Them and Us – The battle lines of Mental Health

image

 

This week has been busy, on Monday I faced yet another Care Plan meeting; my CPA, I wasn’t looking forward to it as I particularly dislike having my meeting at sites that I regard as the medical professionals territory. This meeting instead of being on neutral turf was at the Community Mental Health teams base and so I felt at a disadvantage somehow.

I had to literally force myself to go, I felt so stressed and so wound up about going there, the CPA meetings are bad enough but on their turf it felt like a mountain I didn’t want to climb. I don’t think things were helped by the fact I had not had therapy for 2 weeks so that made me feel somewhat distant from my psychologist who I knew would be there. It’s funny how such a short gap can leave me feeling less secure and at ease with people.

The meeting went fairly well given my mood, it felt as though everyone was pleased at what I was achieving and they said the usual kind of things that are familiar at these events. I found it hard to give eye contact at first which was silly really, but happened to be a phase of that day, the meeting was by far the quickest I have ever had. I was thankful for that and couldn’t wait to get out of the venue and that building.

Looking back I can see my feelings are a little skewed, I mean it’s just a building, it’s just a meeting with people who I’ve met so many times before. I knew the format, who would chair it and I even knew what I wanted to say and had written it down in readiness. So why was I so bothered?

I grew up in an environment that wasn’t always safe, and people would challenge me with questions I couldn’t win no matter what I said. When I first became ill and ended up in secondary mental health services I truly thought these individuals could help me. Instead I felt judged, penalised and worthless even more so than before I entered the system.

That generated a growing feeling of fear and mistrust, a feeling of them and us developed and I suddenly became the person who I felt they all wanted to hate. They certainly controlled me, where I lived, my medication and my observations levels. Even when out of hospital they still had a heavy presence in my day to day life, they decided if I stayed free or was sectioned, if I needed more meds or had to attend things. It really was a surreal existence and a life I didn’t expect for me, I never thought I would be detained against my wishes, restrained or forcibly medicated but it happened.

Those experiences tainted how I viewed these professionals, they no longer had individual identities they were a collective, and in my eyes they were at times the enemy. Just like people from my past they controlled me, they would ask questions all the time often intrusive ones and it felt that I couldn’t answer them right no matter what I said.

image

 

Over the years those feelings of mistrust grew and my attitude towards these medical professionals hardened, the more I felt undermined or belittled the more I responded just as I wish I had done in my past. But of course in my past I didn’t for fear stopped me, as an adult I didn’t fear so much, instead I became belligerent and annoying. I’d challenge people, demand responses, expect answers and object at every turn of events that led me to feel belittled or treated unfairly. I’d ask so many questions as it felt unfair to be treated the way I was and yet looking back it didn’t help me or the staff. Instead it allowed the battle lines to be drawn, further barriers to be erected creating an increasingly them and us culture.

I don’t think I was unreasonable, I was merely trying to express my opinion at a time when everyone was making wrong assumptions about me. If I had stayed quiet and complied, I’d have just felt like a puppet such as I did as a child controlled by my mother. That wouldn’t have helped either and I would most probably have still endured all that I did within the mental health system anyway.

However I had a bit of an epiphany moment after the meeting on Monday, one of my PA’s and my psychologist have helped me to reconsider my thinking. To see things in a different context and understand that the so called enemy isn’t quite as it seems.

I realised this week that these people, and in particular the community team are just doing there job. They are trying to understand me and my rather complicated diagnosis, they are operating in a system that’s all ready defined for them by the people at the top. Most of all they are trying to help me and now they treat me with respect and listen to my views, they don’t judge and they are not overly critical either. In fact they reinforce positive beliefs, telling me how well I am progressing and helping me to remember just how far I have come.

My fears on Monday were based on the past, on the reinforced thinking from my youth and the way some Mental Health staff treated me in hospital and secondary services. Yet it’s wrong to judge them based on someone’s else’s behaviours, it doesn’t do me any good either as I live in a state of fear. I ended up building a barrier between these people instead of learning to trust and develop mutual respect.

Today I can see that the healthcare professionals involved in my care now are not a collective enemy they are caring individuals who work hard to ensure I am treated with respect. They are trying to ensure I am treated as an equal and have a right to express my views, most of all all of us are working together to keep me moving forwards and making progress.

Copyright DID Dispatches 2014

The impact of the Mental Health system on my life

 

image

I sat this week just for a while and let my mind wander, wander back into that place I used to be, before I entered the mental health system. It was hard not to think of all those missed opportunities and long lost hopes and aspirations, those dreams I had of career promotions at a job I now no longer hold.

I also began to think of all the things I have learnt over this time and I realise how much I have changed as a result of my interactions too. I am far more sceptical of medical professionals, more willing to challenge and ask questions of those who are involved in my care. In truth I guess I’m a different person shaped by my experiences in a system that at times has felt more like an enemy than a friend who is trying to help me.

The reality is so much has changed since I first became unwell and so much of that change has been negative. I lost my job due to my mental health admission, it was it seemed impossible for my employer to employ someone who had been in a psychiatric ward. I can still remember being let go and thinking how unfair and unjust it was, I knew I wasn’t well and I knew it might be a while before I could work full time again and yet I so wanted to keep my job. It gave me hope and a future and something to hold on to and strive for and then suddenly it was gone.

I lost my dignity the little that I held, the first time I was forcibly restrained and held against my will – it didn’t feel good, it felt disempowering and it hurt. Here I was a vulnerable person being treated like an animal to be caged, no one spoke to me they just seemed to shout orders. I felt like no one cared and no one understood.

Before I entered mental health services I knew nothing about mental health law, sections, forcible restraint, forced medication, deprivation of liberty or locked wards. I’d never had to live by the law of a hospital ward, those that dictate when you can and can’t have a drink and even then it’s from a machine. I learnt to tolerate powdered milk and powered tea from machines that gave patients lukewarm drinks, some days I use to beg for a hot drink like normal human beings have. I just wanted to be treated like a normal human being not some second or third class citizen.

image

Time off the ward was a luxury and one which once on a section had to be negotiated, pre planned and approved, suddenly I became adept at forward planning my entire life. That’s what being in a mental health hospital does for you, it makes you an automotive robot who is controlled by others rules and commands.

Before I entered the system, I didn’t realise how scarce talking therapies were, how things were time limited no matter if you were well or not. I can recall my first therapy was CBT and once I had the maximum number of sessions allowed, no matter how well I was it stopped. What a waste of public money to withdraw a service before it’s had the desired outcome, it’s a bit like taking a cast of a broken limb before it’s healed.

During my time in mental health services I learnt that good old saying that seemed to come from mental health nurses I encountered, “in five minutes” of course I soon leant that meant not now, go away. I often wondered why these people couldn’t be honest and tell me they were too busy.

I also learnt that people judge by appearances, so if you happen to look clean and tidy then they assume your mentally well and coping. Though of course that may not be the case, but they had their rule that tidy means well. The number of times I have been told but you look tidy and that equals well, I might not have showered in a month but because I didn’t smell they thought I was ok, they never asked they just assumed.

Just like they assumed if you challenged them or asked questions you were deemed aggressive and labeled as having violent tendencies. Of course it couldn’t be the case you were just asking a question or challenging archaic rules and regulations which made no sense to anyone but the hospital staff.

image

I soon learnt about labels too the ones which medical professionals use at will and stick on a person like some kind of post it note. The very first label I got was actually wrong, yet it’s still on my file for all to see. The doctor who gave it me had seen me for just a few minutes yet his skill was such he could diagnose so quickly and as it turned out so wrong!

Labels, judgements, assumptions all seem to be things I have learnt and in truth they are negatives I’d rather not have seen. I guess mental health services are an eye opener for those who suddenly find themselves thrown into this world of chaos and confusion.

Before I entered this system I wasn’t aware of so much disparity between mental and physical health existed. I also didn’t realise so many things about myself, I have faced many negatives and yes they have changed how I view the world and how it views me, but I have also learnt much too. Not just about the mental health system but about myself as well, I know now that I am a fighter, I want to learn to cope with dissociative Identity disorder and one day in the future I will get back to work. But it won’t be in the job I once did, oh no my aspirations have changed and I like to think for the better.

 

Copyright DID Dispatches 2014

Feelings and Therapy

image

 

It’s feels like an age since I blogged even though it’s less than a week, but so much seems to have happened. I haven’t had a busy week in fact it’s probably been a rather lazy one, I’ve tried to self care a great deal as I realised things were going array.

It’s really hard to juggle the demands and needs of life sometimes, recently I had attended a major sporting event here in the UK which took up a few days and entailed long journeys to and from Scotland. Don’t get me wrong I had a great time, but it was exhausting and it pushed me a great deal.

I wasn’t in the quiet countryside that I’m now used to, instead I was in a very busy cosmopolitan city which was extremely noisy. I was attending sports venues with large crowds and lots of activity and whilst I was enjoying myself, there were parts of me that clearly felt uncomfortable.

image

By the end of the event I came home and was literally exhausted, this didn’t set me up well for therapy and I arrived with feelings of anxiety overwhelming me. I had that overwhelming feeling and tearfulness that seems to be a part of me currently, this is really not normal before therapy so it bothered me a bit. I realised that in my excitement and busyness I hadn’t given much time to my alters and that was probably not helping how I felt.  Juggling is a skill you need as someone with D.I.D, it’s like trying to organise a family with competing demands, wants and needs. The only difference now is instead of an actual family made up of separate people, there is just one body and my internal family of parts.

In therapy we discussed the reality that I’m still trying to control my sessions and which of me is there and I’m still in denial, denial of them, of my emotions and of my pain. In order to help with this I was set homework and I was keen to try and do this exercise, I really invested a lot of hope in it and perhaps that was part of my downfall.

The following day when I attempted the piece of homework my psychologist had given me things didn’t go to plan, I’m not quite sure what I was expecting but it wasn’t what I got. I ended up confused and distressed and most of all I knew I had potentially damaged the relationship with my alters.

I’m not sure what I need to make me truly accept I have Dissociative Identity Disorder, that the alters are something that hold my memories. But at one point on Tuesday I felt like I needed a huge concrete wall to hit me full on in my face, and loud sirens shouting ‘wake up these are real’. I needed something to help me stop doubting, doubting what I know logically to be true and yet seem so set on trying to continually convince myself of the opposite.

image

On Tuesday and the days that have followed I have seriously thought I wasn’t ever going to cope with this, that I’d never be able to not doubt my reality. That I’d never be able to just accept who I am, me and my parts of me.

Worst of all I have seriously thought that therapy wasn’t going to work, I have thought that my psychologist wouldn’t want to work with me. You name it I have thought it this week, so much confusion, doubt and concern. It’s as if a part of me is trying to undermine my sessions, undermine the good that has gone before and yet I don’t fully understand why.

I have spent lots of efforts trying to rebuild the damage I caused with my alters, I am grateful that my teen and I have communicated using the ideomotor signals which we have found helpful. These do work and yet at times I still doubt them, which I think frustrates me as much as my teen part.

Yet now as therapy draws near once again I’m nervous and anxious, how silly is that – I mean I emailed my psychologist the other day and he has told me not to worry. But worry I do, I think partly because I have read and re read the email I sent him and I guess I was angry and exasperated when I wrote him. The language I used in my email was blunt, contained rude words and demonstrates I guess that I felt pretty frustrated when I wrote him. I don’t think I’d have sent that kind of email I mean it not how I normally write, but I know did, I can’t say it was an alter because I know it was my thoughts I wrote down and my feelings that jump from the words.

image

I guess for once in my life I have allowed my feelings to be shared, to be seen and that is unusual for me. Whenever before I have shown my feelings be that anger or hurt it’s tended to get me in trouble, at times big trouble. Medical professionals especially find emotions difficult, they see an act and they react, rather than think what caused the initial action. It’s led to some really complicated and difficult periods of conflict and of pain, reactions are not always patient led they are punitive and harsh.

Maybe that’s part of the reason I’m anxious about my session tomorrow, maybe I’m worried about any reaction to the outburst of emotions in my email. I doubt I will sleep tonight I’ll probably be replaying in my head all the possible consequences for that lapse in my rigid iron wall that shuts all my feelings deep within to prevent reactions. I know tomorrow is going to be a long day as I wait for my therapy session, I can’t even imagine what state I’ll be in by the time I get there. Hopefully at least I will get there and I won’t bail out of going, believe me that thought has crossed my mind once or twice already.

 

Copyright DID Dispatches 2014

 

Self harm and the attitudes of medical professionals

Self harm and the attitudes of medical professionals

 

self harm

This week I heard from a friend who had to attend her local hospital to receive treatment as a result of self harm and her treatment was unfortunately not very helpful. This led me to thinking about the times I either attended A & E or was taken there by the police for treatment, usually as a result of self harming or being deemed mentally unwell and requiring treatment.

It is nearly ten years since my first ever hospital admission, but for many months before I had hidden the self harm that was taking place. I tried hard to wear long sleeves to hide the cuts and dressings which I needed to stem bleeding etc. I was determined not to require anyone to know that I felt so desperate and confused that I could only survive by self harming. This was in the form of cuts, burns, starvation, restricting my fluid intake or overdoses, by the time I was admitted to hospital my self harm was a daily occurrence such was the turmoil I found myself in.

I hid my self harm from medical professionals, my family and my friends no one but me; I thought, knew I was living this life. I can recall going out for days with the children carrying implements in my bag ready to harm, and hibernating in bathrooms and cutting during these days out. I would feel myself getting so distressed during the day that I couldn’t survive any longer and so self harm took place. Yet once it was done and I felt a wave of release that I had punished myself which I felt I deserved I could then calmly walk back out and carry on with life.

I was confused to such an extent that I believed I needed to punish myself because that way I would be safe from others hurting me, and I was terrified that past abusers would come and hunt me down and hurt me. I even had a notion that because one of my abusers was my mother that I was bad as I had her blood inside me, thus if I bled enough I would rid myself of her badness.

Now all this time no one knew how much I was struggling, the GP knew I wasn’t too great but all they kept saying was ‘take time out and relax more’, and ‘all women go through these phases’.
They never asked if I felt suicidal or what scale my mood was, they did eventually arrange for me to see a doctor and thereafter just told me I was on a waiting list to see a psychiatrist. Yet in the meantime I was continually told to ‘hang in there’, occasionally they’d tell me things would improve.

Of course things just kept getting worse and when I attended the GP one day and I saw a different doctor who asked to test my blood pressure; because I looked like I was going to faint, he saw the wounds that by now littered my arms. Recent cuts had been deeper and the blood loss alongside starving myself wasn’t helping me feel any better. It was then that he made the call and I was suddenly being sent to the local psychiatric unit for assessment. At this time I realised my eldest child had sensed something was wrong and had suspected I was self injuring, but we had both said nothing until I was en-route to the unit.

image

A & E staff from the start were slightly arrogant and mainly uncaring, if I had to attend as a result of cutting I lost count of the times I felt to blame by their attitude towards me. It was as if they weren’t best pleased to be treating me after all in their eyes I had self inflicted this injury upon myself, they never looked beyond the injury to the person. On only one occasion can I recall a doctor being helpful, he was actually concerned for me wanting to know why I hurt and was I getting help for my mental health. He treated me like a human being and not an attention seeking time waster which is what many other medical professionals seemed to treat me as.

The sad fact is the attitudes that I faced ten years ago still exist today, that means the medical profession has failed to learn about or understand self harming behaviours in a decade. That concerns me because I am aware of the efforts of so many different groups including government health organisations whose aim was to educate about self harm and improve outcomes for patients. A decade ago these organisation were trying to produce guidance to end the stigma that exists around those who self harm, if attitudes haven’t changed does that mean their efforts failed?

Self harm is not something we should ignore or take for granted for behind every scar, every injury there is human suffering. I didn’t harm for the fun of it and if I wanted to seek attention believe me I can think of lots of better ways of doing that. I wasn’t time wasting either, I was in acute emotional distress and I needed help. I couldn’t explain the anguish I was going through, the only way I could find to deal with the turmoil that was my life was to inflict injuries upon my own body.

Be that cutting, burning, overdosing or restricting the amount of food or fluids I took in, each act was either an attempt to deal with intense pain and turmoil, or the result of irrational thoughts. I wasn’t doing this because I enjoyed it, truth be known I hated myself for doing it, in fact I loathed my scars. The reality was I tried so desperately to avoid seeking medical attention as the last place I wanted to go to was A & E where I would be made to feel even more ashamed and be stigmatised.

Self harm controlled me a decade ago and at times of crisis it can still take control of my life today, it is sadly my default position when the pain is too much. Now when I lapse back into self harming I tend to injure in other ways in the hope it’s less visual, but it’s still harming all the same. Now I am not proud of the fact I self harm and I don’t want these feelings either, I would like to be free of self harm and yet I now understand it is a symptom of the life I lived as a child. A life which caused untold damage and will take a long time to deal with and heal from, my self harming is a symptom of my mental health not the cause.

The cause is my past and today I am having to face the harsh reality that I was betrayed, abused and psychologically damaged. Currently I am feeling emotions for the first time and I am starting to grieve over the fact I was hurt, I’m starting to come to terms with the dawning realisation that the horrific memories I hold and continue to recall don’t belong to my alters at all. They just carry my memories, and it was this body, it was me as a child and a teenager who the abusers defiled. Believe me that’s tough, it’s a harsh journey survivors walk there is a lot of pain and anguish that has to be processed and dealt with.

Perhaps when dealing with a person who is self harming instead of vilifying them and judging them medical professionals should remember to gently seek out the cause of this symptom. They should in my opinion treat those who self harm with the dignity, care and respect they so badly need, and they should afford them the right treatment to help them move forwards.

Copyright DID Dispatches 2014

 

 

 

Accepting my alters, facing upto the past.

 

image

This past weekend I had the privilege of attending a conference on trauma and dissociation, it was an interesting event and very informative. As I sat listening to one of the speakers they said something which led me to think about myself, my past and my alters which I thought I would share.

When I was diagnosed with Dissociative Identity Disorder initially I felt very perplexed, in truth it didn’t seem real, this diagnosis though it seemed right somehow sat uncomfortably with myself. It was I believe the fact that the lead up to diagnosis was chaotic and at times frustrating, people would tell me for example that I had done this or that and I knew very well that I hadn’t. I thought at the time everyone else was making these things up and suddenly I was faced with the dawning realisation that in truth it was me that had been wrong. Some part of me had been angry, some part of me had been drawing like a child, some part of me had skipped as we fed the ducks, I could no longer deny this reality that I was a person fragmented and with various parts, parts whose existence I had no idea of.

Following my diagnosis I called my parts names, I felt of them as separate beings because in all truth they do have their own thoughts, feelings and ways of perceiving the world. Therapy in the early years seemed to allow me to place the horrific memories of the past which had been unveiling themselves to me for a while by this point, on the alters, these memories belonged to them and certainly not to me, Carol.

As a multiple fragmented person, I was someone who had dissociated since a small child in order to avoid the pain and suffering inflicted upon us, the alters held and in many cases still hold that pain and those memories. It was therefore easier for me to allow there to be a very distinct separation between myself and the alters, it allowed me not to face the harsh reality that these dreadful memories belong to me. This denial allowed us a chance to live this rather chaotic life existing with D.I.D, losing time, switching uncontrollably and with a huge brick wall between me and my past. Of course I had no real control over this amnesiac barrier or the losing of time, chaos and switching which were and still are part of my everyday life.

Denying the memories as my own, allowed me the space to function at least in part and to not fall apart into an even deeper crisis. I convinced myself that whilst I knew logically the alters were a part of me the painful past was theirs to carry and not mine. Denial worked at protecting me from the heavy burden of the truth, the truth of my childhood.

 

image

Over the last few months through the work in my psychology sessions I have stopped being so blinkered and I now accept that the alters are parts of me, yes we all have our own feelings, thoughts etc but in truth we are a fragmented, dissociated person who has one body with lots of different parts. The alters well they carry my memories not theirs, yes they endured the pain and the suffering whilst I dissociated but in truth it was this body of mine which suffered those terrible things.

Today I now know that I dissociated multiple times as a child and that at these times other parts of me were created to hold the memories of that time for me. The other parts of me, my alters have taken the burden for years of holding those memories away from my conscious being in order that I could function. Function that was until my melt down over a decade ago when the amnesiac barrier began to break and those memories that have so far leaked through became part of my reality. Yet denial still allowed me to cushion myself in a way by thinking the memories were the alters, I knew logically they were mine but I wouldn’t accept that fully.

Now I can hear the sceptics amongst the readers of this blog saying, how do I know these memories are true. Well it would quite simply be impossible to make up the things I have recalled, and the way these memories have revealed themselves is a clear indication they are true. All my life I knew I had a volatile childhood, my home life was not stable in fact it was violent and chaotic.
I suffered psychological abuse from a very young age, and some physical abuse too and I, Carol had carried those memories in to my present, but it was the worst of the trauma which I had dissociated from. I have Dissociative Identity Disorder and that isn’t a myth but fact, fact that is backed up by a wealth of professional expertise and significant research and medical knowledge. If people wish to be sceptical about D.I.D then that is their choice to hold that opinion, all I ask is that they allow me and the many others diagnosed with Dissociative Identity Disorder the right to hold our opinions.

Of course for me now I face the hardest tasks of all, 1, trying to communicate with and have some understanding of the other parts of me, 2, breaking down that amnesiac barrier one brick at a time and 3, accepting that the memories which have been locked away for so long are in fact mine.

These are no easy tasks, I have to learn to co-operate with my alters, I have to try and find ways to be able to control at least in part the switching and loss of time. I have to work hard to internally communicate with the other parts of me, and believe me this is both tiring and time consuming, it is ongoing and a part of each and every waking moment. There will be a need to allow the amnesiac barrier to be broken in order that the alters, my other parts can share with me the past they carry. Yet most of all I need to be able to deal with the pain of that past, the memories which for so long I have been protected from. I will have to face each painful memory one by one, deal with the pain it brings and that isn’t just physically pain but emotional pain too. I have to find ways to live in the knowledge that this body in its younger days was defiled, betrayed, mistreated beyond words and in many cases by people who should have cared for me an innocent child.

Accepting my alters are parts of me has so far not been easy, it’s taken me over 5 years post diagnosis to get this far. Now I face the hardest part accepting the pain and the past, I know this journey won’t be easy but that I am supported by a loving family, and have the help of dedicated professionals who will guide us on this path. I’m hoping I can conquer the denial which is such an intrinsic part of dissociation and find myself stronger, wiser and more capable from facing up to the past, my painful past.

image

Copyright DID Dispatches 2014