Words of warning and welcome:

This is very much my blog, so don't be surprised if this doesn't follow accepted patterns and norms. It is a place where I can be anonymous and honest, and I appreciate that.

It will deal with many things and new readers would do well to check out the "Story So Far" Page above this and the "New Readers" tag down there on the right. Although there's nothing too bad in here there will be adult language, so be careful. If you think this needs a greater control, please let me know. Thank you!

Wednesday, 4 April 2012

Consolidation Plan

As part of my last CBT session my therapist was, well, rather disappointed that I hadn't made any progress whatsoever on something she referred to as a "therapy blu-print", to the point where she even suggested that we junk the session and rearrange for another time.  We didn't, but the guilt trip worked and I'm now here to do something on it.

The example version that I was given to work from (did I mention how much I like to work from examples?) is called a Relapse Prevention Plan from someone who managed to sort themselves out and get 'fixed' in the 20 sessions the NHS deem necessary.  I was given this particular example because it was the mos compassionate that my therapist had to offer.  As part of this process I was also given a series of questions to answer, which I shall list here to make sure I cover:

1. Define the problem
2. How has this been developed and understood?
3. Evaluate the strategies that have been used to deal with it.
4. Where do we go from here? What changes need to be made?
5. Create a 'Crisis Plan' - to deal with the problem if it gets too much again

I'll be honest, I'm not looking forward to any of this.  The final stricture is that the whole thing be about two sides of A4, so about 800 words, give or take.  I could write, have written, ten times that on the problem alone.

The Plan
As a consequence of my life experience and my own internal analysis of situations I reached the point where I find it difficult to rate myself as being 'worthy' or 'useful'. This is, in part, down to the way that I was raised, my parents underwent the loss of a child to cot-death - no explicable cause of death or way of avoiding it - and suffered as a consequence; and, in part, down to my own introversion as a child.  Coupled with moving house this created a situation where I found it hard to make friends or connect on an emotional level with others, something that I came to actively support and encourage.

Allied to this were increasing feelings that there was a reason for my not fitting in and an identification with those of different gender to myself, culminating in puberty with a feeling that I was not entirely 'male' and, again, was at variance with those around me.  As a consequence I developed a coping mechanism that distanced me from other people, actively or passively, and where I would seek to negatively reinforce behaviours that I classified as 'helpful' or 'useful'.  That is, creating behaviours that I found acceptable or desirable through punishing those aspects that did not fall under these headings.  In time I came to accept that I was not able to live up to my own standards and thus created situations where I would reinforce my core belief that I was useless and unlovable, where 'different' was equated with 'wrong'.

In relationships, which were few, I am haunted by the fear that it will end, that any emotional involvement will inevitably lead to the end of a relationship and painful suffering once that relationship is over.  As a consequence I avoided any relationships of any kind and sought to fade into the background, hiding this behaviour with extravagant displays of comedy, humour, intelligence and debate which, in turn, engendered group social situations that I felt I could manipulate and control.

These coping mechanisms failed when a friend, colleague and superior at my workplace deemed me unfit for the job he had helped recruit me for.  This tapped into my own insecurities surrounding what I was being asked to do and so I internalised the criticisms and accusations.  This led me to begin active sabotage of my own work and my home life and family relationships.  I feel that I am useless and ineffective and support this by being useless and ineffective.  Where anger is not appropriate I feel anger, where self-absorption is an issue I respond with self-absorption and where assertiveness was called for I respond with passivity.

In these times of stress I returned to coping mechanisms long dormant with a vengeance and, in revealing them once more to my wife, was met with incomprehension and anger.  This, combined with the situation at work, pushed me into a depression deep enough to make me seek help.

In CBT I was asked to develop mechanisms that were healthier ways of dealing with the problems I faced and created.  These included SMART targets, which I subverted and a survey to test my own core beliefs, which I not only subverted but also confirmed that my problems were more complex than I was prepared to admit.  Being Mindful worked in the short term, in that I was able to create a functioning safe place and focus on the feelings in a shower.  However, in both cases I actively subverted the technique and destroyed any benefits that these methods may have in the long-term, culminating in the destruction of the safe place as an effective method and simple abandonment of Mindfulness in the shower.  Being unable to imagine a life where I was not beset by my inner-critic or actively sabotaging my own life we moved to Chair Work.  This proved effective in that I could create compassionate answers to some of the internal criticism I subjected myself to, however, it also created a violent and angry response in me through the fear of something working.  I also attempted to write compassionate letters to myself but found this time-consuming and of limited benefit - once these letters were written I consigned them to the bin, certainly I had no urge to re-read them and, in writing them, I tended to be sarcastic, caustic and disparaging to the point of condescension.

In order to rescue my relationship with my wife, my children and attempt to save my job I need to be less passive in general.  I need to change my own anger response, my lashing out at anyone close enough when faced with the fear of things going well, and create more appropriate coping strategies than I currently use.  I need to see the good in myself, what it is that God loves, in order to effectively love others.  If I cannot nurture myself then it is unlikely that I shall be able to offer adequate nurture to other people.  I must find a way to be supportive of my wife, so that she can rely on me to undertake simple day-to-day tasks without fear of me 'flipping out' or crumbling.  At work I must find a way to manage my time more effectively and operate without fear of being 'found out' that creates the very situation in which people feel that I have something to hide, however erroneously.  To do this I must a find a way in which I can engage in therapy, of any flavour, rather than attempting to manipulate and subvert it.

To cope in future crises I shall avoid making sweeping statements of my own lack of utility or threatening to walk away from the perceived issue at the time (be that job-related or relationship-based).  I shall also attempt to respond in a more reasonable and appropriate manner to the issues raised with an increased assertiveness of my own views and thoughts on any given issue.  I shall, in effect, emerge fighting in situations where there is unfairness or a lack of recognition of my own feelings and thoughts but be prepared to hear views aside from my own at the same time.  Rather than avoid stressful aspects of my work I shall instead attempt to process them so that I am not left feeling that I am not achieving and, more importantly, others do not feel that I am failing in my duties and responsibilities.  I shall attempt to create and adhere to a planned timetable where I have time for myself rather than grabbing time here and there, feeling that I have no time and then failing to carry out basic tasks for work or family - thereby avoiding the more gregarious and flagrant abuses of position that I am accused of making.  Where I cross-dress I will do so privately and in secret, no one needs to know or wants to hear it, and I shall attempt to minimise the financial impact of clothes buying.  This will be part of the timetable planning to avoid the stress that such a situation may cause and minimise the disruption that keeping it private will inevitably bring.  This applies equally to singing and dancing to loud music - it is inappropriate to engage in these behaviours in the home, with small children, or the workplace.  Finally, I shall choose who I speak to about my problems with more care than I do currently: fears about my workplace are best not shared with my colleagues or my parents, for example; equally, relationship issues are best not discussed with my wife, colleagues or family; and finally, cross-dressing is best not discussed except on the anonymous blog created for that purpose.

Whilst these measures mean I can never become too public a figure they may mean that future crises will be less debilitating.

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All comments are welcome, I have a thicker skin virtually than I do in real life!