I’d been seeing an NHS clinical psychologist for thirteen years. Let’s call her Marie and me Sarah (all names are changed in my story). We talked about what had happened to me and how it had affected me, we looked at what I found difficult. We considered strategies to manage my distress that sometimes manifested as profound anxiety and dissociation, and at others as depression. We used relaxation techniques, grounding techniques. She offered phone support between appointments if she had space, set up a good plan with the GP for their support and for me to use three days of low dose diazepam if I was become overwhelmed and exhausted, just enough to get me back on track. I had some art therapy. We thought about all aspects of my life and how I could best look after myself within my friendship/family groups.
But I began to struggle more as we wrestled the most traumatic episodes of my childhood. I started to feel increasingly suicidal for more of the time and the self-harm increased. I needed more help. I lived alone. We’d often thought that were there a safe place to go, a restful, peaceful, caring place, that would have been so good. Marie and the GP (rightly) suggested hospital would not be that and reviewed what could be done. With some persuading, the Crisis Team began to offer me some support from 2005. They were mixed. One CPN, Matt, was fantastic; most saw me as ‘hysterical’ or a bottomless pit. But they didn’t know me.
Then the Trust axed Marie’s post at a crucial point in my psychodynamic therapy. I was in turmoil. A new clin psych was found, Simon. It took me a time to trust a man, but eventually work became possible and we got back to exploring the part of my past that so often caused me to feel I was a nothing and a no-one with no right to life. I felt I was fighting this beast called suicide who was sucking me in such that only my toes were sticking out of its clamped jaw, jaws my arms could not prize open. I just had to hang on, to not be swallowed, for 2 days until the appointment with Simon, and then there would be help.
The next day the phone rang to say the Simon has gone off sick. I couldn’t get anyone to believe that my desperation on hearing that was not caused by him going off sick but by how I was feeling and had been for several days. My panic was at not knowing what to do now. I had no-one to talk to, no-one to help me save myself. The Crisis Team were antagonistic, they thought I was behaving like a spoilt child because the therapist was missing a week. I have no idea how I survived. Just thinking about it brings me out in a cold sweat. That was early July. No Simon all July, all August. No word of when or if he might be back.
Simon was part of a service that I didn’t really fit into, but it was felt one of his team should ‘pick me up’. Two months later I received an appointment to see George, a Medical Psychotherapist (i.e. psychiatrist + psychoanalytical psychotherapist). He, not unreasonably, felt we should move towards my care being on a more ‘normal’ footing, i.e. based in the CMHT (I’d managed without them until then) and to let the CMHT decide ‘What next?’ I was pretty mad about all this because the only reason my therapy had ceased was Simon’s sickness. My healthcare Trust seemed to think I’d had enough therapy (money spent on me), and that was that. No clinical review, nothing. But George wasn’t for that, either. Rather he thought that were anyone else to take me on for psychotherapy on a more common 50 mins per week, no other contact basis, it would be helpful to me to have a CPN to turn to for additional support. This meant George had to write a referral to the CMHT. He did. He copied me into it. He put a diagnosis in the letter: Dissociative Identity Disorder. I was horrified to be labelled and to find out there was a name for what they thought was ‘wrong with me’. What I thought was wrong was the fallout of having been repeatedly raped and tortured for over ten years by my parents.
It transpired that the only way the Crisis Team had accepted a referral from Marie was when she agreed to put a diagnosis on the referral form. She used the same one as George but never told me and asked the Crisis Team not to use it with me either.
The label was additional trauma in an already traumatized time in which I’d had a breakdown and tipped towards psychosis (so George explained when pressed a couple of years later). The assessment appointment came through with the CMHT. I met with a psychiatrist, Helen and a CPN who drank tea and looked bored or sceptical. Helen said she didn’t think I’d cope with psychotherapy. ‘But I’ve been coping with it for years, it’s been helping me, I am so much better,’ I said.
I was utterly devastated. I tried to manage over the weekend but knew the edge was getting closer. I had everything ready – the pills, the note, letter lined up to the people I cared about, the funeral arrangements etc. I felt so bad I couldn’t call anyone. I didn’t want to distress them. By the Tuesday morning I knew I couldn’t go on any longer. There was only one person I felt I could burden with how I was feeling. She was in the midst of moving house, she didn’t have a mobile phone, I didn’t have her new address yet. Thankfully she is a vicar so I managed to track down the phone number for that parish’s vicarage. Not knowing whether she was there, and it being 7.30am, I picked up the phone and so did she.
I talked, she listened. Then she said, ‘Sarah is there just one thing that might make life worth living, no need to answer that now, but will you think about it and I’ll phone back at 6pm, but ring sooner if you need to.’ She did phone and I said: ‘Yes, I want to have the chance to finish the therapy because only when I’ve finished will I know whether I can live an enjoyable life. I owe the child I was the chance for that.’
And so the fight began. Cutting a lot out, it was helped by Marie who decided to act as an advocate for me from within her new job (in which she no longer has clients). She told me it was me who convinced them, but I feel sure she helped. I did see the bored CPN a couple of times. She at least had the honesty to say she’d never worked with anyone who experienced dissociation. I gave up on her when she criticized Marie (and by implication, me) for taking so many years to work through my traumatic past.
The fight to complete the therapy made me angry for other people who might not have had the articulacy or the capacity I had for that fight. And it showed me I was not as vulnerable, weak and useless as I’d thought.
Simon never came back to work. Nine months after he went off sick I started work with George. With his help, I completed my journey, we made me pretty much as whole as anyone else is. I had no hospital admissions throughout the 21 years of therapy (with odd gaps). No anti-depressants or anti-psychotics, just my occasional helper diazepam, trusted to my control. I see Helen quarterly, we’ve stuck up a workable relationship. We met with George a couple of times and that really helped. I feel she’s on my side and respects me (as I do her now).
As of July this year, and at the age of 56, I have a new label: Sarah Cambridge BA (Hons) Creative and Professional Writing. I won a University Prize for the highest undergraduate mark in the faculty and a School Prize for academic achievement in the face of adversity. I have emails from Marie, George and two members of the Crisis Team in response to me sending them my graduation photograph. I treasure most Marie saying: I knew you could do it, all of it. I am so proud of you.