“I’m very relieved to know that you’re still alive”

Those were the words that my therapist greeted me with as I arrived at my session today. It may seem blunt, but such is my life and I appreciate her taking the bull by the horns and making that sentiment known to me (she knows full well that I believe myself to be a burden on resources and feel that my death would allow her and the other professionals involved in my care to spend their time with a more worthwhile patient). She went on to explain that she hadn’t been able to check my notes since Friday and, as such, was wary of what might await her today given how unwell I’ve been. Now, that’s a bit of an eye-opener when laid out in black and white from such an experienced mental health professional, but is an entirely accurate reflection of my current state of health. Sometimes it’s better to name the elephant in the room, and this was one of those times.

Although I had been terrified of this session, things actually went better than I’d expected. I had managed to prepare well for what I wanted to discuss and actually conveyed my thoughts and feelings with honesty. The therapist sensibly slowed me down and, before fully starting to address ‘Schemas’ she suggested that we go right down to the basics of me noticing as many self-critical thoughts as I can. It might sound simple, but my messed up brain simply sees these thoughts as glaring truths and accepts them without acknowledging what they are, let alone challenging or questioning them; these thoughts, accepted unquestioningly as truths, then provide ‘evidence’ for my suicidality. So, first things first, this week I’m to try to simply pay attention when I criticise myself and what I’m being critical of, writing it down if possible – nothing more. So far, since I started doing this at around 4pm I’ve managed to pick out 76 separate incidents of me criticising myself significantly – with each of those looping further and no doubt I’ve missed some in this first attempt. 

The plan is that noticing these thoughts and recognising them for what they are is the first step in distancing myself from them. From there, hopefully we can find a doorway in to working on the schemas that make my life so unbearable and suicide feeling so logical, hopefully freeing up some space to work on everything else. 

For once, my therapist didn’t suggest that we not embark on this due to my extremely high risk levels, but simply acknowledged the fact of the risk and how this could likely increase – so it seems like my care coordinator’s plan of separating out that -[I desperately don’t want to say ‘responsibility’ here but my tired brain is failing to come up with an adequate substitute]- seems to be working so far. I think we’re all at such a loss with my predicament that everyone has realised it’s a case of going for it, and acknowledging that the level of risk is high either way. 

Oh, and I’m to try to be kind and gentle to myself…  

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