I’ve recently been going through a very rough and troubling time. Since October last year I’ve been dipping in and out of crises. As of two weeks ago, after relapsing quite badly, I have been under the Crisis Resolution Team (CRT). I’ve had many dealings with similar teams and most of them have been unpleasant. There are members of these that have been kind and helpful, but I’m afraid to say it’s a rarity. Most of them are simply lacking training with regards to people with personality disorders. Which isn’t their fault, government cuts over the last few years have left the NHS in a pitiful state. Occasionally though you also get the other type of HCP. Unsympathetic, practically eye rolling and needlessly cruel. During my many years with this diagnosis, I have seen the way we are treated differently and often more harshly, because of the misconceptions many professionals hold. So I’d like to reach out to those HCPs who are overworked and underpaid. Let me explain some of the things you’re doing you might not even notice are causing harm.
Emotional Blackmail - Yes, it really does happen. A lot more than you’d think. I came to my meeting with the CRT in the hopes that someone would be able to offer me support. I was terrified of what I might do to myself and what I had already done. It takes a lot of courage to walk into a meeting and explain that you’ve relapsed with your self harming behaviours. I don’t want to tell you because I want your attention. I want to tell you because I’m scared of what I might do. I’m telling you I need help. Now if you were seeing a HCP you would expect them to be compassionate. My confession was met with utter disdain and even anger. The CRT member said to me
“If you can’t keep yourself safe and have to go into hospital, then you won’t be getting your therapy!”.
She went on to tell me that I had the capacity to make my own choices and I knew what I was doing. I felt physically sick. Did she really think I was doing this on purpose? I tried to explain how I lack control when the impulse takes over, but she wasn’t listening. She’d already made up her mind about me.
Guilt Tripping - Very similar to the emotional blackmail. I’ve known too many professionals who fall into the trap of doing this to their patients out of desperation or frustration. My personal opinion is this happens when the HCP lacks the skills and training, to treat the patient successfully. Which explains why it often occurs with patients with personality disorders or complex needs. After telling me I wouldn’t get my therapy if I self harmed, she resorted to saying
“you should feel lucky you’re getting treatment and that you have a partner/ family/ friends.”
I’ve been one of those people waiting 5 years for the recommended treatment. I have jumped through hoop after hoop, and I have fought tooth and nail to get it. I am not lucky. Also saying to someone their pain is invalid because they have friends and family is ridiculous. BPD is an issue with the way I process emotions and how I perceive the world around me. Whether I have a partner or not won’t change this, and the idea that it will is naive and ignorant.
Closed Listening - I come to you to try and explain my current situation and the struggle I’m facing. Your job is to listen to me and assess me. It’s clear and straightforward, but for some reason it seems it’s a skill that doesn’t get put to use. The problem is I start to tell you what I’m experiencing and instead of waiting for me to finish you assume you already know. Because of this you’ll never truly understand what is actually happening. At times it makes me want to scream “you’re not actually listening to what I’m saying.” But if I did that you’d put in my notes I was violent or aggressive, so I stay silent. Closed listening leads to people blocking out HCPs and therefore hinders the recovery process.
Underestimating Me - There is nothing more irritating than when you work up the courage to call the CRT and you get this in response to suicidal thoughts.
“Go for a walk, then you’ll feel better.”
I actually hate this. It is something that people have been telling me since I was 17. No, it doesn’t help me. I have tried. Did you think I hadn’t thought of this? Such a simple solution to the problem. Having lived with BPD all of my adult life, I’ve had to become quite resourceful to survive. I practice mindfulness, yoga, various forms of creative writing and have become relatively good at self soothing. By the time I reach crisis point I have tried everything I can think of. So please don’t get annoyed when I dismiss your suggestions. I’ve already tried them. I understand it isn’t meant to be patronising, but that’s how it comes across. If you take the time to get to know me better and read my notes before our meeting, you’ll see that I’m a very capable adult and then maybe you’ll treat me as such. Also if you know what helps me, you’ll be able to make better suggestions.
Being Dismissive Because I’m a “PD” - Uh oh… it’s this abbreviation again. It gets thrown around mental health teams constantly. I know from my time as a student nurse and in my current role; so let’s not pretend. Most of us living with a personality disorder know the constant headache of being categorised and stereotyped. Patients are often spoken about as being dramatic attention seekers, who need to be treated with tough love or simply discharged from services. I’ve been in situations where this judgement has been made by HCPs before they’ve even met the individual. You may think it’s harmless as long as you don’t say these things in front of us, but the attitude carries like a stench on the wind. People with BPD can read a negative facial expression from a mile off, and believe me it shows.
I apologise if this has seemed like an endless rant or an attack on HCPs. After all, I am one myself. But, I think it’s really important to recognise our weaknesses and therefore improve. Helping people with complex needs is a tough job and in a service where you’re barely getting time for a drink or even to go to the toilet, I understand. You don’t have enough resources to help everyone and it causes you to feel emotionally fatigued. I’m hoping however that you’ll see we can be helped and kindness does work. I’ve had HCPs that really have made a difference to my life. I want you to see that it’s worth it in the end. So please stick with us while we figure out life in this crazy world.
