“When people are going through the worst day of their lives, you’re that person standing right in front of them…”
Kyle, NEAS Paramedic Apprentice
You can watch the first few episodes: https://bbc.in/3pjjHVO
On August 11th, BBC One aired the first episode for the new season of Ambulance and this time, they’re following my local Ambulance Service: North East Ambulance Service (NEAS)! Of course, I watched it and tweeted throughout (@aimes_wilson), and all the thoughts and feelings it stirred in me, have inspired this post…
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When I finished my first suicide attempt at school, I passed out in the middle of a corridor and the teachers called an ambulance. Whilst that was over ten years ago, I can still remember how lovely the NEAS paramedics were… I remember them speaking so softly and carefully, which was just what I needed considering the attempt was largely the result of the auditory hallucinations I had started to experience. I remember their jokes, which brought some very welcome light to the situation when I asked if we had to go to hospital and they said “no, we thought we’d take you for a holiday!” And I remember the appreciation I felt when they said, “we completely understand if you don’t want to tell us why you’ve done this.”
At the hospital, the paramedics left, and their very real presence was replaced by the hallucinations who had gone quiet from happiness of my attempt; but were now loud and furious at me for accepting help and being so close to having treatment to counteract the attempt. Their anger led to my refusal to cooperate with the A&E staff, and so I ran from the tiny room (it would have totally rivalled Harry Potter’s cupboard under the stairs!) and managed to almost get into the nearest town centre before I was stopped by the Police. And, for the very first time, the Officers detained me under section 136 of the 1983 Mental Health Act and as a result of the subsequent assessment with two Psychiatrists and a Social Worker, I was put onto section 2. This allowed the professionals the ability to have me transferred to a psychiatric hospital once I’d had the medical treatment for the attempt.
The antidote treatment that I had to add as ‘saving my life’ was pretty terrible because I had an allergic reaction. Even when the antihistamines settled it down, I felt nauseous for the entire – almost – twenty-four hours it took for the treatment to be administered. Then, when my blood tests showed the antidote had worked, it felt like I had barely taken a breath before I found myself being given a tour of the psychiatric ward.
After recognising that I was the youngest person on the ward, I had the stark realisation that if I didn’t start telling people about the trauma I’d experienced when I was younger and the hallucinations, I wouldn’t get any better and I would likely end up in the still in that place at the age of the other inpatients. So, I finally started talking and within a few weeks, I was discharged home and left with a ton of challenging memories that had led to many thoughts and feelings which I knew would likely not go away any time soon… I mean, experiencing ‘firsts’ in any area of your life – not just mental health – can really shape and define your opinions in a way that can be powerful enough to control your future experiences of the same thing. Even where – if measured separately – they’re strikingly different.
So, from that first attempt, I built the opinion that NEAS were kind, caring, and non-judgmental, and I already felt that the Police and A&E staff were very slightly becoming the enemy. The fact that they had all restrained me numerous times and during which, had given me a lot of sedative injections made me question how much I could trust them and their motives. Did they even care how I felt, or did they just want to get on with their shift in peace? And with that question racing around my head, I became more and more uncooperative to the point where, a few months later, I found myself making another suicide attempt, being sectioned in my mum’s home, and then literally carried out of it by six Police Officers. But there was a miscommunication between the Police and those who had sectioned me and so once I was in the Police car, they drove off to the local psychiatric hospital instead of the medical hospital.
I remember a male Officer getting out the car and then I heard him having a conversation with the psychiatric staff who’d come out of the hospital and were telling him that I couldn’t be admitted until I was medically fit. So, he got onto his radio, and I remember him shouting down it that he was “fed up with all of this!” He got back in the car and reeled the entire thing off to the female Officer who turned to me in the back and said, “are you going to stop *bleep* us about now?” And that one sentence was kind of like the real validation to my opinion of them. It left me feeling more confident and assured than I had when I knew I only had that one experience shaping my view and attitude. So, the Police’s poor attitude and horrible comments and the A&E staff’s frequent restraints, sedations, and treatment against my consent became a huge starting point for my evolving resentment toward these professionals.
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The next escalation of that resentment was on my third hospitalisation. I hadn’t made a suicide attempt; it was purely because I was found hallucinating in public. That I felt I’d done nothing ‘wrong’ and couldn’t appreciate why it turned into my longest admission when I hadn’t even been suicidal; meant I fell into the notorious us vs them thought process. I saw the Police, A&E and psychiatric staff as the enemy and felt well and truly hell bent on being completely belligerent during any contact with them. Which meant I became incredibly vigilant for any words or actions that would validate that. That would leave me thinking ‘yes, I have every right to hate them!’
The one consistent comment I heard from pretty much every one of those professionals was “we have a duty of care to help you.” Now, I don’t mean to sound nit-picky, but I think that the meaning behind this would be better phrased as “I really want to help you.” Referring to having a ‘duty’ seems to hint at the fact that the professional is simply ‘doing their job’ and experiencing the notion of a lack of care, kindness, and empathy when you’re in a mental health crisis, can be so detrimental and can not only end up exacerbating your thoughts and feelings, but also the entire situation on a whole! I think that a huge element to feeling suicidal or having suicidal thoughts, is loneliness and this can be perpetuated by the notion that the people who are meant to be the ‘best’ people in that situation, actually aren’t that helpful. It gives a complete sense of hopelessness because if the professionals can’t help you, who can? But what’s more than that if the professionals only seem to make things worse… Well, who are you supposed to turn to then?!
The controversial and debateable aspect to the issue of unhelpful professionals is that it’s ‘not all of them.’ Now, with this point, I recognise that there may be a level of unfairness to make assumptions of all professionals simply because one of their colleagues were unhelpful or just plain rude… However, I think that it’s important to recognise and accept that there needs to be a degree of responsibility and accountability. That it had to be realised that each individual professional is representing their organisation and so, the rest of their colleagues’ actions and attitudes will reflect upon them too. I mean, it should be considered how someone in a mental health crisis will feel or think about this… Well, for me, when I’d met a Police Officer (yes, I chose the profession that most obviously do this!) that was judgmental, spiteful, mean, and aggressive/threatening, I would be extremely reluctant to give other Officers the chance or opportunity to prove that they’re not all the same. Mainly because I absolutely hate the thought of feeling let down – by anyone! I mean, if I give someone the benefit of the doubt, and they turn out to have not deserved it, I will feel so stupid and disappointed; and these are thoughts and feelings that I struggle to cope with in a safe way.
Alongside the resentment with professionals for their response, I also found myself experiencing it in regard to their actual act of doing everything in their power to keep me alive. After a while of the hallucinations, the self-harm, and the hospital admissions; I began to find myself considering life to be a bit of a punishment. Which was a difficult thought process because on the one hand, I was blaming myself for the abuse I’d experienced when I was younger and that very obviously meant that I thought myself worthy of punishment, but, on the other hand, I wanted to escape it… And this thought process led me to resent anyone and everyone who were saving my life and very dedicatedly and aggressively, fighting against my attempts to end it. It made me question their motives. Like, how could they say they cared and wanted to help, yet they were making me go through hardship?
Then, about two years after my first suicide attempt, the professionals seemed to collectively reach a point where their attitude became concentrated on the thought/opinion that I was a complete attention seeker who was just manipulating the system. To be honest, I think that the majority of that belief was a result of my Borderline Personality Disorder (BPD) diagnosis because there’s so many assumptions and stigma surrounding it. I also think a part of it came from me feeling completely incapable of verbalising how I was feeling, what I was thinking, and what I was experiencing… I mean to them; they’d see me self-harm, take myself to A&E only to run away and cause a drama with Police involvement… But actually, the hallucinations led to the unsafe thoughts and feelings and so when I self-harmed they would be happy and quieten down, and without them; I didn’t want to die or be in pain, so I’d go for help. Then – whilst sitting in the waiting rooms – I’d find the hallucinations would come back and I’d lose my control over the situation and have to leave.
Now, in fairness, I think that I shouldn’t have had to learn how to describe things to prevent them from treating me that way; it shouldn’t have made a difference. But it did. And so, in a way, I do try to appreciate that I needed to be able to do that because it meant that eventually, I was better supported and that also contributed to my ability to articulate my mental health – something which is obviously very useful in blogging! But, at the time, I found it frustrating and became genuinely resentful of the people who I should have really found to be comforting, validating, helpful, and completely non-judgmental. And that was worrying – particularly for my Mum who became concerned that their attitude and behaviours were going to result in me ‘slipping through the net.’
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I always say when people talk about suicide being a sign of ‘weakness’ or the ‘easy way out’ that the fact human instinct is to survive. Everything we do is about surviving. Staying alive. We eat, we take medication, we sleep… So, to go against that natural, automatic way; actually, takes a considerable amount of ‘strength’ (albeit not in a healthy, safe way) and should be a sign that the person feeling suicidal or making an attempt to take their own life, must have some pretty damn good reasons for that! And so, knowing the effort and sheer determination and dedication (again, in a not so healthy or safe way) that goes into feeling suicidal or making an attempt, it should illustrate how essential and important it is for people to be there to help and support the person who is struggling in that way; because without someone stopping them – sometimes literally/physically – there’s a very real chance an attempt will be ‘successful.’
That, and a few other reasons, have me thinking of myself as incredibly lucky that I’m alive… I mean, it’s kind of a miracle that I made it through all those attempts and all those instances where the professionals were unhelpful and – sometimes – just completely detrimental; to the point where they seemed to make things worse, not better. It was so difficult because whenever I attended hospital, staff would say “why didn’t you ring such-and-such before you did it?” And I’d try to explain that my fear that some other professionals would only worsen the situation, stopped me from even giving them the opportunity to do anything different.
So, with my lack of cooperation and worsening mental health, in 2012 I found myself waking up from life support in Intensive Care. The next thing I knew, the professionals in my local mental health team were recognising that if I didn’t get better help and support soon, there was a very real chance that I would kill myself. So, I was sectioned and taken to a specialist psychiatric hospital over 100 miles away from home, where the average length of admission was said to be 12 – 18 months. And when the staff there commented that had I lived in their locality, I would’ve been admitted to their hospital after just one suicide attempt, I became so frustrated and upset with the professionals back home. But now, I focus on how lucky it made me and how it has turned into huge motivation for me to work with those professionals and organisations to ensure that the poor treatment I received doesn’t happen to anyone else. Someone who might be a whole lot less lucky than I was.
Being in that specialist hospital though, it didn’t mean I was instantly better. In fact, it wasn’t really until almost one year into my admission that I felt as though I was making steps towards recovery. However, it took something pretty big to be that extra kick up the bum that I really needed to encourage me to put more effort into cooperating with the staff and engaging in therapy. And that kick up the bum was when I ran away from the hospital (it took jumping over a number of fences!), made another suicide attempt, and was once again put on life support. But this time it was for a lot longer, and when I was finally woken up from the coma, I was moved to the Psychiatric Intensive Care Unit (PICU); which I had heard so many horrible stories about (they were really validated when a patient on that ward murdered another one).
So, I remember being in this bedroom, banned from having anything more than a mattress and bedding in it, and still being on ‘eyesight’ observations (meaning a member of staff had to have me in eyesight the entire time) when I finally felt well enough to take a shower. And I remember just sitting on this horrible bed, feeling sick and crying and just realising that I didn’t want that to be my life (which doesn’t mean there had been a point when I did, just that it was more that I had stopped even caring about my life and everything that it meant). And so, from that moment, I found myself more passionate about life, more determined to reach recovery, and more dedicated to wanting to always be doing something that was helpful for others.
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In finally making such huge steps towards recovering from my mental illness, I started to experience feelings of guilt and fortunately, since I was still in hospital when these thoughts and feelings began, I was supported and helped to not only find a positive to them, but also to cope with them in a safe way…
So, the first rationale for the guilt came from the recognition of the upset and pain I had put my Mum and loved ones through over the past few years… You know, the number of times I’ve heard or seen people accuse someone who commits suicide as ‘selfish’ is ridiculous! Especially when you consider that actually, a lot of people commit suicide whilst holding the belief and conviction that their loved ones will be ‘better off’ without them. The thought that you’re putting your friends and family through great upset can be so detrimental to absolutely anyone – whether you have a mental illness or not! – because it’s incredibly isolating. If you think of yourself as some sort of burden or inconvenience to the lives of your loved ones, it really limits who you can turn to for the right help and support that will counteract the suicidal thoughts and feelings and reduce the risk of suicide. I mean, I said I believe that my Mum knows me the best; yet I didn’t want to upset her in telling her how I felt, what I was thinking, and what I was experiencing… So, how effective, and useful can anyone else be if they don’t know me as well?
There’s also the fact that family related difficulties (arguments, bereavement, illnesses etc.) can actually be the catalyst for someone to feel suicidal and/or to act on it. And that leads me onto another guilt I experience from the recognition that I’ve hurt myself or attempted suicide because of someone else. This one’s more complicated for me though because there are two ‘someone else’s’ that have led to my attempts.
The first, has been the auditory hallucinations who would constantly berate me and repeat all of the worst thoughts I had about myself to encourage me to think of them as gospel. These comments that no one else could hear – and which some people even debated the existence of – felt so suffocating and overwhelming that it was often mostly just about me wanting to escape them. I heard the voices as you hear music through headphones; they seemed to come through my ears and fill up my head, so it felt as though they would take control of me sometimes. It felt as though I was constantly battling for space to be in charge of my own head, and that was exhausting.
Even with all these reasons why the hallucinations fuelled by suicide attempts still meant that afterwards I felt guilty for granting them so much power and control. It left me wondering if people were right about the whole ‘suicide-is-a-sign-of-weakness’ sort of thought process because surely, if I was strong; I would be able to overrule these voices and fight against their commands and comments.
The second ‘someone else’ who fuelled a number of my suicide attempts was very obviously the person who abused me when I was younger. I think the hardest aspect of my thoughts and feelings towards him now are largely centred around the idea that he’s getting on with his life. That just because the Crown Prosecution Service didn’t think there was enough evidence, he’s free to live his life. To continue working in the job that allowed him the opportunity to hurt me (fortunately, he’s only just now leaving that position). It took so long to figure out that I wasn’t to blame, but once I had, I had to contend with the notion that even though it wasn’t my fault and I was in no way responsible for any of it, I was still the one suffering.
My guilt around my suicide attempts and with this person, was similar to the hallucinations in that I struggled with the realisation that I had given him power and control over my life. Enough to be able to have some sort of dictatorship over the end of my life. And did he deserve that? Did he deserve so much important space in my life? And was it fair on my loved ones to commit suicide because of him? Because I can imagine that it would leave them with thoughts and feelings of resentment and frustration that they might not be able to resolve or cope with. More guilt.
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The final part of guilt in coming through suicide attempts for me, has been survivors’ guilt, but I thought it really worked well with this bit about experiencing a sense of pressure and need to prove myself worthy of all the time, effort, and resources that have been put into saving my life on all the occasions when I didn’t want it to be saved.
I think that a big cause of this guilt comes from the fact that I’m still very much involved in the mental health world and therefore I regularly hear/read about someone I’ve known (either personally or digitally) committing suicide. The thing is, in all honesty, having that knowledge as a consequence of staying involved in working with my local NHS mental health Trust and blogging about mental health and using social media that revolves around the subject, doesn’t leave me thinking that I’d rather stop what I do than hear of all the suicides. And I think this is because they don’t all only lead me to the challenging thought of ‘why should I be able to live when they can’t?’ It means that I have to weigh up just how difficult the survivors guilt is to cope with, and compare that with how I feel from this sad reminder of just how lucky I am. And I totally appreciate that it shouldn’t take something like that to really bring that notion home and make me appreciate my life more, but I think it’s actually similar to something a lot of people experience where they seem to take something for granted until they don’t have it any more.
Another reminder these horrendous deaths bring me, is that I’m doing what I do for a reason. The right reason. I’m not in this for freebies and likes. I want to save lives. I want for my blog’s content to help someone in some way. And I think that this genuine passion and goal provides me with some amount of reassurance that reduces the pressure I’ve struggled with around the feeling that I need to prove myself as worthy of absolutely everything that has been done to save my life.
This feeling or pressure is likely something where those who love me and care about me would tell me not to think that way, but it’s incredibly hard to let that comfort me against all the memories of various professionals telling me I was wasting their time or purely attention seeking and being manipulative. I mean, how – in your young twenties – do you stay strong and remember who you are when you have real, grown up, Police and Doctors saying those things? I mean, it’s intimidating. And the fact those things were said in pretty vicious and aggressive tones and ways made them all the more scary and strengthened their impact on me and my thoughts about myself.
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Finally, how do you really, genuinely thank someone for saving your life?
When I apologised and voiced the feelings of guilt to my Mum, she assured me that I have nothing to be sorry about because she’s 100% sure that it wasn’t really ‘me’ doing those things. Since I’d say that my Mum knows me better than anyone, for her to say something like that, is really comforting and validating. For me, it very much illustrates her unconditional love and support that have been so helpful and life saving. And how do you say thanks for that? How can I show her my gratitude in a way that’s as big and important as her actions and attitude?
Of course, my Mum isn’t the only person to have saved me from myself… And even whilst they definitely weren’t all kind or empathetic, I’m still grateful for every single professional who have sometimes taken massively drastic actions on occasions when I would’ve died if they hadn’t. But I think that it really needs to be recognised that I’m only still grateful to the rude, judgmental, and cruel professionals because I recognise the bigger picture. In fairness, I shouldn’t have had to. They shouldn’t have behaved the way they did or treat me the way they have. Really, they’ve been incredibly lucky that I am where I am today because if their words had led to my death… but they didn’t. I made it through, both because of and despite, their comments and actions. I made it.
Read my first collaboration post with NEAS here and prepare yourself for more, later this year!!
You can watch the first few episodes: https://bbc.in/3pjjHVO