a little, and I’ve had a couple of outbursts; panic-driven, tear-stained, get-the-hell-away-from-me-or-I’ll-explode. I’m getting finicky about calories again and standing in front of the full-length mirror, loathing everything about my silhouette. Started wondering, “what’s the point in worrying about all this when i’ll inevitably go wrong anyway?“.

So I was quite surprised when S, who was leaning his head on my arm as I read in bed, said, “you are still enjoying living with me, aren’t you? I know I can be a pain.

It’s rare for S to show any real vulnerability. Not out of some misguided macho pride; he just doesn’t, and it seems to work for us. It’s always a surprise when he does, and I never quite know how to deal with it. After all, could I really be 100% honest without terrifying him? “Actually, I’ve never been so happy, and just being around you is making me more comfortable than I’ve ever felt in my life. Waking up with you is the best thing ever, and I feel like I could explode when you make me a cup of coffee because it’s so damn awesome to finally be living with you”.

No.

Past relationships – especially those with O and J – have taught me that it’s very easy to say the wrong thing, and sometimes it’s best to just keep my mouth shut if I want things to run smoothly. So I just stroked S’s hair, kissed him on the nose, and said “I wouldn’t be buying plug-in air fresheners if I didn’t want to live with you, would I?

Couple-on-Sofa

 

The past week has been strange to say the least, and I feel guilty for writing posts and not responding to comments. I had planned to get stuck in to this blog a little bit; find the time somehow to sit and relax and really think about everything which has happened and all the little occurrences I should be writing about. I do read every single comment, and it’s not like I simply shrug them off; many of them stay with me while I’m going about my day, and I find myself thinking of certain readers, wondering how they are.

I never really explained in my last post why I had a great big needle stuck into my ankle. In truth, I haven’t really wanted to speak about it much because although it’s wonderful that I’m finally – finally – being taken seriously and tests are now beginning to show results, it’s also scary. Words are being thrown around which I’m not entirely comfortable with. Suggested diagnoses. Referrals back to rheumy. Discovery of a misdiagnosis, and something big which was missed entirely.

Long story short, my ankle/foot pain was never being caused by Achilles tendonitis, despite it being diagnosed by physio, the bio-mechanics clinic, and orthopaedics. I’ve actually damaged a tendon in the side of my foot, meaning that the exercises I was all but bullied into doing despite my protestations of pain were just exacerbating the problem. The ultrasound I had a couple of months ago showed a tear in the tendon, and also a light mass in my ankle joint. Fluid. Lots of fluid.

So I was rushed through X-Ray. Being rushed through any department in my local hospital is a miracle in itself.

Then finally, after almost two years of constant pain, referrals, tests and appointments, it all began to come together.

Xray

 

The damage to my tendon is a symptom, and the reason why I’ve been in so much pain is because my ankle joint is incredibly inflamed, so I’m getting pain from both things, and the tendon can’t heal because the swelling keeps it constantly stretched.

So far, so normal, really. Dr. B did say I have osteoarthritis in my knees and fingers, so why not elsewhere? Only, my othopaedic consultant sat down and asked me a load of questions about my health; when I had pain, where the pain was, how well I slept, my eating habits, the history of my fibromyalgia… read back through my notes, and spoke to another consultant.

I’m going to send these results to Dr B. With your history and symptoms, we may well be looking at rheumatoid arthritis“.

He’s the third medical professional to say that in the past six months.

Only this time, they have actual pictures. Proof. Proof that I’m not faking it, and that there is something wrong with my body. That ultrasound scan.. just one scan, 15 minutes of my time, and finally things are happening.

Do I want RA? Hell no.

Do I believe I have it? Yes. It all fits. Everything. Almost too well.

Tests are beginning next month.

Maybe I’m just like my father: of psychiatrists and psychotherapy

Psychotherapy is a general term referring to therapeutic interaction or treatment contracted between a trained professional and a client, patient, family, couple, or group. The problems addressed are psychological in nature and of no specific kind or degree, but rather depend on the specialty of the practitioner.

Psychotherapy aims to increase the individual’s sense of his/her own well-being. Psychotherapists employ a range of techniques based on experiential relationship building, dialogue, communication and behavior change that are designed to improve the mental health of a client” – Wikipedia

woman-in-therapy-session

In my experience, most mental health centres and hospitals look the same. Red-brick buildings with NHS-standard signs directing patients to different departments, a row or two of (usually blue) chairs in a soulless waiting room, and old copies of Lancashire Life stacked on a low table if you’re lucky. Mazes of corridors and doors which are always kept locked. A buzzer or bell to gain entry or allow exit. Sometimes the paint on the walls differs, but it’s usually a palette of beige, pastel green or pastel yellow. “Calming” colours.

They inevitably make me think of the contents of an unwell baby’s nappy.

Our local mental health centre is, handily, in my town. It was recently refurbished and is now very different from the brief glimpses I got when I was being hauled – twice – to a private room on suicide watch in my teens. Back then the entrance led to a huge staircase which dominated the entire hallway of what used to be a beautiful old building but which has now been added to so much that it’s lost most of its character. Now, the staircase has been remodeled and everything’s been painted an off-white. There’s lots of glass and bright posters. It almost feels like a primary school, except you’re always aware that there are people upstairs, being watched 24 hours a day in case they hurt themselves.

waitingroom

I sat with my mother, and waited. As my legal appointee, she has a right to accompany me to any appointments and while I usually try to wriggle out of it… sometimes I need her. My fear of going back into the mental health system after over a decade of let-downs and damage inevitably took over, and I know I wouldn’t have coped on my own. As it was, I had a small panic attack when I realised the psychiatrist was stuck in traffic and would be late; if I ever needed control, it’s when I’m about to open up my fucked-up heart to a complete stranger.

I was mildly surprised that the psychiatrist I saw was a young woman. I’ve become used to stuffy old men in shirt and tie, peering at me over their glasses and shrugging off all my concerns as being “down to my age”.

Another blue chair. Another desk, another patient file. I’ve done this so many times that I may as well just record what’s said and play it at the inevitable next appointment a few years later. You see, I have a problem sticking with things, and I’ve already spoken about how I find it almost impossible to be honest when faced with authority. When everything becomes too much I cave in and accept professional help, but I either pretend nothing’s wrong, or never go back. It’s as though I want to help myself, but the process is too frightening. Therapy means a loss of control and a need to be painfully honest; two things I find almost impossible to deal with.

I explained to the psychiatrist that I felt I was too old to still be dealing with all this, and that the mental health system has let me down a lot in the past. Picked at my jeans and stared at the wall as I detailed everything; the panic attacks, obsessions, paranoia, the total lack of self-esteem, the drugs, the painkiller addiction, the times in my teens when I relied on stolen bottles of gin to get me through the night, the self-harm, the bulimia. As I spoke, I realised that honesty was never going to come easy; although I was forcing the words out with all my strength, I still held back. However, my stumbling confessions were enough to confirm the diagnosis of BPD, and to earn me a referral for psychotherapy.

chickentherapyhut

Specifically, I’m on the 18-week waiting list for CAT Therapy.

Cognitive Analytic Therapy (CAT) is a form of psychological therapy initially developed in the United Kingdom by Anthony Ryle. This time-limited therapy was developed in the context of the UK’s National Health Service with the aim of providing effective and affordable psychological treatment which could be realistically provided in a resource constrained public health system. It is distinctive due to its intensive use of reformulation, its integration of cognitive and analytic practice and its collaborative nature, involving the patient very actively in their treatment.

The CAT practitioner aims to work with the patient to identify procedural sequences; chains of events, thoughts, emotions and motivations that explain how a target problem (for example self-harm) is established and maintained. In addition to the procedural sequence model, a second distinguishing feature of CAT is the use of reciprocal roles (RRs). These identify problems as occurring between people and not within the patient. RRs may be set up in early life and then be replayed in later life; for example someone who as a child felt neglected by parents perceived as abandoning might be vulnerable to feelings of abandonment in later life (or indeed neglect themselves).

It all sounds like much of a muchness, and initially I was reluctant to even consider it. Most experiences I read online leaned very much towards the negative, and the idea of writing a “goodbye” letter to my therapist is an odd one; I usually leave therapy sessions by simply walking out and never coming back.

However, I’ve given it a lot of consideration over the past few days. Knowing CAT is a “cheap” therapy is a concern; does that make me a snob? I’ve decided that a minimum of eighteen weeks is a long time to think it through, and I do have the safety net of being able to leave whenever I want; I’m not being forced into psychotherapy. It’s my choice, and I think at least giving it a go is the right decision.

I think.

I hope.

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