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Ashamed

This is a personal piece. Please be aware some of the content may be triggering.

Today I had a melt down. Not just a little one but a major, uncontrollable show of emotion. I was in the DBT peer support group that I’ve started attending and I got triggered and that was it. My mind started turning over everything. Memories came back with full force. The voice started. It was overwhelming. I started by sitting quietly with tears going down my face. We were doing an exercise and everyone was focused and I just couldn’t ask for help. Then someone noticed me. They asked if I was OK and I got asked if I wanted to take a moment. That’s when things just nose dived.

I practically ran out the room. I wanted to slam the door behind me but couldn’t do it. This infuriated me and I hit the wall and ran to the stairs. At that point I just sobbed and emotion overtook me. There were so much emotion that I have no idea what it was I was feeling. All I know is it was horrible. In that moment I wanted to die. Everything was so intense. It felt unmanageable. I felt nothing was going to be OK again.

Luckily the peer support facilitator followed me. She was amazing. She got down to my level. I think she grabbed my arms. It’s a little hazy. I can’t remember what she said. All I know is she got someone else to go in with the group and took me somewhere quiet.

When we got in the office I just wanted to curl up small and hurt myself. I hated my reaction as well as still feeling the heightened emotions. Also everything was still going through my head. I couldn’t look at her. I was so ashamed of myself for so many reasons. For my reaction. For my feelings. For the thoughts of what had happened in the past. For what the voice was telling me. I started to hit myself as I was asked to stop. I hadn’t even realised I was. Things were hazy. It was like being in two different places.

The facilitator started talking to me. The conversation is a little bit of a blur. But it started to calm me. She got me to focus on my breathing to bring me back to the moment. She then had to leave me to go back to the group but someone else sat with me. They talked to me about nothing in particular but it helped. I started to be able to respond and the tears seemed to stop. The intensity of the emotions slowly eased.

When the facilitator came back we decided to have another talk. I opened up about a lot of things from my past. It all kind of blurted out. There were things I had never really spoken about. It just felt, well not easy but, OK to talk about. I felt listened to. I felt understood. I felt I mattered. But this was also contradicted by other feelings of shame (of what had happened in the past and of needing to ask for help), of being selfish, of guilt. I hated myself. As much as I was told it was OK I couldn’t believe it. I was (and am) an awful person. I couldn’t stop apologising.

Eventually I left, apologising as I went and promising to email her and contact my care coordinator. I decided to text my friend. She was the only one I wanted. I explained to some extent what had happened and she was concerned about me. Immediately guilt started to escalate again. But I kept talking (still apologising). She kept me calm. She was great. I’m so grateful for her. I’m so grateful for the facilitator too.

When I got home I got into trouble for being home late. It started as soon as I walked in. Immediately all the negative emotions started to rise again. I tried to explain I had a melt down and the questions started. They were things I found difficult to discuss but they wouldn’t leave it alone. Even when out walking with mum she brought it up and told me I just need to get over it. Maybe she is right but it added to how bad I’m feeling. Shame came forward again.

Since then things have been hard. My mind has been going over things. The voice has played its role. I’m trying hard to stay afloat. But its tough. I hate myself.

If you have any suggestions on dealing with shame feel free to share in the comments or on Twitter, Facebook or Instagram.

Picture from Pinterest

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Murder Not Mental Illness

I wouldn’t normally comment on things that happen in America as it is not my country. But this is an issue that comes up again and again with regards to mass shootings in America. The common rhetoric is to claim the perpetrator is mentally ill. Now it is possible that they do have a mental illness but for the number of mass shootings that happen each year in America, that is a lot of mentally ill people with access to guns.

The truth is that these mass shootings are murder. Even terrorism. Often racism is at the core. This isn’t mental illness. Racism isn’t a mental illness. It’s a societal issue. Also America is not the only place where people are mentally ill, yet the number of mass shootings that occur there is disproportionately high. Surely this points to a deeper issue (*coughs* gun laws).

Here is the reality. People with a mental illness are more likely to be victims of violence than perpetrators. I only have access to British statistics but this paragraph from Time to Change’s website shows the rate of murder caused by someone acting as part of their mental illness:

“According to the British Crime Survey, almost half (47 per cent) of the victims of violent crimes believed that their offender was under the influence of alcohol and about 17 per cent believed that the offender was under the influence of drugs. Another survey suggested that about 30 per cent of victims believed that the offender attacked them because they were under the influence of drugs or alcohol. In contrast, only 1 per cent of victims believed that the violent incident happened because the offender had a mental illness.” Time to Change (Accessed August 2019).

It shows that while mental illness can cause someone to become violent, the chances are you’re more likely to be killed by someone drinking or on drugs. Yet this is never given as a possible explanation to those carrying out mass shootings. They also forget to mention that those with a mental illness are more of a risk to themselves than others.

It’s too easy to blame mental illness. To take something that people already fear and stigmatise against and use it to “explain” something so scary. People don’t want to think that someone who is a neurotypical person can be capable of causing so much death and destruction. But that is the case. Their brain may have been warped but it is not by mental illness, it is by racist ideologies (most of the time).

I know there will be many who won’t accept that mental illness is not to blame in the majority of cases. The thing is, even if a person is mentally ill, there are many other things that contribute to these situations. You need to look at your treatment of those with mental illnesses. You need to look at the ease of access to guns. It is not simply “this person was mentally ill and so there was nothing we could do”. Even when a person with a mental illness is violent, there are things that can be done to reduce this risk as there are often signs that this may happen.

So there we have it. Think before you say that a perpetrator is/was mentally ill. You are adding to the stigma. Maybe think what could be changed to prevent this ever happening again. What could of prevented it. What was the real motive. It is more than likely much deeper than “they were mentally ill”. Think. Yes, I’m looking at you Mr. President.

If you have any thoughts feel free to share in the comments or on Twitter, Facebook or Instagram.

Picture from Pinterest

Self Harm Etiquette For The Medical Profession

This is a blog post for anyone working in the medical profession. This includes Doctors, GPs, Nurses, Healthcare Assistants, Paramedics, Support Workers, Psychiatrists, Care Coordinators, Psychologists, Pharmacists, Admin staff and Receptionists. Basically anyone who comes into contact with a person who may have self harmed (therefore could also be useful for police officers too).

It has come to my attention that some of the people we want to help us deal with self harm can be some of the least useful with their comments and actions regarding dealing with self harm. Therefore I thought I’d put some tips together specifically for them and any professional that needs to help with self harm.

1. Don’t comment on it in front of other patients

This may sound really obvious. Patient confidentiality is key. Bringing it up in front of other patients without permission is wrong and can cause harm to the person who is self harming, the relationship between patient and professional and possibly even the other patient/s who could hear about it. You never know where this information will go. Unfortunately I know it happens. I’ve seen it happen.

2. Don’t guilt trip us

I’ve had this happen with a former GP. I was told I obviously didn’t love my parents over my self harm. It was awful. I didn’t return for treatment until two years later after a suicide attempt. This isn’t the only impact it can have. Self harm is not a selfish act. It’s a way of trying to keep going. It’s a way of coping. Most people who self harm probably already think about the perceived damage they do to others. To be guilt tripped by a professional is more likely to make the situation worse and even cause the patient to withdraw from seeking help, maybe until it is too late.

3. Don’t mimick self harm behaviour

Again this is something I have encountered and not just with one professional but many. It seems some can’t bear to say the words “self harm” and so use actions like using their hand to mimick cutting across an arm. Not only is this not clear communication, it can be triggering. It is a difficult topic but it is one that needs to be dealt with sensitively and professionally. Yes you do need to ask, but please use words rather than miming actions.

4. Be careful with what you say

Most professionals are careful with what they say. They think before they speak and take into account the individuals situation. That’s great if they know the patient. However without continuity of care, which is heavily missing in places, you may not know details or you may just be someone that only encounters someone briefly so has no background information to draw on. This means being careful with what you say. I’ve heard things that concern me. They may be useful for some but I can also see them as potentially inflammatory to the wrong person. I’ve heard “you’re scars look cool”, “just use your faith” and “what would your family think?” as common phrases among others. Let’s work backwards, the last comment can easily be seen as a possible guilt trip but it can also cause some negative emotions to surface, particularly if there is friction within the family. The middle comment is also dangerous as some people don’t have a faith and this may be because of trauma or abuse. It can also suggest unless you have a relationship with a god, you can’t be helped. The first statement may be the most troubling though. You’re reinforcing the behaviour. Yes self harm shouldn’t be something people feel ashamed of, but it shouldn’t be highly celebrated either.

5. Don’t judge or use stereotypes

Some professionals have a preexisting picture of what a person who self harms is. They may see them as frustrating and a drain on resources. They may see it as attention seeking. These stereotypes tend to grow over time within a staff member. I can see how hard it must be to treat someone who seems to be causing their own suffering. But it is a symptom of an illness. It is like an addiction. It is hard once you have started to stop. It can feel like all you have in the world at that time. It is a sign of distress. Being compassionate, non judgemental and just kind to the patient goes a long way. It can help the person to keep accessing help. Doing the opposite could push people away and leave them in dangerous situations.

6. Don’t compare us to other patients who have self harmed

Every person is going through their own unique experience with mental illness and self harm. Self harm is self harm. So it may not be as deep or as “bad” as someone else you have treated, but to that person the pain they feel inside is probably just as intense and unbearable. Hearing that we aren’t as serious as someone else because it doesn’t reach a certain level is heartbreaking and can have a negative impact. It can cause us to try and do more damage. It makes us think we aren’t good enough or that we don’t deserve help. Everyone, whatever level of self harm they present with, deserves support and compassion.

7. Don’t use the terms “superficial” or “attention seeking”

I hate the term superficial when it’s used to describe my self harm. It makes me feel like a rubbish self harmer and that I need to harm worse or more. It can encourage the behaviour and make things worse. The same can be said about the term attention seeking as it can drive the behaviour underground and prevent people getting help.

Those are just a few helpful hints for medical professionals. It might not be a regular thing you encounter but it is always useful to know how to help someone who self harms.

If you have any tips you wish professionals knew then feel free to use the comments or Twitter, Facebook or Instagram.

Picture from Pinterest

1000 Days Of Self Care

As many of you know, especially if you follow me on Twitter, I have been doing the #365daysofselfcare challenge created by The Blurt Foundation. This involves trying to do some form of self care each day. Recently I managed to reach 1000 days. Therefore I thought I’d reflect a little and discuss self care again.

First of all let’s totally go over the point that self care isn’t selfish. It is the act of looking after and treating yourself with respect. People may interpret it as looking out for number one but really it’s bigger than that. By treating yourself with kindness you are helping those that you care about too. In order to be the most effective friend, parent, son, daughter, carer or partner you need to be in a fit state yourself. Self care is important.

Why did I take up the challenge?

The reason I started #365daysofselfcare was because I knew things needed to change. Mentally and physically I was a mess and I had no respect for myself. I felt worthless. Then I saw that The Blurt Foundation had started this challenge. I’d never really considered self care before; why would I when I felt so rubbish about myself? I decided to read about it and discovered it didn’t have to be big gestures but instead could be simple things that meant I was looking after myself. I thought I’d give it a go, after all what harm could it do?

What do I do for self care?

As I’ve already said self care isn’t all about spa days or trips to the cinema (although they obviously do count as self care and are great if you can do them). Sometimes self care is a nap, getting dressed, having a shower, clean pyjamas or just eating and drinking. It might sound boring but self care doesn’t have to be exciting. It’s just important that you are looking after you.

What’s been tough?

Doing some form of self care every day is not always easy. To begin with it was really strange deliberately doing something each day to look after myself. It was a totally alien concept and I felt like I didn’t deserve to look after myself (and quite often I still feel this way). There were many days where I didn’t feel I had done anything that constituted self care. I learnt though through talking to others that I was actually engaging in self care without realising it. Doing it as part of the #365daysofselfcare challenge actually made it easier, especially at the beginning, as I felt I was doing it for other people rather than me which spurred me on when I felt worthless. Also having the support of The Blurt Foundation team, as well as other people taking part, made things easier too.

Overall I would highly recommend trying to incorporate some form of self care into each day. It helps me be a little more respectful of myself. It makes it easier for me to be there for others and feel less of a hypocrite when telling others to look after themselves. Even if you just start small it is just as important as the big things, maybe more so.

If you want more info on self care you can check out my blogs on the subject here or check out this information from The Blurt Foundation. A very big thank you to Jayne Hardy and the whole The Blurt Foundation team. If you want to follow me on the #365daysofselfcare challenge then head over to my Twitter. You can also keep connected on Facebook and Instagram.

Thanks to Jayne Hardy and The Blurt team for the pin.

6 Months From The End Of DBT

This is a personal piece. Please be aware some content may be triggering.

It’s been roughly six months since I finished my DBT (dialectical behaviour therapy) skills group, therefore I thought I’d reflect on how things are going.

In all honesty I found the DBT skills group difficult. It revealed a lot more areas that I need to work on than I thought I did. I learnt a lot about myself and how BPD (Borderline Personality Disorder) effects my life. It is a lot more than I thought. I think I thought some of the things I thought were normal, when actually it’s far from normal.

DBT gave me some ideas on how to cope with the self harm urges and things to do instead of self harming, as part of the distress tolerance module. While I’ve tried to practice these, I’ve not found them that effective. The urges don’t go away like I hoped. Instead I’ve found myself fixating on the idea of self harm and how much damage I could do. The only thing that seems to relieve this is to self harm. This isn’t a failure on DBT’s part, it’s mine. Although I do feel I would of benefitted from a revisit to the skills, I also feel I needed some individual help to go through the problems that lead me to self harm and someone who could help me find what’s effective for me.

I knew I always had problems identifying emotions. The most I could do was say whether it was a good or bad emotion. I used to use cues from others to put a name to the emotion. It was something I started working on in art therapy as a teenager as before that I could barely express how I was feeling. I think with DBT skills I learnt some more ways to identify my emotions and the 10 page handout on ways to decide which emotion it is you’re feeling was comprehensive. I just wish I had it in the form of an app on my phone as you can’t really carry a thick A4 handout around easily.

I also learnt through the emotional regulation module that emotions aren’t wrong to have. It’s something I’ve always said to others but never applied to myself. Anger has always been a tricky one for me to deal with. But I’m working on accepting it. I punish myself less for feeling angry though I do still struggle to express it outwardly. I think at the moment I’m not in a safe enough space to allow this expression so hopefully with time that will come.

The biggest learning curve for me came with the interpersonal relationships module. I thought this module would be a waste of my time. I thought I was doing OK. How wrong was I? I came to realise that I was allowing people to treat me like dirt and accepting it too easily. I learnt that there were ways to try and change this and that I didn’t have to accept it or just go into a rage over it. I must admit that most of my time doing this unit I was trying to figure out my relationships and which needed working on rather than the skills to tackle this. Over the last six months this has continued but I’ve lost my grasp on what skills to use. I feel I would maybe benefit from repeating this unit at a later date. I’m not ready at the moment still.

In the core mindfulness module of DBT skills I learnt a little about how to make myself be in the present moment. Before DBT skills group I had a tainted view of mindfulness as something I was no good at and would never master due to previous experiences in therapy. What I learnt was that for me I need to approach mindfulness in a different way and that there are many more ways to practice mindfulness than I had been taught before. For me, mindfulness wasn’t about sitting in silence breathing. I needed to do activities mindfully. This was a revelation but it was, and is, useful.

Overall I’m in two minds about whether DBT skills have been useful. I think there is potential for them to be useful in my life but I don’t feel the course was long enough for me personally. I also feel full DBT, which includes individual as well as group therapy, would have been more useful. I feel that one of my psychiatrists agreed with this also (he’s left now but it would of been good to have him on my side). I am also hoping to attend a DBT skills peer support group that is starting as part of my local Mind. Hopefully this may help a little with the gaps in my knowledge.

For more about my therapy you can click here or you can follow me on Twitter, Facebook or Instagram.

Picture is from Pinterest

Shutting Out The World

This is a personal piece. Please be aware some of the content may be triggering.

Things at the moment aren’t great. I’m not in the best place. My head is a mess and I’m not tolerating the world very well. Therefore I’ve been shutting it out.

I know this is not the best course of action but at the moment it’s what I can cope with. The world feels overwhelming. People feel overwhelming. Life feels overwhelming.

I don’t know what has caused this decline. I have theories. It could just be a depressive episode. It could be the disjointed care. It could be turning 30. It could be a number of individual things or all of them combined. I don’t know. And I guess it doesn’t really matter.

Shutting out the world means avoiding Facebook interaction. It means not messaging friends. It means not asking for help. Instead I have replaced it with self harm and thinking of suicide. I have spent my time dwelling on the fact that everyone would be better if I was no longer here and have been on a mission to prove it to everyone.

I’ve also been experiencing physical symptoms. My body aches. My head is thumping. And I feel sick. I either sleep too little or too much. I either have no appetite or binge on food. It adds to the mental difficulties.

I hate myself for the way I’m coping. I hate myself for doing what I logically know is the wrong thing. I see it as protecting myself but realistically I need people and I need help. What help they can offer I don’t know. I guess I won’t if I don’t ask. The thing is I’m put off asking at the moment by the fact I have no stable care. I feel a burden to everyone, including those paid to care for me. I know I’m just another caseload that they could do without.

So what would my advice be for anyone else feeling this way? I guess it would be to do what feels like the hardest thing, ask for help. You deserve it. You are worth it. Now I just have to try and believe it for myself.

If you are struggling the Samaritans are available 24/7 in the UK. If you are outside the UK then please check out the crisis help page which can be accessed via the menu. To follow my experiences you can do so on Twitter, Facebook or Instagram.

Picture from Pinterest

CMHT Fail

This was not the post I planned on sharing today but I needed to get this out.

Today I had a psychiatrist appointment. It was with a new psychiatrist and my latest care coordinator. Except it wasn’t. While in the waiting area I received a phone call telling me my care coordinator had left on Friday and trying to arrange an appointment with my interim care coordinator. When I told her I was waiting for my appointment that was already running ten minutes late they rushed down. Remember they don’t even know me.

In the appointment the psychiatrist had no access to my notes as he had been blocked from the system. Thanks to the interim care coordinator he was able to access the last letter but couldnt read in detail.

He asked me how I was and when I mentioned my mood was low a lot and unstable, he asked more questions about my concentration, appetite, memory and sleep. He asked me to rate my mood which I put at two at best. I mentioned I was having suicidal thoughts and that the voice I hear is worse. He said I didn’t have plans to end my life, he actually didn’t ask.

The psychiatrist then wanted to refer me to a service that has refused to take me on. When I explained this he said he understood and offered no alternative. He did not want to change my medication despite my obvious deterioration. I managed to persuade him to up my mood stabiliser but he did it by the smallest margin possible.

I tried to bring up some other concerns but by that point he was already wrapping up the consultation and urging me out the door with the words “I’ll see you in two months”.

Everything felt like it was too much effort for them. This is from a trust that is rated as outstanding. A trust that can’t seem to retain staff or offer support. It is currently a postcode lottery within this Trust as to what treatment you can access (I am aware that this is actually down to the CCG).

When did continuity of care in mental health services become unimportant? Especially with people with BPD where fear of abandonment is a major symptom. When did it become acceptable not to fully risk assess people?

Unfortunately this seems to be the way it goes for many service users of mental health services. It isn’t often I cry in an appointment and straight after in the street but today’s fiasco made me feel awful and worthless. (Thanks to the psychiatrist who actually sked if I felt worthless).

To keep up to date with my mental health experience, follow me on Twitter, Facebook or Instagram or use these and the comments to share your experiences.