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Advocacy Meeting Non-Fail?

Posted Jan 18 2011 10:48am
I finally met Derbhla the mental health advocate today, after her sickness a fortnight ago.

I don’t know what I was expecting her to be like exactly, but whatever it may have been, she wasn’t it.  She is thin, softly spoken, with a modestly lilting Norn Iron accent (as opposed to one of the ‘broad’ ones) and with long, strawberry-blonde hair dangling down her back.  I was pleased to observe that she was quite friendly towards us, and came across as professional and competent.

There isn’t a great deal to say really (but of course I’ll say a great deal anyway, if previous experience is anything to go by).  A and I told her of my 14-year floatation around mental health services and how the Trust had almost always passed me from pillar to post and otherwise fucked about.  We mentioned my experiences of therapy in the private and voluntary sector, then told her about C and how the relationship had been prematurely severed in a swirl of frustration and embitterment, which inevitably led to allusions to the year-long laugh of correspondence with Mr Director-Person.  We pointed out that the Trust had even acknowledged its failings, but had completely and utterly failed – even at one point lying about it – to attempt to offer me any assistance beyond my existing relationship with NewVCB when things with C came to a close.

Indeed, I told her that NewVCB had been opposed to C cutting the therapy short and A went on to out that, although the therapeutic process had actually been apparently progressing fairly well (in terms of me opening up to C about the sex abuse, mainly, something I’d hidden from him and everyone else until then), it had ended up utterly re-traumatising me due to the fact that I had to relive and relearn all the grotesque, horrific images and feelings, only for C to dump me in the gutter and neglect to help me resolve the multitude of issues therein.

“Like opening a Pandora’s box,” she noted, a comment with which I fully agreed.  A later asked me if I’d had an eyebrow-raising moment when she said that, and I had, slightly.  It’s a common term, to be fair, but when I hear the word ‘Pandora’ out of the context of this blog and those associated with it, I must confess to a momentary uncertainty as to their knowledge about me.

Anyway, we didn’t go into specifics with her as to how the re-traumatisation manifested, but she knows about the “with psychotic and dissociative features” specifiers at the end of my string of diagnoses, so I’m sure she can take an educated guess on the point should she wish to do so.  NewVCB and the notes she keeps on me, as well as drivel on this blog, can certainly attest to my having gone even more mad in the wake of the end of matters with C.

The issue of re-traumatisation seemed to be the main point at which Derhbla realised I could maybe have a viable case to present to the Trust, though naturally she had appeared annoyed regarding their previous failings and the amount of money I had to fork out in the private sector as a result of same.  She asked me what it was that I wanted them to do; that sounds like a blunt statement, but it was not delivered that way.  She simply wanted to know what my idea of a way forward was.

A pointed out that C himself had suggested that the Trust could outsource appropriate therapy for me to a private sector therapist, and that we had been thinking along those lines.

“However,” I pointed out, “I would be willing to see a psychologist within the Trust again as long as they would guarantee to operate that within an adequate, fairly long-term, timeframe.”

We discussed briefly what kind of timeframe that might be, and I couldn’t really identify a specific period, but we did note that the standard recommendations for the conditions with which I am diagnosed are for therapy to take twice a week for at least 18 months.  I did point out that I had absolutely no interest in either CBT or DBT after my previous experiences of their wanky, patronising, victim-blaming cuntitude (not that I put it in quite those terms, however ;) ).  She nodded, and accepted that I was both experienced and knowledgeable enough about my conditions and the various therapeutic models to be qualified to feel that dynamic or analytical therapy was the way forward for me.

Although she didn’t say it such a fashion, Derbhla did subtly suggest that I might have to be willing to compromise with the Trust; although I pointed out that I didn’t that think that their lack of resources should be reflected in the care they are meant to provide, both A and I told her that we did accept the economic reality of the NHS’s circumstances.  To this end, Derbhla suggested that when we meet the Trust, we agree to a willingness to cease any proposed new therapy when I feel able to return to work.  In that way, she thinks that I will not come across as being overly demanding by requesting tremendously long-term treatment from them. Indeed, my strong desire to eventually return to work should be seen (correctly) as a willingness to get back off benefits and therefore, in the long term, cost the public less money.

She said, “you’ve studied to post-graduate level, so it’s obvious you want to work.”  Thank God someone else has noticed that in an unsolicited fashion.  It is true.  I didn’t put the time and effort into all those bloody letters behind my name just to intentionally languish on benefits.  Who the fuck would bother?

Anyhow, getting to the point through psychotherapy of readiness for a return to work seems reasonable and fair to me.  I don’t expect cures, as I have eternally argued here.  I do, however, think it’s only right that this public service to which we all contribute help me by giving me back at least a little control of my life.  To use a cliche I despise, but which nonetheless fits the circumstances, I think they should be willing to help me help myself.

At the point where I said that I would be willing to consider seeing an NHS psychologist rather than necessarily have any proposed therapy outsourced, Derbhla asked me if I would be willing to see C again.  A actually laughed at the suggestion.

I didn’t, but I still responded negatively.  We told her how there had been so many mixed messages from C on whether or not the cessation of therapy was specifically his fault, and how as a consequence my trust in him had been all but irreparably damaged.  I said, “the only circumstances under which I would consider seeing C again is if they allowed me a lot of therapy with him, as it would take a long time to rebuild my trust in him.”

I try not to think about C very much, though I have noticed when I am writing my reviews of sessions with Paul that I compare the two quite a bit.  In all honesty, despite my best efforts to compartmentalise and repress it, there is a part of me that misses C still; it was such an intense relationship, and I did work with him for quite a while.  You can’t just switch that off because the person is absent, or because they did something (profound as it was) to annoy you.  In that way, part of me would like to see him again – but I think it could only possibly be a productive move if an awful lot of time were allocated to it in order to facilitate working on the myriad of trust issues hanging over from our previous liaisons…not to mention the issues for which I need psychotherapy in the first place!  Ergo, regardless of the vague regret I feel about it, I don’t think seeing him would be a particularly good idea, and it was right and proper that that was what we told Derbhla.

So.  Anyway.  I noted that I was waiting on my entire psychiatric and psychological medical notes, and that I didn’t want the meeting to take place prior to this.  Derbhla asked was it really necessary to wait for them, stating that, “if this meeting doesn’t go satisfactorily, we could organise another one after the notes arrive. The thing is, the Head of Psychology (HoP) is retiring at the end of January.”

I haven’t mentioned that here yet, but I was cognisant of this development; the Assistant Director of Mental Health (AD), the other person with whom the meeting is due to take place, wrote to me about it about a week ago.  I decided to ignore her letter until I had met Derbhla.  Derbhla seems to think that meeting HoP – let’s call him Bill – before he retires has several advantages:

  • He is a very experienced professional psychologist, and therefore is best placed to understand the types of therapy and treatment that I am likely to be bringing to the conversation.  I didn’t ask her what background the AD has, but I’d be fairly sure that it’s either nursing or psychiatric medicine.  But then I’d assumed that about Mr D-P, and he is mere a bureaucratic manager of jargonwank, so I suppose AD could be too.  Either way, it doesn’t sound like she is a psychologist.
  • Reading between the lines, I get the impression that Derbhla thinks Bill is quite an understanding man.
  • Crucially, he is retiring.  So what, Pan?  Surely that’s not good, because you can’t see him again if he actually is any use?  What can he do when he’s gone?!  Well.  Derbhla’s point, and I hadn’t thought of this, is that he has nothing to lose by trying to accommodate me at the forthcoming meeting.  A very, very salient and well-made point, I thought. Given that this is 18 January, the meeting would have to take place either this week or next, as he’ll be gone in less than a fortnight.  That’s not ideal for me, but as A rightly noted in today’s meeting, if we can progress this issue now – especially given Bill’s lack of reason to care about the future of the Trust’s finances and whatnot – then surely it is best to do so.  I agreed to let Derbhla organise a meeting with them and get back to me within the next 24 hours.

    And that’s that really.  I know I’ve been banging on about therapy in a way that suggests they will automatically grant it to me under certain conditions, but be assured that I don’t actually think that.  I’m merely writing here about what we discussed with Derbhla, and what I hope may happen.  To be honest, I don’t expect anything really; I hardly dare to hope for even an insincere apology for all the shit these arseholes have thrown at me. Given my anxiety issues, although I despise the idea of meeting Bill and the AD – who shall henceforth be known as Noreen – it is a something, and even if Derbhla isn’t a miracle worker, at least she seems to want to support and assist me in taking them on.  It may – it probably will – result in absolutely fuck all, but it’s worth a try.

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