Eighteen: Recapitulation

I need to write here again, if for no other reason than that after three months essay writing-free I'm beginning to lose my grip on my grasp of the English language.  I'm perhaps three quarters of the way through the mega-reading list I set myself for next term, and I find when I'm annotating texts that there are words I need which were familiar once and now escape me completely.  Not so great if you happen to be doing an English literature degree.

There is still another month to go before I return to York.  As the weeks wear on I realise more and more that I need to cherish the time I have at university.  It is really very little.  Being that bit older than the other students on my course, with friends who graduated last year and are struggling to find their feet in a job-market that is smaller and more competitive than ever, I know just how lucky I am to have this opportunity. 

I don't feel particularly lucky at the moment though.  My reading distracts me, as does my boyfriend, as does the oblivion-seeking sex, drinking and occasional drug use I turn to when I'm really itching to hurt myself.  Apart from one cigarette burn inflicted in Poland I have been self-harm free for months now.  Tomorrow it will be 90 days since I last made myself sick.  I am a healthy 60kg for my 67 inch height, and I try to remember that I have made peace with my body.  But it was always a very tentative peace, and right now it feels particularly fragile.

Diary entry, 3rd August 2011 (I was still in Poland):

It just keeps getting better.  After a call from Dr S of York Psychotherapy Services, in which I was informed that my therapy at the Tavistock would cease to be funded in October, I found out from A (my therapist) that even this may be in question.  There is something of a row developing between the Finance Department of the Tavistock and York, who are apparently refusing to pay for any of the psychotherapy I have been having at the Tavistock since I moved from London. (I have since been told that the reason they are giving for this is that the Tavistock have prevented me from engaging with their local services - the only problem with this argument being that said local services proved on several occasions to be unwilling to engage with ME).  I don't know quite how this will affect me, but it does mean that money-wise my therapy with A is even more in the shit than before, and it is unlikely that the Tavistock will themselves finance any extension to the October deadline.  I did feel a glimmer of hope when A (I called her from Poland when I received the news, and we had a brief conversation over the phone) hinted at our previous discussion about paying (her?) privately.  But only a glimmer.  I'm sure A will think of a dozen different reasons before I see her again at the end of August as to why this arrangement would be unworkable.

As I understand, A is still fighting to build a case as to why my therapy with her needs to continue.  I have been invited to a meeting in York on Thursday with Dr S (consultant psychiatrist/psychotherapist) and a therapist to discuss whether the group therapy or individual therapy they may be able to offer me would be suitable.  Talking to these people is not at the top of my wish-list at the moment, to say the least.  I envisage throwing things - if not objects, then hard words.  It's childish.  But I am not inclined to give them any more of my time.  There are a number of reasons why I do not think it will be beneficial for me to either enter group therapy (again) or establish a new, short-term psychotherapeutic relationship.  Experience has taught me however that my opinion falls on deaf ears - if anything, it will be seen as further evidence that I am refusing to co-operate, possibly as a result of an unhealthy dependency on my therapist in London.  My boyfriend wants me to go to the meeting, and has said he will accompany me. I still haven't made my mind up.

This brings me to the question of what WILL happen if my therapy at the Tavistock is terminated at the end of October.  A has tried to discuss this with me in our sessions.  She says we need to talk about our options.   I am,in effect, stonewalling her - it's just to painful.  I cannot see any "workable" options being made available to me - rather, in anticipating the conversation I see my last hope, of her agreeing to see me privately (at a cost I would be able, if only just, to afford) being crushed.  Again, M (boyfriend) says I need to have a frank conversation with her.  Not knowing is draining me.  I don't know how much longer I can go on in this state without resorting to the ways of coping I swore (sort of) to forsake once and for all at the beginning of the summer.

I dread Sundays, because they signify two full days until Wednesday, when I have my session.  I dread Mondays and Tuesdays proportionately more.  A keeps apologising to me for what is going on.  It doesn't help.  I have a lot of rage inside of me - rage I do not want to direct at her, but which seems to be blocked whenever I aim for more appropriate channels.  I cannot help but feel that I am just not being heard.  I have come so far, and I refuse to give up something which has helped me so greatly -something that has given me my life back and which I believe needs to continue to fully restore me to health - without a fight.  But there seems to be nothing to take on but smoke and mirrors - the thin veils of bureaucracy.

If there were a God I could believe in, I would ask him to help me through this.  For the lack of one I must try to believe in myself, and my strength - which has surprised me before and may surprise me again.

                                                           Street art, Wrocław Poland.

Sixteen: Sweet reminder

"You're lagging Grace, you're lagging", as my boyfriend would say.  I promised myself I'd write up the second opinion meeting I had last week, but something in me is resisting.  Not that anything spectacular happened.  I just seem to be in a sort of mental torpor where the whole issue is concerned, and I don't want to disturb it just yet. 

I keep re-reading and editing my last few sentences.  I am not at all sure that what I am writing is making any sense.  It is my speech but I do not quite understand it anymore.  In the days following Amy Winehouse's death it would be crass to suggest my own drug use creates anything like the problems attached to serious addiction, but I do have a growing sense that I need to slow things down.  Tonight is the third night we've smoked pot (the Americans staying with us roll Californian joints, composed wholly of weed, no tobacco), and the first night for a while without a (in)decent amount of  alcohol.  Within the past two weeks I have also tried LSD and ketamine, two substances I never touched before.

M isn't right.  Within half an hour of lighting up I noticed an abrupt change in his manner and speech.  It's persisting and I hope to God it will lift when he sobers up, but what if it doesn't?   My own cognition is somewhat impaired too, but it's as if he's in a whole different realm to me, a place where time creeps and thoughts shift like sand, burying all my distressed attempts at connection.   He's silent unless I ask him a question, which he may or may not begin to answer after a prolonged pause and will certainly not finish.  He stares at me, or his eyes don't move.  He hears me within his own frame of reference, divorced from and contemptuous of mine. 

It scares me.  The M I know is just no longer there, reminding me and warning me of  the possibility of a complete, future absence.  The absence of psychotic mania, or the absence of any other unwanted parting.  When I think about losing him, my best friend, my lover, I can't stop from crying. In losing the (nearly) complete understanding that I thought we had achieved, I lose myself.  All the castles in my head come crashing down, shuddering and splitting to their foundations which vanish like scotch mist.  The wilderness overwhelms me.  I doubt whether my perception is accurate.  Maybe it is me who cannot understand him, and maybe it is me that needs to understand him, because I am the one that has strayed from the path of reality - I have conjured this storm myself.  Again, I know this may not make much sense.  My words are running away from me.

I will stop now and read over, once.  Then try to engage with the man in his dressing gown, pacing the kitchen and trying to see over my shoulder.

Perhaps lagging is needed after all.

Fourteen: Awaiting a second opinion

Tomorrow (actually today in eight hours) I have to catch a train to York.  At 12 I have an assessment with the psychotherapy service as requested by the Consultant I saw at the CMHT, who wanted a second opinion as to whether to the mental health commissioner should be advised to grant funding for continued psychotherapy.

I have reached a dead end in Anxiety Street.  I feel I should be going over in my head what I need to say, rehearsing and perfecting my argument, but I cannot suppress a conviction that it hardly matters what comes out of my mouth tomorrow.  My inner pessimist warns me that the matter has already been decided, and that a favourable outcome is extremely unlikely.  Warring against this faction is the part of me that is still desperately hopeful, a part that I indulged this evening in requesting a meeting with M's mother.  Although she works privately, and I knew it was clutching at straws, I did feel an informal chat with another psychotherapist might be helpful - at least in taking the edge off the worst of my nerves.

It wasn't a waste of time.  She understood that all of this is mainly bureaucracy and politics, machinations against which I have little agency, and agreed with what I had felt -  that the letter sent to the psychotherapy service by the consultant I saw, stating that he was "torn" about whether or not he felt continued funding was necessary, had given me a false sense of the potential influence I have on the panel's decision.  This said, however, she did give me some advice about how to best present my case.  One thing in particular that she mentioned, that it was important for me to state that I do want to work towards an ending with A, but as there is still work to be done this needs to be prolonged, seemed especially relevant.  If the PCT has some sort of time-scale around which funding could be arranged, with a definite end date in sight, they may be less likely to dismiss it out of hand.  She also thought I should play up the destabilising effect a too abrupt ending would have on my mental health, but I have already decided to steer away from tried and tested threats.  I think it is a far better idea to concentrate on the important changes that my therapy has helped me to make, despite ongoing difficulties, without forgetting that my therapist and I both feel there is work still to do within a perhaps more specific time frame.

Tomorrow is not the be all and end all.  My mother's advice was simply "que sera sera", and in a way she is right.  I will survive a premature ending to therapy, as distressing and difficult as it might be, and as horribly unfair as it might seem.  After tomorrow I will try to put the whole thing out of my mind.  I've fought a good fight and I'll see it through to the end, but at some point I do have to let go.  Not everything is within my control.

Two.

This blog, which is barely a blog (consisting as it does of a whole two entries) is already presenting me with problems.  When I made it I was very aware of not wanting create a public “journal”, a space to whinge about and cling on to issues that have served only to disfigure my life and threaten my future.  This year is in many ways a turning point for me – I have finally, at 21, made it to university.   I have been discharged from nearly all psychiatric care, and… dare I say it… I have started to enjoy life more often than not.   I have moved back in with my mother during the holidays (she evicted me when I was 18, and discharged prematurely from a self harm unit for losing too much weight), and slowly, slowly, my friends and family are starting to trust me again.

I am cautiously ambitious.  I would, eventually, like to go into academia.  I know I will write, and I hope that during the three years of my degree my literary interests will develop in a direction that I will be able to take further.   The course I am on is everything I could have wished for.  I know I am in the right place, and I want to stay here.  I will fight to stay here.  The trouble is, I may have to.  I enjoyed a lot of support in London – as well as psychotherapy twice a week at the Tavistock I had a care-cordinator who I saw weekly, a consultant at the CMHT, a dietician and another psychiatrist at the eating disorder unit.  There is nothing like that available here – although I was referred to the CMHT, they were able to offer me very little.  My experience has been wholly negative – one consultant who assessed me remarked that “frankly, I am very surprised that someone with a personality disorder of your severity is able to do a degree”.  This being the case, however,  he  wouldn’t be seeing me “just to monitor your sertraline”.  Of course, I determined to prove him wrong, and with the support of the GP on campus I did rather well, up to the last few weeks of the spring term.   Stress, weight-gain, fears of losing my therapist and whatever-other-excuses-I-can-come-up-with combined to send things spiralling out of control.  Arteries were opened, ambulances were called and it was all just one big mess where I was being advised to take medical leave of absence, an option that was impossible because I would a) be homeless b) be unlikely to receive any more help than I am currently getting and c) be deprived of the structure of university life, which has been hugely important in keeping me well.

They could not, however, force leave of absence on me unless I was sectioned – and luckily I was able to get a grip on the situation before that became a likelihood.  Over Easter I rested, got back to work, and handed in essays that received a first and a 2.1 respectively.  But what I am trying to say is that however much I would like to erase the past, forget how I have survived it, concentrate purely on my studies and make a blog that deals exclusively with the “un-personal”, the literary, the sophisticated analysis of current affairs,  I cannot do it.  Not quite yet.  At times the two sides of my character seem to be mutually anatagonistic and incompatible.  I must either be wholly sick, or wholly well.  I am either  the determined, “gifted” student with an exciting career ahead of her, or I am the girl who’s spent the last five years in and out of hospital, the  girl whose father killed himself when she was 17 but who was fucked up before then anyway, the girl who hurts herself and those around her again and again and never learns, the girl who by rights really shouldn’t be alive.

Well, isn’t this cheerful!  I  have actually had rather a good weekend.  Booked  a ticket to see Andrew Motion when he comes to York to give a reading in a few weeks, and also secured a place at a conference on “The Literary Eassy in English” being held at Queen Mary in July.  Hermione Lee, Andrew O’Hagan and Adam Phillips (who was actually visiting professor at York last term) are amongst the speakers.  There IS a world outside the stagnant, deadly jungle of my introspective head, and I will dare to take my place in it.  One slightly less self-absorbed blog post at a time.