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Functional Psychosis, Self-Harm and Depth Psychology – Paul: Week Three, Part II

Posted Oct 27 2010 5:19pm
***Psychosis / Suicide / Self-Harm / Sex Abuse / Sorry Use of Alliteration Triggers***

****In Fact, Probably Every Post About Paul – Given the Nature of the Therapy – is Hereby Deemed to Require Trigger Warnings****

The following is a continuation of this post .  Today’s date is 28 October, so refers to a counselling session that took place over a week ago and not that of this week.  The meeting of of Monday 25th was, as I rather bemusedly noted on Twitter that afternoon, one of the most horrific and appalling therapy sessions I’ve ever experienced – and yet, intellectually, it was sublimely interesting.  Misanthropy and joking about our species’ mass stupidity aside, the human mind is truly a fascinating device, capable of more than will ever be understood in my lifetime, and indeed in all probability of that of my phantom, not-to-be descendants.

Anyway, regardless of Monday’s rather philosophical awe, Paul is still A Good Thing.  Where we went last week immediately after the short discussion on the 4 October Plan as linked to above (my immensely long post was stupidly deceptive) is, by now, anyone’s guess, but I believe that he must have asked me how I had been in the week since I’d seen him, because I ended up confessing to him about an incident of self-harm about which I had (at that point) not told anyone.

It happened on the Sunday, the evening before I saw him.  I was sitting minding my own business quite indifferently one minute, and the next I was in one of the bleakest depressions I can remember this year, and maybe for even longer than that.  I can’t say “it just hit me” or something similar, because that would suggest that it felt ‘new’ or something.  It didn’t.  Obviously I know that it was sudden, but depression fucks with one’s most rudimentary grasps of the passage of time, and in this curious way it felt like it had always been with me.

A, perturbed by this reasonless nosedive, reminded me that we had a fun weekend to look forward to* but I remember responding that I doubted I’d still be respiring by that point.  Actually, my usual retrospective analysis makes clear that of course I would not have done myself in whilst in such a state; it takes effort and a certain amount of determination to develop a suicide plan, and I didn’t have either.

In that regard, self-harming at the time was an odd progression, but then again the cuts were pathetically superficial and required little direct attention on my part.  I wrote ‘EVIL’ and slashed the blade about randomly for a bit, watching in a satisfied trance as it all bled.

Self-harm, as a mood management function, works (at least for me).  I find myself rather reminded of last July – as soon as I had emblazoned the word ‘HATE’ across my abdomen on that occasion, I was quite simply fine.  And so it came to pass on this occasion also.

I told Paul about it, perhaps a little sheepishly.  I know he told me at the end of the first session with him that he expected my mood to probably get worse before it got better, but still – it seems nasty to tell a therapist that in the course of your work together that things just get shitter and shitter, to the point where cutting yourself is not only a desirable course of action, but a required one.

Of course, it takes more than that to faze Paul.  I remember C finding some of my elaborate acts of self-harm to be quite perplexing, but Paul makes no judgement one way or the other (more on the refreshing nature of this later).  His main point of concern, after establishing the extent of the damage, was why the word ‘evil’ was my chosen form of body art.

I didn’t know the answer to this.  I remember resisting the urge to shrug, because it seems sort of rude to do so, but it seemed the response that most accurately answered his question.  I had no idea what the exact reasons were, and to be honest I didn’t especially care.

Paul being the type of therapist he is though – almost Fruedian or psychodynamic in some ways, even more so on certain points than his predecessor – thinks that nothing is motiveless.  I wrote ‘evil’ as opposed to ‘I love fluffy puppies’ for a reason.

“I suppose it’s rather obvious, though,” I said eventually.  ”It was, at least at the time, how I felt about myself.  I don’t now especially, but I probably did then.”

I don’t recall his exact response, but he is always very direct in revealing what he thinks and, as he has done in the past, in some way or another he voiced the view that I had nothing to feel ‘evil’ about.

I said that I knew that rationally – at least sometimes – but that did not make it any less real in terms of visceral feeling.  It just ‘feels right’ sometimes to think that I am an evil being.

Naturally, he thinks that I have largely projected the apparent evil of others onto myself.  Such thinking has apparently been encouraged by those who inflicted their apparent evil upon me, and it all alchemises in a large cauldron of psychic confusion.

We talked for a while about the general mechanisms of cutting, and about how it improves my mood almost instantly.  I said that I appreciated the biology involved – endorphins rushing to the site of the wound and whatnot – but that I felt that there was more to it than just that.  For one thing, I find the flow of blood calming and fascinating.  Also, the short, sharp shock of making an incision is a far better grounding mechanism than C’s stupid breathing techniques ever were, are or will be.  I remember W once sagely noting that those were comparable to throwing half a small bottle of Evian on a state-wide Australian bushfire.  Quite so.

Anyhow, I told Paul of how I would ‘use’ self-injury to prevent myself dissociating, to ease anxiety, to manage my moods and to distance myself from psychotic symptomology.

So began a discussion surrounding the types of psychoses I’d experienced.  I said, “my psychiatrist thinks that my psychoses are not of the traditional schizophrenic type.  She thinks they’re sort of dissociative.”

“In what way?” he enquired.

“Well, rather than be engaged in some sort of external fantasy, my mind ‘branches off’ into these kind of voices or unreasonable beliefs.”

“Which sounds like a good description schizophrenia to me,” Paul replied.  ”One of the best explanations I’ve heard for psychosis is that the reality of what the mind is faced with becomes so huge, so unbearable, that the ego ‘splits’ and ergo psychosis takes over.  Oftentimes, it is a horrible place in which to be, but it’s still an externalised psychological fantasy designed to mask reality, and in that sense you will find that parts of the self – as in your case, and as in others – are expressed in ‘unreal’ ways.  So I suppose I’m saying that it is in many ways functional – a protective device of the mind, just like more obvious forms of dissociation.”

So, it is as I suspected.  Paul believes in the trauma model of mental illness – he doesn’t hold particularly to the idea that bio-chemistry can be responsible, at least in some cases.  I, of course, do not agree with such an assessment, but then it hardly matters in this context.  He is there to treat me for trauma-related symptoms, whether or not there is a biological element to them or not.  My agreement or otherwise with his hypothesis is unimportant, as long as we are on the same wavelength vis a vis my treatment – and so far, I think we are.

As I mentioned in the previous post pertaining to this session, Paul thinks there is a small ‘nugget’ of my mind that cares about myself and wants to protect me, and it is his view that the late Tom represented said nugget.  The nugget kept me from purchasing the helium needed to kill myself on 4 October 2010.

By the same token, ‘They’ are the dissociated side(s) of myself that view me as the whore that seduced Paedo (and, it seems,  others ).  ’They’ are the parts that believed Paedo and friends when he/they said (or otherwise intimated) that I was ‘evil’.  Every time Tom, or some other ‘part’ of me, wanted to comfort and soothe myself, ‘They’ fought back.  Before they were dissociative hallucinations, they manifested as depression, mixed states, yadda yadda.

“In some way or another, he’s always inside your head,” Paul said, alluding further to the presence of ‘They’.

“They,” I murmured, absent-mindedly.

“Sorry?” he pressed.

“Not just him.  They’re always inside my head.”

“The voices?”

“No.  Well, I mean, yes, of course the voices, even though they’re controlled by medication.  But what I meant was it’s not just him.  You know…” – I hung my head and lowered my voice – “…more than one.”

He asked me to be more specific.

“I don’t know if it’s real,” I started, but he told me to forget for a minute whether or not it was real, and just concentrate on telling him what it was that was on my mind.

“I mean, there’s him, of course there’s him – him for years and years and years.  But I think, maybe at least once, I don’t know – I think ‘he’ was a ‘they’.”

“Go on,” he gently encouraged.

But I couldn’t say it.  I can type the words ‘gang rape’ here with relative nonchalance, but every time I took a breath to speak those words, that breath seemed to literally stick in my throat, rendering me mute.

This went on for what seemed like twenty minutes, though in reality it was probably closer to two.  I desperately wanted him to say the hideous phrase for me, and for me then simply to confirm that was what I meant.  He did know what I was talking about, I’m pretty sure; but he wouldn’t let me off the hook.

By some miracle, eventually, the words found their way out.  They took on a strange and almost ethereal quality as they did so though, like they had been elongated and pulled out of my mouth by some unseen but nevertheless powerful force.  Gang rape.

“OK,” he nodded.  ”You aren’t certain that this happened?”

“It probably didn’t,” I said, regaining my characteristically dismissive tone.  ”I have an overactive imagination.  I just thought I ought to bring it up.”

“There you go again,” he said, looking at me almost sadly.  ”Your last line of defence.  ’This never happened‘.  The ultimate in self-blame, in avoidance, in coping.  It is easier for you to face being wrong than to face the wrongness of what he and they did to you.”

I looked away, wordless.

“I’d like to try something with you,” he said, changing his tone slightly.  ”It’s not hypnosis.  I’m not even sure I believe in hypnosis, and even if I do, I haven’t a baldy notion of how I’d go about conducting it.  This is just us…taking a little walk.”

“What, to go and get a coffee or something?” I asked, slightly mystified.  On reflection it was a ludicrously stupid question, probably the stupidest I’ve ever asked in any therapy session.

He laughed.  ”No, not literally taking a walk.  Just seeing where your mind takes you when you let it wander a bit.  It’s called guided imagery .  I ask you to imagine a few things, you do so and we see where your mind goes within those confines…potentially, it can allow you to psychologically go to places that are tucked away somewhere.  Would you be happy enough to give it a go?”

It sounded a bit faffy to me, but after a few seconds of consideration, I thought, ‘what the hell?’ and decided to go with it.

He asked me to relax, and I rather surprised myself by feeling comfortable enough to close my eyes in front of him.

Paul said, “imagine you’re at a waterfall ["oh my God," I heard myself say, "one of these new agey 'see your inner rainbow flying out of your arse' techniques.  That's all I need!"].  Picture it falling, into a pool at the bottom, with greenery and trees around it.  Can you see it?”

“Yes,” I replied, the even tone of my voice disguising my internal cynicism.

“OK.  Move round the corner, and you’ll find yourself in a field, or a green plain.  There’s a fence somewhere in front of you, with a gate.  Do you see it?”


“Can you describe it?”

“Ordinary.  Innocuous.  That dull, light colour of wood you often see separating fields in rambling trails.  The gate is secured by a black bolt thing on the back.  You have to reach over it to open it.”

“OK, go ahead and open it…Have you done so?”


“There’s a path ahead of you.  Do you see it, and what’s it like?”

“I see it.  It’s not an official path, it’s just one formed from the constant wear and tear of many feet walking the same route.”

“Follow it.  At the end of it you’ll see a house.  Can you describe that?”

“It’s small.  Thin.  Detached, two-storey, whitewashed, with black window ledges and a black door.”

“Is there a fence?  A wall or hedge?  Anything surrounding it?”

“Nothing, no.”

“OK.  Go up to the door, open it and head inside.”

“It’s locked.”

This took him aback slightly, but he covered it well.  ”You have a key,” he told me.

“OK.  It’s open.”

“Can you describe the hallway?”

I could.  It had three rooms; one opposite me, two on the right.  There was a staircase to my left which had a turn in it.  The walls were panelled with quite a dark wood.  There was some sort of table thing near the stairs, but it had nothing on it.

He asked me to go into each of the rooms, in turn.  The first one was a living room.  It was sparsely furnished, with a dull coldness to it.  The dining room next door was similar, and both were distinctly uninviting, although not particularly belligerent.  The kitchen was warmer – there were lingering smells of food previously cooked, the actual heat a hangover from same.  He asked me to look in the cupboards.  Most were empty, and the ones that weren’t only had old-looking tins of food populating them.

As I got to the stairs, they morphed – and, it turned out, so had the outside of the house.  I told Paul that it reminded me of the TARDIS – tiny on the outside but massive on the inside.

“At the top of the stairs there are three doors,” I told him.  ”However, I know there are more than three rooms.  There are extra rooms off these ones, I think.”

He asked me to enter one of them.  Sure enough, there was another door over to my right.  The room – indeed, upstairs in general – caused me much more trepidation than downstairs had done.  It felt as if there was a malice about it, a sinister, unquantifiable undertone that I couldn’t quite see, as if it was just outside of my peripheral vision – but totally ready to pounce when it deemed the time to be right.

The room was dull and dark.  There was a double bed, dressed in a non-descript beige.  There was a chest of drawers and a window with a dark curtain over it.  It reminded me of a room that would have been vaguely offensive to its occupants even in the 1970s.

Paul instructed me to go through the second door.  This led to a second landing; there were three rooms off it that I could see, but I knew there was at least one more on the other side, which was obscured by a low roof on my right.  On my immediate left was a dark, indistinct storage area.

The undercurrent of menace seemed to swirl around me, starting at my ankles, slowly creeping higher.  It was palpable and, if I’m honest, slightly suffocating.  I could cope with it, but I kind of got the impression that if I went further into the area, the ominousness of the situation would only increase considerably.

It was therefore merciful that it was at this juncture that Paul asked me to leave the second landing, and indeed to depart from the house and walk back down the path, away from it.

There followed a discussion on how the exercise had been.  I was surprised by how the simple act of seeing things in my head had created such sensations and an almost palpable alternative reality for me, especially given how cynical I had been about it.  I told him that I thought it was interesting to have observed that – and, indeed, potentially telling.

Paul agreed.  Apparently, the first thing he really noticed was that there was no wall or fence around the house.  To him, obviously enough upon reflection, this denoted the lack of boundaries that I had, whether currently, historically, or both.  ”That of course is perfectly exemplified when your boundaries are robbed from you, when you’re being abused,” he said.

Apparently I was the first person with whom he has tried guided imagery that had a locked door to the house.  I was silently quite pleased about this (I love being unique), but I’m not sure that it’s really a good thing.  If indeed this kind of therapy can yield results, does the potential for same decrease for me because I have so much locked away that I don’t really want to discover?  Who knows.

“The kitchen,” he murmured wistfully.  ”The smells, the heat – they had been there, but you only caught their embers really.  It was kind of as if there had been some warmth and homely normality in some part of your life, but that it’s been taken away from your conscious recall, or that it’s somehow died in your head.”

I nodded, but said nothing.

“Don’t you find that incredibly sad?” he asked.

“It’s just the way it is, I suppose,” I replied, resignedly.

“Indeed,” he returned, with a tone of deep regret.  ”That’s what’s sad about it.”

Another thing that Paul found intriguing was the maze of rooms in the upper portion of the house.  The symbolism requires no explanation, really, so there you go.  He finds it intriguing; I find it deeply concerning.  What all don’t I know?  Do I really metaphorically exemplify the tip of an iceberg?  Or is this all just new age bollocks that simply means I once imagined looking through a house that I didn’t like?

And so, on this unsettling but somehow compelling note, Paul began to draw the session to a close, tying it up with a few housekeeping matters.

“On the issue of self-harm,” he said.  ”At this point, I’m actually supposed to negotiate a contract with you stating that you won’t engage in it over the next week.  I’m not going to do that, however; if you ended up injuring yourself whilst under a contract, that would be only one more reason for you to be critical of yourself – and anyway, at times you need to self-harm.”

My heart leapt with joy.  Finally, a therapist who gets that!

“That said,” he went on, “if you’re feeling really desperate, you can always contact us.  I can’t guarantee that I’ll always be available, but someone will.”

He paused momentarily, and then said, “I have a phone number that I use for work too.  You can text me on it if you want and I can text or phone you back.  It’s only for use during working hours – I’m not an emergency service – but please do use it if you need to during those times.  Don’t wait until you’re at your wits end.”

I was frankly stunned by the very notion that I am allowed to contact someone qualified and familiar with my case if I’m going mental.  I kept thinking about all the times I practically begged C for advice on who I should contact in such circumstances, and how I was always dismissively told to ring those arbiters of life and death: the fucking Samaritans (no offence to them, but they simply are not fully fledged mental health professionals).

The guided imagery thing was weird, and was expanded upon in the following session (report on same coming soon).  But weirdness aside, I’m still encouraged by this therapeutic relationship.  At the very least, for once it actually feels like someone gives a fuck about me as a person, rather than them feeling that I am just someone who takes up fifty inconvenient minutes of their week.

* And it was a fun weekend; thanks from both A and I to Chaos and Control , Magic Plum , Finding Melissa , @ talkingtocactus and of course Zarathustra for a great mini- Mad Up on Friday night!  Roll on the next one in December :)  Thanks also to my dear friends CVM and Daniel for their excellent company, and to Newcastle United Football Club and its supporters for making our first away fixture surprisingly non-shit!

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