It’s been another difficult week. This is partly down to fall out from the holiday we just got back from. but a lot of other stuff has been going on as well. My wife also had a minor operation on Tuesday, and I’ve been busier than usual looking after her. Then I had to see a gynaecologist on Thursday, as my GP thinks I might have endometriosis, and finally I had a CMHT assessment on Friday.
The assessment was probably the most stressful part of the week. I was last assessed by the local CMHT in February, and they referred me to a psychoanalytic therapy service. I had my assessment with the therapy service in May, but decided against further treatment with them. I found the therapist there really intimidating: she wasn’t trying to be warm or engaging like any of the previous therapist I’ve seen, and it felt more like an interrogation than an assessment. She asked very blunt questions, like why I felt the people who raped me had chosen me (definite victim blaming implications there), and whether I thought it was a good idea for me to be in my current career. Their approach at the unit is to wait for you to speak, and I find that really hard – once I trust someone a bit it’s hard to shut me up, but just sitting there staring at me like a snake isn’t really going to facilitate that. And her whole manner – the coldness, the implied judgements, the air of not giving a shit about me – profoundly reminded me of being treated similarly by my mum and others in the past, which was really distressing. While I realise part of psychoanalytic therapy is about discussing the projections the client makes onto the therapist, this wasn’t just transference – that woman was just scary and triggering and not at all helpful. So I thought maybe the CMHT would have other ideas about things that could help me.
It’s been five years since I have had any ongoing support from NHS mental health services. I had mixed experiences with previous treatment in another county – my CPN there was helpful, but the main psychiatrist I saw was as cold and invalidating as they come. They could also be quite unpredictable. One example: at one appointment in early 2007 the doctor suggested I could be admitted to hospital to have my meds changed, as I had a history of reacting badly to withdrawing from and starting new medication. At the next, when I was really struggling with withdrawal and asked if hospital was still an option, I was told hospital couldn’t keep me safe and my desire to be admitted was a sign that I was becoming too dependent on the services. There were a lot of incidences like that regarding that particular doctor. I was also treated poorly by the eating disorder services. I was grabbed by a family therapist when I was having a panic attack and stood up to leave the room during a group session, and then chased down the corridor to the day room by her, shouting about how I would die if I didn’t engage with treatment. After discharge and a re-referral the following year, having individual sessions with that woman was made a condition of them helping me again. I eventually put in a formal complaint about that, and received an apology, but that was years later – at the time I was incredibly unwell and vulnerable, and their treatment put me at greater risk.
As a result, for five years I’ve kind of ‘sworn off’ NHS mental health services. However, last winter I was desperate, in another part of the country, and having left it five years I thought maybe things might have changed a bit. And the doctor I saw then was nice enough, although I was so shocked by seeing a nice doctor I forgot to ask what I was supposed to do for support while waiting for this therapy referral to come through. After that didn’t work out, and my self harm got really out of control in May, I was re-referred. I guess I was lulled into a false sense of security by how smoothly it went in February, because the (different) doctor I saw this time was totally different. He accused me of being in denial about the result of the therapy unit assessment (of course I disagree with it, I was so scared by that woman I said whatever I thought she wanted to hear until she let me leave), and of using my psychology studies to obstruct treatment. I asked about the specific symptoms I was supposed to be in denial about, and explained to him that my behaviour with that particular therapist was not representative of my behaviour with other professionals (those who are not lizard people), but he wasn’t having any of it. It’s impossible to disagree with a psychiatrist determined to turn every point you make into evidence of your defensiveness and denial. He started talking over me after ten minutes and at fifteen told me firmly that they didn’t ever offer ongoing support, it was all target driven, and that he would pass my details onto the psychology team with a view to helping me with the problems the therapist thought I had.
So that went well.
Things got a little farcical after that. I went to pick up a wheelchair we had hired for my wife while she’s recovering from this operation, and got so distracted I accidentally took it for a walk on the town moor, in full sun, through the cow poo and everything. How on earth I got that lost I don’t know. I was so hot and bothered by the time I got home I burst into tears and cried on/ranted to my wife for about an hour, before swearing off NHS mental health services for another five years. Probably.
I’ve said this on Facebook and Twitter over the last few days, but I’m really angry about how unjust all this feels. It seems pretty common to people seeking support for the effects of abuse, bullying, and other forms of trauma. So, you’re victimised and traumatised through no fault of your own (regardless of what that therapist thought). In my case this has included emotional abuse and neglect, bullying at school, and rape when I was 18. I had no safe person to talk to about any of these things, and every time I sought help I was invalidated and blamed. The teachers at my school accused me of just being too sensitive – the people bullying me were just being kids. My mum accused me of attention seeking and trying to hurt her when she found out about my eating disorder and self harm. The mental health services accused me of not taking enough responsibility for myself from day one, as a scared and traumatised sixteen year old who had never been taught what to do with difficult emotions. There’s the second injustice – first you are traumatised, secondly the resulting problems are your fault. And thirdly, if you are lucky(?) enough to receive some form of help, there is often a punitive element. In eating disorder treatment I was always being told off for not trying hard enough, even though I was trying so hard I was eating my meals in tears at the day unit. In another type of therapy I had, any form of self harm resulted in a 24 hour ban from speaking to a therapist, and they kicked me out because my weight was too low after a few months. My psychiatrist told me age 18 that I would always be the way I was, and that I’d just have to learn to live with it. The only time I ever cried in front of him (in desperation, because medication side effects had made me suicidal) he stared at me for five minutes, then said “I can’t do anything about this”.
And finally, it’s hard to even be angry about all of this because there is a cacophony of voices in my head, put there by my parents, doctors, teachers, and society in general, telling me that I’m playing the victim, I just need to get a grip, take some responsibility, and stop trying to get other people to clean up my messes. I want to apologise for my distress by listing all the things I’ve done in the name of recovery – eventually gaining to a healthy weight by myself, reading hundreds of self help books, teaching myself to live independently and to form stable relationships, graduating last year after dropping out of my education five times. I’ve always tried so, so hard to engage with the services in an ‘appropriate’ way, ask for what I need clearly, not resort to desperate gestures when they screw with me, and it makes no difference. And I feel pathetic, because I’m getting sucked into their game, in which no one deserves help or support unless they can prove they are ‘deserving’ enough.
Maybe if society didn’t look away nervously when the subject of abuse came up, slap bullies on the back and tell victims that it’s character building, and actively fucking condone rape, there wouldn’t be a mess in the first place.