Therapy Tales Part 1- So You’re Terrified of Death?

(If you’re wondering where my previous post went, I have made it private as I’ve found this to be true. Thank you for all your comments and encouragement!)

So, I’m starting therapy for death anxiety (my medical diagnosis that led me to it are generalised anxiety disorder and panic disorder but I prefer to think of them as ARGH).  Expect this series of posts to be even more introspective and self obsessed than usual, and for this blog, that’s saying something.

Two years ago (christ), I wrote a post called, “When Fear Becomes Phobia”. It described my ARGH FUCK panic around death and deadness, and how my world was getting smaller and smaller because of it.  Last year, I went to the doctor and asked for help. She was so sympathetic that she made me cry. Saying what an awful thing to carry around with me for 12 years (14, now) and she referred me to therapy. I found out I was pregnant, had an assessment and things didn’t go any further because I was suffering such crippling morning sickness that the 40 minute bus journey to the appointment was 1 hour 30 minutes because I’d have to jump off twice to vomit. Later on in pregnancy, I dispensed with such courtesies and just huffed up all over my lap, or into a friendly plastic bag.  Pregnancy was also pretty distracting- all my anxieties were focused on that, and I didn’t have the mental reserves to panic about death anymore.

My panic has returned, as it does. It’s not constant and strikes at night when I’m trying to sleep (and flip, I need my sleep!) It doesn’t disturb anyone because I sleep in the spare room (Robert does night feeds due to my medication). It means it’s quiet, private, lonely. It comes and goes, ebbs and flows.  It’s probably unsurprising. I had a baby, then I lost my grandmother, and it was my dad’s anniversary.  Catholicism ritualises death in a way that’s both comforting and horrifying. It makes you look at it, it makes an object of it.  She was in a coffin in the sitting room that my dad’s coffin was in, for days, with the same yellow, unnaturally smooth, chillingly cold skin that you have to touch to say goodbye. Their coffins, and every childhood Christmas. These things bring death bubbling back to the surface of your mind. It’s hard to close it out when you’re trudging up a hill behind it. Robert’s grandmother died the month after, and her funeral was like a trip to Argos. Closed, quiet, scripted, burned. I prefer the visceralness of Catholicism, even if it haunts me. It does at least give death, and life, some gravitas.

So, I’ve been referred back to therapy for it. My psychiatrist initially wanted to increase my medication but I refused. This feels existential, albeit obsessive. I’ve often been able to distract myself and try to be less up my own arse, but distraction is tricky and I’m introspective generally. It doesn’t need to be medicated away- that just makes me feel worse.

The assessment happened pretty quickly. A chat over the phone, which gave me a sense of pride that I didn’t have to list a litany of other issues. I haven’t self harmed in six years, my bipolar disorder (if I ever had it) is pretty well controlled. I wasn’t depressed, wasn’t struggling otherwise. I’ve come quite a long way. I knew what they’d recommend- CBT (*spits*) but I’m willing to give it a chance.

The therapist is called Sean, which means the assessment didn’t entail the usual 45 minutes of tuition in how to pronounce my name. It’s high intensity IAPT (Improving Access to Psychological Therapies), so the sessions aren’t at the mental health team (thank bollocks, I used to work at my local one), but in an unassuming house with comfy sofas, pot plants and James Frey books that I had to stop myself openly guffawing at perched proudly on the Ikea shelves.

He asked me what I wanted help with so I explained. I forgot to bring the questionaire they sent me so went through some of it there. My depression score was low, as I knew it would be. People tend to assume I must be suffering from depression if I’m having panic attacks and anxiety.

Au contraire.

Depression is both a mortal enemy and an enemy of mortality. For me, it is ageless, timeless emptiness. It tries to kill me, and it kills the thing inside me that makes me afraid of it doing so. I want to die when I’m depressed.

So when I’m not depressed, I’m scared of that. It’s like being held under water and a peaceful acceptance of what it happening envelopes you, until the final second, and you kick, you convulse in order to be free, to be alive, to throw off the aggressor and then relive over and over at how close you came to drowning.

I do sometimes feel depressed because of the panic. I feel frustrated and angry with myself that I have panic attacks. I feel frightened and distressed by some of the intrusive thoughts I have (like when I’m speaking to someone and suddenly an image of them dead flashes into my brain, with hallucinatory vividness) and sometimes they make me feel like I’m going mad. But depression and this panic don’t come together, and that’s a big massive pain in the hole. The panic tends to be the worst during the happier periods of my life. I’m happy, hurrah, and then my mind goes, “This will end it, all of it, everything, and because it will end, this is meaningless, you won’t be here one day, any day, none of them will” and that’s just BLOODY FUCKING GREAT isn’t it. I don’t want to die, ever, because I enjoy my life. I’m essentially a happy person who wants to see what’s going to happen.  I want to be standing at the end of the universe with Robert and Oisín watching supernovas and planets and the sun.

(Rest your head)

(Close to my heart)

(Never to part).

Maybe it is partly a coping mechanism, the fear. Like pinching yourself.

He asked me if I had other anxiety- I do, social anxiety, but I’m dealing with that in my own way so I didn’t want any help which he accepted (and I think it’s tied up in this anyway).

Two things were said during the assessment that made me willing to continue. One was something stunningly obvious but that I had genuinely never considered. The therapist said that my kind of anxiety is, “idiosyncratic”. It’s not a common reason people come to therapy. That floored me. “Doesn’t EVERYONE feel this way?” I said. No, apparently not. At least, not to the degree they end up in therapy. So, is it that this is such an ordinary fear we live with it and are in denial, or am I the odd one for being periodically consumed by it?

Another was asking me where I think it came from. Nobody has ever asked me that before, and it’s not something I’ve thought about. The worst of my panic began when I was 15. That’s when it started flinging me screaming across the room. “Is that when your friend committed suicide?” Yes, it was- but the panic attacks started before then. Robert (who I first went out with when I was 14), remembers my panic on the phone, but it was more contained, and I was easier to comfort and distract.

It started well before then, when I was about 7 (?). Both my parents had mental maladies. I felt like they were going to die and I was terrified of it. I became aware they wouldn’t be there one day and I feared all the time it was the day. I used to pad into their room at night to check they were still breathing, then pad back and lie awake in the moon (just like I do now with the baby!). I realised I was going to die too, and sometimes would wake up screaming.  Death felt close, ever present, non abstract. I could only perceive it in my childish way, but I never felt safe, and I never have since.

Of course, that’s just a bit of it- I might be wrong, but I had never connected the two things before. I had a massive resurgence after my dad died, too, which is natural. But it wasn’t so much his death as knowing that he feared it. That kills me, still. I hate that he was afraid. If I could do one thing in my life, one magical thing, it would be to take that fear from him before he died.

He asked me what I wanted to get out of therapy. I don’t know really. Not to have panic attacks anymore. To be able to watch/read/listen to anything again. Not to have to ring in late to work because I’ve disintegrated at a funeral procession. To fall asleep. To be able to think about Oisín’s future. At the moment, I’m too scared to talk about it, think beyond tomorrow, in case he’s not here for it, or that I’m not. I’m petrified of something happening to him, and feel superstitious about it. It’s a loss I know I would never, ever recover from, be able to go on living beyond.  Pregnancy should have taught me the futility of this- when it seemed like there was bad news at the 20 week scan, my anxiety didn’t protect me. It didn’t cushion it, it didn’t make anything easier.  I want to be able to talk to Robert about him riding a bike, or going to school, or falling in love. I want to be here and present in the moment without thinking how it’s going to end. That it is. I want to be able to sleep without hours of panic beforehand. I want to be able to not feel regret about not living if I do die tomorrow. When I’m going through anxious periods I always feel mildly dissociated, not here. I don’t want to feel that way anymore. I don’t want horrible flashes in my brain anymore. I don’t want my coping mechanism for the feelings of helplessness and inevitability to be nihilism, as it means I make unhealthy choices (like smoking, which will actively shorten my life, and thus leads to more panic attacks). I want to be present for myself, for my child. Life is so brief. And it is all.

He said that this will involve some unpleasant feelings, but that it usually helps. He says when it doesn’t, “work”, it’s often because people haven’t done the things long enough (bit of, “blame the patient” here, but I understand what he means as my last assessment person gave me a workbook I barely glanced at). I’m pretty frightened of what this is going to entail, and how hard it’s going to be. I’m aware it might mean it gets worse before it gets better, and I’m feeling pretty apprehensive about that. Shit scared, to be honest.

But I’m doing it. So let’s see where this goes. I’ll keep you updated!