Crisis services – my experience 

I read about out of hours services today and it led to me to thinking about my experience with crisis services in the past. The first time I encountered a crisis team or out of hours service my experience wasn’t great they seemed to totally misconstrue me and failed to help or support in any way. I can recall one time when they visited me at home and having decided that I was safe leaving me there in a crisis and in chaos. I was suicidal and desperate and so clearly losing time and switching, but they didn’t see that they just me as inadequate, dysfunctional and a nuisance.

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They left me alone and still suicidal and so intent on dying that in desperation I tried to harm and then I dissociated, during which time I took off only to surface a few hours later some 60 plus miles from my home. I was picked up by the police for my own safety after they saw the distress that I was in and I was taken to a nearby hospital, they assessed me and admitted me to hospital.

Crisis at home had failed me, sadly it is often what happens, for me at least.
There was the occasion when I couldn’t live at home and had no where to go, I had been in hospital and discharged just a few days earlier but I had no place to stay. I had self harmed and the police had taken me for an assessment at the hospital, I sat waiting until the crisis team arrived and then they didn’t even talk to me except to give me a list of hostels. I hadn’t gone to hospital because I wanted a place to stay, I wanted to die, I had gone there by force and against my will and yet I was treated like I was a nuisance.

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Then on one occasion I was at home and struggling, crisis care was put in place and so for a couple of days they visited me. I saw a different person on each day, I never saw the same person twice and after a couple of visits I was put onto telephone calls only. The calls would be brief, wanting to know how I felt and then not really being able to offer any guidance or support really when I said how bad things were. By day four I was discharged from the crisis team to my regular mental health team, I wasn’t any better yet the crisis team support was only meant to be brief. I guess it didn’t matter that it didn’t work, or that discharge to me seemed too soon, too swift. Two days later I was seen by my community team and they admitted to hospital, I spent six months in hospital on that occasion, so crisis clearly couldn’t help prevent my downward spiral.

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The crisis team in recent times has just been telephone support, but if I’m honest I avoid calling them unless it’s absolutely dire. If Samaritans are not able to help and I’ve tried everyone else I can think of, then and only then will I call crisis, it is a last ditch attempt. The last two occasions have been pretty much the same really, I call, I say I’m struggling and they go through a list of techniques to try. ‘Take a warm bath, have a hot milky drink, try a nice walk or have you watched TV, tried to distract yourself?’ these are their usual lines.
They never assume I might have tried these things before, that I might have already thought of them myself. It never occurs to them that I don’t actually ring them when a crisis starts, or that they are usually the last person I try. It’s as if the staff manning these services are reading off a predetermined script and are unable to offer any person centred approach of any kind.

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The last time I called I was desperately trying not to self harm, struggling with grief and the difficulties of accepting my trauma. I needed some help to try and keep me safe, I didn’t want wrapping up in cotton wool I just needed some guidance to help me, help myself. Some advice to point me in the right direction to prevent that slide back into harming. I was desperate not to self harm, desperately busting a gut as I fought to resist the urges growing ever stronger. I had already tried all their suggestions before I even called them. In the end the only advice was have another drink, try some art maybe and call back if your struggling still.

About an hour later I did call back, this time I got a different person who initially went through all the same familiar suggestions. Then I heard another phone ringing and the nurse on the end of the line basically told me she was hanging up on me as there was another call and she couldn’t help me. In the end I stayed safe but only thanks to the support of those on social media and then later my family. The crisis team didn’t even inform my local community mental health team that I’d contacted them and was struggling, how is that joined up care.

The crisis service were and I believe are unable to offer any support or guidance that is of use to me, after all they don’t even know my diagnosis.

In the past decade my encounters with the crisis team of two separate hospital trusts have shown me that their understanding of dissociative disorders is limited. Their ability to assist and offer support is limited, in fact for me they are not there in a crisis because they can’t comprehend me or my diagnosis and without that they appear to be unable to help when I need them most.

In the future when I call, if I call, I will explain what I need which is usually someone to help me mentalize things, someone to just listen, to know my pain. I don’t need pointers like a bath or a drink I just need five minutes of their time and for them to hear me. From now on I aim to take control of my interactions with Crisis services and hopefully that will educate them as we go. Maybe this way they can help me when I need it most, only time will tell.

Copyright DID Dispatches 2015

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Therapy – what a difference 18 months makes

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This week marks the half way point for my therapy, well it’s half way through the agreed three years of funding. I sat in therapy on Monday and thought about how I feel at being at this point, after all when I first started therapy I had so many ideas of what it would be like. In fact I had ideas of what I wanted to achieve and it’s been weird really to see were I am now.
My concept of successful therapy has been changed and the possibilities that have been opened up have grown as we have progressed. When I first began treatment with my psychologist I had previously seen a psychotherapist, she had basically helped me to regurgitate my trauma. She did understand D.I.D. which made a change from other professionals I had encountered. However we had not really moved forward, we still had 24 hour care and I had no internal communication of any kind.
So when I started with my psychologist what I really wanted was to move forward, to just be less chaotic in my life. I thought I had to work through all my trauma in order to progress and to remember absolutely everything that has been hidden for so long. Well 18 months make a huge difference to attitudes, to beliefs and it’s made a huge difference to me as a person.

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I can so recall that first session when my psychologist told me that he had no magic cure, that he only saw me for 1 hour a week and that meant I had to work hard on my own the other 167 hours. I thought he was a bit forward and well I sat and thought I didn’t expect a magic cure, I knew I wanted to make it work so of course I knew that I would work hard.
I spent a few months trying desperately to check that I was working hard, that professionals knew I was trying my hardest – I guess that was my insecurity playing out. I didn’t believe that talking to myself, my alters, would make any difference and it sounded stupid and yet it’s being transforming. I soon began to realise the psychologist didn’t treat me like I was unequal, I didn’t feel like a patient in fact it’s often felt like I’m visiting someone who is an acquaintance or maybe a friend as we sit and have a brew and chat away as equals – I like that.
I think the first six months I was basically building up trust, that’s been hard for me and yet I did find myself being able to do the things suggested without much difficulty. I could say if it wasn’t going well and we rarely went into trauma, well not in any depth and that felt ok at the time. In fact I was afraid to discuss trauma and I was quite bothered about venturing onto that stage of therapy.

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Six months in and I realised I knew more about myself than ever, I realised I had low self esteem, a lot of negativity and lots of issues with my own self confidence and self belief. In fact I realised that because of my childhood I had so much learning and developing to do and I began to see that there were many things I had never done. When paddling was suggested I thought it was daft and I can so recall how it felt as we spoke about it, but I began to consider it and thought maybe just maybe I can do this. That’s why exactly a year ago I ventured to the beach and splashed around like a child, self talk however weird it felt was helping me establish links with my alters and so one of them helped me on that day.

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Building sand castles soon followed, painting and art became more regular, cartoons became a regular daily feature of my life and we even managed to have a barbecue picnic. I realised fun was a great way to get in touch with the alters; the other parts of me and I learnt giving them time was helpful to all of me. But with the fun times came the grief, that grief of knowing what I had missed and of starting to accept the trauma and the emotions that my alters carry.
We then began to do more stabilisation, so more progress with internal dialogue and understanding the alters better. I started to challenge myself when I was critical of myself and in sessions were before my psychologist would counter my negativity, now I was doing it myself. I think there was a period were I was dreading discussing trauma, dreading if I couldn’t cope and feeling afraid of it. But I guess my psychologist realised that and I was helped to feel assured and less bothered by it. In fact letting my tears flow in the sessions was hard back then, I have always find it hard to express my feelings. It has over time though got easier and now there are times I feel like a tearful wreck.
In the past six months I have continued to learn things about myself and I have continued to grow and develop, when I felt bothered by a session I was slightly surprised I felt comfortable to actually say – but I did. It was more than ok though, my psychologist was truly helpful at reassuring me. I realise that were as before I might have reacted very differently to such situations I am now able to think more rationally about things as I’m less impulsive, well except when it comes to booking treats which I do far more often – that’s because I now believe I’m worth it.
My ability to interact with other medical professionals has improved as I no longer see myself as insecure and lesser somehow, I feel I have a right to be an equal and to be treated as such. I can sit through a CPA without storming out in frustration and my adolescent part is now able to respond in a far better way. I am losing less time which is amazing and I’m learning so much more about myself and my skills and abilities.

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Half way through and I’m totally amazed by how different I am, in fact others now see that difference too and practically I need less care. I am able to understand myself far more, understand the complexities of D.I.D and the things I need to do to make life less of a challenge. This week I even realised that I have skills and abilities I never realised were there, I cooked Sunday lunch last weekend for my family and yet a few months ago I couldn’t poach an egg without dissociating and losing time. That marks progress in a practical way, but there has also been progress on another level too in that I can cope far more with things that life throws at me, I cope better with flashbacks, thoughts of self harming, attacks of negativity and self doubt and I know I can cope better with the trauma too.

I realise that I don’t need to recall or process all the trauma, just enough and I can work with and accept these memories are mine- they are just carried by the alters. I also see that progress is possible in fact it’s evident already. I can see that life is moving forward, there is less chaos, I am growing as a person and that is far more than I ever imagined would be possible.
I still have much work to do and yes there are times when it’s hard and that it feels way too much, there are times when I feel I can’t cope but somehow I do. Most of all I now realise having D.I.D whilst it is a challenge each day is manageable, it is possible to live with this condition and the impact of my abuse – to have a life – now I never thought that I would be saying that, especially at the half way point.

 

copyright DID Disptaches 2015

When physical health and mental health collide – stigma ensues. 

Earlier this week I felt unwell and ended up calling my out of hours doctor, who decided I needed to attend my local emergency room. There followed a bit of a mad panic as the first responder medic arrived who duly began taking down my details and telling me an ambulance was on the way. My daughter ran around trying to get some things together to take with us as the medic began to do basic observations like blood pressure. A short time later the first of three paramedics arrived at our home and they began to do more tests, I live in a remote rural area so the hospital and ambulance station are miles away.

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The paramedic did some heart tracings and sugar levels and things and I tried to stay calm, except deep inside I felt anything but calm. My chest hurt like hell and I was starting to panic a little, all this attention was unsettling and when more paramedics arrived I felt well overwhelmed. Inside I was trying to communicate telling all my alters; the different parts of me, that we were going to be ok. I kept trying to reassure them and explain what was happening and what was likely to happen next.

A few heart tracings later and I was being whisked to the emergency room in an ambulance, the ECG monitor still connected to my heart. I was given medication to help with the symptoms and that in turn helped calm me down thankfully. On my way to hospital I remember telling inside that it was ok we’d probably be home later and all would be well, except I really wasn’t sure what was going to happen. The paramedic was great he asked me about any other health conditions and I’d said I have Dissociative Identity Disorder and he wanted to know more about it, he’d never come across it before.

The hospital staff were at first quite helpful, they did more tests and then we just had to wait for results. But then I noticed a change in attitude, it was odd but after I’d been put in a hospital gown and my arms and their scars were visible it seemed to change things. I’d like to think they were just busy but I realise actually it was more than that, there is and I guess always will be a stigma attached to self harmers and I was a prolific self harmer not that many moons ago.

I was sat alone in the hospital as relatives were not able to stay with the patient, something to do with space apparently. Yet for the little parts of me that meant fear and doubt creeping in, there we  were alone in a busy environment and so much chaos going on around us. There were people being sick, people shouting, people clearly more unwell than me and it wasn’t easy for any of me to be there. I tried to keep reassuring my alters and settling them down, but I was still suffering pain and I felt woozy so it wasn’t ideal at all.

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At one point I felt on the verge of tears, but I daren’t cry for fear of being judged which in hindsight was a bit silly, after all I was already being judged by my scars. I tried to block the emotions pummelling through and at one point I texted my daughter who was sat in a nearby waiting room and said ‘I want to go home’.  I knew the pain was subsiding yet I felt tired even unwell, but I just wanted to feel safe and I didn’t there. Staff didn’t speak to me for quite a long time, in fact I think I sat waiting for the results for over 2 hours with no staff interaction at all. If I’m honest I felt quite abandoned and that was quite hard to deal with. Now I know most adults would find no interaction ok, some would maybe find it hard but they’d cope and yet I was there with chaos going on inside my head and I didn’t feel able to cope. I felt vulnerable, I felt exposed and I felt unsafe it was so hard to just sit there with a hospital gown on, things stuck on me and a cannula in my arm.

When I eventually had a chest X-ray that felt worse, my radiographer was a male staff member and for me that felt too scary. I didn’t have the courage to say I can’t do this, to say I have a trauma history that makes this too hard, so instead I retreated inward and felt as if I was no longer in control of me. Whoever came out did an ok job they kept us safe and they began to deal with the doctor too, when I came back the doctor was asking me more questions about my health history and of course my mental health came up.

I tried to explain I’m in the process of a medication reduction and as such I’m reducing my anti depressant, but of course that gave them something to hang a label on me. The conversation revolved around who was supervising the reduction, was I no longer depressed and why such a gradual reduction. The logistics of reducing meds is a whole other blog, but I tried to explain to the doctor and yet I knew I wasn’t making many inroads into the stigma she clearly held.

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When eventually they said I could go home I was utterly relieved, and so were the other parts of me after all none of us were enjoying this time. My daughter helped me get changed back into my own clothes and that felt a huge relief and then together we left the hospital. On the drive home I sat and talked inside reassuring everyone and thanking them too, for they had been helpful and stayed  as calm as they could. By the time I got home it was the early hours of the morning and I was truly ready for bed, I felt exhausted.

But perhaps because I have alters, because I have D.I.D going to sleep wasn’t a straightforward  option. Little parts of me had missed out on their cartoons and they felt agitated and unsettled by our visit to hospital, the chest pain which had now gone had frightened all of me. I knew trying to sleep wasn’t going to work, I also had at least one part who was steaming mad at the stigma we had encountered. I decided to acknowledge the frustration being felt, I said I understood how it made us feel and I reminded us of just how good we are. I told myself that they had no right to judge me and it was their problem not mine, after all I don’t mind my scars or my mental health history it’s just part of who we are. I can’t help my past but I can help how I let it influence today and as such I can chose to not let the stigma and archaic views of a few medical staff hurt me.

I did settled down eventually to sleep, watching cartoons in bed as I tried to relax and calm down different parts of me. Since then well we have had more tests and more pain, but we are working through it as a team my alters and me. I guess that’s what I’ve learnt this week that if I face situations that freak me out or unsettle me I can deal with them if I do so as a team. A few years ago I would have just dissociated not for a short period but for days, I wouldn’t have coped with the stigma either I’d have reacted to it.

Perhaps the last few days have shown me just how far we have progressed in terms of working collaboratively.  I realise now that I need to accept stigma exists and whilst I don’t like it I can’t change other people’s ignorance. That doesn’t mean I won’t fight to end stigma, of course I will and I’ll continue to challenge where I can attitudes that need changing. Having D.I.D is a challenge especially when you are physically unwell, people don’t understand  it and they don’t want to either. Guess I have to work at educating people about this condition after all that can only help people like me in the future.

 

Copyright DID Dispatches 2015

2 envelopes 8 years apart – from suicidal to survivor mum 

Trigger warning : please exercise self care. 

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This week I came upon an envelope, on the outside were handwritten instructions of desired funeral arrangements and the envelope was addressed to three young teenagers. Shaking I gripped hold of this envelope as thoughts raced through my mind. Was it wrong to read it, would it stir up memories and emotions I wouldn’t be able to deal with or was it best to leave this well alone. Yet as I sat transfixed my eyes focused on this emotional heartfelt letter I knew what I needed to do, it was time I read the words that I once had written to my own three dear children.

As I carefully unsealed the envelope I examined every word written on the outside, it hit me that these were my funeral plans, plans I had at one time felt so vital to record on paper. I hadn’t wanted my children to have to make those difficult choices so I told them simply what I would like. The letter was long, it started with an apology, and those familiar words of I love you, I am sure many people will never understand the thoughts that raced through my head when I had written this letter, but 8 years ago when I wrote it I didn’t feel like I could survive.

You see back then my trauma, my past were destroying me and I felt I could take no more, the turmoil and anguish I felt were basically consuming me. Each day was a torment, painful and soul destroying, it felt like I was being abused over and over again, as the flashbacks consumed every minute of every day. If not the actual flashback, the fallout from them filled every day and I couldn’t take anymore of this anguish. I can recall the feelings of desolation I had felt at that time, and then the decision which seemed like a rational, sensible one to me was made. I’d end my suffering, I’d end everyone’s suffering and instead of being the nuisance to my family; that I felt I was, I’d give them a fresh start. They wouldn’t have to worry about me anymore, they wouldn’t have to watch me being consumed by the past or see my torment; which was the result of my memories. Suicide I had felt gave me the best solution, best for me and most certainly best for my children.

That was my mind set the day I wrote lovingly to my children, fast forward 8 years and here I was sitting with this letter I had written them. I digested every line, each word and I sensed the anguish and the torment I had been in when I wrote to them. It seemed somehow to seep out from within the pages, it was palpable and so clearly evident that I was suffering. I recorded the distinguishing traits of each one of the children, the things that made me proud and their individual strengths. I told each one how much I loved them and why this was the best outcome for them. I apologised numerous times for all the pain I had caused them and how I just wanted to make things right for them and I  begged for their forgiveness. By the time I had finished reading it all, tears streamed down my face and my body was shaking as I sobbed and sobbed uncontrollably.

You see I know how close I had come, how close I was at that point to no longer being here with them. I had planned so much, it wouldn’t go wrong and yet somehow it did and somehow I’m still here looking back retrospectively at that dark time. No longer in that dark unforgiving place, that once overwhelmed me and made life seem impossible to live.

I couldn’t help think of all the things we had done as a family since that time, all the highs and the lows. This was written before my stay in forensic psychiatric care, before my being sectioned under the mental health act. But it was also before any of them had graduated, before I even began to study for my degree and before they had celebrated milestone birthdays. There is so much we have done since that time, so much I so nearly missed out on.

I have had the joy of watching these teenagers grow into amazing adults, seeing them all receive their degrees and feeling such motherly pride as they did. We have shared so many Christmases, birthdays and holidays together, things that I’m so glad I didn’t miss out on. I’ve enjoyed learning to have fun, to laugh at myself especially when I splash in the sea and I now gaze in awesome wonder at the beauty that I see in this world all around me. I appreciate it from a different viewpoint today, as I see things from the perspective of my little parts of me.

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But when I wrote that letter I didn’t see any light, I didn’t see any hope, just pain and I thought it was best for us all for me to not be here. Now looking back I see that whilst it hasn’t been an easy journey and I have a long way still to go, I’m aware that I’m stronger than I ever believed was possible. I’m now aware that you can with the right help overcome those dark days, learn to live with the pain of the past and carve a new way forward. I’m learning the skills I need to cope with my life, with the damage that was once done to me.

Looking back isn’t easy, but it was important to do, it reminded me of how far I’ve come and of how much I have achieved. It’s allowed me to reflect and be glad that I’m still here, that I can tomorrow open other envelopes this time address to me and not my children. These envelopes will contain cards to celebrate Mother’s Day and I have no doubt that I will cry with joy as my wonderful children’s card tell me how much they love me.

Their words mean so much to me, because they know how close I came to not being here, they know we so nearly didn’t have this day. They have been through this nightmare with me and we have had to rebuild our relationships after the prolonged periods of my hospitalisation. I’ve kept the letter I wrote it’s hidden away in a box, I think one day when my treatments over I will burn it, till then it’s there and it’s my reminder of a time that once was desolate but now has beams of hope shining through it.

If I could have written to myself back then, it would have said quite simply ‘hang in there, it’s not going to be easy but you will get through this, you will get the help you need one day. Most of all you have a future, you will laugh again and even when you cry that’s ok, because often they will be tears of joy and of motherly pride.

 

Copyright DID Dispatches 2015

 

 

Forensic Psychiatric Care

Plastic fantastic

Sitting in the back of my kitchen cupboard lurks a cup, one that I haven’t used for a number of years now but still I can’t throw it away. This cup symbolises so much for me, it’s made of melamine, a heavy type of plastic and it is practically unbreakable, it’s decorated with pretty flowers and it would happily form part of a good picnic hamper. Yet this cup has never been used on any picnic, instead it was used behind a multitude of locked doors.

This was the cup I used during my time in forensic psychiatric care, in the secure unit were for over a year I was confined. It was specifically chosen by my children as it adhered to the strict regulations about the type of non breakable cup I was allowed. The regulations about such items were very strict and if your cup didn’t conform you simply wouldn’t be allowed to keep it. On finding it the other day I thought of my time in that place and how dehumanising the whole experience was, you see it’s hard to suddenly be labelled as too unwell or perceived as too dangerous to use normal everyday objects like a china cup.

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The reality of course I now know was that I was sent there because I was depressed and self harming, but the scale and level of my harming was not in anyway as extreme as some of those I met in these places. Yes I cut myself on an almost daily basis in the hope of making the internal pain I was enduring somehow physical or more visible in some way. It was my way of protecting me, because at the time I truly believed that if I didn’t harm myself others would and this way I could control the harm done to me. I did bang my head on occasions purely out of frustration at the way in which no one seemed to understand the horror of flashbacks, of memories and of how I felt. But in all my time of harming I have never used a cup, or a knife, or a fork or any number of other items that suddenly I wasn’t allowed in this place to self injure. Nor had I ever harmed another human being, so I wasn’t dangerous in any way, yet in secure forensic services everyone is labelled and treated the same.

I look at that plastic cup and I remember how the so called professionals treated us, how they made me feel so worthless, so pathetic and so very wrong. I left an open unlocked ward and in the time it took to drive 200 miles I was viewed as a whole different person. No longer a free citizen who just happened to be ill, but a forensic detainee who could be barked orders at, denied her possessions and forced to do things whether I wanted to or not.

The forensic unit didn’t treat me as if I was ill, I never felt like a patient who was regarded an equal, no I suddenly felt like a third class citizen who they regarded as bad. In truth I feel they saw all of the women in there as criminals, yes I know many of the women I lived with in that place had criminal histories that had resulted in them being sent there, but not me. Yet these people couldn’t treat us all as individuals we were collectively dealt with in punitive ways.

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Like the cup made of unbreakable plastic, I can recall the lukewarm drinks we were served, and the mealtime chaos of cutlery counts and at times being made to eat meat and vegetables with a spoon. I was thinking back the other day to my first meal in this place and being lined up in a queue to collect my food, spaced out from the person in front with staff all around. When they handed a plastic plate, a spoon and a serving of meat, vegetables and potatoes, I was perplexed. Only that morning as I left my open ward I had sat with a china bowl and had open access to knives, forks and spoons and yet now I sat on a long bench table, surrounded by staff and other patients holding a spoon thinking how do I eat with this? I remember saying I needed a knife and fork, and being told that I wasn’t allowed such items and to shut up, sit still and eat. Yes the staff really were that blunt. My drinks in those early days came in polystyrene cups and I was told I wasn’t allowed a plastic cup until I had approval from the team.

The Team became a familiar part of my life, they ran my life for me after all they were in control, in charge and me well I was just a nobody. I soon learnt that if you challenged them over anything it didn’t get well received, but try as I might I couldn’t not challenge some of the more ridiculous rules and procedures this institution operated. They’d count the cutlery every single meal time first it was counted out then back in at the end, if they mis-counted then we would all be made to wait and wait and wait, while they hunted for the missing object which in truth there never was. Of course I never once saw anyone harm with cutlery, but pens that were freely available were used by many to self injure, as were a plethora of other objects we had access to. I learnt a million and one more ways to self harm, I learnt the weak spots in the system and I witnessed many awful incidents in there too.

It soon became clear that you could tell when certain women were more anxious and you could certainly sense who was going to harm before they did. Yet it surprised me over and over again to find the staff didn’t sense this increased anxiety and risk within a person, the team over focused on physical security and so missed clear opportunities to help women. Physical security included stupid rules about cutlery and certain other object and it also included an over reliance on locks. It focused on staff dominance and patient compliance to rigid rules that made no sense and yet the system failed.

A forensic unit has a higher level of self harm incidents and serious incidents endangering life than other types of psychiatric facility. It’s not just about the clientele they serve it’s about the complex nature of people who need help, and yet are failed by the system. It would have been so easy for me to have got sucked into the cycle of punitive rules, punishments and de-humanising that took place, it would have driven me to self harm even more if I had let it. I had to fight not to succumb to this place, to not end up like many who had spent years existing in these units. Who no longer felt human or had any worth, they felt better off harming and dead than existing in this horror in which they lived. Many didn’t have visitors or leave and they were rarely empowered, encouraged or given opportunities to believe they had a future.

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I was fortunate, I had a family outside, I had children who cared and friends who stayed in touch, most of all I had years of experience surviving similar controlling environments. My abusive childhood was all about control, punitive random punishments and dehumanisation, dissociating allowed me to survive that time. Dissociating again allowed me to survive this period of my life too and parts of me would ensure I never spiralled into being a continuous long stay forensic patient.
The truth is I can’t throw away that cup now because it will forever be a permanent reminder of the fact we survived the horror of our time in forensic care.

 

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

My Battle With ‘Self Harm’

TRIGGER WARNING

 

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The feelings come suddenly swooping down and descending upon me, the darkness hits me when I least expect it. I’m use to my mood changing, it fluctuates quite often as I switch from one alter to another but this is different. A part of me is clearly struggling and her mood is more lower than usual, she feels despondent and so negative and I am finding it difficult to know what to do.

This alter, this part of me has never been so evident until now and yet suddenly the emotions and feelings overwhelm. She loathes herself and it’s seeping slowly into me and whilst I try to not feel so negative it’s in built in some weird kind of way. I was never good enough as a child and it’s clearly influenced my thinking and now I’m more aware of just how self critical and self loathing I am prone to be. So it’s no wonder my feelings this week have been far more negative than in recent months and it’s impacting upon life.

I wrote earlier this week about the desire to self harm being strong, I thought it might be helpful to explain what that’s like for me. The urges come from nowhere suddenly appearing and so powerful and strong, they start often without any warning and they catch me by surprise.

The other night I couldn’t sleep, no matter how hard I try it just wasn’t happening and I felt on edge and agitated. I couldn’t explain why I was so anxious or agitated I really didn’t understand, however I did know I felt a dark cloud hanging over me. I tried distraction, relaxation techniques and even the hot drink that I knew my crisis worker would suggest yet nothing worked. As the time ticked by once again and I felt exhausted but still couldn’t sleep my feelings towards myself sank lower and lower. I guess I get illogical at these times in some kind of way and soon everything bad that ever happened in my childhood was my fault, I was bad, I was to blame. Then began the urges, I found myself searching for objects that I could use, I haven’t done that in a while. A few years ago I wouldn’t have had to search, the blades were close by and all I had to do was take a few paces to find one.

Now I have a somewhat different tactic I try not to have any blades in the house, yes there are knives in my kitchen but they are usually not great ones more blunt than anything. So I had begun looking at things and deciding what to use, I was logically working out where I would cut to avoid it being seen by others. My children are far more sharp eyed these days and I can’t just hide a scar like I use to, as all these thoughts raced through my mind the urge to cut was growing stronger by the minute. My head was a whirlwind, voices raced away in conversation some clearly urging me on whilst others condemned me. Meanwhile others mainly my protector alter were stating quite clearly that harming wouldn’t help and telling me I didn’t want to do this.

The feelings of confusion kept growing and tears were streaming down my face, in truth when I’m strong and coping with life I don’t want to harm, but I know I might and that is something I have to accept. You see harming is my default position when emotions become too strong too much to bear and when I feel I’m bad it’s even harder. I looked at my arms and I saw my veins and began thinking of the her DNA, her blood running through me. I can never escape the reality that my Mother made up half of my genetic code and without her I wouldn’t be here. Years ago I wanted to just cut her out of me, but of course that isn’t possible and I found out that after years of cutting and harming it didn’t eradicate her from me. So today I know that deep down I can’t take her away by hurting me, maybe that’s why I worked harder than ever the other night at trying to stop myself from giving in to the urges to harm and eventually resorted to extra medication yet again to help numb my pain.

The desire to harm has continued at a pace this week often linked to feelings of anguish and turmoil and the pain of years ago suddenly overwhelming me clearly demonstrates that healing hurts. I think feeling such self loathing and negativity; it’s been stronger than ever recently, hasn’t helped either as I feel I need to be hurting physically not just emotionally.

This evening I had been doing ok and then it swooped out from above and descended like a thick heavy cloud squishing me. I felt like my heart was being ripped in two and tears began to stream once more down my face. The feelings of self loathing grew instantly like a huge crescendoing wave battering me as if I’m being tossed in a storm. I realised I was scratching my arm, desperate to self inflict harm, desperate to hurt me for being so pathetic and so definitely to blame for my past. I want to somehow express in a physical sense the emotional hurt I am feeling, but I know self harming isn’t going to stop this pain well not for long anyway.

I am surrounded in lots of ways by a loving family and tonight my daughter and eldest son have been a big help. They have phoned me often, made me cups of tea, distracted me, reassured me and generally badgered me. Telling me how good I am, how it’s not my fault and reminding me of the words my psychologist has said about not being to blame. It hasn’t stopped the urges far from it, but it’s helped me reach into my tool box of resources and work at trying to stay safe.

Earlier this week my psychologist kindly emailed me and I have re-read his email over and over, slowly the words are sinking in. Slowly all the stabilisation work we have done in the last year of therapy is coming to the forefront of my mind and I’m able to use it to good effect. Internally parts of me are hurting, others though are rallying to help and yes my protector has been telling me I deserve better and reminding me who was to blame in the past. My teen alter has also been present and using her way of communicating to reassure me, I know my distress impacts upon her and I don’t want to hurt her. It’s strange how getting to know my parts, my alters has meant I care about them more and as such I don’t want to cause them more distress.

I’m still here and I’m still trying to not self harm, but if I do please don’t look down at me or think I’m attention seeking or bad. If you only knew how hard it was, the anguish and the pain we go through, then maybe you’d understand why it’s difficult to not self harm. Why I’m in the midst of a battle and I’m not sure if I’ll win.

Copyright DID Dispatches 2015