Into the system…

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Posts Tagged ‘therapist

Therapy Update…

with 4 comments

So I had my second therapy appointment a few weeks ago now, but I haven’t had the chance to post about it yet. I’ve wanted to write a lot over the past few weeks, but for one reason or another I haven’t managed it.

The appointment covered pretty similar territory to the last one really and I am not sure it was all that helpful. I guess it was worth meeting again, if only to let us bring things to a close a little better, but it still felt a bit like a waste of time. It would have felt very rushed if we only had the one appointment though and I guess I may as well make the most of the psychologist’s time whilst I have it.

Unfortunately, she didn’t really have any further information on the future of the therapy service or when I might be able to see another therapist. They don’t know what is going to happen and it is unlikely that anyone else will be joining the team in the near future. It seems there are only 3 therapists working in the service at the moment, which explains why the waiting lists are so long. Two of those are CBT therapists, so are not really suitable, although apparently one of those is “much more than just a CBT therapist”. The other therapist is male and the assessing psychologist thought that a female might be better and more challenging for me (due to my usual preference of dealing with men). They all have full case loads anyway, so wouldn’t be able to take me on, even if they were considered suitable. It was suggested that perhaps the “much more than CBT” therapist could have maybe taken me on, but the assessing psychologist wasn’t sure if she had the space or if she’d really be suitable. She was going to talk to the team manager and discuss that possibility, but she did think that someone else would probably be better. If she can take me on though I wondered if I should just see her. At least there would be a concrete offer of therapy soon, which could mean I would get started before I am planning to go back to work. I am worried that if I have to keep waiting I will miss my opportunity.

The other option is to wait for the therapist that is out on maternity leave until November and hope that she will be able to take me on. She is a psychodynamic therapist and the psychologist I saw thinks she would be best placed to work with me. I am worried that she will decide not to come back to work or that she won’t have room in her case load for me though. Even worse, I worry that I won’t like her or be able to work with her. If I am going to have to wait a few more months, I’d like there to be some guarantee of a positive outcome at the end of it.

Otherwise I will just be waiting for someone else to join the service, although the likelihood of that happening and them being suitable seems pretty slim. I still can’t believe there are only 3 therapists for the whole service. I dread to think how many people they are meant to be covering between them or how many people are waiting.

As well as talking about therapists, we also talked about topics for therapy and what things I needed to address when I eventually get offered a therapist. We didn’t really identify much more aside from the previous session, but we did look at a few things in more depth.

We talked about school and about bullying a little. I never used to think much of the bullying I went through at school. I didn’t think it really bothered me, aside from making me a bit miserable at the time, but I’d been dreaming a lot about some of the main protagonists lately and some of the dreams or nightmares have been really upsetting. They have been less frequent in the past fortnight, but in the weeks before that they were starting to bother me a lot. I would wake up shaking and confused. I don’t know why it has suddenly come up in my dreams. There is no reason for it to be a problem all of a sudden. I’ve had a lot of nightmares in general lately, but school has definitely been the main focus. Some of these dreams are so realistic, they feel like buried memories and I wake up terrified that I’m back at school. Others are strange and convoluted and make little sense. It has made me think about how I felt back then, a little more. I wonder if things were actually worse than I remembered or hurt me more than I would like to admit. There are periods from school that are really clear in my memory, but other times are just gone and I wonder how much of that is me trying to forget the worst of it all. My  memory is patchy these days anyway, especially since the ECT, but my long-term memory is certainly less affected than more recent times.

Specifically we talked about how there were two kinds of bullying I went through and how they affected me differently. I was teased and bullied during a lot of primary and early secondary school. On the surface, most of the bullying at secondary school came in the form of name calling and the occasional push on the stairs from a bunch of lads in the year above. This was annoying, but I tended to brush it off and ignore them, or be pretty mouthy back. I was usually too quick for them..

On the other hand, even though it was less visible, it was the other stuff that got me. There was always a lot of teasing and bitching from most of the girls, many of whom were meant to be friends. There were a lot of things supposedly said in jest, that really hurt and worse of all, they were meant to hurt. People would pretend to be nice, but many of them were pretty damn cruel when they wanted to be.

In the long-term, this side of things has certainly had the most effect on me. I became afraid to get close to anyone, because they always seemed to stab me in the back. Even now I struggle to trust friends and worry about what they really think about me. I get anxious in social situations and never feel good enough. If people are being nice, I always worry they aren’t genuine. I try to come across as confident, but afterwards I always analyse everything to death and worry I came across as an idiot. I have little true self-esteem (although I can pretend), but when it was battered constantly for years, that is probably understandable. The only thing I have much faith in is my intelligence, ability at school/work and the like and over the past couple years that has somewhat taken a knock too, due to being ill.

Anyway, this wasn’t what I set out to write about, but we didn’t discuss all that much else aside from what I wrote about in the last post.

We left the situation with the psychologist planning to talk to her manager to discuss whether “Not Just CBT Therapist” or “Maternity Leave Therapist” would be best placed to take me on. She was then going to call me to let me know what is happening.

I thought she had forgotten about me, but she finally called on Monday. It seems I will have to wait for “Maternity Therapist” to come back. She may not be able to take me on straight away, but at least they will know more then. It could be months before I actually get to see someone now though.

I’m still frustrated by this. To think the wait is coming to an end and then to be let down is annoying. I just don’t know if it will be worth bothering by the time I actually get to see someone.

Oh well. I don’t know why I expected anything better.

Written by intothesystem

Wednesday, 6th October 2010 at 1:47 pm

EAP Therapy…

with 4 comments

I’m still not able to face the draft I started the other day, but here’s hoping I can try and complete a post for once.

In my last proper post I mentioned the EAP and the fact I was being referred to a therapist nearer to here. An appointment was arranged with a therapist based in Manchester and I attended last Thursday. The appointment basically consisted of CORE form filling. I knew I would have these forms to complete. I had the same forms to complete last time I used the EAP service, but I hadn’t expected them to take the whole session. I had expected the chance to at least talk a little.

The thing is, I don’t think I’d have talked given the chance anyway. I wasn’t comfortable with him and less so after completing the forms. I think he was surprised to have a client who could tick the inpatient boxes and the high risk sections. I’m not sure he knew how to deal with someone who suffers from severe mental illness as opposed to the work-place stress and occasional bereavement that he will be used to. I may have been paranoid, but it almost felt like he was scared of me. Don’t get me wrong. He seemed nice enough and I think he would have been good with his usual clients, but it just wasn’t a fit.

So. I rang back the EAP and told them I’d quite like to see someone else if possible. The original telephone counsellor had made a point of ensuring I knew I could do this before the therapist was allocated, yet I still felt like a nuisance. They got back to me though and told me they were trying someone else. The next day I had a missed call and voicemail from DP, my old EAP therapist. His number was still in my phone so I knew it was him before I’d even checked the voicemail. He had remembered me. I don’t know if that is a good or bad thing. I called him back and we made an appointment for Wednesday.

I am in two minds about seeing him again. I’d mentioned the other day that I was secretly hoping I’d be referred back to DP, but I’m now wondering if that is wise. I guess at least I know that I can talk to him. He knows some of my history (although an awful lot has happened since our last appointment!!).

I’m scared though too. When I last saw him, I was one of those work-place stress and bereavement cases that EAP therapists are used to. I was not the mentally ill patient, that has been through the system. Admittedly I was in denial about my mental illness back then. It was definitely there and I even started to enter the system as a result of our appointments, but I hadn’t tried to kill myself, been in hospital and the rest. Will he know how to handle someone with severe mental illness or will he be just as clueless as last week’s therapist?

I also looked back through the emails we’d exchanged last year. I remembered with horror that I’d sent him the URL to this blog! After our appointments had finished we’d been in touch a couple of times. I’d given him an update as to what had happened after seeing my GP and telling my bloke. I guess the fact I shared this blog with him, shows that I trusted him, but I had never expected to see him again. I don’t know if he’ll remember. Shortly after I emailed him this blog was found by my partner and I stopped writing for a while. I suspect if he did read he would have given up then.

I wonder if I should just remind him this blog exists, but I am a little scared about sharing it with a professional, especially one who will be in touch with my GP and CMHT. It would be easier than explaining things though. We only have three appointments (the one with the first guy still counts from my allocated four), so it will help speed things along.

I don’t know. We will see what happens tomorrow.

Written by intothesystem

Tuesday, 8th December 2009 at 3:33 pm

More Evidence…

with 3 comments

Some of you may remember my post on Trichotillomania which I made a couple of weeks ago. In it I referred to this BBC article which mentions some research into the use of N-acetylcysteine (NAC) for the treatment of Trich. Today I saw Dr G and towards the end of the appointment my bloke mentioned the article and I explained it to her. I couldn’t remember the name of the drug involved, so she asked me to check and let her know. She hadn’t heard the news story herself, but was interested to know more and was happy to check if it will interact with any of my other drugs before I can give it a go. Dr G is quite progressive and innovative with what she prescribes anyway. She won’t always wait for things to become proven and approved before she prescribes something. She also mentioned a new drug, for which I could spot a leaflet about on her desk, that is meant to be good for sleep, but it’s also an antidepressant and she’s scared of the effect this may have being bipolar and my past experience of antidepressants. She said research is currently being done, but this one she didn’t want to risk.

Anyway, whilst I was looking up the name of the drug concerned in this article, I did a little bit of research and stumbled over the fact it had also been connected to improving residual depression in bipolar. Someone has done a some research into this and the paper was published last September. This article sums up the findings. If this really is the case, then there are two reasons for me to be taking it. I am certainly willing to give it a go. It’s a proven drug for other things, so should be safe and even if it isn’t, do I really care? Maybe that is flippant of me and my partner will be horrified to read it, but I really don’t worry about such things anymore. I guess that is the suicidal thinking that undermines everything. I should be thinking about this positively though and my willingness to try anything is the part of me that just wants to get better and doesn’t care how I do it.

For a change, Dr G was running on time. My therapist, M however wasn’t. With that in mind, we got started and did a quick meds review initially. The expected increase in Lamotrigine happened and an increase in the Nitrazepam too. I could do this prescribing lark myself these days! In two weeks time we shall do the increase again and I will then be on the 200mg she’s aiming for.

We talked about how things over the past few weeks seem to be showing signs of stabilisation and improvement. This is true but I say it with caution. In the past three weeks I’ve gone from rapid cycling every day or two between an almost okay mood and a horrifically suicidal one. This was followed by a week of consistant suicidal depression and generally feeling awful. Then over the last couple of days I’ve kinda felt depressed but getting closer to okay mood. The suicidal thoughts are still there, they never go away, but things are quieter.

The thing is, I don’t trust the cycles to not come back. My mood sometimes settles down and then the swings come back with avengence and I am up and down like a yo-yo again.  I also don’t trust the curve on the mood graph to continue rising. It has only been a couple of days of slightly improved mood and I’ve had that before. The bubble bursts as quickly as it forms.

Dr G is hoping that things are stabilising. Last week was stable but hell. If things stick like that it just isn’t going to work. I will get frustrated and then fall off a cliff, which is similar to what happened last January/February. She knows this and I think is as worried about it as I am, but I guess neither of us knows what to do about it. We just have to try and hope that this mood holds out.

M turned up and we talked a bit about what we’d said last week. Dr G was meant to have another appointment with the four of us there last week; Her, M, my bloke and me. At least that’s what three of us thought. Dr G was at her daughter’s graduation and had somehow double booked herself. The three of us carried on and had a session anyway talking about some of the relationship issues we’ve been having and communication. It is a topic that always comes up but an issue that doesn’t go away. Again the solution seemed to be to wait a few months and try not to think about it. Easier said, but they aren’t living with the torment all the time.

The rest of the appointment consisted of lots of ums and ahs whilst I grappled for something I felt comfortable to talk about. I generally failed until the mention of that article came up.

The previous couple of days have been spent at my grandparents. I hadn’t seen them since March last year, when it was my great grandma’s funeral. It was good I guess to see them although always a bit surreal and slow. It always feels like a bit of an act at the best of times, but even more so at the moment. I also saw my two cousins on that side of the family. H, the youngest, loved our puppy. My animal-mad aunt did too for that matter.

The future holds very little at the moment. I don’t know what to do with myself and that is scary. I have a lot of uncertainties and I want answers. I see my worker on Monday and Dr G in a couple of weeks. Aside from that, who knows?

Trying to talk…

with 10 comments

I have struggled to write this week. I have sat and stared at the screen many times, but failed to pull anything together.

Twice this week I’ve brought up the problems that I mentioned in this post (basically thinking about splitting up with my bloke but feeling that I can’t for various reasons) with professionals and both times I found little solace or support. I tried to convey just how much distress this is causing me, but I seemed to fail. It’s frustrating when you are expected to talk to people about things, yet when you do you get little in return. I need to work this out in my head, but feel stuck. The thoughts are feeding my feeling of hopelessness and of course that only encourages the negative thoughts. It is making me worse yet it seems to be seen as a distraction and not worth talking about.

The first person to fail to help was my CMHT worker who I saw on Monday. I tried to talk to her but found it really difficult. She kept trying to use the “think positively” stick and didn’t seem to want to listen. She also tried to explain to me the effects of mental illness a million times. As if I don’t know them already! I hate being patronised. Generally the whole conversation was awkward. I hope things improve or there’s no way I’m going to be able to work with her long term.

Then on Tuesday I saw my therapist at The Priory. She also failed to grasp how much I am struggling. It was our last session so she was keen not to talk about new topics. It didn’t seem to occur to her that I’d have liked to use the session to help rather than just talk about superficial things. I guess she didn’t want to leave me stranded if we didn’t cover everything.  I don’t know how I feel about it being our last session. I don’t know how useful the sessions have been, but it was always something in my calendar each week. A constant in a world of uncertainty.

Today has been my last day of day care at The Priory. It hasn’t hit me yet but I am going to miss it. I’ve been going for therapy there since October and it has been a big part of my life. I’ve spent over 3 months living there!. I will be back a couple of times yet to see Dr G, but other than that it’s all over. I will miss the empathy and support you get there. I will miss the time out to think. I will miss the food. It is going to be a big loss and I’m not sure how I will deal with it. I know I will have to leave sometime, but I wish I was leaving through choice and because things were on the up, not because of money and NHS politics.

I think I’m going to have to give up now. I can’t write right now. My head is in pieces.

Written by intothesystem

Thursday, 16th July 2009 at 8:31 pm

Trichotillomania…

with 8 comments

This is interesting. I have pulled my hair for so long I can’t remember not doing it. It’s something I’ve always been ashamed of, but don’t seem able to stop. My partner can never understand why I do it even when he tells me not to. It is something that gets worse when I’m stressed or feeling low, but is such an ingrained habit it is there when I’m well too. I really do wonder if there is a magic pill that could stop me and if so, why haven’t I been given it yet?

Aside from that, today I saw Dr G with my bloke and therapist. It was strange having the four of us in Dr G’s little room. I felt quite intimidated and overwhelmed and it didn’t take me long to start crying from the stress of it all. We talked about how I need to be more open about things, something that has been repeatedly a topic for discussion, but something I find very difficult. I often think I don’t want to be open and honest about how I feel. I don’t want people to panic and I don’t want to be helped. If you’re feeling really suicidal, the last thing you want is everyone to know so they can stop you. I don’t see how I can break that barrier to openness.

Yesterday I finally met my CMHT worker, J. She’s a social worker, not a CPN, which I’m slightly disappointed about. I have been told they don’t distinguish between them in our trust, but I somehow think a CPN would be more use. They’d have more understanding of my illness and what it really entails. We chatted about my life and the past year as she wants to get to know me. I don’t know if what I said was helpful but the time raced by. I wanted to ask what is going to happen to me but she didn’t seem to know. She was surprised that I hadn’t yet had been sent an appointment with the consultant so is going to chase that up. I am not sure her coming to see me is going to be that helpful but we will see. I might be able to talk to her properly eventually. I found I was being economical with the truth when she asked me how I was feeling. I couldn’t help it. I don’t yet trust her. I see her again next week.

I am seeing Dr G again on Thursday as she didn’t have time to do a medication review today. She said she’d review my sleep again, which has gone haywire since coming off the Haloperidol. I’m a little more awake during the day but not sleeping much at night. Temazepam was suggested so we shall see what she comes up with. I’m sure the Lamotrigine will go up again too. She has to titrate it up so very slowly. It’s hard being patient waiting for the increases. I just want her to stick it up to a high dose and be done with it, but I know she can’t.

Generally I feel a little empty and numb. I am just carrying on because I have no choice, but it’s hard. I don’t want to.

Typical NHS…

with 4 comments

I got through yesterday, although it was a long day. My partner didn’t seem to understand why I was so anxious beforehand, nor did he understand how drained I felt afterwards, but I guess he hasn’t experienced these sorts of appointments. I find the strain of having to try and articulate yourself when your head is spinning and you have relentless negative and suicidal thoughts just too much at times. It’s so hard when you have to explain exactly what is wrong and why you need more support, when you don’t really know the answers to those questions.

Before the two scary meetings, I had a one to one with my therapist. This would usually be something that would make me nervous, but I had much bigger fish to fry yesterday, so it wasn’t a problem. The session went a similar way to most of them recently and I’m not sure how helpful they are being, but it went a lot quicker than usual, for which I was grateful.

Lunch was difficult as I felt sick with anxiety. I tried to eat but struggled. Then it was time for the session with my partner and Dr G. My partner arrived at 1pm, but she was running late, so I was sat in reception feeling very nervous. I didn’t know what to expect or what they were going to say.

The meeting went okay, but I’m not sure how much use it really was. Dr G had received my last letter and she said it was helpful, although she already had an idea that I was really struggling without me having to tell her. I guess that’s positive.

We tackled the question of medication first and I have got my wish and am coming off the Depakote. This is being replaced by Lamotrigine. I just hope it doesn’t give me a rash like the Depakote did. If we fail with the Lamotrigine then it’s onto Lithium, although Dr G is reluctant for me to do that.

Following that was some discussion about how me and my partner can improve our communication and work together to ensure he is not suffocating me. I think at the moment a lot of that was going in one ear and out the other as I just can’t process it. I just feel crap about it all, even if the reality might not be like that. I don’t know what reality is like. My head just feels like fuzz. I can’t really remember anything else from the session, which shows how much use it was to me.

The meeting with the CMHT was frustrating and has left me feeling strange and disappointed. I had hoped that the session would ensure I would have some NHS support within a few days, but that is looking extremely unlikely. The assessment itself was uncomfortable to say the least. I felt like they were trying to catch me out. It was almost as if they didn’t want to take me on and they just wanted to find an excuse not to. I had no confidence in any of what I said and felt like I was always saying the wrong thing and I just couldn’t concentrate a lot of the time. I didn’t know what to say, couldn’t remember anything and generally found myself struggling to articulate everything. I wonder if all assessments are like that.

The most frustrating thing was they were completely unprepared for The Priory and NHS liason thing. They hadn’t a clue how it was likely to work and seemed to want to get me to agree to being transferred completely over to the NHS. I don’t want that as I want to make the most of my day care before my insurance runs out. I don’t want that as I want to stay under the care of Dr G now that I have got used to her. I don’t want that as I just have no faith in the NHS for mental health services. The whole point of my referral back in April was that the NHS would have time to work out how they would manage me and my care within The Priory before assessing me. The fact none of that has happened is annoying. I found myself getting more and more annoyed as I realised that nothing has happened and nothing is going to happen until someone cuts through some red tape.

So I am left waiting. Waiting for some support. Waiting for someone to do something. Waiting for an answer. I’m left in this strange state, not knowing what comes next. I can’t think and I just feel awful. I wish it was over.

Medi-go-up and one-to-ones…

with 8 comments

My Quetiapine (Seroquel) dosage is going up to 400mg. It seems like a lot for someone who is being prescribed off-label and doesn’t have a diagnostic label to match, but nevermind. I saw my consultant again today. It was better than recent visits, perhaps because she has changed something rather than just asking me to wait and be patient, but it is still difficult. I go into my appointments shaking. I seem to lose my tongue and forget what I wanted or needed to say. I forgot to bring up the fact my eyesight has been bad lately and I am still not able to drive, despite knowing I had to. I will have to try and catch her at some point before the Christmas break, but I do not know if she will be in on Friday. She often takes it off.

Anyway, the other revelation of today is that I am being referred for one-to-one therapy at last. I am apprehensive, as I do not know what I am expected to use the therapy for. A few weeks ago, one-to-ones were discussed and it was decided that I wasn’t well enough yet and didn’t really have any key issues that were going to be possible to tackle in one-to-ones. Since then, nothing seems to have changed. I have no idea what I should talk about. I go into group sessions and have no idea what to tackle each week, but I can’t ask for the spotlight to skip to the next person in one-to-ones. I still do not have any answers or even the right questions. I just don’t know where to start. I am lost in this quagmire of shifting moods and negative thoughts. I am still struggling to see much further ahead than the next few hours and I’m still uncertain of what the future brings. I am still depressed more often than anything else and I am still frustrated and agitated. I feel like I am staring at brick walls in all directions and I don’t know which way to turn or how to break through them. I am glad that I am being referred to the therapist that I did my life maps with. I trust her and she seems to understand my frustration and confusion. She understands that I feel trapped in this limbo, not knowing where my diagnosis lies or how to fix the problem. The only problem with this is, I also know she doesn’t know how to fix the problem, so I am unsure of how much use an hour a week with her will be.

I am scared of therapy. It can bring up more things than it solves and it is hard work. I know I need to put the work in if I want to get better and I can’t just wait for medication to do it’s magic, but it is still daunting. Therapy seems to just drag up all these things and makes you question everything. It leaves you sitting in a mess of confusion and not knowing where to start or how to solve it. I don’t know where to begin untying all the mess.

I think most of all I am left feeling frustrated. I am worried that treatment will never work. I only feel that I am more and more confused and the fact that I am doing all the things I am told I need to do to get better and it is not making any bloody difference only adds to the desperation I feel. WHY AM I NOT BETTER!?! IS IT ALL MY FAULT?! WHEN WILL IT BLOODY WORK?!?!!!! WHAT ELSE CAN I DO?! ARRGHHHGHGHGHGHGH!!!

You get the idea.

I…am…fed…up.