deon
12-09-10, 14:06
Sorry if this offends anyone, but I need to get this out. I've written this for my CBT practioner in the hope it will help her understand what's happening to me as they might be about to abandon me. It's a complete and honest statement, I need to be able to say these things and this is the first time I've been able to say it all.
Everything may have started with my earliest memory. At 6 months old I remember standing in my cot. Looking around me at the dark looming furniture of an unlit room, everything reverberating with the sounds of a heated argument. The words made no sense, I could not understand the noise. I fell. My mother says I fell out the cot, I thought I had fallen back in. My mother and father had been arguing. I don’t remember ever having seen him at that point.
As a toddler, maybe three years old I was beaten by my mother’s boyfriend, Bob. My nose and collarbone were broken. Bob was the father of my brother. I have no memories of him from that time except of them arguing. Around the same time two female friends of my mother sexually abused me. They babysat for her, one blonde, one brunette. I remember the brunette placing her mouth between the legs of my teddy-bear and then between my legs. I didn’t understand the feelings at the time and I was unable to make sense of the memories until my early twenties. I had vivid re-occurring dreams:
The brunette places her mouth between the teddy-bears legs. She swallows the teddy bear, I watch from the perspective of someone standing at the doorway to my room – teddy moves down her throat into her cavernous insides and sits in her belly. In my memory, she is like a cut-away diagram, with a three year-olds idea of anatomy. Then it’s my turn, a sharp, intense tingling between my legs, before I am swallowed and slide down her gullet to join my teddy trapped in her belly.
As a young adult I had difficulty with women especially large blonde ones. Perversely I was terrified of them yet attracted to them. My mum stayed in contact with one of the women , the blonde one. She came to visit us when I was about eight or so. I remember being very tearful that day, I knew who she was. The dreams stopped in my early twenties, when I told my mother and later, my now ex-partner, what had happened. Both their reactions were negative. My mum screamed and shouted at how she was sorry that she’d been a bad parent. My then partner, told me she couldn’t handle it, she’d lost all respect for me because of my vulnerability. I was unable to relax whilst receiving oral sex until my mid-thirties, after ten years of patient effort by my wife.
Being held back in class and physical abuse from one teacher hampered my school years. My early teens were spent living in fear of violence, my mother’s boyfriends tended to be either criminals or ex-mercenaries. I lived on a rough estate in Camberley, I was occasionally hunted by skinheads or attacked, sometimes with knives, once with a .22 rifle. I escaped, but my friend was captured and tortured. I was often threatened in the home, but rarely hit. I always carried a knife even indoors and usually barricaded my bedroom door to buy myself time if I was attacked. I kept a bow and arrow ready as I knew I could not win a fistfight against these men. I slept with a knife and a loaded pistol under my pillow. My school-work suffered and studying was impossible, I left school and joined the forces as soon as I was able. I needed to escape the random violence and aggression, the constant fear of attack.
In the forces, I found I didn’t really fit in. I was a good soldier but I was psychologically sensitive and too used to thinking for myself. More violence followed, with bullying and regular institutional abuse. Rules and power were misused to punish me randomly. Psychiatric evaluation recommended I be released after I had a mini breakdown. The squadron’s Captain disposed of my medical records and refused to let me leave, eventually I bought my self out.
So far I had learnt that institutions and adults were randomly abusive, threatening and violent. I am afraid of every institution whether it’s the dole office or a hospital, employer or university. Almost all my dreams are very violent in which I always die. I am often filled with rage, I walk back and forth agitatedly, sometimes flinching or jerking uncontrollably while my mind is focused on a past or future situation, deeply embarrassed if I am spotted. When people are around I keep this under control but it’s always there under the surface.
Then I spent four years working for a company. I had studied hard to get there and loved my job but the director subjected me to random and inappropriate disciplinaries, now and again aided by one or two managers. Generally, I was popular and well liked by the management and my colleagues and many senior staff and colleagues expressed their support for me, and their disgust at how I had been treated. I lived in terror of going into the office and of meetings. Eventually I became ill with stress, having two health-scares. My panic attacks began and I was quickly made redundant.
One night I had an attack of acid reflux but I did not know. I woke up unable to breathe, with a pain in my chest. I knelt on the bed, unable to rouse my wife. I knew my time had come and I waited to die. The acid that had caused my esophagus to close, reopened and my breathing returned. I went to A and E. They showed no concern or interest; after four hours they checked me and said there was nothing wrong. I went to see the doctor and got the appropriate medication. My work situation continued to deteriorate until one day I lost the ability to speak, my mouth and left arm went numb, with a sharp pain in the head. I was taken to hospital and tested for a stroke. A TIA was suspected and I was put on statins, spending four entire days in a state of absolute terror, unable to eat. From that point on I have remained in a state of heightened anxiety, nearly two years now. Even after they scanned my brain and determined it had been a migraine attack, I spent the next two years with regular panic attacks, almost constant chest pain and unable to tolerate even minor stress.
For the first year, I continued to try and hold down work. I had tried CBT unsuccessfully and counseling was offered, but fell through because of work commitments. My condition gradually deteriorated, the panic attacks so violent and frequent that work became impossible and embarrassing. Gradually I withdrew from everything I could; I tried to avoid going out or seeing friends; I was unable to have sex without panicking or even play with my daughter. After a year, with no help on the horizon and things getting worse, I decided to take a year out and try to fix things. It took eight months to get another round of CBT, although the Mental Health people had already decided that CBT would probably not work. I understood it was necessary to go back through CBT before I could be recommended to counseling.
After a year, despite the suspected TIA, my fear of stroke subsided. Always at the core of my fear was the irrational fear of a heart attack and anything that would raise my blood pressure, whether it was sex, eating or climbing the stairs, sitting on the toilet or being asked to do something. All could trigger panics although sometimes thy came out of the blue. After two years of continuous anxiety and physical pain, my body and mind are deeply sensitized. Often the panics occur with out any conscious thoughts. I have to work hard to try and find out what is happening in my subconscious that is pushing the anxiety over the top and triggering an attack. Because the nervous system is sensitised, the panic attacks can be triggered by physical events. For many years I have had electric shock like feelings run through my body when ever I bump something or drop something, similarly for ten years I have had chest pain and intense feelings of anxiety when working on something requiring close concentration and repetitive action. Sometimes I can link these physical over-responses to particular stressful events when they first began.
With the CBT, it all seems to depend on thoughts, but when these thoughts are sub conscious or the panic is triggered by a physical event it is difficult to elicit the ‘thought’ behind the attack. I guess the base thought is ‘I’m going to die’. I’m terrified of heart attack or anything that might contribute to it, I can’t abide to read about it or hear about it. I know there is nothing wrong with my heart after I enjoyed several weeks of intense back pain and the chest pain stopped for the duration. It has come back now, less intense and less frequent as I have stopped working, but it comes back, sharp and frightening when I am placed in stress situations. After a couple of blissful weeks without chest pain or panic attacks, the experience helped me to truly understand and more importantly, to believe that they are a product of my mind.
Now, I see that the panic attacks are the icing on the cake. I was already deeply sensitive to stress before the panic attacks and the events that immediately preceded them. I considered that I might have PTSD stemming from the physical and sexual abuse as a child. The absence of flashbacks was a stumbling point as it has been suggested that PTSD cannot occur without them. But I wonder, what form would flashbacks take for a three year old child, who could not understand what was happening. Perhaps now the memories have subsided, perhaps it is PTSR, however the strong physical responses to continuous states of high anxiety with violent reactions, feelings of fear and rage and panic attacks, seems to fit with PTSD. Flashbacks are not a prerequisite of PTSD, but merely a very common symptom. The other symptoms are long established in me and are part of my everyday experience, more common to me than hot meals and endured with even less thought, hence my difficulty in explaining and analysing them.
I can understand the CBT model of anxiety. I understand the logic, but I was a deeply logical person and if logic were all that was necessary, I would have fixed things myself. There is more than logic to the human mind, we are still animals, and my fear is an animal response. There are no words that accompany a base instinct like fear except for those I make up to try and explain to others. They do not occur at the time, but I can form them afterwards though they are a poor reflection of the experience. I have been trained to respond to danger without thought but with action. During a dangerous situation I appear calm. My fear is suppressed as was first learnt as a toddler in order to cope with the beating and abuse. But no method for expressing or releasing that fear was learnt and so it shows itself in the form of little breakdowns, illness and now, unable to be contained any longer, as continuous, ever present anxiety and pain.
CBT might be able teach me to manage the panic perhaps, so that I do not seek death to bring an end to my pain, but to bring an end to the cycle of fear and anxiety I need something that will help me to deal with my earlier experiences. I need counseling and maybe a psychiatrist or psychologist. I am poor, and cannot afford to pay for treatments. I have no work, no realistic prospect of earning an income sufficient to afford treatment and no money from the state although I am still registered as unemployed. I want to be a functioning member of society, useful to my family and friends, but I am broken.
So, here is a panic attack from Saturday the 12th September. It was a very mild one.
Environment - All day had been spent in a TESOL class revising. At first I had experienced sharp chest pains but these had subsided. In the evening I worked hard on a delicate and complicated assembly for an overdue model kit already late for the magazine. Then around 20.30 hrs. I had dinner and sat down in front of the telly with my wife.
Thoughts – what thoughts? Clearly there are thoughts of heart attack, pressure of time and other’s expectations in the back of my mind, dimly guessed at, but not at the front of my mind. My mind is on the telly, nothing is happening, no conscious thoughts or obvious stimuli, save that which is always present - maintaining my anxiety - my subconscious.
Feelings – I am tired and I can sense the looming prospect of much hard work to come.
Physical – Suddenly, I feel as if I’m being drawn away from my body, as if I were dying, as adrenaline surges through my body, I tremble briefly, the situation unreal and frightening, catching my breath, my mind numb, my heart pounding, waiting to die, mute and unable to think clearly.
Thoughts – ‘I’m dying.’ and then, as suddenly ‘No, I’m not.’ the attack passes and I know that it’s all a sham.
Behaviour - I retreat to the loft, shaky and exhausted, to continue working, I repeat to myself, my mantra –
‘ There is nothing wrong with me.
My heart is healthy and the fear and pain is all in my mind.
There’s nothing to worry about.’
And so, back to the beginning. The constant pain and panic attacks have once again reinforced and reinvigorated my anxiety, promoting their reproduction and re-occurrence like a virus. An endless cycle, so deeply entrenched that it often passes without conscious thought, without forming words in my mind, without deliberate consideration. My experiences are part of my self, indivisible and only indirectly and vaguely influenced by my conscious thoughts. However many hours I spend in contemplation, forgiving those who harmed me, considering the reality of my situation, the source of my unhappiness and possible solutions, reassuring myself of my wellbeing and determining to continue to live and try to live life normally, I cannot compete with that which resides in my subconscious.
All day and all night the fear resides, whispering over and over – ‘you are broken, you are afraid, you are in pain and are going to die soon, you cannot escape this death….and it will be better for you.’
Everything may have started with my earliest memory. At 6 months old I remember standing in my cot. Looking around me at the dark looming furniture of an unlit room, everything reverberating with the sounds of a heated argument. The words made no sense, I could not understand the noise. I fell. My mother says I fell out the cot, I thought I had fallen back in. My mother and father had been arguing. I don’t remember ever having seen him at that point.
As a toddler, maybe three years old I was beaten by my mother’s boyfriend, Bob. My nose and collarbone were broken. Bob was the father of my brother. I have no memories of him from that time except of them arguing. Around the same time two female friends of my mother sexually abused me. They babysat for her, one blonde, one brunette. I remember the brunette placing her mouth between the legs of my teddy-bear and then between my legs. I didn’t understand the feelings at the time and I was unable to make sense of the memories until my early twenties. I had vivid re-occurring dreams:
The brunette places her mouth between the teddy-bears legs. She swallows the teddy bear, I watch from the perspective of someone standing at the doorway to my room – teddy moves down her throat into her cavernous insides and sits in her belly. In my memory, she is like a cut-away diagram, with a three year-olds idea of anatomy. Then it’s my turn, a sharp, intense tingling between my legs, before I am swallowed and slide down her gullet to join my teddy trapped in her belly.
As a young adult I had difficulty with women especially large blonde ones. Perversely I was terrified of them yet attracted to them. My mum stayed in contact with one of the women , the blonde one. She came to visit us when I was about eight or so. I remember being very tearful that day, I knew who she was. The dreams stopped in my early twenties, when I told my mother and later, my now ex-partner, what had happened. Both their reactions were negative. My mum screamed and shouted at how she was sorry that she’d been a bad parent. My then partner, told me she couldn’t handle it, she’d lost all respect for me because of my vulnerability. I was unable to relax whilst receiving oral sex until my mid-thirties, after ten years of patient effort by my wife.
Being held back in class and physical abuse from one teacher hampered my school years. My early teens were spent living in fear of violence, my mother’s boyfriends tended to be either criminals or ex-mercenaries. I lived on a rough estate in Camberley, I was occasionally hunted by skinheads or attacked, sometimes with knives, once with a .22 rifle. I escaped, but my friend was captured and tortured. I was often threatened in the home, but rarely hit. I always carried a knife even indoors and usually barricaded my bedroom door to buy myself time if I was attacked. I kept a bow and arrow ready as I knew I could not win a fistfight against these men. I slept with a knife and a loaded pistol under my pillow. My school-work suffered and studying was impossible, I left school and joined the forces as soon as I was able. I needed to escape the random violence and aggression, the constant fear of attack.
In the forces, I found I didn’t really fit in. I was a good soldier but I was psychologically sensitive and too used to thinking for myself. More violence followed, with bullying and regular institutional abuse. Rules and power were misused to punish me randomly. Psychiatric evaluation recommended I be released after I had a mini breakdown. The squadron’s Captain disposed of my medical records and refused to let me leave, eventually I bought my self out.
So far I had learnt that institutions and adults were randomly abusive, threatening and violent. I am afraid of every institution whether it’s the dole office or a hospital, employer or university. Almost all my dreams are very violent in which I always die. I am often filled with rage, I walk back and forth agitatedly, sometimes flinching or jerking uncontrollably while my mind is focused on a past or future situation, deeply embarrassed if I am spotted. When people are around I keep this under control but it’s always there under the surface.
Then I spent four years working for a company. I had studied hard to get there and loved my job but the director subjected me to random and inappropriate disciplinaries, now and again aided by one or two managers. Generally, I was popular and well liked by the management and my colleagues and many senior staff and colleagues expressed their support for me, and their disgust at how I had been treated. I lived in terror of going into the office and of meetings. Eventually I became ill with stress, having two health-scares. My panic attacks began and I was quickly made redundant.
One night I had an attack of acid reflux but I did not know. I woke up unable to breathe, with a pain in my chest. I knelt on the bed, unable to rouse my wife. I knew my time had come and I waited to die. The acid that had caused my esophagus to close, reopened and my breathing returned. I went to A and E. They showed no concern or interest; after four hours they checked me and said there was nothing wrong. I went to see the doctor and got the appropriate medication. My work situation continued to deteriorate until one day I lost the ability to speak, my mouth and left arm went numb, with a sharp pain in the head. I was taken to hospital and tested for a stroke. A TIA was suspected and I was put on statins, spending four entire days in a state of absolute terror, unable to eat. From that point on I have remained in a state of heightened anxiety, nearly two years now. Even after they scanned my brain and determined it had been a migraine attack, I spent the next two years with regular panic attacks, almost constant chest pain and unable to tolerate even minor stress.
For the first year, I continued to try and hold down work. I had tried CBT unsuccessfully and counseling was offered, but fell through because of work commitments. My condition gradually deteriorated, the panic attacks so violent and frequent that work became impossible and embarrassing. Gradually I withdrew from everything I could; I tried to avoid going out or seeing friends; I was unable to have sex without panicking or even play with my daughter. After a year, with no help on the horizon and things getting worse, I decided to take a year out and try to fix things. It took eight months to get another round of CBT, although the Mental Health people had already decided that CBT would probably not work. I understood it was necessary to go back through CBT before I could be recommended to counseling.
After a year, despite the suspected TIA, my fear of stroke subsided. Always at the core of my fear was the irrational fear of a heart attack and anything that would raise my blood pressure, whether it was sex, eating or climbing the stairs, sitting on the toilet or being asked to do something. All could trigger panics although sometimes thy came out of the blue. After two years of continuous anxiety and physical pain, my body and mind are deeply sensitized. Often the panics occur with out any conscious thoughts. I have to work hard to try and find out what is happening in my subconscious that is pushing the anxiety over the top and triggering an attack. Because the nervous system is sensitised, the panic attacks can be triggered by physical events. For many years I have had electric shock like feelings run through my body when ever I bump something or drop something, similarly for ten years I have had chest pain and intense feelings of anxiety when working on something requiring close concentration and repetitive action. Sometimes I can link these physical over-responses to particular stressful events when they first began.
With the CBT, it all seems to depend on thoughts, but when these thoughts are sub conscious or the panic is triggered by a physical event it is difficult to elicit the ‘thought’ behind the attack. I guess the base thought is ‘I’m going to die’. I’m terrified of heart attack or anything that might contribute to it, I can’t abide to read about it or hear about it. I know there is nothing wrong with my heart after I enjoyed several weeks of intense back pain and the chest pain stopped for the duration. It has come back now, less intense and less frequent as I have stopped working, but it comes back, sharp and frightening when I am placed in stress situations. After a couple of blissful weeks without chest pain or panic attacks, the experience helped me to truly understand and more importantly, to believe that they are a product of my mind.
Now, I see that the panic attacks are the icing on the cake. I was already deeply sensitive to stress before the panic attacks and the events that immediately preceded them. I considered that I might have PTSD stemming from the physical and sexual abuse as a child. The absence of flashbacks was a stumbling point as it has been suggested that PTSD cannot occur without them. But I wonder, what form would flashbacks take for a three year old child, who could not understand what was happening. Perhaps now the memories have subsided, perhaps it is PTSR, however the strong physical responses to continuous states of high anxiety with violent reactions, feelings of fear and rage and panic attacks, seems to fit with PTSD. Flashbacks are not a prerequisite of PTSD, but merely a very common symptom. The other symptoms are long established in me and are part of my everyday experience, more common to me than hot meals and endured with even less thought, hence my difficulty in explaining and analysing them.
I can understand the CBT model of anxiety. I understand the logic, but I was a deeply logical person and if logic were all that was necessary, I would have fixed things myself. There is more than logic to the human mind, we are still animals, and my fear is an animal response. There are no words that accompany a base instinct like fear except for those I make up to try and explain to others. They do not occur at the time, but I can form them afterwards though they are a poor reflection of the experience. I have been trained to respond to danger without thought but with action. During a dangerous situation I appear calm. My fear is suppressed as was first learnt as a toddler in order to cope with the beating and abuse. But no method for expressing or releasing that fear was learnt and so it shows itself in the form of little breakdowns, illness and now, unable to be contained any longer, as continuous, ever present anxiety and pain.
CBT might be able teach me to manage the panic perhaps, so that I do not seek death to bring an end to my pain, but to bring an end to the cycle of fear and anxiety I need something that will help me to deal with my earlier experiences. I need counseling and maybe a psychiatrist or psychologist. I am poor, and cannot afford to pay for treatments. I have no work, no realistic prospect of earning an income sufficient to afford treatment and no money from the state although I am still registered as unemployed. I want to be a functioning member of society, useful to my family and friends, but I am broken.
So, here is a panic attack from Saturday the 12th September. It was a very mild one.
Environment - All day had been spent in a TESOL class revising. At first I had experienced sharp chest pains but these had subsided. In the evening I worked hard on a delicate and complicated assembly for an overdue model kit already late for the magazine. Then around 20.30 hrs. I had dinner and sat down in front of the telly with my wife.
Thoughts – what thoughts? Clearly there are thoughts of heart attack, pressure of time and other’s expectations in the back of my mind, dimly guessed at, but not at the front of my mind. My mind is on the telly, nothing is happening, no conscious thoughts or obvious stimuli, save that which is always present - maintaining my anxiety - my subconscious.
Feelings – I am tired and I can sense the looming prospect of much hard work to come.
Physical – Suddenly, I feel as if I’m being drawn away from my body, as if I were dying, as adrenaline surges through my body, I tremble briefly, the situation unreal and frightening, catching my breath, my mind numb, my heart pounding, waiting to die, mute and unable to think clearly.
Thoughts – ‘I’m dying.’ and then, as suddenly ‘No, I’m not.’ the attack passes and I know that it’s all a sham.
Behaviour - I retreat to the loft, shaky and exhausted, to continue working, I repeat to myself, my mantra –
‘ There is nothing wrong with me.
My heart is healthy and the fear and pain is all in my mind.
There’s nothing to worry about.’
And so, back to the beginning. The constant pain and panic attacks have once again reinforced and reinvigorated my anxiety, promoting their reproduction and re-occurrence like a virus. An endless cycle, so deeply entrenched that it often passes without conscious thought, without forming words in my mind, without deliberate consideration. My experiences are part of my self, indivisible and only indirectly and vaguely influenced by my conscious thoughts. However many hours I spend in contemplation, forgiving those who harmed me, considering the reality of my situation, the source of my unhappiness and possible solutions, reassuring myself of my wellbeing and determining to continue to live and try to live life normally, I cannot compete with that which resides in my subconscious.
All day and all night the fear resides, whispering over and over – ‘you are broken, you are afraid, you are in pain and are going to die soon, you cannot escape this death….and it will be better for you.’