Guest blog by Hazel - Seeing a shrink

My shrink was a registrar and agreed to see me at short notice, an emergency referral.  She called me into the consulting room and invited me to sit.  It was a good start.  She called me Dr Christie and I tried not to look frightened.   She took a full case history.  Childhood passed into adolescence and grew into adulthood.  Important points were noted.    ‘My father’s a nasty patriarchal bully’ I said, with a familiar clutch in my stomach.   ‘You’ve had a previous depressive episode’ she countered.  ‘I’m barely managing to cope with the kids’ I admonished.  ‘You set yourself very high standards’ she retorted.  I said I was open to counseling.  She shrugged and said the waiting list was enormous, not really worth going on to.  She liked drugs, as most shrinks do, and so came the jewel in her crown.  ‘Why are you on such a low dose of Mirtazepine?  15mg isn’t even therapeutic!’  It was the closing round.  ‘I’m going to up your drugs to 30mg’.  Shock registered on my face; I was being drugged up and sent away, period.  But then the lifelines came, as unexpected as they were welcome.  ‘Would you like to see me again, on a fortnightly basis?’.  ‘Yes, yes I would’.  ‘And I’ll refer you for counseling’.  My body felt weightless in its relief, as if a hurricane had passed through. 

Some two weeks later I saw the shrink again.  This time her agenda was support.  What did my typical day look like?  What did Alan do?  What family did we have? What friends could we call upon?  Who else could I ask for help?   I felt the stinging slap of yet another professional refusing to hear that we had ourselves and no one else.  But I was not as fearless as I thought.  ‘We have no other help’, I screamed.  I flinched from the anger in my voice but I forced myself to speak, to tell her the thing she must hear.  But she did not hear it.  I must ask Alan to do more, and I must learn to ask for help more widely as if there’s a reservoir of resources waiting for me.   ‘I am not’, she tells me, ‘as distressed as last time’.  This is good.  It must mean the drugs are working. 

Session three and Alan had been summonsed.  I hated this; the hushed conversation before being called, the agony of being exposed.  In the room, I worried privately.  Alan gave anguished answers to the opening questions.  When did he notice a change in me?  What was the cause?  Some people choose to stay to hear the responses their partners give.  I preferred not.  I fled, unwilling to hear the dissection of my self, wanting to give Alan space to answer.  When I returned, Alan was chastened.  A chill ran through me.  More drugs.  ‘We’re going to go up to 45mg of Mirtazapine now and mix in something for sleep’.  There was a tension in the air, and something heavy like humiliation.   ‘You have’, she told me, ‘a very bad attitude to drugs’.  My face was flushed with it.  Her eyes burned with it.  ‘It’s time’ she told me to ‘get over it’, and take the medication.  Later, over coffee, I learnt of Alan’s humiliation, of being told he must do more at home; he who does so much.  Her words, repeated now by Alan, drew breath from me, left me stuttering.  He offered to come home early each day to ease the daily wall of panic.   My reservoir. 

I arrived for session four, relieved to be alone.  She’s concerned this time.  I don’t recognize my illness and I fight her at every step.  She’s right.  I listen to her every word, but imagine it as a story only.  As if it were a dark figure in a book instead of me.   She tells me another story to unsettle me from my fiction.  ‘You are ill,’ she begins.  ‘Every week I see people who’ve been referred by their GPs but who are not ill, and I send them away’.  I listen.  ‘But you are ill, and you must let me do my job.  You must stop fighting.  You wouldn’t like your students to tell you how to do your job, so please let me be the expert and do mine’.  It seemed like the greatest arrogance or stupidity not to have fully taken on board that I was ill, but I had not done so.  I had not internalised any of this, I was just ‘not coping very well’ rather than ‘ill’.  The silence was so profound I felt I could hear the blood coursing round my veins.  Desperate to fill the gap I said ‘ok, ok, I am ill’.  Saying it out loud was more shocking than I thought it would be.  The realisation came in waves, drowning me.  ‘You will get well again and if the drugs help you to sleep a little better, and to get you through each day a little more easily, then that is a good thing ’.  I am frightened but it is the beginning of hope.  We have parried with each other, but the words are only surface deep.  She will not be hurt, and I will allow her to do her job.  There will be a moment after this, and another after that.  It is strangely civilised.  Battle had been done and the two sides parted in peace.   

Later, I began to see improvement in my form: longer days and more social contact resolved out of the numbing grey depression.  I had edged ahead of anxiety and was a whole length in front of crisis point.  Deep inside there was the sound of healing.  But healing comes and goes and stronger days were woven through with weaker ones, just as surely as night follows day.  And our fifth appointment fell when I was down, very very down, when the overwhelming numbness flared through me like flame in dry gas.  For the first time I deluged her with my misery: the horror of having Mark at home from school; the fury at loosing my recovery time; the void of people to help us; the hatred of feeling overwhelmed and out of control; the anger that I was not at work.  I lambast the support group I’m going to.  It is full of ‘scary depressives’ that ‘I wouldn’t want to meet on a dark night’.   This time I have tried her patience, and she tore me apart like a hunter attacking a fresh carcass.   Her meat today is agency and choice.  It’s a simple matter, she lectured, of learning to help myself in a world that is made up of individual choices.  ‘No one is forcing me to see a shrink’, ‘no one is forcing me to go to a support group’, these things are ‘my choice’.  ‘And’, she rose like a phoenix from the ash, ‘do you think that you are not scary?’. She closed in on the heart.  ‘There is nothing more that psychiatry can do for you’.  Her words pressed in on me, weighed down my tongue.  I resorted to glib sarcasm and angered her further.  But she holds the upper hand.  My case has been discussed.  I will be seen twice more and that will be it.  I am not suicidal after all.  My sojourn with the shrink is coming to an end.  I hold my tongue. It does not feel like a good resolution. 

I’m doing better.  I’m relieved to have new strength, able to make the occasional foray to see friends, able to do simple chores in town.  But with a frenzied haste I agree to go out one evening.  It’s too much.  I seemed to sit across the table from my other self, though still so close I could feel the greyness rising from my skin.  I leave.  It’s part of the tension and worry in my build up to session six.  Am I ill or not?  I confronted her.  ‘I felt very uneasy about our last meeting’.  She admited that it didn’t go well.  My sarcasm, my dismissive attitude got under her skin, needling her like a thorn.   I tell her I’m doing better, that I’ve come a long way since our first meeting, but that I cannot escape the feeling, that below the surface, something is dragging me down.  Her advice is commonsense.  ‘See your friend again, but go in the morning’.  I tell her that she was the first person who ‘made me feel ill’.  She refused to believe this, that I had not recognized my illness, that I could interpret sick lines from my GP and a referral to a shrink as something routine.  And she put me in my place.  Depression is not something to ‘wallow in’ and it’s ‘not like I have cancer, after all’.  No, but it’s been 12 months stolen from children and husband, from friends and colleagues.  The final blow came.  Psychological services want me off their waiting list for counseling.  I am ‘too fragile to take on such intense work’.  ‘And I am not’ I add, ‘suicidal, after all’.   This time the sarcasm washes over her.  The end came at last, and she released me, battered and bruised, to my domestic world. 

I have one more meeting with the shrink.  The battle lines are drawn in the sand. 

by Hazel