Tag Archives: therapy

Control

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

Control is the thing I crave most in my life. I’ve known it for a while but it’s taken a while to admit it. A lot of what I do is about trying to retain some control in a life that constantly feels out of control. It’s also about managing the feelings of being out of control. The problem is I’ve gone down what people would call negative routes to deal with this.

The reason I think I need the control is that so many people have taken away any control I should have had. People have taken away control of my body and my life. Little decisions don’t feel like mine to make. My life doesn’t feel like mine.

The things I use to feel in control include self harm and hair pulling. They are not the only things I have used or do use. These are just the most regular. Food has been something I’ve used to feel in control (I do not have an eating disorder nor been diagnosed with one, this was just a period of restriction). Alcohol was another thing until it took control of me. I also feel some of my suicide attempts have been an attempt to be in control of when my life ends among other reasons.

I also can see my need to be in control in other situations. When I sit in a room with others I try to be first in to choose a seat that I feel safe in. I’m constantly early. I plan things meticulously. If I’m creating things I find others input hard to deal with. Relinquishing control on things and allowing others in is hard. I’d much rather do things myself. It’s things I’m trying to work on.

So what are your tips to deal with the need for control? Feel free to share in the comments or on Twitter, Facebook or Instagram.

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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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One Year From The End Of DBT

The 18th December 2019 marks one year since I finished DBT skills group. A whole year. It feels both not very long and forever. So I thought why not have a look back at how it has influenced me.

Since finishing DBT my mental health has been really up and down. My year was going well until August time. I still had major mood swings and was self harming but I was coping and building up my life. This all changed. The truth is I came off some of my medication by myself, no tapering, just cold turkey. I had my reasons. And these were accepted by the mental health team when they found out. However it led to a major crisis which was picked up, maybe ironically, by the facilitator of the DBT peer support group I started attending in August. But this really is unrelated to how I have been managing with the DBT skills. I just wanted to give a bit of background information on my mental state.

So as I mentioned, in August I started attending a DBT peer support group. It was set up with my local mind with the support of the NHS Trust that runs the mental health services in my area. It was designed to be the follow up to doing the DBT skills therapy group. Only people who had done DBT could join. I’ve found it amazing. I love the people. Even the facilitator has BPD and done the six months skills group. Everyone is on a level and so supportive of each other.

We use the time to discuss issues and how we can use DBT skills in those situations. This is what I find particularly helpful and what I needed in the first place. I’ve found that I’m definitely putting the skills to more use now I have the support of the group. Some situations have definitely improved and there is more of a chance I will use the skills or ask for help than self destruct. I’m not saying I’m perfect but I’ve definitely seen improvements and found myself embedding skills into life rather than having to think “which skill can I use now?”. It’s become a little bit more automatic. Hopefully this will continue.

One area I still really need to work on is identifying my emotions. This is something I still struggle with. I really need a pocket book I can carry to refer too until its a bit more automatic. This would then hopefully allow me to bring those emotions more under control. I won’t say “not great” or “fine” or “it’s been a bit difficult” when asked how I am and be able to express myself more easily. Well that’s the idea…

Another thing I need to work on is finding a way to reduce my self harming. The thing is at the moment I don’t feel I’m at a place to work on it properly. I also need to get over the fact my self harm is not impulsive so the distress tolerance skills don’t seem to work for me.

Overall I’m finding the skills more useful now and having the follow up has definitely helped me. I’m seeing the point of them. I’m seeing their potential. Hopefully it will help things to improve.

For more information about DBT, you can look 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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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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Am I Happy?

I’ve been feeling good which has been an unusual feeling, especially as last week I was nearly admitted to a psychiatric ward. But is it happiness I’m feeling? What else could it be?

There are many different definitions of happiness. These include phrases such as feeling joy or contentment. These definitions all seem very abstract to me. How do I know from this if what I feel is happiness?

DBT (Dialectical Behavioural Therapy) teaches us how to identify emotions as part of emotional regulation. I guess the idea being that in order to regulate your emotions, you first need to know what you’re feeling. Identifying feelings/emotions has always been a weak point of mine. Most of the time I can say an emotion is either good or bad. I might be able to describe what it feels like in my body but not always successfully. It is something I’ve been trying to work on and DBT has some skills that are useful to help with this.

As part of my DBT skills therapy we were given a booklet of about 10 pages identifying the core emotions and how to recognise them. It covers different ways of identifying the feelings from looking at physical reactions to situations where it has arisen. It is a useful guide but very chunky and not ideal for carrying around with you. This means working out how to react at the time is difficult.

But back to whether what I’m feeling is happiness. It’s hard to tell. It seems to start out as a feeling of great energy. I feel I can do what I want to do and nothing will stop this. I have energy. My appetite fluctuates. I’m trying hard to make jokes and make people smile. I’m trying desperately to look after people. And then it becomes irritable.

In my mind this isn’t happiness. It doesn’t seem to fit with the feelings that are linked to happiness. There are no obvious events linked to these feelings. None of it fits. So what is this?

Some people would call this a kind of mania. There are similarities. But to me it is a high. It might be fleeting or it may last longer. This time it’s lasted a few days and is dwindling. The irritability has definitely kicking in. For someone with BPD this can happen. A huge mood change, from one extreme to another. It can be exhausting to live with.

For help with identifying emotions these worksheets may help. It’s a skill that can be worked on and is definitely something I am still working on.

To discuss further please use the comments or Twitter, Facebook or Instagram.

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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