Thursday, 24 January 2013

IV) The Wise Counsel

I want to touch on the subject of therapy.

I feel it gets a pretty bad rap, especially on TV with the stereotypical inane therapists, who ask cult questions and hum and har whilst scribbling away at a clipboard and passing the odd tissue, whilst some poor soul pours out their entire life story.
If this is your personal experience in the world of psychiatry, then I am sorry to hear it. I hope that this post may help a little, even if it just ratifies what you already know.

First off I want to talk about the differences between a psychologist, psychiatrist, counsellor and a therapist. (because I myself am often confused)

A psychiatrist is someone that deals with diagnosis, prescribing medications and other things that need to be put in place to treat mental & emotional disorders.
A psychologist is qualified to perform psychological research, testing and therapy.
A therapist is basically someone skilled in a special type of therapy.. this could be anything from psychological therapy (psychologist), to massage therapy etc. The word therapist doesn't necessarily pertain to mental health and psychiatry alone.
A counsellor is someone who gives advice. A counsellor once again may not specialise in psychopathology (mental disorders) - so when seeking a counsellor, make sure they specify first which areas of psychology they are trained in, some counsellors will like to work with only certain age groups, genders, and areas of neuroses.

My first ever experience with counselling was around 13 years of age. I had a conversation with my Mother about this today, asking if she remembered when I first attended counselling. I asked if it was 11 or 13, and we established it was the latter (I got out my journal when I returned home to verify this) - she made a point, that I probably should have seen a therapist after my friend died, but it just wasn't the suggested thing back in those days. I don't think mental health was really something that was discussed either. All I ever knew about it, was not to talk to the guy who walked up our road each day in his boxer shorts with his hand down his pants 'playing with himself'.
I remember being a little bit afraid of him, despite the huge grin he always wore, because he was 'mentally ill' and as a child who had never met anyone with a mental illness before, that translates into 'crazy'... he was an unpredictable and unknown entity.

Anyway, back to the counselling, I began that after a scary episode, where some friends and I were robbed in the down town public toilets, as a result my anxiety took a dive for the worst, and because the culprits all came from my home town, and unfortunately ALSO resided in the town I was attending boarding school in (about an hours drive away), I felt trapped, whether I was away at school, or home for the weekend, I felt like they would recognise me, like I couldn't leave the house.
So here begun my journey into the world of therapy.
I started off with an Art Therapist. I believe this is usually the first choice for therapy with children and young adults.
Designed expressly for those of us not used to explaining our feelings to a stranger, or communicating exactly what is going on within us, art therapy is perfect. It taps into your inner child, your subconscious thoughts, by asking you to do activities that have no right or wrong answer. Instead of focusing on getting things right, on saying/doing things you think the adult wants to hear/see - you act blindly, not knowing what they are wanting to see from you.
An example of some of the therapy I did with this therapist, is using a Sand-tray.

For those of you who have never come across one of these, it is a pretty basic exercise. You are given a tray of sand, and some shelves of toys and nick-nacks and asked one by one to place something to represent something.
I think for my first ever sand tray, I was asked to place my mother, my father, siblings, friends, grandparents, anyone else I wanted to add.. then asked to add anything else that jumped out at me.
After that you explain to the therapist why you chose each piece and why you think you put them where you did, yada yada.
It sounds like a crock of lame, but to be honest, looking back at my first sand-tray's polaroid picture (not the one featured), and reading the notes I made, it sounds very apt.
I had chosen a playful character for myself, but placed it behind a large mask,
I had a fence around myself, and everyone else stood on the outside of it.
This kind of therapy helped me to explain how I was feeling in relation to my world, and the people in it.
I completed several sand trays with this therapist. I am not sure when I got discharged from her services... but perhaps with the help of the medication I started, or perhaps because of her services, my anxiety settled down enough for me to venture out into the public again.
I think it was largely helped when my family relocated to the city I attended school at, and I got to leave boarding school, I am sure anyone with a mental disorder can agree, living with hundreds of other girls 24/7 was about the worst thing I could imagine, not that my parents were to know, my sister loved it, and continued to board there even after we moved to town... meanwhile I spent much of my free time locked in the luggage cupboard reading books, avoiding the constant barrage of noise and interruptions boarding school provided.

I revisited art therapy again many years later, around the age of 19 or 20, as I wanted to do some inner child work, I felt I hadn't properly dealt with many of the issues I had developed in my formative years.
Whilst it was the same activity as before, it is a lot harder to do this kind of thing without over analysing ... it definitely worked ten times better the first few times, before I had learnt to analyse my subconscious on my own.

My second counselling experience was when I was 16yrs of age.
About a week into my 6th form year at school, I felt the walls closing in around me. I had never skipped a single day of school in my life, nor had I ever received a detention or mark against my name. But I was suffocating, I felt panicked all the time,
I was told I had to see the school counsellor before I could sign out, I don't remember the appointment, but I do remember her telling me she would only sign me out, if I promised to attend a counselling appointment she was making for me with another counsellor.

So that is how I met my second counsellor. A young woman in her thirties, she was pretty cool, and I guess that was rather important to me at that age... she seemed to know her shit, and through my GP I was diagnosed with depression and put onto my first antidepressant..
Being a depressed and rebellious teen, I dreaded going though,
I dreaded opening up and having to go through all these feelings I was trying to shove deep down inside. I felt better afterwards each time, but I still put off going when I could.
During this time I started experimenting with drugs and drink, I got into bad situations. I was date raped, and ashamed that it had happened. It was my first time.
This tipped me over the edge, my cutting increased, and after my emotions all boiled over, I overdosed.
We saw a family therapist after this; but I felt I could say nothing... as far as I was concerned my mother was the root of all my problems, (I was depressed and our personality differences I took personally).. she was also paying the bill.

Then there was yet another episode where I refused to go and see my personal counsellor and my mother yelled at me saying I could bloody well move out if I wasn't going to listen to her, I don't blame her, she was paying for me to go, and I refused to help myself. I was forever forgetting my medication and missing appointments.
I packed my stuff, and moved in with my friend and her dad.
I knew my mom was just angry, and wasn't being literal.
But I was hurt, and I was confused, and my emotions were a roller coaster. I was going through my teens, with an extra large helping of teen angst on the side. 
Stubborn was my middle name, and as my mother often aptly said "I would cut off my nose to spite my own face".
That was the end of my counselling. I moved into a small flat with another friend, and went off my medications cold turkey. I spent my 17th birthday working in McDonalds drive-thru feeling sorry for myself.

I moved back home eventually, not before dropping down to 43kg... stopped drinking so much, stopped drugging, and my job stopped giving me just one shift a week, and started giving me overtime instead, and promoted me up the chain a few times, I was doing well.
My mom offered to pay for me to see a Cognitive Therapist, also known as CBT (cognitive behavioural therapy) something she or my father had heard about. It was pricey, but my mom has always been wonderful like that, and spared no cost when it came to supporting me in my mental health.
I think perhaps I was at the wrong age to be doing this, I wasn't quite THERE yet with enthusiasm, or willingness to help myself, and rolled my eyes a little too much during the course, that was self directed, yet held at their premises.
It wasn't wasted money though, as a lot of what I learnt and tossed aside then, actually sunk in, and has worked it's way back to the front of my brain now.
Cognitive therapy teaches things like how a lot of people with depression think in black and white (they are either on my side or not, mad at me or happy with me, they don't want to talk to me because they hate me, otherwise they would want to talk to me) It taught me things such as remember there is always a gray area. That person who is speaking to you in an offensive tone, may have a headache and not realise they are speaking abruptly.. that person who didn't wave back may not have seen you, they may have been deep in thought, they may not have registered it was you til it was too late. It sounds silly but a depressed mind will often analyse and analyse and analyse a persons tone, facial expression, how long they spoke for, the pace of their speech... a depressed person will usually take it the wrong way, a depressed person will project their feelings about themselves, and feel like this is how everyone else must be viewing them. I know this, because I am that depressed person... and there is nothing I do better, then to assume that people are thinking the worst of me! anyone else know that feel?

After that finished, mom shelled out some more precious moolah on hypnotherapy. This same hypnotherapist  I have heard great things about from people I respect and admire, and they felt she did them wonders... but personally for me, my brain goes 19 to the dozen and I cannot lie there and not think a million things. It just doesn't happen. I either am thinking like a chemistry set, bubbling over with this that and the other, or I am asleep. I think I did fall asleep on a few sessions, and only her frustrated repetitions of "when you hear my voice, you will wake.... you will WAKE when you hear my voice... WAKE UP!!" brought me out of my slumber...
and the times when I didn't nod off, I found I was compelled to do as she said such as "raise my finger" etc etc, because if I didn't she would keep repeating the command and I would feel embarrassed for the both of us.
Eventually I begged my mother to discontinue the sessions.. I have always been a sceptic  and I needed something scientific to focus on, not to picture people I disliked in bunny ears. Just not my thing.

My next bout of counselling didn't start until I was 18-19 years of age, after my panic attack at University brought me home.
This counsellor was different than the others. She was soft spoken and an older lady and to this day I have never met such a genuine person. We clicked.
The leaps and bounds I have made since being with her, I cannot explain, she is one of the best things to happen in regards to my mental health and the things I have discovered about myself with her help, are infinite.
I still see her to this day, though I need to start my sessions again for the year. She even waived all fees for me as I stopped attending due to financial difficulties. She is truly a life saver, multiple times over.

Also in the interim I have seen a few psychologists and psychiatrists since being in hospital.
After one attempt at my life I was referred to a psychiatry team near my home.
They signed me up for DBT (dialectical behavior therapy), but it never got off the ground, as there is noone practising it where I live.
I was in a low place at the time, as you can guess, and when the psychologist contradicted my diagnosis of Borderline Personality, with a diagnosis of Bipolar with SECONDARY Borderline... I baulked.
I didn't want to be Bipolar.
Bipolar was a dirty word, it was incurable, it was a crazy diagnosis. The guy who streaks through town on occasion in high heels and a wig, and used to be the top of his profession in town, is bipolar. I am not THAT. I am not HIM.

I stopped going, she didn't know me, she had barely met me, how could she diagnose me in such a short time?
I refused to go back. I was signed out of their service.

Then I started seeing a guy from something that was called Challenge Trust at the time.
It is like a social worker, that works with you through all the aspects of your life making goals and helping you navigate the system and get your life on track yada yada. I still see him once a week. It is slow progress, but I think I am in a better place to make better progress now. I was treading water for a while there.
He brought up the suggestion that I had Bipolar as well as Borderline Personality.
I listened to him because I respected him, I had been seeing him about 6 months. He explained his reasons, and It made sense.
After my latest (and hopefully last!) attempt on my life, I saw another Psychiatrist from the District Health Board.
He read through my notes and talked with me at length.
He agreed with the diagnosis of Bipolar with secondary Borderline... they both have the same treatment, and told me that he thought I was an inspiration, an amazing person, and he was suprised I had coped as long as I had. He didn't know how I got out of bed in the mornings after all I had been through in my life. (much of which I cannot talk about, even here)
I don't really like compliments as I never truly believe them.. they feel good, but I always think "they don't see the other side of me" or "they don't know the full story" - but his compliment really did me good. I felt VALIDATED.. "Yus! somebody who doesn't just tell me to get on with life, to just keep trying!, somebody who throws up their hands and says WOW that sounds hard!" - I think this approach appealed to me, because It gave me the lift I needed to keep going. He said he admired me, that meant I was doing something right in my life!, he said he liked my sense of humour about it all, and that I seem to be very knowledgeable about what is going on with me. He said he didn't think there was anything he could offer me in the way of mental health support that I would benefit from... because between my counsellor, my friends and family, and myself.. I seemed to be doing a better job then anyone on the outside could do.

This has given me inspiration, inspiration to keep on trucking, and to try and have a sense of humour about it at all times.
If we can't laugh, we cry.
Find people who empathise or understand personally, so you know that your struggles are shared and there is a way past many of these hurdles... even if the only solution is to wait them out.

I would recommend counselling to anyone at any time in their life. It is like a manicure for the brain... even the most well put together person could use a little maintenance from time to time. If you don't find the right counsellor right away, keep trying, trust me, it is worth.. I have been with my counsellor longer than most my friendships.

So be kind to yourself, maintain your brain and reach out to someone you can safely TALK to :]


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