Tag Archives: professionals

Kindness At A Higher Level

We live in a society that is often far from kind. I’m not talking about individuals, I’m talking about policy and societal norms. Being individually kind is important but we need kindness as a society to make a larger change.

Unfortunately we live in a world led my money rather than kindness and what is best for people. I can understand this. Money is finite and so we have to spend with care and this can mean cuts that are the opposite of kindness. We see this in mental health services all the time. People are turned away as not sick enough or not enough resources. People are sent miles from home when unwell and needing the kindness of family close by. There are some changes that really need to be made and cutting more and more is doing the opposite of kindness and therefore worsening mental health issues at times.

Also as a society we are far from kind to those who attempt to end their life. Many are labelled attention seeking and selfish. Many a person has been heard on a train that has hit a person berating them for ending their life and delaying people. The kindness that this person needed appears to of been absent in their life and their death. Instead of asking what could of been done to help them before this event they are condemned for seeing no other way out.

Society is also cruel in its use of social media. While social media can be great there are the trolls and the nasties who are far from kind. They band together to bring cruelty to one person. They push people over the edge as they can’t show kindness. They condemn people as guilty before hearing the full story. They forgot that a little kindness could improve the world and keep people alive.

By changing our outlook from the top down we could prevent so many deaths. By acting as a society we could improve life for many. It’s time to unite to be kind as well as individual acts of kindness.

I’d love to hear your views so feel free to share in the comments or on Twitter, Facebook or Instagram.

Cancer Scare: Waiting For Diagnosis

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

The date today as I write this is 15th February 2020. Three weeks ago I found a lump in my breast. I regularly check mine but this one was actually brought to my attention by my cat kneading my chest as she loves to do and it not feeling right. So I checked it out and it felt sizeable. It had been 2 weeks at most since I’d last checked.

I kept checking it over the weekend just to make sure it wasn’t just some lumpiness that would go away. Then the following week I tried repeatedly to get a GP appointment, finally managing to get one on the Thursday. Luckily it was a GP I know well and trust as with my history of sexual abuse it was raising anxiety. When he checked he said he thought it was about 5cm. He referred me on the two week wait cancer initiative.

My appointment came through for 12th February 2020. I went along with more apprehension of facing the tests than the results. It started with an ultrasound of the breast. This seemed to confuse them and another person was brought in to look. Then it was decided I needed both a mammogram and biopsies. Normally someone my age would not be given a mammogram as it may not show anything. But mine showed the lump clearly.

The biopsy process was painless due to local anaesthetic. I was still just thinking it was a normal part of the process and they would be like it’s all fine but we just have to know what it is. That was not the case.

After the biopsy I was asked to wait in a room. My mum was with me. We got called back in and I was faced with a number of people which put me on edge. They explained that they were concerned about the lump. That I was going to have to return for another appointment to get the results of the biopsies and find out the next steps. That they were pretty sure surgery would be needed whatever.

One of the people in the room was a breast care nurse. She had been assigned to my case and would be my point of contact. She was lovely. She took me and mum off into another room. We discussed a few things and she sorted out the appointment. Her comment that there was a lot that they can do to treat cancer made me feel they know already but I can’t be sure. I’m in a state of not knowing.

So I’m sat here having a mixture of thoughts. I’ve been through so many emotions in the last few days. From the incredibly calm to the extremely anxious to suicidal. I’ve been showing others the calm side. I’ve been pushing my emotions down. A few people have heard some of the worry but not the full extent. Not the thoughts that have been going through my head that make me ashamed of myself.

There is a part of me that feels IF it is cancer then I don’t want to go through the treatment. The thought of dealing with being unwell and making it worse to get better scares me. The thought of trying to live when mentally I want to die all the time seems hypocritical. In fact it feels like it could be my way out which is a terrible thought isn’t it? But I know others will want me to go through it all. I know I will have to do it for them.

Obviously at this stage I have no definite answers. But this doesn’t stop the thoughts. Google is not my friend at the moment and the late night Google searches are not a good idea (other search engines still available?). I feel so much guilt over my thoughts. I’m just trying to push all the feelings down. I don’t want the pity. I don’t want to be treated as delicate. I don’t want people thinking I’m brave and strong. I’m not. I’m a mess. Not because I care about me but because of those around me. I don’t want to cause them anymore suffering.

So yeah that is where I’m at as I write this. I don’t know anything definite. If I publish this I may know more by then. I will keep people updated. Feel free to connect in the comments or on Twitter, Facebook or Instagram. For more information and support about cancer click here.

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All I Want For Christmas

I was thinking about things I’d really like for Christmas. Obviously there are the materialistic items (🤞Harry Potter and The Goblet Of Fire illustrated edition) but also there are some huge things I would love to see happen personally and more for mental health in our society. Therefore I thought I’d share some of my wishes (though I’m aware with just 2 and a half weeks to Christmas (at time of writing) these are unlikely to happen, maybe 2020).

1. No suicidal thoughts

This is personal, although I wish it for everyone. I’d just like to be like others and not be wanting to die on a near constant basis. It feels impossible at the moment when my first thought on waking is I wish I wasn’t alive. It would be nice to have at least a break from the overwhelming thoughts of dying.

2. Shorter waiting times

This is one for everyone in mental health services. Often we wait forever for support. It can be from weeks to months to years. It’s really not good enough. I’ve been referred for therapy again and been told if the referral is accepted I could be waiting up to two years. We need real change in this area to stop people falling through the gaps.

3. Continuity of care

This is huge to me and so many others. Seeing the same person is essential in all areas of health but the turnover of staff in mental health is huge. This means we often are faced with new staff at our most vulnerable who know nothing about us. I’ve lost count of the number of psychiatrists I’ve seen in the last two years. It is nearly always someone new. I’m on my fifth care coordinator of the year. The changes effect my mental health massively. We need to retain staff.

4. More money for mental health research

Mental health is one of the least funded areas of research in medicine. Yet again it is the poor relation in health care. It is also one of the least understood areas. This needs to change when it effects so many people. It would also help other areas of health care as helping people with their mental health aids them looking after their physical health too.

5. Better self esteem.

This is a personal one. I hate myself. It’s not a secret. I have no feeling of self worth. I put myself down constantly. It needs to change but it’s a struggle so if I could get it magically fixed for Christmas that would be great.

6. My friends to be well

My final wish is that all my friends have good mental health. That they feel better. I want so much for them to see their worth. That they are awesome. In fact I want it for all of you. You are all fabulous. Thank you for being amazing.

Feel free to share your own Christmas wishes in the comments or on Twitter, Facebook or Instagram.

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A Paradox

Please be aware some of the content may be triggering. Please take care.

A paradox: a person or thing that combines contradictory features or qualities.

I love the word paradox. I think it’s one of my favourites. I don’t know where I discovered it but it totally made sense to me straight away. I am a paradox a lot of the time. In my mental health, in the food I like, in my interests, in my personality. Most of the time I don’t mind this. I feel it makes me that little more interesting. I have found others who are a paradox too and they’re awesome, interesting people. But sometimes it means that in certain situations I’m not taken seriously.

I mentioned that I’m often a paradox with regards to my mental health. What I meant by this is that my behaviour is often contradictory to my thoughts and feelings. This can mean when I’m in distress I’m not taken as seriously. I can understand this to an extent but as most people with a mental illness are good actors anyway it should be thought about.

Take this morning. I’ve been actively thinking about suicide. I feel so low and useless. But with my care coordinator I laughed at a couple of things and had a sense of humour. This made it seem I was better than I was. It was contradictory, a paradox.

I also felt I was worthless. Then I had an email about helping review mental health factsheets and put myself forward. I feel I’m rubbish at what I do yet still I try to do more.

Being a paradox can be interesting but it can also be highly frustrating. Sometimes I want people to understand and see I’m not OK without me saying. This doesn’t happen as I can laugh and joke and still feel depressed. People don’t take my reactions to questions and comments saying I’m suicidal seriously. I’m dismissed by professionals who can’t see that I’m really struggling because my actions aren’t always in line with my feelings.

Also I can feel extremely suicidal to the point of making plans but still be doing things that suggest I’m still going to be around in time. The thing is this doesn’t mean my suicidal thoughts are any less serious. I still am desperate to die and can even make an attempt on my life despite future plans recently made. This is the reality of being a paradox.

I think there needs to be more awareness of paradoxes in mental health. It can leave people isolated when their actions go against what people expect from the mental illness. The truth is mental illness comes in many guises and this needs to be recognised more widely, especially with regards to those of us who are a paradox.

To comment further on this subject feel free to use the comments or Twitter, Facebook or Instagram.

Dear GP

There is an amazing account on Twitter called Dear GP where people write letters to their GP about their encounters with mental health professionals in the same way mental health professionals write letters about their patients to their GP. You cam visit the website here. I thought I would have my own go at this below after an encounter with a member of staff who is no longer involved with my care.

Dear GP

Today I met with care coordinator P. She was casually dressed in jeans and trainers. She seemed disorientated and unsure about what was happening. She did not know where she had to be and was indecisive of her next steps. She appeared very disorganised and had not booked a room or remembered that she was meant to be attending my psychiatrist appointment.

Before the psychiatrist appointment, P appeared to disappear and it soon became apparent she was making secretive actions with the psychiatrist. She made no eye contact when I entered the room and was distracted and on her phone throughout the appointment.

P made some abstract comments that only just related to the conversation between me and the psychiatrist. She was keen to please the psychiatrist and back up his treatment plan despite knowing the issues with this way forward, which had been discussed previously. P then showed that she had been trying to rid herself of responsibility and discharge herself from my care with no input from myself. This was overruled by the psychiatrist. She seemed disappointed in this course of action and did not make anymore conversation and avoided eye contact for the rest of the appointment.

At the end of the appointment, P decided to arrange another appointment but was inflexible in this leading to no date being set and no forward treatment plan being set.

I thank you for sending P to see me but I think that going forward there may be no working relationship unless her behaviour becomes more open.

Regards

Jo

To share your own experiences feel free to share in the comments or on Twitter, Facebook or Instagram.

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They’re Not All Bad

I realise I’m quite often pretty scathing about mental health professionals but some of them are OK. Some do an amazing job and are let down by their colleagues. Quite often our bad experiences overshadow the good and we get into a negative view of all professionals, which is understandable.

I’ve had a few good experiences with different professionals. The negatives with these professionals only come when they are let down by the system they work within, otherwise they are amazing and make all the difference. When someone is caring and takes time with you it makes you feel valued and has a positive effect.

The first professional I found that was great was my art therapist. This was the first major mental health professional I worked with. At the time she was part of the young person’s service which was part of CAMHS (Child and Adolescent Mental Health Services) and worked with those aged 16-25. I was 20 when I started working with her. She treated me on a level with her. I was training to be a teacher and she treated me like a professional as well as a patient. She didn’t patronise me and went at my pace. Her main work was to get me to communicate and she did well with this but at my pace. She made herself available between sessions if I needed to leave a message or write a letter to help with the next session. She’d talk me through situations. She tried to teach me it wasn’t all my fault and at times I almost believed her. The main thing that sticks with me though is that the young person’s service was disbanded so all over 18 were to be taken on by adult services meaning I’d lose my therapy. However she fought for me and told them it ws totally the wrong time to take it away from me and that she needed to continue her work with me. This led to me having a further 18 months with her. Leaving her was hard and I miss her a lot. I still have the card she gave me at the end of therapy.

Another mental health professional that gave a good impression was a psychiatrist I had in adult services. She is the one that diagnosed me with BPD (Borderline Personality Disorder). She always valued my opinion and explained things when asked. She wasn’t perfect in that she didn’t discuss my diagnosis with me before it appeared on my notes but she was happy to go through it after. She was also a consistent presence for nearly a year before she moved on. This makes a difference.

The next professional who I had a good relationship was a care coordinator of mine, L. L was very proactive in my care and worked hard to get things sorted for me, not only with my mental health but my physical health too, even spending ages on the phone to a hospital trying to sort an appointment for me. She didn’t make me feel like our time was limited, it was always as long as I needed to talk. She took an active role. It was sad when she moved on.

My current care coordinator is also great. She’s not been involved in my care for long but has already shown me how great she is in that she gave me direct contact details for her and allows me to text rather than talk on the phone. She doesn’t mind me messaging between sessions and is quick to reply even if it is to tell me she’ll get back to me properly later. She’s also always on time or early for appointments which makes all the difference. I’ve kind of thrown her in at the deep end with my crisis but she hasn’t made me feel bad about it. I hope we can work together for a while.

Unfortunately these professionals are the exception rather than the rule. It shows as these are four out of many professionals that I have encountered. Hopefully things will improve and we will get more professionals that want to help rather than make us feel like an inconvenience or stigmatise us more. If we can be part of the education of professionals I think it would help them to be more empathetic and understand us more.

Have you had any good experiences? Feel free to share in the comments or on Twitter, Facebook or Instagram.

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Screwing Up

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

I have screwed up majorly. I have pushed people away and withdrawn from others. I didn’t mean to. I just am either too much or not enough. There is no balance. I warn people and they say they can’t see it and then when it happens they recoil in horror. I tell them they need to tell me as I’m not skilled at picking up social cues but they don’t and just ignore me. I know it’s my fault but it hurts.

All that is going through my head is how much I must of hurt these people. I hate myself for it. I’m not excusing my behaviour but I don’t always realise when I’m doing or saying something wrong. If people let me know I could try and talk to them and make things right but I don’t always get the chance. I understand that maybe they get too hurt by it but when they just ignore me without telling me I’ve hurt them I feel worse. I know that’s selfish as it’s not really about me but it would help others too as I could learn what I’m doing wrong instead of just guessing. Also I really want them to know how sorry I am and I dont get the opportunity to let them know.

People say I’m being paranoid. That I need to understand that people might be busy or not well. I understand this I do but I can’t help going through everything I’ve said and done to the point I make myself sick. It makes me push away further if they do come back. It also makes me try to not get too close to new people. Though I fail at this massively. I get caught up in it all too quickly. My feelings for people go to an extreme and I’m desperate to talk to them and help them. It all becomes too much again and again people ignore and hate me.

I want to ask what is wrong with me but we all know. I’m just not cut out for friendship. I deserve to be alone.

It’s not just friendships I screw up though. It seems I destroy my support systems and the help I’m being provided. I reach crisis point and they say its too much. They can’t help me. I trust them and ask for help and it backfires. I’m pushed further away when what I need is reassurance. They wonder why people don’t talk when they’re suicidal but what other option is there when you’re scared you’ll lose everything anyway. Why try to make yourself better? For people that say they are good at working with people with BPD they seem to forget the fear of abandonment part that can cause further crisis. It feels like they’ve helped me hit self destruct again. But then at the end of the day it is my fault. I should never of asked for help instead of acting on the thoughts I was having.

So there you have it. Why I’m a screw up. Don’t worry I hate myself more than anyone else.

For further comments please use the comments, Twitter, Facebook or Instagram.

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I Want To Die

This is a personal piece. Please be aware some content may be triggering. I have sought professional help.

I want to die. That is my overbearing thought at the moment. Its there when I wake up until I go to bed. My thoughts go to how I could do it. The voice tells me how much better for everyone it would be and how useless I am that I am still alive.

My body is something I’ve lost respect for again. I feel its failing me again. It’s not doing what it should. It’s a constant trigger at the moment. I hate that I can’t fully get the help I need with it because of what has happened in the past stopping me managing the tests I need. I hate that where I have tried to sort things they are not going to plan. Why should I care about something that has let me down in the past by reacting when I didn’t want it to react? I hate it. I want it gone.

The memories at the moment are overwhelming. I always try to push them down but sometimes they just rise again and again. I hate that they effect me when I know they shouldn’t. I should be over it all. I try and believe people that it’s not my fault but then the logical side kicks in and shows the evidence of why it is my fault. I know people are just trying to be kind to me but I don’t deserve it. I’m a horrible person.

Stress at the moment is also high. Home life is hard. I feel that whatever I do isn’t good enough. Nothing I say is right. If I try to help I’m wrong. If I don’t I’m wrong. I feel guilty constantly and like I’m letting them down. I’m trying to help but it’s getting on top of me and I don’t know how to respond without upsetting people. Noone cares how it effects me. But then I know I’m not worth anything. I’m just a burden.

I feel guilty for asking for support. I feel I take too much. I don’t want to take away from other people but I fail at that. Again a lack of control makes this worse. I don’t want to cry or get emotional in front of others. It’s not me. I don’t want to make them worry. I’m not worth worrying about. Therefore if I’m gone it would be for the best.

My life is pointless. I have no potential. I fail at everything. I try and then things get in the way. I suck. I’m a burden to those around me. Why would they want this useless mess in their lives? They are too kind to say otherwise but I know I shouldn’t be here as it would make their lives easier. They could focus on the important people who deserve help.

I should die. I need to die. I want to die.

If you are feeling suicidal the Samaritans are there to listen or if you are from another country you can find a list of crisis lines around the world in the menu. Feel free to use the comments or Twitter, Facebook or Instagram to share your thoughts.

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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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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.

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