Fake, fake and another fake

When making sense of my OCD I create jargon to summarise the various facets. The term “fake” means that it feels like I was contaminated, my mind (if asked) says, “yep, you’re contaminated right now”, but I’m not.

Some fakes aren’t a problem can be brushed off in seconds as it is overwhelmingly clear that I wasn’t anywhere near, anywhere from 20cm to 2m, the object that I was supposed to have made contact with and had it contaminate me. The most common example is going near a surface that isn’t clean enough to use on the way to doing something else.

This evening however the fakes were about hitting items in the bathroom, where cleaning off the contamination would generate needing to have a shower immediately (which normally takes 4 hours, on a good day, without any special contamination) if not cleaned by other methods. I was aware that I probably didn’t hit anything, and every time I repeated an action that supposedly hit something I could see that I didn’t actually hit anything.

That didn’t prevent spending 40 minutes dousing clothing and my hands with disinfectant in a desperate attempt to remove enough contamination to avoid suffering through a 4 hour shower.

Eventually, well and truly fed up with the procedure, and safe in the knowledge that from any “normal” person’s perspective I’d have obliterated, multiple times, any biological or other material that could potentially cause harm I decided that “I hadn’t actually hit anything” and stopped there. Deciding that I had been hit would have required more cleaning, and a more intense version of what I had just done.

I use the phrase “a hit” to describe becoming contaminated which something as a result of impacting a contaminant or a contaminated item.

When I manage to avoid actually hitting anything, my mind seems so determined for a cleaning procedure to take place that it creates fake hits that I’m “required” to clean, unless I can show that they didn’t happen. Figuring out that I could avoid the cleaning by showing that it didn’t happened wasn’t what happened initially though, so lots of stuff got cleaned pointlessly (or even more pointlessly, as OCD isn’t solving a real problem).

I can temporarily distract myself and avoid cleaning a hit, but minutes, hours, days, or even weeks later the memory of the hit can impacts me at which point I’m compelled to clean everything I can to obliterate the memory of the hit – the logic being that by virtue of not cleaning the original hit the contamination has spread a lot.

The experience of having a hit overcome me long after its actually happened is what drives me to clean even when I feel that the hit maybe, probably, sort of didn’t happen, as getting past my anxiety to convince myself that not cleaning is OK feels impossible. So far I’m only able to bypass my mind when I can reason that the hit isn’t bad enough to require cleaning.

This brings me to more jargon I use. A “bypass” is when a hit that would normally require cleaning occurs, but I’m trapped in an important (for me) social situation, or deadline, basically something else is stressing me, a lot. This means that so long as I can vaguely reason that the hit “isn’t that bad” I will skip the cleaning is possible. The threshold for “badness” is low, so hitting the floor or shaking hands usually the worst I can bypass.

When trying to deal with everyday hits that no-one else is bothered by its sometimes possible to create a “skip” or a “cheat”, basically a rule that says that “in this situation, with this hit, it doesn’t count”. The rule is created after analysing previous stuff I’ve done, what other people do, so using logic to “skip” my OCD ritual. These usually require a trivial hit (knives and forks, say from a café) and won’t work when my anxiety level is too high and I lack the energy to enforce the “skip” as valid.

There is some overlap between a “skip” and a “bypass” as both provide practical advantages. However a bypass is created by sufficient stress overwhelming the distress created by my OCD, and a “skip” is created by using logic to work around my OCD, without actually beating it. As a “skip” doesn’t actually beat my OCD its also cheating in a way, as I’m not beating my OCD by overcoming it, just by side-stepping, hence the fact that I sometimes call it a “cheat.

P.S. Its been a while since my last post, a couple of instances of superficial cuts, but nothing since September, but my OCD has become worse and more overwhelming. My psychiatrist is referring me to a specialist OCD unit in London though, so that’s hopefully going to make a big difference.

It’s a training issue…

Met a a CPN (community psychiatric nurse) (lets call him Mark, not his real name) on Tuesday for an assessment. He had training in handling difficult behaviour.

It’s not what you think, his training focussed on understanding why someone would do something, and how to work with them.

So his first response to me self-harming is why did it happen, not how to deter or stop it. Although how to avoid it happening does come later, and the procedure is based on understanding the person.

He did understand that a lot of staff didn’t really want to focus on the triggers, just avoiding the problem of self-harm, especially when they are the triggers. Obviously 99% of staff don’t have the behavioural training, I really wish they did.

Oh, and as a double-plus I found out that my current social worker definitely subscribes to the same view as Mark, I’d suspected that beforehand though, as her behaviour towards me indicated that.

This gives me a bit of hope that the CMHT might be able to help me.

P.S. I’m an unusual case for Mark, usually he’s called in to deal with aggressive/uncooperative behaviour, that isn’t me, but he was still the best option. For me it was that stuff triggered me to self-harm, but most staff had (some?) trouble figuring out how to help and reduce incidents.

P.P.S I’m not sure just giving all staff behavioural training would work, as some have been on the job for long enough that their mindset that “the patient is always the one at fault, not the system they’re in, and definitely not any staff”. I’m not sure what would be required to fix that, other than making sure that new staff don’t develop the mindset so that eventually it’ll disappear as staff retire.

Almost, but not quite ðŸ˜

So tonight I almost burnt myself, but pulled back at the last minute.

Unfortunately I did spent more than 75 minutes procuring the means to burn myself, and I cut (superficially) earlier.

I’m gonna call this this a victory. I still have the means, but I haven’t used them.

What got me distracted? Had a new phone which had all the wrong ringtones, so I had to copy them from my old phone onto the new one, and pick the right ones. It was a mundane task, but having my new phone just the way I like it made me feel better (the old phone probably stopped charging because the charging port had too much water/cleaning damage).

I did call the local crisis team as well, just had a quick chat with them about what I would be doing tomorrow and later in the evening, when they asked for details, not much time spent on the self-harm. Not sure how helpful it was, but I didn’t harm myself afterwards, so it can’t have been all bad…

I don’t know about tomorrow, or the day after, but for tonight, I’m good.

P.S. Was assessed by the occupational therapist on the local CMHT on Tuesday. She was really nice, and somehow made me feel safe describing a lot of the rituals that I go through as part of my OCD. Guess the confidence is a psychology staff thing, only seems to really exist around them. Just to be clear, safety exists with other staff, but psychology staff get to the “safe zone” a lot faster somehow (ie. not after lots and lots of meetings).

My worst psych ward experience: “Finish the job” … and “stop wasting [our] time”

Warning: If you are affected by self-harm or suicidal thoughts, or have experienced mistreatment by psychiatric staff this post may be triggering

This ward admission happened in August 2018 last year, so 12 months ago now.

I had overdosed, for the third time in 3 weeks, and was being assessed by a member of the local crisis team after being treated in A&E for the overdose.

She asked me the usual questions, was very nice, and explained that my care coordinator (mental health social worker) and my community psychiatrist had written emails to her asking her to admit me to a ward while they figured out how to avoid another incident. Spoiler: They changed nothing about my care, so this ward admission was entirely pointless.

She said that it was up to me, going into a ward I hadn’t been to before, or being followed (with phone calls) by the local home treatment team.

I’d been followed by the home treatment team before, and discharged from them, and was in A&E just hours later, with a broken heel (my mind went a bit crazy and I went out a first floor window)… So I wasn’t anxious to repeat that, and had no confidence they could help me.

Being offered a different ward was a surprise. Had it been the ward I’d been in before, I would have answered no – had a bad experience there.

I wasn’t keen on the idea, but as care co and community psych had recommended it, and I wanted to be as “not difficult” as possible, so I agreed to it.

I’ve never been accused of being difficult my my care co, psychiatrist, or any therapy staff I’d interacted with. Some ward staff on the ward I’d been on before this one had viewed by OCD behaviour as being deliberately troublesome though…

Arriving at the ward, a new environment was unpleasant, but insignificant compared to letting a psychiatric nurse search through my stuff, mixing up all the contaminated and non-contaminated objects. I just pretended it didn’t happen in order to cope, despite the fact I was standing there, watching it happen!!! It was still very awful though.

So far, mostly OK, nothing abnormally bad. Maybe I need to get a new definition of bad, but escaping all the stuff that’s bad beyond a “normal” perception would mean getting rid my my mental health condition, which (as of August 2019), really hasn’t gone away, yet…

The following day I was assessed by the consultant psychiatrist, who told me I was wasting everyone’s time with the repeated self-harm harm, and I should either finish the job, or stop trying.

She also suggested that morphine would be a far more effective drug to take (it would take effect in minutes, not days, which I already knew). My verbal response to here was “If it didn’t kill me, I’d be left with brain damage, and I wouldn’t know how to get hold of it anyway”. She didn’t respond to that.

Her knowledge of the effects of the medication I had been treated for before coming to her ward was a bit sketchy, she seemed to assume I’d have to take it multiple times in a week for it take effect, which I guess appears the same as taking it once, and waiting a few days for it to take effect.

After she had finished asking questions, she said she wanted to discharge me immediately. My reaction (internally): I let all my stuff get contaminated, and watched it, for nothing!! I asked her to telephone my care co first, and my care co persuaded her to keep me for another 24 hours. Technically I still hadn’t been forced to do anything at this point.

I guess this is the part where my actions triggered a reaction, I took several photos of people free areas of the ward, and no anyone’s room but mine. I did accidentally take a photo of all the patients names on the “meals orders” sheet, that’s my mistake.

After the assessment had completed, and I was back in my room in the ward the psych knocked on the door, which 3/4 nursing staff behind here.

I was then accused of recording the assessment, because I had my phone in hand, by the psych and I was told to hand over my phone and laptop.

My phone was in hand as I didn’t want to leave it anywhere, for fear of getting it contaminated by the surface it hit, and no, I didn’t record the meeting, kinda wish I did – I didn’t realise how unpleasant it would be.

I called my care co to ask her about my options, which came down to “it’s her ward, I can’t do anything”. I asked “could I leave the ward”, she said I could, as I was voluntary, she didn’t attempt to persuade me to stay. It seems the psychiatrist called my care co before approaching me about any issues, and told them she had evidence of my photographing staff!!!!

Strangely enough, that wasn’t mentioned on my discharge papers, as they wasn’t any evidence – I hadn’t taken any, the other photos were!

In my mind I took my care co not trying to persuade me to stay, as an indication it would no longer make me look “difficult” if I just got discharged.

I let them take my laptop and phone, and then asked to be discharged.

As I walked away from the hospital building (which contained the ward) my mind focussed on jumping in front of a train. I was angry, frustrated, and just wanted to stop feeling so awful.

Fortunately my care co called me just moments later, as she had been told by the ward they’d discharged me, and calmed me down just by letting me explain the events I had been subjected to, and how I felt.

Conclusion: I am NOT agreeing to go in another ward, ever again! I was in there less than 24 hours, but it left an outsized mark on my mind, even a year later, so many of the details of the incident are still in my mind. The overdosing taking a background position.

Fortunately no-one has advised me going in a ward again, even though I have overdosed twice since then, and burned myself multiple times.

The knowledge that I react badly to wards, and wards react badly to me, has persuaded my care staff that its counterproductive to admit me.

P.S. Ongoing CMHT assessment (August, this year) update, got a new care coordinator, the old one from my last time under the CMHT is going on maternity leave shortly. Discussed some stuff, apparently the extended assessment is for the CMHT to review me, and identify whether my problems are as “intractable” (their words, not mine) as they appear, and is there anything they can do that will help.

P.P.S. My only diagnosis is “Severe OCD”. I have been considered for other things, but that’s the only label which stuck.

It was worth it…

  • To call Samaritans about my worries (which took 45 minutes)
  • To have a shower (which took 3-4 hours)
  • To leave my flat (at 20:00…)
  • To visit my parents
  • To put up with the noisy crowed bus, where anyone could bump into me (OCD and contamination, not fun)
  • To go to the supermarket

Just so I can have moments of peace and quiet now that my day is done, and there’s no pressure to do anything

Just so I can listen to calm music.

Just so I can surf the internet without panicking every 30s that I haven’t done something.

Just so I can be happy, today wasn’t a disaster!

When life is hard, it’s the little things that really matter, doesn’t matter that you aren’t perfect, just that you’re here, and now.

Bye for now.

A good day, for me…

In the last 24 hours I’ve

  • Tidied up the rubbish in my bathroom and taken it out
  • Cleaned my shower (as I put stuff in there while tidying the rest of the bathroom)
  • Changed, not, cleaned the shower curtain
  • Had a shower
  • Gone out of my flat
  • Got food
  • Got back

Six months ago that would have been a bad day, so I’ve deteriorated quite a bit.

Tidying my bathroom is hard, not just because its a bathroom, but because every time something hits my skin, clothing, whatever, the only way to adequately clean it is with bleach, for skin that means putting bleach on, and quickly washing it off before my skin starts to sting too much.

Onto the next day, fingers crossed, it’ll be better – at least because the first 3 items won’t take up any time, as they’ve been done 😉

P.S. CMHT have decided to do a six week extended assessment to try and get me “better” before deciding whether to put me on the books.

Just talk :)

I’ve self-harmed and needed to go to A&E again (see last post).

However, on the plus side I’ve been reminded, again and again, by various people that I can just talk to people about how I am, and that they’d prefer to know, no matter how bad it is.

I love having people around me who feel that way, they’re the best kind of people.

I am sad that I forgot that they were there to talk to, as it has been so long since I’ve had an incident like that, that I just forgot.

Just wanted to say, people are there, and some even want you to talk to them 🙂