Saturday, 11 May 2013

Therapy and The Police.

Well. Feeling shit. Feeling ashamed. I don't really know what happened.

Will start with the psychology session first.

We talked mainly about the other night when I started self harming and stopped by leaving the flat. He said it was really positive that I managed to stop but he was concerned I was putting myself in a risky situation and there could have been some replacement going on. By this I mean that I was replacing the feelings of self harming by feeling a rush of being in a potentially dangerous situation. He likened this to me swallowing something as while it may not do something there is the potential for it to do something. While it wasn't intentional, I think he does have a point about what I did.

We went through everything that had happened that day. Even to the little details of what I had had for lunch and dinner. Even though it was only two days before I had trouble remembering what I had done that day. We talked about how I had been to the doctors. I didn't talk about why I had went but I said how I was a bit annoyed as it wasn't because of the letter from the psychiatrist about medication, but just because she wanted to see me to see how I was doing. And, that I didn't get any answers to the things I wanted to discuss with her. Those being that I haven't had a period in 2 months, that my voice has still not returned after being on the ventilator, that my hair is falling out and I have a bald patch and that one pupil is dilated all the time while the other is normal. She couldn't tell me anything or give me any possible reasons for why I seem to be falling a part. All I have been referred for is blood tests to check hormone levels and my thyroid function (in some ways I am hoping it is under active as would be a reason why I am so over weight and I can't seem to lose weight even though I don't eat crap etc, at least treatment for it would help me lose weight).

We then went on to talk about the visit from my OT and what we had discussed. So queue me getting quite emotional about uni and the possibility of not being able to go back. I said I feel as though I have had so many obstacles to jump over about being there. Like in my first year when the counsellor I was seeing raised concerns about my fitness to practice and I had to inform uni about my mental health problems and I was convinced that they wouldn't let me continue. Then when I was in hospital the first time and I had to inform them I was in hospital and they said I would have to defer for a year. Then when I was in hospital the second time and I had to tell them I was in again and had been about 6 months on a PICU. As well as the time I broke my ankle and had to finish placement early and miss days of it. I missed the first couple of days of placement because I was in hospital with an infection in a self inflicted wound. I missed the induction week at uni as I was in hospital after an overdose. I really don't have a great track record. As I was talking about it I got a bit upset. I didn't start crying or anything but thinking about the future and the possibility of not doing what I want to do because of illness really does upset me. I told him how I felt as though I was waiting for my life to start. I explained how I was 30 next year. And I have nothing to show for it. I have nothing of what I expected to have by now. Not married, no career, no job, no family, no own home and not even close to anything, except I could possibly have a career if things go the way in which I want them to go.

He asked how much I had thought about it since and I said I try not to think about it as I don't want to face any possible negative consequences. He said he will meet with the course director for me and wants me to go a long. I'd rather not be there actually. I hate being discussed while I am there. I do think he would try to be positive for me, but even still. I would really prefer it if I wasn't there. He gave me his email address and told me to email the course director and copy him in so we could sort something out. I really appreciate his help with everything and feel he is going beyond his duty for me with this. I will be sad to stop seeing him when we come to the end of the treatment. He asked me if I had done anything on my dissertation. I said I hadn't as was worried about putting in lots of effort in to it to only be told I won't be able to continue with the course. He got a bit annoyed with me and said something along the lines of "for fucks sake, buck up". I don't mind him being like that. It makes him more human and in a way shows he does care. He said he was probably being unprofessional, I said I didn't really care if he swears etc. I suppose if you didn't care about a person you wouldn't get pissed off with them would you?

So he said I needed to start working on my dissertation as that will go in my favour when looking at going back to uni. It shows I am committed and making an effort. If I am told I can't go back but haven't done anything to show that I am moving forward I will feel a lot worse than if I have done something and put my efforts in to showing them I can move on from this. He said if the latter happens at least I will be able to feel I have done everything I can and that I will be right to place some blame outside myself. Where as if I don't do anything all I'll be able to blame is myself, thus feeling a lot worse. I told him how I had never thought about it like that before and it has now motivated to actually start doing some research.

We didn't really go into reasons about why the DBT wouldn't work for me at the moment or anything about the assessment. We did spend most our time talking about Tuesday and what happened to lead me to self harm etc. But he did say I could try Schema Therapy. So we talked about what schemas were and a bit about the therapy, but not much. He gave me a questionnaire to take home and send back to him in the post. From doing the questionnaire it is pretty obvious I have maladaptive schemas and can see that the therapy would be much better for me than DBT. I did quite a bit of reading on it and have read psychiatric and psychological journals on it, and I must say I am feeling quite positive about it. But, I do have some concerns about it I need to raise...

Firstly that when comparing SFT to TFP there was only a 45% recovery in patients using the SFT. The TFP was even lower. However, it did show improvements in 70% of people. Still not great numbers but well. However, these figures were based on 2 sessions a week over 3 years. And it also says that success is strongly related to the duration and intensity of the therapy. I am assuming that we are not going to be meeting that regularly or for that much longer, so realistically how likely is it to have a positive impact on me?

It can take up to a year to notice benefits. Again the question about intensity and duration comes in because at the moment I see him once a fortnight for an hour. So is it going to have any impact at all.

Secondly, it seems a bit Freudian to me and places a massive impact on childhood. I had a pretty normal childhood with no major dramas or upheavals. My parents were pretty normal and nurturing. And while I can see that I do have maladaptive schemas I don't think that these are a result of negative experiences that happened as a child. So I am worried I am going to make problems out of something that was never a problem. For example one of the areas that I have highlighted where there is a maladaptive schema is in failure. I do have strong feelings that I am inadequate to others and don't match up to them. But this is not as the theory states that I wasn't given enough support/ was expected to fail/ was treated as stupid and never taught discipline.

It also involves things like role play. I hate role play and get so embarrassed that it is of no use to me.
So there are a few concerns I have, but I am willing to do this and can see that even just by doing the questionnaire that I definitely have negative maladaptive schemas. So I think it could help.

That's about it for the psychology session...

So, then what happened. I was ok. I was feeling ok. I really fancied some wine so at about 9pm I went down to the shop and brought a bottle of wine. Fine. But after I had finished that I wanted more. So what did I do. I ordered a bottle of vodka online and that was delivered. This is where it all went wrong. I was only going to have a couple. But I didn't. I don't really know what happened, I remember tears. But the next morning I woke up in bed fully clothed to hammering on my front door. It was the police. I ignored them as I couldn't face them. But then I had about 5 missed calls from a private number. So I answered the phone and it was the sergeant. He said he knew I was in and ignoring the officers who had come round. I told him I was fine and he said they were concerned I had taken an overdose and they needed to check on me. I told him I didn't want anyone coming round and that I was fine and all I wanted to do was sleep. After about 15 minutes on the phone to him I thought I had convinced him and he said ok. But then I get another phone call about 10 minutes later from the police man who came round the other week to check on me and who had also been the one to find me when I ended up in hospital for 2 weeks nearly dying. He said I was lucky he was on shift as if he hadn't have been there I would have had the police back again and forcing entry as they knew I was in and just not answering the door. I told him I was fine and that no one needed to come round. I tried all I could to convince him I was ok and just needed to sleep. He asked how I was feeling and how I had been since I saw him last and I told him that things had not been good. He gave me the option of him coming round then or having a number of them coming back, forcing entry and carting me off on a 136. Not much choice there. He told me I couldn't ignore them and he was giving me the choice. Not much of one was there.

So he rocks up about 20minutes later with his partner. I am in a right mess. I feel like crap both physically and mentally. The female asks if she can look around and go through my bins as he said he is not convinced I haven't done anything. And to be honest neither was I. But I didn't tell him that. The female officer came back with a bag of meds and in it there were empty packets. I can't remember taking them, maybe I popped them and flushed them, I have done that before. But then why was there still numerous unpopped ones. I didn't want to say I was unsure as that would have resulted in them having to call an ambulance and I really didn't want that. It was obvious I wasn't feeling well and he said he would be happier if he called an ambulance and got them to check me out. But I told him I was fine. I said that they were old packets and that I hadn't taken anything. He kept saying how he wasn't happy to leave me and could they take me somewhere to be with someone. I said not as all I wanted to do was get back in to bed and sleep until I felt a bit better. If I am honest while they were there I was having all these thought about self harming and taking an OD and I didn't really want them to go. But they aren't babysitters. So I didn't say anything.

I really don't know how and why they came round. I have looked through my phone and there are no calls or texts to anyone. I didn't write about it. Nothing. I don't know if I did take anything, but if I did at the most it would have been about 20 pills. So that won't have caused any major damage. And I feel fine now.

I feel so awful about it all. I don't get where it came from. I was stupid for ordering that vodka. Vodka doesn't agree with me. Especially not when I have drunk a bottle of wine and then that is followed by a whole large bottle of vodka. No wonder I felt like shit.  Well, I say I don't know where it came from, it's been no secret things are not going well and I am struggling with everything at the moment. Also, I did self harm on Wednesday night by swallowing a nail. It came from no where. Ok, there were small urges but I was dealing with them. I was managing. But then I walked past it and saw it and then I just picked it up and swallowed it. No planning, all impulsiveness. But, of course I didn't talk about this with the psychologist as that would have meant a trip to the hospital and a possible admission. Not what I want or need.

That's about it really. So things have taken a turn for the worse in a way. And, now I have swallowed and not been worried about the consequences it will probably happen again. I am having massive urges to as well which I am really struggling with. I did think about calling crisis team as I am still open to them and have been told if I need a visit I am to call them. I don't see my CPN until Friday. So maybe the extra support would help. But I don't know what to say to them. I don't want to tell them I could have possibly OD'd, or that I got so drunk I don't know what happened, or that I did swallow something. But I could do with the help. But I am too ashamed to ask for it. I don't know what to do really. Help.

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