Tag Archives: Dignity

Shut Up

This is my response to some comments I’ve had and seen other people have. It is my personal opinion. Please be aware some content may be triggering.

“Shut up!” are the words I wanted to say. Someone tried to tell me what I could do even when I expressed how difficult it would be. They totally invalidated my feelings. They totally disregarded my illness. It was like they thought I had a choice over how I felt.

The thing is this is common for people with mental illnesses (and I’m aware it’s the same for those with chronic physical illnesses, especially if they’re invisible, but I don’t really have much experience of this so would not like to comment further on this). People seem to think you are just being difficult. They seem to think it’s a choice. They can’t see how much of a battle these so called “simple” things are to do.

Mental illness can create barriers to doing certain tasks. Getting through these barriers takes a lot of work. Just because you put it in simple terms does not make it any easier. It does not take away the mental, and sometimes physical, blocks. It does not change my feelings. It does not take away my anxiety (or depression, BPD, bipolar, schizophrenia, etc). All it does is frustrate me as I feel misunderstood.

What can be worse is when it is someone who has experienced their own mental illness. You kind of expect some understanding (and most are) but instead you are met with their own standards of what you “should” be able to do with a mental illness. This is so wrong. Everyone with a mental illness is different. It effects people in different ways. What might be an easy task for me, might be the hardest thing for someone else and vice versa. Please don’t hold us all to the same standards.

In short before you voice that someone can do something (and not in a “you’ve got this” way but in a “you will do this as you are capable” forceful way) think. Why are they saying they can’t do it? What can you do that is a practical way to help? Are they ready to tackle this right now? Maybe ask them these questions. Please don’t invalidate what they are feeling.

If you’ve got any thoughts on this feel free to share in the comments or on Twitter, Facebook or Instagram.

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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.

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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.

Unhelpful Things That Have Been Said To Me

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

I’m currently in a state of crisis. I’ve been struggling with self harm and suicidal thoughts. I’ve been quite open about this on social media and had lots of supportive messages but there have also been some extremely unhelpful comments too. Here are a few.

“Everyone feels like this some days, it will be better tomorrow” – A well meaning comment I know but for those who have a chronic mental illness it feels like you are downplaying what we are feeling and going through. Often tomorrow won’t be a better day. In fact it could be ten times worse. This makes us feel like we are doing something wrong to still be in this pit of despair. Also not everyone goes through what we are going through. A lot of people will experience similar things but what each person feels is unique to them. While there may be some comfort in knowing we are not alone, pretending everyone has experienced it just makes us feel like we are not coping as well as others do.

“I’ve heard camomile tea is calming” – This was said to me by someone with a mental illness and again I know they meant well. The problem is camomile tea is not going to solve suicidal thoughts. My mental illness is much more complicated than that. If it was as simple as that I wouldn’t repeatedly fall into crisis.

“Have faith in God” – I have nothing against anyone who believes in God or follows a religion. That is great for you and if it helps you to feel better than I am pleased for you. However please don’t try to make me believe in God or have a faith. There may be a number of reasons someone doesn’t have a faith and even if they do it can not always help them when dealing with a mental illness. It is not a crisis of faith that causes mental illness.

“There’s plenty to do that could take your mind off things” – I know that keeping busy can be useful to distract from the distressing thoughts but I had been doing hours of distraction and keeping busy when this was said to me. I felt like I couldn’t do anymore and even when I was busy the thoughts were still there. Also sometimes it is not possible to just keep going. Having a mental illness can be so exhausting in itself that doing something else is just impossible. Distraction also only works for so long. Eventually your thoughts will catch up with you if you don’t deal with them.

Those are just what have been said to me this time round in crisis. There have been many more that I have experienced over the course of having had a mental illness.

If you have had some unhelpful things said to you and feel you would like to share, feel free to use the comments or Twitter, Facebook or Instagram.

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Losing A Mental Health Professional

This piece contains my personal opinions and some of the content may be triggering.

Sometimes in life we can’t control what is happening around us. People come and go in our lives whether we want them to or not. This can be hard to deal with. One big change can be when we lose a mental health professional who has been involved in our care for a long time. We may have come to rely on their help and support. We may have built up a good relationship with them. And then it ends.

As someone with Borderline Personality Disorder (BPD) endings can be particularly tough. Having a fear of abandonment means that when someone does actually leave our lives it is like a self fulfilling prophecy. Our worst fears are happening. This may lead to us getting involved in risky behaviours or rejecting the person before they are out of our lives in a way we believe will protect us.

Recently I was given the news that my care coordinator was moving on and I was going to have to say goodbye. It was difficult news to take as we had a good relationship and she was a great and supportive care coordinator. Getting the news made me feel like I was being abandoned as at the time there was no replacement on the horizon and no idea when one would be recruited. I was close to tears. Many thoughts went through my head including “was this my fault?”.

As I came to accept that this was going to happen I started to pull away from my care coordinator. This is what often happens with people who have a BPD diagnosis. It’s a way of protecting ourselves from a perceived abandonment even when it is not a true abandonment.

What helped though was the way my care coordinator rounded up our sessions together. She made sure my care plan was updated before everything ended so the next person would know what I needed help with and what I was working on already. Also in the end a new locum care coordinator was appointed so my old care coordinator could introduce me to the new one. This allowed her to inform the new person as to how often we met, what my major issues are and what needs to be brought up at my next psychiatrist appointment. It also helped to make a plan with the new care coordinator as to how our meetings would work.

What should a mental health professional remember to do when leaving a therapeutic relationship?

  1. Let the person know your leaving face to face
  2. Answer any questions about the change that the service user/patient has about the change
  3. If possible introduce your replacement to the service user/patient
  4. If unable to introduce your replacement, leave notes for your successor
  5. Tie up all loose ends

What can I do if I’m losing a mental health professional?

  1. Talk about any issues you feel need to be taken into account with a member of your mental health team
  2. Make sure you have numbers of people you can contact if you need help
  3. Create a support network (if possible) away from the mental health team
  4. Be open to a new mental health professional, remember just because they are new doesn’t mean they’ll be awful

Those are a few pieces of advice that I have but if you have more then feel free to use the comments or Twitter, Facebook or Instagram.

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Language Matters

The language we use surrounding mental health and mental illness matters a lot. It can fuel stigma if used incorrectly. It can make people think differently about the subject being talked about. It can minimise the seriousness of this topic. So below I thought I’d discuss some of the common terms that get misused or that create stigma.

1. “Committed suicide”

The term “committed suicide” comes from when suicide was against the law. This is no longer the case and hasn’t been for several decades. Using this term can make it sound like someone is criminal for taking their own life, instead it is better to use the term “died by suicide”.

2. “You’re so OCD” and other OCD misuses.

This is so wrong. It minimises the suffering of people who have to deal with this complex illness. Using OCD as a way to discuss how neat and tidy you are is undermining the seriousness of the intrusive thoughts that people who suffer with OCD get if they don’t carry out their compulsions. So before using OCD as an adjective remember how serious it really is.

3. “Psycho”

The term “psycho” brings up all sorts of awful thoughts and images, but using it to describe someone who has a mental illness doesn’t help with the stigma surrounding mental illness. It makes people wary of people with a mental illness and makes them think they are going to be attacked or hurt by us. The truth is that people with mental illness are more likely to be a victim of violence than the perpetrator.

4. “Doing this would be an act of self harm”

This is a phrase I have heard used by many MPs and I dislike it intently. It feels like they are dismissing the distress someone has to be in for them to hurt themselves. It is used as a cheap point scoring exercise. The seriousness of self harm is being overlooked.

So that is just a few of the terms that I feel people need to think mre carefully about using. If you can think of anymore feel free to share using the comments, Twitter, Facebook or Instagram.

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Dignity in Mental Health

This years World Mental Health Day was focusing on dignity in mental health and towards those who have mental illnesses. Therefore I thought I would write about what dignity in mental health means to me and how I see it at the moment. I also thought I’d share some experiences and how I felt they affected my dignity. These are my own personal views.

Part of the definition of dignity that I looked up talked about a feeling of worthiness and self respect. These are two elements that I think are important to consider when looking at dignity in mental health. Being treated with dignity should be about being treated like we are worth treatment and support. Sometimes this is not the case and it can have a negative effect on the individual who is being treated. After an attempt on my own life I was made to feel I was wasting people’s time and this led to me feeling worse about myself than I was already feeling. This I believe was due to staff showing a lack of care about my dignity and not making me feel I was worth the effort of treatment,

I have also had good experiences where I was made to feel like I was totally worth the treatment I required and therefore was treated with dignity. This is particularly the case with my GP who is fantastic and very supportive. She respects me and treats me with dignity at all times. This in turn means that I feel that I can discuss my care and treatment more openly with her and I know that if I have any symptoms or things that are worrying me I can easily talk it through with her without fear of judgement. This is the care we all deserve in all areas of the health system; not just mental health but physical health too. Unfortunately this is not always the case as my previous experience has shown.

I also mentioned that the definition I looked at for the word dignity mentioned self respect. I think this is important too. I have previously written about self stigmatisation and I think that by self stigmatising I have shown a lack of self respect and also therefore a lack of dignity towards myself. If we are to expect dignity from other people towards our mental health then we need to also show dignity towards ourselves. I understand that this is easier said than done. I myself struggle to feel worthy of treatment and help at times especially when my mental health is at its worst. This is another reason dignity from other people is so important in mental health as we need to learn from others that we are worthy of being shown dignity and we need to also learn how to do that sometimes. Thinking back to my GP she has shown me that I do need to discuss what is going on in my head and therefore by her listening I open up more. This is an example of being taught my worth and how to respect myself and my mental health. In turn this teaches me how to have dignity for my own mental health.

Overall dignity in mental health means to me that we are shown and taught our worth as well as learning how to be respected and respect ourselves. To me this is something that is majorly important in improving the treatment of those of us who have mental illnesses. I know that many staff already do a fantastic job and I hope they continue to do so and teach others that dignity is necessary for recovery.