Wednesday 27 June 2018

Emotion Regulation Therapy: Session Six, Last Session

(TW: Overdose, mentions of self harm, abortion)

Since my previous Emotion Regulation session, my mood had been worsening. Thoughts and feelings were building up rapidly, and there were feelings I found hard to understand. One of them was this heartbroken feeling. I hadn't broken up with anyone recently and I'd not suffered loss for a little while, so I couldn't understand where it came from.

I was also having dangerous urges to self harm and overdose. My thoughts were racing and needed some sort of release. I wanted to shut out my emotions as well. A few days before my last therapy session, I took an overdose. Although small, it was more of an overdose than the last couple of times. Again, I wanted to be unconscious. I didn't want to think or feel, because it was too painful and confusing.

By the time this session came round, I was feeling desperate for more support. I wasn't happy that this was the last session, and I felt I needed more support (although I wasn't sure what support I needed). I also wasn't happy about the fact that my appointment with my CPN (whenever that will be!) will probably result in my being discharged. I felt as bad (if not worse) as I did when I was referred to secondary services, and felt guilty for not improving more through therapy. I had learnt new skills to tune into emotions, self soothing, and how to lessen/delay urges, but I found them very difficult to put into practice.

I spoke about this to my support worker, during my therapy appointment. She was disappointed and worried that I'd taken another overdose. Although she knew that I wasn't exactly suicidal at that time, she did tell me that I could end up killing myself if I keep on like this. She said this unhealthy coping mechanism was in danger of becoming a habit. I admitted it was starting to become that. As for support, she told me that there wasn't a lot the CMHT could do. They could advise me to not overdose, but they didn't have the resources to stop me, especially as I have "insight and capacity".

As for therapy, they could only offer short term sessions. What she did say was that there are some group sessions for Distress Tolerance happening next month possibly. She will have a word with my CPN, to see if I could go to those before being discharged.

We then spoke about the feelings I had noticed recently; primarily the "heartbroken" feeling. I told her I couldn't understand why I felt this way, and what had led to it. What she responded with, really clicked with me though. When we have an unexplained feeling, that we cannot understand in terms of where it came from, it's likely that it is an old feeling resurfacing. She gently suggested that it may be due to the abortion I had nearly 10 years ago. Suddenly, it made a lot of sense. Things such as the Ireland vote had triggered my thoughts and feelings about this. I'd tried to avoid this, but it has been all over the place recently. I knew it affected me a lot, but I guess I didn't expect the feeling to last weeks.

(I'm now dissociating as I write this. It is one of my only ways to cope with speaking about it)

I started to shake and cry as I told her I agreed with her suggestion. I had many complicated feelings about this time in my life, and apart from an amazing friend who was with me throughout, I did not get much support. The man who would've been the father was really upset that I had decided to have the abortion. I know that he'd always wanted children. He never asked me how it went, how I felt, if I was ok etc. He lit a candle to honour the baby that wasn't to be.

My new boyfriend at the time appeared to be sort of supportive, as I had times of constant crying, numbness, and silence, but in arguments afterwards, he told me he was angry that no one had considered how he felt. He also said something disgusting about babies, which really upset me.

When it happened, the nurses treated me as if I was a bad person and an irresponsible child. I was offered no counselling (even though I was clearly distressed) and the only appointment I had afterwards was a nurse's one to put me on the contraceptive pill.

I told my support worker most of this, and also that I worried in case it was my last chance to have children. She said what I needed to do was problem solve. My main worry was about fertility, so a check up with a doctor would be the first step. The next thing would be to get bereavement counselling, so I am able to cope with this and gently expose myself to situations where the topic of abortion arises. She also said it may be helpful to connect with others who have been in similar situations. This type of thing triggers me badly though, so I'm going to need support through it.

We then moved onto the last worksheets. feeling our emotions. It involved staying with uncomfortable feelings, and practise doing this until it becomes easier to cope with. The worksheet spoke about Emotional Mindfulness as a way of feeling emotions without judgment. There were 6 steps to this: acceptance, paying attention, slowing down, giving way, seeing it through, and reflecting.

Acceptance involved understanding that feelings come and go, and we cannot control this. We have to accept them without judgment instead of fighting them.

Paying attention reminded us that feelings are felt in the body. We should pay attention to those bodily feelings and try to link them to certain emotions to see if they fit. We also need to stay in the present, and not try to figure out why we feel this way

Slowing down by focusing on each feeling that arises, and sitting with it as well as observing it closely.

Giving way when the feelings arise. Letting yourself cry or feel angry for instance. You don't have to do anything apart from let go.

Seeing it through by considering the positives that come from feelings. According to the worksheet fear brings wisdom, sadness brings healing, and so on. We should be able to feel our emotions through to completion, and feel lighter once they subside. If we are "stuck" in one feeling, and can't ride it completely, there may be reasons for this. These feelings could be defensive (feeling angry when actually upset etc) and there may be more going on. Another reason, as I explained above, may be that our feelings have roots that go back to a previous time. These feelings are not resolved, so linger and resurface.

Finally reflecting. It is important to reflect on our experience and understand how important it was to feel our emotions through to completion. It is not an easy thing to do, and takes courage.

The session soon came to an end after this. I was still very tearful, but also emotionally exhausted. My support worker told me to look through the worksheets and practise the tasks on them. Also, she said to not put too much pressure on myself. This takes time and isn't easy. I must not blame myself if I can't do this sometimes. She also urged me to not self harm or overdose again. Lastly, she reminded me that she would be suggesting to the CPN that I am not discharged yet, and that I may benefit from the Distress Tolerance group.

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