Care Plan Meeting – treat me as an equal

In recent days I have begun planning for my CPA early next week and I started to think about the things I need to cover in the meeting. After all this meeting will involve my new care coordinator from the new team my care is transferring to, I haven’t met them yet. It will also involve my existing social worker and my psychologist as well as my daughter, who goes to represent the family and support me.
I know that in the past my interactions with health care professionals haven’t always set off on the right footing, I usually find it hard to trust new people. I certainly have difficulty when professionals treat me like some second class citizen and not the equal that I am. My last experience of the new team dates back some 8years; it wasn’t so great and so I do have some reservations.

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I so want to explain to these people that I am not like many of the people they will have worked with, I have a condition they may never have heard of for starters. I am at times able and capable to do most things and then there are times when I things are too overwhelming and hard, times when I need support and help and times when I need them to step back and let me get on with it. Of course those times fluctuate from one day to another, in fact from one hour to another, depending upon which part of me is up front and driving this body we share.
I want them to know how I find each day, what its really like to be me and yet I’m not sure how I tell them that. The fact is I’m not sure my current team get how complicated and complex life can be for me. I’m certain they don’t understand the juggling I have to go through each day just to stay on an even keel, so how can I really expect my new team too. Yet I’m desperate that they do get me and they get the real me, why, well if they misconstrue me then they will judge me wrongly. They will like many before label me, stigmatise me and make assumptions about me which aren’t true and yes that does bothers me.

 

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I know I need to say things at the meeting about how I’m doing, what’s going on in my life right now and yes I can tell them about therapy and what’s happening. Yet I feel drawn to tell them about the things I’m really struggling with, because I need them to know. Yes I have made huge progress in the past 18 months and I’m really glad that I have, but there is still so much I need to do. For starters I want to be able to understand why I’m crying when I cry and yet there are many times I don’t. I want to be able to stop worrying about being judged but it feels like a mission impossible currently for me.
I want so much to be able to sleep in Bertie bedroom, that’s the name I’ve given the room in order to make it feel less scary, yet right now I’m able to just manage sitting in there for short bursts of time and then I need to leave. I visit the room a couple of times a day to get dressed and undressed but that’s all really, I can’t face sleeping in there and I can’t say when I will. It is as I’m often reminded a work in progress and it’s been months of hard work and effort just to get this far, that’s the joy of fearing a room because of linked memories. My bedroom of course is safe; I know that, but bedrooms and beds weren’t always so safe and that’s the issue. I have to overcome a fear that is ingrained in me from when I was young and sadly it still affects my life.
I want to be able to sleep in a real bed and not face struggles doing that, and yet currently I can’t. In fact I’ve slept on a sofa for 9 months now and that’s not so easy to admit to a random stranger; who I want so desperate to see me as an equal. In fact admitting or discussing most of this to someone who can impact my life in either a positive or negative way isn’t easy at all. So my dilemma is do I tell them at the CPA what’s concerning me or do I sit and pretend everything is perfect just because I have a new team.
How do I really trust these professionals who have the power after all to detain me against my will, give me treatment I don’t want and who can forcible medicate me or lock me in institutions all under the guise of healthcare. The power imbalance that exists between me and the professionals is a bit like having a pink elephant in a room, we all know it’s there but no one talks about it.

 

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That power imbalance though is concerning to me, I don’t like feeling out of control and the fact the new care coordinator and her team can take control away from me is frightening. So as I plan ahead for the meeting that in truth can go one way or another, that could be either a huge success or a terrible failure I need to find ways to stay focused. I need to remember these people are not the enemy, they are professionals whose task is to help me recover and deal with my mental health. In truth they are as at much risk of being sectioned as I am, that power hangs over everyone of us no matter who we are, Doctors, nurses, service users we are all able to be sectioned if we are deemed unwell enough.
This meeting maybe a scary prospect but I realise it also allows me a chance to educate people about Dissociative Identity Disorder and about me. It offers a chance to show them that actually I am working hard, it offers a chance to demonstrate my desire to recover and live an effective life with DID. I know parts of me are frightened by the upcoming meeting, trust is a big issue for us and so getting to know new people is hard. But my job now is to stay calm, reassure my alters and focus on showing these people who I really am and how I expect to be treated as an equal partner in my care.

Copyright DID Dispatches 2015

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Update on Funding and transferring CMHT

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Funding as been an issue for some months now, well mainly the debate over which CCG is going to pay for my psychology sessions. Alongside this has been an underlying issue of a potential transfer of care from one NHS trust to another and of course as the patient I had little say in what was happening. At times I have felt frustrated and annoyed as professionals have made decisions which have an impact upon my life, it’s often felt as if those decisions could have been made swifter, easier and well to be blunt in a far better way. They have procrastinated over me and the financial implications when all I have wanted is a smooth transition from one CCG to the other.

Over a year ago I was told that the wrong CCG were paying for therapy and yet the talks between the two bodies didn’t even start. One claimed to send letters to the other and the other claimed not to have received them, in the middle of all of this was me. It all seemed to come to a head when a few months ago funding for therapy was suddenly stopped by the original CCG without warning.

Now I’m sure it seemed like a good idea to Shropshire CCG, a saving they could instantly make except it had huge implications for me. They said that as they had no legal responsibility to pay why should they and pointed me in the direction of the new CCG, who were now legally required to provide my care. That’s the impact I guess of Government changes to legislation. So I spent time worrying as therapy hung in the balance, numerous telephone calls and emails followed and eventually thankfully Shropshire CCG reinstated funding on an interim basis until they could negotiate with the new CCG . The new CCG responded well in the crisis and I was told by them last week that finally a transfer had been agreed between the two CCGs, so therapy is safe for now and I can breath a sigh of relief.

At the same time there has been ongoing discussions over the transfer of care from one NHS trust to another, I agree I need to access services locally and not from an NHS hospital or CMHT in another county. But at times in the past few weeks I have felt like a commodity, a commodity that is passed from pillar to post and back again. Ive been reminded so often of how much I cost the NHS and how much people see me as an expense. It doesn’t help ones self esteem or feelings of self worth to be reminded of the feelings I once felt as a child, feelings of being a commodity to my main abuser.

Whilst the transfer to a new CCG has appeared seamless I’m unsure if the contract issues between my Therapist and the new CCG have been resolved, I can only hope that is the case. However the transfer to a new CMHT and NHS trust seems less organised sadly and I feel lost in a mire of bureaucratic red tape and confusion. Most of the confusion stems from the fact I seemed to be the last to know about the transfer and that does seem rather wrong.

I haven’t met my new CMHT or the newly allocated CPN yet, that is scheduled for late June, but apparently if I am in a crisis or need help now I have to turn to them. Well that’s what my old CMHT has said on more than one occasion, except for a while I didn’t even have a contact number for these people.

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So yes I feel a bit like I am piggy in the middle between these two CMHT’s as the transfer clearly hasn’t gone so smoothly. I don’t blame my new CMHT at all they haven’t as yet met me, that will happen at the CPA arranged by my old CMHT, where I assume the formal transfer will happen. But my old CMHT seem keen to rid themselves of me and my costs ahead of that date which really makes me feel great.

When my old Care Coordinator visited last week, she told me that as I now had a new CPN from the new team when I need help I am expected to contact the new team. As I didn’t have any contact information for this team I asked how I was meant to do this? she seemed perplexed she had assumed I knew the contact information. So days later following my challenge that not having these numbers left me high and dry, she emailed saying oh you can use the old CMHT until it’s sorted. A few days later numbers for the new team were duly sent in a two line email that does just contain the numbers, so now I’m left wondering does that mean I use these now or do I use the old team?

You see I think the transfer has officially happened except the new team hasn’t even met me and I don’t know if they have a copy of my care plan or the latest reports from the psychologist. My family don’t even know I have been allocated a new CPN and I’m not sure if that person will have my contact details or my families, so it feels less than ideal.

It would be so easy to spiral into confusion, distress and a heightened sense of anxiety over all of this, it would certainly be easy to stress over feeling like a commodity. I have however been able to talk through these feelings in my therapy session and it has lessened my fears thankfully. I don’t know we’re I would be if I hadn’t been able to discuss these concerns so I’m grateful my psychologist was able to help.

Now I sit waiting for my CPA and am hoping things work out okay with the new team, I am still slightly anxious as each team I have been under differs in their approach. I just hope I’m not left feeling confused for too much longer and I hope they understand Dissociative Identity Disorder. Most of all I guess I hope they treat me as an equal and someone who has a say in their care, after all I have felt like a commodity and an object to be ‘done too’ for far too long.

 

Copyright DID Dispatches 2015

Funding Update

 

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An update on funding, well I have spent so much time chasing Clinical Commissioning Groups regards my therapy funding this week I think my phone bill will have quadrupled. However some slight good news came through at the end of this week which at least means my psychology session this next week will not be my last.

Despite telling me the decision to cancel my funding was concrete and non reversible, it seems that if you explain the guidance that CCG’s must operate under and point out you won’t just accept their decision, they take notice. I’m not sure if it was the numerous phone calls I made, my blog or the tweets that filled my time line on Monday and Tuesday of this week, but something made them think again.

I received a call from the team responsible for the funding from Shropshire CCG advising me that they had given some thought to the situation. They spelt out that the law says they do not have to pay for my treatment any more, but that Cheshire CCG now needs to and then what I was told stunned me. The lady said ‘However’ and then followed a pause that felt like it lasted forever as I waited with baited breath, the lady continued ‘we do feel it is important that there isn’t a gap in your treatment’. She went onto explain that whilst they negotiate with Cheshire, Shropshire will continue to fund treatment in the interim, to enable continuity of care. To be honest I didn’t believe her at first, after all I had endured so many closed doors just the day before when they showed no care or concern.

I’m not normally brave enough to ask for things in writing, but before I realised the words came tumbling out and she agreed to email me. Unsurprisingly I sat nervously as I waited, was this true had they had a change of heart, and then an email came confirming that for the interim whilst the two CCGs talk I’m not playing piggy in the middle. I asked Shropshire if they’d started dialogue with Cheshire and they said No, which I found a bit odd after all surely they need too, so in the spirit of helping things along I shared the telephone numbers of the opposite CCG with each of them. I’m hoping dialogue happens now as it most probably should have many months ago.

The call gave me a moment when I felt a wave of relief rush over me, immediately followed by worries over various ‘what ifs’ that crossed my mind. What if Cheshire say No, will treatment stop, what if Shropshire change their minds again, what if it all takes too long and funding isn’t sorted in time. Interim means just interim, short term, is funding within the NHS ever a quick process, I’ve never known it to be.

I have to confess I sent the email onto various people, to ensure my family and my therapist all knew that this decision had been made. I spoke to my current CMHT who were still very perplexed and felt truly in the dark about the entire matter, but I think relieved it was for now temporarily sorted. Then I just sat on my own and reflected upon the past few days and the future challenges we face. I cried part in relief and part in fear, such was the weight of emotional turmoil I have felt under this week.

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It’s clear I have really found this stressful and it’s an ongoing issue which continues to cause me anxiety, I’m aware that these funding changes also reflect other changes that I will now encounter. My CMHT is very likely to change and the hospital trust that will deal with me will change too, I don’t mind this as currently I don’t get seen in my locality and that I feel is something that should happen. I’m more prepared for these changes but I am still anxious about them, will the new team know enough about D.I.D?, will they treat me as a partner in my care not someone to talk down to, or someone they can do things too? I find I need to feel an equal partner in my care, my treatment otherwise I feel out of control and that reminds me of my past, my trauma. In my past I was controlled and dominated by my abusers, so if professionals exert control over me it has a negative impact.

For now I’m just hoping that when the changes happen we get off on the right foot, that if we don’t it can be rectified without too much grief. I guess I’m hoping it’s done swiftly and that all this uncertainty clouding my head over changes in services and funding is resolved. I have a great deal of recovering to get on with and so I’d like all these distractions to be resolved, so 100% of my energy is directed at moving my life forwards.

I’d like to settle things down a bit, as internally the past week has been chaotic, parts of me are fearful, were hugely impacted by the thought therapy was ending just as it had begun really. Parts of me really struggled this past week, parts I don’t know too well, are building trust with my psychologist even thought they haven’t to my knowledge communicated with him yet. They felt aggrieved, bereft even, at the thought someone they were just beginning to feel safe with wasn’t going to be there to help me deal with their memories and emotions. In fact he wasn’t going to be there to help them.

If I could say anything to my current CCG it’s that I wish they realised the impact of their decisions, how much torment, anguish and hurt it caused and I want them to know I’m truly grateful they’ve given us a reprieve. To the potentially new CCG I’d like them to see me as a person, to understand how much difference my Psychology is having upon my life. I hope and pray they make the right decision, that they honour the funding contract and give me the rest of the time I was assured of 14 months ago to undertake treatment. To my new Mental Health NHS trust, I’d like to say please see me as human being just like you, please treat me with respect and understand me, all of me.

As I write this I know nothing is certain, nothing is guaranteed and my future, my life and well being are no longer in my control fully, but in the hands of bureaucrats and medical professionals who don’t know me at all. It’s a scary time, but at least there is a sliver of hope that therapy will continue for a few more sessions at least. I guess over the next few weeks I’m going to have to learn to be patient and try my hardest not to worry more than necessary.

I will keep you posted on this continuing saga.

 

Copyright DID Dispatches 2015

 

 

 

 

Hidden truths -revelations of betrayal

Yesterday I realised just how much some Mental Health professionals have judged me in the past and how because of my Dissociative Identity Disorder I am at times seen as complicated and complex. You would think I’d be more able to deal with these kind of situations, but when the envelope arrived yesterday morning containing a few documents from my medical records I found myself quickly getting annoyed.

I had requested some very basic information, I wanted to know how many contacts I had had with my local community mental health team over a given period of time, and how many nights I had spent in psychiatric inpatient services. Simple you would think in this age of modern technology for any NHS trust to gather this type of data and forward it to me the patient. Well I thought it would be simple I was wrong.

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Firstly whilst modern technology exists it is only as good as the data entered into the system, my local NHS trust doesn’t keep at hand a record of such things. Instead 40 days after my original request they sent me some documents which didn’t actually give me answers to most of the questions I had asked. For instance they have no accurate record of my admissions to hospital, well they didn’t send me the data. In fact some data was withheld because despite the various documents being about me, I’m not allowed access to them if there are compiled by a third party such as the private hospitals the NHS paid for me to be held in.

But what I did receive was eye opening, in this small bundle of papers were letters written about me from various medical professionals. They contained the reasons I was sent to secure services and the reason I was kept detained in a medium secure hospital longer than the psychiatrist based there felt I needed to be. I found out how people have over time judged me in ways you just wouldn’t believe and being judged well that makes me cross. I also realised how financial issues have impacted upon my care and how little my views and wishes were taken into account previously.

In one letter it states the reasoning behind my being sent from an open mental health ward to a forensic secure service. It states that I was transferred to the forensic unit because I was struggling with depression and self harm related to remembering and subsequently disclosing childhood abuse. The primary thrust of the secure placement was to ensure that I could engage in the necessary therapy whilst being in a safe environment that I couldn’t walk out of. Of course there was no evidence I wouldn’t engage in therapy, in fact quite the opposite.

To think that my move there was because I was depressed, self harming and in need of talking therapy infuriates me. If depression and self harm really lead to me being placed in what I can only describe as a hell hole, then it’s scandalous. Talking therapies are available in the community, I really didn’t need to be incarcerated amongst murderers and other criminals. But I guess it was easier for the local team to just move me on and not have to provide any support, that and the funding came from a different pot of money so their budget remained in tact.

In another letter they talk of my being kept in that hell hole for longer than needed, it transpired that my psychiatrist at the medium secure unit felt I didn’t need to be there he felt I should be moved to a secure rehab unit and yet my local team and others over ruled him, not because it was in my best interests but for budget reasons. The local team needed time to put in place a funding request as lower secure services were financed out of a different pot of money.

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To think I suffered that trauma, that loss of liberty over a simple budgeting matter is hard, we never knew before. I took what they told me at face value, I guess I expected them to serve my best interests and my family trusted them to look after me and to ensure my needs were met in a safe way. It does feel like a betrayal, a betrayal of trust.

The letters that I now have talk of me having issues, being a nuisance, being complex, having flawed behaviours, having considerable contact with services and being detained. They seem at times critical of the fact I understand my condition, have insight and awareness, perhaps it’s more difficult for the Mental Health professionals to accept that.

Of course besides the letters, I still need the information that I initially requested and so I will have to pursue that over the coming weeks. It’s clear attitudes at times towards me have been misguided, professionals clearly unable to understand or consider my view point or feelings. It’s clear too that finance or rather the lack of it have played and continue to play a significant role in how mental health services are delivered. I can’t help wondering how many more people suffering depression and self harm are being sent to inappropriate placements for talking therapy when it would be far cheaper to deliver this in the community.

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The letters and documents I have received will now be filed away, I’m not going to focus on the past too much or let them upset and distress me. I know yesterday when I did get distressed and annoyed it affected my alters; the other parts of me. I had to spend time calming myself down and I did walk away from the paperwork and do other things. In fact one of my alters intervened she told me to stop, to put the file out of sight and not get upset, she was worrying about me. For once in my life I listened to advise and the file did get put down, I realised this could overwhelm my weekend. But I know now I am far better and worth much more than others silly attitudes and stupid judgements. Yes it hurts to think they misjudged me, to think they don’t understand but I can choose how I respond.

If I’m honest I feel sad for those mental health staff who have no understanding of what it’s like from a patients perspective, who feel threatened by patients who understand their condition and who have no idea of the impact of secure units on people. Most of all I worry that talking therapy for trauma and D.I.D is at times seen by medical staff as just impossible, whether that be because of funding restraints, time limits or a simple lack of awareness.

Copyright DID Dispatches 2015

The Impact of Mental Health Service Changes

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As I sat with my care coordinator this week discussing the likely transfer of my mental health services from one NHS trust to another, we realised this means more changes. I chatted with her about the number of care coordinators I have had since my discharge from hospital five years ago and how that impacts a service user like me.

I know I am not alone, many other service users encounter a constant flux of professionals who seem to come and go, no sooner do they arrive they leave again. Usually it’s been staff turnover or staffing structure changes which have meant job descriptions have changed and they no longer undertake the care coordinator role.

In 2009 I started out with Sam, I had been fortunate she’d worked with me since late 2006, we knew one another and I trusted her. However shortly after I returned to out patient services things changed. We soon had a list of people who came and went, there was Caroline a social worker, who left the department, then Marion a Community Psychiatric Nurse who left for a promotion. She was followed by Richard another social worker, who sadly never did understand us or the diagnosis, Jane came along next she was another social worker. She and I got along quite well until one day she cancelled my Care plan meeting without consulting me or my family, this caused friction and unnecessary distress as we had issues at the time that needed discussing at a meeting urgently.

When she left her post Malcolm took over, he was head of the team and so often difficult to get hold of, but he seemed to understand what it meant to engage with a client and treat them with dignity and respect. They stopped having pre meetings ahead of my care plan meetings which I felt relieved about, I hated the fact the so called professionals would meet to discuss me, decide what was to happen and then claim they’d consulted us. That’s what happened for years, in fact from 2004 to at least 2011. When I was told he was leaving it felt like I wasn’t good enough to keep anyone to work with me, and I remember thinking ‘not again’. I also feared things would return to the old way of working, I’d stop having true engagement and consultation and instead they’d resort to treating us like some third class citizen, who they made decisions about.

After him came Marion who by now had returned to the team on yet another promotion, she and I had departed last time on awkward terms and my level of trust in her was low. Trying to engage with a person who you don’t trust is a bit like walking on egg shells, wondering if you are going to make a mistake and constantly wondering if I could trust anything she said. In truth trusting her well it didn’t happen, I never met her alone always insisting my daughter attended our regular meetings so I would always have a witness to support me if she said anything later that contradicted what she had in fact said.

By the time Colin came along it was only 3 years post my discharge and yet I had already had six different care coordinators and one of them twice. Such changes equate to each care coordinator being with me for an average of just 4.5 months, how is this helpful. Colin was care coordinator number eight and thankfully he stayed for over 18 months, then his role changed and Fiona took over less than six months ago. Now I’m facing another change and this time it’s because of funding changes and me potentially moving from one trust to another.

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When I sit and think of all these changes and the staff who undertook the role prior to Sam, I can’t help thinking of how in the last five years staffing within NHS Community Mental Health Teams has constantly shifted. The turnover has been high, as merges, staffing levels, structures, processes and the like are changed by people in suits far removed from the front line and service users.

On top of the care coordinator roles changing, in the 10 years since I first began my life as a patient and service user I have faced changes of psychiatrist so many times. It’s as if you no sooner get to know someone really well, they actually understand you and how to work with you best, then it all changes. I have had 13 different psychiatrists in just over ten years, that equates to one every 9 or 10 months. How does this give continuity or allow a trusting therapeutic relationship to form, how does it allow for the skills or knowledge gained by a doctor about me to be transferred to another. After so many changes how can doctor number 13 understand me as a person, the things I have endured in the psychiatric system. Will he really know more than a brief synopsis of me, my diagnoses or the medications that do or don’t work. Will I even get time to build any kind of trust or understanding of them, or will I waste time trying to explain the complexities of my diagnosis to them only for them to leave as soon as they grasp it.

Many other service users face having their care coordinator removed altogether often despite having a severe and enduring Mental illness. Some people are being discharged back to primary care services and now fear they may never be able to access the secondary services they might need again, be that a care coordinator or Psychiatrist. Why because due to changes in access to secondary services, staffing cuts and funding issues, service user needs don’t seem to figure so highly.

I am sure it can’t help the staff either facing a constant state of flux as their case load or job descriptions change. I’m told the trust I am under currently is having a more stable period but I do find it hard to believe, after all each change previously has always been spoken of in terms of this is the last one. It can’t help when workloads are increasing and you feel stretched to breaking point, it can’t help to know people you’d once have seen now slip through the net. Surely it’s time for serious re investment in Mental Health services not just for the benefit of people with mental illnesses but for the staff too.

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Copyright DID Dispatches 2014

Is My Care Plan Written About A Stranger?

When your care plan doesn’t reflect you and your needs

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There are times when I feel Mental Health professionals just do not understand Dissociative Identity Disorder and what it’s like to live with it. There are times when I feel that I am judged by my time in hospital and it appears assumptions rather than facts about me rule the day. Unfortunately the arrival of my much awaited care plan signalled it was one of those times. It’s clear from reading the document which outlines my care needs, the interventions put in place and potential signs of relapse, people still need educating about D.I.D.

I knew it was unlikely to be positive when the boxes which stated I and my carer or significant other had been involved in developing the plan were marked ‘ Yes’ . This is the first time I have seen a care plan in over a year and neither I nor my family have been consulted about it at all. More frustratingly I guess is the fact we have only received a copy because we have asked repeatedly if one still existed.

It seemed strange to see a note attached to the plan which my care coordinator had written saying ‘we can discuss any amendments on my next visit’, amendments I thought, I want to re write the whole darn thing! Yes it’s that bad really, which is sad given I’ve been with this particular team for over 8 years and they know about my diagnosis. It’s even more bewildering given that some though perhaps not my current care coordinator have been given specific training on Dissociative disorders.

I’m more conscious though of the glaring misconceptions that stare at out at me, the plan has a list of skills and support they expect my PA’s to provide none of which mention dealing with my alters; the many parts of me. The person who employs my PA’s hasn’t been consulted about these either so was rather taken aback when I showed them the care plan. My PA’s are now meant to be specialist mental health care providers apparently, of course they aren’t, because to have this would cost far more than the Local Authority will fund. But my PA’s do provide valuable help, support and assistance on a day to day basis and they help deal with and interact with the many parts of me. That’s a skill in itself and one that needs to be recognised…but it is not even mentioned in the plan.

My community mental health team seem to think I can just stop switching, on command! The plan states ‘carol to undertake independent activities where she is required to remain in an adult state’. I liked the word ‘required’ it seems so out of sync with what it is like living with D.I.D, after all I can try and manage my time, juggle the needs of the various parts of me but I can’t just switch off the switching. Yes I try at times to stay focused, it takes a great deal of effort, I know I still switch from one adult me to another and at times will suddenly descend into a child part. I’m working hard to work in cooperation, watch and observe as little parts of me take control of this body we share, but I have no ability to ‘remain’ in an adult state at command. It’s simply not yet a feasible option.

I’m quite good at covering it up and people who don’t know me well may not even notice the switches that take place, but that’s the same for most people I know with D.I.D. The majority of people I interact with don’t notice the internal struggles that go on constantly as I try and remain at least aware of what my parts are doing. But I’m still losing time, I’m still having periods each day when I wonder what the hell I have been doing. I have to balance my time and my days to try and give myself a fighting chance each day and yet they expect me to just on command remain adult. I wanted to laugh because they refer to the time I don’t have care and they assume I stay adult me in this time. This is more than half my week and yet they assume I can just be an adult! I think they might be surprised if they saw me at these times, because their assumptions are so far of reality it’s quite sad.

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Take for instance the other day I had no PA’s I watched cartoons well my little me’s did, and then we had breakfast which was chocolate. (I observed but had no control). Then I lost time, apparently I snoozed and had a mid morning nap before even more cartoons. The rest of the day I switched from one part to another and back again, some were adult parts, some teens and some little parts. I think I failed if they expect me to ‘remain adult’ oh well I live with D.I.D., the professionals clearly don’t understand it.
The plan goes on to talk about how my daughter and I are meant to monitor and report back any risky behaviours and it says ‘ increase periods of stabilisation and reduce the risks of self harm or harm to others’ I have never harmed others, the only person I ever hurt was myself. I find this assumption so offensive, just because I have self harmed, just because I have been in secure hospital settings does not mean I have ever been a risk to others! How dare these people treat me as if I maybe a risk. I’m going to be asking for their proof that I have ever been a risk to others because I know I haven’t and I want the comment removed.

The plan outlines my signs of relapse, well given the signs they suggest are indicative of a relapse I should be in a hospital right now. Well dissociating on a daily basis is deemed a sign of relapse and having flashbacks is too. I’m doomed if these stay on my list, I have D.I.D for goodness sake of course I will dissociate! I also want to know which individual never has arguments with their family, because if I do it’s a sign of relapse. Yes seriously the signs are so silly even my family are dumbfounded by them.

Finally there is that solutions box to relapse, it’s great even though I have no PRN medication it’s listed as a technique to use. But worst of all 5 years after my last hospital admission the threat of readmission still remains, the plan states ‘if risks continue to escalate to a level above carols ability to cope in the community consider hospital admission’ why? Surely there has to be other solutions first, maybe extra therapy. They assume increased dissociating is a risk, with such signs in the plan I can’t win, if relapse and risk are dissociating, if it’s having arguments with my family how can I win. I have a dissociative disorder of course I will dissociate and when I’m stressed or have increased anxiety I will dissociate more frequently. That doesn’t mean I need to be locked away in a hospital. It means I need help maybe support to deal with the stress and the anxiety, why do mental health professionals still look at the problem they can see and not the cause.

My plan is an absolute joke, it’s so poor it’s insulting and as I maybe changing teams soon it needs more than ever to be right. I don’t need a battle right now I want them to just get it right, to understand me and my D.I.D, is that too much to ask?

Copyright DID Dispatches 2014