Kath, well done for writing the letter. I hope it all goes ok. I am sorry for not spotting this sooner.
PM me if you want a PDF copy of the ICD-10or the Mental Health Act 1983/2007. I ALSO HAVE THE DSM-V BOOK and am a pharmacology student.
I have a visual impairment / neurological problems so I need people to type in clear text and no funny fonts. Also excuse any typos, my vision blocks things out.
I have autism and have problems communicating, PMs included.
Just becasue I type well doesn't mean I speak well. I am only part time verbal.
I know earlier i posted the start of the letter to the Psychologist.But it has changed since then and also grown.So i will post the copy i actually gave him [edited for identity and RYL purposes] below.It is long though.So dont worry about reading! i thought about deleting the bit i put up earlier and just having this version up but i decided that might make the thread look strange so will leave it for now but this is really the proper version.
Dear Dr R
I hope that you do not mind me writing this for you today.
I know that I need to talk too but sometimes I find this difficult if not impossible with some of my situation [talking sometimes makes things seem too real, too painful and i cant come to terms with things which have happened/ive done so talking can be hard but i know i need to try]and especially hard at first so thought I would write too and I hope that this is ok.
Thank you for your phone call. I am sorry that I couldn’t manage to speak to you. I suffer from chronic anxiety and speaking on the phone is one of the things I really struggle with sometimes.
My situation is complex and I don’t know how much we will get through today but will try and explain as much here as possible at least.
I am 26 years old and live alone in [insert area].
I am also physically disabled but like to be as independent as possible.
i work part time in admin and love my job and it has been very very good for me even if sometimes I do struggle with it due to the current state of my physical health.
I have only in recent months started having contact with my family again who live elsewhere in the UK after I fled when I was younger quite a few years ago.
I am just slowly getting to know them as people again and realise I have a lot of making up to do especially for the time that I have not been there.
I blame myself that I have been away so long but I was too scared to go back.
I currently have a CPN from [insert name of clinic] who sees me around once every two to three weeks.
It appears it may be every three weeks right now as she is only just back part time after being off sick since October.
During that time I was only seen once by a different CPN.
I didn’t feel able to ask for more help that I needed during that time.
My CPN is good with me but I am now looking at the possibility of supplementing her support.
She knows about my situation and is aware that I may look at this.
The CMHT do not currently have me on medication cos of the level of risk to myself.
I was on various medications several years ago but none of them significantly helped and only a couple helped a very tiny bit with my anxiety/sleep problems but not much at all even when I was taking them correctly for long periods of time.
One of my main difficulties currently is that I often feel very low and over recent years I have been overdosing daily.
I am currently taking between around ** to *** a day.
When I started doing this five or six years ago I started with lower amounts with around ** tablets a day as a minimum.
And I was only taking one lot of tablets. So I was not taking quite so many as I am now regarding number of pills or the three different types within the same medication group I take now [though one of them is not taken daily but just added every now and then.]
The amounts I take daily vary.
And on average have grown over time though as I say the daily range falls somewhere between ** to *** plus tablets a day which has been the case for a while now.
Just with an increasing average over time I guess if you see what I mean!
Some days I might take ** and others I might take ***.
It really does vary quite a bit if you see what I mean but in general the overall amount has probably increased over time.
Sorry I guess im not explaining this very well!
I guess I started doing this years back because I had attempted suicide by overdosing in the normal way on various medications on various occasions and was frustrated that I had failed.
I thought that this way was slower but that at least I would get there eventually.
But by eventually I meant a few weeks at the most not years.
I guess I also felt that I need punishing before I die and it felt that this way that would happen too.
I had to be punished before I died.
I also had/still sometimes have strong images of my head of my funeral and nobody being there.
And this symbolises to me my lack of worth and drives me on to take more tablets.
Especially if I get them during the night which is often the worst time for me as I cant sleep and so start thinking and getting more anxious and worried about things and sometimes also end up looking at stuff on the internet related to dying/suicide or communicating with others online with similar problems.
I often take most of the tablets during the nights too.
I guess at some point that you are going to ask why am I here seeing you today if this is my situation?
And I think that this is a good question.
I still don’t feel able to fully commit to life right now – that is a step above where I am.
This is a place where I am still trying to reach.
I was hoping to be able to fully commit to life and staying alive before looking at the possibility of looking at getting any additional support to supplement my CPN but I now feel that maybe for me to have any chance of getting to the place where perhaps I can commit to staying alive I may need some support as I improve my life to try and even get to that stage!
I feel that maybe I need some more support as I am looking at trying to sort out my life so that maybe in the future I can get to a point where I want to remain literally physically alive and literally not physically kill myself if you see what I mean!
This seems like it has to be the main aim for me now.
I don’t know if I will succeed in it but I need to get to a point where I want to be physically alive.
And be able to continue that way and see a future.
I tried just stopping the tablets but I couldn’t do it and me putting pressure on myself or others doing so just seemed to make the problem worse and I think me and my CPN have now realised that perhaps I have to focus on sorting out other areas of my life first so I really want to be alive and then maybe things with the tablets and the suicidality will fall into place too.
And I guess this is another reason why I am seeing you.
It is quite daunting but to try and focus and explore more the psychological issues and reasons behind all that is happening for me.
Also I find it hard to stop cos my mind keeps making me think that I have to take the tablets at the times when I do manage to try and resist or something will happen to people I care about.
Though I also feel at other times regardless of the tablets that I have to touch something a certain number of times so I will be safe and I wont be physically hurt or that others I know and care about wont be physically hurt/killed.
And then I always worry I didn’t do the thing right or touch the table or whatever the right number of times and it might still happen and then I have to do it again.
I know that all of this is really stupid but it really does effect and scare me so much.
Also I am aware that I could have choosen to see a counsellor and not you as a Psychologist!
However I have had counsellors before [and some good experiences, some not so good and a bit difficult] though never seen a Psychologist really.
I am aware that obviously counselling is very much also part of your role probably but although im not very good with these things im also guessing that as a Psychologist you have probably had more training than someone who ‘only’ counsels and I also wanted to make sure I got someone who could cope with the complexity of my situation and would be well placed to deal with it given the work they have also undertaken previously and the environment they usually work in.
I had been waiting since last May to see the GP counselling service at my local NHS surgery.
This was at the suggestion of my CPN as she felt it would be suitable as a supplement to the support she is providing as I had been really struggling.
However after nine months of waiting [the counselling service say they didn’t receive the original referral from the GP even though I even chased this on two occasions and the surgery confirmed it had been sent/received!] this service then rejected the referral.
My CPN has now also put me on a waiting list for a Psychologist from the NHS mental health team.
However I am told this will take at least 18 months.
My CPN has already said she is not able to see me more frequently at this time though and due to the fact that I am still not sure I want to be physically alive and still might die I don’t feel able to ask more about this or push the NHS for more support.
i feel that I do not deserve it if I cant even say im gonna be/stay alive.
I shouldn’t be entitled to it if im not sure im gonna live.
My physical health is also deteroiating.
I am feeling/being sick a bit more often cos of the tablets.
Recently I have also started on a few occasions to be sick over myself when I am literally trying to swallow the tablets down.
It is like my body cannot take anymore and I am very weak.
I stop mid sentence often and just cant remember what im gonna say or what someone had literally just said to me.
I also think that maybe I am beginning to lose my memory in general and also my dignity cos of other things.
There are other effects but I wont go into too much now as I know this is getting quite long and also you are probably getting bored!
I feel I am also probably very disorientated and that my mind is also probably very muddled due to what has happened to me.
However I don’t feel able to accept physical treatment for any of these effects unless/until I can feel better emotionally.
I used to be able to accept blood tests/physical treatment for things I had done to myself years ago and even at a push when I first started taking the tablets in overdose daily four or five years ago but now I cant anymore.
i just cant do it.
The more suicidal I have become the harder that has become too.
But my being unable to accept physical treatment is also another reason I don’t feel able to go to/push the NHS for more emotional support.
Again I feel I should not be entitled to it unless I can accept the physical treatment too for what I have done to myself and I cannot.
Dr R I do not know how much I have spent on the tablets in the years I have been doing this but it must very very literally be well over a few thousand and certainly enough to get me into debt at times.
The amount I have spent on tablets and my need to kill myself are both things amongst many others that make me feel like I am/have been a bad person and I am struggling to come to terms with all I have done.
It sounds odd when I say that the thing in my flat I have ever spent most money on is the collection of tablet boxes which are now empty and were once full all left around in bags and boxes and hidden away.
I keep the boxes cos for me they symbolise my truth and the truth of my reality for me and have also given me a kind of physical visual symbol for my pain too.
All of them and the mess and heap that they are if they are put out on the floor together then its like they become my pain all put out when they are ever all tipped out into the floor.
Its like they are a symbol of my inner pain.
And cos it is physically there and I can see it and touch it it means I can get to know it and hold it and know what im working with rather than having this pain but not having anything physical I can grasp onto to say that’s it cos its on the inside not the outside.
The pile is so big and messy and jagged and overwhelming.
Im sorry if none of this makes sense.
But I realise I must have empty tablet boxes in my home for at least ***** tablets right now.
And that’s only for much of the past two or three years.
It doesn’t include the empty boxes for another ***** I had to get rid of previously a few years ago before that [which I found rather difficult to do discreetly etc] or anything else before that/which I hadn’t managed to count.
Most of the tablets I try to get in bulk these days and buy quite a bit online.
I buy quite a bit from vet companies as animals can have some of the medications I overdose on also I guess.
A lot of them have also come from abroad.
I always used to say to myself and feel like anyway that I didn’t care where or whom I got the tablets from anymore [and I guess I didn’t/don’t cos a lot of the individuals or companies I buy tablets from when I do get them online etc I don’t really know who they are] but a little while ago I realised how bad my situation has got and that I had got to the point where I really do mean just that.
Some tablets arrived from some people/company from abroad who were a vet company and I know id said to myself I didn’t really care who/where they came from anymore but I wasn’t expecting what happened next.
I opened the package and inside was a container with the tablets inside.
But it was so so dirty inside where the tablets were too.
i Inow it was a vet company but it looked and smelt like it had come straight out from the farmers barn!
But I still felt the need to take them and still did so without any thought and I know it makes me a bad person but I think if im really honest I know id do the same again.
Also I wont lie cos I know taking the tablets has also probably become a bit of a physical addiction/dependence for me over the years but I think that mainly my difficulty is probably mostly emotional.
You see I need the tablets because I need the hope of my death.
They also symbolise that to me.
Hope of my death and I must be such such a bad person.
Dr R I also feel that a major part of what is perhaps not helping me to get better at the moment is that I cant come to terms with what I have done, am doing with the tablets, that I have been/am trying to kill myself, how I have acted to others in the past few years and also what I have done to my life and the effects I have no doubt had on my family with my absence after I fled years ago.
I feel like such a bad person for all of this and I cant come to terms with it.
I also feel during the time I have been taking the tablets I have lost my ability to live life and to know what to do and also how to interact and socialise etc with others anymore.
i don’t know even very basic things.
i feel I have lost all of that and I am scared.
Also though obviously I left for different reasons and was not taking the tablets at that time they know obviously something is not right now either since the time I got back in contact but they do not know my current situation with the tablets and my mental health/health.
I am also not the person I used to be.
And I cannot live with the person I have become and now am.
I cannot live with who I am and what I have done.
I also often feel like I am two different people but don’t often see it at the time.
i just switch between the two.
Its like theres one of me whos like the person I am at work and was before – the person who gets on with life and wouldn’t even dream of doing any of what I have and then theres the other person, who I am when I get home and am alone or when I am buying the tablets.
Buying the tablets is supposed to be robotic though and is something to be done without feeling.
Its like I am a person physically walking to the chemist but I have to be brutal to myself and not allow myself to feel.
Taking them is meant to be the same too and sometimes I do manage to do these things now this way without feeling and without even being conscious that I am doing it like this.
It is just an action, just a picture.
Sometimes I also feel like im looking in both on the situation and my own actions and indeed life in general all of it as though it’s a film – im not participating just watching.
Again sometimes it feels like I am there without the abiility to feel or intervene but just as a spectator in life.
I am also ashamed that as my mental health has got worse so also has my ability to look after myself and my home.
I am ashamed of this and it is something else I also worry people would think badly of me for.
And though my CPN has never been to my flat she tries to monitor this with me from afar I guess also.
I also used to scratch/cut myself a bit quite some years back but I stopped that quite a while back now and though still feel tempted sometimes I have not gone back to it so I guess at least that has to be a positive!
I know that I have given you a lot to read and I am very sorry.
Thank you for taking the time to see me.
I just often feel so alone but maybe in my situation that’s how I deserve to be.
i do not always manage to be around but i wish you all the very best - love and luck to you all!
So i went to the appointment and im very tired and worried about what to do now but the Psychologist has said a number of things.
1. He is willing to see me [however given monetary constraints on my part cos i paid A LOT to see him - and you guys would think im stupid if you knew how much - the absolute most i could manage this would be every four to six weeks and i still well might but it already takes me a long time to trust!].
2. He works for a CMHT as well as privately [though NOT covering my area] and he says the NHS should be giving me more support and that i should push for it.
3. He said i should be under the NHS crisis team to stop the possiblity of my ending up in a psychiatric hospital and as an alternative to this.
4. He wonders if the CMHT could give me something like a support worker who could help me go out and about etc and also with my anxiety and around the home.
5. If it was his CMHT i was under and they had suggested the GP counselling service and the GP referred me but then the referral was refused he said that he would be looking at inserting my name further up on the psychology waiting list than just starting now and instead backdating it to when i was first meant to be on the counselling one.
6. He thinks i have obsessive thoughts and am probably also suffering OCD.
i dont know where all this leaves me.i just know im not in a good place but do feel better for talking.i still feel bad/guilty about the amount of money though and spending it to make myself better.i dont deserve that and i also think some would think of me as stupid for what i paid.Maybe i am but i needed/need the help.
i dont know whats gonna happen now, if or when i will go back.id like to.He is very nice and very good with me but also very expensive and as he said maybe the NHS should be doing more and i should be pushing further down this route [think he felt bad about charging me] but i feel so weak and ill right now i dont really feel up to asking for more especially if its gonna be a battle and i dont feel entitled to it as i said in my letter.
And if i pay someone and then die it doesnt matter, it is more acceptable to me than if i take even more help away from other people on the NHS and then die if im not sure i can live right now.
But i do know somehow i really do need something.
He was very kind.i was very embarrassed though cos at the end he walked quite a way up the road with me too in the dark as i am disabled and he was worried about me catching the bus and in the end he found the bus stop and even put me on it!
i really dont know where to go from here.But now probably isnt the time to think about it.im very very exhausted right now.From the past few days and getting ready for the appointment and that.
And i would also like to take this opportunity to thank everyone for all the support that they have shown me the past couple of days.
It really does mean a lot.
Last edited by Sleepless123 : 25-02-2009 at 12:28 AM.
Reason: To add a bit!
i do not always manage to be around but i wish you all the very best - love and luck to you all!
I havnt read all of your posts (sorry) and I assume you've had the appointment. I just want to advise you to not rest all your hopes on this. its great you are taking steps but when I've gone to inital appointments, being highly suicidal and hoping that they could understand and help me, they've often let me down which has left me in a more vulernable state. i wouldn't want that to happen to you, be careful xx
I haven't read all this post in detail but have been following your progress re making a decision re seeing someone privately recently.
You are amazing hun! I would never have had the guts to do this. Maybe you can speak to your GP re some of the things he said especially re extra support to ensure you finally get the support you need.
You are incredible, do NOT forget that!
*hugs*
"Everything is possible through Christ, who gives me strength". Phillipians 4:13
Thanks but im not incredible and i certainly dont feel like it right now!
i dont know about speaking to the GP.
i should speak to someone.
But i still dont feel entitled to ask for more support from the NHS cos of my situation and that i cant accept physical treatment/not sure i can live etc.
Even with this guy telling me tonight who saw me privately but also works for mental health - he told me i was entitled NHS care still even despite these things too but for some reason i just cant see to let myself feel it!
But im gonna have to make myself soon.
Or i fear what will happen.
Thank you for your support.
i do not always manage to be around but i wish you all the very best - love and luck to you all!
I agree with *pixiedust* in that you must have had an exhausting day and should try and get some sleep. If you can't though, please feel free to keep on posting or pm me, although re the latter not sure how long I can hold out hope.
*hugs*
"Everything is possible through Christ, who gives me strength". Phillipians 4:13
that sounds like some very good feedback from the psychologist. i wholeheartedly agree with what he said. is there a way he can assist you with putting into place some of these things, like engaging with the crisis team and backdating your place on the waiting list for longer-term psychology? maybe that could be something to work on if you do decide to see him again. xxx
*hugs* well done for giving him the letter. I hope everything will work out for you.
PM me if you want a PDF copy of the ICD-10or the Mental Health Act 1983/2007. I ALSO HAVE THE DSM-V BOOK and am a pharmacology student.
I have a visual impairment / neurological problems so I need people to type in clear text and no funny fonts. Also excuse any typos, my vision blocks things out.
I have autism and have problems communicating, PMs included.
Just becasue I type well doesn't mean I speak well. I am only part time verbal.
i think the psychologist is right, you could get mroe off the NHS. and the reasons you think you don't deserve it are actually the reasons why you do need it. if you're not strong enough right now, could you ask your CPN to do the pushing for you? it sounds like he said a lot of very sensible things.
Thanks everyone for your kind words, encouragement and support.
i dont see my CPN now until 12 March.
And i am struggling to stay alive.
And aside from that she is off on holiday next week anyway.
Maybe there is more the NHS could offer if i could feel entitled to it.But i dont know.i mean what could they do?My CPN has already said [without me asking] that she would like to see me more often but cant so wouldnt want to pressure her even if i could [and she is already working part time now with a full time case load] and im on the waiting list for an NHS Psychologist.....i just have 18 months to go.
i had to stop the tears coming out of my eyes when i went into work this morning.Not about anything in particular.Just everything.i am really struggling.i think my manager noticed something was wrong or id looked like id been crying with the few tears that had managed to come out a bit before i got in - she asked me twice in the first five minutes how i was today.
This afternoon i havent done much.Some of it i was asleep or whatever.......probably cos of my lack of sleep at other times and also i have been feeling so emtionally and physically drained recently.Also maybe partly to do with the high amounts of medication ive had recently too i guess.
Oh well at least i dont feel the pain when im asleep.
Also to answer peoples questions from earlier the Psychologist suggested these things and asked if my CMHT had full details of my situation but did not offer to speak to them for me.And i wouldnt want to have to ask him to do that.One i would have to feel i was entitled to the support first and two i wouldnt want him to feel he had to do something that he didnt want to/didnt feel comfortable with.
i saw him privately but he works for another CMHT in the area im in [not the one im under] and i guess he might feel like he shouldnt tell them how to run their team or whatever even though he has suggested to me what might be helpful.i also worry that he may think its my responsiblity etc to ask them about his suggestions.
i am worried that he would say no.
Last edited by Sleepless123 : 25-02-2009 at 10:15 PM.
Reason: To add a bit!
i do not always manage to be around but i wish you all the very best - love and luck to you all!
i'm sure doing some work with the psychologist would help in building up your confidence to speak to your CMHT. he could perhaps practice with you and help you develop some strategies in order to get what you need. that's a good thing about psychology - two minds being better than one.
Quote:
Maybe there is more the NHS could offer if i could feel entitled to it.But i dont know.i mean what could they do?
i'm not sure, but in my area they have things like:
crisis team/HTT
community support workers
supported housing
day hospital
inpatient ward
MIND
women's counselling service (a voluntary service)
they're what i can think of off the top of my head.
obviously it will be different in your area but there should be some variations of the same thing. some are NHS, some voluntary, some social services. i wonder if there would be a way that you could become more aware of what's available in your area.
this is a stab in the dark, i don't know if you live near Leeds, but Leeds have a big counselling service that works on a sliding scale - something like £10 an hour. if you don't live near Leeds, maybe there's something similar where you are.
there is hope... i hope you find it. *big hugs*. xxx
