Following Up From Turbulent Waters

Two weeks ago, I wrote a post about what happened when my GP and I tried to get me back into the mental health clinic here. I received some supportive responses (both here and elsewhere) and I received one comment that has been on my mind.

I thought about replying to this on the original post, but most of what I have to say feels appropriate as its own post. I won't lie and say I didn't have an emotional reaction to the comment - in truth, I had an extremely strong one. I felt rejected, dismissed and invalidated; my knee-jerk reaction was to quit and never write here again. Obviously I've chosen not to take that path, but then I had other paths I could take. Should I let the comment stand? Should I treat it as gospel and take it to heart or should I dismiss it entirely?

After a couple of weeks reflecting, I decided to do neither. It's important that I don't simply take on board whatever anyone says about me - but it's equally important to me that I'm open to criticism and don't deny something simply because I don't like hearing it. So I reflected; I thought about what was said, and about the beliefs I have around the statements used, and I read my own post through several times.


So, in response to,

"Anonymous said...

You have to see it from their point of view - if after all that help you're still not much better, why would they invest more time and money in you? They've already invested a lot in you and it didn't do a whole lot, so they are now giving other people a chance. Don't go playing the victim."


I would like to start by saying that I don't believe, in this situation, I am "playing the victim". That term, to me, is about not making use of the power that you have. I am, in actual fact, powerless over what decisions the Mental Health clinic makes about my care once my part is done. Their decision was not in my power - what was/is in my power is my reaction. That, I accept responsibility for entirely -- what I choose to do with and about their decision is in my power (within my own limitations) and nothing to do with Mental Health.

However, that "within my own limitations" is important. It's not an excuse to say "to Hell with it" and give up - but it is important for me to remember that I deserve to give myself leniency for things I legitimately cannot help. Everyone has limitations and nobody is perfect. One of my limitations is that DBT was not enough to stop my self harm.

Whether "anonymous" intended it or not, the implication behind the comment was that because, after investing so much time and effort into me (I assume through my course of DBT), I was not better "enough", I do not deserve further treatment. In my view, this is wrong. Everyone deserves health care. Everyone.

If we apply this logic to physical health concerns, it becomes much more clear. If a skin graft operation is unsuccessful for whatever reason, the surgeon does not simply cross the patient off and move on. He or she sits down and thinks about what to do next - and then puts the options into place. Sometimes this means that the procedure is repeated. Sometimes it means that alternatives are explored. If a surgeon simply threw up his hands and refused further treatment because the patient was not "better enough" there would be an outcry.

Why 'would' (or 'should'!) they invest more time/effort/money in my health? Because they haven't tried everything. Because there are avenues that have not yet been explored. Because DBT is not, and was never intended to be, a one-size-fits-all cure. The fact that DBT has not helped me "enough" doesn't mean I am not trying, it doesn't mean that I am beyond help, and it should not stop me, or anyone else, from receiving further treatment.


And yet... this is what is happening in the mental health industry, especially when dealing with those with Borderline Personality Disorder. I don't mean just locally to me, either, this is happening all over the world. Mental health problems are just as valid as physical health problems, and there should not be barriers to receiving treatment and care based on the fact that you are not "well enough" after completing a particular treatment.


There were two other things I'd like to address from that comment.

First, I'd like to dispute that DBT didn't "do a whole lot" -- I think most people who know me well have seen massive changes in me since DBT. Not curing me is not the same as not doing much.

Second, I'd like to say to everyone that although I have allowed anonymous comments so that those without an account can still comment, I would very much appreciate knowing who leaves comments. As long as things are kept respectful, I don't mind people having opinions that differ from mine, and I'm okay with being called out on things... but I don't think that doing so anonymously is generally respectful. In my opinion, if you don't believe in your opinion enough to stand by it as yourself, then you don't believe in it enough to say it with good intentions.



Take care of yourselves until next time, and may we all find our own small fences along the way.

Turbulent Waters: I'm Really Not After A Miracle!

It's no secret that life's been a bit of a rough trot here, lately. Part of that is due to circumstances in my life right now/recently, part of it is not having medication that works properly, and another part is not having a large enough support network offline.

Whatever the reasons, though, the end result is the same: I've been struggling for a while, and things aren't getting better on their own. After yet another bout of what's being termed "severe self harm", my doctor last week decided to push for me to be seen at the free mental health clinic again. I told myself I wouldn't allow myself to hold out too much hope for a better outcome than last time, I told myself that I would be okay if/when nothing came of it.

Everyone else was so sure something would come of it. Surely. Surely, they had to see that I wasn't making it on my own now. It's been just under a year since I was closed off the books, a year since I did DBT. I've been using my skills, even this blog itself is proof of that. I fight every day to be okay. Surely they had to listen now. I started to let my hopes rise. And then I was given an intake appointment.

So I began to get more invested in the outcome. I began to believe that I had a chance at getting real help again. And then the call didn't come when I expected it.

I felt let down, but I told myself that maybe they were just busy. Maybe I misinterpreted what Intake had said, that I'd got it wrong and that they would call at a later date. A few days after I had originally expected the call, I was about to head out when my mobile rang.

"Hi C, it's [old case manager] here from mental health."

My heart skipped a beat. This was the case manager I'd worked with prior to DBT; the one I'd worked really well with and trusted. I thought she might be calling to say she'd be my case manager again.

"I just wanted to let you know what the Intake team have decided about your case. Now, you've done DBT. You clearly don't want to stop self harming, there's nothing more we can do for you. You know there's no miracle cure, medication isn't going to fix you. We have decided not to take you on."

I was gutted. Crushed. The crushed hopes were bad enough alone, but to have them crushed like that by [old case manager] was like being told by Santa Claus that he wasn't even going to bother leaving you coal. A few minutes of silence followed where I fought my tears before she added insult to injury with,

"What did you even expect to come of this? What do you want?"
"I... I don't know. I-"
"Exactly. So, bye then. Good luck with everything."

I was hurt. Betrayed. Crushed. Gutted. Afraid. For a little while I was even furious. Not just angry but actually furious! How could they? I have fought so hard for so long. I try so hard, I have made so many changes. My feelings were a confused jumble of negative emotions and I cried fairly hard at first. I pulled myself together and left for my appointments, but the emotions didn't go away. They're still right there, because this is a big hurt.

It got bigger when I went to report back to my doctor and found that mental health had got there first and read him the riot act about how manipulative Borderlines are. My formerly supportive doctor greeted me with "do you even want to stop self harm? How much?" then proceeded to tell me again that there is no miracle cure, and told me that since I have done DBT mental health are not interested in wasting their time or mine.


I am tired of being told that there is no miracle cure. I am not looking for one! I'm not afraid to put in the hard work, I've been doing that. It's not working (enough). I know medication makes a difference for me, when it works. I know that. Why won't anybody in a position to do anything about it listen to that?

Dear mental health professionals,
Please, stop assuming that because I happen to have a label with a bad rap, I fit what that label means to you. Please stop assuming that wanting medication that works for me is synonymous with "I want a miracle cure". Please stop assuming that because I'm struggling to stop self harm it means I don't want to. Please stop assuming that I have manipulated my GP into advocating for my treatment. Please just stop making harmful assumptions about me!

I'm asking for help, not a cure. If I didn't have the BPD label, you would be falling all over yourselves to help me. Your labels are supposed to be there to help, not hinder, my treatment.


And now, since mental health is again a non-option, we're back to square one. Where do I go from here? It's so tempting to give up - all the professionals have, why shouldn't I?

Because when I give up, there'll be no chance for it to get better. And because I deserve better than that. I am getting a psychologist referral, and I will take my 6-12 free sessions and do what I can with that. It's better than nothing.

And so I go on putting one foot in front of the other and doing my best to get through each day however it comes. Imperfectly, certainly, but until I can move (something that I can't do until I receive the money from my settlement over my knee which is currently held up due to an error) it's my best option.


Challenge and cheerleading statements:
* Things are not as hopeless as they seem. This isn't forever.
* This situation does not reflect my value.
* I deserve better than to give up on myself.


Take care of yourselves until next time, and may we all find our own small fences along the way.

Mixed Messages: How Are You?

Today I got to thinking about my relationship with my emotions. It’s not something I usually avoid thinking about, but it’s also not something I am particularly constructive with, either, most of the time.

Several hours ago, I was logged in when a friend signed on and asked a question that sent my anxiety levels through the roof. Did she ask what to do if a prowler is in your home? What to do about some sort of medical emergency? No, it was nothing like that; nothing that big or important. In fact, all it took were a few simple words: “how are you?”

Some days, I just don’t know. Even after a year of DBT, my emotions are a relative stranger to me. I still label them incorrectly; I still struggle to see them at all; I’m incongruent; and I definitely still try to deny and hide them. I hide my emotions so well, in fact, that our DBT coordinator commented on it. “[dawni] is hard to read, yes. She’s a very good cloaker. I think, actually, she’s the best cloaker I’ve ever met.” There was a lot of power in that; I could fool a therapist I respected a lot, without even trying. Of course, the flip side of that was that, without even meaning to, I was treading on my own toes - how could anyone help me get better if they didn't have a clue what was going on?

And that is what brings me to why, today, “how are you?” set off my nerves.

If I know what I’m feeling, I’ll try my damnedest to hide it from you. Hell, I’ll try my damnedest to hide it from myself. On the other hand, I don’t like to lie. If you ask me how I am, I will feel compelled to answer you honestly – while at the same time I will feel compelled to not reveal what’s going on. If I’m lucky, I’ll have something physically going on I can hide behind. “I’m a bit tired” is probably my ‘favourite’, but “my knee hurts” gets a pretty good workout as well, these days. When my physical health isn’t an issue, though, there’s not much I can do except answer or avoid. And as much as I know that simply avoiding the question, especially after the second or third time you’ve asked, is its own answer, I am often too caught between the two answers to give a decent answer. And buried in there, underneath it all is the little thing that sparks it – fear.

I always vaguely suspect that people don’t believe me when I tell them how I am; what makes this so frustrating is that the thought is strengthened by the very behaviours it causes. Of course you’ll have trouble knowing what to believe if my words say “I hurt” and my face and body say “everything is fine”. It gets worse when, as a protective coating, out comes my humour. Now my body’s saying “I’m fine”, my face is saying “I’m fine” and my words are saying, “I’m not fine, but let’s all laugh it off”.  Talk about mixed messages! But doing otherwise, allowing my body to tell its share of the tale? That leaves me vulnerable – not just to you, but to the one thing that frightens me most of all-- myself.

If I admit, honestly, to you what is going on here in my head, I have to admit it to myself. I’m not so good at that. I seem to believe, down in my core, that if I can’t see it, it’ll go away and I’ll feel nothing. For years now, I have been on a quest to simply cease feeling. I am, if you’ll pardon the Star Trek reference, the anti-Data. He spent years trying to attain the ability to feel – I spend them trying to avoid it.

The first step, I’ve heard, is recognising the problem. If the second is to find the why, then I’m well on the way. It’s pretty easy to figure out, this one: the answer is fear.  Are you picking up on a common thread, yet? I’ll probably talk a lot about fear in here – it’s one of my big hurdles.

What does fear have to do with my relationship to my emotions? Everything! I'm afraid of my emotions - including my fear of them. Maybe even especially that one. It seems that I have a few core beliefs about emotions and/or expressing them, that still need challenging.

It is okay to feel. Whatever I feel.
It doesn't matter what lengths I go to, I will continue to feel things.
It is sometimes okay to tell others what's going on for me.