The Shark in the Swimming Pool

Every week has its own shape, although it is never possible to predict in advance what the shape will be.  Last week started out very well, but was then shipwrecked by another overdose; this week began in the doldrums but is now slowly improving.  However, I think I have finally begun to piece together a little more of the puzzle of what the experience actually feels like for Julie.

When Julie is fairly unstable, as she was over the weekend, she finds some pieces of reality become a bit more slippery to negotiate.  Is there, after all, a vampire on the landing outside her room?  It is not that she actually believes in the vampire, but in her mind the existence of a vampire has become a possibility.  As she improves she will agree that a vampire on the landing is not very likely after all, and when she is doing very well she can say with confidence that there is nothing there.  There is a whole spectrum between complete belief at one end, and clear refutation at the other, and she can move up and down this in a matter of days.

Take another example: the shark in the swimming pool.  At the weekend swimming with Julie was made complicated because there might be a shark at the deep end of the pool.  As a matter of fact, before you smile at this one, I have to admit that I recognise this fear myself.  I have often been afraid of dark water, though I have taken care not to make this too obvious to my kids.  But it means that I can see why she might be frightened, and why I found it quite easy to talk to her about it.  We agreed that some pools were better lit than others, that some were just deeper than others, and that strong dark lines on the bottom of the pool (marking the lanes) were playing tricks with our eyesight to give a very reasonable (and disconcerting) impression of something very large swimming way beneath us.  The difference between Julie and I is that while I don't seriously expect the council to be keeping sharks in the municipal swimming pool, this weekend Julie honestly did think there was a real possibility of encountering a shark.

I am trying an experiment at the moment of asking Julie to be quite open about her fears with me, voicing them, and sometimes challenging them.  In the swimming pool, I reassured her in very simple clear unemotional language that there could not be a shark, we talked about why it might seem as if there was a shark, and then I asked her to look right into the dark shadows of the water to confirm for herself that there was no shark.

The more Julie voices her beliefs the more I get a fascinating glimpse into what is going on inside her head.  In some ways, these spoken beliefs are the best barometer yet of the course of her illness.  There have been endless futile attempts to match the ups and downs of her illness with her reported or observed mood, endless analysis of what was taking place just before the crash, anxious discussions about whether she is "ready yet" to move on afterwards.  Obviously the antidepressants do have an affect, and she needs to work on stabilising her mood, but mood seems to be only broadly correlated with the detail: put crudely, she can seem to be in quite a good mood and still go and take an overdose.  It is much simpler to ask her whether she still thinks there might be a shark in the swimming pool.  And on a practical level, if she still believes quite strongly in that shark, then the chances are that it is too early for her to go swimming on her own.

Some beliefs are not as accessible as the shark in the swimming pool.  I don't, for example, really understand the exploding head.  Talking to Julie about why she won't shower when she is very unwell, I was expecting to have a conversation that revolved around feelings of worthlessness, or there being no point in looking after herself - perhaps some negative feelings about her body.  What I didn't expect was to hear that she thought that if she showered her head might explode.  I'm still digesting this particular belief.  It is tempting to laugh, because you can't see how anyone could believe that - and when she is feeling fine Julie does laugh about it.  But it is a real and present possibility to her some times, and if you felt reasonably convinced that your head might explode, then probably you would decide to skip on the shower too.