Trusting professionals

Lately I’ve been experiencing a large number of thoughts around self-harm. This has started my thinking about who do I trust to tell about them. The answer is, very few people, and just two professionals.

Trusting professionals is the subject of this post.

When I’m in crisis I’m advised to call the local CRHT (crisis resolution and home treatment) team. I don’t, ever. I am too terrified that I’ll call and be accused of threatening to self-harm. I don’t trust the CRHT to help me, and I have too many friends who have been dismissed by the CRHT as not at risk.

Comments made about me by professionals express that I’m too high functioning to need continued access to support, with the same arguments for removing me from the ward now being used to justify discharge from the CMHT (community mental health team). The reasoning being, that they don’t appear to do anything for me.

Then there is the incredibly common expression by psychriatric staff “it’s your choice to [self-harm/kill yourself/…]”. It doesn’t help, at all, it just works as a way to absolve the staff member of any responsibility to help you. This isn’t personal, it is just how they always respond, with the idea being that this will provide you with the willpower to not hurt yourself. It does not consider the case where you actually want to hurt yourself as it doesn’t feel like there is another option – they don’t explicitly provide another option. This also gives the staff grounds to disregard whatever you do to yourself as “your choice”, “your responsibility” and ignore the emotions and distress that led to the action. When seeing a psychologist this doesn’t happen, they understand that this method is extremely unhelpful and acknowledge your distress. Unfortunately staff are trained that reacting to your distress or expressed thoughts is a bad idea on the grounds that it encourages you to express yourself that way for attention. I’ve found it really doesn’t matter how little attention they issue, it doesn’t put me off self-harming, as the goal is internal and for me only, how they react isn’t relevant.

From my point of view that means I might as well self-harm without telling them, then they can’t accuse me of being attention seeking or say anything at all; at that point all that’s left to do is patch up and prevent any serious damage and send me out into the real world again (as stated by my care plan).

The staff reaction isn’t all bad. When I encounter A&E staff who are trained in treating physical problems I have found them sympathetic, supportive and worried. In a way I’m lucky, my diagnosis is OCD. If it was BPD there is a significant chance it might be the other way around.

Onto my two professionals, a psychiatrist, with whom my time is coming to a close. I did get more than the maximum allocated 20 sessions, which I am glad of – just 20 wouldn’t have been enough. The other is a social worker who has helped me navigate the benefits system and access a psychiatrist when necessary.

However I am going to lose both of them shortly, as I haven’t had any serious incidents since September (barring attempting to burn myself earlier this week). As such I am no longer view as appropriate for the CMHT to follow me.

The part that puzzles me is the remark that “my crisis plan will remain in place, with some follow up by CRHT”. It feels like it won’t matter how bad I get, I will not ever be brought back onto CMHT support. I do not like that. It feels that if I’m going to be at risk of hurting myself, I should still be on the CMHT, not the treat any phsyical problems, then discharge ASAP from A&E plan.

I have to admit this post isn’t the most cheerful, and is very busy expressing how I feel. That last paragraph is only expressed here, hasn’t been said anywhere else, and I wish it was, hopefully I’ll find a moment with a trusted professional to express that…

I don’t find it easy to trust staff, as there are way too many of them and they all react differently, trust only comes with extended positive interactions, which are rare.

Sorry I haven’t edited the post, it was too anxiety provoking to go back through it.