Wednesday 31 July 2019

My last Counselling session, and a referral to CMHT :Counselling Session 11

(Trigger Warning: Self Harm details, Suicide, and Abortion)


Mood Swings and Intrusive Thoughts:

A couple of days before my last counselling session, I was slightly hyper, overconfident, in a confrontational mood, and impulsive. I did not have much money to be impulsive with, so I just bought a jacket for my mum. Days before that, I had spent money online, buying lots of makeup and hair products. This hyper feeling only lasted a couple of hours, and then I became very anxious and paranoid; particularly about social media. I'd posted my response to an article about disabled people protesting and being reported to the Department for Work and Pensions (DWP) simply for protesting. I thought this malicious reporting was disgusting and I criticised the police who had done it. I fully expected an angry response from police officers/people who supported the police unconditionally, but thankfully I didn't get any. My Anxiety didn't subside much though, and I soon found myself in the deep pit of Depression. I was also very distressed, as I was experiencing graphic triggering mental images (mostly of abortion, and self harm) as well as intrusive thoughts and strong urges to self harm. I was supposed to call the Access team for some guidance, but I was too distressed and nervous, so I opted to email them instead.

The response I got the next day was very cold and dismissive. They basically told me I was right to say calling would result in a quicker response, and that I should do that instead. There was no sympathy for my situation. If anything, it nearly put me off calling, as I expected the call handler to be just as cold and dismissive.

By the end of the day, I was desperate to talk to someone though. I brought up the number on my phone and pressed "call" before I could talk myself out of it (again) due to thinking my situation wasn't urgent enough. The call handler was lovely though. They had a really calming voice, listened to me, and took me seriously. They also gave some helpful advice.

Counselling:

Skipping forward to my counselling session,  I was still very distressed and depressed. As I explained to my counsellor, how I'd been feeling, I became more distressed, confused, and tearful. There were some things I hadn't realised about myself, that had now come to the forefront as I exposed myself to triggering conversations through counselling. The problem was, I needed support inbetween counselling sessions, as I had talked through my trauma in the session, and when it had ended, I was left to deal with the result of opening up. That's not to say counselling has caused my crisis (is it a crisis?) but it has brought some difficult things to the front of my mind; which has then led to a crisis.

I spoke to her about my intrusive thoughts, the mental images, the suicidal thoughts and urges to self harm (specifically cutting my arms and legs in the shower). This took over the session, as it was so urgent that I get help soon. My counsellor was very concerned and wanted to know how likely I was to harm myself.

She told me that to deal with the trauma and learn practical skills for coping, I needed to have trauma specific CBT. She then said that she didn't feel I was stable enough to commit to it at the moment though. Primary Care didn't have the resources to help people who are at risk of suicide or self harm, or the very complex issues that are causing me to need help straight away. She said that if I wanted, she would call the Access team so they could step me up to secondary care

She also asked what I felt I needed, if I were to be referred to Secondary Care (aka Community Mental Health Team). I took a minute to gather myself together, then told her I felt I needed a medication review, because I felt the Sertraline wasn't working anymore, and I shouldn't be in this state while on the highest dose. I also needed to be assessed for PTSD, and have a CPN to monitor my progress.

She asked me how I felt they could help me become more stable (other than the meds review) and I started crying as I said I wasn't sure, but I didn't want to keep struggling with the trauma I've experienced. I didn't want to feel this way anymore and I'm no expert so I don't have all the answers for how to help myself. I felt like I needed to have all the answers though, otherwise CMHT wouldn't know how to help me. I told my counsellor about the last time I was assessed by them. I did need their help though, so would like her to ring the Access team for me. She asked me to tell her what I wanted them to know. I said that I wanted her to tell them that I was having strong urges to self harm, I was having suicidal thoughts as well as graphic intrusive thoughts and mental images. I also was very depressed and distressed, and needed help very soon.

The session had come to a close at that point, and my counsellor confirmed she would ring Access team and tell them what I'd told her. I'd stopped crying by that point, and was checking my eyes weren't too red. I was very grateful to her for all her help, and I was very apologetic about how I'd behaved (I was worried that I had been rude and in her face. It turned out I hadn't though).

What Happened Next:

The next day, I expected a call from the Access team, but it never came. I rang them and explained everything. They checked my notes on the system, and said that I'd been stepped up to secondary care/CMHT straight away, and an appointment had been booked for me for 7th August.

I will blog about my appointment with CMHT soon. Please keep your fingers' crossed that they can offer me some help!


Resources:

Police force admits agreement to share information about protesters with DWP: https://www.disabilitynewsservice.com/police-force-admits-agreement-to-share-information-about-protesters-with-dwp/

Dealing with intrusive thoughts: https://www.mind.org.uk/information-support/your-stories/dealing-with-intrusive-thoughts/#.XUGQsehKiM8

Treatments for PTSD: https://www.mind.org.uk/information-support/types-of-mental-health-problems/post-traumatic-stress-disorder-ptsd/treatments-for-ptsd/#.XUGRW-hKiM8

Community Mental Health Team: https://www.rethink.org/advice-and-information/living-with-mental-illness/treatment-and-support/community-mental-health-team-cmht/?gclid=CjwKCAjw-ITqBRB7EiwAZ1c5U6Ry5KJLjfr8k89GV4DpHT1_3NVTwxF-_nqPRrzqeF1QNV6cVwo2PRoCqIQQAvD_BwE

Post Traumatic Stress Disorder: https://www.nhs.uk/conditions/post-traumatic-stress-disorder-ptsd/

Mental health professionals: https://www.netdoctor.co.uk/conditions/depression/a638/mental-health-professionals/


Friday 26 July 2019

Lack of Resources: Counselling Session 10

(Trigger Warning: Mention of trauma, self harm, overdosing, and suicide)

I had been experiencing a lot of emotional numbness and the need to avoid my feelings; leading up to this counselling session. Because of that, I wasn't sure what to talk about. My counsellor did ask me to embellish on the numb feelings and avoidance though and we found I was doing this to protect myself from intense distress and depression. There'd been some triggering storylines on television, and instead of panicking, I found myself dissociating in order to protect myself from the horrible feelings of being triggered.

My mum has had to fill in a work capability questionnaire too, and helping her do this, seeing her so anxious and depressed, has really rubbed off on me. It also took me back to the times I've had to fill in these forms; how much I've struggled emotionally, remembering back to that awful first face to face assessment. I never want to go through that again. My mental health worsened partly because of that assessment, and I haven't significantly improved since. As for emotions rubbing off on me, I told my counsellor that this happened in many situations, and I found I even got affected by atmospheres in a room. If it's a depressing atmosphere, I feel depressed. If it's an anxious atmosphere, I feel panicky, and so on. If a person is upset, they don't have to be showing it obviously, or tell me. I can sense how they feel, and it makes me feel the same. I suppose I'm an empath, in that sense. I've always been told I am both sympathetic and empathetic to people's situations.

We talked about how my emotions tend to be very intense. Even being numb can feel intense.  I find it hard to "catch" myself before my emotions have gone from 0-100, so balance is something I would love to strive for.

We also talked about the dissociation I experienced. I explained how it felt as if I was looking at the world through a thick glass window, or an out of body experience; where I'm watching myself do and say things. I'm not really there, I'm just a body without the human element to it. I also feel very spaced out. I find it hard to talk about things fluently. I can't concentrate properly and nothing feels real. When I'm like this, I worry about what I will say or do as I'm not really *there* to face the consequences.

I started experiencing dissociation when I was bullied at school. It was a way of protecting myself and escaping from the bullies' cruel words, the abandonment I felt when left out, the lack of support and understanding from my elders. I was avoiding my feelings, and it took a while to ground myself.

We then moved on to what would happen after the last session (session 11) of counselling. We'd decided that, although counselling had helped me to talk freely about what I needed to, and understand the problems I have with trauma, it was not a specific therapy for trauma. What I needed was something trauma focused. The counsellor said that the Wellbeing (Primary Care) Team only offer trauma focused CBT. I considered this, but wanted to know if secondary care would offer anything. She said she'd spoken to her manager, who had decided I'm not unwell enough for secondary care, and to be honest, they just didn't have the resources to offer the long term help I needed.

So it was CBT or nothing.

I told my counsellor that I had set up a fundraising page to try and raise enough money to fund a few private sessions of trauma therapy or EMDR . This would help me to get specialised help, but it cost around £80 for an hour's session. Unfortunately, the fundraiser was a flop. I had a grand total of one donation.

I decided to say yes to the CBT. It was my only choice. My counsellor had been under the impression that she could refer me straight on to be placed on the waiting list for CBT, but unfortunately it doesn't work like that. Once counselling has finished, I need to self refer, go through the telephone assessment, and then be placed on the (8-10 week I think?) waiting list. It's not ideal, but it really is that or no help at all.

I told my counsellor about how, although I was grateful for the help I had got, I was frustrated about the lack of choice of therapies in my local mental health team. I knew it wasn't the staff's fault, but it didn't stop me feeling as if I wasn't really getting the right help for me. I also felt abandoned by secondary care. Again, I was grateful for the help they had given me (a referral to a psychiatrist, and a couple of sessions with them, as well as a CPN, and support worker who gave me some very short rounds of self compassion therapy and emotional regulation therapy). The last time I was referred to them though, I was very unwell, self harming, overdosing, and even hallucinating, they would not help me. I was assessed then discharged; being advised to get CBT with the wellness team. Usually, they would tell me to call if I ever needed them. This time, they didn't. It could've been a mistake on their part, but my brain told me that they didn't want me to call them ever again. I felt as if they'd washed their hands of me because I didn't deserve the help, and I would have to have done something drastic if I ever was to get their help again.

I said to my counsellor that, when it came to urgent help, mental suffering was not seen as bad enough for assistance. It had to be that the mental suffering had led to physical consequences (such as self harm/overdosing/a suicide attempt) before anything would be done. Even then, help wasn't guaranteed. I suppose I did blame some of the staff for not taking me seriously enough, but it was also to do with lack of funding from the government, leading to lack of resources, and therefore lack of help and choice of care. It's such a shame. No one should be left to suffer in silence.

I have one more session left, then that's it for counselling. I told my counsellor at the end of the session, that I would miss her a lot, and I felt that we had a great therapeutic relationship. I think she appreciated that; she was grateful anyway.

So my plan now is to wait a few days after my last counselling session, then ring the mental health team to self refer for CBT. I'm hoping the therapist I see knows a lot about trauma, so that they understand the things I tell them. I'm keeping an open mind about going through CBT yet again (5th time now?) so I'll have to wait and see how it goes. I will of course blog (and maybe also vlog) about my sessions. In the meantime, "just keep swimming!"



Resources

My ESA Tribunal Experience: https://www.amysmysteryillness.co.uk/2014/03/my-esa-tribunal-experience.html

13 Signs That You're an Empath: https://highlysensitiverefuge.com/empath-signs/

Grounding techniques: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/self-care/#TryGroundingTechniques

Dissociation and Dissociative Disorders: https://www.mind.org.uk/information-support/types-of-mental-health-problems/dissociation-and-dissociative-disorders/#.XTtgYuhKiM8

Cognitive Behavioural Therapy https://www.mind.org.uk/information-support/drugs-and-treatments/cognitive-behavioural-therapy-cbt/#.XTtg2ehKiM8

My Ko-Fi fundraising page: https://ko-fi.com/W7W0XG96?

Eye Movement Desensitisation Reprocessing: https://www.ptsduk.org/treatment-options/eye-movement-desensitisation-reprocessing-emdr/?gclid=Cj0KCQjwyerpBRD9ARIsAH-ITn8wTsjUzlHWODMZO6to9j5467XJogbBYhhHsDZpozCQXg0x83b4DAwaAvmdEALw_wcB





Tuesday 16 July 2019

What's Next? : Counselling Session 9

(TW: Abortion, abuse, and bullying mentions)

I'd been very emotional; leading up to this session. I'm not sure what set it off, but everything had felt so intense. I also wanted to control situations more, and had more flashbacks. It didn't help that I'd had flare ups of my physical conditions; especially the pains. TV shows had been full of abortion story-lines, and coupled with being on my period, I really wasn't having a great time.

I don't think I've been very open about how I've been feeling to be honest. This is a sign that I'm isolating; not something I always realise for myself. I do hate feeling like this though.

I let everything out at my counselling appointment. Thankfully, I don't really feel judged by my counsellor and I feel like I can tell her anything.

We went through how things linked to other things, and how my past had such an impact on how I react to things now. We also discussed the main things affecting my mental health at the moment. We decided that my main issues were my trauma (from bullying, the abortion, and the abusive relationship), as well as my need for control, and my anxiety.

In the previous session, we'd created a time-line to determine what led to my need for control, and what the consequences were/could be. Right at the start was the bullying; where my belief that people would be kind to me if I was kind to them, was challenged. Because they acted in a way I didn't expect, and they were horrible to me, I wondered if I was a horrible person and I questioned whether I deserved to feel good. This then led onto me not trusting people or situations, and therefore wanting to read minds, know what the future would bring/what would happen next, as well as feeling bad about myself. This led onto the need to control.

The consequences of controlling or wanting control over situations or people, was categorised into Pros and Cons. Pros were gaining reassurance and certainty, feeling strong, and knowing how to respond. The cons were the risk to relationships, feeling less reassured if trying to control didn't work, lack of nice surprises and spontaneity, and the fear that I may manipulate others.

This session, we did a similar time-line, but with anxiety in the middle. Right at the start, we established my true persona was that of a leader and decision maker. Being bullied changed my role from leader to follower however. As the bullying had made me a follower who was quite sensitive, I expected certain people to take care giving roles. When I had my abortion, I expected the nurses to be compassionate and supportive. After all, I was making a potentially upsetting decision and going through something quite big; so the least I could expect was support and understanding. When I didn't get it though, I felt very vulnerable. Similarly with the abusive relationship. I expected to be looked after, not taken advantage of and abused.

These made me feel misled, and again I felt people weren't acting in ways that I expected them too; which made it hard for me to trust others. A lack of trust in society/the world made me feel insecure and scared of what the future would bring, which then led to the anxiety.

From anxiety came pros and cons. The pros were that my need for survival was achieved by my anxiety. This would release adrenaline, which made me prepared for any perceived threats. The cons were much more however. These were the inability to relax, finding it hard to concentrate, not trusting people or situations, judgement being clouded. not giving people a chance, holding myself back, and not being as sociable. This also led to potentially affecting relationships, feeding others' anxiety (especially if I socialise with them less), being stuck, not moving on, not grabbing as many opportunities, not meeting people as much, and therefore a lesser quality of life.

We then moved onto an overview of our sessions, and what I needed help with most right now. For me, I found the trauma bothered me most, and was holding me back. I said I needed some sort of trauma therapy or EMDR. My counsellor said I definitely needed something more long term, but unfortunately all that Primary Care could offer was CBT. I was reluctant to agree to this, as I'd not had great experiences with it in the past. I've always found it far too rigid and simplistic for the problems I have. I asked whether Secondary Care offered anything, as my problems were complex and they were supposed to help with complex mental health problems. She told me that it was unlikely I'd have anything long term with them, but she would have a word and see if they could offer anything. She said she'd be happy to step me up to that level if they could help. If they couldn't though, would I consider the CBT? I reluctantly said yes. I would rather have that than no help at all.

We only have 2 sessions left, so we booked those in for me, and my counsellor said we'd make a plan for what help I could get next. She checked I was OK with finishing in 2 sessions' time too. I expected it, so I was OK. I just hope that something will help me address the trauma I've been through!

Although my Ko-Fi fundraiser has been a complete flop (only raising £12 from one lovely donor) I'm still keeping it up if anyone can help me to afford private trauma therapy. Please click this link to get to my page, and share and/or donate. I would really appreciate it! In return, maybe I could write something on a topic you would like to read about?

Tuesday 2 July 2019

Connecting the Dots: Counselling Session 8

(TW: Abortion discussion)

This session, I told my counsellor how I'd been feeling very overwhelmed with everything. She asked me to embellish, and I said how a lot of it was due to triggering news and discussions, as well as bad political news items. I read up on this because I'm interested in it, but it does get me down; especially when it seems that a lot is going wrong in the country or the world. I've also found it hard to reply to private messages from friends, due to being so overwhelmed. As much as I love talking to friends, it can be a draining process when there's lots of messages, and/or long messages. I think about what I need to do in order to reply. It includes:


  1. Reading the message
  2. Processing each point made
  3. Thinking about what to reply with
  4. Writing it out, while re reading parts of the message received so I don't miss anything out
  5. Reading through my reply to make sure I've written it properly and the tone is alright
  6. Sending the message
  7. Waiting for a reply
  8. Go back to step 1 and repeat
Eventually, I have to distract myself from messages and reply again in a day or two (or a week or two if I forget!). I feel bad for ignoring my friends, but I literally don't have the energy for long conversations anymore. 

As for the triggering news, a lot of it was about abortion, and a certain politician's views on it. I just can't seem to cope with other people's opinions on this topic. Whenever there's a negative view towards it, I take it so personally, and it brings me right back to my own traumatic experience. It took a while for me to realise this was a trauma for me, and I haven't processed what happened, and my feelings about it properly. The way I was treated was in a cold, uncaring, judgmental way. I didn't feel supported by the medical professionals I was under the care of. I was not offered the counselling I so desperately needed after it was over. I just had to get on with life at university as if nothing had happened. I remember feeling so numb sometimes, and so low other times. I would spend time with my then partner (the one who turned out to be abusive) in silence. I know it affected him too, even though he wasn't the father. Nowadays, discussion (or even mention) of abortion makes me panic, feel scared (as if I'm in danger), very low, guilty, I have graphic mental images of the abortion itself, I can even feel the physical pain I was in. I think I do actually have flashbacks now.

I certainly wasn't as fluent in talking about the abortion face to face, as I am, writing it now. I can sort of disconnect when I'm the one talking about it. It's almost as if I'm talking about a character in a book; not myself. Face to face, talking it through with another person, and hearing their views on my experiences, is different though. As I tried my best to talk through what happened and how I felt, as well as the feelings and mental images I have when experiencing flashbacks, I began to feel breathless and panicky. I also became dizzy and struggled to pronounce words. Every time I said a long word, I kept repeating it, and saying to the counsellor that I wasn't sure if I'd pronounced it properly. It was all very weird. I felt very weird, and it took a little while for me to get to a point where I could talk about other things.

The bad news around the country and the world fed into my low mood. I felt as if everything was going wrong. I catastrophised things and felt hopeless about it all. I wanted to help people, but with situations in the country being so bad, I didn't know if I would be able to do it. 

After listening to all of this, my counsellor said we should do an exercise. She handed me a sheet of paper, and asked me to write "Low Mood" in the middle of it. I was then asked to draw a spider diagram; writing the things that related to this feeling, or happened to lead to it etc. The things I wrote included the following:

  • Abortion - Not processing what happened properly. Feeling trauma, panic, shame, guilt and loss. Complex thoughts around the foetus; thanks to pro life/anti choice opinions. Worrying about this being a loss, and I might never have a chance to have a baby again
  • Low self esteem 
  • Bullying
  • Frustration with myself - not being able to fully control my mental health
  • Feeling I'm lacking a sense of purpose
  • Using therapeutic techniques, but them not working
  • Wanting to control things, e.g. my own mental health
I explained each of these things, as I wrote them down. A running theme seemed to be wanting to control things. We then went onto another exercise. This time, I would draw a sort of timeline, with the word "Control" in the middle, things that fed into or led to the need for control, along the left hand side of the timeline, and pros and cons of having control, on the right hand side. 

Left Hand Side:
  • My early beliefs about the world, and people. I'd been taught that if I was nice to people, they'd be nice back. If I helped people, they would do the same for me. 
  • When I was bullied, I found that the bullies acted in a way that I didn't expect, so this threw me off. I wasn't prepared for this, so I had no idea how to respond.
  • After a long time being bullied, I began to wonder if I even deserved to feel good and have people being nice to me. After all, these people had been horrible, so surely they wouldn't do that if I didn't deserve it? (Remember, these were my early views, I know the world doesn't work like this now)
  • Because of all this, I began to want to know what would happen next, in situations, conversations, people bullying me etc.
  • I wanted to predict the future, and read people's minds, so I knew how to respond.
  • I felt helpless, weak, useless, like a failure, like I would humiliate myself
  • So in order to fix this, I needed to gain control.
Right Hand Side:

  • Control would lead to reassurance, certainty, feeling strong, knowing how to respond to situations and people. 
As for the negative side to gaining control, this will be discussed in my next session. My counsellor told me that there were only 4 sessions left, so to be aware of that. We discussed what I wanted to do next. I said that counselling is helping me progress, but I need something more intense and specialist in order to focus on and hopefully process properly, the traumatic abortion that I had. I felt I needed some sort of trauma therapy or EMDR. I asked my counsellor what was available. She told me that under this mental health team, the only therapy they offer for trauma is CBT. This is something I've had before, for Depression and Generalised Anxiety Disorder. I didn't find it helpful, so I didn't feel very sure that it would help my trauma either. I told her that I'd give it another go, but only because it was that or nothing, so I'm not sure if I'm in the right frame of mind to be having it at all. 

My only other option is to consider private trauma therapy. I've looked up what's available in my area, and the prices start from around £80 for an hour's session. My only regular income is from ESA and PIP, so there is no way I could afford this, on top of all my other bills. I recently decided to set up a Ko-Fi page, which asks donors to buy "coffees" for the person whose page it is. You click on the amount of "coffees" you want to buy, and that goes directly to the person's Paypal account. I have had one donor so far, who I am so grateful to. I need to raise around £800 though, so I can get enough sessions of trauma therapy. The button that links to my page is on my blog, but I've placed the link again here in case anyone would be kind enough to donate and/or share.


Resources