Psychology assessment outcome
 

I had the second part of my psychology outcome. She said they won't work with me on an individual basis whilst I continue 'to engage in life threatening behaviours'. I don't engage in them though. My harming is not that 'bad'....it is no where near bad enough. She said there is a 20 week group course I could go on based on DBT but only group work, with no individual therapy, but before she would do the referral then I need to commit to it by making a decision to 'stop or significantly reduce my harming because there is no point if I don't want to stop it' and I need to get rid of and not replenish my excess med supply or allow myself to entertain suicide as an option.

She said there is no point working with me individually or even in a group if I could impulsively overdose (which I have not done for about 2 years) or accidentally cut too deeply because 'we can't do psychology with a dead person'. I don't know what to do. I have two weeks to think about it and she wants me to make a decision, she says being willing to 'give it a chance and see how it pans out' is not committment enough. I don't think I can commit further than that though. I can't promise to give up or even reduce my harming. I can't. I said I would give it a chance but that is not enough. Without the promise to try and stop the harming and get rid of all my excess meds and having a detailed argument for why this 'WILL help me' then they won't take me on the group.

Maybe I am too ****ed up to be fixed. Maybe I should have lied....I knew what they *wanted* to hear but I was trying to be honest, I thought it was for the best, honesty is important in working towards getting better right?? I feel like they are giving up. Maybe they should. I honestly, genuinely don't know how to make that committment or decision in the two weeks she has given me though. I agreed to the assessment (they sent out about four 'are you sure' letters you had to send back, I went to the first, then it got carried to another and I went to them. And that was really hard for me....does that not show I at least WANT to try??

I know it is not perfect....I don't know how to suddenly promise to stop harming though. If psychology won't accept me without that, and psychotherapy have indicated they won't either then what does that leave? Nothing. I am hurting my friends and family and I hate myself for it. I hate what and who I am as well.

I don't know what to do anymore. It feels like I am finally, totally, out of options because I don't know how to give up my self harm, but to get any psychological help then that is what I have to do. I always thought you would get psychological help to do it but apparently that is not the case....you give it up to get the help. And I can't do that. I don't know how or even if I want to. I am scared about who will get hurt if I do. If I just make it 'enough' then it will be ok....right?

Their priorities do seem really wonky, and has little understanding of the compassionate psychology of the dynamics of sense of personal power and supporting you to gain a healthy sense of that. As in, your self harm etc seems to give you a sense of control, albeit unhealthy, and if you have that taken away before you're supported to have a healthy sense of control, recovery won't be a full and deep one. It's not about meeting where you really are, and that makes me sad.

Have you thought about Mind or similar for counselling?

I think your health system is screwy. Aren't they supposed to help you so you CAN give up harming? Though I agree with them and not you on the fact that it's life threatening. you constantly downplay your harming but I know how bad it is. And i'm all for you getting rid of your excess med supply! I dont' really know what to say, I can't fix it :( I wish you were here and then I could help but the stupid ocean is in the way and that sucks! I love you heaps and want you to get any help you possibly can!

Why should they let you on a course to help you stop harming if you have no intention of stopping? That makes no sense to me at all. Its not fair on them, the system and others who may be waiting for a place who do want to try. This may sound uncaring and hard but this is the situation you are in. Its called reality!

Would you accept a course of life saving cancer treatment costing thousands with the knowledge you wouldnt try and get well? I doubt that.

Yes you have to make a choice and yes its time to take some responsibility for your health. Its as simple as that. There is nothing more to it.

You need to ask yourself why you wont reduce your harming and get rid of your pills. If its because you dont want to be well then dont accept the course. If its because you are frightened that you cant do it then perhaps that can be worked on. However YOU and ONLY YOU can decide that you are going to try!

They did not say promise to stop, but they said to make a commitment to reduce significantly. This is your starting point. They DO NOT expect you to stop and be cured before you start. That would be plain stupid. But in order for this to work there needs to be commitment from you because no amount of therapy or pills can beat your will if it is intent on keeping yourself in this same situation.

You see Emma recovery is a two way thing. I dont mean to patronise but they cant make you better. You have to switch that switch on in your head that says im going to try, before they can help you.

I guarantee that all the people here who have started recovery will have faced this question. Its ****ing hard! Its scary as ****. But whats the point in getting treatment if you dont want to bother yourself? What will happen is that you will set yourself up to fail this course so that ultimately you can feel even nmore **** about yourself and probably end up harming even more seriously just to prove you are a failure and useless. THEY WILL BE AWARE OF THIS!

For this to work you MUST make a commitment to them, your family and yourself. They will know slips happen. They will know some wont make the full 20 weeks. They cant stop that. They cant ask you to be perfect. They cant ask you to self cure and they wont expect that. It is not unfair of them to ask for your commitment. They will tell you that your commitment to this program will make the difference between succeeding and failing. That ultimately without you on board they cant do anything.

Its big girl time and its your choice.

I think this is really the key. ^^

Crazy analogy coming up...

Imagine a group for people that are training to run a marathon...

Someone could turn up, and be totally unfit, but have a definite plan to run a few times a week. They aim to do a fun-run in a couple of months, and see how it goes from there. That would be OK.

But if someone turns up in high-heeled shoes saying they can't afford to buy trainers, refuses to do warm up exercises, and keeps telling everyone they hate running and would rather be at home - well it's never going to work!

I do understand what Matt and people are saying. I know recovery is a two way thing. I totally understand, accept and agree with the fact that recovery is not 'done' or 'given' to you. It takes work and effort and it is hard. I know that and I accept it. I went to the assessments knowing it would be hell if I was to get accepted but I genuinely thought that it would be 'therapy' in order to get to the cause and work through things so that maybe I could get to the point where I could see the point and maybe even (and this is uncomfortable) *want* to stop self harming. I did not expect it to be the other way round, where you stop or minimise the harming before getting help with anything else. My social worker and psych both told me that they excepted that was probably not going to be helpful for me and that they understood that was not what I wanted. This was a general referral and we (social worker/psych/htt) thought it would probably lead to individual therapy.

I understand that a course designed to help people wanting to stop harming when I do not feel ready for that is probably not going to help me and I also accept that I have no right to take up a space on such a course when I don't agree to engage in that ideology. I asked if I could not do something, some sort of psychological work to help me understand why the harming is such an issue and get to a point where I agree and want to reduce it but she said (very clearly) that they would not offer that. So I was (am) left with a situation where I either agree to reduce and stop my harming or get nothing.

I agreed to try it and to try and apply the skills instead of harming but she said that was not good enough! She said if I am not willing to guarantee I want to greatly reduce the behavuour then I can't do it, she wants me to convince her I want to do that before I can even try the course. I very rarely harm now....i.e a couple of times a month. I can't reduce that anymore at the moment. My harming is not impuslive. If anything I am acutely aware of the feelings that it is not enough. To me that is something that needs exploring via one to one therapy. It is not something that I can deal with by learning a load of impulse control DBT skills, which yes, would have maybe helped two or three years ago when it was fairly regular and often impulsive. That is not what I need at the moment. I told her that.

She said it did not matter and that nobody would work with me until I 'significantly reduced' the severity because it would be a 'waste' of their time just in case.

To be clear...I don't WANT to be this person anymore. I don't want to feel like this. I WANT to feel and be different. I want to be 'normal'. I just don't know how and I don't know how to promise to reduce my harming severity when anything less than that does not even count as me self harming. I told her I went to the assessment knowing they may want to address it and that I wanted help to understand it and be more in control of it.

I know what they want to do the referral. I can't do it though. Any option would have been difficult for me but this seems almost the reverse of what I was expecting. I genuinely don't understand how they can ask you to almost stop self harming before they will help with the feelings/thoughts/emotions behind it. I don't understand. The course would most likely not start till March either. How am I supposed to keep that control over self harm thoughts etc until then??

I REALLY wish person centred counselling was on the NHS! I think that could really help you. Meh. You need support, damn it.

Personal counselling IS available because i was offered it! I had a 3 week assessment and was put forward for one to one.

Ok now i understand the situation a little more. For your assessment did you have a series of interviews with a psychologist who asked you loads of questions about your past future and present, current state etc etc? Mine was over a 3 week period meeting once a week. It was like therapy.

Firstly i would say that if your current support group are insisting on one to one then you need to get them to help you appeal this decision. I dont know how it works but perhaps there is a way for your gp or whoever to ask how and what the decision was based upon. I think without knowing the reasons its hard to judge why they offered this to you.

From a document i was given by my old crisis team (Birmingham MHT) on how the assessment works (i still have it), it basically listed all the types of therapies available and what sort of needs a person would have to show to require it. from what i gathered they would take the information taken from your assessment and offer the best therapy available that best suited your needs.

Now perhaps one of three things happened here:

Firstly it could be the NHS in your area are not capable opf providing the correct service? either the assessor was crap, they have no money, they dont have the right option available to you due to resource or they just plain screwed up.

Secondly, it could be that the way you came across in your interview/assessment lead them to think that group therapy was the best thing? I dont nkow what you are like when explaining how tyou feel to the services, but many of us are bloody awful even when we think we are good! It could be possible that you came across less in need that perhaps you feel? Youve mentioned before about the humour and being misread. Im not saying you were silly or funny, but from what you have said previously i know you play yourself down.

Finally, it could be that they truely believe this is the best course of action for you? Again you would need to find out why. It could be they are right, or it could be related to reason 2 above?



note: You know sometimes one to one isnt all its cracked up to be; each therapist works in their own way, some CBT, some psychoanalytical and some god knows what. Im guessing you dont want cbt but want to know the root causes? This can be great to realise why you do what you do and where it stemmed from, but it doesnt mean it will stop you. There is a lot to be said for practical and cognitive approaches. Psychological gentle kicks up the arse and re-workings of old behaviral patterns. (sorry i dont read books on this so i dont know all the fancy terms, i can only speak from my heart so apologies for the lack of accuracy).

Find out why they chose this route for you and then decide what next to do.

Thanks Katie :)

Matt, originally the assessment was supposed to be just one appointment consisting of 15 minutes of those standard anxiety/depression screening tick box tests and then an hour of talking but after an hour and a half talking we had to stop and she arranged another appointment to finish which was what I had on Monday. She asked me about present difficulties etc, history, family history of mental illness, past treatments etc.

I think I was pretty honest with her but yes, I guess I was fairly joky although I tried harder not to be and even cried in front of her on Monday. The 'proper' DBT service of individual alongside group for 2 years of whatever is currently being closed due to funding cuts, or at least they are no longer accepting people from my area and are moving current patients from my area to a different centre. This group is kind of their attempt to put something in its place even if it is only a short term once a week group. The other service she said she could put me forward for would be an day therapeutic community the other side of the county where I could go for several days a week and have group and individual therapy for up to two years. A close friend literally started there last week though so that is not possible.

I asked her if I could do something like cognitive analytical therapy or psychoanalysis but she said I would a) have to be referred to the psychotherapy department (I did not know they were different departments) and b) they probably would not take me unless I stabilised and reduced the self harming because apparently it can make people more unstable when they start working on difficult things. It just feels like a catch 22 situation. She said she did not think CBT was appropriate (plus I have had individual and group courses based on it before) and she has to make a referral for a treatment that studies have shown 'work for people with your difficulties such as self harm'.

I saw my social worker today and she told me she thought I should try the group but I explained to her about what the psychologist wanted me to do and why I was apprehensive. I am a bit confused, she said it would not help if I was going into it expecting it not to help and then she told me that even if I got rid of all my medication then it would not be hard for me to just replace it over the internet so could I not just throw it away just to please the psychologist? She has already spoken to the psychologist about my self harming and explained that it is not generally impulsive and she agreed with me that the psychologist had misjudged that and also seemed to think my moods were very changeable and reactive, which again they generally aren't. The only other thing they have suggested is doing a 'WRAP' (Wellness recovery action plan) with me. But again, I have done them before and I actually find them more irritating than helpful. It is another superficial 'treatment tool'. A long form with questions like 'when I am well I am.....', 'when I am ill I am....', 'what helps me.....' and stuff like that.

It just feels like this is too engrained in me for something like that to help and it is frustrating me, and honestly making things feel pretty damn hopeless that this is all that seems available. I could ask for a psychotherapy referral but I will have to turn down this group if I do that and I can't see psychology offering it again if I turn it down and psychotherapy then say no.

I have not been doing well recently so my social worker made me a psychiatrist appointment last week (funding cuts in my area also mean you no longer see your psychiatrist regularly and they do not prescribe medication, you have to go to your gp). I will try and talk to my psychiatrist when I see her next Wednesday and see if she has any bright ideas. I just don't know what to do and I also found out last week that my landlord is selling my flat (the one I literally moved into less than three months ago). I'm supposed to be aiming to go back to uni part time in October as well and I literally am seriously struggling to cope at the moment. Sorry, I know those last two sentences are slightly off topic. I'm just....lol, well I don't even know what.

jesus christ!!!

I REALLY dont get other country's mental health system.

You were being honest which should count for something!! you werent manipulating!!

An educated doc or therapist KNOWS that you cant wave a magic wand and erase years of destructive coping mechanisms.

obviously, you want the help or you wouldnt be asking for it.

and yes, there are plenty of cancer patients who try and give up until someone convinces them to fight for themselves. you NEED that. you need to be told that you are important enough to fight for yourself!! and a therapist is the one who ultimately will help you decide that!!

how do they possibly expect you to answer all their bs questions with a level head?? it's THEIR job to help level your head damnit.

im sorry Emma.
love you to pieces.
xxxxxxxxxxxxxxxxxx

I think your social worked was totaly wrong to imply you could or would get meds online. for one if you hadnt thought of it she could have implanted that thought and for two its a pretty stupid thing for a professional to say unless you have a history of ordering online and they are aware of this?

I think its quite telling that you are so insistant that nothing will stop you unless its this type of analysis youve not tried yet. Perhaps you should look into this.

I have on rare occasions bought medication online before and it would be in my notes.

What did you mean by your last two sentences? Look into the therapies? Or look into why I am 'insistent' on wanting something analytical?

Just wanted to clarify that I meant Person Centred Counselling as pioneered by Carl Rogers. Very good for developing self acceptance, and a good lead in to eventual deeper, and more directly practical proactive work.

Was wondering if you had thought any more about all this?

I have been thinking about it but I just keep going round in circles. I do want to try psychology and if that means the group then I want to try that it is just really hard. I tried to get rid of some of my pills yesterday and got rid of about a third of them, benzos before totally breaking down. I couldn't manage to get rid of the rest of them and even getting rid of that is making me want to harm more. Something in my head decided I needed to OD on the same number to punish myself. I didn't but it was really really difficult, the 'need' is still there but under control for now which I guess should be a good thing but it isn't. How am I supposed to get rid of the rest when getting rid of about a third has made me think and feel like this?

I know it is my choice and if I don't then I won't be allowed to do the group unless I lied but I really don't know how to. I'm sorry, I'm not meaning to be difficult. I'm just scared I can't do it and I'm scared I can't do the group and there is nothing else.

I'm seeing my psychiatrist tomorrow morning and then my social worker so I guess I will talk to them about it some more. I have until next Monday to decide. I just don't really know what to do.

I tell you what you do: you tell them what you did and how you did it and why you did it and how it made you feel. For someone who CANT give up or get rid of them you certainly did a bloody good job at starting.

It doesnt matter if you cried! you ended up getting rigd of a huge safety blanket without hurting yourself. sure its hard. Its not meant to be easy you silly sausage!

Im actually really proud! I really think you can do this and i think you just showed youself you are stronger than you think. Of course you will find a way to make your achievement seem meaningless in your head but thats all part of the process!

WELL ****ING DONE!

Emma, I am so proud of you for getting rid of a third of your pills. It must have been so hard to do...and then to have the strength not to harm yourself or take an od..you should feel proud of yourself. xxxx

Well done for getting rid of some. I do a form of CAT and I can understand why they would be reluctant to not let you do it before your self harm is under control. For me I hadn't self harmed in years and the therapy triggered off so much that it started again. I hope that you get to go to the group. x

Emma, i have to agree with everyone else. It must have been very hard for you, but you did it!

Really well done emma *high five*:-D

LOL....I just tried to call the crisis team because I am struggling with the same thoughts as a result of throwing away my medication. I don't just call them unless I have already tried my distractions, grounding etc etc. Apparently with 'your diagnosis' then I need to learn to take responsibility and just keep trying things. What the HELL is the point? I've tried, I really have. I've spent the last six or seven hours trying to 'behave' and when it go too much then I called the CRT just to speak to this stupid woman who basically told me I needed to 'take control and responsibility'. I am actually trying to, regardless of what everybody else ****ing thinks.

What the hell is the point though when all it leads to is NOTHING?

Just wanted to say I've read this. I do believe you about how hard you are trying to keep control of this and hold off from doing anything damaging.

I'm sorry the woman from the crisis team was so unhelpful. I've often found professionals useless when I'm in a crisis myself, so I can relate a bit to this. If they can't suggest anything that makes it better (which is difficult if they don't know you ) they ought to just listen with respect. You are a human being who is doing their best with a state of immense emotional pain.

It is a huge step (in the right direction) that you took, getting rid of some of your excess medication. People here are impressed and totally recognise what a big deal it is, and also how much it has brought up painful feelings.

You sound as though do have a good degree of ability to control the urges and not act on impulse. This is shown because you have resisted for quite a long time, although I would imagine this is wearing you out.

Please, please try and hold on until tomorrow. The feeling will lift at some point, and also you are going to see the psychiatrist and social worker and they may be much more helpful.

A huge well done for getting rid of some of your meds! I'm sorry you're going though all of this, I wish there was a simple answer to help you. Keep trying the distractions, you're doing really well for even calling them. I know distractions can get annoying but do whatever you have to to keep safe.

Thank you. I am not seeing my psychiatrist anymore tomorrow. I left a message to cancel about four or five hours ago. There is no point. I actually can't believe how unhelpful the crisis team are being (and I never thought that was something I would say). After nearly three hours of waiting for a call back I phoned them and on the sixth attempt got through to somebody who spoke to me about distractions etc again and then told me he wanted to speak to the 'shift supervisor' to get his opinion and would call me back in ten minutes if I could promise to stay safe until then. I assured him I could and 45 minutes later am still waiting for a call back. Oh and please don't be too 'proud' cos I already harmed earlier. I know I'm pathetic. I don't need reminding. At the moment I am struggling enough to try and shut out the 'more serious' thoughts. I can't believe I was weak and stupid enough to throw away any of those pillls.

Just noise all the time. Pathetic. I know. I just want to sleep. I need it all to shut up but no....just goes round and round and round like a giant circle, always there, never ending, just round and round and I can't take it. No....scratch that....I don't want to take it anymore. I just want it to stop.

Emma, I just read your rant...I'm so worried about you. Please don't do anything, you're (understandably) upset and might not be thinking clearly and calmly, don't do something now that you'll later regret. I know you think you regret it but anything bad could happen to you and none of us here want that for you. I think you should try go to your appointments tomorrow. I'm sorry I have nothing better to say.

Thank you. A rather frank exchange with the crisis team just brought me straight back down to ground. They mentioned their team coming round to do an assessment to see what I needed and I freaked. What am I doing? I don't want that! They mentioned talking to an out of hours GP on the phone before coming to see me and then 'taking things from there'. I need to get a hold on things one way or another. I spent some time reassuring them I just wanted to sleep, that I would be fine and promising to see my social worker in a few hours. Now I feel a bit stupid. At the time when the supervisor phoned back and mentioned all this I just wanted them to go away and leave me alone, before hand and now then I am not so sure. Although I guess they are for CRISIS and I am not immediately in crisis right at this second. I can control things. Kind of. Although I was not sure of that a few hours ago but I can, for now. Strangely being pissed off with them for not phoning when they said they would was kind of distracting (although definitely not something I would want again). I am just going to try and sleep for a few hours before social worker turns up. Uuurrrghhh. Such an idiot, I know.

Not an idiot at all. Just someone going through a lot of pain right now and trying to deal with it anyway you can. I'm glad you're a bit more on top of things now, good luck get lots of sleep and I really hope you wake up feeling a little better and more hopeful. x

****, i think you made a very big mistake here. I really really eally hope you can rectify this. I hope today went ok. Cancelling the psych was a mistake. We make mistakes. It doesnt make you an idiot. Perhaps irrational.

Im sorry you felt so bad. x

Thank you. I saw my social worker and spoke to her about everything. She said we can rearrange my psych appointment next week and she will speak to the psychologist and explain about me getting rid of some of my meds and see if we can come to some sort of agreement so I don't get quite so freaked out. She said I had done really well and some other stuff. I hate it when people say nice things to me, I feel like I need to explain why they are wrong but then I worry if I do that then they will think I am just looking for more compliments which I'm not....I just want them to understand why they are wrong to say nice things. Does that make sense?

Anyway, yes I do agree that it was kind of silly to cancel and part of me is regretting it now. Social worker was much nicer and understanding about the harming and cancelling than I thought she would be (or I would be to anyone else) and hopefully her talking to my psych and the psychologist might help a little. She did say there are two programmes at the place my friend attends and she will discuss with them why I could not be referred to the one my friend is not at so I guess we will see. I kind of want it sorted sooner rather than later though because as of 1st October my CMHT is being totally jumbled up and I might have to change care co-ordinators and I'd prefer someone who knows me to try and arrange treatment.

I'm sorry, I'm trying really hard not to be negative and defeatist, I really am. This feels so uncomfortable though, it feels like even talking about this stuff, psychology etc is going against every part of my body and my head is screaming at me. I should be excited right? I'm not, I just feel guilty and weak and scared. The OCD aspect of my self harm is kicking in telling me I'm being selfish and that people might get hurt because I'm being too weak to harm properly and I need to punish. I'm sorry. I really am. My head just feels so scrambled and I can already feel things building again.

Tahnk **** they sorted it! You have a good team!

hugs xxxxxxxx

Ever feel you are doing the same thing over and over again?!

This is what I see is happening (and I could be wrong and it isn't meant to sound like an accusation or rude btw):

You ask for help, you're offered help, you get scared about getting help and its implications, you project your fear out onto other people and get angry at the people trying to help because you think they can't understand why you are scared, you get angry that what they are offering isn't right, you then get mad at yourself for being selfish and bad, which leaves you feeling guilty for not being able to be 'good enough', so you seek reassurance and 'check' the help is still there and you've not pushed it away with your badness (via crisis line), which leads you to connecting with help again, then you get scared about the help, which makes you angry......and back round the same loop over and over again.

Again, I'm not meaning to sound rude, just wanting to point out this push-pull type situation you seem to be always having going on. I'm not saying that your feelings about the situation aren't real or extremely powerful...just attempting to show you what you may be doing, so you can try and stop it. E.g. you got demoralised so cancelled your pdrs appt - essentially you pushed any help that could be offered away. In my mind rather than focusing on the self harm and reducing that, i'd be increasing all the things you could do to help yourself....such as attend appts etc. I'd do some stuff that goes against the grain abit. E.g. I always tell myself to attend appts even if it is the last thing i ever want to do, ever!

I understand it is hard getting out of the patterns in our heads.

Actually no, I don't think that is what I am doing. I have not missed a single appointment that I can recall since moving to this area in April 2010, nor have I turned down any help that has been offered. My social worker was fine with me missing the appointment because I do not do it regularly and I was not in a state to go, she even said that she agreed I would not have made the most of it hence why we she had no problem rearranging. What is it you think I have turned down? Yes I have turned down HTT and hospital before now. I am hesitant about this psychology group (which I have posted and said I will try and have tried to get rid of medication to enable me to do that) but my hesitation is valid....even my care co-ordinator, my old psych agree and my family and friends also think that individual therapy is what I need given that I have already tried groups more than once in the past and that on my Care plan it is says 'assessment for individual psychological input'.

I am intrigued why you have this opinion so if you could examples or explain further what 'this push-pull type situation you seem to be always having going on' is in your eyes. I have applied to go back to uni again part time in October, I've agreed to try to do the group and until Wednesday that I have not missed a single psych or psychology appointment that I recall. What is it that I should be doing that I am not?

How are you doing today? I was quite worried about you the other night. I know what it's like to think people are wrong when they compliement you, but try to think that they wouldn't go to the trouble of saying things if they didnt think they were true. I know it's hard, but you need more confidenece in yourself (I think most of us on here do too). Anyway, I hope you're ok.

Thank you and I'm sorry for worrying you.

I just spoke to the psychologist since she told me two weeks ago to ring her today. She told me a bit more about it, it is a 2 hour group once a week on a Friday. She also said that she has spoken to Social worker and her colleagues and if I start the course then they are aiming for me to see one of the group psychologists individually for an hour a week (this is not what I was told during the first assessments just to be clear). I am going to have a further assessment with her and someone else to discuss the course in more detail and so they can explain what is expected of me. She said she was not convinced I was 'ready' but she will give me a chance and put me through to the next 'stage' and if the other person agrees then I can try the course and it will either be starting in October or in March. I'm really nervous. I could do with some support if possible rather than 'don't screw it up' etc. Sorry.

No one is gonna tell you not to screw it up. Well not in those words anyways. :P

This sounds quite good to me. I like the added one to one and im sure that has appealed to you also? For now i would just keep going with the flow. stay in contact with whoever and let people know about the possibility of this course and what it could do for you. I know for me personally when i had people around who knew it kinda helped me stay on track as i didnt want to let them down.

If you accept the course and go on it you will be fine im sure. These things are never as bad as they seem. They are usually quite gentle and they will know what kind of people to expect and how to deal with them. the same old addage will apply as with anything like this in that there will be nothing they havent seen or heard before.

I know its not easy not to worry about it as i do the same with things so far in the future but try to keep real about the timescales. there is a long time between now and then and so try not to use up too much time worrying. there is nothing you can do yet.

I am wondering if some sort of affirmatin you could put on the wall could help? Im thinking something along the lines of "my course and the team i have around me have my best interests in mind. No matter how stressed or scared i get i will not act rashly without consulting my team"

I know thats kinda cheesy and perhaps cheeky from me, but things written when fairly sound of mind can last with you. It could be something you look at when you are thinking of quitting and telling them to all **** off that could bring you back down and prevent a load of unessessary trouble? Just a thought.

Take care and remember march is a long way away!

do someting nice today!

Matthew x

Thank you Matthew :)

I might try and make a little sign to tape to the back of my door. It could give me some encouragement as well to go into town and do a couple of tasks I have been putting off as I could buy some nice card and stickers and stuff for it. I think I may also try to make a list of counter arguments to some of the thoughts, or like reassuring things like 'Nothing bad is going to happen to anyone if we don't self harm...that is the *insertwordthatisnotillorunwellcosIhatethosewords* side of you talking'. I just feel a little pathetic for needing to do these things and I am SICK AND TIRED of the bloody 'thought voice' that keeps going on at me and gets worse whenever I try and do something 'positive'. My Grandma is unwell again and it keeps telling me it is my fault because I'm trying to do this course instead of doing what I deserve and hurting myself. This is the sort of thought that I would tell anyone else is incorrect and needs challenging so that means I should challenge it myself right?? Hmmm.

I am pleased about the individual aspect although she was clear that it will be mainly to discuss my feelings about the course, help me apply skills each week and manage any thoughts/problems the course may raise. It is not exactly what I ideally wanted but I'm certainly not going to turn my nose up at it!

I would love to just do something I want to do tonight, like curl up in my pjs with a load of wine and a new series of something. Unfortunately I am trying to reduce my alcohol in take (and I am ashamed to admit this) because I think I maybe, possibly, might have or be developing a problem with alcohol. Today is the first day in a while where I am attemping not to touch any alcohol at all and it is actually really hard and I don't feel physically very well and am also out of lorazepam (ironically considering the excess med issue).

I have decided I do not like today very much because of the above reasons combined with the lovely mental backlash of agreeing to this course (and therefore agreeing to try and control my self harm). In fact rather than feeling pleased with myself, I actually just want to cry.

I am however spending the evening with some friends playing geeky card games in a bid to distract myself.

Em you dont need to be ill to have positive affirmations pinned up arounf the place. Many successful happy people have them to remind themselves and to chanllenge the negative thoughts that can creep in. Its somethig i need to do myself.

Tell you what; you make one and i will make one too!

Deal :)

Yeah...I'm not seeing a group psychologist individually after all. Apparently this was what they were aiming for but instead it has been decided today that my social worker will be trained to do 'applying skills' with me and we will meet once a week for 30 minutes to do this instead of my usual weekly meeting with her. If I do not adhere to sticking with her new role which will be 'strictly just to apply course skills' then I will be discharged from the group. NHS changes in my area from 1st October also mean that we now have to apply for funding from GPs who will decide a set length of treatment with the aim being to discharge more people to GP care to prevent 'dependency on support from the CMHT'. Oh and I will not be getting my support worker back because from the 1st October 'the role of your support workers will be changing'. My psychiatrist has also been changed. Who am I supposed to talk to about everything else and the actual issues I am having with my mental health? I'm really upset.

That sucks! They are changing my services too. Take what you can. I'm not sure how a GP cam decide length of treatment as most if not all have little our limited knowledge of mh issues. Is there anyone in services that can help you with the application?

Sorry, I should have maybe been more clear. I don't fully understand how it will work. By 'we', I meant my 'care pathways manager' i.e my care co-ordinator which is my social worker and I. She discusses it with my team and I and they put in an application for a certain type of treatment and treatment length to be approved by the GP before it can be funded. She said they are now being told to look at stabilising people and then discharging them back to GP. I have to push forward harder with recovery to try and improve or face being discharged. I have been trying recently (believe it or not). I'm finding it really hard to do these things though when it feels so 'wrong' and I am worried I won't be able to improve, or at least not fast enough and then I will be discharged with no support apart from my GP (who I have never met) and ironically that worrying is making me feel worse!

I've been looking the course up online to try and get some more information. I am not going to dismiss the help. I am actually feeling more comfortable with doing the course now I know more about it but it does seem incredibly repetitive of stuff that I have already done.

:) 5 chars

Your system sounds very strange. I would be considered stable, but have still been with a clinical psychologist for 4 years and it is entirely up to him how long I see him for and my GP has no control over it.

Feel Bad. Really bad. Triggered....triggered plannings. Need to be stronger than this. Better. Scared though. All at the same time. I just need things to make sense. I need a hug. How could I even believe a uni would accept me part time to continue my degree....pathetic. How could I think psychology would be able to help. Evil, BAD. I know that. But I feel so alone, so sad, so scared. I don't want to be by myself with this :crying:

You're not by yourself. Call the crisis team. Call a friend. Call me! *massive cuddles* you're never alone honey.

What do you mean "phychology being able to help"?

Your psych help doesn't sound too good. Or they sound a bit preoccupied with shoving you through the system as quickly as possible.

I only read a few of your posts so I'm sorry if I'm repeating what has been said already but cutting and negative or harming thoughts are a product of something deeper.

Perhaps going for a different kind of therapy could help rather than just trying to get rid of the harming?

Thank you all. Sarah my psychiatrist changes so often it is laughable but I do believe my social worker is trying the best she can with the options available.

Matt: I guess I'm just scared that psychology will say no and there is also a massive part of me that is scared of the consequences of them saying yes as well. I've looked a lot into the course and whilst I am more comfortable with it and less concered I think (I don't know is scared or hopeful may be a better explanation) that it is not going to work. I'm scared it won't but at the same time at least if that is the case then I don't have to deal so much with the mental backlash of doing the course. I don't know what I want....I just know I don't want *this*. I have looked at the week by week break down and it just seems so 'untailored' to me or so 'not me' it is a joke. I guess I want someone to come up with something revolutionary, or intense, however scary. I think I could be more hopeful if it was, but this course....it just doesn't seem right and I am scared at the same time it will make me resentful of mental health services. I only just got over that from my last area and it took A LOT No of emotional effort to do that. The course has not even got enough funding to offer the level of support that the course 'writers' suggest. I feel like I am actually going to lose support and help rather than anything else. I just don't know what to do. And it is not as simple as just trying everything offered because I can quite easily see the lack of individual support (i.e by losing a regular contact like my care co-ordinator who would not be replaced) as being a massive set back. I am terrified of becoming really ill again. And yes, there is the chance that won't happen....but I know myself and how I react and how I have done historically. I want to try this course in case it can help but in doing so I lose support (which is the exact opposite of what the course writer's recommend) and in trying to get well I know I will need more support to counteract the negative side. I don't know how to cope with the extra self abuse and the lack of support. I am barely coping now.

I'm scared.....Really scared. And alongside the fear from that, I have the added issues of the possibility my housing is in limbo and at any time I could be told I have to move in X months and also the wait to see what happens with uni. I always wanted to go to uni but have been 'taking time off' since March 2009. I tried to go back that year and made myself really ill again. I have applied to go back part time next month and am still waiting a decision. Whatever the result, this is going to cause a massive upheaval. If I go back then the reasons are obvious, if I don't then I am kissing goodbye to everything I ever dreamed of including the career I always wanted, forever. That may sound melodramatic but funding (and the fact I have already used some of it before 2009) means if I don't go back now then I never will and even 'well' me will have to replan everything I ever wanted. It is one thing changing your plan and adapting, it is another finding over 20 years of planning is not possible because of your mental limitations.

I am scared about everything, every possible outcome. And I feel terribly alone. I should just cope better.

Ah ok i didnt know if you meant a psychology course at uni or the actual treatment you get.

4 years ago a psychiatrist i was under (who i now know with hindsight was completely insane), tried to get me into a 12 month residential for people with Borderline. All the letters were sent and i was posted a big package detailing the course and the accomodation and all that jazz. It totally freaked me out because i knew 100% i was NOT borderline! At first i went a long with it because i didnt know any better, but after a few months it really started to dig at me and then i knew i did not want to go and would not go on it. Thankfully i changed areas and got a new psych up here who questioned me and was happy i knew i wasnt Borderline, as he did not agree with the diagnoses at all. I was given the chance to give my reasons why and pretty much everything i said to state my case was agreed upon and accepted.

Basically what im saying is that if it feels that wrong in your head to do this then you do have the choice. I would also get some advice from others too. Im not sure if you can ask for a second opinion but there are huge difference in approach and attitude with many of the psychs.

Sadly, (and a little shockingly) i find it almo0st impossible to believe they would take your care off you by not going onto this course. I really do think you need to get some advice. Im not sure where to turn but i would perhaps start with your GP if you have a good relationship with them, or another person within the MHT you have a good raport with and take it from there. You need, of course, to make sure your decision is qualified and backed up by either those who know you or someone medical who can assure you that you are making a valid informed choice and that this isnt your mind playing tricks on you.

When it was me i spoke to my friends here who i trusted and who knew me well, i spoke to some of my family and i also spoke to pretty much anyone in the MHT who would listen.



I cant help with accom, but it will get sorted. As for uni, you are still young and theres plenty of time. the finances will sort themselves. you may have to do OU or just part time or do it over 5 years, but where there is a will there is a way. (i really need to say that to myself)

*sticks a small robin in your pants*

I might not have explained very well, I know I wouldn't lose support straight away if I didn't do the course, well at least I don't think I would but there is no other psychology or psychotherapy on offer and my social worker said you only keep funding if it is shown to be effective in helping you get better and I think in some ways my social worker does help, but it is really slow and bumpy a couple of comments have worried me that I am not progressing quickly enough and under the new system would therefore be kicked out. I don't know. I'm really confused. The only thing I do know is that if I DO do the course then I won't have the support of my social worker as it is now for the duration of the course. I would see her for less time and it has to be 'strictly to work on skills from the course' and nothing else and that scares me too.

I have not turned it down. I have another appointment with the psychologist and someone else next Tuesday to discuss it more with them. I am also seeing my new psych at the end of the month so I will talk to her as well. My social worker is on holiday this week but I will bring it up next week. I have discussed it with some of my family and also one of my friends and they are trying to be supportive but even they aren't convinced this is right for me. The course is called 'systems training in emotional predictability and problem solving' and a lot of it is about how your emotions and thoughts impact your relationships with people on a weekly basis and well....I just don't think that is something that is a major problem for me and neither do my friends or family!

I'm sorry to be a pain and I know I'm probably being repetitive and ranty. I'm just scared and I'm not even 100% sure what of, it seems like everything and every possible outcome!