SESSION ONE

Every lot of face-to-face therapy I’ve had has been held in the same kind of room: yellow-beige walls, with an old computer on an MDF desk on one side and two grey, comfortable, functional chairs on the other. There’s always a clock on the wall, and always a small table with a box of tissues on it within easy reach. Good tissues, too. The kind that can hold a lot of snot and tears, and can be squeezed into the fist and wound between the fingers over and over without getting frayed.

The first time I was in one of these rooms, it was for a group CBT induction. It was massive – ten comfortable, functional chairs, with ten awkward, malfunctioning humans of all shapes, sizes, ages and genders sitting in them, all being led through exercises designed to keep us alive until we moved to the top of a waiting list. And then when I hit the top of that list, I went to a smaller room in the same building and met my therapist, Olu, a beautiful woman with skin so dark it was almost purple, enormously round brown eyes, and a mischievous nature entirely at odds with our conversations about how I was too scared to leave the house sometimes.

The second lot of therapy I had wasn’t in one of those rooms – it was online, via chat boxes, with a woman named Paula, who said things like ‘Your mind is a river, and your negative thoughts are like leaves blocking the flow’. I didn’t do well with Paula. Olu made me feel like she took my problems seriously, like I was a normal person who could sort themselves out with a bit of steering. Paula made me feel like I’d been cursed, and only the right combination of her well-meaning but entirely empty words would save me. After a few weeks, Paula told me that I wasn’t engaged enough with therapy and had dumped me back into the NHS’s mental health system. I had cried, quietly to myself, about how I was such a failure, I couldn’t even do therapy right.

Janae’s hen party convinced me that I needed to try therapy again, but I felt sick with fear as I sat in my third beige room and eyed my third therapist, Bjorg. Already I’d waited seven weeks to get here after Penny had come to my GP with me and made me show the doctor the bite marks on my wrists. I’d started to see this as my last chance. What if it didn’t work again? What if Olu was a fluke and I was going to be stuck like this forever?

Bjorg’s face was unreadable as she read the Patient Health Questionnaire (PHQ) I’d filled in, the one you have to do at the start of each session, which tells the therapist exactly how mad you’re feeling that day. She had blonde hair, delicate features and enormous sleepy blue eyes. Why did all my therapists have such fucking enormous eyes?

All the better for seeing into your soul, my dear.

‘So,’ she said finally, looking up and giving a small, measured smile, ‘thank you for coming in.’

‘Thank you for, um, seeing me?’ I asked.

Fuck! Why did I say that? It’s literally her job. Twat. TWAT.

‘It’s not a problem,’ she said placidly. ‘Now, I’ve read through your questionnaire …’ Oh God, oh God, oh God, oh God, oh God. ‘… and I can see a few obvious things for us to work on. It looks like on a daily basis you’re feeling anxious, your mood is low, you’re finding it difficult to enjoy things, you’re easily irritated, and you’re having trouble relaxing.’

I felt myself shrivel with shame as she spoke, but she was doing that therapist thing of talking about my horrible, private, personal secrets as though discussing the weather. It was weirdly reassuring. Like, no matter how awful I felt things were in my head, she’d seen it all before and would be entirely unfazed by anything I unleashed.

‘You say you are currently self-harming daily –’ I clenched my fingers into fists, digging my nails in the soft flesh of my palms. ‘– and think about ending your life in some way at least once a day,’ she said mildly, turning over the sheet of A4. She glanced up. ‘Do you have any intention of acting upon those thoughts?’

I shook my head. ‘No. I can’t do that to my friends, my husband, my parents, so I have to keep … I mean, not have to, it’s, um, it’s a good thing? Yes. I mean, uh, yes, I have to keep going.’ I coughed. ‘For … for them.’

‘Okay,’ she said, just as mildly. ‘You know, you don’t have to say it’s a good thing if you don’t think it’s a good thing.’ Pause. ‘Do you think it’s a good thing?’

‘Well …’ I squirmed internally. Christ, I was tense. My entire body was taut, like a horse about to bolt or the string of a bow before an arrow goes flying. ‘I know, like, rationally, it’s a good thing, but it doesn’t really help when I feel overwhelmed. I feel trapped, and like there’s no escape.’

She nodded again, looking at me thoughtfully. ‘What do you feel overwhelmed by?’

‘By how awful I feel.’ My voice caught, I swallowed hard. ‘I just feel hopeless, like I’m going to be stuck in this brain and this body, and this stupid, shitty life forever.’

‘You think your life is stupid and, uh, “shitty”?’ she asked curiously. No derision or pity in her voice, she was just interested.

I shook my head tightly and looked back at my clenched fists. ‘No, that’s the thing. I know, um, rationally, it’s not? I know I’m fine. I know my life is fine. It’s good, in fact! Good job, good friends, good flat, good husband …’ I stared at her desperately, willing her to understand. She didn’t look away. ‘And I feel so guilty, like, I hate myself for feeling like this. Other people have much worse problems than me, and they don’t feel like this.’

‘That you know of,’ she said, kindly.

‘Well, if they feel like this, they … they cope. I don’t cope. I hate myself so much that I bounce back and forth between feeling nothing and feeling everything, and I can’t do it any more. I just can’t do it any more.’

Fuck. I had wanted to spend this first session in control, and I was failing spectacularly. I gripped the seat of the chair and squeezed hard.

‘Huh. Okay, then,’ Bjorg said, leaning back in her chair. ‘So, what do you hate about yourself?’

‘Everything,’ I said quietly. ‘I hate my body. I hate my personality. I hate how I feel and how I think, how scared I am of everything. I hate how useless I am. I hate how my friends are all better than me, and how I’m rubbish compared to everyone. I hate that I’m not as good as I should be, and no matter what I do to try and keep up, no matter how many To-Do Lists I make to make sure I’m keeping up, I can’t, and no matter how hard I try to be perfect, I always –’ Don’t swear, don’t swear, don’t swear … ‘ – I always fuck up in some way.’ Fucksticks! I glance at her to see if she minds the swearing; she doesn’t seem to.

‘No one is perfect,’ Bjorg said mildly.

‘I know, I know. But I can’t … I can forgive everyone else for not being perfect, but I still feel like I should be.’ I gesture at myself, helplessly. ‘I can’t be perfect, and I hate myself for it. I hate myself for it.’

‘Okay,’ she said again. ‘Okay, there’s definitely a lot to work with here. Just one last thing: what do you want to get from these sessions?’

What a question! The truth was, I wanted to get better but I didn’t think there was a ‘better’ any more. I thought I’d been ‘better’ after Olu, but everything had gone wrong again. So, if I couldn’t get ‘better’, what did I want?

I thought about the last few months; about being with the friends I love most, and the heavy self-hatred that followed. I thought of laps in the pool, and the disgust I felt for my body afterwards. I thought of going to work and drowning in inadequacy. I thought of feeling awkward and ill at ease with the people I’m supposed to feel at home with. I thought of my good, strong marriage and the feelings of despair that had rotted its edges. I thought of my life, of my good, happy life, and how no matter how hard I tried, it felt absolutely intolerable.

‘I just want for things not to be shit,’ I said, eventually. ‘I just want to be able to go about my life and not feel like everything is awful because my stupid, broken brain is telling me that’s the case. I just need to be able to enjoy my life, a little bit. I just want to live and for it not to feel terrible, and exhausting, and impossible, all the … all the fucking time.’

She nodded, like this was an entirely normal thing to say.

‘Okay,’ she said brightly, and gave me a small, kind smile. After a moment, I smiled back. Just a little. She’d not said more than 50 words to me during our entire interaction so far, but I felt safe. It was scary to put the smoking, steaming wreck of my brain into her hands, but for some reason I trusted her with it.

‘Okay. That, I think, we can do.’