Even amidst my disappointment, there is growth

Although I had originally intended to follow through on my individual criterion focus this week, in sitting down to actually do it, I discovered that I could not get it to just "flow" quite right. In fact, everything I write tonight sounds either stilted or whiney. I'm scatty and I seem to lack any semblance of an attention span, but I've written and rewritten this entry a dozen times over, and I just cannot find my comfortable Blogging voice.

Today has been a difficult day for me.

After DBT ended, I knew that the plan was for me to be released from Mental Health, but when I spoke to my psychiatrist and let her know my concerns, she said she would talk to the team, and then we would discuss what was to happen at my next session (today). At that session I also made a completely unsuccessful attempt to be placed on a different medication. I resolved that I would work harder to get my point across this time. I did a bit of cursory research and came up with two alternatives that we've not yet tried. I made notes reminding me to use my DEAR MAN skills and to stand my ground. I also included a note and phone number to remind me to have her call my GP, as per his request from the last time I'd seen him. I assumed that once all of that was done, we would finish up and that would close my file, and I surprised myself by finally being more okay with it than I'd expected.

So, when I turned up for my appointment today, I was prepared. I held my folded paper in my hand, a tangible reminder of the work I had done, and the importance of being effective. I shook in my boots as I entered that room, but I worked to Appear confident. (Those of you familiar with DEAR MAN will recognise the A from "MAN" - everyone else, please just be assured I have not decided to begin random capitalisation!)

Before I had a chance to even begin to Describe the situation, my psychiatrist spoke. "I closed your case yesterday and sent a letter to your GP."

I froze; all of my false confidence deserted me. Where was the discussion she'd spoken about last month? I had come to terms, in part, with being transferred solely into my GP's care - but I still wanted discussion. I wanted to discuss the medication issue. I understand that medication won't solve my problems with self harm; I know that medications won't stop me from feeling. On the other hand, I have experienced (briefly) what it is like when the medications are working, and I would like to experience that again. And perhaps most of all, I wanted my GP to air his concerns to the psychiatrist so that she could reassure him, because my reassurances mean very little. I, after all, am the patient who presents regularly with what he terms "severe" self harm; the one who reassures him she's fine, only to turn up with new injuries a couple of days later.

I was humiliated when the next question she asked was "what happened to your face?" I am a skin picker. I don't view it as self harm (although throughout DBT, Sandy tried to tell me it was) and I feel that my reasons behind picking are very different to my reasons behind self harm; it is closer to a compulsion than an urge, and I am even more deeply ashamed of it than I am of self harm.

She spoke to the air for most of the time I was in that room. I nodded occasionally, said "yeah" a few times, and stared at a fixed point. I didn't bother bringing up the medication; without any prompting she launched into a speech about how I know the skills, I'm simply not using them; and another speech about how no medication will help me at all. I did make an attempt to have her call my GP, but she dismissed it, telling me she had written him a letter. Mostly what ran through my head was "don't cry don't cry don't cry don't cry don't cry". I feel dismissed and rejected; I feel abandoned. I feel an extremely strong urge to self-destruct. Those are not emotions. I felt sadness, disappointment, guilt and anger. I feel fear that my GP will not believe that I tried to get her to call him.

I find that, also, I am disappointed that I went to pieces so quickly, disappointed that I didn't make better use of my DEAR MAN skills; and yet even in this I can see signs of change.

I allowed her to see that I was upset. I didn't talk to her about it, but for once, the emotions I displayed were congruent with the things I had been telling them.

I did attempt my DEAR MAN skills. This is growth, many's the time in the past I would let everything slide rather than ask for anything.

I identified and expressed the emotions I'm feeling about the situation.

I didn't listen to my urges to self destruct.

Apologies for the lack of thought on this entry, and the over abundance of whine. Perhaps tomorrow my brain will work better again.


Today's thought challenges/cheer-leading statements:
These feelings are unpleasant, but they will pass.
The urge to self-destruct is just an urge. I do not have to listen to or follow any urge.
I am adjusting. It will get easier. I am doing okay.
I have a good GP. If I explain to him that I asked her to call and she felt she had said everything that needed saying in the letter, then he will understand. If he does not understand, I have the skills to handle that situation.
This is not a sign that I am not worth helping, that I have been thrown away or that I am not good enough. This is a vote of confidence in my ability to manage myself for a while.


Take care of yourselves until next time, and may we all find our own small fences along the way.