Thursday, November 6, 2014

I Broke My Therapist and Got a New Diagnosis

Warning:  This post contains possible triggers for self-harm.  If you are not safe, please don't continue.

The new diagnosis is Bipolar II and doesn't really have anything to do with me breaking my therapist.  It's something that's been tossed around as a possibility a couple of times in the past.  I think we're calling it semi-definite now.  Enough that I'm trying a new medication for it.  We'll see if that does anything to change my life.

But the real reason for this post is the whole breaking-my-therapist thing.

Let me start off by saying how much I adore my therapist, Dan.  A lot.  He's amazing and has helped me so much over the years.  He's seen me through some very difficult stuff and walked me through the dark corners of my life that I didn't want to go into.  I would recommend him to anyone.  Well, almost anyone.  Anyone who needs help but doesn't have a problem with self-harm.

You see, along with being a hero, my therapist is a person.  Just a regular human being.  With issues.  I know.  Therapists aren't supposed to have issues, huh?  But they do.  And he does.  And self-harm is the one I triggered.

For anyone who doesn't know me well or hasn't read my blog much, self-harm and I are old friends.  She's helped me get through some really heavy times.  (Not sure why I called self-harm female, but let's just run with it.)  Generally I'm a scratcher.  I use a broken plastic spoon to scratch myself (usually my arms) until I get through several layers of skin and it welts up and bleeds and stings really good.  I say good because to me, in those moments, it feels good.  Don't ask me why.  It doesn't make sense in my logical brain.  It just does.

I'm not good at knowing what will set it off.  It just happens.  I go months without doing it and then WHAM!  Out of nowhere I'm slicing my arms open.

Only this time I maybe should have seen it coming.  I've been fighting a nasty depression (with a couple days of hypomania thrown in, just for fun).  I went quite dark a few days.  Started isolating myself.  Quit getting dressed or leaving the house.  Stopped communicating with people.  Not a happy place.

I don't know what the straw was -- you know, the one that broke the camel's back.  But something happened and I knew I was going to hurt myself.  And being in that dark place when it started coming on, the idea of asking for help didn't occur to me.

But this time I didn't need to scratch.  I needed to burn.  See, it's like getting an itch.  And it's a peculiar itch.  An itch that will only be well scratched with the proper technique.  Sometimes that's the spoon.  Once in a while it calls for the curling iron.

Almost before I knew it I had a nice, big, second-degree burn on my arm.  Ugh.  I'd gone so long without doing it.  I'd been able to wear short sleeves without worrying about traumatizing my kids or others.  And then BAM!  All down the toilet.  Dang it!

Yes, it felt better in the moment.  Yes, it took away the itch.  Was it worth it?  I don't know the answer to that yet.

But then I had a therapy session.  Therapy only works if I'm honest with my therapist.  So I told him and showed him.  He wasn't happy, but we were functioning.  We were even making some progress.  Until near the end of the session.  When I, in the interest of honesty and knowing it was something I should tell him, told him I was thinking of using a blade.

And it triggered him.  And he lost his therapist brain for a bit.  And he called me a coward.

I completely shut down therapeutically.  I refused to look at him.  I started crying a lot.  I told him I was done and wanted to leave.

He could tell things had gone off the rails and tried to fix them a little, but it wasn't going to happen.  He asked when my next appointment was (because now he was very worried about me; it's never a good sign when you leave a therapy appointment in a more fragile state than when you entered).  When I told him it was in two weeks he said that was too long.  He looked at his schedule for the next week to see where he could squeeze me in.  It was packed full.  But he had an opening for the next day.  Would I take that one?  Whatever, just get me out of here.

I called my husband and told him what had happened.  He could hear how bad I was.  He tried to talk me through it.  I said I was safe (therapy code word for not-going-to-hurt-myself).  I said I was just going to go home and go to bed.  Maybe watch some Angel or Buffy the Vampire Slayer.  He offered to come home.  I said he didn't need to. 

Apparently he didn't believe me, because he showed up a couple hours later (he has a two hour commute).  I needed him more than I thought and spent the rest of the night next to him.  Then he took the next day off work so he could come to my therapy session with me.

I don't often want outside help.  My husband is many things, but my strength is not usually one of them.  This time it was.  I needed him to be my buffer with my therapist.  Also not a good sign.

Usually when I take my husband to therapy with me it's because he's having a problem (we see the same therapist) or we're having a marital problem (which still usually means he's having a problem).  So as we sat down in the therapist's office he asked if there was a marital problem.  I said that we were fine.  He asked if Bill was there as support.  I said yes.  Then I looked him in the eye for the first time since he'd called me a coward and through my tears said, "I don't feel emotionally safe with you."

I chokingly explained what had happened the day before, thinking that maybe he didn't understand what he'd said or didn't mean it that way.  He said, "Yep.  I did."  Then he went on to defend it with the idea of challenging a patient.  Using the relationship between patient and therapist to push the patient into something healthier.  He said self-harm was a deal breaker for him.  It was his Achilles heal.  He said sometimes people forget that therapists are people, too, and have their own issues.  This was his.  If I couldn't commit to not do it anymore maybe it would be a good idea for him to refer me to someone else.

I've been seeing him off and on for over eight years.  The idea of starting over, of having to explain everything - my whole life story - again to someone new, was not appealing.  Was exhausting to just think about.  But I was pretty sure I couldn't work with a therapist that I knew saw me as a coward.  Someone I wouldn't feel comfortable telling when I self-harmed.  And I knew I couldn't say I was done.

I told him I needed to think about it and let my husband spend the next forty minutes asking about Bipolar II (really, just to get our money's worth; I had made the decision).  Then my husband ran out of questions.  It was time.

My therapist apologized for using such a "harsh" word.  I looked him in the eye again and said, "It wasn't harsh.  It was demeaning."  He just nodded.

We all sat in silence for a minute or two.

Then I looked him in the eye and told him I needed him to refer me to someone else.  I told him I've never not seen him as a person.  I never thought he didn't have issues.  But I have my own issues and I can't carry his, too.  I have to carry the issues of too many people in my life.  I can't carry his.

So he said he would refer me out.  He said his feelings weren't hurt.  He said I could come back if I ever needed to.  I understood completely why he reacted the way he did (I know what it's like to be triggered).  We patched things up amazingly well and respectfully.  I left with a recommendation from him (Jason) and a promise from me that I would get medication for Bipolar II ASAP.  And with a heart that was breaking, because even though I knew it was the right decision I was so sad about leaving him.

My husband and I left his office and I immediately set appointments with the new guy.

Lest I leave you with a bad feeling about my therapist, there is more.

He called me later that night to check on me and make sure I was okay.  I was.  I was actually doing great.  Much better than I'd been in days.  Because I'd done something very brave and very hard to stay true to my own needs.  I was riding a bit of a high from that.  He also said that what I'd said, about not carrying his issues, had stuck with him.  He'd been thinking about that a lot and would continue to do so.

Then he called me a few days later to apologize.  He said not only had he handled the first appointment horribly, inappropriately, but he'd botched the second one, too.  He said it's never okay to call someone names.  He acknowledged that he'd not been in his therapist mind at the time.  He said he'd spoken to some colleagues about it and understood a bit better.  He said to force me to transition to a new therapist while in the midst of a deep depression was completely wrong of him.  He said he knew that he'd shut me down when I needed to be heard.  And he was so sorry about that.

Then he said he'd also talked to his colleagues about his issue.  He said he understood self-harm better and how to see it as a symptom and to treat it as such.  He said he thought we'd done great work together over the years and still could.  He said he thought he could work with me, that he liked working with me, and wondered if there was any way we could repair the relationship.  Would I be interested in coming back?  Seeing him again?

I thought about it for a few seconds, but the decision was easy.  Because just moments before he'd called me I'd gotten out of a session with my new therapist.

I thanked him for his apology and gladly accepted it.  I told him we had done lots of good work together.  And then I told him I'd just met with Jason and wanted to try that course for a while.

He said he understood and that I would always be welcome back.  I told him it was nice to know I had a parachute, should I need one.

Will I go back?  Honestly, I think eventually I probably will.  I want to see what this new therapist has to offer.  Maybe he can help me kick the self-harm thing for good.  Maybe he can help me want to.  He thinks he can.

But I don't imagine he can possibly solve all the problems that keep me crazy.  My life is not simple and shows no signs of letting up any time soon.  I imagine I will work with him, get better for a while, leave therapy and try to make it on my own, and eventually crash and burn again (I mean that like a plane going down not depression and self-harm).  And when I do I will look for that comfortable place.  That worn pair of pants.  Because Dan and I still fit.