Sunday, 22 September 2019

THE TOP MENTAL HEALTH FAUX PAS




faux pas

[ˌfō ˈpä]

NOUN

an embarrassing or tactless act or remark in a social situation.



Someone asked me about the title of one of my recent blog posts (WHY “LOOK HOW FAR YOU’VE COME” & “DON’T LET HIM WIN” ARE BECOMING MY NEW PET PEEVES) because they’re two phrases that this person uses with me and I think that they were worried that I’ve been finding them unhelpful and just not telling them. I explained that I understand people – because it isn’t just this person who frequently uses these phrases – always mean well when they say these things and that they’re trying to help but mental health can be a minefield and sometimes, when you hear the same thing over and over again it will, of course, become a pet peeve, change it’s meaning and change its impact.

So, for the record, here’s – what I think are – the top mental health faux pas:



“Self-harm isn’t the answer”

I’m sorry but I don’t recall ever claiming that it was! I had a discussion recently about the other inpatients when I was in the long-term, specialist Hospital and how they had each encouraged one another to self-harm. To the point where one person had snuck in a blade and they had passed it around one another knowing full well what each person would be doing with it. I explained that even though I sometimes find self-harm ‘helpful’ in some way, I would NEVER promote it or encourage others to try to use it as a coping mechanism. One thing I’ve known since I first cut myself - but it’s something I’m only just really learning - is that self-harm can be an addiction. A cycle. When my anti-psychotic medication was reduced and the auditory hallucinations came back, I began self-harming again in response to them and because of that, self-harm has – once again – become my first port of call when I’m struggling. When things happen that are upsetting, rather than attempting to use my Dialectical Behaviour Therapy (DBT) coping skills, I’m resorting to self-harm and of course I don’t want to be constantly in and out of hospital, covered in scars and bandages, so I’ve wracked my brain trying to think of what really got me out of the cycle last time. And it was being admitted to a psychiatric hospital. But I was determined that it isn’t going to take something like that to help me; I can do it myself! I hate the feeling of being out of control so I lassoed all of the energy I have left and I’m very proud – and relieved – to say, that it’s been seven days since I last self-harmed; which is the longest period for the last five months! 



“Think of how your friends and family would feel if you killed yourself!”

A common belief among those who feel suicidal is that their family and friends would be ‘better off’ without them. It’s incredibly ‘easy’ to come to this conclusion when you’ve seen your behaviours and attitude upset the people you love and care for. I think that for this reason, it’s hard for loved ones to know what to say and which emotions to let you see. Hearing how upset they are when you’ve self-harmed or are struggling can go one of two ways; it can either serve as evidence that their life would be better without you in it. Or, it can be motivation for you to stay safe and not self-harm to attempt suicide by focusing on how painful it’d be for your friends and family. The danger that this statement can go either way – I think – makes it a big no-no as something to say to someone in a mental health crisis. When this has been said to be in the past it has sometimes exacerbated things because I could have been on the brink of attempting suicide and then that comment has left me feeling that I actually had little choice but to continue because otherwise I was putting everyone through all of this for no reason.



“You can’t stay on medication for the rest of your life!”

This statement makes me feel that professionals believe I actually want to be on medication! There’s been a lot of heated discussions recently with my Psychiatrist around my medication after she said that studies show that the majority of people with Borderline Personality Disorder (BPD) don’t benefit from medication. No matter how I phrased the ways that I do benefit, it wasn’t changing her opinion and I had no choice but to go along with the reduction plan! When I was still doing well with my anti-psychotic medication (Aripiprazole) on 10mg, I didn’t argue when she proposed we reduce it further. After my mental health deteriorated and the hallucinations came back, she finally agreed to increase it back to 10mg and within three weeks the hallucinations had gone completely! So when my new Community Psychiatric Nurse (CPN) asked if I could imagine a life without medication I had to think about it. I’d said ‘yes’ to the question as to whether I could envision a life without Services and without self-harm but this one had left me having to think on it. I think that I actually knew my answer immediately but that I knew it wasn’t popular among professionals… I told her that I recognized and that I didn’t want them to think that I want to be on medication but that I really believe that the benefits to it outweigh the ‘possible long-term side effects’ that my Psychiatrist keeps listing. So long as these pills help keep me safe – and I realize that it’s important not to rely on them and that I have to do my bit too – and I’m not ashamed to say that I take psychiatric medication, I won’t argue against being on them.



“Have you tried taking a bath?”

It’s a bit of a joke with mental health service users that you’ll often call a professional such as the Crisis Team (who are probably the most guilty for using this comment) and be met by a useless comment like this or the equally useless ‘you could try watching a nice film instead of self-harming!’ This might be one of those comments where some people will argue that it’s well-meaning but – in a mental health crisis – that doesn’t make a difference! If a comment is unhelpful in a crisis then it’s unhelpful; you can’t sit there and think ‘ooh well actually, he/she does mean well by it, so I’ll try to react nicely to it.’ These comments, for me, have stemmed from times when I’ve been asked what I find helpful when I’m struggling and I’ve listed the usual ‘self soothe’ and ‘distract’ activities that I do e.g. doing a beauty treatment, watching a film, blogging, playing with my pets etc. I guess that professionals don’t recognize that when I call them for help it’s because I’ve exhausted everything that usually works and everything that I can do. I wouldn’t call the Crisis Team if having a bath made a difference. And the ironic thing about this? I’ve never even said having a bath helps because I don’t have a bath in my house; my bathroom is a wet room with a shower! I also think that asking this question can feel a little patronizing and demeaning as though something so ‘simple’ could help your mental health at this point. It’s true that there have been times when professionals have reminded me of things that I’d forgotten I’ve found helpful before and it’s also true that ‘little’ things can massively help sometimes but this comment doesn’t do that justice.



“You’re letting your abuser win by doing this…”

I’ve talked about this one in a recent blog post (which you can read here) and how it used to help and motivate me to want to change things but it’s now lost that meaning because it’s been said to me so many times by so many different people and in so many different situations. It’s made me consider ‘well, that must mean I’m the loser for self-harming.’ I guess it’s another well-meaning statement, but it has the potential to cause harm and that’s what this post is all about. I also worried that talking about my mental health in terms of there being a ‘winner’ just demeans everything into it becoming a game and that I should want to be alive purely so that my abuser isn’t the ‘winner.’ For a long time, the benefit my mental health recovery would have on others was my motivation to strive to achieve it, but I learnt that it needed to be more than that. You have to want to get better for things to really change. Using others as motivation got me through the worst of it but I needed to want it for myself before I could really see things through. The wording of this comment should also be regarded because ‘letting’ implies that you have the power and control to not self-harm and are just choosing not to use it.



“But you’ve got so many positive things in your life!”

This was actually said to me really recently and again; it’s well meaning but that doesn’t make it helpful! I think that often the intention behind this is thinking that it might be a reminder for the person struggling to consider any positive things in their life and to draw their focus to these as opposed to the many negatives. But actually, this comment can appear dismissive; as though the person doesn’t want to hear about or put any focus on the hardships in your life that are influencing your self-harm or suicidal thoughts. When this was said to me it also made me feel as though I had no right to be feeling so bad; like I was being ungrateful for the lovely, kind people in my life and the special achievements I’ve made. And it made it sound as though all of the bad things were actually rather trivial and nothing important compared to the positives. As though the memories of the abuse should be cancelled out by the fact that I have over half a million readers on my blog!



“We should be helping all of these other people…”

This has been said to me by professionals varying from Police Officers to A&E Nurses and Doctors! It usually stems from the Police radios constantly buzzing into life or numerous patient call buttons sounding while the medical staff are with me. Now, believe me, I need no help in feeling like a time waster and believing that I’m not worthy and completely undeserving of professionals’ help and support. This statement is often used in a crisis and in those moments – when I want to self-harm or even kill myself – the professionals are my enemy because they’re the ones trying to stop me from doing what I want. So, for me, in those moments, I wished more than anything that they would help all those other people who are dialing their number or crying out for their attention! To be told this, but then have Nurses and Doctors say that I’m poorly and need to be in hospital or have Police Officers say that they have a duty of care to look after me, is confusing. Sometimes I felt like screaming ‘make your mind up; do I deserve your attention or not?!’



“Do you want a pat on the back for doing what you should be doing anyway?!”

This was said on two particular instances; the first was whilst I was in a psychiatric Hospital and had returned from unescorted leave. I cheered to a member of staff that I’d come back as opposed to the previous time when I’d jumped over two fences and ran away and I was met with this comment. A year or so later and I was proud that it’d been so long since I’d self-harmed and when I announced how long it’d been to a member of staff – a different person but in the same psychiatric Hospital – I was met with this response. On both occasions, the comment was upsetting. It felt as though staff were constantly trying to encourage me – and other inpatients – to recognize achievements and accomplishments but then when I finally was, I was being smacked back down! I’m so used to beating myself up and tearing myself down that I find it challenging to recognize when I’ve achieved something, and I find it even harder to actually say it out loud because I’m very wary of sounding as though I’m big-headed or being cocky and full of myself. But over time I’ve learnt that recognizing your accomplishments is actually part of having a healthy mental health because it helps to keep you motivated and give you drive and passion.