Wednesday 8 May 2019

How do I define myself? Counselling Session 2

My second counselling session came around at just the right time. I'd been feeling extremely low and anxious over the past couple of weeks, and although I did confide (a bit) in friends, I needed to be able to just let it all out in a therapeutic setting.

Naturally, the PHQ etc scores were very high, and my counsellor seemed concerned about this. She asked how I'd been recently, and if anything had triggered my low moods and anxiety.

I started by telling her about something that had cropped up again recently, on social media. It involved an ex friend who had set up a malicious forum to name and shame people they believed were over-exaggerating or faking their illnesses/disabilities. Of course, this caused an uproar with the online community this person was a part of. How could we trust someone who may judge us and question how disabled we really are, just based on our social media posts, hobbies etc? Everyone is different in terms of their capabilities, what debilitates them severely, moderately, mildly etc. It is not the job of a random person to decide who is disabled enough to deserve the support they get. This is probably the last time I will talk about this, as it is far too upsetting, but it was something I mentioned in my counselling session as it was a big trigger for my anxiety.

We then talked about paranoia. It's a term I use a lot to describe my feelings about certain things. I wasn't sure if my anxious feelings (about being judged for my disabilities) qualified as paranoia anymore as they were much less extreme than they used to be. At my worst, I truly believed that if there were any car or van outside my house, that I did not recognise, it would be an informant for the government, spying on my daily activities. I also felt the same about strangers I passed in the street, if they stared at me for too long, or made any odd comments. As well as this, I would be hyper aware of anything strange going on with my laptop, online accounts etc. I thought someone had taken control of my laptop, regardless of how many times I checked anti virus/anti malware/anti spyware etc programs. Although my feelings are much less extreme now, she believed that how I felt still counted as paranoia, and that this is more of a scale where you can be mildly paranoid, severely, or anything inbetween.

Next, the counsellor wanted me to do an exercise. There was a whiteboard in the room, and she drew a table with 3 columns. The first was entitled "Who I am", the second was "How others perceive me", and the third was "Who I want to be". I had to put words and phrases in each column to answer the question in the headings. At first, I found this very difficult. I didn't want to just put negative things about myself, even though I was feeling very negative and depressed at the time. With the counsellor's help, I wrote the following:

Who I am

  • Friendly
  • Caring
  • Ambitious
  • Determined
  • Strong Morals
  • Negative
  • A Worrier
  • A Perfectionist
  • Weird
  • Struggling
Whilst writing these things, I paused to think about my answers as well as how specific the header's question actually was. How do we define ourselves? Is it about who we are, and/or what we do? Should we mention academic achievements as part of our identity? How about chronic mental or physical illnesses/disabilities? I asked the counsellor this, and she found it very interesting how I analysed the question to such a degree. She asked if I felt my illnesses formed part of my identity now. I thought about this for a few seconds, before saying that yes, I did feel that way. This was partly because I'd been ill for so long, and partly because my interests in breaking down stigma to do with mental illnesses and chronic physical illnesses were so strong. I guess how I assert myself and teach people about things to do with stigma forms part of how I define myself. I feel I have to "do" something in order to be someone. I found certain things people have said about me in the past, and the way they had treated me, were so ingrained that they became how I saw myself, so words to describe this (weird, negative etc) were written in the first and second columns of the table. 

In the second column, I had to write words/phrases about "How others perceive me". I found this a little easier to fill in, because I have spent so much time focused on how I believe others perceive me. Here's what I wrote:

How others perceive me

  • Lazy
  • Defeatist
  • Negative
  • Friendly
  • Strong Morals
  • Weird
  • Incompetent
  • Stupid
  • Weak
As you can see, a lot of these descriptions are very negative and harsh. Defeatist was a word I worried that mental health staff felt towards me. They often only see my negative days; where I feel useless and deflated, as well as very pessimistic about the world in general. I speak as if I have the weight of the world on my shoulders and nothing will ever improve. I feel that they believe I have given up and have no desire to change the things I can. In truth, I'm struggling and I'm asking for help because I still have that slight bit of hope that things will get better (with the right support, for enough time). I am willing to put in the effort and commitment needed, but I need a long term type therapy that focuses on my past traumas. I am presenting my therapist, CPN etc with the feelings/symptoms I have, some mentions of diagnoses, and how my struggles affect my life, aspirations, relationships etc. This is in the hope that they will make connections with these struggles, and decide the best course of treatment/therapy for me. In reality, they may try to do this, or they will just pick out the anxiety or low mood symptoms. In terms of treatment though, my local CMHT barely have a thing they can offer me. 

"Incompetent", "Stupid", and "Weak" were descriptions I felt people have associated with me for years. I can link a lot of that to the bullying I experienced throughout Primary and Secondary School. Everything I said, did, wore, enjoyed, knew or didn't know, was judged severely. My bullies would make me feel as if I was completely wrong about everything and couldn't do anything right. I didn't fit in, I was far too polite, I cried too much, I didn't start conversations enough, I was too quiet, my nose was too bumpy, my ears stuck out too much, my makeup wasn't right. Even the way I sat was mocked! I doubted everything about myself, and even now I have to ask reassurance for certain things. Most recently, I spoke up about something and then worried that people would demand sources for my information. I worried that I would not be able to find strong enough sources and people would just put me down as a bitter and bitchy person who didn't know what they were talking about. 

Lastly, I filled in the "Who I want to be" column. I couldn't think of many things, but the following terms were included:

Who I want to be

  • Successful
  • Happy
  • Confident
  • Assertive
  • Balanced (less mood swings)
Until finding out otherwise, I tend to believe lots of friends and acquaintances fit all these descriptions, by what they say/how they express themselves online. I admit I get very jealous and compare my life to theirs. I want the Doctorate in Psychology, I want the spouse and children, I want to move out before I turn 30, I want to react to criticism in a less extreme way, I don't want to be triggered by things. I want to grasp every opportunity I get. 

Whilst speaking to my counsellor about this, we realised together that I actually blamed myself for things that were (mostly) out of my control. Of course, the termination experience came up, as my struggles around this are exactly why I sought counselling this time. Part of me regrets having the termination, as I worry this may have been my only chance to have children. I hate that I hurt my ex partner (who would've been the baby's father), even though it was my body and my choice to make. I at least told him what I'd decided to do. Even though I was only 19 at the time, I knew other friends who had managed to bring up children from a young age. I guess I thought a person was supposed to feel a certain way after a termination and I thought I had all the "wrong" feelings about it. I expected to feel relieved and able to move on after a while. Instead, the memories, mental images, conversations I had with people, the way I was treated by nurses, stuck with me. I felt that I had made the decision too hastily and almost as if I'd done it for other people rather than myself. I felt ashamed about getting pregnant so young, especially while studying and living in halls. I'd just started a new relationship and I guess I didn't want him to have to deal with my "baggage" (to put it extremely bluntly). I had all of these feelings, and worries that my thoughts about it were taboo, that I didn't know how to deal with it. So I have this huge messy knot filled with memories, images, feelings etc and I'm searching for someone who can help me unpick it and deal with what we find. I don't want to completely forget what happened, I just want to accept it and not worry so much about the future.

The hour was nearly up, so the counsellor decided we should look at the bigger picture and see how things are linked, certain things affect me and why. 

One glaringly obvious conclusion was that the way I believe others perceive me, has a big effect on my moods and therefore my mental health as a whole. I am easily triggered by things that play on my insecurities and deeply held worries. My chronic physical illnesses/disabilities are very debilitating, but the way I believe others judge me can be very debilitating too. 

The counsellor then asked how I would feel, and what I think my life would be like without the worry of people perceiving me in a certain way. I said that I couldn't even imagine this, but I think I would feel a bit more free, confident, and like I was "allowed" by society to go out of the house whenever I was having a good enough day. Maybe I could try things like a gentle form of yoga, to see if I could cope with more exercise. At the moment, the fear of someone reporting me to DWP for being too active makes me feel I can't even go for a taster session. 

I told the counsellor how I felt society thought that everyone should be in a job and that no one is truly unable to work (of course this is wrong, but this is what I believe politicians and the media have taught a lot of people). The way I am now though, I can't imagine what sort of accommodations could be put in place in order to allow me to participate in a job. My illnesses are so predictable, and I would have so many sick days that I would end up losing my job within months (or even weeks). I feel my employer would see me as far too much of a liability to keep on. I think back to how much I struggled when I did work. I had at least one sick day every month, and my pain, exhaustion etc slowed down my processing, communicating, organising information etc. I would make mistakes and need help. I couldn't learn things in 5 minutes and be at the same standard in 1 month, that someone had got to in 3 years, for example.  

Chronic illness in itself is a full time job. I'm especially feeling like it is, this month. There are many appointments with GPs, specialists, mental health professionals to go to, in order to review medication, continue therapy, have tests of various kinds etc. The times inbetween include managing daily life. This consists of making sure I sleep when I need to, I take my medication on time, I make sure to avoid any food that might flare up my symptoms, I pace what I do, but also try to get some sort of exercise, I do any therapy homework required of me, I make phonecalls to doctors etc if needs be, I try to socialise in order to tackle anxious thoughts and raise my low moods, I monitor how I feel from day to day so that I can accurately give information (at appointments) about my symptoms. I fear the future because I want more out of life, but I can't see how anything can change, unless treatments improve for example.

Overall, I found this counselling session very interesting, and it gave me opportunity to think about various things; including how I react to the things I believe are happening/may happen. I get on well with the counsellor, and feel I can confide in her. I'll keep documenting my sessions (there may be more than 10 posts on this alone)

I'm sorry this is such a long read, it was a very full on session! Thank you so much, and also well done for reading this far. I will keep you posted about my next one.

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