Grief Revisited

“I can accept the idea of my own demise, but I am unable to accept the death of anyone else.
I find it impossible to let a friend or relative go into that country of no return.”
Maya Angelou

Last week, my dad’s dog Charlie had to be put to sleep. Arthritis had brought him to a place where he could no longer stand on his own. He had pined for my dad over the Charlierecent weeks since my dad died, and so the decision was made that no matter how much we loved having this very tangible link to my dad, it was time to let go. Anyone who has stroked a dog reassuringly whilst the vet prepares them, and finally administers the injection, knows how moving this can be. Charlie went to sleep and then he was gone.

Once the vet had removed Charlie from the living room, the house seemed bigger and emptier. I made a coffee and went and sat in the garden. I recalled previous visits seeing my dad and Charlie playing in the garden; or my dad cutting the grass; or the doors to the shed open with the sound of sawing or some other carpentry activity. I could see more recent days with my dad and Charlie, two elderly companions taking careful slow steps around the garden.

Charlie was gone as my dad had gone just a few short weeks earlier. I felt as if I was relieving the hours after my dad had died. I became overwhelmed by the silence of loss. Charlie was gone and my dad was gone. I no longer expected to see my dad come in from the kitchen (as I had done since his death) when I walked through the front door with his customary “Hiya Nick. How’s things?” I no longer expected to hear my dad’s voice when I answered the phone “When you have a minute can you take a look at my computer?” I knew I would never experience the joy of cooking a meal for them or sit around the table talking and enjoying each others company. With Charlie’s death I finally felt my dad was dead too.

As I sat there in the garden with that realisation, I began to sob. I could feel tears slide down my face. I felt my body begin to shake with each sob. This was so alien to me, so unknown. Equally it felt so normal “Is this what normal people feel?” This was the outward sign of grief I had expected from the start, but just couldn’t touch. When it subsided a couple of minutes later, I felt I had ‘let go’ of my dad. I felt at peace, incredibly sad, but at peace.

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Grief

It is not a feeling of numbness but rather a sense of nothing within me; no feeling, no ache, no tears. As if I am hollow.

“Shape without form, shade without colour,
Paralysed force, gesture without motion;”
The Hollow Men by TS Elliot

I would love to be able to tell my dad about the number of people who attended his funeral two weeks ago. About the diversity of people who came to share in their grief and support each other. My work colleagues who raised a considerable donation for the hospital where he died; the neighbours, and friends. It may sound odd, but he would have appreciated it. Salvation for my dad was through work and therefore seeing the senior management from my employers in the congregation would have given him a huge sense of pride and satisfaction.

DadMy dad died on Easter Monday just a few days after I came out of a long stay in St Patrick’s Mental Health Facility. I was adjusting to ‘life outside’, when I quickly had to adjust to life without my dad. I had seen him deteriorate since last Autumn when we were told the cancer was back. I had cooked his last Christmas Dinner for him; I had taken him to various appointments; and as driving became more difficult, shopping for both my mum and dad, in fact much of my life was devoted to their care. Now he was dead.

It is three weeks to the day that he died. People have gone back home, back to their jobs. The constant wave of visitors to see if my mum was ok has dried to a trickle. It is as if his death has been forgotten by the world except for me and I seem to be stuck in that moment. It is not a feeling of numbness but rather a sense of nothing within me; no feeling, no ache, no tears. As if I am hollow.

I am assured that what I am going through is “complex” or “complicated”. I was referred to St Patricks with complicated depression back in January. In other words the bottom had not dropped out of my mood because of contemporaneous events but rather a complicated mix of childhood traumas, unresolved adolescent behaviours, and the exhausting life I was leading when my mood crashed. So added to these the death of my dad or rather, these are now defining how I grieve for the loss of my dad, and the whole state of being has become very complicated.

For the past three weeks I have waited for the tears, for the pain of loss and the sorrow. But I have felt none of these. My dad’s death seems to have become another one of my life events that I am unable to feel or express emotion over. A psychologist at St Patrick’s told me that when someone holds onto emotional pain, the secret of abuse, other behaviour defining childhood traumas, coupled with a Personality Disorder and depressive moods, grief and emotion do not always come easily.

So for now I feel hollow, not numb, but hollow. I am caught in the twilight world of knowing he is dead but not feeling that he is dead, in the same way that I know I was abused as a child but not feeling emotionally the abuse that I suffered. My dad loved me I know. In the final hours of his life I was at last able to hold his hand and tell him that I loved him.

 

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Recovery and Personal Responsibility

“The point is, the brain talks to itself, and by talking to its self, changes its perception.”                                                     Girl Interrupted by Susanna Kaysen

Last week my psychiatrist had spoken to me about being discharged. Today I was given a date of next Tuesday. I have been at St Patrick’s mental health facility in Dublin for a little over five weeks now having come in with what was described as ‘clinical depression’, following my spectacular emotional and mental crash back in January and finally admitting I needed help and support.

In the two or three weeks following this and whilst waiting for a bed to become available, I built up a picture of daily therapies, group discussions, and various programmes that I would undertake at St Patrick’s, designed to ‘cure’ me of the madness that had finally taken hold. The reality couldn’t have been further from the truth. The first week to ten days was spent with very little in the way of the structure I had imagined. There were the weekly meetings with the care team, daily check ins with the nursing staff on the ward; apart from these however there was not the deluge of therapies that I had imagined or even hoped for. I started to question why I was there. The daily lectures were very interesting and intellectually stimulating, but how was this helping my recovery. The twice a week depression programme I had started, again was interesting but not something I could relate to certainly not in terms of my recovery.

This afternoon I realised I was missing the point. I attended a lecture on Recovery where the speaker said that we need to have a narrative as to how we got to where we are, or in my case how I had emotionally, physically and psychologically not only crashed but burned too. Once we have that narrative, that insight we can start looking at what our needs are for recovery. What was my narrative? In short my narrative was stress, overload and exhaustion. Not only that but also how, through childhood traumas my reactions to stress and not having enough hours in the day to do everything I planned and was asked of, was not to cut back but to ignore the friends who were telling me to slow down. In response to this I increased not decreased my workload in an attempt to keep everyone happy; afraid to say “No” in case the whole world collapsed without my help. In the end it was not the world but rather me that collapsed.

bingoSo today with four days left I have been reflecting on my time here. I have spent many quite hours just sitting with myself; reading; listening to music; going to the gym; and even Bingo which has saved me a fortune in toiletries. During this afternoon’s reflection I have come to realise that it is not the planned therapeutic interventions that have been important, but rather the time spent with and learning about myself. This may sound selfish and maybe it is especially given that my father is fighting a losing battle against the cancer that rages out of control in his body; or that others have had to pick up where I abruptly left off. This may also sound unrealistic as not everyone can afford the luxury of taking five weeks out from their lives nor indeed afford the health insurance to cover the cost. I am aware of that and please don’t think I am rubbing it in by writing this. I am not.

I am coming to the end of my first stay at St Pats (I am due back in May for part 2), and what have I learned? Firstly I have learnt that there is a whole murky swamp from my childhood I need to therapeutically explore. I have learnt that I must not ignore my triggers again; that I must listen to others if they notice the warning signs. It is not always possible to sit in the garden for several hours and read a book when you have family and work commitments, but I will try and extract myself from the pressures and stresses of life when possible. Above all I have learnt that I must take responsibility for my recovery and when needed, ask for help.

I am still very much a work in progress. What has worked for me may not work or may not be affordable for others. That campaign is for another day. Right now I need to focus on me and getting back to the outside world.

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What is appropriate for me to feel?

“He studied how they moved, sat down, stood up; copied how they ate…………..When the children watched television, he squatted near them and looked from the screen to their faces, for he needed to know what reactions were appropriate. If they laughed, then, a moment later, he contributed a loud, hard, unnatural-sounding laugh.”    

                                                                                                  “The Fifth Child” by Doris Lessing

It has been 10 days since I came into St Patrick’s Hospital in Dublin as an inpatient following my inability to hold up the sign that said “I am fine” any longer. Five weeks ago I believed that I could carry on pretending that all was well and hide everything away, out of view from those close to me, those that worked with me and those that spoke to me. I was wrong.

MeI have never been off work due to my mental health let alone hospitalised. So the past few weeks have been a double whammy. My anxiety was peaking as I filled in forms on being admitted; even the reassurance of the Registrar did little to relieve the overwhelming urge to grab my bag apologise for the mistake and run. Nor did the search of myself or my bags for anything that I could use to harm either myself or others, do anything to convince me that I should be here.

The facility is modern, very clean, very well run by professional attentive staff who have the time to talk to patients. There are regular meetings with mental health professionals where treatment plans are fully transparent and put together with full consultation with the patient. All this is totally at odds with the conversations I have had with people who, unable to afford the luxury of health insurance, rely on a very overstretched and underfunded public mental health system. I consider myself to be one of the very lucky ones.

The first week or so has been filled with assessments, care plan reviews, and meetings as well as personal down time. One thing that has taken me by surprise is that whilst I am familiar with and able to articulate what it is like for me living in the extremes of mania or depression, I have no sense of what it feels like for me living in the middle. When I am in that vast emptiness between mania and depression, I am unable to answer the question “How are you?”; not because I am ‘acting out’ or because I am attention seeking. Rather quite simply I have no sense of how I am feeling in that ‘in between’ state.

During my psychotherapy training, at the beginning of each lecture we had a ‘check in’, where we were all asked “How are you right now?” If I was not experiencing either extreme but rather in the ‘in between’  space I would practice on my way to college answering the question.

“How are you?”

“I am ok”

“What does ok feel like”

 “Well, it feels like……errr..feels like…..good?”

Sometimes I would answer the question before anyone else. Other times I would wait till the end, listening for a phrase that I could steal from another.

I have not been in either extreme since I have been at St Pats. I have been in that middle void between mania and depression. Again I am facing the question “How are you?” on a regular basis from nurses, psychologists, psychiatrists and increasingly from myself, yet I am no nearer finding out how I am in the middle. I find myself watching and listening to my fellow patients, searching for that one word or phrase that will unlock my understanding of how I am feeling. I feel separate from the rest. They are feeling openly and honestly. What should I be feeling? What is appropriate for me to be feeling? I am in danger of becoming others, adopting their behaviours, their words.

My psychiatrist believes this is a form of disassociation. If however I am to move forward, put in place strategies to identify when I am heading towards the extremes and more importantly to cope with them, I need to understand and feel “how am I” when I am in the middle. Right now I wish I could slide into depression, or fly into mania just so that I dont feel such a fraud, such an outsider.

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Discovering I have Clinical Depression is very scary.

I have been put on sick leave following my admission at work that I was struggling due to my mental health. A recent diagnosis of Clinical Depression has meant that I will be off for some considerable time. This is all new. This is all scary. I have no idea what I should be doing.

I have sat at my computer this morning waiting for the fear to subside. I feel ridiculous as I have posted in this blog many times. But this is different. Over the past eight months or so I have noticed that the often chaotic mood swings that have been my mood disorder since my late teens have slowed down. This I believed was partly to do with working hard in therapy and seeing the disorder as a collection of behaviours and emotional reactions that I had learnt or adopted from my childhood; either because it was the “norm” or because I needed to survive the trauma. Now however, in these past months I have become even more aware of the immense sadness that is my normal day to day emotion. Within this sadness though, my mood has  dropped several times  into a dark place, not for a few hours or a day or two but for a week at a time.

Silhouette of depressive manTwo weeks ago I was struggling so badly I was sent to the company doctor, who signed me off work for at least six weeks. In the meantime I have seen the psychiatrist who has diagnosed me with Clinical Depression. Now I am waiting for the call from St Patricks Hospital in Dublin to go in as an inpatient for a week or two.

I have never been sent by an employer to the doctor and certified sick apart from the usual flu. This is different, this is unknown, this is scary. It won’t be up to me to decide I am ok to return to work. It will be up to the doctor and psychiatrist. So how will I know I am ok to return, how will they know?

I have tried to keep a routine. Set my alarm for 7:30am. Up and do the housework, empty the fire. Look at the clock. 9:30am. Ok. Go for a walk or go to the gym. Look at the clock. Lunchtime. Now the afternoon. Another walk. Look at the clock. It is exhausting just trying to stick to this. But should I be doing these things? When I am off work sick with a physical illness I stay in bed or lay on the sofa until I feel better. People can see I am sick.

But what about now? What if someone sees me? Should I be doing these things? Then there is the reality that I am unable to keep such a tight schedule everyday. There have been days where I just laid on the sofa looking out the window, unable to find the mental energy to tell myself to move.

I have also tried but often failed to remember that sometimes depression is a result of external events and stress. The psychiatrist explained that depression in adult life and in particular in my case, may well be the result of how I learned to respond to stress in my childhood. This I can see clearly, however I often ignore this as it is more comfortable and easier to say that my depression (and anxiety) is as a result of some unseen anomaly in my brain rather than childhood trauma and chaos.

This is all new. This is all scary. I have no idea what I should be doing. Friends from work have been contacting me to see how I am doing. That makes me feel ashamed. Right now my mood is OK. That makes me feel guilty.

This is all new. This is all scary. I am trying to take it one day at a time but it is not like waiting for a head cold or flu to ease. Right now I feel “normal” the way I would feel when I am at work. But then I look back two weeks ago, or the time before that, or before that. How I struggled. How I was not being honest either with myself or with those who cared about me.

Yes this is all new. Yes this is scary. Maybe what I need to do is start being honest. I cannot hold up the “I’m OK” placard for ever when I am not. I need to listen to others and I need to listen to myself even when what I am hearing is causing feelings of shame and guilt

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Childhood full circle

I am grateful that we will have the opportunity to have one last Christmas as a family, where I will treasure the memory of my father at the table, in fairly good spirits

Christmas can be a very triggering time of year. It can conjure up memories of a childhood of magic and joy; it can also bring back dark memories of childhood; it can touch feelings of loss and regret; the deafening silence of Christmas day can amplify the loneliness that many feel. I am therefore, very careful about assuming that what Christmas means to me, will mean to others.

Trafalgar SquareI have this photograph, taken on our regular Christmas trip into London after school. My parents would meet me after school and take my sister and I on the short train ride to Waterloo Station. That sense of excitement on the train and tube; to see the tree at Trafalgar Square; to visit Uncle Holly and Father Christmas at Selfridges Store; to buy a bag of hot chestnuts; to wander through China Town; and the lights of Regents Street. This for me was Christmas. It was magical.

This year I am pulling out all the stops, food, decorations and a general feeling of celebration. As I put the finishing touches to the tree yesterday against the back drop of falling snow, I felt that sense of magic and awe that I recall from many of my childhood Christmases. This year will be special because it will in all probability be my father’s last Christmas. We do not know for certain, but the reality is that God’s great practical joke, the Cancer that my father has fought so bravely for the past five years is once more raging in his body.

This time it’s different. The chemotherapy that he acknowledged was “keeping me alive” has been withdrawn, his body unable to tolerate the chemical cocktail racing through his veins. He does not want to know the prognosis and we have resisted the temptation to have a ‘quite word with the consultant’ out of earshot of my father in case we betray too much of what the coming months hold. I have spoken with friends who have a professional knowledge and friends who have a personal experience of nursing a loved one through cancer. The general consensus is that we are in the final few miles of the journey, although one friend said they continuously said goodbye to their grandmother each Christmas for five years before she died.

I am grateful that we will have the opportunity to have one last Christmas as a family, where I will treasure the memory of my father at the table, in fairly good spirits. I will for this one special day forgo my vegetarian principles and eat meat not out of my own craving, but because I really want to share this meal with my father. I want to taste and enjoy what he will taste and enjoy. I am so very grateful that I have this opportunity denied to so many, to be fully present at the table with a loved one for one last celebration; with both my parents for one last magical Christmas as a child and as a son.

“And you, my father, there on the sad height,
Curse, bless, me now with your fierce tears, I pray.
Do not go gentle into that good night.
Rage, rage against the dying of the light.”

                                                                                         Dylan Thomas

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When its NOT okay to be not okay

I yearned to be a child and for someone else (my parents?; my grandmother?) to hold me emotionally.

depression-quote-1For the past two weeks I have experienced a blackness I have never known before. I have not been “okay” during this time. It has been frightening, draining and very bleak. On several occasions I have seen the slogan that I would have previously ascribed to, “its okay to not be okay”. Now however I know this is not always true. The way I have been this past couple of weeks, I have to say “No. Its not okay”. I don’t want to feel like this. Because I don’t feel its “Okay” to feel this way I have adopted some healthy coping mechanisms; namely taking some time from work and making an extra appointment with my own therapist. As both a therapist and a client I know how being able to do this is not always possible. Sometimes the fear is so great, the darkness so suffocating that we are unable to move.

Normally I am fairly good at holding the darkness in. But this was different. It had settled like a ridge of slow moving low pressure. Each morning I woke up and everything was just grey. I could feel the darkness pressing down on me from the outside and from within. I was living my life in black and white. People began to notice this was different, more prolonged and more intense from my usual BPD turmoil.

During this time I was aware that I was drawn to memories; photos and films that touched the child within me. I was becoming very emotional and very sad as if I was constantly on the verge of the tears that have eluded me since beyond childhood. I yearned to be a child and for someone else (my parents?; my grandmother?) to hold me emotionally. I called on my parents and dropped several hints that I was in deep emotional pain such as “I am taking time off work” or “I have mad an extra appointment with my therapist”. But as I looked at my parents, my mother smiling as she watched London’s Lord Mayors show on the TV and my father sighing at the floor, worrying about his next bout of chemo, I knew it would be wrong to burden them right now with how I was. In their 80’s my parents deserve peace and rest; and so I quietly left to the sound of cheering coming from the TV and my father nervously tapping the arm of the chair with his fingers.

I have a good and healthy support network. My confidante and champion Terry checks in now and again to see how I am. Tomorrow I have my own Therapy. I am starting to feel the light again but this episode of prolonged sadness and darkness has left me shook. I need to find out what happened, why and how I am going to fix it. Right now I feel as if I have been kept awake by a storm raging through the night and am reminded of the opening few lines of “Quite Early One Morning” by Dylan Thomas:

“I went out of the house, where I had come to stay for a cold unseasonable holiday, to see if it was raining still, if the outhouse had been blown away, potatoes, shears, rat-killer, shrimp-nets, and tins of rusty nails aloft on the wind, and if all the cliffs were left. It had been such a ferocious night that someone in a smoky ship-pictured bar had said he could feel his tombstone shaking even though he was not dead, or at least was moving; but the morning shone as clear and calm as one always imagines tomorrow will shine.”

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Taking Time Out

 

My exercise regime has in recent years fallen totally by the wayside. As a result I was totally dismayed but not unsurprised therefore yesterday when I went for a medical that I had put on 13kg in the past 4 years. This I put down to a change in working hours, Bloggiving up coaching a local rugby team, and letting my gym membership lapse. I explained that getting out of the habit of regular daily exercise had meant that when my mood had dropped, lethargy kicked in and the last thing I was able to do was put on a tracksuit and go for a run or to the gym. I have instead sat transfixed staring out the window, feeling guilt for not exercising which adds to the blame, shame and pain that accompany these mood changes.

Having said that my life has, is and continues to be very hectic. Work, caring for elderly parents, family life, psychotherapy (both mine and my clients) all fill my hours in a hectic swirl of activity leaving very little time for exercise, or myself.

A good friend of mine, Terry has been onto me for months now to take time out, relax, rest. Each time this was mentioned I would protest “But I have days off from work”. It wasn’t until yesterday when I finally went for a jog and I stopped midway round that I realised I was missing the point. Terry was right. I had stopped to stretch my calf muscles and found myself staring at the ground. In that moment was the realisation was that not in hours or even days but weeks this was the first time I had stopped. No phones, no “can you do this or that?”, no decisions, no checking the clock to see if i was late, not even guilt. Just stillness. In that nothingness, I realised Terry was right and finally understood what he was saying.

I am not one of these that advocate that the only way to overcome or improve our mental health is to go out resplendent in our Lycra running gear smiling as we cross the finish line of the Dublin marathon. Yes exercise does release chemicals that have a positive impact on our brains but sometimes we are just not able to get to that place because of our emotional or psychological state. We and other have to accept that.

I would suggest however that it is more important to follow Terry’s advice, take time out and rest, in what ever shape or form that takes. I know how difficult it is to let go, to rest, to experience stillness when our minds and emotions are caught on that out of control merrygoround.

In the past I have had periods of unemployment, as well as the emotional turmoil that is courtesy of my mood disorders. I have been told “why do you need a break?” ; then been instantly compared to a well paid, seemingly well balanced successful person. “You are unemployed/ill/lazy/depressed/moody; why do you deserve a break?” And if I was to tell the truth? “Because I am utterly drained and broken? Because I feel there is no respite from this pain?”

So yesterday while staring at the twigs and leaves on the ground of Belleek woods, I finally understood. It is when we are at our most hectic; when we are at our most vulnerable; when we are in the midst of psychological turmoil that we need to rest and take time for ourselves.

I will leave the final words to Terry. “The most draining situation is being unemployed, or trying to cope with mental health issues. We become overwhelmed with the feelings of guilt, shame and hopelessness. We may not be able to switch off from these feelings; whilst we cannot clock off,  we must try to take care of ourselves, find that place in ourselves that we can retreat to whenever we can to self soothe, to rest and recover. Above all we must tell ourselves that it is ok to take time out”

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Searching for Safety in an Unsafe World

AlleyFor the past few months my moods have been fairly level. I have learnt that I have choices; that I can choose to step into the abyss or I can walk away. Easier said than done I appreciate, however I am getting there. Above all, my emotional responses to any given situation have become more proportionate, and the almost hourly sickening swing of emotion from ecstasy to despair, has flattened out. This has all resulted in me experiencing one emotion at a time and usually in moderation rather than as one enormous ball of plasticine of different colours that have been squished together to make one unfathomable mess.

With this separation of my emotions in to clearly identifiable strands, I have for the first time in my memory been able to have a fair go at regulating my emotional responses (and my emotions) to any given situation or event. One thing that I am beginning to realise is how I am constantly in search of safety; scanning people to see if they pose a threat; trying to sense danger in any environment; looking for clues in what those at work/family/friends say to try and asses the threat level. As body language or facial expressions are a great indicator to any potential threats I enter realms of unbelievable anxiety if I have to make or receive a phone call.

What all this amounts to is hypervigilance – the clinical term for those of us who through childhood trauma and abuse or unstable home lives during our childhood and adolescence have become acutely aware that the world we live in is a very unsafe place. With this realisation comes an insatiable craving for safety above all else. This is one of the many effects of PTSD. When we have been placed in danger such as childhood sexual abuse, our brain becomes rewired. What was once perceived as a relatively safe world is now seen as a melting pot of danger and risk. This rewiring of our brain can last a life time or until we learn to manage it through appropriate therapy

Paradoxically whilst those of us who are hypervigilant crave safety we are often although not always drawn to unsafe situations, relationships and environment. In my own life through my teens and early 20’s I ran from one abusive relationship to the next where to me abuse, either emotional, sexual or physical was the norm.

Hypervigilance manifests itself in physical, emotional and psychological ways. I have a habit of waking most mornings at 3am. As I try and find sleep again, paranoia takes hold and I firmly believe that there are people trying to get to me, trying to break into the house. I have heard the doorbell rung or banging on the door, so real that on several occasions I have gone down stairs to confront those that I believe to be there.

I am constantly checking with those around me to try and gauge whether I am at risk. Often my questions about “How are you?” or “All good?” are asked as part of my continuous risk assessment. Depending on the response, the tone of voice, the facial expression, the body language, I will adjust the threat level accordingly. At the very best I feel that the threat level usually is “moderate”; at worst the threat level is “critical”. I am therefore usually on high alert; in defence mode often sending out a pre-emptive strike before the attack starts. Sometimes I thwart a real attack on my safety but quite often the threat has not been real and I have become the aggressor.

This continuous search for safety in an unsafe world is exhausting. Where others can relax and close their eyes to regenerate, I remain alert and constantly scanning my environment and those around me for danger. It is exhausting.

 

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Guest Blog: Psychiatric Appointments For Dummies (**Trigger Warning**)

Very proud to post a guest blog from Lucie and her wonderful blog Square One (http://square1one.blogspot.ie ). In this blog, Lucie describes how the creaking and depleted Mental Health Services in Ireland are leaving clients in utter despair at the lack of much needed continuity between appointments and attention to each client’s case history.

To whom it may concern:

This is not a complaint against any one service or professional but it is a complaint against the way that the mental health services are organised.

I attend an outpatient psychiatric clinic in …………………..  I have attended this clinic since December 2013 and I have appointments regularly, sometimes with a few weeks in between, sometimes one or two months. During this time, I have seen the consultant psychiatrist three times and each of those visits has been productive.   However, outside of that, it has happened only twice that I have seen the same doctor on two consecutive visits.  Otherwise I see doctors who come and go.  A lot of the time they have not read my file.  I have been asked on more than one occasion  for my diagnosis.  Because of this I have been finding my appointments increasingly difficult and get very anxious in the run up to them. I know I will most likely be talking to yet another stranger.

Today’s appointment was the worse one yet.  I’m not complaining specifically about the doctor I saw because he did his best-it was just that everything he did represented everything that I feel is wrong with the service. I had been having a hard time and came with a few questions I wanted to ask.  But most of the appointment was taken up with rehashing yet again where I am in my life and why.  He gave me advice which I have heard time and time again-relaxation, exercise, yoga.  I tried to politely explain that body focused meditations are very triggering for me only to realise that he didn’t know my background or why I had this difficulty.  He suggested books for me to read among them, “CBT for Dummies”.  I explained that I have done DBT which has a lot of the same material.  He did not know this and asked me about it-another relating of basic information which must be in my file.

I explained to him about how I am struggling to find joy in life, how badly I miss looking forward to things or enjoying myself-I asked if he thought I should look at changing my medication or coming off it all together.  At this stage I sounded shaky and I felt very emotional.  He did not respond. Instead he put the issue back on me, asking if I felt I was just not noticing the good things and if I can feel the sun on my face.  I think I gave up at this point.  It didn’t seem worth trying to tell him that on bad days, the sun on my face just reminds me of everything I can’t feel or enjoy.

I feel hurt that my fight for health over the last few years gets overlooked again and again. What I need is a chance to know and trust a doctor enough to ask them about trauma and the effects it has had on me, why I have horrible images in my head that are blocking out the good things, why I can’t see a future, what is going to happen if this situation doesn’t change?  Is my diagnosis really right or is there something else wrong?  Have I always been as different as I feel or is my mind just struggling with the “different” things it is trying to process.  I badly want to ask these things. Instead I get Yoga-again and again and again.

Yoga, smile and come back in two months time.

I accessed DBT though the National Counselling Service and the people there have been the only ones who have understood, treated me as an equal and been able to see and explain the effects of childhood trauma in a way that includes and supports me.  The psychiatric services just feel more and more like everyone is judging me for not just getting better with the “one size fits all” approach.

I also realise that I am one of the lucky ones.  Plenty of people can’t gain access to mental health services. Here I am actually getting appointments-but I can’t keep feeling I should be grateful, that I should stay quiet, that I shouldn’t question because I have a very real fear that sooner or later my mental health difficulties will get the better of me.  I have fought long and hard all of my life and with respect to that doctor and many others I’ve seen, I know more about my condition than they do. Instead of trying the “cure all” suggestions I wish they would ask me what I need, or let me ask my questions.  Instead of pointing out what a “positive” it is when I say I force myself to do things I wish they could acknowledge that while good I’m pushing myself, it’s exhausting and really can’t be an option forever.

Is it really too difficult to have a team of doctors in each service and alongside those that come and go, have the core people who can do ‘handovers’ and try to have the same doctors and patients working together for as long as that doctor works in the service?  Is it really impossible to have doctors read the patient’s file before they see the person, even just to know the pertinent facts?  Is it really not an option to know the basic needs of each patient based upon their diagnosis and match them accordingly to who the best person on duty that day might be for them?

What a person with depression needs is not the same as a person with anxiety or a patient with Bipolor disorder.  EUPD appears to be alien to most professionals from what I have experienced. From my uneducated point of view I have a fair idea that childhood trauma features in a good portion of psychiatric patients and because of this some of the “general” suggestions will not work-body work can be triggering, meditation is not a good move for someone who tends to dissociate; nightmares and flashbacks can have a terrible effect on someone’s mood and “CBT for Dummies” is not going to help with that.

If all of these things are too difficult for the services, sadly the services have just become too difficult for me.

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