Bravery at its best - Coming clean.

Delivering this is the letter is the bravest thing I have ever done.
It was to my psychologist, 6 months ago. This is how I came clean. It took me two weeks to write it.

Dear....
I’ve decided to write this, because I’m worried I won’t have the guts to do it face to face, or if I do I will revert and back out halfway, or that you’ll be so angry or shocked or take it so left-field that you won’t be able to listen to everything I have to say, Maybe you’ll kick me right out of your office then and there. What I’m hoping like hell is that you’ll understand I’m really sick, and please help me.

I have Factitious Disorder.
I don’t know what you know about it. It's like Munchausen's. I’m sure you’ve heard of that. People who poison themselves, or injure themselves, or fake suicide attempts or pretend to be sick in order to receive medical attention. They don’t really have the illnesses or problems they present at hospital with, they are feigning. It is a type of Factitious Disorder, it’s in the DSM IV. Ok I don’t have the type that present with physical symptoms. Nor do I have Munchausens by Proxy.

I have Factitious Disorder with psychological presentations. What I’m saying is that I have a compulsive need to lie about my psychological and psychiatric condition. Deep breath. I’ve been lying to you ever since I met you. I have fabricated, and exaggerated and just plain deceived you. I haven’t been sexually abused. I don’t have Dissociative Identity Disorder. I don’t have flashbacks. I don’t self-harm by cutting myself. I’m sorry I made you believe I did. I know you put your heart into your work. I’m sick. This disorder controls my life. It is all I think about, and obsess over. It dictates my life every single day. I spend hours and hours of every day and night obsessing and thinking about it. I even believe it myself sometimes.

If you can’t understand, I can appreciate that. I’ve read accounts of people on the receiving end of Munchausens Syndrome and they talk about feeling emotionally raped, betrayed, lied-to, and humiliated. I’m SO, SO, SO SORRY to have done this to you. I really have tried to fight it, I just can’t control it.

I know some things I’ve brought to our sessions have really played on your mind and maybe disturbed you, or been something that has lingered with you. I can’t imagine how it must feel to find out they weren’t even real things. I’m so sorry. Plenty of the things I’ve talked to you about ARE real and genuine and I haven’t been just laughing at you, I really have felt a strong rapport with you, and connectedness and safety with you. Firstly this is maybe the reason I’m going to try to ‘come clean’ with you when I haven’t been able to with other shrinks.
Secondly it makes what I’ve done all the worse, because I’m sure you’ve trusted me too and I’ve completely abused you and taken services from people who really need it. I am horrified at myself. I have so much shame, but I’m just sick. I couldn’t stop. Oh please forgive me.

I know I have taken advantage of you, I really didn’t mean to. I think Factitious Disorder is about getting the attention and care that I really need but displacing the reason for needing it. I have plenty of real issues. I really can’t have sex. I really get terribly distressed with invasive medical procedures. I really suffer with depressive episodes and have suicidal thoughts. I really have all the struggles associated with being a lesbian married to man. I really do have separate parts of me, but not as distinct as I have created for you. I really do have problems with being highly dissociative. I really do have problems eating. My Dad really was a mean angry emotionally abusive father who made me feel like dirt and treated me like a dog. In fact I think every single thing I have ever fabricated is based on some truth that I have just twisted or exaggerated for reasons I don’t even understand. I’m still the person you’ve been sitting opposite in therapy all this time, I just am, well, more screwy than we both imagined.

‘Coming out’ like this to you is without question the bravest thing I have ever, ever done. I can’t begin to tell you how terrified I am. I am terrified of being rejected by you (though you have every reason to do so). I don’t know what I’ll do or where I’ll go from here. I obviously need help, but what shrink is going to help someone who has a problem lying to shrinks?? I feel incredibly alone and just so frightened. I don’t know what I’ll do without your weekly support. I know that might not make sense because you think I don’t really need support with the things that you’ve been supporting me with, but I really do. I need so much help.


I used to lie mostly to my best friend, then I decided I hated lying to someone I loved, so I found a shrink to tell lies to, someone I couldn’t hurt because they had no relationship with me. I was seeing this one shrink for almost 6 years, for some real stuff, and some fabricated stuff. I became so attached to her, my sessions with her was all I ever thought about. I was completely obsessed with therapy. I eventually tried to break away because I started to really cared about her, and really hated lying to her, and tried a few times to tell her, but I didn’t know about Factitious Disorder then, I just thought I must be a compulsive liar. I tried and tried and eventually stopped seeing her, though I still really miss it. I couldn’t stop the factitious urges and compulsions, and I knew I had real issues that I hid behind the made-up one.

I started this time by telling the intake person I didn’t ever want to talk about the abuse, or what had happened, because I wanted to stop lying and I knew I had a propensity to make up stories. I wanted to just deal with the issues. That probably makes no sense. I honestly wondered if maybe I had some unknown history of sexual abuse, but had repressed the memories, because I identified so strongly with issues from a childhood abuse history. Maybe because of my Dad and that emotional abuse, I don’t know, I’ve never paid it much attention, I’ve been too busy dealing with things that aren’t real.

This was the shrink before you. Anyway it felt better to begin with, because I wasn’t so attached to her, she was a stranger so it wasn’t like lying to someone I knew and had a relationship with. Well of course over time we developed a client/therapist relationship and here I was once again lying to someone I knew and had a relationship with. I was partly devastated when she moved away, and partly relieved that I would be forced to stop lying to her. Then of course came you. First you were a stranger, and now we know each other. I started hating lying to you as well, and thought I’ll get you to refer me to a psychiatrist, and start over before I do too much damage. I thought what you don’t know won’t hurt you. Because I am fully aware that knowing this is likely to hurt you. Maybe you’ll question your intuition, or be kicking yourself, or feel foolish. I don’t know, I can only try to imagine. I’m just SO sorry. Please take me trying to ‘come clean’ as a sign that I really am trying to do what is right.

I think what happened is that I started on the anti-psychotic meds, and well I think it worked, and my head cleared of all the delusionary Factitious stuff, and I was able to see it for what it is. Honestly, sometimes I can’t tell fact from fiction. Sometimes I become so involved I believe it myself. It’s terrible. Anyway I read this week that the medications they recommend for Munchausens is SSRI’s and Anti-Psychotics, it is like I just got the combination right by fluke and it started to work and my head cleared.

This brings me to something else I’ll beg you to please have the patience to listen to. I’ve only been learning about Munchausens & Factitious Disorder for a couple of weeks but so far I’ve found that Munchausens Syndrome has a terrible stigma. It is not very well researched or understood, there is very little support out there for someone like me. Hospitals black-list people like me, and won’t treat them even when they really are ill. I honestly do have gastro-intestinal problems, and breast-lumps, and I’ve never had a pap-smear. Apparently another symptom of Munchausens is not seeking proper medical attention for real illnesses, maybe in the unconscious hope that they get worse, hence the person gets more sick and get the care they crave. People die from Munchausens because they neglect their health so much. Other people are ‘cured’ when they finally really do get so sick they have all the care and attention they ever wanted.

In a country and age where medical professions adhere to such strict guidelines about confidentiality and patient rights, the confidentiality rights of Munchausens patients are often ignored. Someone finds out they have a Munchausens patient, they call that patients GP, and local hospital, and specialist and mental health professionals and everyone to tell them not to believe this person because they have Munchausens. Please don’t do this to me. Please let me deal with this at my own pace, and approach people I feel safe exposing myself to when I feel ready. I really want to get help. I have just now February 2009 discovered that I have Factitious Disorder with Psychological presentations. I feel completely ashamed and humiliated by my behaviour. No-one will ever trust me, or respect me again. I Know you think I maybe don’t deserve it, but I think if I have support and help from people I feel safe with, that I have a chance of overcoming this. I think if I am confronted and ostracised, I will never cope with the rejection. I already feel like every one hates me. I think about killing myself and that being the only way out of this mess.

Please. I know I have no basis from which to ask for ANYTHING in the way of a favour from you, but please respect my privacy. Please allow me the time and space and power to decide who knows I have this mental illness. I really want to fight this. I really want to heal from this. I hope to be able to go to those people like yourself who I have lied to, and tell them the truth, but please understand this is EVERYONE in my whole life. All my friends, all my family, all my healthcare professionals, my husband, my best friend, EVERYONE. If I am blown out of the water all at once I just will not cope. I really genuinely need my support network but please let me do this a step at a time. Since I discovered I have Factitious Disorder, I went to my best friend straight away. I had to go to my best and dearest friend and tell her I’ve been lying to her forever. I can’t tell you the fear of abandonment I felt and the incredible courage this took me. Approaching you is my second step, I would rather just run away and never tell you, or just keep lying forever. I don’t want to tell you and hurt you and make you second guess yourself and feel betrayed and lied to and hurt or whatever you feel. But I really want to do what is right, and I really want to be honest, and try to heal. I have to. I can’t live my life like this. I haven’t been good with God for a long time, and that is really important to me.

I’m just asking that you don’t go telling this to the whole planet. I mean my husband. I mean the Hospital. I mean my GP, I mean my psychiatrist or anyone. I won’t survive that. Please if you feel you absolutely have to do something like that, please at least consult me and let me do it myself, or give me some time to process and deal with everything. This is all new to me. Factitious Disorder has a terrible reputation. I’m not a professional con artist. I’m not intentionally hurting someone. I’m really sick in the head. I have a real mental illness. Please respect my privacy and my right to my own information. I plan to get professional help. I plan to contact my previous shrinks and apologise and tell them the truth, please just let me do this in my own time. I don’t want to tell everyone, because they are not people I feel safe with, or trust. I will find a new shrink and for once in my life go to them with my real problem and tell them I have Factitious Disorder. But I need to find someone safe. I have my best friend to be accountable to now. Already in just the few days she has been there supporting me I have been able to contemplate telling you, and getting real help, all of which utterly terrifies me. I can’t tell you the courage this is taking me to type this, and the tears I am shedding out of fear and shame. This is a huge risk for me to be taking to just tell you this and not know how you will react, or if you will just ring everyone in my life and tell them not to believe a word I say, and I’ll be rejected by doctors and hospitals everywhere. I am begging you not to do that.

I appreciate this revelation is likely to have an emotional impact on you. I realise you might need to de-brief and maybe talk to someone, or your supervisor or whatever you need. Please do. It has never been my intention to con you, or hurt you or anything. I appreciate your sincere efforts to help me. I know I don’t deserve anything. I know there are people with real sexual abuse/assault issues that needed you when I was using your precious time inappropriately. I hope you can forgive me and understand me a bit. I will understand if you can’t.

I’m so sorry. Thank you for all your help. You really have helped me. You may feel like it was all a waste or all fictitious. But you really have helped me. Mindfulness has helped me to recognise my factitious thoughts and cravings. I’ve tried to eat and look after myself. I’ve begun to think about the idea of needing to see a psychiatrist. I have learnt a lot about my depression. I’m learning to deal with anger. A hundred other little things that are real, that have come and gone in the time I’ve known you, that you’ve helped me with. These are real things. Real gifts you have given me. I don’t think I could ever have felt safe enough to do this with anyone else. Please know there was easily as much truth as lies. I don’t know how I’ll manage when I stop being able to see you. You really are a great shrink. I’m sorry it had to be you. I’m sorry I lied to you. I’m sorry I screwed with your head. You are a wonderful person. I really hope I haven’t jaded you, or quenched your passion for the real and vital work you do.

Sincerely
(and as sorry and ashamed and as scared as hell)

Isynia

The torture that is finding mental health professionals....

There is great freedom in anonymity. I have spent my life lying, to people I know and love and now here where no-one knows me I can be honest. I carry on my everyday life, work, the kids, my husband, my friends. Went to a Fringe Festival Gig last night. Going out for dinner tonight, and yet woven through this seeming normalacy, is the constant mind-butting, the ever-present reminder that I am not normal.

So I put off seeing my shrink because of the pressure she puts on me to upgrade, to a more heavy duty mental health regime. She can't cope with me, no-one has ever been able to cope with me alone, everyone needs a team. What if I don't want a whole freaking team of mental health professionals converting me into a big fat file, into a case-study, a client. What if I don't want them all talking about me when I'm not there? So I need a psychiatrist for a full assessment and to monitor my medication. Ok fine, except they are so EXPENSIVE and I don't fit in a box and I don't want anymore labels. I'm pregnant and I don't want to try any new medications while I'm in such a condition. Yes the anti-psychotics work, but they have side-effects too, like causing me to sleep so much I can't LIVE or look after my children properley. Surely that is more impairing than helpful? At least the crazy me can work and live and care form my children.

So there's this one 'specialised' DBT clinic my shrink wanted me to check out. I have to go to the dodgy doctor she recommended for me. The one who practically shrunk across the room from me when she realised I was the one who has factitious disorder and complex other presentations and couldn't get me out of her office fast enough. When I went back last week for my pregnancy she had forgotten who I was and treated me so warmly. Today I will go back and get a Mental Health Plan so I can go to an assessment at this DBT clinic. So DBT is supposed to be the way to go for borderline personality, suicidality, self-harm. Blah blah, one little part of me, what about the rest? I have SOME features of Borderline, I've certainly been suicidal in the past, or have I? Or do I just love the drama, the Sylvia-Plath-Emily-Dickinson-Virginia-Woolf-ness of it all. I mean there's no denying the fact I very almost went under that train half-naked once, and probably would have if not for the gallant and heroic rescue on my bothersome husband. Yes suicidal thoughts. Self harm? I don't even Self-Harm in a 'normal' way...

So on Tuesday I go and see the intake assessment shrink at the DBT Clinic. It's supposed to be very 'managable pricing, but turns out a group session and a private session after all the rebates and medicare money back will still cost me $450 a month, then there's the childcare for two children while I'm there $350 and the travel and parking $100. Suddenly it is costing me $900 a month. Where the hell is THAT meant to come from?? Oh yeah I can really do an extra day work with two kids at home and one on the way and impending illness imminent. My shrink will roll her eyes and say if can afford a trip to Europe and my husband getting a motorbike, then I can afford therapy.

It's important of course.

*Rolls eyes*

There is available to me, a psychologist through the hospital once I register my pregnancy, and I can get counselling at work for free. But of course my shrink thinks this is repeating the pattern of chain-shrinking and none of them are anywhere near specialised enough for the complexity that is me. No-one can cope with me alone. So what to do?

I write this blog.

Isynia

two blue lines

I'm pregnant. Up the Duff. Bun in the oven. Knocked up. This is my third child. Well no, my fourth. I had one baby die in a miscarriage already.

This was the first month we'd even tried. I'm a fertile myrtle. This is the first time I have conceived naturally. In fact the first time in my five and half years of marriage that we even have had conventional penetrative sex. I bet you think that is factitious. It's not. Truth can be stranger then fiction. In fact I daresay that MY fiction was created in the corridoors of my mind to make some sort of excuse, some sort of reason for my strangeness. Is it the fact that I'm a lesbian married to man? Is it that I believed the horrors of my own fabrication so completely that I developed such phobias and adverse reactions and hang-ups and triggers as though I actually lived this story? Or were they all just part of the fabrication, that I enacted so fully, even to myself when all alone in the echoing portals of my mind that they became true? Were they true at all. Did I not have sex with my own husband for five and a half years and despite 3 pregnancies just to plant false evidence of my fantastical story? Or did I live a story, some story, some forgotten trauma that haunts my subconscious? The very root of the factitiousness at all. Where is the truth? What is the truth?

I don't always know. But I do know there were two lines on that pregnancy test last night, my husband was grinning, possibly at the sense of manhood that finally comes with knocking up your wife without the assistance of a turkey baster. My eldest thinks it's a baby girl and has images in his head of microscopic hands clutching onto the inner walls of my belly. My youngest thinks its a magpie. Me? I think its a girl, and I think I better start saving for her psychotherapy now.

Isynia

paralysing possibilities

I'm pretty sure my shrink hates me. She is cold and cynical and clinical and throws a lot of labels my way. I think about her every day. I have been in bed for the most part of everyday and haven't been working this week. What is getting me down? My shrink. Plain and simple. The possibilities are these. 1. This is some kind of therapeutic strategy. 2. She is suffering some personal distress that is effecting her work. 3. She is having a personal reaction to something I have said or done. 4. This relationship rupture is in my mind and she's not being cold at all.

My good friend who is a psychotherapist says this is a perfect therapeutic opportunity for me to learn sit with the feeling of someone hating me. I often think people hate me. I don't cope with it all at well. I could just never go back to therapy. I could attempt to utilise it as a therapeutic opportunity as my friend suggests... I could confront the heartless mean bitch. I could create a sympathy-engendering drama such as a complete emotional breakdown, a suicide attempt, or get someone to convince her my story if is fact real, so she drops this antagonism towards me and questions herself.

Meanwhile I lie in bed and cry a lot.
This is my worst nightmare, to tell someone all my insides and bare my soul and have them reject me. Great. Just fabulous.

Isynia