“When
it comes to improving care for women and girls with mental health problems,
there is no substitute for listening to those with lived experience. Not only
about the complex life problems they have faced, but also their views about
what has helped, and hindered their recovery. That’s why I’m so pleased that
Aimee will be joining us, because she has lived and written about her life and
has a very powerful story to tell.”
Linda
Gask, Emerita Professor of Primary Care Psychiatry at the University of
Manchester
Earlier this year, on February 27th, I gave a speech at the Emotionally Dysregulated Young Person: Neurodevelopment, Mood, Trauma and Personality CPD Event for Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust (CNTW). The Trust’s Deputy Medical Director; Doctor Hermarette Van Den Bergh was also at the event and as a result of my input, she contacted me afterwards and asked me to speak at the upcoming Women’s Health Conference at the end of June. It was such an honour and filled me with pride at the thought I must have done a good job at that first event! So, I wanted to discuss the main reason why I’m going to speak at the event – to share experiences that professionals may not often hear…
A Recent Formal Example of Service User Involvement Being Beneficial
A little while ago, I was asked by the Waythrough
Inclusion Manager to help another service user to interview six candidates for
the two vacancies in the position of Trustee for the organisation. In the
interviews, we had three set questions we were asking each candidate, and one
was around the fact that Service Users (beginning with myself) have begun
attending Trustee Board meetings.
So, we asked candidates what they would do if
someone brought a negative experience of the service to the meeting. We were
really looking for candidates to see this as a positive act and figure out ways
it could be useful to Trustees, and one candidate made the comment that the
knowledge you can gain and the lessons you can learn from real-life experience
is so different compared to that which you can take from research and statistics.
They expressed their sincere and genuine belief that these experiences can be
more valuable and important than studies which might not have even included the
Service Users or staff. So how could it be relevant to the organisation? Why
should it impact the way an organisation is run?
A Personal Experience to the Benefits
of Real-Life Experience Being Heard
A key personal experience I have that’s relevant to
this was when my previous Pharmacy made an enormous blunder with my medication
and just randomly stopped requesting prescriptions for my anti-psychotic
medication. My Mum and I had to meet with a Psychiatrist to have the medication
re-instated and she made the comment “research studies show that people with
your diagnosis, don’t benefit from anti-psychotic medication.” My Mum and I
were pretty speechless – a rarity for us both! I remember thinking ‘I wasn’t involved
in that study so why are the findings being applied to me, my care, and my
treatment?’ And I remember my Mum making comments around the fact that the
Psychiatrist was putting me in a box and treating me in a ‘one size fits all’
type of approach. She explained why she felt this was so wrong and eventually –
after around two hours in that office – my medication was re-instated!
I think that this example really supports this
rationale I have for giving this speech because it highlights the idea that
professionals are only receiving and, understandably, they’re then just focusing
on research studies and statistics. But I think it should be acknowledged that
if they really wanted to hear the experiences and opinions of real Service
Users, they could very easily do this – especially with the online world and
the sheer amount of mental health themed content on social media.
Key
Reasons Why Service Users Might Not Share Their Experiences
In fairness though, I always try to think of all
perspectives – even when I can’t exactly identify with one – and so I think
it’d fair and worth considering reasons why professionals don’t hear enough
real-life experiences actually being down to the Service Users rather than the
professionals failing in some way. And this raises the question: why would a
Service User not speak up?
1. One
reason for a reluctance to voice anything, could be the belief that nothing
will change if they do. That services and professionals won’t learn from the
wrong-doing that has occurred in the person’s experiences. That no one will set
in place plans to make improvements. That no one will take action or make any
effort at all to prevent the same thing happening again to someone else. And if
this is a concern, if a Service User is convinced nothing will happen with
their experience, why put themselves through having to recount an instance that
could be traumatising and/or which could have triggered unsafe coping
strategies?
2. Another
answer to the question could be that the person simply doesn’t have the
confidence to speak up. Often, the only way to make changes and improvements
based on a person’s experience is to either register a formal complaint with
the organisation or NHS Trust (CNTW actually have a very admirable and kind Complaints
Team and you can read more about this here: Complaints and
comments | Northumberland, Tyne and Wear NHS Foundation Trust
and, for more informal issues, they also have a great feedback form on their
website: Give
your feedback | Northumberland, Tyne and Wear NHS Foundation Trust)
or to speak with the ‘higher ups!’ And by that, I mean Governors, Trustees, and
Directors etc. Both instances can be somewhat intimidating and/or a challenging
thought that may seem to require or demand a lot of strength, bravery, and
confidence.
3. This
third reason is very much linked to the last part of that first point in that
another reason could be that a Service User is concerned how difficult it might
be to talk about a poor experience of a service or of a professional. Often a
negative experience can be somewhat traumatising and triggering because this is
often the reason or definition as to why it is deemed ‘negative’ in the first
place! This factor, or even if the Service User wouldn’t deem it traumatising
and simply ‘negative’ or ‘wrong’, can lead to concern on coping with the
experience when remembering it and having to talk about it. For me, this is
reminiscent of a motivation I have for speaking up; and that’s my concern that
if something that happened to me also happened to someone else, they may not
come through it as safely or as luckily and fortunately as I did.
The Importance of Hearing Negative
Experiences Too
In that first point, I mentioned the idea that
professionals and organisations should really take complaints and negative
feedback as learning opportunities rather than being the chance to deflect,
deny, and dismiss. Personally, this – the idea of learning from it – has always
been a hugely motivational goal when I’ve had to speak up too. And this concept
really speaks to, resonates with, endorses, and supports, the theme of this
CNTW event particularly in so far as its thought-provoking tagline; ‘We Can Do
Better.’
Senior Clinical Research Fellow for the University
of Edinburgh and Honorary Consultant Psychiatrist for NHS Lothian, Doctor Katie
Marwick has explained her hopes and reasons why she thinks her part of the
event will be a learning curve:
“I’ve agreed to speak as a I think
considering reproductive transitions such as the menstrual cycle and menopause
in the assessment and management of mental health conditions is a big
opportunity to improve care.”
To be honest, even just in our first speakers/event
planning meeting a few weeks ago, I genuinely already learnt a lot from the
other speakers just from hearing the subjects they specialise in, the messages they
want to convey in their speeches, and the more specific details on their topics
and the nature of their induvial professions that mean everyone comes together
with the same end goal! And learning, is something I really enjoy! It’s a huge
reason why I love online learning because it feels far less compulsory than
classroom education and I think speaks to a far more genuinely passionate
motivation in studying your chosen subjects.
The keynote speaker; Linda Gask, Emerita Professor
of Primary Care Psychiatry at the University of Manchester told me of her
personal lived experience of Depression and then she explained the details of
the topic she’ll be referring to in her own speech:
“I will be providing an overview, in
the keynote, of how the mental health problems women and girls have been
misunderstood, misdiagnosed and mistreated and why we need gender sensitive
mental health care (based on my recent book ‘Out
of Her Mind’).”
My
Own Learning from Negative Feedback & Comments
In addition to my personal experience of learning
and my passion for it, I think I’ve also got a different – but similar! – type
of experience of learning from negative feedback. The difference is that rather
than it be feedback, it was two negative comments. Now, I was going to quote
them or add screenshots but the accounts who posted them on my content have
deleted/removed them. Which says a lot, I think.
So, the first comment was after I’d posted content
that was somewhat critical of the staff of the psychiatric hospital, I had been
an inpatient in for over one year when I created my blog in January 2013 (I was
in that hospital for a further year and a half). Because the author of the
comment has now removed it, I can’t tell you which post in particular it was
on, but I do remember it being a bit of a rant about the staff. The comment was
basically a dig at me and raised the point that I should be more grateful for
their help and support and also for the service provided through the hospital
in general too.
The lesson I took from this was that not everyone
who reads my blog is going to appreciate, understand, or empathise with the
content on it. Not everyone will know how it feels to be suicidal or to
self-harm or to be sectioned. Not all my readers will recognise that inpatient
admissions can be challenging and that psychiatric hospitals aren’t necessarily
the safest of places, nor do they always have the greatest staff. And so, in
learning this, I came to realise that I was going to need to simply accept it as
the way things generally are in both content creation and mental health. Accept
that as much as I wanted to change that and as hard as I tried through my
content to do so, this might always be the way things are. The way people are. And
there’s really only so much I can do about that. There’s only so much impact I
can have. Only so many things I can try to contribute to changing.
Regardless of accepting this, I also learned that
there was still every point in trying to do these things. There was still a
need to put the effort in – if not for me then at least for the sake of others
who feel no one is empathising, understanding, or appreciating what they are
experiencing with their mental health. I really hate the thought or idea that
there are people out there feeling as alone as I once felt – particularly in
terms of the trauma I experienced. I honestly believe that social media and
really any kind of online content creation can be fundamentally essential and
impactful on making these things better and contributing to healthy, safe, and
valuable change.
The second negative comment was actually the one
which led to me closing I’m NOT Disordered at the end of 2014. The comment was
in response to my World Suicide Prevention Day blog post on September 10th,
2014 (you can read it here: World
Suicide Prevention Day | I'm NOT Disordered) where I had
listed and discussed the three suicide attempts, I had made prior to that point.
At the end of the blog post I mentioned that my reason for choosing the format
the awareness date content in that way was with two hopes: the first was that
my friends and loved ones would better understand how bad I had felt so that
they had an improved knowledge of why I did those things. And the second reason
was to provide hope because I finished the blog post by saying that despite
being so desperate and convinced that those attempts were really necessary and my
only ‘option’ (as I phrased it in the post), things did get better, I was
alive, and that it wasn’t ‘so bad.’
In fairness, the comment in response to this blog
post needs no screenshotting or the fear I will misquote it, because it was
literally just; ‘good luck with attempt number four.’ At first, I honestly
couldn’t believe that someone could be so spiteful and so heartless. But on the
other hand, by that time in my blogging career, content creation as becoming a
real ‘thing’ and there was a lot of publicity and awareness-raising around
online bullying and trolling. So, I thought receiving that comment really shouldn’t
be so hugely surprising to me, however, it was such an unkind remark that I had
literally never experienced before so I had no already-developed acceptance nor
any previously established coping skills.
It was this lack of coping skills which, I think,
made a huge contribution to my decision to close the blog down on September 12th,
2014. In my blog post announcing the closure of I’m NOT Disordered (which you
can read here: The
End of I'm NOT Disordered | I'm NOT Disordered),
I stated that I recognised the closure looked as though that horrible person
had ‘won.’ However, on October 29th, 2014, I made the decision to
start blogging again and published my first come-back blog post: An
Explanation | I'm NOT Disordered. In this post I
mentioned the fact that since ending the blog, I had continuously had the
thought that I had given up one of the most important things in my life because
of a bully.
Bringing it back to learning from negativity, the
lesson learnt from this second negative comment on suicide was around the fact
that if I was going to be set on blogging so openly and honestly about really
personal topics like my mental health, suicide attempts, self-harm instances,
and the rape and abuse I had experienced as a teenager, then it was certainly
and understandably going to make me vulnerable to comments like this. I was
clear though, on also recognising that despite accepting that I had somewhat instigated
this vulnerability, I wanted to also be confident that this didn’t mean I
believed that the negative comment was at all, in any even remote way,
acceptable. It didn’t at all make it ok. But I did learn to be more aware of the
level of detail I share – especially regarding rape, abuse, self-harm, and
suicide.
The Challenges to Learning from
Negativity
I won’t lie though; this was incredibly challenging
because I feel that I’m such a naturally open and honest person anyway… In a
way, I actually think this is a really good quality because it means that my
content isn’t ‘fake’ or ‘ingenuine’ in any way. It’s natural and it comes from
the heart, and I think this isn’t just generally a good quality to have in
online content, but that it’s also pretty vital and prudent for mental health
related content. I think it can actually be the difference between the content
being successful and popular and receiving support and positive feedback to it
falling flat and even receiving negativity, criticism, or trolling.
So, I thought this might a good a relevant point to
discuss some of the key reasons why learning from negativity can be
challenging:
1.
The
fear of admitting that you’re ‘wrong’
Let’s be honest, this could have its completely own
blog post entirely, couldn’t it?! It’s relevant here though because I think so
many organisations who receive complaints will immediately – and almost
instinctively – be defensive and take the stance that they couldn’t possibly
have done anything wrong and are completely innocent to whatever the
accusations are in the complaint. Sometimes, they can do this even prior to/completely
without, actually investigating the validity of it.
I think that one of the greatest reasons why admitting
you’re wrong can be unappealing – especially for large, public organisations
like the NHS or emergency services etc – is the need or desperation to maintain
a good, safe, and trustworthy reputation that is essential to the good
operations of such organisations. This is also reminiscent of being protective
of their identity and illustrating a strong sense of ego.
In fairness, this is actually something I can
appreciate and understand through my own content creation career and with I’m
NOT Disordered. Over the last thirteen years of my blogging work, I’d 100%
agree that my blog has become a brand more so than it simply being something to
do in my free time as it was when I created it. Recently, I arranged for a bit
of a collaboration between a store and an organisation, and the organisation
failed to stick to the terms of the collaboration (which was to mention/tag the
store in content about the gifted products they had provided). And my upset
with this wasn’t about their failure, it was more about the way it reflected on
myself and my blog. This was concerning because the store was one, I’m NOT
Disordered has collaborated with numerous times and one that I’d want to work
with in the future too and I felt that this was spoiled by the organisation’s
attitude/lack of gratitude and respect.
2.
The
shame and embarrassment that it had taken someone else to teach you this
When I gave AI (namely Chat GPT) a prompt for extra
ideas/content and asked if it could think of reasons why learning from negative
experiences would be challenging, it mentioned the word ‘humiliated’ and
referenced an example of this being if other people have witnessed whatever
wrongdoing a person is voicing their experience of. I decided to take this and
my own thoughts and interpretation of the point, to create this point about
being ashamed and embarrassed that it has taken someone else to point out your
error/room for improvement.
I think it can feel awkward to think that you
hadn’t realised or recognised the space for learning yourself and I actually
think that it’s somewhat normal to have the attitude and thought process that you
should be more on the ball and on top of your game. Especially where it’s a
huge organisation that can have a massive impact others in general, but especially,
also in their most vulnerable moments when the organisation – such as the NHS –
can be incredibly influential and life-changing. But I think that a lot of any
difficulty with learning from negative experience that is reminiscent of shame
and embarrassment can be driven by pride and thoughts on it being some sort of
‘failure’ to need to improve or to have come against an opportunity to learn
changes you need to make.
One instance with my Influencer career which I feel
is incredibly similar or relevant to this point, was when – a number of years
ago – I received a comment (when I used to allow them after passing my approval)
in June 2014 on one of my blog posts where a reader stated: ‘I don't know if
it's just me, but you seem quieter lately. Hoping you are well and just to say
on behalf of your readers, we're thinking of you.’ In response to this, the day
I received the comment (June 12th) I actually ended up writing an
entire blog post titled: ‘I’m Sorry I Hadn’t Noticed’ (you can read it here: I'm
Sorry I Hadn't Noticed | I'm NOT Disordered).
In the post, I talked about how a huge element to
my life involved someone else who had asked not to be mentioned etc on my blog
and that this made it so much more challenging to create current, personal
content. And so, instead, I had been publishing a lot of guest posts, and I
used this to talk about how – when my mental health was at its most poorly – I
would almost ‘test’ my family and friends by pushing them away just to see how
much they actually cared about me and how supportive they genuinely were. And
whilst, as I said in the blog post, this quietness with my content hadn’t been
about that at all – which is especially evidenced by the fact that I actually
hadn’t even realised I’d been quieter! – it felt good to think that my readers
had passed any thoughts around such a test!
Anyway, it was a little embarrassing to realise
that I, myself, hadn’t really noticed my lack of personal content until it was
clearly pointed out to me by a complete stranger! It made me question whether I
was a failure of a blogger for not figuring this out by myself. However, after
admittedly beating myself up quite a bit, I came to the – fair and reasonable,
in my opinion – conclusion that the most important thing about the situation
was that I wasn’t just blaise about the comment from the reader. That I didn’t
just read it and go on with my day and continue my content creation the way I
was before it. I acted on it. I did something about it. And I honestly believe
that it’s so important that you do respond – literally in whatever way – to
negative feedback/experiences voiced by others because it shows respect and
appreciation and also, it strongly illustrates a sense of humility. Making changes
is a great example of your passion for your work/the industry you work in
because it shows you want to improve and will take negative feedback and even
perhaps just full-on criticism and complaints and use them as something
positive and productive and a reason or motivation to do better.
3. Perfectionism
Perfectionism is defined as being a ‘refusal to
accept any standard short of perfect’ and I think this is relevant to finding
it challenging to learn from negativity because doing so, is like admitting
that there is room for improvement. That you/your organisation is not perfect
at all. And in that prompt with Chat GPT, it also listed perfectionism as a
reason for it being challenging by stating: ‘perfectionists often struggle
intensely with mistakes because they hold themselves to unrealistic standards.
Being wrong can trigger anxiety or self-criticism.’
This is something else I can totally identify with
via my content creation/Influencer career because I will fully admit being a
bit of a perfectionist and will confess that I definitely hold myself, the
quality of my content, and the standard, success, and popularity of my
blog/content in general, to a high standard. I wouldn’t go so far as to say
‘perfect’ but I’d agree to pretty damn close! And I honestly think that a huge
reason for this stems from something that happened during my GCSE studies and,
more specifically, my Art, Design, and Textiles studies.
We had a Teacher who, for some reason, was
incredibly harsh on me – and, honestly, only me! – to the point where I
genuinely believed that I literally couldn’t do anything at all right! I mean,
she’d give us a topic/assignment and if I produced work that took the task
literally and was strictly aligned to what had been asked of us, she didn’t
like it and would say I needed to be more creative. So, the next time, I’d do
something more avant garde or imaginative, and she’d say it was too dissimilar
to what had been asked of me! She’d comment that it was to the point where you
couldn’t even tell/assume what the original task/topic had been yet the task
before that, she had literally said that’s what she wanted me to do!
I was 100% confident that I genuinely – because I
know it’s something that’s said quite a lot and for less realistic/more
unfounded reasons – couldn’t do anything right! And this was only exacerbated
by the fact that the abuse I experienced began whilst this mistreatment was happening,
so it wasn’t as though the unconstructive criticism was the only difficult
thing in my life at the tender age of fifteen! And I think that this definitely
contributed to how hard and challenging it really was to cope with this one Teacher’s
attitude and terribly negative feedback.
So, I think that this experience at school – even
though it was literally like, twenty years ago(!); has really stuck with me and
caused or inspired a sense of holding myself accountable to a fairly high
standard and having pretty intense expectations of my content and both its
success and its popularity too. However, the hardest result it had was that it led
to me developing a real difficulty with self-esteem and confidence – especially
in terms of my creativity and in the work etc I produce along those lines e.g.
my drawing, writing, and even with the little, simple arts and crafts packs
(intended for children!) that my Mum would send in the post when I was a
psychiatric hospital inpatient over 100 miles away! And I think that the
hardest part of this, was that I actually still really enjoyed doing those
things, I was just too critical on it to show anyone what I had drawn, written,
and/or made/created.
In that psychiatric hospital – which I ended up
being an inpatient of for two and a half years – there was Occupational Therapy
(OT) team and one of their missions in their work specifically with me (because
in addition to working with each inpatient individually, they would also work
with us as a group/ward) was actually to improve my confidence in my creative
skills and abilities. And over those two and a half years I can confidently and
appreciatively say that they managed to accomplish this! To the point where, for
my second Christmas there in 2013 (I was admitted in Summer 2012), I drew and
then painted a robin on a branch on a canvas as a Christmas gift for my Mum
(who is a huge fan of robins!). It made her emotional because she recognised
that it was a huge step and a big sign of progress in my self-esteem. I also
did two pieces of fashion drawings (which is the type of drawing I became most
confident doing) with one of them being of a Christmas tie for my Consultant
Psychiatrist (who always had the strangest patterned ties!) and a trendy,
Christmassy outfit for his Deputy (who I was incredibly close to – literally to
the extent that I got her a friendship bracelet when I was discharged from
there in September 2014!).
Part of improving my self-esteem in my creativity
meant that I learnt a lot about perfectionism. I became more aware of instances
where I was starting to think and feel that way and I eventually came to the
conclusion/realisation that putting in the effort and simply ‘trying’ and
putting the effort into something, is honestly so much more important than
being ‘perfect’ with it.
4. The fear of consequences
I feel that this final challenge to learning from
negative feedback or criticism is a lot more transparent and honest…
A while after my mental health first deteriorated
in 2009, I was given the diagnosis of Borderline Personality Disorder (BPD but
now referred to as Emotionally Unstable Personality Disorder or EUPD) and professionals
(particularly the Crisis Team though) started preaching about responsibility to
me. In all honesty, it wasn’t until I was in recovery and being discharged from
the psychiatric hospital in 2014 after that lengthy admission that I finally
recognised they were very right and valid in promoting I have this attitude
because I never took responsibility for my actions. If I were to self-harm or
make a suicide attempt or something, I’d always say “I only did it because such
and such did this” or “it was just because such and such said this.” I never
once sat there and said “yes, they said or did that, but this is how I’ve
coped.”
I think a huge difficulty and barrier stopping me
from doing this was the notion that when I would self-harm or when I made my
handful of suicide attempts, I never did so with the feeling that I had a
choice. I never once thought ‘I could cope this way, but I’m going to choose to
be unsafe.’ I’ve always been absolutely convinced and certain that the unsafe
coping mechanisms were the only way of getting through something. The only way
of surviving it. Or, where the unsafe coping mechanism was a suicide attempt,
I’ve believed it was the only way things would get any better. The only way to
stop all the bad things from happening.
In fairness though, I think I was partly right
about feeling I had no other option because it wasn’t until I underwent
Dialectical Behaviour Therapy (DBT, which is the recommended treatment for
someone with a diagnosis of a Personality Disorder e.g. BPD) as an inpatient in
that long-term psychiatric hospital that I really learnt safe and healthy
alternative ways to cope. Now, in all honesty, the hardest about DBT and
learning these new skills – and something which is particularly relevant here –
was the embarrassing recognition that these skills were actually incredibly simple
and basic. This gave me the attitude ‘how did I not think to do this myself?!’ Alongside
embarrassing, it also made me feel stupid for not thinking of these things.
When I say ‘simple’ and ‘basic,’ the four skills I
find most helpful from DBT are distraction, self-soothing, mindfulness, and
pros and cons…
1. Distraction:
This skill comes from the DBT module titled Distress Tolerance (there’s an
overview of the entire module on my favourite DBT site here: Distress
Tolerance: Dialectical Behavior Therapy) and is basically
about engaging in distracting activities when you’re struggling. If you want to
try this skill out and are struggling to think of activities or if you’re
wondering whether the activities you’re thinking of by yourself are ‘right’ and
on the correct track, that favourite website has a huge list of examples and
more about the skill in general here: Distracting
Activities: DBT Skills, Worksheets, Videos.
2. Self-Soothe:
That distraction skills lead perfectly to this one because three of my
favourite distracting activities would also be relevant or defined as
self-soothing actions too! I enjoy taking a shower (and especially washing my
hair!), doing my nails, and putting make-up on. At first, when I realised these
were the activities I found most helpful, I was a bit ashamed and reluctant to
admit it because I worried they were things which made me appear superficial,
but also that other would judge me with the thought ‘how can she be struggling
that bad if putting false nails on is that helpful?’ Again, to learn more about
this skill or for a list of recommended activities to self-soothe, the website
has a page on it too, it’s here: Self
Soothing: DBT Skills, Worksheets, Videos, Exercises.
3. Mindfulness:
Something that’s quite funny with this one is that I was actually the only
inpatient to have the same Key Nurse for as long as I did, which was partly
because of the high staff turn-over but also because it was a long-term
hospital – the website stated the average lengthy of admission as being 12 – 18
months because everyone has DBT and it’s meant to take one year to complete – and
so with everyone being there so long (out of all the girls who came and went
during my entire admission on there, only one was there for less than 12 months!)
unlikely that staff would be there that long too! So, she and I had a really
lovely bond – to the point where my Mum and I said she was like my second Mum
whilst I was so far away from home – and almost inevitably, after my discharge,
we became friends on Facebook! She’s followed my journey since then (and we’ve
actually gotten together a few times – one of those times is coming up in July
when she’ll be attending my Mum’s wedding!) and when I began promoting
Mindfulness on my blog and social media, she commented that if there was anyone
she thought would be unlikely to do that, it was me! I absolutely detested
Mindfulness during my admission because I worried that being ‘in the moment’
would be dangerous. I felt that I was only alive because I had distanced myself
from the memories of my trauma and other negative experiences. Eventually
though, I learnt that like many of the DBT skills, you sometimes just have to
adapt it and turn it into a way that is fitting for you. So, for me, my
adaptation of Mindfulness was to be ‘in the moment’ when I was engaging in my
distracting or self-soothing activities. I would really concentrate and focus
on what I was doing and this actually ended up making my use of those skills
even more effective in helping my mental health and my safety levels. If you
want to know more about Mindfulness (which is actually its own Module in DBT)
there’s an overview and links to the different skills within it, here: Mindfulness
: Dialectical Behavior Therapy.
4. Pros
and Cons: Finally, this last helpful DBT skill actually also comes from the Distress
Tolerance module (though on that favourite website, it is labelled Cost Benefit
Analysis) and it is the basic action of considering the benefits and negative
results of an action or an event etc. It’s mostly really used in regard to
unsafe coping skills because it helps you to recognise that you’ll gain more
from safe and healthy coping mechanisms that you would with unsafe ones. In
addition to the overview of the skill – which you can read here: Cost
Benefit Analysis: Exercises, Worksheets, Videos
– that website actually also has activity sheets (which it does for other
skills too, but theses ones provide a layout for engaging in this skill) that
you can view and download here: dialecticalbehaviortherapy.com/wp-content/uploads/2020/04/DBT-Forms-Distress-Tolerance-T1.pdf.
In that PDF it actually lists/describes the thing you’re analysing the pros and
cons of as a ‘problematic behaviour’ which, I think, really helps to broaden
the definition or idea of what you can use to engage in this skills/do this
activity.
So, to bring it back
to consequences being an off-putting impact of learning from negative feedback
and criticism, and the relevance of all that discussion of DBT, having that
Therapy was a consequence – for me – of learning from all the comments that I
wasn’t taking responsibility for my actions. And in all honesty, the hardest
part of this lesson coming from numerous lectures from various professionals,
was that all these years later – now that I do take responsibility – I’ve come
to find that a lot of organisations and professionals actually don’t do it
themselves.
I believe that
typically, it’s because they know that doing so, will result in a number of
consequences that they just really don’t want to experience/undergo. And I feel
that it’s only fair that they do experience consequences because I had to go
through at least two and a half years of – what could very fairly be labelled
as at least somewhere close to – hell. So surely, they can withstand having to
issue a written apology, re-do – or create a new set of – training, be put
under closer supervision by management, and/or make changes to policies and
methods of operation etc…?!
A Fundamental Benefit from the Lessons
Learnt
It’s only fair to include and recognise that there
are also benefits to learning from negative feedback too, but I feel that there
are so many this blog post would become even longer and so, I decided to just
quickly talk about a fundamental one – and one a lot of people may not think of
– an increase and improved self-awareness…
In asking AI – again specifically Chat GPT – its
thoughts on this, it came back with: ‘feedback can reveal blind spots in your
behaviour, communication, habits, or work. Understanding how others experience
you helps you make more informed choices.’ It also defined self-awareness (for
those unsure of the term/concept) as: ‘the ability to recognise and understand
your own thoughts, emotions, behaviours, values, strengths, weaknesses, and the
impact you have on other people. It involves being honest with yourself about
who you are, why you react the way you do, and how your actions affect those around
you. In simple terms, self-awareness is the difference between simply
experiencing life and actively understanding yourself within it.’
Next, I asked it for signs of good self-awareness,
and it listed: recognising your emotions as they occur, understanding what
triggers certain reactions, acknowledging your strengths without arrogance, accepting
your weaknesses without excessive self-criticism, noticing how your behaviour
affects others, reflecting on mistakes and learning from them, and understanding
your values and priorities.
Now, my personal experience of improving my
self-awareness from negativity is again, related to my Influencer career and it
actually goes back to that second horrible comment I mentioned earlier where
the person had wished me luck with my next suicide attempt on my World Suicide
Prevention Day content back in 2014. The one that led to me ending I’m NOT
Disordered for over one month – the first and only time (in thirteen years!)
that I’ve ever stopped blogging. So, how did that comment lead to an increased
self-awareness for me? It was really about that last part Chat GPT stated – the
bit about how a sign of good self-awareness is understanding your values and
priorities.
For many years, one huge rationale behind my
suicide attempts was actually this incredibly certain and passionate conviction
that I had been put on this earth to kill myself at a young age and in a way
that would shed light on the failures of mental health services and other,
relevant professionals. For a long time, I actually didn’t tell anyone or talk
about this belief until I was an inpatient on that lengthy admission. And I had
Psychology on Tuesday 8th April 2014 (I only know the exact date
because I blogged about it, you can read it here: The
Early Death Belief | I'm NOT Disordered) and, to overcome it,
the Psychologist actually had me do a really similar exercise to the pros and
cons skill in DBT. She had me sit down with her and list the reasons and proof
that validated this belief and provided evidence that it was correct, and then
also list all the contradictions to it and examples or instances that
undermined the belief and would make me question the accuracy of it (in that
blog post, I included the lists, so if you’re curious to find out what was
actually on them, you can go read that!).
When I ended, I’m NOT Disordered a few months later
though, the self-awareness came in because in no longer blogging, I came to
realise that actually, perhaps blogging and creating content was my purpose in
life. That maybe I had gone through all that I had and come out the other end with
the reason that I could use both the difficult, upsetting, and traumatic
experiences as well as my recovery and more positive memories to help others
and to inspire me to start blogging and to create my online content. I had
finally found a positive reason for being ‘here’ and finally had a purpose that
was powerful enough to keep me alive.
The accountability part is also true for me too in
the way that I talked about earlier regarding me realising or acknowledging
that I had myself somewhat vulnerable to these comments by creating content
regarding very personal and somewhat private parts of my life. Parts where many
other people, I’m sure, would disagree with my decision to share them or – at
the very least – they would state that they wouldn’t have disclosed these
things if it were them. I’d like to think, however, that seeing and establishing
the positive impact my openness and honesty have, would mitigate a lot of that
concern some may have for my wellbeing and for my self-inflicted/self-created
lack of privacy.
The Lessons I Hope Attendees Take From
My Speech
1. Mental
illness doesn’t define you.
2. Always
have hope for a service user in case they don’t.
3. Recovery
isn’t linear.
4. Hearing
lived experience matters.
5. Take
complaints and negative feedback as learning opportunities.
For more information on the Women’s Mental Health Conference, see the flyer and to book tickets or for more information, please email the Team via: MedDevelopment@cntw.nhs.uk
