Archives for posts with tag: self-harm
The Acorn Programme at The Retreat

The Acorn Programme at The Retreat, York. After a long struggle it looks as if I might get the funding I need to go on this excellent programme, which offers specialist treatment to women suffering from complex post-traumatic stress disorder, such as myself. A big part of the treatment is the therapeutic community approach.

Hi, again.

Qualified staff tied up

Over the last four weeks I have spent time thinking about my care and the future, which felt bleak. During my admission, I have met some very nice people and on numerous occasions we sat together complaining about our level of care and our feelings of hopelessness. One of the main complaints was the lack of therapy and treatment, and it was apparent that the way the acute ward is run is based on observations, containment and medication. The qualified staff were tied up with administrative duties, and the support staff spent time with those patients who were under observation and needed personal care such as washing, dressing and feeding.

Patients left to cope with anxieties themselves

Those patients who didn’t need observations and personal care were expected to occupy themselves during the long days with very little to do, and to cope with their anxieties and mental health symptoms themselves. Support from most of the staff was limited, as staff reguarly claimed they were too busy. At times there was a lot of noise on the ward due to patients trying to abscond or presenting with psychotic symptoms. Staff often seemed to use control and restraint procedures and drugs to calm down the most challenging patients. Over the weeks it seemed that the only support some of us were getting was from each other, or from one of the activity groups coordinated by a lovely lady from an organisation called Rainbow Learning.

When I moved areas four years ago, funding for my care at The Retreat was withdrawn, and I had to access local services. Although the Primary Care Trust (PCT) states that its employees should not be treated locally, my new consultant was insistent that the local services in the area in which I work were the only option available to me. Services that were available were:

  • out-patient appointments with my new consultant
  • 72hr crisis support, and
  • admission to the local acute ward.

Focus on containment, not therapy

My new “care-provider” seemed to focus only on containment and not on therapy and treatment. I have endured various admissions to our local acute ward, formally and informally, and while the staff are generally pleasant (although not all of them always engage with me), I have never had any therapy or treatment during my stays. My fluctuating condition, which I think is best described as complex post-traumatic stress disorder (the same thing many war veterans are afflicted with), has therefore tended to deteriorate over recent years, and ultimate recovery has seemed doubtful.

Therapeutic communities and aspecialist programme focused on recovery

During the present admission I reflected on The Retreat Hospital and the type of care they provide. My experiences in the acute ward at my new hospital are hugely different to my experiences at the acute ward at The Retreat. There were many types of group therapy during the day, as well as regular one-to-one care with variously qualified members of staff. As patients, we were encouraged to look after each other too, and the ward was described as a “therapeutic community”. The Retreat also runs a specialist programme –  the Acorn Programme – for women who suffer with complex post-traumatic stress disorder, such as sexual abuse survivors. The programme operates as a therapeutic community, and there is even more group and individual therapy than the acute ward. The main ethos of the programme, in my opinion, is that everyone works together during therapy and supports each other in or out of therapy. The programme is about recovery, and is run by some excellent therapists.

A suggestion

During my current admission I have noticed how we as patients have been supporting each other and sharing our experiences. This type of interaction between us as patients has got me thinking. Surely if patients are lucid, orientated and want to recover from their illness would it not be more cost-effective to run more therapeutic communities in hospitals, to provide therapy groups throughout the day and daily one-to-one therapies, and to focus on recovery before discharge? Surely this would reduce admissions to hospital and the drain on resources in the community, A&E and general medical and surgical wards who provide care for those who have repeatedly self-harmed?

Consultant now looking for in-patient treatment for me

Talking of therapeutic communities, following the MDT meeting on Tuesday when my consultant asked to see me she gave me the news I had so longed for. She discussed my care over the last four years and voiced her concern that my admissions to hospital had increased and that my condition seemed to be getting worse. Out of the blue she began to tell me that she felt that all local services available to me had been exhausted, and she feels I would benefit from in-patient therapy. She told me she had made enquiries at St Andrew’s Hospital in Northampton who run a specialised programme for women. However, they only accept patients who are on a section 3.

News got better but four years wasted

The news got even better! She then told me that she had also made enquiries at The Retreat Hospital about the Acorn Programme, and was willing to apply for funding from the PCT for me so I could have The Retreat’s specialised treatment. I couldn’t believe what she was telling me! The sense of relief flowing through my body was amazing. The light at the end of the tunnel had finally appeared. Although I realise the process of gaining funding and waiting for admission will take some time, just the thought of knowing that treatment will eventually be available has made me feel more positive about the future. If one had applied a common-sense approach to my needs, then surely I would have been referred to the Acorn Programme years ago?  The money that has already been spent on my admissions to hospital over the past four years plus on medication, the use of  the local crisis team and admissions to hospital generally, would have amounted to far more than the Acorn Programme would have? I can’t help feeling aggrieved that I have wasted the past four years of my life because it has taken that long for a consultant to realise the treatment I need is specialised and that a therapeutic community is more appropriate for me. I can’t help but worry that there are many others like me who are still only receiving minimal and inadequate services and that recovery is therefore not an option for them just now.

Local treatment inappropriate

In order to strengthen my case to the PCT, my MP is writing to the PCT to support my application. The solicitor I have been using, who specialises in mental health, has written to my consultant informing her that it is inappropriate that I am treated locally in the future. I have had to treat many patients during my duties as a paramedic and then to have to see them again in hospital as a patient is not only embarrassing but I feel it could also compromise my professional position. Thank goodness I work with very supportive colleagues, a fact that helps enromously and means a lot to me!

My consultant granted me home leave Tuesday to Thursday, and requested that I see her on Thursday morning at 9.15 to discuss discharge and the future. In a new post I will let you know how that meeting went and what further hurdles I have to face over the next few months.

Love and best wishes

Angela x

Angela Bayley with Father Christmas

Here I am with Santa. Many children are traumatised by meeting Father Christmas (Santa Claus). However, what caused my complex post-traumatic stress disorder (or borderline personality disorder) was far more disturbing. In this posting I discuss these diagnoses. I hope healthcare workers will read it.

Hi, everyone.

I hope your weekend has been as good as mine.

Off like a shot

I didn’t tell you in my last posting, but I had originally thought I would be leaving the ward at 10 a.m. yesterday, not 1 p.m. I was set ready to go home at 9.30, full of excitement, and so I was absolutely horrified to hear that my section 17 leave was to start at 1 p.m. Like I mentioned in yesterday’s blog, time passed slowly, but Andrew eventually appeared at 12.45 and as soon as the clock struck one I was off like a shot.

A cuddle and a whirlwind

I arrived home and the first thing I did was cuddle Laura. Her face was a picture of happiness to see me home. I felt motivated to crack on with the chores Andrew hadn’t managed to get done due to the pressures of work, caring for the girls and visiting me. It’s been a long since I felt interested in my surroundings or motivated to look after the home we have built together. Yesterday I was ready for action and determined to get back to normal, put my Mum and wife head back on, and make up for the things I had overlooked. I went through the house like a whirlwind, cleaning, washing, ironing and changing beds. The house felt clean and fresh and I was looking forward to getting into a nice clean bed.

Mid-afternoon, Sarah and Charlie (my childhood social worker and her husband) came to see how I was before they went on holiday, and they brought me a lovely scented candle for the lounge. We all sat together in the kitchen, putting the world to rights, and we also discussed my current situation with the police, social services, mental health services and work.

Positive – no flashbacks or alcohol

For once I managed to engage in a positive conversation and not be haunted by flashbacks and avoidance tactics, like medication, self-harm and alcohol. Andrew had bought me a bottle of wine, based on our agreement that I would only drink at weekends. I managed to forget it was sat in the fridge.  Compare this to a few weeks ago when I’d have finished it within hours of it being bought and would be well onto my second bottle! With Andrew’s support, I was determined to stay focused and positive as well as tackle my problems head-on.

My stepmother is harmless now

Not long after Sarah and Charlie had gone, a blue car pulled up outside the house. My heart sank as I saw Lillian (the stepmother whom I describe at length in Disruptive) get out the car with her mother. I didn’t want anything to ruin my weekend, and I knew her presence could trigger bad thoughts and feelings. Although she is harmless now, and has certainly repented her sins, she is a clear reminder that I had a troubled childhood and that my father abandoned me on more than one occasion.

Not swamped by uncomfortable feelings

Anyway, I opened the front door with a big smile and told myself that Lillian’s visit was with good intentions and she wasn’t going to trigger my emotions or cause me any harm. She handed me some beautiful flowers and I led her and her mother to the kitchen for another cuppa. We had a good natter about “this and that”, and then she told me my father had been in touch with her to tell her about my book Disruptive, which she hasn’t read. This was the first time it had been mentioned since I had started writing it. I managed to push my anxieties to the back of my mind and explain the process of my writing and how useful it had been. I told Lillian what my aim was – that it wasn’t to apportion blame but to help me understand things that had happened to me in the past as well as help other survivors similar to me. I really stood my ground, whereas normally I would pussyfoot around Lillian, feeling guilty if I upset her and caused any disruption. It was an achievement to believe in myself and not be swamped with uncomfortable feelings and maladaptive behaviours.

Enjoying the moment

Andrew, Laura and I managed to sit down on the sofas with our pizzas round about 8 p.m. Andrew cracked open my bottle of wine as well as getting himself some pear cider. Laura wanted to watch “Casualty” so we selected the film we wanted which we put on at 9.30 p.m. It was so nice to just relax all evening with my family, climb into my own bed and enjoy the moment instead of dwelling on my difficulties.

The diagnoses of “Borderline Personality Disorder” and “complex Post-Traumatic Stress Disorder” and health workers’ reactions

Talking of difficulties, one thing I struggle to get to grips with is the label I’ve been given: “Borderline Personality Disorder” (BPD). One of the kind comments on the blog talks about mental health workers only able to care for those with simple mental health diagnoses, such as depression, bipolar disorder or schizophrenia.  My consultant when I was at The Retreat, Dr Chris, was very sensitive about the label BPD, and would use a kinder label “complex Post-Traumatic Stress Disorder” (complex PTSD). My experience of mental health workers’ reactions when I tell them of that diagnosis is so different – it’s a lot more sympathetic! This just goes to show how discriminated against we sufferers of BPD are, and why there is such a lack of care.

Stigma: “attention-seeking and a nuisance”

NICE guidelines for some years now have included clear instructions for people with PTSD. However, it’s only recently that NICE recognised BPD, and, whilst they suggest that people with BPD are the highest risk group for suicide and that they can have terrible mental health symptoms, they are not very clear about treatment and appropriate care. Sadly, there’s a limited number of establishments that specialise in BPD, and they are usually private hospitals. The stigma of mental health is bad enough and workers are always wanting negative opinions to change. However, many mental health workers frown upon people with BPD, labelling them as attention-seekers and a nuisance. It’s clear that they have little training in this area of mental health and find it hard to understand or implement treatment. The feelings of not being understood are raw for people like me with BPD. I think services should start educating workers more in this area of mental health to prevent ignorance, discrimination and judgemental attitudes.

Please read about BPD!

As an NHS worker myself, I realise that many of us would like more training to deal with difficult situations and diagnoses but it’s seldom available due to cost implications and lack of resources. Therefore can I ask anyone who has an interest in mental health or works with people with mental health difficulties just to take a few moments to read up on BPD, and on how you can help? You would be amazed what a difference it makes to someone’s mood when they feel understood. Only 1% of people suffer with BPD but it would be useful if those 1% were taken more seriously.

User-friendly complex PTSD?

Maybe we should ditch the American label “Borderline Personality Disorder” and change it to the more user-friendly diagnosis, “complex Post-Traumatic Stress Disorder”? I would be interested to know what your thoughts and views are. I hope you can help.

Promised to be home soon

Today has been an easy day. I’ve done some more chores to ease the burden for Andrew. I also cooked a huge Sunday lunch, finished off with homemade apple and blackberry crumble and custard. It felt good to look after the family without considering it to be a big effort or chore. Time passed so quickly and before I knew it, it was 5.30 p.m. and time to go back to the hospital ward. I kissed Laura goodbye and promised I would be home soon.

Abusers have controlled my life for too long

Andrew dropped me off at the hospital and spent an hour with me. He seemed pleased that I was feeling better and encouraged me to stay in a more positive frame of mind. My abusers have controlled my life for too long and at times nearly beaten me. However, I’m still fighting and I am going to try and keep doing so.

I look forward to hearing your comments.

Love and best wishes

Angela x

[This post was written on the evening of Tuesday 6 July 2010, and posted the following morning.]

Hi, everyone.

I hope all is well with you all.

A new way of coping with borderline personality disorder

I thought I should begin with a quick explanation of why I didn’t blog yesterday. Due to some stresses I was experiencing I began to present with a psychosis i.e experiencing auditory and visual hallucinations. Part of my therapy was to be in a low-stimulus environment and have an early night, hence no entries to the blog. You may ask why I’m being so public about myself on a subject which sadly today is still a taboo subject. Well, my reason is so others with borderline personality disorder (BPD) will no longer feel alone, and it also reflects the fact that I have discovered a new way of coping.

Derogatory voices

Normally when I’m distressed I feel helpless, and because of this I push what limited services there are away, saying they are useless and can’t help. When I started with my symptoms this time, instead of reaching for the drugs and trying to knock myself out I decided to face the horrible symptoms head-on, and whilst I was feeling rational I kept telling myself they were not real. I then told my named nurse quickly before anything got out of hand. Together we formulated a staged plan, focusing on recovery instead of avoidance. I kept myself in public areas, was allocated a member of staff to stay with me to try and talk through how I was feeling. I used methods of distraction and my elastic band (see the end of this post). In my head I spoke to the derogatory voices, telling them to go away and that they were not real.

The Mansfield Chad article on my experiences.

This was how my story was recently covered in a newspaper. It will give you some idea of what lies beyone my present circumstances.

Verge of self-harming

In the afternoon I spent some time alone and, recognising when I was on the verge of self-harming, I sought help again and asked to see a doctor. The doctor came and prescribed some injections to dampen the voices and the anxiety. We agreed that although drugs can be sometimes an avoidance technique; it demonstrated to me that drugs are not the immediate answer and, in a way, experiencing distress also helped me realise that it can be dealt with in lots of ways, and the more I feel such symptoms for longer the more I will “desensitise” them and the less they will affect me.

Stopping and thinking

Tackling my illness head-on and “stopping and thinking” before I do anything destructive or maladaptive is a real way forward for me. I feel proud I haven’t self-harmed and that I dealt with things in a healthy way. If just one person reading this adopts my new way of coping then that will be one fewer person getting hurt.

Pampering and some hope

Today – Tuesday – has been a mixture of emotions. This morning I spent sleeping and then self-soothing by pampering myself a bit with lotions and potions. This afternoon I did some art and craft, which really helped take my mind off the MDT (multidisciplinary team) meeting between 14.00 and 16.00. I eventually saw my consultant, who was adamant she was going to continue to keep me in a very contained “well”, due to EDT (Nottinghamshire County Council) influence. My named nurse was with me and really supported me when I challenged my consultant’s decisions and actions. I wanted some leave and the section lifted. After a big debate, she agreed that I could be on a lower level of observations and that she would review leave tomorrow, discussing it with Andrew (my husband). While I was disappointed, a quick tug at the band on my wrist helped me stay positive and focus on making arrangements for tomorrow’s meeting.

I hope tonight, by expressing my own feelings and way of coping, I can help other people do the same or understand others.

Night night, everyone!

Love and best wishes

Angela

P.S. You may wish to read about other people’s experiences.