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TW: What Would You Do?

18 Feb

Below is a hypothetical situation – some of it is based on me and some added in to the post. It is based on a situation that involves the home treatment team (htt) (or crisis team depending on where you are from).

Htt is a team that works in the community to stop people being admitted to hospital. It is their job to work with people in acute crisis.

So the following is a situation that I want opinions on please (as I say there is a mix of reality and hypothetical so say what you think).

Htt were due for a visit at the clients home and the client had left a makeshift noose on the table (it could have been anything, not necessarily a noose because of it’s make up). Whether or not the object was left on the table on purpose is to be ignored in this situation.

The conversation went as follows:

Htt (H): what is this for?
Client (C): it’s a makeshift noose, good idea eh?
(H): well no, not really. What are your plans for it?
(C): I think that’s fairly obvious
(H): you do realise the way it’s set up, if you do it there’s a point of no return
(C): yeah, that’s kinda the point
(H): it’s your property but would you be willing to give it to me
(C): no, that’s not an option
(H): ok, I had to ask. You have all the out of hours emergency numbers, would you call them if needed?
(C): to be honest, no, I wouldn’t
(H): ok, all I can ask is you keep yourself self and we are around for the next 4 hours if you need us.

So the question is, what would you as the htt have done in this situation?

 
 

TW: when I need help

30 Dec

**trigger warning – mention of suicidal thoughts**

I’ve had a very short term stay in hospital from 16th December and since being discharged on the 19th, I’ve really struggled. Suicidal thoughts are at their peak, I wouldn’t be missed but make close people around me freer and that’s a hard battle to fight by yourself.

It’s obviously been the Christmas period and I’ve just ignored everyone these past couple of days – this resulted in a cause for concern police visit which was a waste of everyone’s time.

I kept being told by the community mental health team to let them help me and so I decided to ask for help this afternoon and was basically told to call a friend. My issue with calling for support is how can anyone take this dark feeling out of my heart and make it ok again? No one can and so why do they insist on me calling in. I don’t know what the next couple of days will bring for me but if I’m not around much, have a good new year and hope people get the help they need and deserve.

 
 

What is DBT?

13 Dec

DBT (Dialectical Behavioural Therapy) is a form of therapy that was originally set out to help people with Borderline Personality Disorder (BPD) by teaching them certain skills so they could manage their symptoms more effectively. A lot is thought about this therapy and it has quite a high success rate. Let me make it it clear before I go on, I have nothing against the therapy, it seems to help a lot of people and that’s great, but not me.

DBT is made up of four modules:

– Mindfulness, which is done at the end of the other modules for 2 weeks at a time

– Distress Tolerance which lasts 6 weeks

– Emotional Regulation which lasts 6 weeks

– Interpersonal Effectiveness which acts 6 weeks

You are signed up for a minimum of a year and so go through each of the modules twice (except mindfulness which is a lot more).

So why am I bothering to write a post about what DBT is? As I’ve made it abundantly clear in other posts, I do not believe this is for me. I have a 70% attendance rate which to say my granddad died during the time, I think is more than acceptable to say I’ve given it a go.

Let me take the interpersonal effectiveness module (just because I’m now on the second round for this). The aim of this is to allow you to gain your objective in a given situation. Teaching you to express yourself, assert yourself, being able to say no and coping with interpersonal conflict.

Which of these allows me to deal with my ptsd symptoms? I’ve run a business, I’ve had to use these skills more than most people so I’d say it’s actually a strength of mine.

After going through this module first time around I was even more at a loss as to why I was there but decided, after much thought, to carry on.

The next module was distress tolerance and I thought maybe this is where I could learn some new skills and the therapy be worthwhile. However it was full of distraction techniques I’d either already been taught or I’d learnt myself. They also teach you self soothing techniques, but what actually is this? Is it not extremely personal what you find to self soothe? I wasn’t a fan of this module either.

That left emotional regulation and I must admit that I missed most of this module with everything going on at the time but the aim is to look at the theory of emotions, how to describe them and then be able to change them using skills learnt in other modules. I can’t really make a comment about this one for reasons just explained.

Mindfulness is the only one I found useful but every 6 weeks you literally go through exactly the same PowerPoint slides as every other time so nothing new is really being learnt. I forgot to mention, every session, regardless of module, is started with a 10 minute mindfulness practice.

So as you can see, this is a very thorough therapy that covers a lot and as I said at the beginning can be a real help to some people.

But can it be to me? I honestly don’t see how. First time through I have learnt nothing new and so it has come to the point where I need to decide if it’s worth me going through it all again? I know I’ve been reticent from the beginning and this has probably hampered me slightly but not enough to know it’s not helpful.

The problem I have is I don’t think I have any other options. It’s either this or nothing. Some people say, you might as well go, you aren’t doing anything else. Which is fine in theory, but when you’re sat in a room full of people with their own issues there is a certain amount of transference of emotions which leaves me feeling drained and low.

So what do I do? I thought I was allowed to go to 1 in 3 sessions and still get my one to one therapy but I’ve been told it’s all or nothing. I either fully commit to group or I leave the program. Any thoughts would be greatly appreciated.

 
 

It’s Been a While

17 Nov

I can’t believe it’s been over a month since I last blogged. So much has happened but I don’t want to bore anyone so I’ll just give a brief overview:

– I finally started grieving for my granddad (a very important man in my life) and am currently going through that process

– In terms of therapy, I have managed to work it that if I go to 1 in 3 group sessions, I can carry on my 1-1 and as long as self harm free for 8 weeks, begin working on my ptsd traumas.

– I finally allowed my care coordinator to meet with my parents. It’s something she’s been wanting to do for a while. Not to discuss what’s happened as they don’t (and won’t) know the full story, but to work out a way they can support me more. I’ll be honest, it felt like 3 against one. My coping strategy is take to bed until it passes and then come out the other side. They want me to go to my parents house and be around people. I said I’d think about it but I can’t see me doing that – just because my way currently works.

– One of the biggest things is my care coordinator has left 🙁 She has been promoted which means I’ve been handed over to a new one. I’ll be honest, I’m absolutely devastated. She always fought my corner and everyone I came across said how good she was and I was lucky to have her. I’m trying to keep an open mind for my new one and I’m having my first one to one with her on Thursday (I met her in the handover session but it was still more me and my old cc talking).

– It’s not important how but I’ve managed to get myself addicted to diazepam. Luckily it’s only been a short time but I’ve been told mentally and physically not to stop them cold turkey because of the effects. So yeah, you’ve guessed it, I’ve stopped them completely. Their plan was going to take me 5 months to get off and I’m too impatient to do that so I’m doing it my way. It’s not been the easiest so far but think it’s more psychological as I don’t expect that many physical symptoms for a few days yet (although headaches and fluey symptoms are starting). It’s going to be hard, knowing that one little pill will make me feel better but I can’t have them in my life, they aren’t good for me.

– A couple of weeks ago, I ended up taking myself to a&e after taking an overdose. That was only part of my plan but my sister in law sent me a pic of my two nieces sleeping and I just couldn’t do it. I was kept in overnight and most of the next day being observed but then saw psych, knew what to say to get home and left. Looking back, I think I should have been honest about how I was really feeling because the other night I called out of hours social worker (just to talk to someone) and had plans to take another overdose. She called an ambulance (wouldn’t let me drive or get a taxi even though I hadn’t taken anything). Anyway, it took over 4 1/2 hours to arrive (she called at 10pm and it arrived at 2.40am) and after getting to the hospital all that happened was I was asked if I could keep myself safe and then left to make my own way home with no money or anything.

– I think that’s pretty much a catch up for now, it would have been my granddads birthday on Wednesday so that’s the next big hurdle to get over and then it’s the anniversary of the major trauma one day in December and burying my granddads ashes the day after so it’s going to be tough.

 
 

Why Should I Have To Distract?

12 Oct

**TW THOUGHTS OF SUICIDE**

I haven’t posted for a while because my last one got me some trolls on twitter and so I wasn’t actually sure whether I’d ever use this again.

I’m still feeling the same as my last post except now I’m having severe suicidal thoughts. I call them severe because they are at the point of me seriously considering them as my way out (as opposed to just having them as thoughts).

I’ve done as I’m supposed to and called for help to express the way I’m feeling. The answer I could have scripted myself, “you need to distract”. I know this, in fact anyone who has ever been in touch with psychiatric services knows this. But why should I? I’m tired of that, I’m tired of the constant battle in my head – should I, shouldn’t I kill myself?

I’ve even tried the pros and cons list (see I am very rational right now!!) and that points to doing it. And so why should I distract anymore? What is the point? Have a bath, make some tea, are these not just exercises to prolong the obvious?

I will wait until tomorrow and again call the same services that will tell me yet again to distract. I truly am beginning to hate this word now but will take my cue from that conversation.

This post is nothing but a rant really, no words of wisdom or specific that’s happened – just a rant, sorry!!

 
 

Aren’t They Supposed to be Helping?

04 Sep

I’m angry right now so this might not be a very rational post but to start with, let me explain why I’ve not posted for a while. Two weeks ago I lost a very important man in my life; my granddad died. He was a kind and amazing gentleman who was a father figure to me growing up and he will be dearly missed by many, myself included.

If you’ve read my blog for a while, you’ll know that I have family in America. Obviously with our sad news, they were over for the funeral (which was on Tuesday just gone). As people do at these times, we were trying to spend as much time together as possible which meant me, my mum, step dad and brother were travelling about 1 1/2 hrs to be with the family. My brother was only home for 4 days so it wasn’t long (he lives in America).

Now with that background, I spoke to my therapist about missing group on Monday (day before the funeral) and next Monday (the day the rest of my family were going back to America). Not only did I want to say goodbye myself but I know how much my mum will struggle and feel I should be there for her (it’s her sister going back). Apparently my therapist took this back to the committee and was told no, it wasn’t extenuating circumstances and I needed to attend. I had missed the previous two group sessions as one I was in hospital and the second was when my granddad was dying and my birthday which I wanted to spend with him. There is a rule saying if you miss 4 in a row then you will be asked to leave the group and can not re-enter for a year. How can this not be seen as extenuating circumstances?

So that’s the first thing I’m angry at. I had to sit in a group that I hate anyway, getting upset because all my family were together and I wanted to be with them.

Next and the thing that has just happened today is about my medication. After my last admission to hospital, I was given nitrazepam to help with sleep. It was for 3 nights only per week to stop any addiction forming. This has helped me, it’s given me some sleep pretty much every other night and so I’ve been able to deal with the sleepless ones in between.

Today when I called my care coordinator to get back in to see her since my granddad died, I was told my GP has asked for a review of these meds. I explained my point, how I used them and that I’d prefer them to stay this way for a while longer. I got a call back to tell me between my psychiatrist and GP, they’ve decided I will be reduced from 3 to 2 nights worth for a month and then to 1 nights worth for a month and then stopped completely. I really don’t understand the logic behind doing this 2 weeks after I’ve lost someone very close to me. Surely they could have put this off for another couple of weeks.

It just feels like the people/system that is supposed to be helping me is actually causing me more issues right now and I don’t know whether to just ask to be discharged from everything.

 
 

TW: But I Need An Answer

09 Aug

***TRIGGER WARNING: THE FOLLOWING POST IS ABOUT SUICIDE***

This is a very brief post but I need some information and thought this is my best outlet to get it.

To me there are 3 times a year when someone’s death is harder to deal with; their birthday, the anniversary of their death and Christmas.

My question is, if two of those can be merged does it make it easier in the long term for family or does it not matter at all? Eg, if Christmas happened to be the day they died as well – does it matter that there are then only the two big dates to deal with?

As a side note, I know the grief is daily in the short term, but I’m talking over the longer term?

If you don’t want to answer here I’m on twitter as @femaleptsd or you can email me through the contact page on this blog.

 
 

DBT – Pros and Cons

02 Aug

This post isn’t about the pros and cons of actual DBT, it’s the homework we were set in the distress tolerance module. We had to think of a “crisis where you found it really hard to tolerate distress, avoid destructive behaviour, and not act impulsively”.

Now this homework in itself shows me exactly the reason I’m in the wrong kind of therapy. Apart from suicidal thoughts (which I’m not willing to talk about in group), I don’t have any moments of intense crisis like that. I have flashbacks that make me feel incredibly low but I don’t self harm or have issues with drink/drugs that would mean I turn to those. I know that’s not all DBT is about and I don’t mean to offend anyone with that last bit, but it’s just showing the homework isn’t fitting with my problems.

So instead I chose a behaviour I’m being told is destructive and did it for that instead. If anyone is interested, here are mine:

1) Tolerating distress: pros
– feeling safe
– don’t have to socialise

2) Tolerating distress: cons
– isolating myself
– self care diminishes
– think too much

3) Not tolerating distress: pros
– not thinking as much
– easier to use distraction techniques

4) Not tolerating distress: cons
– feel vulnerable
– anxiety increases

As you can see I’ve literally just done my own thing in this as I couldn’t think of anything else!

 
 

It’s Not Depression

23 Jul

This is going to be a rambling post, I have no idea what I’m going to say and so I apologise in advance. However, one of the reasons I started this blog was to use writing as a therapeutic tool and so that’s what I’m doing.

I’ve come to a bit of a realisation this week but I’m not sure how to convey it – let me try! I know how depression feels, one of my diagnoses is major depressive disorder and to have that empty, hopeless feeling that hurts like a physical pain. But this is different, it’s not depression, it’s an acceptance that things won’t get better and that brings about the same empty feeling – making any sense?

It’s as if the symptoms are the same but there is just something different, maybe it doesn’t hurt, it’s just there. I don’t see the future, I know it will end but this isn’t because of an illness, it’s just because it is.

I seem to be on total auto pilot, but doing nothing with myself at the same time.

I’m going to leave this one quite short as I’m not expressing myself very well – if anyone else thinks they understand please feel free to comment, maybe it’s not just me.

 
 

Can Therapy Be Damaging?

15 Jul

**TRIGGER WARNING – SLIGHT MENTION OF SUICIDE**

I’ve not blogged recently – I’ve had a lot of family stresses to deal with which has taken up all my time and energy but after today’s therapy session, I feel the need to write something down.

It’s well documented throughout my blog that I don’t really want to be doing DBT and think it’s the wrong therapy for me, but recently I’ve found myself getting more and more frustrated with the one to one sessions (which was the area I was ok with). In them we do a chain analysis, where you essentially break down the thoughts and emotions and look to see at what point you could change the emotion in the future. For example, if sadness then maybe acting opposite and do things that would make you happy. Not exactly rocket science I know but that’s what we do in the session.

My frustration arises because it’s all we seem to do, everything is a chain analysis and I feel like we’ve done them to death now. I need/want to be dealing with the trauma, my past experiences, trying to diminish the effects of flashbacks and nightmares – is this too much to ask?

Yesterday in group therapy, I sat and cried in private as I felt it was so far removed from what I’m needing right now and I’ve tried to tell people but I just get the same response, that I need to be stable to go through the trauma work, but how can I be stable with such debilitating symptoms?

In today’s one to one session, I think I was quite unreceptive as it’s getting to the point where I’m thinking it’s doing me more harm than good and I told my therapist that I felt like I was wasting her time. She said the same back to me that it felt like she was wasting my time as she felt she was ‘nagging’ me. I didn’t see it in that way but I don’t know how much longer this can go on for.

The other problem I have is that I don’t see a purpose. What am I putting myself through this for? Is all this upset really worth going through to reach an end point that I can’t see? I don’t know if I’m making much sense here but this is when I start to think that logically, taking my own life is the answer because there is no other ending. I don’t know, I just don’t know!