“When
you feel abandoned, don't let painful feelings fester. Instead, use them as a
catalyst to grow and to become more compassionate.”
Amy
Morin
So, collaboration number two with the wonderful Cats Protection – this time, however, the post is in partnership with the charity on a national level rather than with my local Tyneside Adoption Centre (the collaboration with which, you can read here). So, as I mentioned in that piece, the Winter Campaign theme for Cats Protection this year is ‘abandonment’ and the reason for this (which I don’t think I mentioned in the other post) is that cases of abandonment of cats have massively risen by over 30%! Additionally, Cats Protection have found that those cats spend on average, around 39 days in the care of the Charity before finding a ‘furever’ home. With donations of as little as £5 feeding a cat – and last year, they helped around 500 cats per day! – in the Charity’s care for 25 days (other funding equivalents are that £15 would cover worming treatment for three cats, and £20 would fund ten blankets to keep the cats warm and safe); this Winter Campaign is aimed at raising funds as well as awareness of this hugely important issue. Now, to bring this Campaign into relevance for the typical content of I’m NOT Disordered, I thought I’d use this post to write about how to cope with the largest instance of abandonment that I think a psychiatric service user can experience, feeling abandoned by mental health services…
This
was the one instance which I was most eager (if that’s the right word) to write
about when I heard about this theme for the Campaign. It was literally the
first thought I had in terms of making the topic of abandonment relevant to a
blog about mental health; and I think that’s an obvious thing to happen when
you’ve gone through numerous instances of feeling abandoned by professionals
and mental health services. Services and people who are supposed to be helping
and supporting you. Who are supposed to be saving your life. When those people
and organisations turn their back on you and leave you feeling completely alone
in your struggle and experiences, it’s like they weren’t even there, and you
didn’t even reach out for help.
So, for
me, when my mental health first became poorly in 2009, mental health
professionals and the Police were extremely attentive and reactive to
everything I did (namely two suicide attempts and publicly hallucinating). When
I made my first attempt in Spring 2009, I had run away from A&E and the
Police came to find me and take me back. Then I remember being in my local A&E
and this bearded Psychiatrist asking me why I’d done it, and I couldn’t tell
him. I couldn’t tell anyone what had happened to me – the abuse and the rape back
in 2006 – 2007. Apparently, because I hadn’t explained my reasoning, he agreed
with the view of two other professionals and detained me under Section 2 of the
1983 Mental Health Act.
The
second instance in the Summer of 2009, I had made another suicide attempt and
this time, I came home after it, and so my Mum called the Crisis Team who
arranged a Mental Health Act assessment to take place in the house. After sectioning
me, I still refused to go to hospital for medical treatment and so six Police
came marching in, handcuffed me, strapped up my legs in these Velcro restraints,
and carried me into one of their vans to take me to A&E. There, one of the
Psychiatrists who’d sectioned me, had four Support Workers from a ward in the
local Psychiatric Hospital meet us there and stay with me throughout the twenty
or so hours of the medical treatment. I tried to run and detach the drip with
the medication in it numerous times and each time I was restrained and given a
sedative injection until the treatment was finally finished and I was
transferred to the psychiatric hospital.
The
third time that my local mental health services were actually supportive and
attentive, was after I had hallucinated and walked down the side of busy road.
I was sectioned again and this time, I was put on a PICU (Psychiatric Intensive
Care Unit), and I met a lovely lady who told me that she’d been in and out of
psychiatric and medical hospitals for years because when she was younger, she
had similar experiences to mine and hadn’t reported them. Her telling me
motivated me to finally report my abuse because I felt like if I didn’t, I was
going to end up in and out of hospitals for years too. And, at 18, I really didn’t
want that to become my life!
Turns
out though, whilst I will never regret reporting it – no matter how difficult
it was and how many negative results it had – it didn’t have a great outcome on
the treatment I received from Services – though no one said this was why… But I
just think it was far too much of a coincidence that things went from everyone
reacting and a few mutters of schizophrenia (because of the hallucinations) to being
discharged literally two days after disclosing the abuse(!) and then seeing on my
Discharge Summary ‘query Borderline Personality Disorder’ in the ‘Diagnosis’
box! And from that point on? I felt like stain on the bottom of their shoe –
the professionals! Like I was just a nuisance! It’s like I was an inconvenience
– that’s a kind and polite way of putting it(!) and I don’t know why I’m being
kind and polite because they certainly weren’t shy about calling me an ‘attention-seeker’
and a ‘drama queen!’ I remember one time in particular when the Police had
picked me up from walking on the motorway and rang the Crisis Team whilst I was
in the car. The call was on speaker, so I heard them say “just leave her there,
she does this for attention.”
I think
that my thoughts on this abandonment are totally supported by the fact that
after hearing another professional talk about Personality Disorder, I asked my
Community Psychiatric Nurse (CPN) at the time whether that was going to be my
diagnosis now and she said “I don’t want you getting that label yet, no Services
will touch you because people don’t get better from it.” And aside from that
being difficult because of obvious reasons, there was also the fact that I
actually wanted to have a diagnosis because I felt it would mean two
important things:
1.
I
could research it and understand everything better.
2.
I
would feel less alone.
Unfortunately,
the diagnosis of Borderline Personality Disorder – at that time – didn’t mean
either of these things. When I was finally diagnosed with it officially (in
2010), research resources were limited and what was available didn’t seem to
necessarily be accurate or honest. I also knew no one with this diagnosis and
there was no one speaking out about it on social media who I could connect with,
so I remained feeling alone and isolated with this Disorder that quickly became
the most debilitating aspect of getting help for my mental health. Ironic,
really. That psychiatric professionals can give you a diagnosis and then desert
you – or, at the very least, mistreat you – because of it! Like, you did this!
You stuck that label on me and now you’re going to leave me to struggle with
it?!! That’s honestly how it felt.
Now,
some may disagree that I was abandoned by mental health services at that point
because I remained under the care of my Community Mental Health Team (CMHT) for
the three years (from 2009 to 2012) that things were at – almost – their worst.
But I’ll be the first to recognise; CMHT were never really the problem. It was
the Crisis Team. The Crisis Team and the Police. The two sets of professionals
who were the most called upon when I was in the worst points of my mental
health and therefore, to me, the most fundamental in promoting and ensuring my
safety. And the ironic thing was, I would self-harm or something and A&E or
CMHT, afterwards, would say “why didn’t you ring the Crisis Team before you did
it?” And I’d always be thinking (and sometimes I would say) “because I didn’t
want them to make it worse!” I mean, the way they treat me had me convinced that
I could go from thoughts of self-harm to – if I spoke to them – feeling suicidal
and possibly doing something along those lines instead. I mean, eventually I
got sick of people saying it and to prove a point I called them when I was on
the verge of self-harming and the response I was met with? “If you’re going to
do it, then you’re going to do it. I’m not going to try and stop you.” I felt
not just abandoned, but uncared for too. And one of the hardest things was that
my self-confidence and feelings of self-worth were very obviously already extremely
low… So, to manage to still feel disregarded and dismissed? Well, it shows that
their treatment – or mistreatment! – and attitude was really bad, doesn’t it?!
Fortunately,
in 2012 I found myself having three brilliant professionals in CMHT – a CPN, a
Psychologist, and a Psychiatrist who were all supportive, kind, non-judgmental,
validating (a response which can be hugely helpful when you’re feeling of
abandoned), and proactive in helping me. Their first really helpful move came
in early 2012, I was in A&E after self-harming (though it was a method that
could have killed me, I didn’t do it as a suicide attempt) and I was refusing
medical treatment. A Doctor came and deemed me to not have the capacity to refuse
it, but to be able to force treatment on me, they needed another Doctor to
agree. I just remember seeing multiple people and it turns out it was because
they couldn’t find someone who supported that first Doctor’s judgment. After
five hours of needing that treatment, I remember the curtains were closing
around my bed and I could just hear all this whispering and see feet underneath
the curtain. Before I knew it, all these Nurses, Healthcare Assistants, and
Doctors were holding me down whilst an Anaesthetist gave me an injection of
Ketamine.
All I
remember from then was feeling like I was in this pure whiteness, and I was
walking along all these platforms that just kept coming out from beneath me so
that I was falling and tumbling upside down. When I finally came round, I was
being held down by two staff, had a tube in my neck (a central line), and started
vomiting. Apparently, no one knew the Anaesthetist was going to use Ketamine
and so everyone was confused because I supposedly got really violent and aggressive.
Because of that horrible experience – which I still remember so vividly over
ten years later! – I now have Ketamine listed as an allergy on my medical records!
So, as
a result of that incident, my Psychiatrist from the CMHT suggested I have an
Advanced Directive (a legal document you write when you have capacity regarding
how you want to be treated if you lost it. So, in mine, it states that if I’m
saying that I’m suicidal and if I’m refusing life-saving medical treatment, it
means I don’t have capacity because when I do, I love life and I’m very
passionate and determined to live it to the fullest! As a result of this
Advanced Directive, in Summer 2012, when I made a third suicide attempt and
refused medical treatment for it, the Doctors turned to that document to treat
me under the 2005 Mental Capacity Act, and I was sedated and put on life
support.
A few
weeks prior to that, I had been admitted to my local psychiatric hospital and in
a meeting between my inpatient Psychiatrist and CMHT, the Psychiatrist
recommended I be admitted to a psychiatric hospital specialising in Personality
Disorders. He explained that he felt my local mental health service just weren’t
“equipped” to “deal with someone with a Disorder of this extreme.” Immediately
my CPN began looking into such hospitals and I had an assessment for a nearby
specialist hospital, but they decided that I was too high of a flight risk and
their ward wasn’t secure. So, I was then assessed by a hospital further away and
they said I could be admitted, but I refused to go because in my assessment,
the staff from the hospital explained how regimented everything was, that I’d
be having Dialectical Behaviour Therapy (DBT) twice a week and therapeutic
groups 9am – 4/5pm! I hated that concept and so I refused to go.
It meant
that when I was woken from life support, I was admitted to the specialist
hospital and sectioned under the 1983 Mental Health Act. Almost instantly, I experienced
the complete opposite of treatment from the staff of the specialist hospital
than I had my local Crisis Team! I mean, they were far from perfect (my
numerous ranting blog posts from my years in that hospital will attest to
that!), but it was a huge improvement – one that I couldn’t have been more grateful
for. A huge reason for this incredible change was because all of the staff on
the hospital ward were trained in DBT and in helping and supporting people with
a Personality Disorder diagnosis. I think it’s just the most perfect example and
illustration of the fact that to provide effective and efficient help and
support for someone with a particular mental illness (because it’s not just
true for Personality Disorders), it can require professionals to have a specialist
knowledge and understanding.
One of
the saddest revelations I had in that psychiatric hospital over 100 miles away
from home (127 miles to be exact!), was when a Nursing Assistant said she’d
read in my notes that I’d been hospitalised over 60 times in the three years my
mental health was most poorly (2009 – 2012) and she said it annoyed her because
she knew that if I’d lived in the locality of this hospital, I’d had been admitted
to it after my first suicide attempt. It wouldn’t have taken for me to have
almost lost my life numerous times for the mental health professionals to have
sat up and recognised the level of help and support I needed. It was a huge example
of how psychiatric services can be a postcode lottery. That there isn’t equal
access to services across the entire Country. I mean, they had people in that
psychiatric hospital from all over the Country – it wasn’t just me who was from
a distance; and this helped me to recognise that it wasn’t just my locality who
were lacking in providing the right help and support.
To make something positive from all of this, this inequality and unfairness, has actually been a huge motivation for creating the Shake My Hand Campaign which seeks to support Survivors of rape and abuse in reporting their experiences. I want to be able to say that I’ve done my job to improve services and the attitudes of professionals so that others are less likely to experience those thoughts and feelings of abandonment and disappointment that I did. I want for no one to feel let-down. For no one to think that professionals and mental health services in particular, don’t care or won’t be able to help them. I want no one to feel hopeless and worthless. For no one to feel abandoned and dismissed.
You’re heard and you’re cared about.
Ways
To Cope With Feelings of Abandonment
ü
Write
about it so that you can get it out of your head in a way that could also
actually aid you in processing your thoughts and feelings.
ü
Talk
it through with anyone/someone directly involved who could help you to feel
validated or supported in one way or another.
ü
Seek
professional support and be willing to engage in Therapy – DBT can actually be helpful
for feelings of abandonment because one symptom of BPD is a fear of being
abandoned.
ü
Do
something distracting or self-soothing for yourself – engage in an activity or
do something good for yourself that will help take your focus from any upsetting
thoughts and feelings.
Cats
Protection Links: