As some of you might know I'm currently an inpatient on a unit for women with borderline personality disorder. The programme is a year long. Before I came here I was under the impression you did the 12 month programme here and then you would go back into the community. However, my hopes were somewhat dashed today. I saw my social worker and we were talking about how things were e.t.c I said that my main focus was on November (discharge date is supposed to be 27th). She said that there are no guarantees that I will be discharged to the community and that they have to decide whether it will be discharge to the community or another inpatient stay. The thought of not getting out of hospital/off section this year frightens/worries me. I was certain that coming here was supposed to be a step-down from secure units and preparation for going back into the community.
I honestly do seem to be stuck in the system. I've had numerous admissions on acute psychiatric wards, a year on a low-secure unit and then a year here and yet there is no definite end in sight. I've had one tribunal and didn't get discharged. I've recently applied for another but from what I can gather the professionals are still maintaining the view that the section should remain in place.
I don't know what I want from this thread really I just had to vent. If anyone has been in a similar position or has any advice it would be most appreciated.
When life gets you down do you know what you've gotta do?
Social worker just said that it hasn't worked before when I've lived with my Dad so what makes this time round any different. I guess she was asking what skills have I learnt in DBT that I could utilise out in the community. It's difficult though to demonstrate the skills in a hospital setting. I've tried asking for more unescorted leave but they said that this isn't currently appropriate. I'm 6 months into the programme, still on stage 1 of 3 and only have 30 mins unescorted leave.
When life gets you down do you know what you've gotta do?
It must be scary for your aim to have been taken away but do you think it might be helpful to try and stay in the present, and deal with the here and the now? As much as a discharge date can be helpful, it can also be detrimental because it becomes your focus instead of recovery and you might just end up doing things that make it look like you've recovered so you can be discharged. When I say 'you', I mean people in general.
Instead, let recovery become your goal and for discharge to happen when it's the right time because that way you stand a much greater chance of not needing to be readmitted to hospital.
I'm not saying any of that is easy because I can remember when I spent nearly 2 years in hospital and by the end all I wanted was THE discharge date but I realised the more I focused on that, the less I focused on my schema therapy and it was really the schema therapy I needed.
I hope that makes a bit of sense and wishing you all the luck in the world for the rest of your journey. You've come this far, you are doing really well.
Hi Tig, thanks for replying. I do understand what you are saying and it does make sense. After hearing what my social worker said I was tempted to just give up and not bother attending any of the groups but I realised that wouldn't get me anywhere. The reality is I have to do the year here whatever, so I guess I should focus on that at the moment. I can't help but be disappointed in what she had to say. Perhaps there was some miscommunication when I was admitted here as I still believe it was a ste-down place before you were allowed to go back into the community. I can't change anything just continue to attend the groups and do the best I can.
When life gets you down do you know what you've gotta do?
You've got the right attitude there and I really do appreciate how hard it is to come back from the knock down of hearing it might be more than a year, to fighting back and accepting that you need to keep up with the treatment :) I think that shows a lot, and perhaps is testament to how much further you are with your treatment? If you look back, perhaps in the past you might have been less inclined to carry on with treatment or found it a lot harder to come to this point so quickly.
Have you considered asking her or the staff what issues/behaviours it is that they feel make you unsuitable for release into the community at this moment in time? I know you've mentioned BPD, but it might be worth finding out what particular things are holding you back.
It doesn't matter where you come from; it matters where you go.
No-one gets remembered for the things they didn't do.
We won't all be here this time next year,
so while you can take a picture of us.
We're definitely going to hell,
but we'll have all the best stories to tell.
Yes you're right in the past I would not have engaged in groups/therapy. If I'm honest I probably wouldn't here either but if we don't participate then we lose our ipod, t.v e.t.c
Out of choice I wouldn't be involved with mental health services either but I'm unlucky and got 'caught' that's how I see it.
When I fill in my diary card each day the urge for SH and suicide tend to be quite high. To get out they said the numbers need to come down. My social worker thinks I won't get out unless I build relationships with staff, actually talk and disclose how I'm feeling. I have a diagnosis of BPD and apparently Aspergers but there is no confirming evidence for the latter.
When life gets you down do you know what you've gotta do?
What stops you engaging with the groups willingly? What worries you about building relationships with the staff? Are either of these things something you could bring up in your 1-1 or in group?
The only thing that got me out of the long stays (longest solid section was just over 2 years) was to do the groups and talk and be honest with the staff about how you are feeling.
Its really not easy but it is the only way.
It wont be forever, yes its a long time, but isn't it better to be one long admission and get properly better than to get discharged too early and end up back at square one a few months afterwards?
I'm fine! Totally fine. I don't know why it's coming out all loud and squeaky, 'cause really, I'm fine!
I don't find the groups interesting or helpful. I attend so that I don't lose my belongings.
I don't trust the staff at all. Many of us have overheard them bitching about other patients and it makes you think if they can say that about X what are they saying about me. I tried quite recently reaching out for support in a group. I wrote a number of things down and then brought them to the group but each thing I mentioned was either dismissed or argued about by the facilitator.
They know I find groups difficult and just say that it's good that I attend even though I don't want to. 1:1 sessions with my therapist are mainly spent reviewing my diary card, doing a BCA or just general chat.
I did a few silly things and got sectioned.
I find it very hard to talk to the staff for reasons I mentioned above and when I have said I feel this way it gets dismissed or argued that I shouldn't say such things.
I guess it was the shock that it might not actually be a year and that it could be longer. I had November as a goal. Also if I have to stay on section it won't be at this hospital it will be somewhere completely new as my psychiatrist here doesn't intend to increase my stay here.
When life gets you down do you know what you've gotta do?
I'm sorry you're feeling so frustrated and overwhelmed.
Could you talk or write down how you are feeling about all of this and give it to a staff member you feel you trust more than others?
I myself am soon going to be going into hospital for severe bpd/self harm, specialist hospital either in London or another place, and my CPN recently told me it could be up to a year, and now he's said possibly two years.
I completely understand how angry you are and how frightened you must be at the prospect of spending longer in hospital that previously thought.
If you think about this logically and rationally, do you think it'd be a good idea to be discharged when it's you're not ready?
Think about it.
If you are discharged before you're ready to be able to function better in the community - you could land yourself back in hospital either way, especially regarding how high your urges to harm yourself are still.
Wouldn't it be best to stick it out, rather than have to go through all of that again?
I know that being in hospital is very distressing, trust me when I say I completely can relate to that, but they are really only trying to help you.
Not only with BPD do you have extreme difficulty with things like communicating, having relationships/friendships, trusting people, functioning in general, coping with life and problems, etc,
but also with Aspergers[if you do have it],
you also struggle a hell of a lot with the same things,
so to have both needs to be recognized by the staff, and for them to understand it's double hard to do the above.
Could you write down how hard you find it to do what they're asking of you, maybe they could offer some suggestions and advice and support to help you?
There isn't a single member of staff here whom I could confide in. There was somebody about a month ago but I told her something and it got repeated to the team and brought up in therapy. I didn't find it helpful at all. I suppose I could write a letter to my social worker but she would probably say I need to talk to the staff here that are caring for me. I had a chat with her yesterday and that was something she mentioned. She wants me to build relationships with staff and talk.
I notice that you're from Surrey, me too. I'm currently residing in London on a unit treating women with BPD.
Yes, they told me it would be a year placement which I guess it will be here but they failed to tell me that it's not a guarantee that you will get to go to the community after the years up.
I feel ready to leave. My psychiatrist said in my last tribunal that if I agreed to stay voluntarily and complete the programme then he would lift the section but because I said no, I'm stuck here. I even agreed to do DBT in the community. (My social worker is a DBT facilitator). It's not like I'm saying no to doing therapy. I'm willing to give it a go. I'm not doubting that I would find it difficult being out in the community it has been a long time (18 months + so far) but I feel like I should be given a chance.
I admit my SH/suicidal urges are high but as I've explained to various people you can quite happily live in the community with the urges. I've been here nearly 6 months and have only had 2 minor SH incidents. Surely that shows I can control my urges.
I have (just about) accepted that I will be here for the year. I can't get my head around the possibility of having to go to another placement after this one ends.
I do realise that some staff are only trying to help. I guess I find it difficult trying to identify how they can actually help me.
When life gets you down do you know what you've gotta do?
Nickelack4Ever I realise I am not the person you are replying to but your messages don't seem particularly helpful/constructive to me. Your personal views about MH professionals are pretty irrelevant here as the OP is in a situation where she is already involved with them and aware that the best way forward is engaging. Calling the place a hellhole when you actually have no idea what it's like is not constructive for someone who is currently admitting difficulties with accepting being there for at least 6 more months.
Razorbladekisses - do you think there's a way that meetings/groups could be made useful for you? Is there some personal exercise you could do in your head using a point someone else raises? I don't know if I'm explaining that very well. I mean for example if someone else raises a concern could you say in your head 'what would I do if I were them?' Or do you think coming up with ideas to help people in the groups would help you feel good about yourself?
To figure out how staff can help can you try to think of what you would like from people out in the community? Because even there you may not be totally alone - say for example supported housing? Would you want help with daily activities? budgeting? managing strong urges? someone to do things with e.g. watch TV, play board games?
Sorry if I'm talking rubbish.
Always seem to get things just that little bit wrong.
"don't wish, don't start, wishing only wounds the heart"
Nickelack4Ever I realise I am not the person you are replying to but your messages don't seem particularly helpful/constructive to me. Your personal views about MH professionals are pretty irrelevant here as the OP is in a situation where she is already involved with them and aware that the best way forward is engaging. Calling the place a hellhole when you actually have no idea what it's like is not constructive for someone who is currently admitting difficulties with accepting being there for at least 6 more months.
Razorbladekisses - do you think there's a way that meetings/groups could be made useful for you? Is there some personal exercise you could do in your head using a point someone else raises? I don't know if I'm explaining that very well. I mean for example if someone else raises a concern could you say in your head 'what would I do if I were them?' Or do you think coming up with ideas to help people in the groups would help you feel good about yourself?
To figure out how staff can help can you try to think of what you would like from people out in the community? Because even there you may not be totally alone - say for example supported housing? Would you want help with daily activities? budgeting? managing strong urges? someone to do things with e.g. watch TV, play board games?
Sorry if I'm talking rubbish.
I have absolutely nothing to add to this but I think (Claire?) has said it all much more eloquently than I ever could and agree 100%)
Nickelack4Ever I realise I am not the person you are replying to but your messages don't seem particularly helpful/constructive to me. Your personal views about MH professionals are pretty irrelevant here as the OP is in a situation where she is already involved with them and aware that the best way forward is engaging. Calling the place a hellhole when you actually have no idea what it's like is not constructive for someone who is currently admitting difficulties with accepting being there for at least 6 more months.
That sounds incredibly frustrating. I know when I was on acute type units, I hated when I was told to engage more and whatnot. It's really hard when perhaps you don't communicate that way. But it does sound like a good idea to keep doing groups, as that is typically seen as engagement.
Also, could you clarify that even though you have urges, you don't feel you will actually act on them? I think self harm is so engrained once you've done it a while that urges will last a long time, much longer than you need to be hospitalized. I still have thoughts when stressed (and hospital is very stressful for you id imagine), and it's been years since I self harmed and I never did it to a dangerous extent. It seems strange they'd expect those thoughts to disappear with you that fast.
I do know sometimes professionals seem to misunderstand the difference between thoughts/urges and actual intent to harm yourself. Probably because they haven't usually experienced it and so equate urges with really considering it. Perhaps you could see if that needs clarified since you feel in control of the urges? Anyway, you are handling this much better than I ever could. Like said, try to focus on the present. Since you are allowed music, tv, etc, try to distract yourself and just take it a day at a time. Maybe find some good books to help distract you from the fact you don't want to be there as long as you may be. Worrying about the future when you can't control it will just make you miserable.
Stereotypes are the epitome of human laziness.
- me
I try to get the most I can out of groups. I like 'wellbeing' as it's not therapy related it's just different health topics each week. Assertiveness has possibly helped me. I've gone from being passive to aggressive. Although I think they want you to become assertive. The whole DBT programme hasn't really been helpful so far.
I had ward round last week and even the professionals were unsure how to help me further. It seems like we are stuck. I don't trust them and I don't think they trust me. There has definitely been a breakdown in the relationship with staff. I don't see it being resolved.
When I leave here I want to live with my Dad and brother. I've tried supported housing in the past and it hasn't worked out. However, this is another problem as the consultant is saying no to returning home.
When life gets you down do you know what you've gotta do?
Yes I have high SH urges and suicidal urges but I can control it. If I were to do it, it would be well planned IYKWIM. I keep repeating to them that people in the community live with urges to SH/commit suicide, these thoughts aren't just going to go away in a year of therapy.
When life gets you down do you know what you've gotta do?
