The Day I Had To Say Goodbye To My Family

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 I can remember so well the day, it started like any other day in hospital I had woken after a night of poor sleep in my small clinical room. A room that contained just a bed and a wardrobe, and a crate of art things and personal possessions. I listened to my radio as usual, this had become part of my daily routine as a long term hospital patient. I was called to get my medication that morning and despite speaking to a number of staff, no one said this was to be my last day close to home.

My room was at the far end of a corridor and I recall walking up into the main ward many times that day. Talk on the ward between the patients was about Christmas, who was likely to get home and which of us would have to stay. I knew I was going nowhere, I’d be staying in hospital after all my Section 3 had only been in place a short while, but everyone including me believed I’d be close to my family.

The staff didn’t give any glue to the changes that were about to happen, in fact they talked as if I would be there over the festive period. Looking back now no one from the hospital team was honest to me, no one told me I was about to face turmoil, chaos and changes I couldn’t imagine. Perhaps they were worried about how I would react, yet in truth the surprise element only made things worse for me and my family.

I was aware that the doctors had spoken about moving me but no final decision had been taken or so I was led to believe. They had kept saying a move to a trauma centre would be a safe way to deal with trauma work and would be faster than doing it as an out patient. I had no clear understanding of the type of place they were thinking of, nor do I believe had my family. I do know we were assured of lots of things, none of which turned out to be true.

Looking back I’m not even sure that the staff making the decisions knew about secure services, nor did they really understand the nature of the place they were thinking of sending me. A private institution that supposedly could cater for people with a trauma history, that focused upon the control and restrictions it could place upon patients rather than relational security. Intensive trauma work should have meant numerous therapy sessions each week, with a raft of other groups and activities designed to aid recovery. That was the kind of care I was told I needed but it wasn’t how this place operated,  though given it was 200 plus miles away how could those tasked with making a decision really know.

That day progressed like many before it, medication, meals and some Occupational Therapy too, speaking to the staff was limited as they hid as usual behind the office door, failing to interact with the patients. In the late afternoon I recall the doctor visited briefly, I was huddled into a small room to be told the news.

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In that moment life changed the staff informed me that I was being relocated, relocated from an open unlocked NHS ward to a forensic medium secure privately run facility, not a specialist trauma centre.  I can recall it wasn’t a great conversation, it lacked much clarity or detail there were just simple facts. My family who had been informed with as limited a time as possible would visit that evening, I would leave at the crack of dawn the next day and a nurse would travel with me. I had no rights to challenge or question this decision and I certainly couldn’t say no to their plans to transfer me.

I felt bewildered, frightened and confused beyond words, I had so many questions so much fear and yet they told me it was the best place for me. I recall feeling as if the hospital managers just wanted to rid themselves of me, that they really didn’t care about what was best for me or my family. Looking back my views haven’t changed, the move was based purely on financial reasons this certainly wasn’t a clinical decision, not was it based upon risk. I had no criminal history, had only absconded; whilst detained under the Mental Health Act, once and was willing to work at trauma therapy.

When I ask my family about their recollections, the one issue that they recall is the limited amount of notice they were given. My daughter who was my nearest relative was informed late afternoon too, she and her Dad then tasked with trying to organise a visit that included my two sons. My ex spoke with me on the phone, he was concerned with what was happening and he was frustrated at the lack of understanding by hospital staff. He had wanted to take me out for tea, one last family meal before the move and yet the hospital managers wouldn’t allow it. I was being observed and monitored perhaps they thought things wouldn’t be too stable in my last few hours on their ward.

That family meal didn’t happen in the way he or the children had hoped, but defying hospital rules he and the children arrived laden with McDonalds take out. We would have a family meal even if it was different, we would have time as a family one last time, they would say goodbye properly.

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Food wasn’t allowed on the ward, so the staff ushered us into a side room, squashed in this tiny room we had our meal. We enjoyed hugs and a few tears, my sons and daughter gave me something to remind me of them. A photo was one memento I had to have, alongside a number of small hastily grabbed trinkets from home that the children felt signified them. One son gave me a toy model of a dragon, he was really interested in them at the time and there was also a soft cute little monkey that really summed my youngest. Each gift was treasured as I knew that the children had thought carefully about them and they didn’t want me to forget them.

They also brought a small case for me to pack some things in and they took home all my art things as I had been advised these wouldn’t be allowed in my new hospital.  My daughter was allowed into my hospital room for a few minutes to help me pack, it gave us time to briefly talk away from her brothers. As the oldest I needed her to lookout for them and more than ever act as a surrogate mum, I knew I wouldn’t be able to do that for a while.

There was lots of reassurance on both sides, the children promising to visit and write and call. I promised to keep in touch and think of them every day and I really wanted them to know that I would miss them. By the time it came to say goodbye there were tears, lots of them, because despite my mental health issues, despite my past, despite me at times wanting to die, we are a really close family. This move would impact all of us for many years to come, I wonder if the hospital managers realised how much grief and pain, how much stress and worry their decision to relocate me caused. I very much doubt it.

Looking back at that time in my life still hurts, I will forever remember the nightmare journey of those years, the nightmare of secure services. The nightmare of being uprooted and taken from my family, and the anguish I felt not just then but in the years that followed.

Seven years on despite it still hurting, I need to focus not on the past but on the future and to remember the positives that came from that time, for out of the darkest of times came hope. My family and I realised if we ever needed to the value of family, the bond we all share and the separation well it strengthened us all to cherish one another. We have grown together not apart because of that time, and I know my children truly love me despite everything and they know I love them more than words could ever say. I guess facing what we did means today we can be assured that no matter what we will always be there for each other.

Copyright DID Dispatches 2014

Hospital Restraint procedures – a survivors perspective

Trigger warning : some people may find the contents of this post distressing.

Yesterday during a meeting I was asked questions about my time in hospital, one question though was really tough and related to my being restrained. It’s so hard for me to describe in detail my experiences of constant observations and restraint procedures, these are the most difficult of experiences that I have ever encountered in hospital and they stir emotions and feelings deep within.

Being manhandled by other human beings who weald control and hold all the power is impossible to forget, in fact it’s hard to not feel the panic that I felt at the time of those events all over again. Watching others being restraint was scary enough but then when it happens to you it seems so unreal and yet so terrifying. I know that at times I dissociated during these episodes such was the triggering element they contained. I thought it might be helpful to write about the impact of those days so others might understand what it’s like.

It’s hard to choose which incidents to write about but I have chosen two incidents as they reflect I think the many other such times I was forcibly restrained by the so called caring profession.

Having been returned to the unlocked acute ward following an attempt to leave the unit I was manhandled by the police officers from their vehicle to the ward. Nursing staff took over the responsibility of me and a posse of nursing staff grabbed hold of me, in an agitated state I was placed in the locked high dependency area of that ward. I hadn’t threatened anyone indeed I hadn’t done more than choose to leave the hospital environment which had been my home for some weeks. Once behind closed doors the staff laid me on the black solid seating face down and then let go, I immediately began to pace up and down and I did keep telling them I wanted to leave. 2 rather burly nursing staff began the task of looking after and observing me and one kept barking orders at me to sit down and stop pacing. A senior nurse came back into the room holding a medication pot and told me to take these as he moved the meds pot towards me. I refused saying I wanted to leave and I didn’t want their medication it would only dope me up. He told me there wasn’t a choice but at this time I wasn’t sectioned and so I felt he couldn’t make me take anything, how wrong was I. After a few minutes he left still holding the meds I had refused, and I continued pacing.

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What happened next startled and frightened me, it happened at such a speed I had no control and no indication it was coming. Suddenly a number of staff appeared in this small area and pounced, I was forced to the floor and held face down. It felt like I couldn’t breathe, hands seemed to be everywhere and they were hurting me. Not being able to breathe is absolutely terrifying, no matter how hard you try it’s impossible to move your head to catch a breath and I honestly thought I would die. I felt someone pulling down my clothing and then as I fought and fought and they grabbed and pulled and hurt I felt a stabbing pain. Whatever they gave me I’m not sure, but I know they injected me with some kind of drug and it’s aim I guess was to calm me down. I had been agitated before this happened but now I felt even more agitation and I had been triggered too. I am a victim of abuse and being hurt in this manner by staff some of whom I didn’t know was too much to bare for parts of me. A whole cacophony of emotions raced through me and thoughts of are they going to rape me filled my head. I had no control, no rights, no one listened to my cries for help or to stop, they just carried on doing what they did whilst talking to each other. They continued to hold me on the ground for sometime though they turned my face to the side their hands still held me as if in a vice. After a while they lifted me up to my feet my arms still held tight, they manoeuvred me to the seating bench and laid me down. Barking orders about staying still and behaving they released their grip on me, laying there I felt drugged and confused. Most of all I was terrified, my arms felt heavy and sore, my legs were hurting and my head too, my trousers were still not fully pulled up and yet I dare not move to do this.

These were nursing staff who were meant to be looking after me, instead they bullied and terrified me. I no longer trusted them or had any faith in their abilities I had been degraded and treated and manhandled like a piece of meat. In a police station this would be classed as overly forceful in a locked hospital room it’s called acceptable and necessary, police stations have camera to record conduct of officers – hospitals don’t.

If staff had allowed me to talk, to express why I was agitated, to understand my feelings,  the reasons behind those feelings and behaviours then they wouldn’t have needed to restrain me.  If they’d been more observant they’d have seen my distress earlier in the day and supported me more appropriately so I wouldn’t have left the ward in the first place.

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On one of my nights in secure services I became upset, I was on constant observations and a male staff member sat a few feet from my bed. I didn’t want to be on constant observation, I couldn’t understand why this was needed I hadn’t harmed or shown any signs I might do so. Having a male sat in my room so close to my bed was terrifying in it’s own right, I stated I was unhappy and I said I wanted him to leave. The situation escalated as he became frustrated and moved his chair nearer to me and I became more and more distressed. In sheer frustration I began banging my head against the wall, other staff including some males appeared demanding to know what was going on. I tried to be calm to say I wanted to stop being watched, to say I didn’t feel safe with a male, but my rational pleas for understanding fell in deaf ears. Once again I began hitting my head but by now there were a number of staff and 1 of me, they pounced and grabbed me. Holding my head forward from the wall and pushing it down towards my chest, others held my arms and others my legs. I screamed and pleaded with them as they hurt and yet they didn’t care, I recall one of them shouting at me as if barking orders. Stop fighting, stop screaming, stop…..stop…

A doctor arrived yet another male and began asking me questions, by now I wasn’t struggling I was compliant. Still held down I talked to this doctor and cried buckets, I felt so afraid I hated this place and I hated me. The doctor said I was going to take extra meds one way or another and I knew by now what that meant, I swallowed the pills or they’d forcible inject them into me. I guess I was learning because I agreed in fact I think I begged to be allowed to swallow his pills, I promised I wouldn’t mess about and I’d behave. That night I lay in bed with staff either side of my bed, my arms had to be visible as did my neck. I lay in this quiet room vulnerable and scared and terrified yet again I’d be hurt and no one but no one would know.

If staff had helped me to understand their observation policy, taken account of and respected my fears about a man so close to my bed I wouldn’t have got frustrated and hurt in the first place. It could have been prevented but the staff approach wasn’t to prevent such incidents but to forcible deal with them.

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These two experiences demonstrate the full horrors of being restrained by nursing staff on a mental health ward, at no time had I ever attacked or hurt staff and at no time have I ever been charged with any criminal offences. Yet I feel being restrained was a punishment and a gross abuse of power. I do understand that if a patient is unable to be calmed down or reasoned with in a safe manner the staff need to have a solution, but it shouldn’t be restraint in this way. It’s often used too quickly, too often and inappropriately. Things need to change, because right now patients are being held down, forcible medicated and hurt all under the guise of providing care.

I know on both of these occurrences there were other things that could have been done to help me, namely asking me how I felt, why I felt that way and listening to my fears, concerns and taking them seriously. Instead staff chose the heavy handed option I don’t understand why.

As I have said I was restrained on a number of occasions and I don’t believe it ever got any easier, the harsh reality is that fear grips you each and every time whether that be the first or the tenth occurrence. For anyone restraint procedures are terrifying but I truly believe for those who have suffered trauma or have complex dissociative disorders it is even harder to endure.

copyright DID Dispatches 2014

 

 

Them and Us – The battle lines of Mental Health

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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.

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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

Living with the Reality of Dissociative Identity Disorder -book release

 

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This week saw the launch of a book that has been in the making for a couple of years, and it’s a delight to finally see Living with the Reality of Dissociative Identity Disorder – Campaigning Voices published. The book edited by Lady Xenia Bowlby and Deborah Briggs is a compilation of individual chapters written by people who are impacted by Dissociative Identity Disorder.

Back in 2010 I saw an article about a campaign day for those survivors and supporters with D.I.D, they were asking if people wanted to speak. I’m not quite sure how it happened but before I realised I had volunteered to get involved. It was a decision that meant in March 2011 I stood before a room full of people and spoke about my life ‘Living with D.I.D’,  I say I but in reality it was a part of me who stood there.

I have an alter named Caitlyn who is the part of me that is super confident at public speaking and is a good trainer. She stood in this room and she presented our story, I think she had decided the best way to explain our story at that time was to use a multi media presentation. Mainly I think because she wanted it to be her work, to be right and we only a short time slot and well our story is quite complicated .

That day was a success and I can recall traveling back home from London with the two people who had supported me on that day feeling it had gone ok. A few months later I was asked if I’d be willing to write a few thousand words on my presentation for a book, a part of me said yes. That book has been 3 years in the making and thanks to the dedication of lots of people and Karnac books is now complete.

A part of me wrote my chapter over a weekend as I sat in a hotel room a few miles from where I now live I knew I couldn’t write this as the presentation we had given wasn’t my work but Caitlyn’s ‘
Whilst Caitlyn is a part of me I had at that time very limited awareness of her, we didn’t have and still don’t internally communicate fully though I try now but it’s still very one sided.

Once that weekend was over in 2011 I kind of put it to one side, I couldn’t tell you what I’d written or how it flowed as it wasn’t me that wrote it. I’d made that very clear in my chapter as it only felt right to give the credit to Caitlyn who I now know slogged away until it felt right. So this week when I received the call to say the book had finally being released I was excited, after all it’s not everyday something like this happens.

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Book available from.  http://www.karnacbooks.com/Product.asp?PID=35245

Imagine my surprise when I went online and saw a few pages from the book as part of a preview, as I read I realised Caitlyn knew more about my internal system of parts then I did. She clearly knows more about me and the life I have had than I can recall, and yet I know so little about her. It’s clear she is far more confident, professional and organised than the majority of me and she is blunt and honest at the same time.

My children tell me that when I or rather Caitlyn was writing essays for my degree she would complain to anyone who interrupted. Apparently she even hung up the phone on them if they disturbed her mid flow and she’s a burner of the midnight oil if she has a task to complete. Be that the chapter for this book, my essays or training presentations. Of course Caitlyn is a part of me, one of many alters and yet she is a fragmentation of this whole person people know as Carol. I’m quite pleased I have a part of me who is good at public speaking and good at writing in this way, it’s a talent and a skill I often lacked as a schoolgirl.

When the book arrived on my doorstep I read the whole of my chapter and yes it was strange to see Caitlyn’s words, I recall some of the events she talks of and yet there are things here and there that I read and think and I wonder was she really writing about me. Though I know of course she was and that the chapter is all about me, all about my life and my past. Its hard to read back about my past, especially seeing her call my mom our other biological parent, it kind of hits home I didn’t have a mom. I know that deep down but denial likes to rear it’s ugly head here and there.

Reading about my time as a child, my time in hospital and the times when my Dad clearly helped me deal with the symptoms of my dissociating from the perspective of another part of me hasn’t been easy. Yet I can say that since this chapter was written 3 years ago I have made strides towards progress. Progress comes in many guises and for me three things stand out. 1. I now manage and employ with help – my own PA’s/ support staff so am free of the retrainsts of a care company which I find is far better, 2. I’ve started having internal dialogue and some side by side working with some of my parts and 3. I’m now with a psychologist who is helping me to learn more about me, all of me. These things are signs of real effective progress, signs that I’m learning to live with D.I.D, most of all I’m learning I am one person with many parts and I can learn to like all of me.

I’m grateful to have been involved in such a great project like this book, it’s a brilliant legacy to the campaign and a huge asset for those working in the field of Dissociation. I’m certain it will be an invaluable tool for many professionals, survivors and supporters and I hope it remains such for many years to come.

I’m pleased I know so many of the contributors for this book, from the art of Kim Noble to the wise words of Ruth Cureton, Deborah Briggs and Oriel Winslow alongside many others. It shows me that the way society treats those with Dissociative Disorders is changing, by working together we can ensure that everyone including myself has a brighter future and a hope for better things to come despite Living with the Reality of Dissociative Identity Disorder.

Copyright DID Dispatches 2014

Please note I have not been asked to write this blog by anyone associated with the book nor do I financially benefit from any sales of this book. 

How mental health services need to change

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My message to those in Power 

I’m often told to look how far I have come, how much progress I have made and I take that advice on board, but sometimes it is good to reflect and look back at what were my darkest times. I so want lessons to be learnt by those in authority, to ensure that no else ends up in the mess I was in. One of my biggest fears is that healthcare professionals will still misunderstand people in crisis and end up placing those people under further mental stress and strain.

When I look back at the various times I spent in psychiatric hospitals I can see some glaring issues that need addressing and then I wonder how I can get the healthcare professionals to listen. I think mental health services are often treated shabbily and funding is a huge issue, yet somehow the system seems to make the same mistakes time and time again.

The reality is of course that the powers that be who are in charge of our mental health services, the people who commission services, see one thing, funding! I know this only too well as every six months my Clinical Commissioning Group meet to discuss and review my own case. My care co-ordinator has to face the funding panel at least once a year to explain and justify why my therapy and support package should continue. I have learnt over time that it’s all about money, not about me and I’ve stopped stressing as much as I use to about these meetings.

The issues that I feel need addressing are simple and yet cost effective, I believe if you treat a patient right the first time you would reduce costs. If ten years ago I had been correctly diagnosed and treated appropriately, I wouldn’t have spent years in hospital thus saving thousands of pounds.
Instead I’d have received appropriate care in the community, psychological input that was appropriate and works, and I would be much further along my journey of recovery.

Instead of course like many people I was placed in a hospital, misdiagnosed and misunderstood, treated as if I was the problem and had no idea about my own issues. I was left to wander aimlessly through the revolving door of mental health and medicated to a point that left me hardly knowing what day it was anymore. I wasn’t entitled to an opinion about myself or my treatment and no one, but no one asked me how I really felt. I was made to feel guilty for self harming and like most patients ignored by staff on a frequent basis, who seemed so isolated and shut off from the patients in their care.

As I journeyed along I moved from hospital to hospital, I’ve seen sights I’d rather never have seen sights that to this day fill me with fear and sadness. I will never forget the women I met on one ward who was in so much distress she screamed day and night, the staff would yell at her to shut up, some patients would join in and there would be a chorus of people yelling at this lady in obvious distress.

She shared my name and I felt sorry for her, she was someone’s daughter and she was treated shabbily and without care. She needed appropriate support, most probably one to one care and someone to ask her why she was in so much distress who would actually listen to her answers.
All I ever saw was staff shouting at her and them giving lots of medication to her, anything and everything was about shutting her up.

Nor will I forget the patient who in secure services had her arm broken by another patient or the one who when she acted out her emotions was punished, placed in isolation and deprived of her belongings. I won’t forget the way I was made to feel either, the fear that gripped me when I was held inappropriately in secure services and told I had no rights. The way I was watched by staff; especially on close observations and treated that will never leave me.

Now I know the mental health system is not always like this, I’m certain some healthcare professionals care about their patients and treat like them like human beings with dignity and value. I have seen systems that work, for amongst all the darkness were glimmers of hope and examples of good practise and this is what we need to ensure is in every hospital and Community service.

The involvement of service user peer representatives on wards so patients views are paramount, open desk systems instead of closed offices enabling staff and patients to work collaboratively. In one hospital patients were allowed to read and add to their daily nursing notes it meant staff interacted with patients and patients views counted.

Access to talking therapies much sooner than is often the case currently is another essential, and more access to better equipped crisis support would help reduce admissions and ease peoples suffering too. Better community services are certainly invaluable and a less medicalised model of care.

Research shows that delivering appropriate psychological input reduces costs, more importantly it improves people’s lives and that’s what matters the most. My own case is proof that savings could have been made if I had been treated appropriately and not misdiagnosed, my treatment today is still saving costs as it’s cheaper than any admission. More importantly I’m much better with the right treatment and I’m regaining my life, a measure that is priceless.

I truly hope I get the opportunity one day to influence the powers that be so they change how they deal with mental health services. They need to understand how their underfunding causes pain and damage to so many lives, most of all it waste more of the valuable resources they are entrusted with.

Hospital managers need to address how they engage with service users and include them in the decisions regarding their care. I guarantee improving this would benefit their staff as well. They need to address how they run community services in order to provide a better quality of care. Finally they all need to stop sending people to inappropriate units run by the private sector which don’t have the patients interests at heart just their share holders.

 

copyright DID Dispatches 2014

Reflecting Upon Why I Value My Therapy

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Yesterday for the first time I realised just how much I value my therapy, how it is important to me on a level I have never really fully understood before. Now I have had a number of different talking therapy interventions since I first entered into this world of mental health services and many of them have had limited benefit.

Back in 2004 I saw a psychotherapist briefly and they talked to me about my self harming, but they never asked me why I did it, they just kept telling me it was a coping mechanism. They seemed to think I should just stop harming and use alternative thought processes. They implied my thinking was skewed and needed to be corrected, but we never discussed the reasons why I felt so desperate.

A few months later I was referred to a psychologist who saw me for just a short while too, she and I seemed to get along ok and her technique was a mix of CBT and DBT. I believe she was one of the few people who I felt could help me and we were talking about my family and my childhood in basic terms at least. It was upsetting when she told me she was emigrating and someone new would be taking over my case. I had just starting to open up about my family and even though looking back she didn’t fully understand me, she was someone I trusted. If she had stayed maybe I would have made progress at that time, but whilst hindsight is great I can never really be sure it would have worked out.

The person who followed next was to be fair rather awful, I’m sure she was a nice person, dedicated to her job yet she used CBT and I really didn’t need CBT, my thought processes whilst skewed were not the cause of my dissociating. We saw each other for a year during which time I was an inpatient for significant periods. I can recall seeing her and being so much worse after our sessions, she didn’t get me and I ended up dreading every session. My family were relieved when the sessions ended because they realised it wasn’t working, in fact it probably made me worse. Yet when there was this void I felt abandoned and desperate, I just wanted to get better, I wanted someone to help me get better. I didn’t want a magic wand and an instant cure I wanted to be helped, guided and enabled to weave my way through the cacophony of emotions that overwhelmed me and the awful memories I was having.

There was a bit of a break less than six months when I saw no one and then I was referred to a new psychotherapist, I felt we were building up a relationship and I began to trust her. It was only a few months later when suddenly it seemed my memories, my issues were too much for her. Suddenly sessions were stunted and I couldn’t discuss certain issues from my past, it wasn’t about my safety or containment it was about her safety and the fact I was complicated. She went on planned leave and never came back, it was apparently because she wasn’t skilled enough to deal with someone like me. There was no closure work, no goodbyes just a void again.

When I entered secure services shortly afterwards I again had to see a therapist, this person held much power and she was my fifth therapist in 3 years. I can recall being made to feel on edge, she wanted me and all her patients to trust her so much we depended upon her. I couldn’t depend upon anyone at this point, my trust; the little I had, was long gone. This person would take note of my emotions, whether I was angry or upset and she would relay this back to the clinical team who then would make decisions imposing sanctions if they thought I was angry. I lost the right to have my bathroom unlocked because she felt I was angry, this meant I had to be observed once again whenever I used the bathroom. There were many other sanctions that never made sense, usually imposed because she felt I was not showing enough emotion, or refusing to divulge the detail she wanted.

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I can recall it wound her up because I wouldn’t become dependent upon her, I even said I wasn’t going to her sessions at one point. Yet in secure services you don’t have such luxuries as choice, I was forced to attend and the staff stood the other side of the door, so if I tried to leave they could make me return. When I refused to speak to her or answer her questions because it felt like there would be sanctions whatever emotion I portrayed, I was sanctioned for my silence.

In this place I’d lose access to the outside world namely the hospital grounds which at this point were my outside world, or they’d take away some of my possessions. Impose observation levels which were intrusive and bullying and they called this therapy and care. She wondered why I didn’t want to work with her and why I felt averse to trusting a person who I only ever saw as wielding huge power. I saw her for the whole time I was in secure services, I guess I learnt to comply because it was just easier, though I never trusted her. She was the first person to suggest I had Dissociative Identity Disorder and for that I will always be grateful, so many others had misdiagnosed me. But her therapy style wasn’t right for me and it was a relief when I eventually left secure services and her behind.

Then I had yet another psychotherapist someone who I believe was able at first to help, but her skill base though good wasn’t sufficient to deal with someone who had lived my life. She understood D.I.D yet she didn’t seem to understand my thinking processes and this was an issue, I firmly believe we made some progress and yet in the end the relationship disintegrated and fell apart. Yes I was inpatient and I wanted progress and I felt after 4 years there should have been more. I also believe now that I needed more stabilisation work back then before we entered into trauma memories and that didn’t happen, by the time it was suggested 3 years in we were too afraid to stop the trauma work.

So when I started seeing my current psychologist I was anxious, unsure and yet I also knew I wanted to make it work. My psychologist who is an expert in trauma and dissociation was very clear from the start that things won’t always be plain sailing, there will be times when I feel angry and annoyed at him, times when we don’t get along but that together we could always work out those difficulties. It was about having the trust to talk to each other and work as a partnership in this therapeutic journey.

It’s early days I guess but more than six months on and I can see a difference in me, in my understanding of my alters, of me and of D.I.D. What’s been different so far has been a total openness in how therapy works, this is a partnership where he helps me and I then go off and do the work for the rest of the week. I am still finding it hard to let my emotions flow freely, to show anger and distress, but unlike previous therapeutic relationships I have been able to tell him about those difficulties. He is able to be honest with me and I respect his opinion and his expertise, I value his input and his ability to understand me better than I understand myself.

The main difference though is I think that I truly value my therapy, because it’s making a difference in my day to day life. I feel enabled and empowered in a way I never have before, learning to accept my alters, accept they are parts of me as been a key element. Learning it’s ok to have fun, to try even if I don’t succeed, that I’m not stupid or a failure and it’s ok to have internal dialogue even if it’s one sided.

I’m learning that healing is painful, that I have to grieve to heal and that it’s ok to admit that having D.I.D is never easy, that some days are tougher than others. In the past 6 months I’ve also learnt I’m inpatient, self critical and I judge myself harshly, but that these things are a response to my childhood. I will learn to be less hard on myself one day, I am already learning to challenge self criticism and I see when I’m judging myself.

All of these things and the fact I am an equal partner in my therapy are the reasons why I value this therapeutic relationship. I can see that overtime we will make further progress and learn more about ourselves. I don’t want to jeopardise this therapy, I want it to keep working, to keep helping me move forwards, I know I can learn so much more about myself and deal with the past slowly and at the right time. I was never sure I could deal with the past, deal with my emotions but now I believe just maybe we can, yes on a bad day I think I will never be able to cope living with D.I.D but on the good days I realise I have a future. Therapy plays an integral role in achieving that future and that’s why it’s so important to me, why I value it so much.

 

Copyright DID Dispatches 2014

 

The Life Sentence of Being Sectioned

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The other day I read a comment on social media which asked approved mental health professionals to think before they section someone in order to get them a hospital bed. It was stated that being detained under the Mental Health Act remains on a persons file for life, and suddenly it got me thinking about the impact of my time in mental health services.

You see I had assumed that having not been detained under the Mental Health Act for over 5 years, I was free of that part of my life. Indeed I haven’t been in secure services since that time either, so again I had assumed it was behind me. Yet if the comments are true and these things stay on file for life, I am in many ways doomed.

Doomed because no matter how long I keep myself out of a mental health bed when people look at my medical file, my past will jump out and hit them in the face. The professionals will see that I have been sectioned for more than a year and that I have spent time locked in a forensic medium secure unit. Will they then assume that I have a criminal record, because most people think you only get sent to these units if you have committed some type of heinous crime. Furthermore will they wrongly assume I must be dangerous, because believe me that’s what some misguided people think.

When I was studying for my degree I had to challenge the course lecturer on the issue of forensic services, it was stated in course material that these units were for criminals with serious Mental Health issues. It also stated that they had to have demonstrated a high degree of risk to others to be sent to these places. I knew of course this wasn’t always the case, I was living proof of that and yet it took a lot of determination and challenges to prove to them their views, their facts were both flawed and inaccurate.

I doubt that I could change or remove these medical facts about my section from my file, they are truthful and accurate statements, the difficulties lie of course in people’s interpretation of those facts. I have always wondered what people would think of me having being detained, would professionals treat me differently.

I know in the early days post discharge I feared being re-sectioned, I worried that at the sign of any small crisis I’d be locked up and send miles away. I was certain if I needed hospital I would be send back to secure services and yet my then CPN told me I was being silly, no one would judge me. But that fear remained and I think that fear has led me to fight steadfastly to never need a mental hospital bed again. That’s why I find it hard to call for help when I’m struggling, I have self harmed before because I was so desperate and yet I wouldn’t, I couldn’t call crisis services.

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Now it seems that these facts will stay on my file for life and I can’t help wondering if that’s already led to changes in how people deal with me. Do professionals already treat me with more caution, do they pre-judge me when they see my history. Will they pre-determined who they think I am, instead of coming and seeing me as blank canvas and judging me on my merits.

What about if I seek employment will these facts be available to prospective employers and if so how will that impact me, I doubt it’s going to help. What if I want to volunteer and need a DBS check (police check), will these things come up in that. There are so many unanswered questions that I have, so many fears that my past will taint my future. The powers that be need to allow this data to be removed from a persons health file after a certain number of years.

To those Approved Mental Health professionals (AMHP) who now hold the power to take away a persons liberty, I’d ask them to consider their actions. I feel I was sectioned initially to off load cost implications of a specialist bed from one team to another. I know my later sections were done by the very people whose living depended upon me filling their beds, operating in the private sector that was funded by the NHS.

The fact AMHP’s today are placing people on a section because that’s the only way to find a bed is deeply worrying. Do they realise the impact they make on that persons life, not just at that moment of taking away someone’s liberty but the longer term implications. It seems now those implications last a lifetime, and my records are duly marked. As I said before it feels a bit like I’m doomed, this life sentence is hanging over my head forever and there little I can do to change that.

The sad thing is I was sectioned because I was unwell, I didn’t ask to be unwell it wasn’t even of my doing. Yet it seems being unwell is punishable in this country and probably many others too with a life sentence of being labelled, pre-judged, disadvantaged and treated differently.

copyright DID Dispatches 2014