Tag: care team

What you aren’t allowed to admit – the shameful secret that I want to be cared for

The service where I am in therapy at the moment has suddenly (from our point of view as patients at least) changed our care coordination appointments from monthly to quarterly. Less than quarterly, in practice. I was supposed to see my care coordinator today. The appointment has been moved to the end of September. This will be 4 months since my last appointment at the start of June. This comes at a time that I desperately needed care coordination and when everything feels on the edge of fragmenting.

I am furious at how this change has been made, for myself and for other people in my therapy group. I’ll post about that next.

I spoke to my care coordinator about it on the phone and one of the most hurtful things that he said was that this has been an “ongoing clinical decision over several months” and they think this is the best way to challenge us to have more independence because instead of having a care coordinator we’ll have to take the initiative to sort out our problems. I’ll set to one side for the time being the hurt caused by having been kept in the dark, not warned, let alone involved, in the “ongoing decision”; the apparent total lack of awareness of why care coordination is needed; the assumptions about knowing what is best for us….

One thing that really really hurt and I wanted to scream and felt utterly betrayed again by the people supposed to help me and understand me was – we do not need a test, or a challenge, or to be forced to be “more independent”. We desperately need to be heard and to get help. I have been in this service since November 2014 and I am still screaming inside and falling to pieces and trying to be heard over the same issues as when I first came to the service. We have always been on our own. We have had to do everything with no help and knowing everyone will leave us. We just start to trust this service and dare to think perhaps they’ve understood a tiny bit of what it’s like, and then we get proof it was all an illusion. Never in my whole time with the service have I felt safe, been kept safe.

And here comes the thing it’s so very shameful and not allowed to admit. Sometimes – even a lot of the time – I don’t want to be independent. I want to be heard and I want to be cared for. The abused and terrified and frightened child inside me has never ever been heard or believed and has never been cared for. I have fought and fought on my own and I cannot do it anymore. I need help. I can shut up the child for so long by cutting and starving and drinking and overdosing. But there is a point of breaking. And I’ve passed it. I’ve never been safe. Never been safe from my abuser. Never been safe from what goes on in my mind, the pain, the hallucinations and flashbacks. 

I know these feelings aren’t allowed. We have to take responsibility. We have to be independent. We have to be adults. We have to function.

Is it so very wrong to want to be kept safe? To want someone to hear and know how utterly painful it is? To want someone to care for us? To want someone to stick to what they agree to and not trick us, not tell us they understand but then leave us alone when we most need help? If I am not independent is that really the most important awful thing? Why should I not be allowed the help I need because it’s so desperately important I be independent? Nobody kept me safe as a child. Nobody cared for me. Over and over again my abuser tricked me and left me powerless. The service I should be able to rely on now in my treatment, to understand and help me, makes me feel the same. In no way is it an empowering kind of being made independent. It’s being pushed away and tricked and all the cuts made deeper still.

I’m ashamed to admit it but I want someone to care for me. Before I can start to get any more ability to cope on my own I desperately need someone to understand how loud I’m screaming and how much it hurts and not to leave me, hold me and stop me from falling to pieces, stop me from losing all grip on reality because the pain and terror is so utterly consuming, hold me and allow me not to be okay. Then maybe I might be able to take very gradual steps to take back responsibility for one thing at a time. I don’t need to be tested, tricked, pushed away, not believed, not heard, used over and over again and taken to the most vulnerable desperate point then what tiny little things we hoped in taken.

I am full of anger and pain and rage at being tricked and used all over again.

G.

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Slipping through our fingers

There have been several cases in the news recently, in particular two this week, of children suffering unfathomable cruelty at the hands of their parents / caregivers. Much has and will be made of the failings on the part of social services and social workers. How could the horrors and suffering go unnoticed and why were concerns not followed up, staff nor taking a more joined up approach, so the children could slip through the net?

I don’t doubt that there certainly were failings in the services. I’m not denying that. I can’t imagine the guilt the workers involved in those two cases are feeling right now. I’ve suffered myself and so did my mother and so have several other people I care about, because of failings in the organisations that should give support and protection, which let us fall through the net without intervention in times of crisis and without promised follow up or communication across different services. Sometimes the services involved have seem totally unaware of the harm this causes and unwilling to take responsibility. That hurts even more. Fortunately I have never suffered anything approaching what the children in this week’s cases did.

I’m not trying to deny that there were failings and I don’t want to hurt anyone who has been through similar experiences. However I think the somewhat understandable jump to publicise the blame attributed to the social workers and agencies masks some important points.

First, the perpetrators of the terrible abuse the children suffered were their mothers, father’s and family members. That’s the greatest horror. It is terrifying that as humans we are capable of inflicting such suffering on another, let alone on one of our own family or our own child. It’s particularly horrific that a mother can do this to her own child. It so negates every good and nurturing thing a mother is. It means no relationship and no home is immune to evil actions and absence of love.

Secondly, that is such a frightening fact and we want to know why. How and why can a person do that? What does that mean about what’s possible? About our human race? That sounds like an overly broad concept really. But I think it shakes us. Can we conceive that our world is one where what should be the safest and most protective relationship, mother and child,  is used to inflict fear and hurt and pain?  We don’t want to. We at least need some explanation. It’s easier to label the failing of a particular social worker or agency, because that we can understand. That we can name. What brought the abusers to use their own children that way, we can’t.

Thirdly – and this is something that’s hard to explain but significant to me as a survivor of childhood abuse – these horrific abuses can and do happen in secret and undetected. Trying to come to terms with what happened to me and questioning over and over whether the things I can remember done to me are true, I’ve often doubted myself and told myself it must have been my fault or I must be mad and inventing it all, because at the time nobody else realised what was going on and nobody intervened and people thought my family was normal (er okay maybe not but they didn’t often suspect the full truth). These two tragic cases in this week’s news show the awful fact that abuse much worse than what I suffered can indeed continue in secret. Therein lies the abuser’s power to control, manipulate and deny.

Fourthly, no more resources are coming for social workers and care and protection teams at the moment. The little glimpses I’ve seen from my work in hospitals, psychiatric services, care teams and so on has shown me loud and clear that there simply are not enough hours in the day and not enough people on the ground to have the contact and communication and time to spend directly with children, families, patients in need,  as well as following the ever more extensive proformas and completing paperwork that is required to meet the rules and regulations (which are supposed to ensure good care is happening but at the same time take you away from doing it).

This is no new or ground breaking feeling. I think most people in nursing or caring services have been saying this for years. But it’s still frighteningly swept under the carpet and denied by those in power. When I worked in a service that supported teenagers and young adults with mental health needs and social support needs, I would take the minutes of clinical team meetings. In one such meeting, changes to documentation for care planning and recording were being introduced, which would require nursing staff to (a) spend much longer away from patients, sitting at computers completing databases and reports and (b) in many cases require nursing staff to spend already limited professional development time on training in IT packages, not in patient care.  Of course, the aim of all these whizz new care planning systems was supposed to be a magical improvement in compliance with regulations about good care. However, nobody could answer who was going to be delivering the care during the time that the already over stretched nurses were completing the compliance paperwork. I wonder whether there’s a box in the risk assessment screen to record the increased risk caused by the fact the nurses and carers are filling in the [expletive deleted] risk screen instead of assessing the patients? 😉 Time and time again there was no answer to this impossibility. In that meeting, one or two nurses directly asked, how in the same shift with the same staff,  were they to fit in their work with their patients, as well as completing the new compliance activities being introduced. How could they do both? Which was to go when the time ran out? In my eyes the response was appalling. The nurses were told that was an unacceptable attitude to display and there was simply no choice and the compliance work was to be done. This came from a senior clinician who I had greatly respected and her response was totally at odds with her usual very reflective approach. Of course I don’t know the history with that particular member of staff who asked the questions and perhaps there was more to it than that, but there seemed a forced denial of the impossibility of continuing to provide good care and the level of presence on the ground with those we are caring for,  which is so important if we are to prevent tragedies like the children who slip through the net where abuse and suffering goes undetected.

I left the service I mentioned because more and more changes were taking clinicians, and support staff like myself, away from being able to maintain the personal contact with patients.  (I’ve since regretted leaving, I’ll admit.) Clinicians left too, at least in part due to stress and sadness around similar issues. They were a great loss to their patients, in my opinion.

A little later I worked a temp cover role as a secretary for the legal team that supported my local county council’s child protection services. Round about this time I thought about training as a social worker. I didn’t in the end. I thought I’d find far too many situations where my hands were tied and too many times bureaucracy stopped me doing the good that was needed.

….

I cry for the children that suffered and for those who so want to be present on the ground to help those at risk but who are taken away and whose voices are silenced when they highlight the lack of resources and impossibility of meeting the demands of keeping children safe in the field, and complying with everything that’s supposed to be ensuring children’s safety. One thing is sure and that’s that it is far too easy to be silenced – again both in the case of the victims and the carers pointing out the shortage of resources to help them. Let’s keep on speaking out.

Ginny xxx