As a therapist, people sometimes ask me how I cope, spending all day, listening to people’s problems.
And they’re right to ask. In a standard week, I have several conversations about suicide, as well as talking to people about how they were abused as children, or attacked, tortured, trafficked or nearly killed as adults.
Most of the people on my caseload have trauma or PTSD. A smaller proportion have things like depression, or health anxiety (thinking you’re seriously ill when you have something benign like a headache) or generalised anxiety disorder (worrying excessively about small things). It can be harder to feel genuine empathy when seeing one of these clients straight after someone who fled a war-zone, but then I remind myself that if you truly believe you’re dying from cancer, that’s terrifying too, in its own way.
And it’s not just hearing about these awful things. It’s the sense of responsibility and fear of getting into trouble if we get it wrong.
Every time I have a conversation about suicide, there’s a very detailed, convoluted risk policy I have to follow. If anyone ever acts on their suicidal thoughts, every aspect of my work will scrutinised.
Usually, I say one or more of these things, if I’m asked how I cope
- we have really good support and supervision, so it’s fine
- hearing about traumas is nothing compared to actually experiencing them
- seeing people get better makes up for it
And it’s true.
Normally, I love my job.
However, over the last few weeks, it’s been different. I have a lot of patients on my caseload who have experienced sexual trauma – a lot of childhood sexual abuse and some violent rapes, whereas usually there is more of a mix of traumas.
I’ve been experiencing some of the same symptoms as my patients.
I’ve become vicariously traumatised.
These are some of the symptoms I’ve noticed recently:
- hypervigilance – being jumpy and easily startled, feeling like I’m in danger
- being more emotional – sad and tearful, or irritable, when I’m not feeling anxious
- being distracted by thoughts of my sexual trauma patients, when I’m trying to have sex.
It’s not like the traumas on my caseload currently are the worst I’ve had. Last year, I worked with two women who had been trafficked into prostitution and forced to have sex with clients at gunpoint. I found it very harrowing working with them, but I made sure I looked after myself.
I always went out for a 5 or 10 minute walk, after distressing sessions.
One of them, in particular, did really well in therapy, and all her trauma symptoms got better. It’s some of the work I’m most proud of.
I had a patient last year who was so violently raped, she was told she might not be fertile anymore. Again, while I found it hard to hear about, I had time to talk about how I was feeling after those sessions, so it never really affected me outside work. Again, she did really well and her symptoms got better.
One thing that helped previously was having a variety of different types of traumas on my caseload, as well as a variety of mental health problems, whereas now, it’s all sexual trauma and violence at the same time.
But the real difference is that I’m having to see more patients, because our service targets have gone up. And I’m being expected to do more and more with each patient. We’re seeing patients that should really be seen by a more specialist service, but the funding for those services has been cut, so if we don’t see them, no one will. Plus, every few weeks, another task I’m supposed to do with every patient gets added to the list.
There isn’t time to look after myself.
Instead of having a harrowing session for 90 minutes, walking around the block for 10 minutes and then feeling OK to crack on with something else, I’m having to book my patients back to back, with no time to decompress between sessions.
One day recently, I had an incredibly difficult session. It went well, in that it went the way it was supposed to, but it was very intense. We were talking about a violent rape in detail, and the patient was extremely distressed.
I really wanted to have a few minutes to stare at a wall and let it settle down afterwards, but literally, as I opened the door to let my patient out, my next patient was standing on the doorstep.
I had just one minute to go into the office to get the next set of notes, and while I was in there, my co-worker tried to talk to me about how stressed she was feeling, and I checked my phone and saw a message from my Mum saying she was anxious about her memory.
I felt like I was going to implode.
At first, a while ago, I just noticed a small change in how this was affecting me, outside work.
During sex, I’ve always quite liked boyfriends to say certain things, which are not really in line with my feminist principles.
I don’t know why, but if I’m being enthusiastic about sex, assuming I trust him and know he respects me, I find it jolly if he says something like, “you like that, don’t you?” and then calls me ‘dirty’ or something like that.
Suddenly, I realised I didn’t like it anymore. It’s reminds me of talking to women who’ve been raped, and how they were called dirty.
Then, two weeks ago, I was having sex with Andrew, enjoying myself.
Suddenly, I started thinking about a patient who was very violently raped. And then I couldn’t stop think about that.
He was being very gentle. He’d just said, “let’s do it in your favourite position!” and we were moving.
It was completely consensual and comfortable. But it was sex, and it suddenly reminded me of work.
That was weird, I thought, afterwards.
It was playing on my mind, the next day at work. Work has never encroached on my sex life before.
When Andrew came around a few days later, and wanted to have sex, I explained to him how I’d been feeling, and that I didn’t feel like it.
Recently, Andrew’s work has been very busy. His police team have been working on two very serious crimes. Usually, he phones me on his way home from work, or we video call when we’re both in bed.
One night, he called a bit later than usual, and I was about to go to sleep.
He asked how my day was, and instead of going into lots of detail about my day, and the minutiae of what I thought about things my co-workers had said and done, I just couldn’t face thinking about the day, let alone talking about it. I was monosyllabic.
I didn’t want to hear about his day either. Normally, I love hearing about his work, but it’s pretty full-on.
He started trying to tell me about gruesome crime scene he’d been at that day, and I just couldn’t bear hearing it.
“Can we talk about this tomorrow?” I cut in. “I can’t deal with it now.”
But I felt the same the next day, as well.
In the evenings, on my own, I had planned to do things like writing, or housework, or exercise, but I just felt too exhausted. I just lay on the sofa drinking wine instead.
That weekend, I was in my flat a lot, by myself. I started feeling weirdly jumpy and unsafe.
At one point, I was sewing, and I jumped when I saw something moving across my peripheral vision.
Then I realised it was my own foot.
I jumped out of my skin, when my bedroom door opened by itself. Then I realised it was just moving in the draught, which it always does, when the window’s open.
On the Sunday night, I was washing up, and kept feeling paranoid someone was going to come into my flat. I think I felt vulnerable because I had my back to the rest of the kitchen. I kept pausing my podcast and going to check no one was there.
That weekend, I started having nightmares.
I had one dream where I was at a football match, and there was a penalty shootout.
A car drove onto the pitch, and it was a terrorist attack. The car was trying to drive into the crowds, to kill people.
But no one else to could see it. Some people reacted like, “it’s funny that there’s a car on the pitch!” but no one saw that the car was trying to kill people. I couldn’t do anything to stop it, or protect anyone.
It was much more vivid than my usual dreams, and stayed with me.
The next night, I dreamed half a man fell out of the sky and landed in front of me, on the pavement, after having an accident and falling from some scaffolding.
He was a builder, and the accident had cut him in half, so everything from his waist down was gone.
In the dream, I got really involved in trying to help him. Not helping him get to hospital, or anything sensible like that, but helping him with his employment tribunal about how this industrial accident wasn’t his fault.
I felt really unsettled for a while after I woke up.
I spoke to my supervisor at work about how I had suddenly started feeling. He was great, and really supportive.
I knew I had a week off coming up, so I hoped the break would help. We agreed we would both talk to my manager about what could be changed with my targets and things.
That night, Andrew and I went out for dinner. I was feeling better, because wheels were in motion for things to improve.
We had a nice evening. I talked about work enthusiastically, more like usual. We talked normally.
After we’d eaten, we went to a pub for a drink.
We were sitting in the pub garden, chatting, when a memory I hadn’t thought about for years came into my head.
When I was 18, I worked in a pub. Andrew and I have spoken about this before, as we’ve both worked in pubs, and both kind of hated it.
But I had forgotten about this one night. There was some kind of football match in the afternoon. That evening, a large group of men who had been drinking all day, came to our pub.
The landlord told us not to serve them, because they were too drunk.
When we refused to serve them, things got nasty. I can’t really remember what happened, but the landlord called the police.
Then, he went up to his flat, which was above the pub, and left me and the other barmaid on our own, while we waited for the police to come, which took nearly an hour.
We were on our own, with this big group of angry men who were being intimidating. They were banging the ash trays on the tables, shouting.
Then, the other barmaid, who was quite a bit older than me, went out to collect glasses or something, and one of the men came up behind her and groped her.
The landlord didn’t do anything, so she walked out. I was left there on my own.
I hadn’t thought about it for years, but suddenly it came into my mind.
I told Andrew, and was a bit disappointed in his response. He just sort of nodded, and then said, “shall we go?”
Usually, when I talk to him about anything, he seems really interested. He asks lots of questions, or says sympathetic things that show he understands, including difficult topics like death or mental health.
His response this time reminded me of when I first told him about the Swimming Pool Incident (when I was 10, and a stranger groped me at a swimming pool).
When I first told him about that, he just said, “OK,” and then didn’t say anything else.
I was a bit surprised, and wasn’t sure what to make of it. Eventually, I said, “do you think I’m damaged goods?”
He assured me he didn’t.
I felt like maybe he didn’t think it was a big deal, because the man had only groped me and not more. It was minor, compared to what a lot of other people go through, especially people he deals with at work.
A couple of weeks ago, I’d brought up the Swimming Pool incident for the second time. This time, it was because Andrew had been working on a case involving a violent sexual assault. He was stressed about the perpetrator potentially getting away with it, and whether it was down to things he should’ve done differently.
I said that maybe the most important thing was not whether he got a conviction, but how he made the victim feel, when she first reported it. If he didn’t compound her trauma, maybe that’s the most important thing.
I explained to him that, with the Swimming Pool Incident, the response of the police made me utterly confused, for the next 10 years. That had a much bigger impact on me than the outcome of reporting it.
Again, after I said that, he was just silent. I think he kind of agreed, but didn’t elaborate or take the conversation further. He just was quiet and then changed the subject.
I said something at the time, and he said he thought I didn’t want to talk about it.
This time, last week, when we got home from the pub, I said, “Why don’t you seem that interested, when I try to talk to you about things like this?”
We half-had an argument about it. Initially he said he thought I was being unfair, then said again that he thought I didn’t want to talk about it.
“But why would I bring it up, if I didn’t want to talk about it? Whenever I tell you about anything else, you’re great – you ask questions, seem really interested, say helpful things. I want you to do the same when it’s about sexually assault! If I don’t want to talk about it, I’ll say!”
Then, I was lying on the bed, and a slideshow came into my mind, of loads of different times I’ve felt scared of men.
As well as the Swimming Pool incident, there was a time when I was at university. A guy came up to me when no one else was around, and said, “I’ve been watching you for a while. Do you want to share this bottle of wine?”
I felt really freaked out by the “I’ve been watching you for a while.”
I was on my way to an aerobics class, and felt jumpy and worried he was watching me for the rest of the evening.
Nothing came of it.
There was a time I got on the bus in the morning, at Uni. It was the first stop of the bus route, and no one else got on, so it was just me and the bus driver. He told me to stand at the front so he could talk to me.
I said I would sit down, but sat near the front. He was making conversation as he drove.
When we approached the second bus stop of the journey, lots of people were waiting and tried to flag the bus, but he just drove straight past them.
I started to feel freaked out.
He asked me if I wanted to go out with him, and I said No, as I had a boyfriend.
Then, we came to a roundabout where the bus was supposed to turn left, but he went straight on.
He drove around until we were in the middle of nowhere, then said I had to get off, as I wouldn’t go out with him.
Then, when I was standing by the door to get off the bus, he wouldn’t open it for a few minutes, and asked me a few more times to go out with him.
Eventually, he let me off the bus and I had to walk home, not exactly sure where I was (before smartphones and Google maps).
As I was walking home, a van drove past and beeped its horn at me, and I felt horribly exposed.
Another time, I was on the night bus in London, at about 3am, and a guy sat next to me and started chatting to me.
He seemed a bit unpredictable and I’d been pleasant because I didn’t want to anger him (very often, as women, we walk a tightrope between being friendly, because we’re scared of making a man angry, and being too friendly, because we’re scared of leading a man on).
At first it was fine, but then he asked if he could kiss me.
“I don’t want to!” I kept saying.
“You’re saying No, but your eyes are saying Yes,” he kept saying.
“Me and my eyes are both saying no,” I insisted.
I couldn’t get up and move because he was blocking my way out of my seat – I was trapped.
There were only a few other people on the bus. I couldn’t believe no one was helping me.
Eventually he gave up and went and sat somewhere else.
Then there was a time when I was in a nightclub with Faith, and I saw an ex-boyfriend from years earlier. We had a long chat. I was pleased to see him but was clear that I had a new boyfriend by then.
When Faith and I left the club, he walked with us when we went to the Kebab Shop.
I kind of assumed he just wanted a kebab as well, but then when we left the Kebab shop, he carried on walking with us.
At first we were curious but polite, asking if he lived nearby now. Then, he came into Faith’s house, uninvited, despite our protestations, and then came into the bed we were sleeping in, and refused to get out.
Faith and I slept squeezed together on the edge of the bed, as far away from him as possible.
It was difficult to know how far to take things, to get him to leave. It was such a confusing, unexpected situation. After all, he was someone I’d been out with, and trusted. And we were really young, drunk, and it was the middle of the night.
The situation just kind of rattled along by itself, and kept shapeshifting from one thing into another. Two drunk, tired, young people couldn’t keep up.
Afterwards, we said we should’ve called the police when he refused to leave.
But we just tried to sleep.
In the morning, he snuck out and I discovered he’d wet the bed.
I felt utterly miserable as Faith and I took her bedding to the laundrette, and I kept apologising.
I lay on the bed with Andrew, crying, with with this slideshow of memories going through my mind.
I expect most women have their own versions of this slideshow. All of these incidents could’ve been much worse, but they all made me feel horrible.
I told him how I was feeling, and about the different incidents.
He listened well.
We went to sleep without having sex.
In the night, I was having another nightmare, but this time it was about a man trying to attack and rape me.
I woke up, and Andrew was half-awake, mauling my breasts.
Whereas, when he’s fully awake, he’s very respectful and gentle, when he’s half-asleep, he can be a bit of a sex-pest.
I shoved him off, and told him to stop it.
He sleepily apologised and went back to sleep.
I half-went back to sleep, and the dream continued, but this time it was Andrew who was attacking me.
After a few minutes, I woke up again and went to sleep in the spare room.
I often sleep in the spare room when Andrew is snoring, but this time it was because I felt scared.
In the early hours of the morning, I went back into my room and got back in bed with Andrew. We hugged and dozed.
His alarm went off, and he got ready for work. He had to be at work a few hours earlier than I did.
After he’d had a shower, he got back in bed for a hug before leaving.
I told him I’d had a nightmare about being attacked.
“Sorry if it was me,” he said, remembering his wandering hands in the night.
He left for work, but a few minutes later, I heard his key in the door.
He came back because he’d forgotten something, but for a moment, when I heard him opening the door, a weird, half-asleep part of me thought What if he’s come back to harm me?
I knew it was crazy.
Andrew is nothing like any of the men who attacked my patients, or any of the men who have intimidated me.
It’s just that, when I’m in sessions with my patients, I hold some of their feelings for them. I’ve had so much to hold, lately, with no time to put anything down, I’ve lost track of what’s theirs, and what’s mine.
The next day, on Friday, I was at work, and it was my last day before my week off.
I messaged Andrew, because I knew that this has all affected him more than anyone else, and it’s not his fault.
He’s been supportive. To be honest, I don’t think he’s been at his most supportive. I don’t feel like he completely understands, and there have been other times in our relationship, when he has got things more perfect than this, but he’s still been very caring.
I’ve been irritable with him and at times, anxious, and have conflated my feelings about other men with him.
Plus, the night before, we’d been out for dinner with a group of his friends. They were asking about the state of Andrew’s flat, which is a topic I’m very passionate. We all ended up taking the piss out of Andrew, and I got a bit carried away, because I was making them laugh.
The next day, I texted him asking if I’d taken it too far, and he said, “it was a bit of a demolition job, but the truth hurts!”
I wanted to do something nice for him, so I bought him a plant from a market stall at lunchtime.
Then I thought of something else.
He’s always had a bee in his bonnet about having sex in my workplace.
I think it’s because he’s a policeman. He usually follows all the rules, but the thought of breaking them, and having sex somewhere we’re not supposed to, seems to really turn him on.
A few months ago, I started working in a different health centre on Fridays. There were certain things about the logistics of this place that would make it easier there, if we did want to.
I had always said that we probably shouldn’t, but we’d talked in detail about what it would be like if he did come and see me there.
There had been times we’d just video chatted about our how our days were going, and I’d been in that office, and he said just seeing the room had given him an erection.
One time, he’d said, “Maybe I could just come and see you there, and we could not do anything, just talk?”
I decided to ask him if he wanted to come and see me in my office.
I wanted to do something nice for him, but I was also tempted to have sex with him at work.
Work had been encroaching on my sex life. I’d had enough.
I wanted to reclaim sex.
I wanted sex to encroach on my work life, to feel like I was taking sex back.
I know I didn’t have to go through with it if I didn’t want to, but I started feeling excited, after seeing my last patient of the day.
I had a lot of admin to do, and we texted each other.
It was the first time I’d felt like sex in the last few weeks.
We arranged he’d come and see me after 5pm, which is officially when my working day ends, but professionals from other teams are still seeing their patients, so it wouldn’t seem unusual for him to arrive there.
When he texted me saying he was in the waiting area, my heart rate sped up.
I had butterflies.
And not just in my stomach.
I went to reception, and saw him sitting, looking at his phone.
“Hi, do you want to come through?” I asked, just like I would if he was a patient.
We walked down the corridor to my office.
“Have you been here before?” I asked, nonchalantly.
We got into my office, and I closed the door.
“So, this is my room!” I whispered.
He kissed me.
We kissed for a minute or so, then I said, “I’m worried the cleaner will come in.”
Although I’m almost never interrupted when I’m in a session with a patient, just before he’d arrived, I noticed the cleaner was cleaning the next room to mine. It was possible she would come into my room next, assuming it was empty, as it was after 5pm.
We had a quick, whispered chat about our days, and then we carried on kissing.
“Are you finding it exciting being here?” I asked.
I touched his massive erection through the shorts he was wearing.
We carried on kissing. and he put his hand up my skirt, and then asked if it was OK.
I said it was. He put his hands in my knickers, and I shifted position to make it easier for him to put his fingers inside me.
I looked around my office and found it quite sexy, how incongruous and naughty it was.
I said we should stop.
I started shutting down my computer, and tidying my things away.
Then, I put my hand back on his crotch, and he put his hand back up my skirt. We kissed again.
“You’re wet now,” he whispered. “You like this, don’t you?”
I smiled and nodded.
I felt quite close to coming, but I also felt like I couldn’t let go completely and have an orgasm at work.
I knew I was reacting in the same ways I do at home, when I’m close to coming – the same gasps and slight spasms.
“I don’t think I’m going to be able to come here,” I said.
I touched his crotch more, and then got him to unbutton his shorts.
Seeing his penis in my office nearly made me laugh.
I gave him oral sex for a few minutes, then said, “I don’t want us to get caught.”
I stood up, to finish tidying up. “We can finish it at home,” I said.
He put his hand back in my pants, and it felt really good, but then I stopped him again.
I gave him a bit more oral, and then we agreed he’d leave, and I’d picked him up outside, in a few minutes.
With throbbing genitals, I washed up my mug and then walked out to the car park.
I drove out and picked up him on a nearby road, and we drove back to my place.
We were laughing with exhilaration about what we’d done.
It was about a 40 minute drive, and it turned into a normal car journey, but when we were about 5 or 10 minutes from my flat, I started to feel turned on again, at the thought of finishing what we’d started.
“What position do you want to do it in?” I asked, as I joined a traffic queue.
“I don’t know. What do you want to do?”
“Hmm. Upside-down umbrella?” (We’ve made a few of our own names for positions we don’t know the official names for.)
“Actually,” I went on, “how about if we do a position like upside-down umbrella, but sitting on a chair? Because then it’s more like how we would have done it in my office?”
We hadn’t had sex on a chair before. We discussed the logistics of this. I felt more and more excited.
When we got to some traffic lights, about 5 minutes from my flat, I put my hand on his, and moved his hand into my lap.
There were lots of other cars around, but no one could see what we were doing. He put his hand up my skirt and started fingering me.
I felt so turned on!
The lights turned green, and he stopped, and I drove off.
There was another set of lights further on, and he did the same.
This time, as the lights turned green, and I turned onto my road, he carried on. I was moaning, but then burst out laughing, as I couldn’t do drive and do that at the same time.
After I parked outside my building, I said, “let’s go and fuck.”
When we got out of the car, we saw one of my neighbours putting some rubbish out.
“Hi!” I said, cheerily.
We raced up the stairs and I unlocked my front door.
We went straight to the bedroom. He shut the curtains, and I went and got a chair from the living room.
We had a quick conversation about the logistics of the position, and lubrication, and we then we did it.
It was brilliant.
Unfortunately, it only lasted less than a minute.
“Don’t worry! You’d probably had an erection since about 3pm this afternoon,” I said, laughing, as we cleared up.
Sex was mine again.