Tag: suicide

Please plan your crisis 24 hours in advance…?!

WARNING – discussion of suicide, suicidal thoughts, emergency services

Am I expecting too much? I don’t think I am. Yet again I and my friend are being bounced around from service to service when he/we are most in need and so many opportunities for giving help missed. But I’ve certainly been made to feel I am asking too much and am a nasty person and more importantly, yet again my friend is left in avoidable danger.

In my local area, there is a specialist phone line for people in a mental health crisis, accessible via 111. This is a pilot, I believe, which may be rolled out in the rest of the country. According to information published about this crisis line, it is for patients, family, carers, friends and professionals, you can get an assessment of your needs, help, advice and visits, it is available 24/7, every day of the year. It is supposed to help you get more specialist help more quickly than if you have to go to A&E.

I phoned this line today because my friend is suicidal and today is a very “risky” day for him. He has specific plans and whilst there does seem to be a part of him that wants to keep going and not end it today, and I think it’s possible he will get through, I’m very worried about him. He was promised to get help from the crisis home treatment team, but he had one phonecall in which they told him to phone services if he felt worse. They have not assessed him or visited. The community service he was seeing haven’t put anything in place.

I wanted to get advice what to do and how to help my friend. I wanted to raise the alarm that he hadn’t had the agreed support and I was apparently the only person who is going to be with him today. I needed to ask some advice for me on how to cope because I’m getting very near another complete breakdown myself. I don’t know how to avoid me losing it and flipping out again when I want to be helping him.

So I phoned this line. First I was told nobody was available but brief details were taken and I was told I’d be phoned back in a few minutes. 1 hour 20 minutes later, having heard nothing, I phoned again. There was no record of my previous call. “You didn’t speak to me before, how would I know the details?” asked the operator. I went through everything again (painstakingly  spelling every name and number about 6 times…) I was told that I had not been told I would be called back today. Er, yes I was, I was told I would be called back in a few minutes. “Oh no, we have 24 hours to respond.”

But we’re talking about someone potentially about to end their life here. Don’t you think that might necessitate an urgent, even immediate, response?! Isn’t this a crisis line?!

They made no assessment of the situation, would not listen when I tried to tell them the home treatment team input had not been delivered as agreed, gave no advice except for if he attempts to end his life, call an ambulance. What about any support that might stop him getting to that point? What about any professionals putting help in place? At the very least, any advice to me? At the moment I seem to be the only person doing anything today to keep him safe. I have no training, I do not know how to help him, I am ill myself and close to breaking point. I am terrified what is going to happen and whether he’ll still be here in the morning.

I tried to impress the urgency of the situation and that a call at some point within the next 24 hours was not soon enough seeing as he planned to end his life today. The so called crisis line told me that I simply had to calm down, that I had to realise they have plenty of other referrals to deal with, that they are very busy and it is not very nice for me to suggest they aren’t doing anything (not sure how I did that?), and when I insisted on speaking to a manager she continously talked over me and threatened to end the call. I was told that they had told me about plenty of other ways to get support. They had not suggested one single thing.

I would expect more from a crisis line. I would expect immediate response when someone is suicidal. How can it possibly be okay for them to say, sorry we’re too busy? I would expect the promises in their literature about getting assessed, supported and visited by mental health professionals to be fulfilled. There is no mention in the literature that they may do nothing for 24 hours. I would expect professionals to be ensuring my friend’s safety today, not me. I want to be there for him, I want to listen, be a friend, offer comfort and encouragement. I am happy to stay with him when that helps, as I will today. But I should not be the only one doing something to stop him ending his life. Is it really too much to ask? I don’t think so. He has asked for help and so often been turned away. This has been a pattern for him just as it was for me in my care. If harm comes to him today in my opinion it will have been completely preventable. That is not to blame services for the state he is in, but they have failed to provide support they agreed to, could have and should have.

I don’t know why I keep on having some hope in services that they’ll do what they promise. I’ve had enough demonstrations to the contrary. I’ve given up on help for me but I don’t give up so easily for a friend. I suppose it’s natural to have some trust in those we believe are there to help and protect us and that instinct doesn’t disappear quickly even when it’s proven wrong. If I could expect the total absence of support it wouldn’t be so distressing. I’m not looking for sympathy though it probably comes over that way. Just very angry, bitter, lost and scared.

Ginny xxx

Unenchanted April

I have wanted to post but not been able to find what to write. I’m sorry it has been nearly a month. Even this post I started nearly a week ago. I don’t know quite what’s making it so hard to express how I really am.

My friend’s health continued to deteriorate. I was fighting desperately to get him help as the danger he was in increased. Everyone in a position to keep him safe seemed oblivious to tune dangers and I could see how close he was to the edge but with no professional’s help I could not do anything more than what I can as a friend and that is not enough. It’s terrifying to be the only one knowing and believing the risk and I know that sounds like I am very arrogant thinking I know better than the doctors, but time and time again now I’ve known what’s happening or going to happen, the doctors have done nothing, refused even to listen to my concerns, and the thing I’ve known will happen, happens. The toll is greater each time. He has liver damage, blood clots, he’s starving himself, he is barely even drinking anything, there’s much more I wish I could write but it’s too personal to him for me to feel I can share here.

I don’t know how to carry this knowing.

I cannot save him alone. What someone else can give you, or trying to carry on for someone else, will not ultimately be enough to keep you safe or even alive. (I know this from my own darkest times, when I’ve been irretrievably low, hurting myself and planning to end my life, and someone close to me – who didn’t know the half of it – screamed at me, look what everyone is doing for you – why isn’t this enough for you? The answer is a post for another time but I know if he continues it must not be for me, not just for me in any case, so I alone cannot save him.

I can pray. I can try to give comfort. I can try to give compassion. I can try to show I love him and that he’s a good person not as he sees a problem, a burden, someone who frightens people, is bad, is not wanted, is no good. I can try to help him find some ways to build a safe, stable home and life. We can find short times of hope, happiness and laughter together. He has an immense capacity to love others, care for them and about them, to rejoice when they are happy, to fight to help them when they are hurting and share their pain. But none of that can he do towards himself.

He may die. He may end his life. I don’t know how to hold this knowledge and all the feelings that come with it.

****

I have been in crisis myself in the last few weeks and was in hospital for a couple of days. Then I had help from the crisis team at home for a week. When crises come I still flip out and instinctive reactions and thoughts take over along with the hallucinations just as much as they ever did before I had therapy. My “little child” gets out and she really isn’t very nice sometimes. It’s scary. I feel like a failure.

***

I’m realising that my mobility has got a lot worse in the last year. I’m particularly weak physically at the moment. I was diagnosed with POTS a little while ago (a heart, blood pressure and autonomic nervous system disorder). I’ve a lot to learn on how to manage the symptoms. Being very faint, muscle spasms, digestive problems and poor circulation have been hard to deal with this month. I’m now very fortunate to be in touch with a pain clinic at the hospital and there are some good possibilities from what they can offer, so I must be hopeful.

I really will try to post more regularly again and share happier news next time.

God bless you.

Ginny xxx

 

Hospital

My friend has been admitted now (see my last post).

He was in much more danger than I realised. I’m not putting specifics to keep confidentiality and to avoid any unhelpful triggers for readers.  He only told me after we had parted earlier. He didn’t want me to know and be scared. Then he went to A&E but didn’t go in. He was scared. He felt huge guilt too I think. He was confused and distressed and we lost contact and he was walking or lost in the hospital grounds I think. I got there as quickly as I could in a taxi phoning security to search for him. Thanks be to God for Security whose officers tracked his car. Thanks be to God that he did make it into A&E. I still don’t know exactly how.

Again I didn’t want to leave but he really preferred I did as his anxiety about hurting me (which he has never done) was so high. I spoke with the nurses and we all agreed is best for me to come back in the morning. He’s being cared for…he’ll be on a drip…he’s not alone…

I’m scared. He was so weak and drowsy and in and out of consciousness / awareness.

I’m hurting. Shaky. Scared. Exhausted. I don’t know what to do with all I’m feeling for him and the overload in my mind and chest. Hurts to breathe.

I know I have to accept right now I can’t do anything. The doctors caring for him can do something. God can do… more than something. Still I feel so horrible for everything I can’t do and all the good I see in him where he only sees what he calls poison.

I place him in your hands dear Lord Jesus. Hold him please tonight. Whatever happens now.

Ginny xxx

Descent into emergency

Kyrie eleison. Lord have mercy. Christ have mercy. Help us in our need dear Jesus, please, Lord hear our prayer.

6.45pm

I feel so scared and powerless right now.

My dear friend is in complete crisis. I’m so scared he isn’t going to make it. I don’t want to tell all his business here. That wouldn’t be right. But he’s been through some horrific things and his mind and body is in utter pain. He could die, through what’s happening to him physically and the risk he’s at mentally.

I won’t leave him on his own right now. He’s massively distressed. He’s too scared to go to A&E tonight. I’m trying to insistently but lovingly persuade him to speak to the out of hours services to see if he can get to another place of safety, or to speak with his GP. Please God he is going to see the GP in a short while in an evening clinic they have. Please God we get there. He is letting me stay with him now. He so did not want me to at first but I could see the danger. Please God, please may he still accept my company and please may he get somewhere safe tonight. (There are very concrete reasons I can see he’s at risk but they are not my business to write here.) I’m in his car waiting for him whilst he’s speaking to someone who he felt he had to go see about an issue that came up earlier; I don’t think this is going to help any right now for him but he really felt the need to do it and I didn’t want to force him not to. Please God please may he come back soon.

I’m barely hanging on myself. I’ve been losing the grip the past week especially. Dissociating, losing time, self harming, huge panic attacks and flashbacks including physical sensations.

A neighbour has started being aggressive and verbally abusive. He’s been pressing me for money for months. He’s been doing the same to other vulnerable people on the estate. He’s been citing endless disastrous circumstances but it’s now coming to light that something else is going on. I’ve sensed things wrong for a while but now it’s becoming clear what he’s telling me does not add up and isn’t the whole story to say the least. It’s getting out of control. I believed and wanted to help him to get help, supported him with getting referred for a support worker and foodbanks. Now it seems nothing is true. I’m afraid for a vulnerable person he lives with. I’m going to have to contact the police I think.

8.40pm

We have spoken to the doctor and are waiting to hear if my friend can get into a safe place with support. There is no space at the moment. Even if he does it is only open til 1am. We’ve gone back and forth with the doctor and out of hours services. All doing all they can but of course there are these limits… and in the end I don’t know who can keep him safe when he’s as far down as he is now, hating himself and hurting himself so much and so afraid of everyone. I’m ripping apart inside. I’ve been where he is, or similar. I know perhaps I cannot do enough. I care for him deeply as a friend. I wish I could rescue him but know despite all the love I can give perhaps I cannot.

9.15pm

I didn’t want to leave him. He has gone to the hospital. The doctor was worried for me and said I should not go with him. He insisted I not go with him. He promised not to hurt himself and that he’s going there. I couldn’t do anything else especially since it’s his car and I can’t drive. We are keeping in touch by text. I believe his promise but I know from being there myself that when you are going to end it, that blackness and blank terror and loss and self revulsion and pain overrides everything, no matter how firm and true and faithful your promises. The doctor told me to go home because she was worried for me but I so did not want to leave him. I cannot save him in the end but I can be there.

9.25pm

He is at A&E now. The situation is far worse even than I knew but thanks be to God he is there. Thanks be to God he’s going to be taken care of…dear Lord I pray he’s met with compassion there as well as getting the physical medical treatment he needs. Please Lord, please can they still help him. Please enfold Him in your love, whatever comes now, if it’s the end or not, please show us Your saving help. In the darkness of pain and not knowing, danger, even death, You are our certain hope and Saviour.

Mother Mary, St Joseph, please offer to your Son in the way most pleasing to Him, everything I offer, everything I do, everything I pray….

Ginny xxx

 

 

One massive punch

WARNING: contains a very brief mention of eating disorders and abuse in childhood

Well. It’s kind of ironic given my post yesterday about uncertainty in relationships. At least the uncertainty in the particular relationship I had in mind at the end of the post has been cleared up. Cleared up with one massive blow. I’ve rarely felt more hurt and betrayed and rejected though I’m not sure quite why the impact has been so consuming.

I have tried to talk with my friend about what has happened in our relationship over the past months / couple of years and some of how I’ve been feeling.

After a line of further rejections from her, her not hearing when I tried to be honest and explain some most painful things, her not believing as far as I can see, what I experience and what has happened to me in the past – today she told me I have no reason to feel upset or hurt or angry, that I have no right to feel as I do, that because I have a feeling does not mean it is right, that I am to come before God and see if I have any moral right to feel as I do because I don’t, I am to push it down and rise above it.

I was filled with a massive surge of anger and raw hurt. It has not stemmed any in the hours since.

Coupled with her rejection of me and her disbelief or at least dismissal and ignoring of severely traumatic things that have happened to me in my childhood and right now, it was an immensely hurtful judgement of me. And how strange she thinks that she has the power to decide what feelings I am morally allowed to experience and what is real and what is not.

The terrors associated with feelings I thought were sinful, feelings I was not allowed, feelings that were so dangerous, that I had to atone for and punish myself for, were together with my terror of my ultimate evil, the way that I got to life threatening anorexia and then bulimia, daily self harm, overdosing and attempting to end my life. These feelings kept me submissive and within my abuser’s control. The feelings my friend’s judgement of my experience, my feelings, their and my morality, where I stand with God, the truth and validity of what has happened to me, brought in me straight back there again. Straight away my impulse was to cut and make myself vomit. But something had happened to my legs and I was shaking too much to do anything and perhaps that was blessed protection. I just cried.

It hurts worse because this came from one of the very few people I trusted. Someone I shared things with. Someone who brought me to the church and whose child is my godson. Thank the dear Lord I did not share with her the very worst of the abuse I suffered. If I had I don’t think I’d cope in any way now. I already feel violated again. Tricked, ripped apart, judged, rejected, punished, blamed.

As well as the hurt that’s making me go to pieces, I wanted to scream – feelings are not a sin. I have many reasons to feel very hurt, angry, scared… Feelings are not moral or immoral. Who is she to judge what I have a moral right to feel? I have a massive amount of pain and hurt and yes sometimes anger about the abuse. That is normal. Yes, when I’m not believed, dismissed and rejected and abandoned when I’m most desperate, that cuts a little deeper every time and yes emotionally I end up right back where I was in the terror of the abuse. This is not a sin or something I have to crush. I am not a sugar plaster “saint” too “holy” to have any feeling but happiness and superficial love, floating on some supernatural plane disconnected from every real feeling. That’s what she wants. I am not that figure. I am bleeding.

She was the last person left, outside this blog and community and apart from my therapist, with whom I had the depth of trust I thought I did. Perhaps it’s as well it’s gone. I will be very very careful indeed in the future (even more than I already am) about what closeness I allow to develop.

But the hurt is consuming. I am falling into pieces. Shattering. I haven’t gone home yet as I was scared what I’d do and of being alone. But I’m exhausted now and I have to go home. I’ll stay safe somehow. If I can’t I’ll have to go to A&E. I tried to get to the safe place I’ve been to before but they are full tonight.

Ginny xxx

A closing drawbridge and a silent cry: when it’s less safe

A closing drawbridge and a silent cry

Eating disorders and personality disorder

When it’s less safe, but I am no longer my abuser’s child

WARNING: this post contains mention of childhood abuse, discussion of my experience of anorexia and disordered eating and the purpose it served for me in my eating disordered thought processes.

When I started drafting this post, I didn’t actually intend it to form part of this series on eating disorders and personality disorder. I didn’t realise that it would be so much about my eating disorders, but it turns out that it is. I started writing tonight in preparation for my therapy group tomorrow. Last week, we were talking about feeling safe. In the discussion, I said that at some points during therapy (around the past 14 months so far), I’ve actually been less safe than when I was not in therapy. In hindsight, perhaps I should say, felt less safe. It has felt less safe. Despite this, I still feel therapy is a process I need and want to go through. Someone asked me a question about that, to which I struggled to verbalise the answer. I’ve thought on her question during the week. I’m not going to write what she said because I don’t want to break her confidentiality, but I wanted to share the reflection she has led me to about becoming more or less safe during therapy.

As soon as I tried to explain, the familiar eating disorder thought came into my mind – when I was anorexic it was safe. I know how sick and dangerous that thought is and how illogical, the physical destruction of my body having been so clear. Yet, there was a point not very long ago in therapy where I so desperately wanted my anorexia back, because it would have been safe, and not so much too much. With anorexia, I wasn’t too much and nothing was too much. (Except food, of course!) I was encased in a safe, protected place, and I felt nothing but its power, voice and drive. My emotions and my body made no more demands.

With anorexia I could be certain in the knowledge I was starving, punishing, weakening, enough to atone for what my abuser told me I was, enough to avoid the damnation I thought I otherwise deserved, enough to ensure I was not a threat. Enough to satisfy my abuser.  And even years after I had got away from her, I thought perhaps anorexia could take me back to that one time where it had seemed she wanted me, seemed through a child’s eyes that perhaps she loved me, the one time I wasn’t bad, where I was so weakened she took total control. That would be totally safe.

I was never cared for by her. Total control stood in for care instead. The closest thing to care and safety for me was my total self-destruction, total physical weakness, allowing her to take total control of me. My BMI was about 13. I was in unbearable pain in my back and legs. I could just barely walk with crutches and had to spend a lot of time in bed. She took control literally of my movements, my food, my use of the bathroom and toilet, my washing, my dressing and undressing, my weighing (any action that could have and should have been private, she invaded) my contact with other people (even the doctors who wanted to help me, whom she prevented me seeing most of the time). Telling me what I was thinking, telling me what I was doing to the family, telling me what to say, total control – but this total control was the only time that the terrible powers and terrible intentions she told me I had, seemed to cease. My body and my mind ceased to make demands and I succumbed to her totally. This was the only safe place. The rest of the time I lived in fear of what I would do to her or the family and of her terrible threats coming true.

Paradoxically, at other times my anorexia gave me something that was nevertheless mine. It was my anorexia and my body. I think I’ve written before how when she had me strip in front of the mirror, a fierce voice in my head said, this is my body and you will never touch me again, and I resolved to lose as much more weight as I could.

That determination and angry strength was unusual. It was more about cutting off. Later, I stayed as numbed and weakened as I could. Long after I was out of the anorexic weight range, physically safe, I continued to punish myself. Starving. Vomiting. Cutting. Overdose. On the outside, I could do what was required and expected. I achieved. I was together, doing what they required in terms of education and work. Again, that was safe, because I was doing what was required, my dangerous emotions were numbed, my atonement continued. Until I imploded. Everything went to pieces.

As everything fragmented, numb was no longer sure and safe. I desired the end and wanted to end my life. At the same time, my child voice that I had suppressed so successfully for so long, was screaming and desperately needed to be cared for. This was explosively dangerous. My abuser’s threats about what I was would come true; they’d be proved to be true for all to see. The evil in me would explode out of control, if I could no longer punish and weaken myself. I would cause unlimited hurt to others without even seeing it myself, but everyone else knowing the evil I was. I would never be cared for (ie in someone’s total control).

Straight away, the rejections began. (Again. Just as I’d been rejected when I had needs and sought help as a child – terrified what my abuser’s reaction would be; my father not knowing what was going on, so not protecting me.) I was not under my abuser’s control any more, but there was no care for me, no one to protect me, and the few people I trusted were not there for me. The pressures – I don’t know if consciously or not – piled on me made it very clear I am a disappointment, not good enough, not what they need me to be, that they will only accept me as long as I am moving in the direction they think I should be at the pace they have dictated.

I cannot silence the needs any more. Anger boiled out of control, hurt screamed. Going through therapy, the feelings intensified. There was no way back to the protection my eating disorder had given me. Now, when I write about how it worked and why I wanted my eating disorder back, I am horrified. I am horrified at the power my abuser had over me and how I allowed her to have it and how that made me feel safe.

I will never receive now the care I did not receive when I was a child being abused. I will never receive again the closest thing I knew to care, the total submission to another person and control by them. Terrible as that was, I feel as though I will never be sure, as I could for a brief time be then when I was totally dependent on her, that I am not the bad, evil thing I had been taught that I am.

With the loss of all my coping mechanisms, including stopping self-harming and stopping overdosing, as I have somehow by the grace of God managed not to do in the past few weeks, it does feel more dangerous. I don’t know how to find any reassurance, internal or external. My feelings, my emotions, experiences, feel so out of control and dangerous. I am no longer my abuser’s child. I am no longer what my family requires. I will never have the care and security I did not have as a child, nor will I have the safety unconditional acceptance would give, because I do not have that now that I’m no longer what they require. I don’t yet know how to exist without these things.

Part of me grieves for the loss of the eating disorder and mechanisms that kept me safe, because stupid and twisted as it sounds, they did at least protect me; despite the harm they caused, they protected me from ending my life, and though it was fairly illusory, they gave me the closest thing I had experienced to being cared for.

****

I should say that I think that another important part of the safety issue in therapy is coping between sessions with the emotions that have come up in sessions. Also, the impact that this disorder and the recovery process has across your life. Until very recently having the help of my support worker, I struggled badly with the social isolation that followed the loss of many important relationships, and the “domino effect” of all the material stability in my life falling away because of the financial problems caused by losing job after job and my erratic spending when I was out of control. Struggling with this at the same time as my emotions were going out of control anyway, my desperation for help increasing but being unheard by everyone I tried to get help from and had been led to believe I could trust, brought me very much too close to the edge. My support worker has greatly contributed to my safety now.

Ginny xxx

A much bigger loss than they realise

When I signed up to the programme of treatment I am in at the moment, it was to include weekly group MBT therapy, fortnightly individual therapy, monthly care coordination and support available from a duty team.

With no warning, monthly care coordination has been stopped and changed to quarterly. Having expected to see my care coordinator yesterday as we’d previously booked, this was cancelled and my next care coordination is not to be until the end of September, which will be about 4 months since my last appointment.

I could write a lot about how badly the actual communication of this decision has been handled. Actually I did but I deleted it. It probably doesn’t do anyone any good, not me or the service or anyone else, to shoot off into an angry tirade. I’ve been trying to process this through since we (ie all of us in the therapy programme) got letters telling us a few days ago. My emotions are pretty out of control and shooting to extremes at the moment independent of this which is making things harder – ironically, partly because there is so much going on all across my life and I can’t hold it all together; I could have really done with some help from my care coordinator. I’m trying not to just rant in anger here. However, I do think that some of my feelings are shared by other people in the programme and I do think this reduction in appointments is a much greater loss than the hospital realise. There is a huge gap in care here and it’s getting wider.

We weren’t involved in the decision. We were informed afterwards in an impersonal letter. We were informed that this would be best for us. There was nothing personal about the decision. Surely everyone’s needs in terms of care co-ordination may be different, at different times in their therapy, according to what’s going on in therapy, their health across the board, and all areas of their life? The approach being taken isn’t responsive. It’s just a blanket decision.

My views are certainly being influenced by what I observed and experienced when I worked in mental health services in the same mental health trust in which I’m now treated, but I wonder if the source of this reduction in appointments is actually largely to do with funding cuts and staff shortages? Conversations I’ve had with my care coordinator have given me more than an inkling that my suspicion is correct. If this is so, it would have hurt a lot less if this explanation had been given plainly, rather than it being couched in claims that the service think it’s better for us to have less coordination of our care.

Leaving this aside, nobody actually discussed the matter with us whilst deciding what would be best for us. We didn’t get to give any input about why care coordination is important for us, the help we need, the effect this withdrawal of support would have, what our needs are and how they might best be met. We committed to the therapy programme expecting one thing and now this has been changed. We’re expected to stick with the programme and commit to it but they are free to change it how they choose. This is by no means the first time this has happened and what we have trusted in has been changed or taken away. Support we desperately needed, which was insufficient anyway, has now been withdrawn further.

All these things combine to make us feel hurt and powerless and unheard by those we should be able to trust and undeserving of support. I posted yesterday about how when I discussed the changes on the phone with my care coordinator (after I’d chased several times for any explanation of how the decision was made and what’s happening in practice with my appointments going forward) he told me the service thinks this is the best way to challenge us to be more independent, and how much this hurt and how little the service we should be able to trust actually appreciate what we are facing.

Separate from the emotions this brought up, the withdrawal of these appointments doesn’t just affect the appointments themselves; by the very nature of what care coordination is meant to do, it will have an impact on our wellbeing across the board and I think this is where the proverbial baby well and truly has been thrown out with the bath water. It seems the clinicians who have made this decision do not realise what a loss this will incur.

First, on an immediate practical note, it will have a knock on effect on our therapy appointments. We have been told that the clinicians have decided it is most appropriate for us to get help in therapy appointments rather than care coordination. The focus of a care coordination appointment is utterly different from a mentalisation-based therapy appointment . Therapy appointments focus on emotions and interpersonal situations, looking in depth at particular relationships and specific interactions, our emotions and thoughts and our understanding of what is in our own and each others’ minds. It’s not so much about events and information and our circumstances as focussing in depth on our emotional experience and thought patterns. This is totally different from what is covered in care coordination – such as building a care plan, reviewing mental and physical health, looking at input that may be needed from other health professionals or support workers, looking at social and financial problems and stability, monitoring risk and safety issues, communicating with the range of professionals and others involved in someone’s care… the list goes on. If this is now to be squashed into the therapy appointments, either the time for therapeutic work will be greatly reduced or the problems we needed care coordination for won’t be addressed.

This is all the more important since the length of time for which one can be seen in the service is now strictly limited. The service was set up to be a lifelong service, recognising the fact that we may likely need help outside of particular therapy programmes across many years. Now this has been stopped and after we have completed a particular therapy course we are discharged whether or not we are coping or safe or recovered. When time is limited and so soon we will find ourselves alone again or at least without specialist support, whatever state we are in, it’s all the more important that whilst we are with the service we can get help pulled together across all the areas of our life that our mental health affects and that affect our mental health.

And these areas are broad.  Several of us in my therapy group, myself included, have multiple mental and physical health diagnoses. Most of us have many unmet needs at any one time.  Some of this is because of rules that you can only be seen in one service at one time. I’ve posted before on how unfair that can feel – for me one thing this rule means is I’m not allowed any help with my PTSD and trauma following the abuse I’ve been through, because I’m being seen in the PD Service. I know other people who were forced to choose between being treated for their life threatening eating disorder or their personality disorder. Multiple mental health diagnoses are often closely related but I, and I’m sure many others, have had big difficulties trying to find the way through the care and treatments they need and I’m regularly promised help that is then the next minute taken away. Someone needs to pull all this together and make sure communication happens and that help promised is actually delivered. It is too hard to do this on your own when you’re seriously ill and all too often you are bounced between different services, each telling you that another service is meeting your needs when actually nobody is.

Physical and mental ill health tend to cause disturbance and instability to a lot more than health. Just a few examples from my own experience – and all these are shared by other members of my therapy group – are losing your job, being made homeless or having to move from your secure home, having nowhere stable to live, having no money to meet essential expenses of food and rent and bills, falling into debt, trying to navigate the system to claim sickness benefits or help with housing costs whilst working part time – and being met by mistakes and delays at every turn and waiting weeks on end to receive any money, consequent trouble with utility companies, landlords, over or under payment of tax and Benefits, filling out form after form, having less and less contact with friends and having no resources (financial, or in terms of emotional strength) to keep in touch with the little positive things that can keep you well, relationship breakdowns, addiction, crises, losing control and ending up in trouble with the police or other involvement from emergency services… I could go on and on.

It just isn’t possible to sort out all of these things on your own especially when you’re struggling with the daily pain of the BPD itself. You desperately need someone to get you access to help and guidance, to be familiar at least to some extent with the systems you’re struggling through and to know what help is available and refer you there. This help has never come, for me, from the PD Service, and with so little care coordinator input going forward, it’ll be even scarcer.

Yes, a lot of these things are parts of everyday adult life but the fact is by the time most of us eventually get seen in a specialist service like mine, we have struggled without the help we need for years upon years and are very near the end of the road. (Potentially, very near ending our lives, or already having reached that point because there is nothing but pain, dark, utterly spent, utterly trapped, self disgust, I could go on…) Yes, we have to be able to function independently. But we are silently screaming how right now we can’t. We need help. We desperately need to be heard that we need help. Every time we have tried the very hardest we can and there’s yet another loss, obstacle, more and more piled on us, our risk increases and we are less and less able to be independent and more and more locked into our compulsions to overdose and self harm and try to numb and control the utter desperation and silence the painful scream for help inside us. If someone hears us, guides us, gets an understanding of what is happening across our lives, pulls the pieces together and gives some continuity, as our care coordinator could, then we can start to gain strength and start to find some kind of stability that might eventually allow us to heal.

I am incredibly fortunate that I have a support worker (from a local social service, not from the NHS) who is helping me with so many things that I’d have hoped my care coordinator and/or support workers from the PD Service would have done. The response from the PD Service was to brush me off saying everyone has to deal with these things and I did not qualify for any help and one appointment with a care worker who did not know anything about most of the areas in which I needed help. Thanks to my current support worker, I have not been evicted by my landlord, I have been helped to fill in the complex application forms for disability benefits, I have had support to go to assessment appointments, I have had help learning to budget, I have been able to access the correct advice and information from all the services involved (housing benefits, the council, the Jobcentre, disability services etc), I have someone on my side who understands the difficulty I’m going through at the moment in the police investigation into my abuser, and I have some social support which will help me use my time constructively to keep getting better and eventually learn how to get back into work.

In no way did the lack of recognition, lack of coordination and lack of support I received from the PD Service make me better or more able to function. In no way has having a support worker made me less independent or worse. I am now self harming much less and have not overdosed for weeks. I’m able gradually to do a little bit more and then more, because I have some sense of stability and safety and someone who believes me. With his support I’m not alone going through the things that distressed me to the extent that I couldn’t cope and could only hurt myself.

This support is desperately needed. It is very sad that it is so hard to find. Given that the therapy programme is so good, and I know it is such a privilege to be able to undertake it, it is sad that the support towards staying safe and being well and stable, is so lacking. It is much harder to grow and make use of the therapy from a place where you don’t feel safe or heard.

Perhaps I’m overreacting. Perhaps I’ve had an unusually bad experience with my care coordinator or when I’ve been in crisis. Perhaps I’m incredibly dependent. (Well, I think I definitely am.) Probably I should focus more on the fact I have the support I do. I know many services have much less support available. It just seems to me like a big and widening gap and that things could so easily be different.

If I recover enough to ever work or volunteer in this field, I’d like to work on trying to bring together patients’ access to the support that’s out there and bridge the gap of all the unmet needs that are stopping us from having a stable life whilst we’re working through our therapy programmes. I’m sure this would increase people’s security in their recovery.

Ginny xxx

Losing her

Warning: this post contains one very brief mention of suicidal thoughts and overdose.

(Also I’ve a feeling it’s a load of rambling junk. Sorry.)

I’ve lost my friend. It really feels like a loss and hurts like she’s gone away, disappeared, except it’s worse because it’s entirely because of me that she’s chosen to go. She doesn’t want to be close anymore, she said; not close like she says she tried to be or like she says I wanted us to be. My personality disorder, me, my thoughts and needs, have made our relationship something stressful she doesn’t want.

I really care for her, I still do. My feelings for her haven’t changed. I still love her as a friend, want to thank her for all the times she has been there, want to do something to make right the hurt I caused, want to be able to be there for her when she wants or needs me – except she didn’t and doesn’t.

I don’t know exactly how long she’d been feeling she didn’t want to be close anymore before she told me. I’d suspected it for a long time. I really hate what I’ve done to her and that I’ve stressed her and been no good to her. I hate that my illness, essentially, me (my thought, my feelings, my needs, my actions) have been too much. Another person has gone away. Another relationship has gone. I’ve hurt someone else.

You can read a bit morehere (around paragraphs 5, 6, 7) and  here and here about some of the history of what happened with N. Our contact had been strained for several months.

After another period of not hearing from her following my last letter, call and texts, last week before my operation I decided to be more open than usual. I sent N an email, thanking her for forgiving me and explaining I was still really worried about the hurt and upset if caused her, and saying that as I wasn’t hearing from her and she hadn’t said anything beyond that she forgave me,  I was not sure if she wanted to stay in touch. The way I see it, N forgiving me for the hurt I caused did not have to mean she wanted to have contact with me going forward. I directly said I wasn’t sure what she wanted, and asked her.

Also, I took quite a risk and explained to her some of the thought process I talked about in my last post on this topic. I explained how when I don’t hear back from someone I really care about, when they stop communicating, or cancel plans, or don’t show without making any contact,  my thoughts are instantly either: that this proves how they can’t possibly want me around really (who would?) and as soon as I start trusting they leave because all along they knew I’m an evil fake really;  or that they are seriously hurt, or ill,  or got in an accident, and it’s my fault. Often both one after the other. Usually I never admit to these thoughts. I know it’s crazy. I know it’s weird. I know it doesn’t make sense I have these thoughts then get angry with people. I don’t want my friends to feel obliged to take into consideration my weird ill thought processes and make allowances for them in what they do. For example, I don’t want them to feel they have to be more careful what they say to me or to keep in touch more regularly with me than they would with another friend. (Paradoxically I don’t know if, in the way I think and what I need, I do require of people an abnormal level of contact. I’m diagnosed Borderline but I think I have features of dependent personality disorder too!) However things had reached such a point with N that I felt I had to be explicit about what I was feeling and why I had found it so hard to cope when over a few months she stopped keeping in touch and seemed to be restricting contact and canceled or altered several plans to meet (this was one of the things we first fell out over a few weeks ago).

I explained all this as well, as my hesitancy to explain it because I didn’t want to pressure her. I said I know that I make it too complicated and I need too much and my illness makes it too hard to be friends. That I really wanted to be there for her but it was clear I totally failed at that and it’s my fault there’s nothing good for her in the relationship. I said I’d rather know straight if it would be better for her not to be in touch with me.

I’ve never been that open with someone about my thought processes about my relationship with them, outside of my therapy group.

N wrote back a few days later. She was empathic – she said she is sorry there is so much distress going on for me. She said she doesn’t keep in touch regularly across the board when she’s busy. She said it’s stressful for both of us to communicate, when there is so much meaning for me in each interaction. She thinks it’s too distressing for me to cope with the likelihood of her changing plans. She said she can’t be as close a friend as she tried to be or as I want her to be. She offered that we can still meet sometimes or email – which surprised me, actually.

I know it isn’t a total end of the relationship. I’m hoping we can in some way keep in touch and I can remember she doesn’t want to be as close. I hope I can do that and not need too much. But I always need too much. Maybe this whole thing wouldn’t be so bad if I didn’t. Never would have happened if I didn’t.

One of the things that hurts the most is that I can never now make right the hurt I’ve caused N. I have made her and needed her to be closer than she wanted to be. I have made her stressed and upset when she’s done so much for me. It has been as I feared. I was too much, yet again;  I needed too much, asked too much, my thoughts and my behaviour made everything too much for the other person.

I told N some of that briefly too, and I thanked her for telling me honestly. I tried to tell her I’m sorry and thank you. I fear it appears it has little meaning now. I really meant it. I need to thank her for so much over the years I’ve known her. I don’t know if she knows. It seems to me all I’ve done is stress her. I don’t know exactly how long I’ve been making her be closer than she wanted. She doesn’t know it but she has possibly literally saved my life. One night I was on the brink of a massive overdose. She happened to call me at that time and as we spoke, she and her husband gave me some hope back and pulled me back from the edge. She knew I was distressed but not how close to ending it I was. I didn’t tell her explicitly at the time or afterwards, because I didn’t want to scare her or make her feel responsible for keeping me safe from that in the future if she knew how unstable I was and the potential influence ordinarily insignificant interactions and events could have on me. Now I wish I had told her.

Some while ago someone I care about told me, “look at what your friends do for you, why isn’t it enough for you? It’s nobody else’s responsibility to make you feel better,” and they told me I have to be more together so my emotions don’t dominate everything. Yet again I’ve acted on the basis of my weird thoughts, I’ve needed other people to do more than they wanted to, more than normal, and I’ve needed them to make it better.

I’m going to stop now. This post is a mess. I’m feeling so empty, hurting for losing N, hurting and angry for the harm I’ve done her, desperate because of how my PD and just …me….wrecks relationships and makes me too much.

Ginny xxx

 

One of the most dangerous ways to react to someone with BPD who is asking for help when they are suicidal or self-harming

 

 

TRIGGER WARNING: fairly massive warning on this one that this post discusses suicide and self harm and issues around getting care in crisis…

Yesterday I was met with one of the most punitive, ignorant and dangerous reactions I have had from a medical professional. I wonder if people who react like this actually do not realise the genuine danger patients are in and how much further into danger this kind of reaction pushes us.

As I write this post I want to be clear that I am now safe and have received help and I am not posting this to alarm or worry readers about me. I’ve been seen in emergency services and eventually had very supportive care, which I will post about in due course. Please don’t panic about me. I am now safe and have had help. I just think what I experienced earlier is a massively dangerous issue that needs to be highlighted.

Yesterday I was absolutely unable to cope. The pressure of my housing situation, financial problems, threat of losing my flat, trying to discuss things with my landlord, my physical help, repeated errors from benefits services and other supposed sources of support, the lack of help over the past 5 months or so when I’ve been at my lowest points, the voices and flashbacks and nightmares – everything boiled over and again I was in the place where the pain and emotions and loss and guilt blocked out any ability to carry on.

I lost it and I was at the point of trying to end my life. I knew how I was going to do it. I had tried and tried but had nothing left.

I spoke on the phone to the GP Surgery. Somewhere, I guess some part of me was still wanting some kind of help or at least daring to tell someone. (They had called me over issues with a mess up over the prescription i should have had; I’d again been left without my medication. ) I admitted what I was feeling. I begged to see someone. I don’t know what made me do that, ask for help when the decision was already made in my mind that this was it now and I’d come to the end. But I did.

I admitted that I wanted to end my life and that I was self harming. I admitted that I had the tablets to overdose. I asked to be seen and that I needed help now, could they see me or get the crisis team? I said how all the mess ups with my prescriptions and benefits and no help in crisis were piling things onto me and making it more and more impossible to cope. I was having hallucinations and flashbacks. I had been asking for help for months. Now I could not go on anymore, I was going to end it. I needed help.

The GP spoke over me from the start. She told me that “you have to be extremely careful about how you are coming across” if I expected to get any medication. She then told me repeatedly, in response to me admitting that I was suicidal and self harming, that “that is not a fair threat to make to people” that “you will find I do not respond to threats” and that I am a responsible adult able to make my own decisions and there is no reason that I should take an overdose. She then announced that she was going to end the call and hung up on me whilst I was begging her to help me.

If Someone with Borderline, or any other mental health problem, admits to suicidal thoughts, plans or intentions, or self-harm, it is the most incredibly ignorant and dangerous reaction to treat them as though they are making threats in order to manipulate and must be punished accordingly. The stereotype that people with personality disorders or any mental health problem are manipulative, or that being suicidal or struggling with self-harming  is attention seeking,  are extremely dangerous. It is all the more dangerous when it is trusted healthcare professionals acting on the basis of these stereotypes when their patients have dared to ask for help, meaning that when we are in immediate danger we are dismissed, punished and rejected.

Experiencing suicidal thoughts is not attention seeking. Self harming is not to create drama or cry for attention. Admitting that you are in danger and want to end your life, that you are absolutely at the end of the road and can’t go on, that everything being piled on you is pushing you nearer and nearer the edge, is not making threats. The attitude shown by the GP today makes it impossible to ask for help when we are most in danger. I now know that if I admit to the terrible thoughts and feelings, I’ll be treated as though I’m manipulating people and will be rejected. If patients are treated like this, suicide and self harm is made something that must never be admitted to or talked about and for which help can never be sought. If patients are treated like this, all the feelings and events that have brought them to the point of suicide are dismissed in an instant, as our position is made out to be manipulative fabricated threats rather than complete brokenness.

Yes, I am an adult. Yes, I am responsible for my actions. If I self harm or attempt suicide, it is my action alone. If I cause myself harm that is done by me alone. That does not mean that the experiences and emotions behind my actions are not real, that I am not in danger,  that I am fake. No longer being able to carry on doesn’t mean I am manipulative. Asking for help and admitting to the horrible things in my head doesn’t mean I am making threats. Asking for help doesn’t mean the feelings that make me want to end it aren’t real. The fact that if I do something to hurt myself, it’s my action, doesn’t mean I’m not in danger and don’t need help.

I’m terrified of manipulating or hurting people I care about. That’s why I hide my self harm and did not tell anyone for years, why I usually don’t ask for help after overdoses… I’m scared that people may feel responsible for saving me… and the self-harm itself started in order to punish myself and hurt myself to turn it all in and not let the horrible things in me hurt anyone else, and overdosing  is sometimes about utter pain and sometimes utter rage and loathing at myself and fear of who I’ve hurt.

People who are self harming and/or on the point of attempting suicide are not nasty manipulative frauds, they are in massive pain and massive immediate danger. They do not need punishment and dismissal. They need a place of safety and compassion and they need desperately for the hurt and the danger they are in to be believed.

It is terrifying to admit to things like how close you are to suicide or that you’re overdosing. I never say it to friends (though two friends have sometimes guessed) because I do not want to make them feel responsible to keep me safe or worried I’ll do it again. That’s one thing.  But it has to be possible to admit it to healthcare professionals, if there is to be any way to get help.

Yesterday, my life was saved by a police officer who recognised the danger I was in, and by the emergency team who assessed me when he took me to them, and by the mental health workers at the safe haven I was taken to. I owe them my life. Thanks be to God.

The safe haven is a new organisation that has been running for just two weeks in my local area and I think massive good is going to come of it. I’ll post more on that going forward. Please God can that be the support other people find when they are in the state I was in yesterday, not reactions like the one I got from my GP. Sadly I think I’m not alone in what I encountered. And this isn’t the first time. I’ve encountered similar and worse lack of recognition or response to the danger I was in, and accusations of making threats or being manipulative,  from within the personality disorder service and in crisis teams.  If i am ever recovered enough to be able to somehow try to help other sufferers or explain to people what BPD is like and how to help someone in crisis, tackling this would be a massive priority for me.

Ginny xxx

Scared I’ll lose it again

Tomorrow I have my usual weekly group therapy, then I have my monthly care coordination appointment (it’s supposed to be monthly but has been canceled more often than not since October last year). It’s challenging at the best of times when this appointment comes round, especially when it closely follows therapy group on the same day, which is draining in itself.

I’m very worried about the care coordination tomorrow. Last month I was really upset and desperate in the appointment, didn’t get the help I felt I needed to stay safe and left wanting to end my life and overdosed. There was a complete lack of understanding between me and my care coordinator.

I’m scared something similar may happen. I’m scared that I might lose it like I did a couple of weeks ago. I’m so so ashamed of that and I feel dread when I think of it. I’m scared I won’t be able to control what I do and it’ll happen again because I’m so unstable right now, flicking into distress and hurt and anger so quickly.

Also, I’m scared because there are really difficult things I want and need to say. I can’t say everything’s good and fine or that I’ve made progress; I can’t say I think I have the support I need because there are massive issues and have been huge failures in communication and so many things promised have not been acted on. I now operate by expecting nothing from the service and expecting whatever is arranged not to happen. It’s “safer” that way. It doesn’t open me up with hope and trust then twist the knife with another let down or betrayal. It means I don’t ask for help either.

I need to communicate these things. I never do, usually, but if I don’t there’s no going forward. So I’m going to try to say at least some of them and write a letter as well in the next few days.

I do not know how to stay calm whilst I do it. How do you stop yourself losing it? How do you control the aftermath of feelings without harming yourself? How do you keep your emotions level when things that are really deep hurts to you, are unanswered or ignored?

I’d be seriously thankful for any suggestions!

Ginny xxx