Tag Archives: Stigma

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.

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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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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.

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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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Self Harm Scar Etiquette

As it’s summer the weather is warmer and people are starting to reveal more of their body. This brings an anxiety to people who have self harmed, past or present, as they are faced with the choice of covering up (and boiling) or revealing their scars and self harm to the world. Therefore I thought I’d come up with some things that will make it easier for the person with the scars or self harm if you encounter them. Obviously this is just my opinion and others may feel differently.

1. Don’t point it out

This seems obvious to some but not to others. Pointing out scars adds to the self consciousness. We’re already worried what people are thinking without it being obvious that they’re looking at the scars. Also if we are starting to forget about them and enjoy what we’re doing then pointing them out takes away from our enjoyment.

2. Don’t ask us why we did it

Again, this adds to self consciousness. We become aware that you’re really looking and thinking about our self harm or scars. It can make us feel awkward and like we’re being judged. Quite often we don’t know why we self harm or don’t want to discuss it as its obviously something that has caused us great pain. We can easily be taken back to that dark place.

3. Don’t tell us to cover up

First of all why should we cover up? This makes me a little annoyed. I’ve been made to feel ashamed of my scars a long time and this shouldn’t be the case. It’s part of an illness. I have every right to not boil in summer. I don’t want to make people uncomfortable but I also shouldn’t have to feel uncomfortable. People who self harm feel enough shame and it takes guts to show your scars, we shouldn’t have that shame added to.

4. Please don’t stare

This can feel awful. I already feel self conscious enough without people staring at me. I had this once on the train and it really fed in to my paranoia. I know it can be hard to look away sometimes but please think of the person you’re staring at.

It takes real bravery to overcome the barriers to have your scars on show. It is revealing yourself to many people, including strangers. It can take a long time to accept your scars are part of you. Shame is a really strong emotion that people who self harm feel and can be added to by other people making ill thought out comments. Please think before you speak.

If you have any other things you feel people should do or not do help you feel comfortable showing scars feel free to share in the comments or on Twitter, Facebook or Instagram.

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Come Outside

If you’re an adult of a certain age in the UK you will remember a programme called Come Outside, which had a lady going on adventures in an aeroplane with her dog Pippin (not an animation, a real woman, plane and dog!). It was prime viewing if you were off school sick. You may be wondering why I bring this up but I’ve realised something lately: being outside is good for my mental health and so I should of taken Auntie Mabel’s advice a long time ago and gone outside.

There are a number of reasons I found going outside difficult. Sometimes even my own back garden felt off limits. My anxiety around being in public places was the worst part. I found going out alone difficult and things got gradually worse until I couldn’t use public transport (my only means of transport at the time) or be alone outside the house apart from attending my medical appointments and even then I needed music to cope. The idea of going for a walk was horrifying. At one point agoraphobia was added to my diagnosis.

The thing is, with some changes that have enabled me to get outside more often, I have realised that being outside actually aids my mental health. I’m very lucky to live in a house with a back garden. Although at times it has been hard to get into it, I’m glad I managed to work through it to get out there. I now hate it when it rains as it doesn’t feel pleasant going into the garden and I can’t sit out there. I’m no gardener but I do find mowing the grass therapeutic. I put my music on and enjoy seeing the finished lawn with its lines (is it even a lawn if it doesn’t have lines?).

So what got me into the garden? The answer: Guinea Pigs. I got myself two Guinea Pigs. And due to my mum’s stance that she wasn’t having them in the house they lived in the garden (in the shed or garage in the winter). This meant I had to go outside every day to them. At first it was really tough. I’m not the greatest with dirt and it was an adjustment to dealing with it every day. But I loved my boys so much that the challenges were fighting through.

The problem was though that they didn’t get me away from home on my own. This was something that got harder and harder. Things went even further back when my Guinea Pigs passed away. Going outside got harder again. Then I started slowly in the summer trying to sit and read out in the garden. This slowly got easier, especially without the dirt aspect and having my cats sit with me helped. But again I wasn’t really leaving home alone apart from attending medical appointments and I had started to go to a group at my local Mind which had been recommended by my psychiatrist. Public transport was a definite no and walking alone was also something I didn’t feel I could do.

The biggest change for me came with another new addition to the family: a puppy. Suddenly I had a little thing that needed me to go out. To begin with it was a case of going out with someone else to walk him, but this was still progress, I was out walking. As he got older I felt more confident taking him out on my own. I didn’t feel alone as he was with me and he’d shown he was protective of me. He made my confidence grow. We also took him to puppy school. Again, to begin with, I couldn’t go on my own. It was hard coping with new people but he was my focus in the classes so that helped.

Now I walk him regularly on my own and enjoy it instead of constantly being anxious. Don’t get me wrong I still get anxious at times going out with him. Also in puppy school I now take him inside alone (my dad waits outside). I’ve also started doing some voluntary work which involves going into new situations on my own regularly. Without my puppy I couldn’t of done it. Without going outside I couldn’t of done it. Not everything is perfect. I still can’t use public transport or go to busy places alone but I’m making progress.

So what are the benefits of going outside? There are many benefits to mental health as well as physical health. These include:

  • Stress relief
  • Increased concenteation
  • Better short term memory
  • Restored mental energy
  • Sharper thinking and creativity

Getting outside makes me feel more able to deal with things and to even escape my thoughts for a while.

So even if it’s just sitting outside for 5 minutes or standing in your doorway, getting outside can help. Take slow steps to get there. Don’t over do it. And don’t punish yourself if you can’t do it straight away. For more information on going outside check out these links on the Mind website which detail different aspects on getting outside.

If you have any advice please feel free to use the comments or Twitter, Facebook or Instagram.

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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