Thursday, 26 February 2015

Truth and Madness

Hello there, after so long (again!)

Started this post a couple of weeks ago when I'd just got discharged by the CMHT.

It's brought up a lot of things. Things that make me feel crazy. I imagine I look a bit like a "mad scientist" with my hair all sticking up, a flushed face and manic expression, saying "Ahaa! I can see it all so clearly now!"

In a way it's incredibly liberating, like seeing the truth exposed for the first time, or the pieces of the puzzle fitting together, and a shiver goes through me (get this when I have very creative moments too). But there's also the dreadful, sickening feeling that what I see is a tangled, messy web largely constructed by professionals, with me trapped in the middle forever wrongly condemned with no justice, no chance of redemption, like trying to fight a tidal wave. It's horrific.

Part of that is the way most people would not understand - it's easier to blame the 'crazy' person than face the unpalatable (and in most people's view unlikely) scenario that mental health services are not, on the whole, staffed by angels and do not provide what most would consider basic treatment/care. Also because this has given me the... ah... opportunity of really opening my eyes to human behaviour, and insight/different views on things, it compounds the feeling that I am in a very lonesome position. I kind of get the feeling that to fully understand what has been so awful about the mental health system, someone would actually have to re-evaluate their own behaviour, thoughts and worldview - and that is a big ask.

I'm also aware that wittering on (whilst looking like mad scientist, as above) about seeing the truth and no-one else understanding, is classic 'mad' behaviour. I wonder, about those with psychosis... were they once where I am now? Could they see, but our stupid messed up society found it easier to shun them than to listen?

Anyway, not being involved with services is basically a good thing, considering what it's like for me. However, it means there's no way to correct all the errors and horrible judgements made about me (no chance of redemption, as above). Mind you, being involved with them won't either, if I'm honest. You can't get through to people who's worldview rests on them not understanding. I have the feeling... the mistake I made was a classic, expecting my abuser (psychiatry) to change.

One of the things that has majorly pissed me off is that they've been treating me as if I have Borderline Personlity Disorder even though I'm not officially diagnosed with it. I've had horrible experiences with a different mental health team in the past, due to being (mis)diagnosed BPD (I have never fulfilled enough criteria, though I'd say I'm BPD-ish in some ways, when under stress, but then isn't everybody?) These experiences were actually a major contributor to me breaking down later on, and I originally thought the new team understood this – huh! They just sort of pretend to listen and then ride roughshod over everything you say. With patronising smiles and 'knowing' looks. It makes my skin crawl with the shame, despite knowing they're wrong.

So to them I am BPD, but as it's not on my notes I can't demand treatment/a CPN. And if I argue that it's inaccurate, they'll just use that as confirmation it's true (“inappropriate anger”, “manipulative” etc.) and I'll be lumbered with it officially! It feels like they've completely stitched me up.

In my discharge letter, my MH worker (an occupational therapist, not a mental health nurse, which reveals what they think of my problems!) wrote that she'd sought advice from various personality disorder specialists, who all advised they don't know how to help. No-one seems to have taken a step back and questioned the BPD diagnosis, or looked at the actual presenting symptoms – the saying “If all you have is a hammer, everything looks like a nail” springs to mind. It seems they're trying to force me to fit the treatment (and blaming me when I don't), rather than find a treatment that fits me. DBT (standard therapy for BPD) is not suitable for me; certainly not NHS stage-one-only DBT! I self-harm incredibly rarely, and not seriously, I don't make suicidal gestures, and I hardly ever contact the team in crisis. Admittedly, the latter is more like despair knowing they won't help, so why bother, but still. I'm not impulsive, and the only problems I have in relationships are as a result of feeling low and depressed or overwhelmed (not the other way around). The professionals seems to think I feel crap because of all the crazy shit I presumably go around doing, being such a terrible person. Despite me being quite open and willing to explain to them (ad nauseam) the things I am pieceing together, and where I'm at.

They say they accept that I am hurting and traumatised, an can on occasion display this interpersonally, but overall it doesn't affect how I'm treated. (It's like debating with someone who's incredibly racist – you can explain rationally and give examples and they'll agree with you all the way, and then say “but __insert racist comment__” as if the whole conversation hadn't happened.) They encourage sweeping things under the rug rather than dealing wih them, even though supressing everything is why I'm depressed now. In short, they encourage the most unhealthy and counter-productive things possible for me. They condemn me yet expect me to develop high self-esteem. They wont accept me for who I am yet blame me for not building a relationship with them (this was given as the reason for discharge).

They seem to expect me to trust them implicitly, go along with everything they say, sort of... give myself up and be what they want. And yet, if I did that (a terrible idea, I think) I would be incredibly dependant on them, because I'd be giving up the very essence of myself. The bit that keeps fighting. The bit that keeps me safe. The bit that thinks I'm worth something. (Being dependant on services is something they criticise in people diagnosed BPD.)

Hmm... “the bit that keps me safe” makes me think... is it one of those dysfunctional coping mechanisms? Something that once kept you safe but is now causing problems? But that would suggest I should succumb to them and then what? Be left alone in a world that doesn't make sense and thus causes deep psychic pain? Oh what a BPD thing to say! (I hear them say.) Clearly I “lack insight”! (Snigger).

Even if going along with what they say meant they wouldn't discharge me, it would involve “building a relationship” with them where I am not the real me but just a reflection of what they want. This strikes me as a rather unhealthy relationship! (Not to mention manipulative – that “symptom” that is not a symptom but attributed to BPDers regardless.) And it would make me feel trapped, a despicable person who can't be known, reliant on the approval of those who will not be satisfied until I cover up my pain and become a people-pleasing zombie. Which, funnily enough, is not actually a healthy way to go about life in the real world. As well as being blindingly obvious, I spent a good chunk of my life trying to live like that so I know it doesn't work (and causes more problems).

For a start, I'd be utterly reliant on them for approval because the approval would no longer come from inside me. Nothing I did would be good enough for me. I'd feel utterly unloveable, because being myself was unacceptable. I wouldn't be able to cope with any bad feelings, because I'd need professionals to validate me. Which, obviously, they wouldn't do (I'm supposed to be fine) so there'd be a negative feedback loop of despair leading to escalating crises and probably self-harm/suicide attempts. I'd actually gain BPD symptoms – loosing a sense of self, feeling of emptiness, frantic efforts to avoid abandonment... And the professional response would no doubt provoke what they'd view as “unreasonable anger” and “transient, stress-related paranoia”. Or am I displaying those two now?!

So what would their response be to all this? DBT, my friend. Yup, DBT, to teach you all the ways to behave so that you don't bother anyone and can be discharged. Next! What's that – you still feel depressed? Who cares, unless you're about to kill yourself, in which case we'll rediagnose BPD and tut at you loudly until you stop being so damn awkward.

It strikes me that the symptoms of BPD are what everyone is like to some extent, especially when stressed or upset. And that's the thing – I only struggle interpersonally when I'm very upset, depressed or stressed. Even then, I'll only struggle in the way professionals see as a problem (ie. getting angry) out of sheer frustration and fear, because the other person doesn't understand or is expecting me to do something I can't (ie. completely invalidating/not taking into account how I feel, or actually being angry with me for being upset). Obviously this is far more pronouncd around professionals because (a) they see me when things are bad, in the same way a doctor sees sick people all the time, and (b) because of their position, I expect them to have the skills to cope with an upset person and the desire to understand (hahahaa!)

Regardless, I can DBT them up to the eyeballs when I'm on form, and actually am quite a considerate person – I try to do what is right, not what is easy, and care because I think there's too little love in the world (I know that's cheesy but really!) The issue is that I am so often not on form. The heavy weight or knot of anxiety in my chest that makes it a drag to get through the day. The nightmares and exhausted feeling that make me cry in a fog of confusion. And, right now, the sickening, shaky dread that I am forever condemned by those who will never understand and do not wish to. The powerlessness as evil triumphs! (Ah, you dramatic BPDer, you!)

Basically, I want to not feel so crap, and then I can quietly get on with my life. Apparently, this is irrelevant/impossible, and what I should be focussing on is “coping” with feeling dreadful, and honing my skills at covering it up so as not to bother anybody. Whilst a different label would mean I'd be sympathised with and encouraged, the unofficially-hovering-but-inaccurate BPD means I'm invalidated and blamed.

I am incredibly fortunate that I am able to see a therapist privately; the situation would seem entirely hopeless otherwise. Unfortunately, because of all this stuff filling my head (and torturing my soul, frankly, though that sounds melodramatic) the actual long-term in-depth issues are somewhat on hold whilst I try to deal with it. Having said that, there are many parallels to be drawn so it does shine a light on past experiences and the deeper issues. Which means mental health services have actively compounded the issues I needed their help with – I know others labelled BPD have had this experience too.

Well there we go, the mad, hysterical woman has spoken. (There there dear, take a Valium, etc.) I should acknowledge here, the lack of funding, including recent cutbacks, that contribute to my current predicament, but I know that's not the whole story. There is something in all this that makes me feel these problems within the mental health system are actually symptomatic of something deeper and darker in society, possibly even human nature itself. The feeling that I'm from another planet or something, where people make more sense and are kinder to each other.