Scattered pieces

Note: This entry may trigger due to issues around suicide being discussed.

I’ve been fairly open about my levels of suicidal ideation on this blog over time. But the last week or so, I’ve been dancing around the subject. The reason why… on the 2nd and 3rd of August I tried to commit suicide.

I’m still trying to make sense of the attempts, and the triggers which precipitated them.

The main things I remember about Monday, are that I didn’t work my usual late shift, and that I was very tired… very, very tired. So tired, that it made perfect sense to come home, empty a pill bottle into my hand and swallow them down with a caffeine drink.

I vividly remember looking at the pile of pills in my hand, and thinking… “This will help me sleep”.

This terminology is significant… “This will help me sleep”. Usually, my suicidal ideation and intent is termed “running away”, so I wonder if the change in phrasing was an indication that different ones were driving the attempt, or whether I was just really tired?

In the past, whenever there has been even a suicidal gesture, a protector has come forward and immediately called for help. But not this time. This time, I climbed into bed and waited for sleep. That was at about 6pm. The next thing I remember, is waking in a panic at 2.45. I wasn’t panicking about the pills that were now well absorbed into my system…  Oh no, I was panicking because I wasn’t sure if it was morning or night, and I was worried about missing work!

The details are fuzzy, but somehow we ended up in ER. ER’s always seem so bright… so well lit… super bright… I know this is a medical necessity, but it’s also about our fears. We hate hospitals. We feel ourselves get smaller, younger and more tongue-tied in hospitals… It’s hard to hear what people are asking of us, and we become more robotic.

As an indication that there was still come cognitive thinking happening, we’d remembered to bring our iPhone with us. Hours of playing Boost 3D, Euchre, Hell’s Kitchen… Anything to try to keep calm! Then the unspeakable happened, the iPhone battery ran out… This tipped the scales back to crazy.

• We removed the lure ourselves and went to the nurses station, asking to leave. They took us through to the observation lounge instead. Yay… power points for recharging the iPhone :)
• WPT came and visited us in the ER, and we brushed him off… told him we were fine and not to worry about us…
• When we were assessed by the psychiatric team… I say “assessed”, but to the system, it felt like a grilling.  They asked about family relationships, abuse history etc.
• By the end of the assessment, angry protectors were up front and they ripped up the discharge papers as we walked away from the nurses station.

Yes, we were released with no follow-up or safety options mentioned.

When we got home, there was still the need to sleep. I think one of us called the crisis team, but gave a fake name… I remember the crisis person yelling at us that they were sending the Police around. This was the wrong threat to make, as it gave the protectors hope that help was on the way. They became less vigilant…

We sat down at the table with enough pills for a fatal overdose. It was very mechanical and quick. Again, there was a need to have enough pills to “get some sleep”. Once these were consumed, we went to bed. Again, a panicked waking a few hours later and a ride in an ambulance.

This time it was serious… I knew that because of the number of nurses around. I remember looking over when they took my blood pressure, and saying how good it was (53/45). Usually my blood pressure goes through the roof in hospitals due to anxiety (the next day it was 195/146). I asked if I could go home, because my blood pressure was so good, and it was all just a silly mistake…

I remember the nurses being nice.
I remember them wheeling me down corridors to a ward.
I remember a nurse sitting in a chair at the end of my bed all night.

We called the mother, asking her to come up because we needed help. Our cat needed food…

We were kept in for a couple of days, and again had a psychiatric assessment, this one was much more gentle. They asked about safety and stressors. They gave us options – they suggested hospitalisation, or respite. But the psychiatric ward was fairly full, and the respite place would be different to the one I’ve been to previously. Instead, we were released to the mother (a former nurse) at home.

The thing that blew me away about the medical ward, was their compassion and understanding. I was there for an overdose, but they didn’t judge. They had almost no knowledge of mental health issues (I had to tell them how to spell “dissociative”), but they were respectful of me as an individual…

It’s now over a week since the attempts, and I’m still on shaky ground. Last night, R was very present. I know it was him, because I could clearly see what he wanted – to be wearing just jeans, standing in the middle of the road, in the pouring rain, arms up, yelling (in pain, release, anger???).

I’m very aware that I’m still walking along the cliff edge. One little push will send me over.

It’s times like this that I realise how amazing the people around me can be… WPT came to see me in hospital (twice); while my blog friends have been a steady, calm voice of reason when I needed it desperately… thank you!

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Now playing: The Freshman – The Verve Pipe
via FoxyTunes

The last two days have been kind of rough.

Heading into Thursday, I was feeling good and had managed to pull myself onto some sort of steady ground.  That all fell apart late Thursday afternoon, when I got an email from the other team leader, calling into question the quality of my work.  That email sent me plunging back into self-doubt, self-hatred and all the other associated negative thinking.  My cynical friend told me to forget it; but it was such a back-stabbing insult that I couldn’t brush it off.  To make it worse, my own team leader wasn’t around to reality check the content of the email, and I didn’t want to run to the manager about it.  This spun me out to the point where I knew I wasn’t safe to drive home.  I stayed on at work for a couple of hours, before driving home and losing most of the evening to the dissociation.

Then, on Friday morning during my drive to work, we went past a “hurt” cat in the middle of the road.  I always dread this sort of thing; not only does it stir up the system because an innocent animal has been hurt, but it’s a trigger for some of the younger ones.  Like a deer caught in headlights, we can never look away… we started reciting “it’s just a jumper that fell out of a car”, hoping that this will change how we see the cat… it doesn’t.  This means we now have adult parts smarting from the insult to our work, and young ones upset that an innocent cat has been hurt.

So we’re now driving down the road reciting out loud “it’s just hurt, it’s ok, it’ll get up soon and the people who love it will come get it and take care of it”.  There was also a promise that we wouldn’t drive home that way, just in case it hadn’t been moved.

Work on Friday is mostly a blank… I know we had a morning tea for the two new people, and that the manager made a triple layer banana and pineapple cake (which did a rather spectacular topple over during the cutting process).  I also know I played around with the iPhone app kooaba, as we’re looking at new ways to try to deliver information through technology such as QR codes and visual recognition apps.  This was fun because we were going around the library, taking random photos of books, CDs and DVDs to see what information kooaba would return.

Then it came to the drive home… all the way up the street where we should have turned off to avoid going by the stretch of road where the cat had been hurt, we were consciously thinking of turning.  Then there was this little mind fit, and we were suddenly past the turn off.  I could hear the panic, but there was also this firm voice telling me to stop being so silly, that there will be nothing there, and it will all be fine.

Thankfully the cat was no longer there, but that didn’t matter, the panic had set in.  We were switching all over the place and I could feel our throat closing up.  Little Michelle came forward full force, meaning that we couldn’t really drive, talk and only barely functioned enough to get home in one piece.  Because we live in a high fenced section, no one saw us getting out of the car shaking like a leaf and stuttering about it hurting.

We got inside, fed Winnie, turned on all the lights, curled up in the corner of the lounge and tried to ease the shaking.  I had no real sense of what was happening, but there were obviously body memories.  The throat was closed off, and no matter how hard I tried, I could barely stutter.  I managed to take some anxiety medication and send the following email to Allison…

turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide
turn all the lights on an hide

hide got to hide
he’ll find us

I think we finally went to bed at about 8am (it was naturally light by then) and slept for a couple of hours.

Saturday had been good… we’d talked to a friend and took some pictures of the stuffed toy we got for the young ones as their reward for going through the divorce proceedings…

This made me think that tonight was going to be easier… the fear seemed to have eased.  But it’s now 1am Sunday and all the lights are on again.  Little Michelle is ok as long as all the lights are on.  We’re also ok as long as we don’t even think about going to bed.

One of the big problems with this scenario, is that it opens us up to further dissociation and self injury.  We’re so switchy and shaky…

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Now playing: Missy Higgins – Where I Stood
via FoxyTunes

Yesterday during lunch at work, I had no idea who I was.  I had no idea what my name was, how old I was or where in the world I was.  There was a sense of detached wonder about being able to use the computer… “wow, I can use this thing”.  I had no memory of learning how to type, or even how to use my body to do basic things such as pick up my cup.   Everything seemed so big, scary, and yet wondrous at the same time.  It also seemed really bright… the artificial light in the office felt like I was looking directly into the Sun.

This is yet another sign that the dissociation is out of control… this was a young one from our internal Basement, in charge of the body, while at work.  That can’t happen again.  It’s not fair to the young one, or to the ones who usually attend work.

The problem is, what to do in order to get some sense of control back?  We’re actively doing all the coping mechanisms we can think of – breathing, taking breaks at work, distracting, grounding etc.  But I’m still a mess.  I’m constantly getting flashbacks of some sort… I’m seeing things out of the corner of my eye (psychosis or a lack of sleep?)…  It feels as if I’m constantly on the edge of switching – that spacey, free-falling feeling…

There’s also dread… I don’t WANT to know why I keep on seeing flashbacks of the changing rooms at the rugby club; I don’t WANT to know why L&P is suddenly a trigger; and I don’t WANT to know why I keep hearing certain phrases over and over in my head…  I’ve had enough…  Surely there can’t be more.

But, I also know that I need to listen and try to understand what’s happening internally. I know this is the way to healing… listening, understanding and easing the pain.  But, I don’t think I have the strength to do this anymore…

Below is a something that was created while at work earlier in the week.  I’m not good at art – I got a D for it in school.  So I’m unable to translate what is in my head into something that is recognisable in practice.  I keep trying to tell myself that art within a healing context is more about the feelings, than the technique… but I still can’t get past how bad it looks in comparison to what was wanted.  It’s so frustrating when I can’t find a way to express what is going on in my head…

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Now playing: Cat Stevens – Moonshadow
via FoxyTunes

So, we have a new therapist… Let’s call her Allison.  We’ve had two therapeutic sessions with her, and one introductory session to see if there was a possibility that we could work together.  I’ve been studiously avoiding talking about her here, I think because I’m scared of jinxing the relationship.  Here’s a quick run-down of what’s happened so far…

Introductory session
We were switching like crazy, a revolving door of different ones checking her out and asking different things that we knew had been issues in the past.

M asked about what happens to her clients when she goes away – this I know is because we tend to (for want of a better term) “fall apart” over Christmas.  One previous therapist asked us to contact her if this should happen, and another had no provisions in place for a crisis over this time.  I don’t think either approach is helpful for us, as we feel like an imposition contacting a therapist out of hours – especially during their Christmas holidays; and the lack of support led to a downward spiral that ended up with us going into respite care.  Allison assured us that, if we wanted, she has another therapist who will see her clients while she is on holiday.

W asked about religion.  This is a huge issue for her, as she sees herself as inherently evil and gets very triggered by the concept of religion.  Allison was open about believing in living a spiritual life.  While this did raise flags for W, it wasn’t a show stopper.  What was interesting, is that Allison mentioned that those who are brought up within a strict religious environment, often exhibit significant signs of abuse.  This was mentioned in the context of my father, who was raised within a strict religious doctrine.  So, it was about putting life experiences into context, not meant as a comparison or justification.

The other big question was, “are you going to cope with us?”  There are huge trust issues with therapists.  I can honestly say that each of the therapists I’ve seen in the past have tried to help us, and wanted to see us live a full life, free of many of the debilitating symptoms we currently experience.  But for various reasons – their approach to DID, a lack of skills, or being out of their depth, it hasn’t worked out.  After the rupture from Liz, all the feelings of being too difficult, too much and being a trouble maker came up again.  Allison mentioned that she was one of the top therapists in our small city.  This rankled M a little, as she saw it as boasting.  But, I understand that Allison was trying to reassure us.

So, after much internal discussion, it was decided that we’d keep seeing Allison.

First session
This was mainly taken up with housekeeping type of information – brief talk about what symptoms we wanted to address first, what other support systems we have, and how we are coping.  It was a difficult session, where at one point, W was nearly sucked into a flashback.  What was interesting, was Allison’s reaction to the near flashback… she asked us to look at her in the face.  Now, we don’t look therapists in the face – yes, this may be considered rude by some people, but we can’t bring ourselves to raise our eyes above their boots.  During work, we can do eye contact no problem, so it’s just within the therapeutic relationship.  Allison kept on about us looking her in the face – to prove that our reaction to the near flashback didn’t upset her, or cause her any distress.  We had to switch to M in order for this to happen, but we managed it!  And yes, it did help.  She sat there very calmly and greeted M as if everything was fine.  Hmmm… so maybe she can cope with minor crazy… let’s see about major crazy…

At this session, we discussed having fortnightly sessions, due to monetary constraints.  Since then, we’ve realised that the crazy making between sessions is too much for us to cope with, so have gone back to weekly sessions.  Who needs money for food anyway :)

Second session
This was a really difficult session.  It came off the back of Mother’s Day (those of you with the password to the protected posts will see the two word feeling that some of us have towards the day), and our up-coming birthday.  It was predominantly Sophie and B throughout the session, until Mother’s Day came up.  Then woohoo… lets step on the crazy freight train.  The desire to self injure went through the roof… Allison was particularly interested in the ways the self-injury was manifesting and who was potentially holding the needs and desires to hurt.  She talked about the anger we hold as pertaining to the mother… and then “flick”, Aimee came forward.

Suddenly it was all bright and breezy, talking about the calender on the wall that hadn’t been flipped over for the new month, the old heater that was in the corner of the room and other diversionary tactics.  Allison welcomed Aimee, which was a huge relief (her type of diversion had been discouraged with some therapists).  They were chatting along nicely, until Allison, as part of the normal conversation, said the word “shadows”.  This meant an immediate hiding by Aimee… she is absolutely terrified by shadows.  Shadows within our internal house represent evil, danger and the angry ones.  So Allison’s innocent comment caused a trigger switch to a stuttering teen.  We hate it when we stutter.  It’s usually only in therapy, and it’s just awful.  Of course, the more we try not to, the worse it gets.  The stutterer explained what had happened, and assured Allison that in no way was she to blame – she had no idea that such an innocent word could have such devastating effects.

Overall, we’re not sure about Allison.  She is good with the silences… both allowing the silence, and bringing our attention to what is happening during the silence.  She’s good at slowing us down, and getting us to try and notice things.  But, we still think we’ll be too much for her.  This is not because we’re the “worst” case of DID or anything, it’s just a mix of the old messages from the childhood, being re-enforced by actions of therapists who were out of their depth.

So, we’re still fence sitting.  She has shown the most promise of the therapists we’ve seen so far…  But, it’s hard to judge things accurately because we are so dissociated from life.

If anyone has had the “joy” of a comment from us over the last week or so, it’s probably been bordering on rude, pompous or left field.  We really shouldn’t comment when we’re so dissociated.  We again had a comment not published on a therapists site, this time because of our side-ways hostility.  That’s a classic sign that we’re not communicating internally, and M is running parts of the show without input from the calming influences of B and Sophie.  I’m not sure what will get us back on track…

When I was seeing Bob, she asked me to complete a list of 10 things that I enjoyed involving the senses or activities. This exercise was aimed at improving my body awareness and giving options for distraction or grounding when I am stressed. I’m really struggling at the moment, so I thought this would be a good time to share my homework and remind myself of the options available to me… It also will force me to try and expand my lists in the hopes of eventually reach 10 items for at least one of the senses.

Additions based on commenters suggestions in italics – Thank you :)

I added to each of the columns by writing it out here :) I can do this, can’t I?

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Now playing: Cat Stevens – Moonshadow
via FoxyTunes

Yesterday the safety of the respite house came under question. We left to spend the day with the mother, mainly to test how well we are. It turns out we’re still not all that grounded or well…

When we returned we found that a new client had arrived at the respite house. This was fine, they are female and seemingly non-threatening. So we went down to our room to drop off some things, only to find that someone had been in and used our art supplies. The young ones were so upset about this boundary violation. Little Michelle came forward and looked around in tears. This may seem like an over-reaction considering nothing had been destroyed, but it was the young ones who had their things moved and used. M was prepared for our iPod to have been stolen, and it would have had less impact if that’s what had happened. The iPod is mainly for the teens and adults, we could have coped better than the invasion on the young ones things.

Then at night the new client went on a severe binging and purging cycle. It was awful for her, she’d felt so positive during the day. For us it was a huge trigger. We have food issues as well, not to the level of the new client, but her pain and acting out was enough to trigger us through the roof.

So our safe house doesn’t feel so safe anymore. We know it was the carers grandson who used our art things, we know the mother is trying and we know the new client is trying to work through their problems. But we feel so small and scared. We feel like we’ve taken a huge step backwards.

I recently commented on an entry of Ivory’s, and included information from an article titled A failure of curiosity by Janet Migdow.  Unfortunately this article isn’t available freely, but I’ll describe the content here for those who are interested.  It’s an article that has stayed with me for many months, it offers an interesting insight into the therapeutic relationship between an intelligent woman diagnosed with DID and a therapist who is willing to examine their own processes and thoughts.

The first part of the article gives the therapists background – her drive to help people, her natural curiosity that was evident from childhood and her desire not to lose that curiosity.  She writes:

“I have always seen curiosity as the quintessential characteristic of a good clinician. I have never thought curiosity alone would make the consummate clinician. I simply think that, without a burning curiosity, becoming a therapist is a useless endeavor.”

(Migdow, 2008, p. 46).

Midgow describes the client as “Dr. B., a Caucasian, fifty-six-year-old, uppermiddle-class, professional woman of mild manners and distinguished bearing” (Migdow, 2008, p. 48), diagnosed with DID.  She had been a client for 6 years and over that time had stabilised to the point of becoming more aware of the parts and increasing her functioning.  Part way through their journey together, Dr. B. starting turning up late for sessions.  This lateness coincided with the topic of the sessions becoming more banal, with Dr. B. deflecting any attempts to probe deeper into the issues at hand.  Migdow describes this sort of deflecting as hypnotic - as a person who has done this sort of deflecting, I understand what she is talking about, it becomes hypnotic for the person doing the deflecting as well.

It was at this point, that Migdow recognised that she was bored.  She had gone from a place of deep respect for her client, to a place of boredom.  Migdow looked for issues within her own life to have brought her to this place, but identifies that the dissociative fragments encourage detachment from the issues.  This detachment allows Dr. B.’s skill with social chit-chat to maneuver the topic away from anything too deep (or scary).

After forcing Dr. B. to be aware of an incident where she is showing obvious signs of distress, it is revealed that it is the dissociative system is protecting both the client and the therapist from the events of the past.  The secrets were still being so carefully protected from everyone, with this chit-chat seen as the best method to continue all diversion from the truth.  Dr. B. had never realised that this was another of the systems defenses and had always associated it with there being “something wrong with my brain” (Migdow, 2008, p. 51).

Migdow (2008, p. 52) explains the sensation as:

“… you feel like a door cracks open in your mind, you experience yourself as noticing something familiar and then you forget not only what you noticed but the fact that you noticed anything at all. You feel frightened of what you glimpsed and frightened that your own mind seems elusive.”

The explanation for lulling both the therapist and client is found… she isn’t bored, or boring… she has an incredibly protective system that thought the secrets and safety of the host must be maintained in any way possible.  This became a turning point in the therapeutic relationship… one where the right road was found, but the telling was hard (butchered Dante quote).

This article has at times given me hope – it helps me to understand that some of the waffle that I do is possibly aimed at self-protection.  I often find myself losing getting lost in the twists and turns of a conversation within therapy, but I’ve always associated this with me being stupid and not being able to keep up.  The article also helps me when I’m in the denial, this could be another diversionary technique to stop me from delving too deep into the past.  I know that my self-injury could be seen as either a diversion or a scream for help…

So much of what we do is aimed at trying to uncover our truth, but that is a hard road that has been protected for many years.  This article shows how one therapist realised that the road was constantly being passed by and only with strength and knowledge can we go down it.

As a note, while this article particularly dealt with the relationship with a person with DID, I think that it could be translated to almost any therapeutic relationship.

Reference

Migdow, J. (2008). Failure of curiosity. Psychoanalytic Social Work, 15(1), 43-52. doi:10.1080/15228870802111781.

This came through our twitter feed via CakeWrecks today.  It made us smile.

We don’t like the song so much, it’s more about the fun they obviously had making the clip :)

I’ve just dropped the mother off at the airport.  She agreed to go home last night – so she doesn’t put me through more “torture” (her words).

I feel like the worst daughter ever.  I know she doesn’t mean any harm and she was trying to help, but it wasn’t working.  When we woke up this morning, I thought maybe I’d made a mistake and she should stay…  But then on the way to the airport she was talking about the cold snap that has come up the country and how it would hurt all the lambs (yes, I can’t even type what really would have happened to them).  I don’t watch the news at this time of the year because I know they will show the horrific shots of the lambs in trucks.  In my world, no lambs get hurt…  Most people would realise that you shouldn’t talk about cute animals being hurt to someone who is DID and suicidal, not so my mother.  This is why I’m sure that she really doesn’t understand DID or me.  She doesn’t intend to be cruel or nasty, she just doesn’t realise the implications of her words.

Because of her words, this is how Sophie was feeling last night…  It’s bad when one of our most high functioning and optimistic one does a collage like this.

Untitled by castorgirl on Polyvore.com

“Unfit for work…” those words sting, they really do.  They’re the words used to explain why I won’t be able to work for the next 12 days.  They’re part of the standard form that the doctor fills in, so it’s nothing personal, but it means failure to some of us.  We know that our functioning at work has been so poor that there was no other choice, but it still cuts us to the core of what many of us perceive as our self-worth.  M in particular, is struggling with being put off work, yet she was the one who made the appointment and mentioned the problems we were having, knowing full well that enforced sick leave was the likely outcome.  M couldn’t hand the medical certificate over in person – it would be like admitting failure and having to face the disappointment of those around us; so we left it on the team leaders desk with an email message apologising for the inconvenience we were causing.  Some of us consider this the wimps way out… failing to face up to our responsibilities and the repercussions of our actions.

This morning we got a text message from our cynical work friend asking how we were.  I wasn’t sure how to respond, I know that in some ways I’m trying to protect her – she’s got enough on her plate without hearing my sob story.  So I sugar-coated what was happening.  No one at work was expecting us to have this time off, so it probably came as a shock.  I suppose this is one example of how we can appear so high functioning, but really be a total and utter mess.  What I fear the most is the reaction when we get back to work… will people alienate us, want to hug us, avoid talking about it?  At their core, the people that I work with are good and kind people, but they don’t understand mental health issues.  This means that I will odds are lie about what has happened when I get back to work, I’ll find some acceptable lie that doesn’t make them squirm.

This week we’ve also seen Jo and Liz…

Jo became quite worried about our safety after we did a collage with her.  It can be quite amusing on one level to see Jo’s art work which is all about love and happiness, while ours is dark and full of violence.  We both had mindless woman’s magazines to use as base material for the collage.  I had words like key, disappear, invisible… Jo had love and rainbow.  I had a picture of a puppet running through a door… Jo had a smiling woman on the beach.  She was concerned about our safety to the point of contacting Liz.  Poor Liz also now realises how much we were testing her when we first started seeing her – with Jo we go with the flow, but with Liz we resisted and argued at the beginning.  This wasn’t deliberate, but rather an unconscious way to see whether Liz was going to be able to help us heal and put up with what we could throw at her.

When we saw Liz, it was what I would consider a disaster.  Little Michelle came forward and made it almost impossible for us to speak.  She has such a problem with words and forming them that it’s like she is stuttering, but I don’t think it’s a true stutter, I think it’s more about not wanting to tell the secrets.  At one point, we were stuck on one sentence, and in particular one word… “I’m not special“.  We were so incapable of saying the word special, that we ended up having to write it down.  Little Michelle stuttered through explaining that she wasn’t “that word” to anyone, because if you were “that word” you then got hurt.  She wanted to runaway so that the pain would stop.  Liz offered to runaway with her, but Little Michelle said that no one else was allowed to come.  All the time this was going on, there were ones in the background yelling that she was telling lies and it’s all rubbish.  This was the first time the messages about it all being lies were so closely tied to someone saying anything.  Little Michelle shared no abusive events, but her presence alone was enough to stir-up the denial and nay-sayers.  That probably means something in psychology land, but to us it just felt crazy.

So we have 11 more days before we are allowed back to work…  We’re meant to relax and unwind…  This is terrifying!  Work is our structure, our safety.  Suddenly we’re meant to do this thing called relaxation and rest.  We’ve actively avoided doing either of those things for about 20 years…  Today we survived by going down to the gardens and taking pictures with the new lens’ we got the other day.  Not sure how we’re going to cope with another 11 days of this.

Here’s a random photo we took today…

Cherry blossom

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Now playing: Shihad – Pacifier
via FoxyTunes