Tag Archives: integrative

Waiting times.

It’s a month since my counselling assessment and I’m still waiting for my first session. I expect to wait another month, until the first week of March, but I haven’t had a letter yet to confirm when that appointment will be. It’s two months since I first went to the GP about my mental health (or 21 months, if I count it from the actual first time I went, but was too anxious to disclose).

Before that first GP appointment, I wrote:

I expect that I will either not be offered any help, or if I am, it will be either antidepressants or a referral for a few sessions of CBT that I may have to wait months for.

The reality hasn’t been that far off my low expectations and I’m starting to wonder why I even bothered. I’m pleased that I’ve been offered integrative counselling, not CBT, but the wait for it to start is draining and I’m ambivalent about the antidepressants after taking them for two months.

At my last appointment, the GP told me to come back in three months, but that I could come back earlier if I needed to. I don’t know what that means though. How bad does it need to be for me to come back? I’m feeling worse again, but then depression does go up and down anyway, and I’m not sure whether I should expect that pattern to be different on medication? And what will the GP have to offer anyway, besides an increased dosage?

I’m also concerned that the Citalopram is now making things worse. I’ve been having night sweats; I get them anyway, but now they’re almost every night. I wake up between 3 and 4am, throwing off soaking bedsheets, slippery with sweat, my heart pounding and feeling terrified. It’s not easy to get back to sleep after that. This leaves me exhausted during the day, exacerbating the feeling of concrete in my limbs.

In seeking professional help, I was under no illusions that I would receive high quality treatment. What I’m surprised to realise now though, is that despite that, I didn’t really have a plan for what I would do when my low expectations were realised. I think I still thought that after trying unsuccessfully to treat myself for so long, professional help would be the answer. I would get help, and although it might take time, I would be moving towards recovery.

Now I’m not so sure. My suicidal ideation has pretty much stopped, which is good, but beyond that I can’t see any real gains. I’m sure that eventually I will get to see a counsellor, but right now I feel isolated and more lost than before seeking help. At least then, I still had my psychological ‘last resort’ of seeking treatment.

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A counselling assessment.

I had my counselling assessment on 7th January. Here’s what I posted on twitter straight afterwards.

Twitter 7Jan2013

I’d been referred to my local Mind, but I had a flat bike tyre and it took me 40 minutes to get there. It was an area I’d never been to, in a bleak housing estate. I was buzzed into a courtyard where a group of older men were smoking; I had to ask them for directions to reception. As I walked in, the receptionist signalled for me to wait while she finished a counting task. She finally asked my name, rang up for the counselling coordinator and asked me to wait. I sat down on the one seat available, squashed between a cupboard and a second chair which was taken up with a huge carton of sugar. Several more people came in. The tiny space got crowded and everyone else was standing, so it felt like they were all on top of me. The door was open; the room freezing. I took some notes as I waited:

This feels like a place for people who are sicker than me. It feels like all the places I walk into through my work. I want to walk out now, go to work, find myself a private therapist and ask P to help me pay for it. This doesn’t feel like a place for people who work, it’s a place to go during the day if you have nowhere to be. I feel claustrophobic and like I want to cry.

I’m aware these feelings seem judgemental. What they reflect is my anxiety about being displaced from the position of ‘professional’, with the status that comes with it, into the vulnerable position of ‘service user’. This was part of the reason it took so long for me to seek help, and sitting in that reception, I felt out of control and wanted to run.

Perhaps the receptionist picked up on my discomfort, because she sent everyone else outside to wait and asked if I was cold and needed the door closed.

Eventually Liz* came down to collect me. She looked younger than she sounded on the phone, and seemed friendlier. She took me upstairs to a small but comfortable room. I noted that she positioned herself closest the door. I know that she does that is so she will have an easy escape if I turn violent. Liz told me that the only reason any of my notes would be shared would be if they were subpoenaed, which was a relief given concerns I’ve had about information being on my medical record. She asked detailed, difficult questions, but was gentle and empathic and I trusted her. I disclosed pretty much everything, and I cried a lot.

She asked if I’d been diagnosed in the past and I told her about the Borderline Personality Disorder. She later asked whether I’d been angry at that time. I said yes, and that I suspect that’s why I got the diagnosis: women aren’t supposed to be angry. She laughed and nodded, which I liked, and said, “We don’t do diagnosing here.” She clarified that their counsellors work from an integrative approach, which means they draw on a range of theories in their practice. I’d been worried they would offer cognitive behavioural therapy, which I’ve found unhelpful, so was glad she agreed that CBT wouldn’t be appropriate. As she said, I don’t know why I’m feeling the way I am, so I need therapy that allows me to explore where my feelings are coming from.

The assessment took 35 minutes and Liz offered me 12 sessions of counselling. I need a female counsellor in the evenings or on the weekend; she thought she would be able to allocate me an someone next week, but would call to confirm. I left wishing that Liz could be my counsellor, but feeling hopeful that her approach is reflective of the ethos of the service. She called back this week, but unfortunately can’t offer me a counsellor for another five weeks. I’m going on holiday then, so I won’t start counselling until the first week of March: three months after my first GP appointment.

*not her real name

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