This piece of advice might seem a bit surprising to be coming from me after my post a few days ago on their huge failings and my subsequent, resulting complaints against the Crisis Team (if you missed it, you can read it here). In keeping with typical I’m NOT Disordered’s fashion though, I’m going to keep this bit honest, open, and real and start this bit by saying that I 100% recognise that psychiatric services and the various professionals who can be involved in a mental health crisis, aren’t always beneficial with self-harm…
After a
year or so in the specialist psychiatric hospital, a girl was admitted and the
first thing I noticed about her was that she had her sleeves rolled up and had
no scars or wounds on her arms. Firstly, I think it’s actually quite sad that
seeing someone who hadn’t self-harmed in that way was a rarity for me.
Secondly, after speaking to her, I finally learnt that self-harm could take
many different forms because her admission was a result of her continuously
misusing her Diabetes medication as methods of both self-harm and suicide
attempts.
Unfortunately,
I think it’s quite a common understanding that psychiatric hospitals aren’t
necessarily always the best place for someone, and I felt that – by the time I
was being discharged (another year or so later) – this girl was a prime example
of this fact, and I say this for two reasons… The first is that when my
discharge began being talked about and planned, she asked me what had been the
thing that I felt had really changed things around for me. Without thinking, I
replied honestly and told her that it was after having gone AWOL on some
unescorted leave from the hospital and making a suicide attempt that left me on
life support for the second (but longest) time in my life. When I finally woke
up, I was transferred to the Psychiatric Intensive Care Unit (PICU) on the
floor above the ward I’d been on for over a year.
Now,
this PICU… Well, it was a ward that I’d heard terrible rumours and stories about
and being directly below it on our ward meant we often could hear screams,
bangs, and alarms going off up there. And what’s massively more horrific than
that; one patient actually suffocated and killed another patient (it’s still on
BBC News here) on that ward a month before I
left the hospital! So, to be put on it whilst also feeling really physically poorly
from being under sedation for so long, felt like – not to sound too dramatic –
hell on earth! I was being sick almost constantly and when I wasn’t being sick,
I was asleep and for the entire time, I was on ‘eyesight observations,’ which
meant that when I finally felt physically able to take a shower, I had to be
watched the entire time. And I just remember this one, massively powerful
thought coming into my head; ‘I don’t want this to be my life.’ And that mindset really proved to be the kick
up the bum I needed to really start cooperating with the hospital staff, taking
my medication, attending the therapeutic groups and engaging in Therapy. I
mean, it wasn’t as though I had wanted everything that had happened until that
point to have happened, it was just that I had felt… apathetic, towards the
whole thing. I literally didn’t have a single care about what happened in/to my
life.
So,
after being honest and telling this girl how that entire experience had shaped
my mindset into finally working towards recovery, the next thing I knew, she
was basically doing all that she could to be sent to the PICU too. I remember
hearing the staff shout at her; “we know you just want to copy off Aimee and be
sent there, but you’re not going when you’re not genuinely poorly like she was!”
That shouting-match led to a huge fall-out between the girl and I with me
feeling so very guilty and seriously responsible for everything she was doing. And
then pretty much the entire ward chipped in with their opinions on the matter
and I was encouraged by everyone saying that the girl really was a grown adult
and could make up her own mind as to what to do and how to interpret what I had
said.
A while
after our argument, I was passing her room and heard a funny noise and
something just made me wonder and at first, I moved to continue down the
hallway, but then I thought that if something happened, I wouldn’t be able to
forgive myself for not helping just because we’d argued. So, I looked through
the observation window in her door and saw her with a ligature around her neck
and her face was turning blue and swollen. I immediately tried to open the door,
but she’d locked it and so I just – almost instinctively – started kicking it
to try and break it in whilst screaming for staff to come and help.
After
oxygen and a trip to the local A&E, the girl survived, but by the time I
was leaving the hospital, her beautiful, empty arms were bandaged, and she was
awaiting surgery for a self-inflicted injury. And the entire thing probably looked
kind of ironic from the outside; the fact that I’d come in with scars across my
entire body and the service and professionals had been really beneficial for my
mental health, yet the girl without those, became more poorly from being in
there. And taking into account the fact that we both had the same diagnosis,
both met the same criteria to be in that same hospital (which was also a specialist
service for people with a Personality Disorder!); I think it’s the perfect
illustration of the fact that what helps one person might not help others (no
matter how many important details people seem to have in common) – one size definitely
does not fit all!
For me,
there have been several ways in which the services and professionals have
helped me in terms of self-harm… I think that the first, largest, and most temporary
way, was by being sectioned to the specialist hospital for two and a half
years. Before I was admitted in 2012, I had spent the previous three years
constantly in and out of both medical and psychiatric hospitals with numerous
acts of self-harm that escalated to almost three times a week and my records
documented over 60 admissions during that three-year period. I honestly think
that if I hadn’t been sectioned to that hospital, I wouldn’t still be here. I
mean, there were no specialist services in my locality for my diagnosis of
Borderline Personality Disorder (BPD) and professionals were becoming
dismissive, rude, and offensive towards me in response to the regularity and
frequency of the really dangerous, potentially life-threatening instances I kept
creating/finding myself in. So, I could easily imagine that had I been left to
my own devices for much longer, deprived of this specialist help and support,
then things would have only continued to escalate.
The
second largest, more long-term helpful act from services and professionals to
tackle my self-harm was being given Dialectical Behaviour Therapy (DBT)…
.png)
So that
leads me nicely onto this second way of developing and maintaining self-esteem
after self-harm; utilising one of the skills I learnt in DBT – self-soothe.
In DBT,
you’re taught four modules; Distress Tolerance, Emotion Regulation,
Interpersonal Effectiveness, and Mindfulness, and it is in the Distress
Tolerance module that you begin talking and thinking about utilising
self-soothing activities as a means to help you to cope with and get through
difficult feelings and situations. Similarly to many of the coping strategies
DBT teaches you and talks about, self-soothing was definitely one which made me
feel incredibly stupid. I say this because being taught that you could try
taking a bath, getting cosy on the settee, read a book, do your make-up to cope
instead of self-harming, truly made me think ‘how the hell did I not think to
try this instead of what I was doing?!’ And my frustration really came forward
with the recognition that had I thought to do so, I seriously could have
avoided so many horrible situations (including hospital admissions).
Also,
similarly to other coping skills DBT teaches you, in learning about the helpful
components self-soothing can bring to your mental health and general safety
levels, you have to make the skills applicable and able to work for you and
your very unique and individual mental health needs. I mean, it’s like I said
earlier; one size doesn’t fit all – especially not in the mental health world –
so it’s essential that you put in the time and effort to take the skills you’re
taught and figure out ways in which you can make them helpful for you. I mean,
for me, ‘taking a bath’ will currently never work because my home has a
wet-room so there is no bath – I once joked that if I tell professionals I’m
taking a bath they should be worried that it likely means I’m now hallucinating
bathtubs!
So, to
adjust ‘self-soothe’ to be relevant and beneficial for me, I take it to mean
the really, genuinely, pampering moments and activities that make me feel
soothed and better about myself. I like to take a shower, do my make-up, put
fresh pjs on and get into a clean bed, do my nails, faff around with my hair when
I have new extensions in, get snuggled up in a blanket with my kitten…
In a
way, I think it’s a good thing that you sometimes have to put in extra time and
energy to make DBT skills applicable for you because it really highlights a few
things:
1.
It
teaches everyone who takes DBT that each person is different and has individual
needs that mean they find different things helpful and enjoyable, and this can help
to minimise any chance of judging others and belittling their favourite things
to do.
2.
It
can be really testing on just how eager and passionate you are to feel better
and to stop self-harming because for those things to happen, you have to put in
the time and effort to apply and test out what you are being taught because
simply learning about it isn’t enough.
3.
It
ensures that you put your own stamp on your experience of DBT and have more
control and influence over how you benefit from it and the impact it has on
your mental health and your self-harming in particular.
4.
It
can end up providing you with a better understanding of yourself and why you
enjoy the things you enjoy, and, in turn, this can, fill you with confidence
and determination to promote those things and to not be deterred or undermined
by anyone who tries to degrade them.
Aside
from making self-soothing relevant to me, the other difficulty I had with
putting it into practice and using it as an alternative coping strategy, was developing
the recognition that I was actually even worthy of doing these lovely,
enjoyable activities. I mean, I had spent the previous six or seven years (from
the abuse starting in 2006 until the start of DBT in 2012/2013) being told
constantly and consistently – both by myself and others – that I was unworthy
of anything pleasant. That I would never achieve anything in life. And that I
was undeserving of not just my own, but also anyone else’s help, support, or
attention.
To get
around this debilitating mindset, I decided to take things one step at a time
and that rather than force my entire head to believe I was downright worthy of
engaging in self-soothing activities, I would just concentrate on actually
doing them and just see if they even helped first. Baby steps. I mean, I think
it would be totally unreasonable and impractical to expect me to just reverse
something that had been a permanent fixture in my head for so many years! Like,
how could I suddenly change that just because this DBT Therapist in the
specialist hospital was telling me that it wasn’t true? How could I trust and
believe in something so big and important from someone I had known a mere number
of months?
So, I
just found the courage and strength to firstly just allow myself to test the
theory out instead of full-on tackling my belief in it. I tried to look at it
as ‘what’s the point in fighting too hard if it doesn’t even help?’ I realised
that if I had tried self-soothing activities and found them beneficial then it
would really help and motivate me to put in the extra time and effort that
might be needed to fight the ultimate fight that would help me feel deserving
and worthy of continuing to use these skills.
Now,
don’t get me wrong; just because this happened – both self-soothing helping me
and me finally finding myself to be worthy of help and support and generally
pleasant experiences – it doesn’t mean that’s it; I’ve reached that point and
I’m staying there. For a long time, I was still having to fight to believe this
on a daily basis, but then gradually, that grew further and further apart and
moved to maybe weekly, and then the odd week, then a couple of times a month…
And even all these years later, I’m struggling to keep it in my head, but by
this point, using self-soothing activities as an alternative to self-harm or to
maintain a good level of self-esteem, has become a bit of a habit more than a
choice or it being an actual decision-making process. This is something the
Therapist said would happen – when you had to fill in Diary sheets documenting
which skills you’d used on which days, why you’d used them, and how they’d
helped – she had explained that eventually, you get to the point where you
can’t record that information because it’s all just coming so naturally to you
that it’s stopping you from being able to pinpoint particular skills/moments.
.png)
My
Top Five Feel-Good Songs:
1.
Praying
– Ke$ha
2.
This
Is Me – from The Greatest Showman
3.
I
Lived – OneRepublic
4.
Warrior
– Demi Lovato
5.
One
Last Time – Ariana Grande
My
Top Five Feel-Good Movies:
1.
The
Greatest Showman
2.
Date
Night
3.
Frozen
4.
Alice
in Wonderland
5.
Legally
Blonde
.png)
So,
when it comes to developing and maintaining my self-esteem, I rely heavily on
the positive things in my life and this massively includes I’m NOT Disordered,
the achievements it has accomplished (did you notice we’re almost on 1.3
million readers?!), the opportunities it has afforded me, the feedback I get
from readers about the content I create, and my enjoyment of creating that
content.
If you told someone who knew me when I was younger that I had become a blogger, I don’t think many people would be that surprised because I always loved writing – one of my teachers in Middle School once told my Mum that she could see me becoming a Journalist when I was older – and enjoyed doing anything creative (which is why I took Textiles as an optional subject to study at High School). Unfortunately, my Textiles teacher was incredibly negative and in my years of study with her, she didn’t give me a single bit of constructive criticism; it was always so derogatory and almost shaming. She took away any confidence I had in my creative abilities and looking back and thinking about how she made me feel, I’m actually genuinely proud of myself for overcoming all of that negativity and unproductive feedback and continuing with my creativity and re-developing my confidence in it, to the point it is now at.