Tag Archives: Psychiatrist

Being Invalidated

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

“To invalidate means to cancel something or make it void, as if it never happened. In invalidate you see the word valid which means true or correct. When you invalidate something you are making it less true, less official, or less correct.” (vocabulary.com, March 2021).

The meaning above can be applied to things you experience. It can be caused by other people and events. It can make you question your thoughts, feelings, emotions, experiences and reactions. It can make you feel awful. And people sometimes don’t even realise they are doing this to you.

When you tell someone that what they feel isn’t justified or to just stop feeling that way, then you are invalidating the way they feel. You are telling them what they are feeling is not true and not correct. Yes, you may not have felt that way in that situation but everyone is different and that doesn’t mean that what that person is feeling is invalid.

It’s important we think before we speak. It’s what might feel like silly things that can have an effect on other people and cause them to feel invalidated and it can start when we are children. What we are saying may to us sound reassuring but it ccam invalidate the child. Saying to a child who is nervous about an exam that they shouldn’t be is invalidating. Instead saying you understand why they feel that way but you feel like they are well prepared so it should go well is acknowledging their feelings as valid while reassuring at the same time.

Some mental health professionals could also do with understanding the power of invalidation. Telling someone that what they are experiencing is minimal or not that bad can have lasting effects on everyone and especially those with a mental illness. It can cause them to deteriorate further. On my write ups from the psychiatrist appointments it would often say my self harm was superficial and it would make me try to cause myself more harm as I felt they weren’t taking me seriously. I’ve also heard of people with eating disorders who are told they are not thin enough being made sicker.

I know that although having a diagnosis can be a burden I felt it a validation for what I was/am experiencing. It made me feel that someone could see that something was wrong and I needed help. However this means professionals need to be careful about removing diagnoses from patients as it can add to invalidation. You are taking away the validation you gave them. There needs to be a conversation and careful explanation.

It is possible also to invalidate yourself as well. This is harder to stop doing, I know I do it a lot. It’s important for us to try and allow ourselves to experience our feelings and acknowledge them. This is easier said than done though.

So when speaking to anyone try to consider their feelings and not cancelling them out. We all need to think of how our words and actions impact on others.

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.

We Need To Talk About… Psychosis

Psychosis! What do you think it means? Does it mean schizophrenia? Does it mean being locked up? Does it mean there is no hope? These things are things I thought before I experienced psychosis and I know many still think this way. This is why we need to talk about psychosis.

So what is psychosis?

Psychosis is made up of many different symptoms. Some people will have many, some only one. They include:

  • Hallucinations (these may be visual, auditory, tactile or related to smell and taste)
  • Delusions (having strong beliefs not shared by others, for example, people are going to hurt you)

Does everyone with psychosis have schizophrenia?

It’s a common assumption that the only people that experience psychosis are those with schizophrenia. This simply isn’t the case. Many mental illnesses may cause a person to experience psychosis. These include bipolar, depression and BPD (Borderline Personality Disorder). Psychosis can also be a result of physical illness or trauma.

Will someone with psychosis recover?

There is hope for those with psychosis. Many people will only have one episode of psychosis. Psychosis can also be managed with medication. There is a variety of antipsychotics. Of course as with any medication there can be side effects but these often are often outweighed by the benefits. It can also be a process of finding what works for you. Sometimes, when the psychosis is caused by trauma, psychosis can be helped by therapy.

What does someone with psychosis look like?

There is no specific way that someone who experiences psychosis looks. The term “psychotic look” which is often used to describe a way someone is looking is a work of fiction. Those with psychosis look like everyone else. The signs are more likely to be in their behaviour.

A last thought

People with psychosis experience extreme stigma. We are made out to be “crazy” and someone to be feared. In fact we are more likely to be a danger to ourselves or be at risk from others. It can be scary to see someone dealing with psychosis but remember they are probably scared too.

For more information about psychosis click here.

To share your experience feel free to use the comments or Twitter, Facebook or Instagram.

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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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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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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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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.

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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.

Why A BPD Diagnosis Can Be Helpful

Recently I have seen a lot of people rubbishing the BPD diagnosis and saying that it would be better if people were not given the diagnosis of Borderline Personality Disorder (BPD or EUPD (Emotionally Unstable Personality Disorder)). I can see why this has been said because of the amount of stigma surrounding the diagnosis but for me I can see value still in the diagnosis of BPD.

Having a diagnosis of BPD is not easy and for me it took a long time to accept it. I was very anti the diagnosis to begin with and so I have seen this from both points of view. I hated it to begin with. I seriously thought the diagnosis was the end of the world. But now I can see some advantages to have the diagnosis written down.

One of the main advantages of having a diagnosis is that it opens doors to treatment and ways to make things easier. There is therapy that can help deal with the specific symptoms of BPD. It helps us to work on the areas where we most struggle.

Another advantage of the diagnosis is that it gives an explanation to our behaviour. It’s not an excuse, but it does help people understand why we may be acting the way we are. This is also useful to ourselves. We may wonder why we are struggling so much in a particular area and having a diagnosis can help us identify why.

Also an advantage of having a BPD diagnosis is that we can reach out to others who are living with the condition. It can make us feel understood and less of an outsider if we have others around us who are going through similar things. We can only find others if we know what we are looking for. Diagnosis gives us that.

A further advantage of a BPD diagnosis is that it can help us identify our strengths as well as our downfalls. It can make us see the good in ourselves if the positives are explained to us. There are many things that we excel at because of our diagnosis.

These are my ideas for why I’m not necessarily pleased I have the diagnosis but why I think it’s useful. If you have any ideas why you believe your diagnosis, particularly a BPD diagnosis, is useful feel free to share in the comments or on 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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