Nineteen: Adventures of Poland

Mostly of the emotional kind, I'm afraid.  It was on the whole a successful trip, but being away with someone else's family brought a lot of stuff up for me.

29th July

Just crossed the Polish border.  M and I committed the cardinal sin of going for lunch at McDonald's when we stopped at a petrol station - M's mother and her partner seem to want to drive non-stop from 9am to 7pm for some insane reason - but barring the occurrence of any tragedies of the natural or human kind we should reach Gdansk in good time this evening.  I'm going to attempt to use the rest of the journey productively, and finish Volume I of "Le Morte D'Arthur".

(later)

Is M's mother still cross with me? (for stopping to eat lunch at McDonald's.) Her silence says that she is.  Why do I suddenly feel so small?  Guilty, fearful and tense.  The pull of negative energy is so strong it's as if we were the only two people in the car.  It's exhausting.  Imagined or otherwise, I wonder what the setup here reminds me of.

(later)

It was probably inevitable that this car journey would remind me of going away with my parents as a child.  My mother would drive, and my father would use a map to get us hopelessly lost.  They would fight.  Sometimes it got nasty.  Nevertheless, I remember it fondly.  Sitting in the back with my brother, a bag of sweets between us, being lulled to sleep by the motion of the car and the BBC World Service rumbling low on the radio.  Secure in the care of the adults in front of us, who (mostly) knew where they were going and would always get us there safely.

The later journeys weren't so peaceful.  Either there was more fighting, more tension, more silence, more failed communication and a greater sense of discord between the four of us (well, three - my brother never really featured in my emotional configurations of the family) or I simply became more aware of what was present all along.  My mother became a vicious, relentless harpy, wounding with words chosen for their lethal precision, the threat of real violence never far away.  My father would either become the bleeding martyred target for her poisoned arrows, or beneath a shield of heavy silence emanate a violence of his own.  His aggression erupted rarely, but when it did it was with an amplified and eventually disastrous effect.

Childhood perception is not wholly trustworthy.  After continuing a while in this vein I find myself explaining my father's suicide in the following way:  as she had almost done to me, my mother lashed out one too many times at the most vulnerable part of my father, and unable to cope with what she had discovered, left him alone with it until it consumed him entirely.  Ergo, my mother killed my father as she had wanted to kill me.  (It may be of interest that, after much provocation, my brother did once actually hurl this accusation at her).

But this isn't the whole story.  My mother loved my father.  The silence and the distance he forced between them hurt her deeply, and the final silence was devastating - she lay immobile on the sofa for days, refusing food and literally wasting away.  After he died, I could find no trace of the former spite and malevolence I thought I had detected in her.  Even in the flashes of anger that sometimes came over her when she felt most painfully her abandonment, the "evil" of before was absent.  She was just another fragile hum being, who had loved too much.  However slowly and reluctantly, I have come to accept that who we were and who we are, what happened and why is a puzzle that may never be pieced together - least of all by me.











                                                                       Botanical Gardens.  Wrocław, Poland.

Nine: Four years

It's the fourth anniversary of his death today.  I don't feel much. Numb.  Anxious that I'll stop feeling numb.  My session at the Tavistock was not terribly gruelling.  I spoke minimally about my Dad, more about my relationship with my boyfriend which feels a more immediate issue.

In short I made it through the 55 minutes without crying, and I felt relatively okay until on the way out, I crossed paths with the inpatient psychiatrist who saw me through the whole ordeal four years ago.  I have seen her maybe once since, also at the Tavistock, and although I think she did nod at me on that occasion I had no expectation that she would engage in conversation with me if we encountered eachother again.  Perhaps it was the date that made her response today seem particularly heartless.  I know she noticed me, as I saw her scanning my face.  When I reached the bottom of the stair case (she was ahead of me on the floor below) she turned round to look at me again, and I said "hi".  That was all.  But she didn't nod at me, or smile, or do anything else to acknowledge the greeting.  She just walked away. 

It hurts.

I've been staying with my boyfriend for the past 6 days, during which time I have not cut myself or vomitted once.  I do however have to go back to my Mum's tomorrow, at least until Monday, and I'm not sure at all how I'll manage.  I'm trying to live very much in the present, and not let a moment's anger or sadness spoil the next.  Tonight we're going out for a Thai meal, and I know I'll feel safe at least until tomorrow night.  If not, the poster campaign I keep noticing around York may (with a certain irony) serve to remind me of why I should not hurt myself:

A visit to A&E costs on average £117 per patient, so Dr Lethem tells us.

Eight: A Cigarette is Like a Kiss

A return to the personal.

A cigarette is like a kiss.

Each toxic puff wastes dizzyingly

Into the stratosphere,

The light getting shorter, you fight for breath

Alone in the fag-end of morning.

One kiss is never enough.

Cling to my lips in familiar grip,

Cling and never let me go.

Who hears  our kisses,

Who holds us to account?

An-ever changing sky watches, receives,

Arranges its clouds in storm-spun silence.

Taste, and taste again the death of morning.

Let you into my heart, my mouth, my lungs

You burnt out too fast for a possible last time -  

But It  did happen.

I  have the smell of you.

The Personality Police would be happy with this one, I think.  It ticks all the borderline boxes.  Which is fine, since it’s a nonsense diagnosis anyway.  Is it not the case that I feel only what every other bloody human being on this planet feels?  I love my transience and despise it at the same time, I want to hold on to all that keeps me fixed and safe,  but I have to let it go or risk a living death.  Somewhere in the holding on or the letting go lies the problem.  It is a problem for me.  But I won’t accept that it could ever be solved – no one has the solution, just the offer of a thicker skin.  And that will come to me in time.

Last week (when I wrote the above) was an angry one.  From (another) letter that I didn't send, the following:

I am horrifically angry at the moment.  I feel let down by everyone and everything.  It disturbs me how angry I am.  I’ve been having some really nasty, graphic thoughts.  Violent images that seem to leap into my mind from nowhere like dreams (I wish they were).   One of these flashes involved me turning up to the Tavistock in a wheelchair, having amputated both my legs.  In another I saw myself  slash one of [ my consultant psychiatrist in the adolescent unit's] arms.  Possibly exhaustion is the cause.  My conscious mind doesn’t usually make such savage leaps to the unacceptable – of if it does, it contains the violence firmly within the boundaries of my own body.  I enact my fury bodily without ever really having to confront it.  Sometimes I think self-harm is the safest outlet for me after all.  The safest for the people who I co-habit this planet with too.  Something must insulate the live wire, or impede the flow of current it conveys.

I come to this conclusion, and then I remember Dylan Thomas: 

Do not go gentle into that good night.

Rage, rage against the dying of the light.

Rage for raging’s sake, even if all I will ever have to make a fuss about is a storm in the smallest of tea cups?

Instead of sending the above to my therapist, as intended, I ended up writing a letter to the psychiatrist aforementioned.  When I left the adolescent unit, she told me that I could write to her and that she would always write back.  Over the years, I have written less.  I had sent her one letter previously this year.  But we are now well and truly in anniversary month (My Dad would have turned 52 today, and next wednesday is the 4th anniversary of his death), and I wanted to send her a card.  Enclosed in the card was a letter, mostly focusing on my achievements and other positive aspects of my life, though I couldn't resist whinging a bit about the psychotherapy funding situation.

I'm still reaching out, however cautiously.

Six: Funding Battles

90% of the review meeting I had with the CMHT psychiatrist turned out to be about the Tavistock funding issue.  He began by saying that given the current economic climate, and the dire shortage of money available for out-of-area treatment, it was not a question of IF I stop seeing A, but when and how it is managed.  Since he is also of the opinion that the *only* truly effective therapy is short-term, goal oriented work, he would not be supporting my case.  Apparently this is also the opinion of the entire psychotherapy service in York.  I brought up the fact that the consultant psychotherapist I have been seeing for 4 years has a very different opinion, and thinks it is important that our work continues.  He said that if either she or the Tavistock were funding the therapy that would be fine, but since they’re not her view is inconsequential. 

I asked him whether he had arrived at this from a clinical or a financial perspective, and he said that for him the two were inseparable.  I pointed out that if the Tavistock treatment is withdrawn and no adequate replacement found quickly enough, there is a risk that I would be turning up A&E more frequently or requiring an inpatient admission if I am unable to manage, costing the NHS more money than the price of the therapy itself.  Since this year, with the support continuing, I have already had to receive medical treatment for injuries and be assessed by the on-call psychiatrist at A&E on seven separate occasions, two of which involved ambulance transportation, that this would be the case is not wildly improbable.  The doctor agreed that I had a valid financial argument, but explained that the problem is that the funding of the NHS is not quite as cohesive as it would need to be to recognise this.  It’s a question of different pots of money for different services. 

The economic problem is very real, and it’s not his fault.  I understood what he was saying, and I also know that the treatment I receive impacts on that which is available for everybody else in the region.  I have been very lucky to have had the therapy on-going for so long – it isn’t available to most people who could profit from it.  What I did take issue with, however, was his idea that A plays a completely “supportive” role in my care, suggesting that since I am not symptom-free, the work has not helped me to make any real lasting changes.   I vehemently disagree with this – and I asked him to leave alone his general views about therapy for a moment and just LISTEN to me.  It really isn’t a matter of being attached to a particular therapist, and not wanting to let her go simply because it will be painful.  A too is of this opinion.  In the past four years, things have changed quite radically.  I am no longer in and out of hospital every few months (my last admission was over a year ago), I have maintained my weight for almost a year and I am  stable enough now to be able to complete a degree course – something which I have wanted to do ever since life interrupted me at 17.

He did listen, finally.  And something positive came of it.  Although it is still extremely unlikely the funding will be granted, he thinks it might help my case if I talk to the psychotherapy service here in York and get them to recognise the value of my treatment at the Tavistock and agree that the short-term therapy they could offer me would not be appropriate.  He said he would refer me to a colleague at the service so the conversation could take place.  I also told him about the psychopath dream, which seem to amuse him.  He said he didn’t even need to turn up to my appointments – a cardboard cut-out would stand in for him just as well!  On a more serious note, he wanted me to know that all of this had nothing to do with the way he or others in the service perceive me.  It is not a case of personal dislike getting in the way of providing me with help.  As I told him, I do know this, rationally.  Emotionally it is another matter.

Therapy yesterday was tough.  I spent most of the session crying.  A has begun to use the past tense when she talks of our work together.  We discussed what would happen when the therapy ends – she suggested the option of paying privately for psychotherapy, though since I have no income I would have to talk to my mother about this (who, I might add, is not likely to help).  I asked if she meant paying to see her, and she said “yes” – “or someone else”.  Ideally of course I would love to keep seeing her, even if I have to pay for the privilege.  But realistically it’s not likely to be affordable, since I would also have to pay travel costs.  Introducing the money aspect more overtly into our relationship is also likely to change it drastically.  I’m sure she is aware of this, and although she conceded it as a possibility that I could pay to see her I am not sure she really thinks it would be the best option for me.

We are coming up to a month of anniversaries – my father’s birthday and the day of his death.  Not the best time to be dealing with this.  But is it ever?