Tag: community mental health teams

Losing Lily

TRIGGER WARNING for discussion of suicide, of deaths of people suffering mental health conditions, and of failings in mental health care. If you are in mental distress, caution is advised in reading this post.

A NOTE: This post mentions anonymously the death of a person who had recently left the care of a service I worked in. There was an investigation into the circumstances of the person’s death and the investigation has now concluded. I want to make clear that this post discusses solely my experience from my point of view and my knowledge of the situation, my thoughts and feelings. It does not reflect the position of the service I worked in, or of any other person or team involved in the person’s care.

During the time I worked in a specialist community and inpatient mental health service 7 or 8 years ago, two of our patients died. One lady had moved away to a different part of the country so hadn’t been in our service for a couple of years when she tragically died from an overdose. The other lady had just left our inpatient ward (as far as I know against doctors’ advice but assessed as having capacity to make her own decision in this regard) and gone to live independently, but deteriorated rapidly within weeks and died 4 months later. I’ll call her Lily*.

At any one time we were working with several other patients in my eyes dangerously close to death – because of their drive to harm themselves (by overdose and substance use and so on), because of their suicidal intentions, and/or because their organs were so damaged physically by the effects of their mental health conditions (starvation and other eating disorder or self-neglect symptoms leading to heart failure or diabetic coma, for example).

We were working constantly short staffed, physically and mentally unwell ourselves because of the workload and emotions and conflicts and fear of making mistakes, within constraints of time and policy that often felt out of our hands, trying to provide a service fair and the best for everyone, but knowing we could not give enough.

Lily has never left me. She’s come to my mind every week or so since the winter she died. I was a secretary, not a clinician. I didn’t know Lily as much as I got to know some of our other patients. She was intelligent and wanted to do well and was very driven for her goals. She made close friendships with a couple of people on the ward. Yet, she really needed love which I think she often didn’t find where she may have most expected it. She really did start to get better but something very painful remained impossible to reach. Sometimes I wonder if she was hurting so much she’d had enough. If everything was so locked in and disconnected from the people she needed and wanted to trust, that in her pain it felt like time to go – if she didn’t choose exactly when but she did know she’d quietly slip away.

We didn’t reach her. Even as she got a little better, we couldn’t reach through her pain. We didn’t catch her. We didn’t keep her safe when she was slipping. We lost her.

There was an investigation – many investigations – after Lily’s death. The final investigation ruled that the harm she suffered, and her death, were avoidable. I just now read the start of the report of the last investigation and horror and panic and confusion took over. The room swayed and spun and I couldn’t breathe. I’m still freezing cold.

Her life is on my hands. Not mine alone, and not the service I worked in alone because several other services were involved – but I was there.

Of course we had not wished to reject her or abandon her or disown her or her care. One of the worst things is that a lot of what was judged harmful in the report, were either actions in line with procedures we were taught to follow to give safe and fair and consistent care to every patient in the service, or matters that within the constraints we faced, we could not personally control. But whichever, it wasn’t right or safe for Lily. Consistency and guidelines and constraints are one thing but every individual patient is in very individual circumstances at very individual risk. Procedure under huge constraints imposed from outside, doesn’t make account of that.

What do we do when the steps that were supposed to have been good or safest or standard, or following established guidelines, or the best we could give, or taken in faith in the decisions of those we work for and trust, were actually steps that led to a death?

Personally, what should I have done and what do I do now? My heart is screaming at me, you did not speak up, you did not speak when you had concerns at what you heard, you did not act, you did not follow your gut – you followed instructions instead, and you know this wasn’t the only time.

Good intentions or having tried to follow what was supposed to be good enough, or even best, count for nothing now.

I’m reminded of my mother and her care and deterioration; how we were locked in an agonising cycle of her discharge, the same crises repeating, her deterioration and readmission, worse and worse every time, all of us knowing what would happen but all held powerless by legislation that didn’t allow us to put in place a few simple steps that would have kept her safe. Ultimately an adult judged to have capacity to make a decision is allowed to make a decision that will harm herself, allowed to cut herself off from sources of help, allowed to deceive everyone who wants to help. Even when those decisions and actions are the work of a delusion founded in deep-rooted, severe psychosis. My mother couldn’t be more different from Lily but I see similarities in how the hands of those who wanted to help were rendered powerless.

In my head when Lily stares at me, slowly fading, I don’t know what to say, and everything I should have said back then echoes around me.

(*not her real name. Again please note that the opinions and thoughts and experiences mentioned in this article are mine alone.)

Ginny xxx

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Looking for an app to track mood and pain

I am seeing a psychologist at the pain clinic for a short number of sessions. When I was first sent an appointment to do therapy I was really worried and almost angry about it, feeling I’d had enough of therapy in other services where I couldn’t trust the therapists or the community team and I couldn’t risk making myself vulnerable again. On top of that I was sure the therapy would be from the point of view that nothing is wrong with me, the pain I have is unnecessary and my fault because I’ve rested too much and not pushed myself enough, which is an attitude I’ve encountered too many times on so-called pain management courses. Amazingly it has turned out to be a very different experience.

I don’t tend to find pain is terribly related to my mood, beyond the fact that I’m more anxious and low when the pain is worse. It’s also connected to flashbacks but I don’t quite know how. We identified in therapy today that I find awareness of my body very difficult. Maybe that is common in personality disorder and certainly in dissociative identity disorder.

I want to try tracking my pain and my mood together to see if this may show up any links I’m not aware of. I’ve done the two separately before as part of learning to pace activity (I did not find the recording gave me any new insights) but I’ve not really done the two together, not over an extended period anyway.

Phone apps exist to track your mood but I’m looking for an app that tracks mood and pain. Ideally I’d like an app where I could record a numerical score for my pain and my mood every couple of hours through the day, with space to make a brief note if something very significant happened (for example if I have flashbacks or an event triggers traumatic memories or dissociation).

Have you used an app like this and did you learn from it? Any recommendations would be very helpful.

Ginny xx

Mental wellbeing scales…. What do you think?

This is the SWEMWBS. Er, bless you?! No, it stands for the “Short Warwick Edinburgh Mental Well-Being Scale” Maybe the longest possible name for the shortest questionnaire!

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I was given a copy of this to fill out on two occasions recently: when registering with a mental health charity locally in the hope of accessing a community-based personality disorders support group, and at the first session with my Recovery Coach. I’ve lost count of the number of questionnaires of this ilk that I’ve done since my mental health conditions wete first diagnosed, for example one or two page scales at the GP Surgery to rate anxiety and depression, to 10 page booklets at the personality disorders service, repeated to examine changes through my treatment. The SWEMWBS is by far the shortest of all these, which could be a strength. I still found it tricky partly as to my mind it seems to have gone to the other, overly simple, extreme. However that does all depend on what you want to measure and why. I may have found it tricky because it didn’t match what I wanted to express. What I want to express might not be what services, support agencies and so on, wish to measure. Arguably, services do need to make sure there is the opportunity for us as patients / clients / service users to express what we feel is most important and often this can’t be slotted into a tick box or numerical scale. I’ve been fortunate that people working with me have given time and importance to that which doesn’t fit into these kind of measures.

As part of their work, a member of my family is exploring initiatives to support and promote mental wellbeing. They are looking at using scales like the SWEMWBS to measure how people feel across participating in activities, and whether the way they feel changes. The activities could be social groups, exploring nature together, art and art appreciation, developing and sharing particular skills – generally community based projects. Reporting how you feel on long complex scales proved off putting and daunting, understandably. In my opinion, there is a certain conflict between the fact that the most respectful and detailed way to find out how someone is feeling may be simply having a discussion with no constraints on how they express themselves; whilst at the same time, to analyse whether a particular activity or therapy has helped, there does need to be some form of quantifiable (so usually numerical) analysis of changes in how someone feels.

My family member asked me for thoughts and feedback on the above and to share my experience on how I find using scales like the SWEMWBS. How meaningful is it? How does it compare to unrestricted feedback where we can express freely verbally or in writing how we feel?

I’d be interested to know readers’ thoughts if you have any you would like to share, whether or not you’ve completed these kind of scales yourself.

I could pass these thoughts on anonymously if you wished, or not if you do not wish.

Thank you!!

Ginny xxx

The Short Warwick Edinburgh Mental Well-Being Scale is copyright NHS Health Scotland, The University of Edinburgh, The University of Warwick (2008).

How long their words stay with us

I’m trying to persuade a friend who is very ill to go to A&E tonight, or at least call 111. I wish I was where he is and could take him.

He is not at all well in so many ways. He’s waiting for several operations.  The worst danger tonight is that he has unbearable pain and symptoms to do with blood clots he has; we know with these symptoms that there is a danger of a blood clot in his stomach. We know he should seek help urgently in these circumstances with these symptoms; medics have told him this.

The main reason he is very reluctant to get help is what was said to him by a doctor the last time he was admitted, a few days ago. The doctor made a range of sarcastic comments about him to nurses and another doctor and said outrageous things to him including that hospitals are for people who are really ill not timewasters like him! This was when he’d been admitted when he’d attended as he was instructed to for an ECG and scans. He was found to have three bloodclots in his leg, as well as the numerous other serious problems for which he is due to have operations.

I cannot conceive what would lead a doctor to say what this person did. I know anyone can have a bad day. Anyone can dislike someone. Doctors, nurses, HCAs and other staff in hospitals are under a critical amount of pressure, now more than ever. But what would lead someone to say such bitter, accusing, unsubstantiated, false things to a person they are specifically there to care for? Did the doctor actually believe it? Or was he somehow venting anger, hate, judgement, for some reason onto my friend?

Not only this but without asking any questions to determine his mental state and without advice from the psychiatry team at the hospital or the community mental health service my friend is seen in, the doctor said to my friend that he should be Sectioned, and started trying to arrange this. Was he assuming or insinuating that my friend’s physical health conditions didn’t exist and were delusions? In spite of countless scans and test results and reports? Had he branded my friend as attention seeking because that’s the stereotype he holds of people with the mental health problems my friend has? Did that stereotype have such a hold it negated the physical evidence in front of him? Or does he regard people with mental health problems as unworthy of help or care however much they need it and think instead we should be shut up in institutions out of the way of those who he thinks do deserve help?

I’ve been on the receiving end of this numerous times. I’m really hurting for my friend and knowing he’s been left in so much danger now. Whatever the reasons behind what that doctor said, his words have told my friend he’s unworthy of help and must not ask when he needs it. My friend struggled enough with that already. He has had enough abusive people telling him he deserves pain, deserves bad, is asking for it. I don’t know exactly how it is in my friend’s head of course, but I know from my own experience how much louder memories that tell us we are unworthy, that confirm what our abusers told us, scream at us than any fledgling sense of ourselves and our value can. Words like this doctor’s join with the voices accusing and taunting us and they do not fade; they take a grip of us and punish us if we do not obey them.

My friend is in unbearable pain now and potentially great danger, and I’m trying to persuade him to go to A&E or if he cannot bring himself to do that, to call 111 for advice. I’m praying that if he does speak to 111 – when he does, please God – the advisers that speak to him are compassionate and show him there are people that do want to help and do have compassion and will help and believe him.

What this doctor said to my friend was awful by any standard, I think. Still, I wonder do people, especially people in authority roles (such as those who determine the medical care we get), know how much difference their words make, for good and for bad? I think words do have greater power for those of us with BPD, with histories of trauma and abuse and rejection, and no doubt with many other health conditions too. This is our responsibility to be aware of and to try to learn ways to cope with and I’m starting to see that very gradually,  with a lot of time, we can. It would not be at all fair to demand that other people treat us more carefully than they treat others. Actually, this is one of the things I fear demanding of others. But when we are already in crisis, desperately needing help, it would help so much if those caring for us knew the lasting difference their words and actions can make.

Ginny xxx

 

 

The wrong voices calling

The voices are very bad at the moment. My emotions are soaring and plummeting at the moment since my last group therapy and discharge on Friday. So it is not surprising the voices are worse. They often are when I’m emotional and stressed.

It’s as if now this stage of therapy is completed and I’m trying to hang on to the good and the real, the voices are getting louder (stronger?) trying to pull me back to the blackest darkness and terror where “reality” was my abuser’s words and threats. All morning I’ve heard her calling out to me. Sometimes just my name. Sometimes the things she’d say – mocking, detesting, making me an animal, less than human, threatening, confirming my evil and the terrible things that would happen (unless I gave in and gave her total control). I hear her. And it is terrifyingly real. It is totally outside, not an echo in my head. I turn towards the voice and dread grips me. It stays totally real to me even as I try to repeat my safety statement.

I am Ginny. I am 32 years old. Today is January 30th 2017. She is far away. I am safe now. I trust in God. …He created me for good not evil.

These aren’t the only voices I have but they are some of the most frightening and separate me most from reality. I don’t know how or if there is any way to stop or change the voices. If there is I haven’t found it in the therapy I’ve had so far. If I can’t change them can I lessen their power?

I try to remember,although the world created by my abuser was my reality – the only reality for 11 years and the most of it for another 14 or so – it is not the truth. The voice is not trying to do anything, or pulling me anywhere. It is a hallucination. It is a memory. It is not a person (now). A hallucination does not have a will or an aim. A hallucination is not physical so cannot pull or drag me. So why does it have power to cause me terror, to return me into the frightened child, to make it impossible to believe in my freedom or any goodness in me?

Several other people I’ve met who have personality disorders have shared having experiences of voices. In my 18 month MBT therapy, we talked about hearing voices in the group sessions. Sometimes for example, I’d share that I was struggling to stay present in the room because the voices were loud and scary and I was constantly being pulled away from reality. But in therapy we didn’t get to explore the experience of voices or how to cope with them, how they may interact with what you’re feeling and what is happening in reality, how they affect interactions… in therapy the focus was on using grounding techniques to move away from them and be present in the group and able to focus on others. Sometimes we talked a little about how the voices may affect our thoughts about ourselves and about others, for instance when we’re interacting with someone, leading to assumptions (they think I’m evil, the know I’m bad, that’s what the voices are saying) rather than curiosity about the other person’s thoughts.

However we didn’t talk about how to cope with them. We didn’t talk about their emotional effect on us, the way they pull us with them, the control they have even though it makes no sense, how they bring traumas right back, how what they tell us and make us feel is more gripping than our current experiences, if there is any way we can respond to lessen their power…

There is a place for using grounding techniques to cope and this is valuable. There is great worth in learning to be able to stay present for others here and now. Probably a value to staying present in the moment for ourselves. Yet I wish there were more than grounding techniques because there’s always next time the voices come. Their apparent power stays the same.

Perhaps I’ll look to see if there are any books that explore voices and how to cope. I’ve pretty much been told that the voices won’t go away but if I keep taking my medication, I won’t lose my grip on understanding they aren’t real. I feel I need to find more than that.

I would be very interested to hear about experiences of voices that anyone would like to share.

Ginny xxx

Update long overdue!

It is a really hectic, up and down time at the moment and I’m much overdue posting. It has been hard to gather my words. I don’t make a habit of 2am posts – certainly not the best time of day for coherent writing – but I did not get to finish this earlier and it felt important to write before a big change coming up for me in the morning.

Belatedly, wishing you good things this New Year. I think I can just about say this since it’s still January! I’m praying that positive times and opportunities come for you and God’s blessings are shown to you to encourage you each day.

January is always a strange time, cold and empty in a way, after Christmas. Right now, so much seems unsettled, in the world, for my loved ones and in my personal life. I’ve written that before not long ago and of course it has not magically changed with the new year; if anything it seems all the more apparent. I’m trying to give generously of time and resources and friendship, for example to friends in need, and that’s how we encounter Christ in every day. But I’m feeling twisted apart inside because I come up against my limitations, what I cannot give and cannot resolve.  The family in my block, both of the partners seriously ill, whose Benefits have been suspended unresolved for weeks so they have no food, heating or electricity. My friend who has already suffered terribly and now faces more surgical procedures, my friend who has been homeless for almost a year and whose life may be in danger… to the thousands on thousands of people seeking asylum, the fear taking hold giving weight to insular policies that seem to offer protection but perhaps already spiral out of control. (The Mexico border “wall” seems to me to teetering somewhere between bizarre Divergent- trilogy-esque images and more than echoes of the Cold War era eastern block policies.)

I steer away from political issues in this blog but I think this turmoil hits ever closer to home. We hope that in times of hardship we come together and hold onto what matters most but I’m starting to think a certain level of hardship and fear brings only divisions. Then again, in my faith I believe somehow this must not be true because Jesus became Man to suffer and experience everything we suffer and go through. And He is all Love. Love came here, into the darkness and despair. Nothing changes Jesus. The despair and dark and hurt didn’t change Him, didn’t change love. So Love is here, Love suffers and struggles, but isn’t extinguished, so even in the hardest times, it’s love that remains – not division and conflict . I mustn’t lose sight of that.

This post has diverged somewhat from the update I originally planned. Probably to do with the fact that it’s 2am. I’m going to try to get back on track.

Since Christmas, I feel I have not been able to catch up at all. Usually, I have a big clear out, going through cupboards and drawers and so on and decluttering. I haven’t managed this at all. I’m frustrated with myself that I can’t keep on top of the housework at all. My emotions are bubbling over and have been for some time and I feel I have no resilience to cope with straightforward things. Saying that, maybe a lot is happening at the moment. I’m about to be discharged from the personality disorders community service I’ve had therapy in for the past 2 years. I’ve been trying to find support and things I can get in place for after my discharge. This has not been easy and actually it has been quite distressing because I have been promised a lot of treatment I haven’t had and I’m left with major mental health issues unadressed. On the positive side, I have made contact with a peer support worker and Recovery Coach who are going to help me short term and I think this will be really valuable. I have also signed up for some courses at a Recovery College, which I’ll post about (and explain) next week.

My physical health is not going through a great patch just now. The cold always makes the pain worse so that’s part of the reason. I have had to give in to the fact I need a wheelchair sometimes now and I’m looking at getting a mobility scooter. At least this will help me be less isolated and take a little stress away perhaps, because I’ll be more able to take part in things outside my home, like my volunteer work.

Practically at home, I am going rapidly up the wall at the company who should be repairing my boiler. I have had problem upon problem since November and now have no heating or hot water. I feel they have handled the whole thing terribly (7 canceled appointments for a start, having to phone 6 times to arrange a very simple thing, and so on, then them accusing me falsely of missing appointments). Ggrrr!! I know this is just part of life but in the state I’m in at the moment, I can’t cope with this, and feel very frustrated with myself for that. My emotions explode out of all control. Then I get angry with myself because so many people are going through so much worse.

A close friend has serious housing issues as well as a huge number of health problems. I’m trying to be there and do what I can. Cook hot food and support him with form filling and trying to get him a support worker who could help. It is a little way I can try to help and use the knowledge I’ve gathered from my own housing issues in the past.

I’m going to stop here. Later this morning is my last group therapy session and this will be a really really hard lot of goodbyes. I’ve been writing thank-yous and goodbyes, some of the hardest cards I’ve ever had to write. I’m sure I’ll write more about this last session and ending therapy, in the coming days. At the moment I’m struggling to find the words. I’ve cried so much today.

Ginny xxx

 

 

What do you do to stay safe?

Today I’m going to the hospital again for another meeting with the CPN. I’m very scared of going after I lost it there on Tuesday. I think I’m scared what will happen, scared of losing it again, ashamed about what happened and still feeling very out of it, although not in the way I usually am when I dissociate. That gives some kind of protection. This is raw at the same time as shaken and disconnected.

Also I’ve got an inescapable question that has been in my mind for several weeks. I’m not at all stable or safe at the moment. I want to continue with therapy. I committed to the group that I’d do it and not give up. I promised to God and Mother Mary in prayer. I’ve made quite a few sacrifices for it – I don’t think I’d have had to leave my last job if it weren’t, at least in part, for my therapy appointments (though my last employer were definitely at fault too, in my opinion). I’ve seen the therapy as the only hope of learning how to get better and manage my condition. I’m privileged to live somewhere MBT is actually available (there aren’t specific PD services in all areas of the UK). I really don’t want to have to stop therapy.

However, at the moment I’m actually more unstable, at least in part because of the therapy and the emotions, memories and questions that it raises. This isn’t necessarily a bad thing. Other people tell me they can see positive changes in me, for example communicating more clearly about emotions and things that happened to me in my childhood, none of which I can yet see for myself. However I trust the people who tell me this and think it has to be a good thing. It’s another thing I don’t want to waste.

So the big question is, what to do.  I can’t keep myself safe at the moment. For example I’m “coping” by cutting, taking overdoses or higher than prescribed doses of medication, drinking* (and this really isn’t me, I do not enjoy drinking in this way), escaping from daily life by ignoring letters, calls, etc and not able to keep on top of the basics of looking after my home and myself (cleaning, cooking etc). I’m more unstable in my moods, especially anger, and I’m struggling more to hide everything to try to participate in daily life by eg going to work. Things like hallucinations or paranoid thoughts or feeling dissociated are pushing their way more into the working day.

I don’t know what to do to change this.

I’ve some hope that medication changes could help and I’m seeing the psychiatrist on Friday. But I doubt that’s going to be the only answer. I’ve tried to exhaustion (both daily and when in crisis moments like the extreme distress or wanting to end everything) the techniques I know like distraction and grounding and self care / self soothing (this latter is very hard for me to do when I feel as I do about myself). It isn’t working. And I feel that the things other people could do to keep me safe, many of which are on my crisis plan, are not happening or not working either. I’m experiencing more and more let downs where xyz help is promised then doesn’t materialise (appointments canceled, calls not returned, planned sources of support withdrawn, mistake after mistake, discharge plan not followed). Or I’m told that the help I want to keep safe doesn’t exist or I don’t qualify. What is offered – and don’t get me wrong I’m grateful that it is offered and I know it’s more than many other services provide – is not enough to keep me safe. For example when I’m suicidal a 5 minute telephone call may calm me a bit for a few minutes but an hour later in usually feeling worse than before and – this is key I think – still on my own trying to cope.

What do I do in this position? Are there other techniques I can learn to cope better? Are there other or higher doses of medications? When I so so much feel I am not safe on my own and really need someone with me (especially when I’m really distressed but also day to day because the slightest thing, as little as a letter that makes me panic or a canceled appointment,  can thrown me into extreme distress, self harm etc) what can I do? The PD service are adamant I mustn’t be admitted and don’t qualify for any carer help and ongoing support in person isn’t possible. I haven’t any other way of getting that kind of support. I live alone, my dad and step mum live hours away and I don’t have friends very locally or whom I see regularly.

So how do I do my therapy and stay safe as well? How do I either answer this need not to be on my own when I’m so much at risk and unstable, or what solution do I have to learn instead?

What do you do to stay safe between therapy appointments or between times you can access support?

I know this probably sounds silly and I do get a lot more support than most people and all I’m talking about coping with is simple daily life. Right now this is where I am.

Ginny xxx

*just to be clear, I’m not diagnosed with any alcohol problem and I’m not comparing my struggle with that of someone who is struggling with alcohol or other substance use. That is a much more painful place. I sometimes use what is probably an objectively average amount of alcohol taken with my tablets to make myself fall asleep when I can’t cope. Not a great thing to do but I’m not trying to compare the two.

I’m sorry for being rubbish this week

I’m sorry for being rubbish this week

I’m sorry for being rubbish this week. I’m sorry for being so slow to reply to comments and not being there enough for you (lovely readers / bloggers) as well as other people important to me in my life. I have been so shattered and sinking and though that’s true and consuming, I hate yet again using that as an excuse. Someone I was close to told me a little while ago that at first maybe you can hope people will understand but not after it’s gone on for years. Certainly “it” has gone on for years for me. Whilst it hurt when she said that I can also sort of see that you cannot expect endless understanding and it feels like asking more and more the longer I am not there and not well.

It is only very special and very empathic people who continue to understand and to be there. I am very very thankful for you. I care about you and I am so sorry for the times I fail to show it when I cannot write or say or otherwise show the love and support I wish I could. You mean so much to me. Thank you.

***

Also, in the past few days I have been trying to put together something in writing, a kind of open letter, about how I feel about my current care and how I have been treated by different services in my struggle to get help. I’m going to finish this tonight in preparation for, hopefully, meetings with a nurse practitioner and the Psychiatrist at the hospital this week. I think I may share some of it on here because I don’t think I’m the only person fighting the failings that have pushed me nearer the edge.

Ginny xx

Group and no more trust

Tomorrow is MBT (mentalisation based therapy) group. I don’t know whether to go.

All trust I had in the service has gone. It’s been completely wiped out by the lies and let downs of the past months, the proofs they don’t believe me, the tricks, the cuts that open me more and more vulnerable then leave me with nothing and noone.

I don’t really want anything to do with a service that does this, but I’m desperate and have nowhere else to go. I’m desperate for help but it’s denied, it’s promised then withdrawn, or I’m deemed not in need or not believed. I want to do the therapy but I can no longer go forward safely with it. I cannot cope between sessions except by overdosing to black everything out and self harming to punish myself, temporarily quiet the voices, temporarily be something other than the utter pain. I’m not allowed any of the things that would keep me safe between sessions.

If I go tomorrow, I will be so angry. I can’t say I’ll keep it under control in the session. I can’t say I’ll stay “stable”. Nothing keeps it in anymore. I can’t mentalise like this and really I don’t want to. These things just are as they are. There’s nothing to be “curious” about or explore my feelings or someone else’s thoughts. Their thoughts have been made totally clear – they don’t believe me, I’m not allowed help, they’re tricking me, they’re cutting me open then leaving me and finding more and more ways to do it. My feelings are exploding and total. Fury. Hurt. Trapped. Over the edge. Liar. Fake. Fraud. Pain. Screaming.

If I go to group I can’t avoid it being clear I have no hope and no trust left. If everyone or anyone else does trust the service and does believe they’ll help them, then maybe that gets them through and helps them and is a lifeline for them. I don’t want to destroy that.If I say what’s happened to me, even in the last couple of days, I could destroy it.

I could go and just try not to talk about anything to do with me and just be there for other people and listen to them and try to mentalise about what other people bring. But I’m so far gone over the edge I don’t think I can trust myself not to explode.

When the group started committed to do it all. I committed to not leaving. I committed it to everyone in the group – not out loud, we didn’t do that, but in my head I did. I promised to God and Mother Mary too. If i leave I break my commitment to everyone, not just the service. I really don’t want to do that.

Yet at the moment I’m just ending up in more and more danger. It seems as if I should just accept this’ll never end, dissociate as much as possible, hope for something sometimes bearable…. but I think I’m too far gone for that. I wish I’d never trusted them.

Time to pack it in and leave, I think

So the last couple of hours have brought me absolutely beyond all hope.

I’ve been led on a cruel dance by all the so called emergency out of hours lines.

The PD service secretary refused to even phone any of the clinicians. She told me all kind of rubbish and lies, like that she couldn’t put me through to anyone else in the hospital, she didn’t have a telephone number for any of the clinicians or anyone else in the service, she refused to get me help, she pretended the crisis team didn’t exist, she shouted over me. I called 111 the out of hours service, since it was after 5. They refused to get me an appointment face to face or telephone. They said my own gp still needed to see me. They were not responsible til 6.30. They refused to make me an appointment after 6.30 or refer me to the crisis team. My own gp put me through to the duty doctor. She refused to visit me because it was too late in the day. She refused to refer me to the crisis team because they wouldn’t accept a referral without her seeing me which she’d refused to do. She then hung up on me whilst I was speaking.  The so called emergency out of hours mental health line went to answerphone 3 times. I finally got through. They had none of my messages. They talked over me constantly and said nobody world come to see me and just go to a&e. I’m too ill to go out of the house and what’s the point of going to a&e? They just send you back out a few hours later. What was the point of the line then if they don’t offer help? If I wanted to go to a&e I’d have gone. The woman actually agreed yes it’s fairly pointless, she just tells people to go to a&e.

I am desperate. I have done everything I’m told to. I have jumped through every &*$/€(# hoop. I even trusted them. What do I have to do to get help? Every single thing gets taken away. How much sicker do I have to be before they’ll help me? Before they stop talking about building my resilience? They’ve taken every bit of my resilience away and finally pushed me over the edge.

I’ve been thinking for some time about just packing up and going away somewhere else. Going off to the other end of the country. Somewhere else I can live hidden, preferably under a different name, nobody else knowing all this $#@/!&£* inside me, nobody pulling me apart and cutting and cutting deeper, nobody tricking me, and it’ll be numb but it’ll be some pretence of normal, it’ll be numb and fake but I’ve seen what trusting gets you, nobody will come near to me again, the real and the screaming and the desperation and hurt, I’ve been shown what that deserves, I’ve had it. I think I should just choose the numb.