It’s been a while, and things are much better than they were when I was last here. Burn out burns out by itself, eventually – I shouldn’t have risked trying antidepressants again, because that just prolonged and worsened everything bad that was happening. Lesson now learned, Katies and medication really don’t mix. I started feeling dramatically better about three days after taking the last dose (several months ago now), even though that week was really stressful for other reasons, to the extent that I worried it would send me right back into the depths. Instead, at the end of it all, I felt hopeful and energetic and really bloody confused, because I’m sorry, brain, what?! Oh well, don’t argue with it too much, it might change it’s mind.
Because there were reasons I was driven to trying antidepressants again, I have put other things in place too. These included rejigging my work schedule, so I’m working two full days rather than one full and two halves, integrating my Skype work with my face to face work so I’m not randomly putting my professional face on for an hour here or there in the morning, and moving to a new office, ten minutes’ walk from my house. Now I can go home in between clients, rather than constantly wearing myself down by having to face the bright, shiny, deafening city centre every time I have a gap. I can eat lunch in my house. I don’t have to get up so early. It all helps. This was particularly necessary because I have just started my PhD, and this would have resulted in spending four days in the city every week if I hadn’t moved work.
I also started seeing a new therapist. I recently counted (of course I counted 😉 ), and this is the 18th therapist I’ve seen since I started really trying to fix myself when I was 16. That is, somewhat embarrassingly, one for every year. Not quite that literally – I saw some of them for the generic six sessions, and stuck with four for 18 months each, but something always seemed to go wrong, or less dramatically, was just missing. A couple of them were wonderful, but circumstances meant I couldn’t see them for long enough to make much progress. Others just clearly didn’t get me, trying to force me to agree with their interpretations, accusing me of being in denial, closed minded, or not trying hard enough if I disagreed. One thing I noticed being common to many was an inability to stay with me when I was very distressed. Trying to talk about traumatic experiences meant being subtly shut down by random changes of subject, sudden interest in an irrelevant detail, or abrupt concerns about my stability when I hadn’t even hinted at feeling self destructive outside of sessions. I imagine the extent of my scars put the wind up some of them. I can’t really blame them, but it’s left me with a sense that I’m on my own with the trauma. Traumas. Impressive number of really shit life events. I was incredibly, dangerously alone when the worst things happened, and I could never find anyone willing to really go back in there with me. With the accumulation of those experiences, it was easy to start to believe that it was me: I was too much, toxic, other people couldn’t handle being exposed to the intensity of those emotions.
Honestly, the NHS mental health services haven’t helped with this sense of being too much. The emphasis has always been on learning to manage, to regulate, to – well, contain. I was told I had severe and enduring mental illness when I was 18, and that I should not expect to recover. The fact that I am now a reasonably functional member of society, who is self-employed in the capacity of helping other people with similar histories to my own, might be somewhat alarming to the doctors who told me that. It’s alarming to me, sometimes, although my therapy supervisor knows all my secrets and is very confident in my safety to practice. And I am a different person to the teenager who was given the letter with that damning prognosis. I worked so hard, and I learned so well from all of those attempts to get me to contain myself (and as a disclaimer, please don’t worry that I think this is healthy, or indeed the approach I take with my own clients! This is historical). At 18, I learned how to manage anxiety and even panic attacks internally so no one would know. I started consciously teaching myself healthy relationship behaviours when I met my first long term boyfriend at 19, so I can deal with conflict without appearing to lose my head – appearing being the operative word, because I’m usually doing an excellent headless chicken impression internally. Multiple people have complimented me on my boundaries and appropriateness with clients (although they probably don’t know how much I swear at work). I have lengthy lists of reasons to feed myself properly, and alternatives to self harm. I practice mindfulness religiously. I am decidedly not lacking in the skillz.
The skillz lessened the frequency with which the trauma-related distress got one over on me, but they did not eliminate it, or even dial down the intensity when it does happen – and happen it still does, particularly when I’m run down, burned out, or otherwise tired and vulnerable. Because the problem has never been that I don’t have the skills to manage every day distress from every day conflict or deadlines or challenges, although as an autistic person I will probably always totally fail to cope with office politics. That’s different. The real problem is that when I am in a longer term situation which is becoming increasingly stressful despite several attempts to sort it out myself and get help, I start getting triggered by memories of other situations which were intolerably painful, distressing, and seemingly had no way out or end in sight. I’ve been in a lot of those situations, from a very young age, and when that very specific set of emotions and memories are activated, I am catastrophically hijacked by a state that seems so very not-me. It’s like a part of me that got stuck as a young teenager is there, in violent, unbearable pain, wide awake in the past, no sense of anything other than having to escape by any means necessary, however destructive to herself, however degrading. When that happens the skills are inaccessible, because for decades no one bothered to teach her, or even try to reach her – the focus was always on strengthening the intellectual, logical, rational, adult side of me.
To be completely fair, I haven’t tried very hard to help that part of me either. I disowned her a long time ago, because she was dangerous and shameful – whenever people saw her, they started talking about personality disorders and how I just needed to learn how to be less sensitive, more regulated. My experience of the first response of most professionals to trauma-related distress has seemed controlling, punitive, like they’re trying to force me to pull myself together again by making it extremely clear that there is no safety net, that containment is solely my responsibility, and that I will just have to try harder. That made me feel completely hopeless, because most of me is extremely good at regulating herself in the way they’re talking about. As if I haven’t spent every day since I was nine talking myself into facing the world, forcing myself not to act mental, smiling nicely, trying to soothe the simmering fear inside. As if I haven’t read every self help book I could find, endlessly discussed coping strategies with people online, and applied everything that seemed remotely useful in helping me function. As if I haven’t genuinely engaged with two different NICE-approved treatments for PTSD, and six months of full DBT. All helped, especially EMDR – but outside of the context of a genuinely safe therapeutic relationship (my EMDR therapist was a bit scary), that core of alone and trapped has apparently remained. It’s not like I haven’t tried, and when I have to ask for help, it’s because that is not enough.
In sci-fi contexts, containment fields are energy barriers used to separate people from various dangerous situations, substances, or reactions – nuclear, criminal, great vacuum of space, etc. The purpose of a containment field is to contain, not to resolve or heal or fix; and sometimes they lose power or degrade. When that happens on a fictional starship, engineers rush around trying to solve the problem so their ship doesn’t explode. When it happens to a person, especially a woman, the fact that we are statistically unlikely to take others out with us when we explode means that frequently, no one seems to care if the ultimate consequence will be having to deal with one fewer of those difficult women, with their challenging, enraging memories of existential terror and unbelieveable pain. How dare they hurt other people by wanting to talk about it?
Tentatively, therapist 18 seems to be different. I’ve been seeing her for about four months, and I like her a lot. She seems like a real person rather than a collection of certificates and techniques, and she is endlessly accepting and validating. She has made it safe to say things I’ve not dared voice for approximately half my life, including all the terrifying relational stuff around attachment and being too much. Working with her has reactivated that state with those feelings and impulses, but in a manageable way – it often feels like she’s communicating with a part of me that isn’t really conscious, but that part is responding right back. It’s all a bit freaky. But trauma – developmental trauma, at least – can be like that. Stuff you don’t have the developmental capacity to understand or put into words at the time it happens can take on a life of it’s own. I and dozens of others have tried extensively to contain her by brute force – because it’s shameful, because it’s cost effective, because it’s easier – but the end result has been none of those things, and now it is time for a different approach.