The University of the Self #92

High Intensity Therapy Session 1

Content warning: this article discusses a therapy session, stress, mental health issues such as Passive Suicidal Ideation and Autism with Phsychosis.

High Intensity Therapy Session 1
Session 2 can be accessed here.

Image description: this is a linocut I made of an imaginary landscape. The paper is white and the ink is black. A large moon or sun lits in the sky (made from horizontal lines) and has a spiral from its centre. There are two soft round hills froming a valley underneath. At the foot of the hills, a stretch of land, then a winding river, then another area of land.

The few-month wait for the High Intensity Therapy sessions is over, and I must begin therapy again. My heart feels heavy, my nerves jangle like a broken mirror being swept into the bin. My luck, as ever, is a fractured thing. At least the location this time is nearer to home and travel to and from will be much less stressful (though as I quickly discover, the car park is a logistical nightmare and the first time I manoeuvre my way out of it I am in tears and have to find somewhere safe to pull over and remind myself how to breathe).

I enter the treatment centre, and the porch is filled with too-good-to-go food. I look at it, but the tray of bread and cakes is uncovered, left open to pollution, and though I don’t have any money right now, literally zero available funds in my bank, I am repelled by the exposed, unprotected food. I can’t bear the idea of the germs and potential for spoil. It should be properly kept, no matter what. People need it. I feel that I ought to tell someone about it, but I don’t. Some of the bread buns have dark-coloured seeds on them and I see flies, crawling all over them. I close my eyes and swallow the nausea down.

I scrabble for my glasses and sign in, explain who my appointment is with. The receptionist imparts some information which I don’t really realise I am not listening to. I have noticed boxes of bright things around the foyer and hall here and there, and my magpie attention is diverted by them. I walk over to the first one, on a table between two doors, which is filled with silicone cake-pop baking moulds in primary colours and fairy tale shapes. I leaf through them like pages in a scattered rubber book but there isn’t a single one that makes my heart beat quicker with acquisitive desire. I don’t want any of them. Underneath, is a large plastic bread tray full of sanitary products. I don’t take one – I almost do but it makes me feel hot and afraid, as if someone is going to jump out and yell. My heart begins to hammer.

A door with a window to the immediate right of the table reveals a view of two people with sewing machines making patchwork. There are an ironing board and iron along the left wall, waiting to steam those neat, creased hems in place. A table to the right is covered in piles of in-progress patchwork pieces and stacks of fat quarters. The two quilters are chatting, too absorbed to notice my nosy yearning. You ought to be in there instead, I tell myself. A door with a window to the immediate left of the table reveals a view of a computer room, in which one person sits, tapping at a keyboard.

Opposite the door and first two boxes, is a skinny corridor. The next box is settled at its aperture, and is filled with bric-a-brac, which is kind of where I find my spiritual home. There is a plastic lidded jug I could quite fancy and three decorative balls covered in beige pleated fabric and pearls. I could quite fancy those too, but I am trying to be good. Really trying. Trying not to fetch home anything else that serves no real purpose, and I don’t actually need…except that I sometimes need things. Because. Just because. But I leave them behind and feel a small pride in myself for walking away.

I notice a sign for TOILETS and travel a little way down the corridor leading straight from the front entrance. With much gratitude, I make another of my numerous daily visits. I have a combination of stress, urge and functional incontinence which means that ‘toilet maps’ of wherever I am are vital.

After, I retrace my steps and turn right, following another of the thin corridors and examine a set of shelves stationed there, with contents including party packaging, some ornaments and books. A confetti cannon sits next to spy novels next to a pair of small cast busts of two men from either history or fantasy that I don’t recognise, next to the shape of a kingfisher rendered in plain grey resin, as if it sat so long in this windowless adit that all its colour bled out. This is a strange, Wonderland-ish place. Curiouser and curiouser, said Alice.

At the end of the corridor, there is a door into a community café. I creep towards it and peer in. A person there smiles and asks me if I am OK. I explain I am here to see X but am a little early, so the person says come in. I take the first available seat that is near enough to be near, and far enough to be far. The Normal Seat, I call it; the sort one might use when one is out and about trying one’s best to appear in public in a guise of ‘normality’. The receptionist is now in here too, absorbed in peeling the backing from décor stickers. He makes for a patch of blank space in front of where I sit and uses his palm to press ‘LIVE every moment LAUGH every day LOVE beyond words’ onto the wall. The two of them stand back behind me to admire it, while I awkwardly look away and attempt to transform into a toadstool.

The therapist, X, breaks the tableau by appearing through the café’s door, asking if I am indeed me. Which, inescapably and often sadly, I most definitely am. I clatter up, loop my bag strap over my head and collect my stick. X leads the way. Back through the Wonderland tunnel, we pass the bric-a-brac box of delights, turn left at the baking silicone and sanitary wares and arrive at a set of stairs, up which X begins to climb. My heart sinks and, drained of energy, I petulantly bleat why is everything in these places always up the stairs? X turns and notices my leg braces and stick and says oh. To break the silence, my right knee makes a loud cracking sound, and I say ouch. Whoops. X shows me then where the lift is and I travel up in it alone.

The lift ejects me into another corridor, with many doors off. X is waiting at the top. I am on excruciating discomfort and high-flight alert, so I flash my eyes around to take in what details about the room that seem initially important. Door. Immediate left of the door, a pleather, slate blue two-seater sofa in simple, contemporary design, squeezed into the gap between door frame and wall. Blue and red 80s style industrial carpet, flecked with dirt. Blue walls. In front of me, a steel-framed, black-upholstered generic chair. In front of that, a plain grey Formica-topped table/desk on which rests a laptop and a crumpled A4 ring binder pad, some pens. In front of that, another of the same chairs with a jumper on the back. In front of that, an un-curtained window with a view of silver sky and a glimpse of the smoke-dirty, chipped-white rendered gable end of the building next door. To the left of the window, a tall metal filing cabinet. To the right, the same, like office furniture guardians of the Window Realm. The portal to immediate freedom if I was limber enough to leap through it, regardless of the consequences. There might or might not be a small potted plant on the left cabinet.

There is a general impression of old use, a little disorganised, scruffy-round-the-edges past-its-bestness. Sit wherever you like, says X. Ah, the choose the right seat test again. I choose the pleather sofa as it is nearest the door for escape, and there is room for me to keep my bag next to me on the seat. With relief I find no small square coffee table with its box of smug, presumptuous tissues (with one tissue pulled up for you in readiness).

I don’t look X directly in the face – rather, I sneak my eyes around it. X has a beard, short hair, is tall. I couldn’t find you, they say. Why were you in the café? Didn’t the receptionist tell you where the waiting room was? Lately, I have been thinking a lot about authenticity and my history of masking. I’ve been so unwell for so long that the energy required for such masking isn’t supplied to my brain as much as it used to be. I am, in all ways, depleted. The days of worry leading up to this first appointment added to the stress of getting to the appointment added to the always-present trials of life and health in general have left me increasingly, as the character Marcee Tidwell in the film ‘Jerry Maguire’ says, “incapable of bulls**t.” I say, I’m sorry. They probably did tell me. I could tell that they were talking but to be honest, I wasn’t listening to a single word they said. I don’t feel guilty. I just feel utterly tired. X explains that the computer room doubles up as the waiting room, so I know for next time.

There are the usual preliminaries – blah, blah, blah. What are my problems? When did these problems begin (I’m paraphrasing)? Let’s go back fifty-something years, I reply. Then I explain that for some reason (and it happens sometimes, like now), I can’t recall exactly how old I am. I say that I don’t want to fill in those pre-session multiple choice email forms anymore. The thing is, I say, is that I have been a person with autism all my life. There is no category for that. No category for expressing how you feel about the impact of physical health issues. No category for how your were bullied or rejected by family. No category for abuse.

I proceed to fill the session with my rambling thought-to-mouth loops which I have only a hazy memory of and can’t seem to talk my way out of. I ask them about my adult assessment and how I cannot progress past certain aspects of it – the use of the book ‘Tuesday’ by David Wiesner; the request I bring a spoon; the fact that I wasn’t a child. How I can’t understand the written description of my mental health state at the time of my call to crisis care as ‘euthymic’. How I am perpetually left wondering why. How things are always mountains I can’t climb. The mountains stay there forever and block my path. Grow more numerous.

X asks a question here and there. What do I want out of these sessions? Not a cure, I reply. Because there isn’t one. We discuss the ‘button’ I sometimes/often wish I had, which I could use to simply switch myself off. My Passive Suicidal Ideation and the weird elation that comes with it. We discuss what I have been calling my ‘paranoia episodes’, and how I often struggle to know, when under such stress, what is and isn’t real. In everyday life, I am often left wondering the same. I tell them how much these episodes debilitate me, that they take weeks to recover from and often I haven’t recuperated before the next hits. I tell X that these episodes make me feel very afraid for my brain. I don’t know what they mean. What is happening? I just want to ask someone if I am…if I am…(and I hate to use this word, but words failed me) mad?

X posits Autism with Psychosis. Says no, I am not ‘mad’. But I am obviously struggling. I ask them to write this down so when I feel able to, I might begin some research of my own. I feel drained. The word ‘psychosis’ makes me afraid. Will the word make people afraid of me? More afraid of me? Will the word make the last few people in my life want to avoid me? How do I cope with another label? How am I going to learn to cope? How are twelve sessions (eleven now remaining) meant to unravel all of this? Time is up.

X shows me the way to the lift again and I walk off, yelling GOODBYE as they are still talking. I press the down button as many times as a moment allows. The lift doors shoosh closed and I feel a rush of relief to be out.

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