Last year, I finished group work in mental health services; they used a fairly new approach called Structured Clinical Management (SCM).
SCM is used specifically for people with a diagnosis of Borderline Personality Disorder. It’s effective because of it’s consistent approach from all trained workers.
This approach was a little bit of a shock at first; I found the weekly group work and weekly 1-1 sessions quite ‘useless’. I thought that everything they were teaching us in the group sessions was stuff we already knew; it was ‘just another theory’ within a whole world of theories about emotions/feelings/relationships.
The group consists of 3 modules. Each individual covers all 3 modules twice within the space of a year. It was scary as hell; having to go into another group setting and discuss personal things. At first I sat and said the same things; it’s all good and well telling us this stuff but we are the ones who have to practice the skills, and this is a problem we’ve been tackling out whole lives; why does anybody think that this time will be any different. 10 years in mental health services is a long time. Truth is, I was only doing the group because the alternative was discharge from services and that was not something I could even consider at that time. In my mind, I wouldn’t survive without mental health services. How would I get through each week without seeing somebody where I could offload all my shit, and leave it there in the room.
Most of the time, those close to me saw me as somebody who was coping well with things. I would hardly ever tell them if I was feeling low, or if I wanted to hurt myself because of how much I hated myself, or if I felt my only ‘way out’ from this destructive, sad and depressing life was to kill myself. That part of me was well hidden by my bubbly and confident ‘front’. Hardly anybody ever saw me fall apart at the end of each day when I would get home and close the front door behind me. There were certain places or situations that I felt ‘safe’ in, where I could crumble with somebody there; and that was mental health services. This part of me connected with services more than it did anyone else, and that was the unhealthy aspect of it. I depended on them to help me to contain or hold my emotions. I relied on them to take it away when it got too much. I was disappointed when they couldn’t take it away and was left feeling alone and like nobody cared. That was never true; throughout the last 10 years I have always had people around me who cared for and supported me. But I would put people or services (professionals or inpatients for example) up on some pedestal which in my mind meant they could change how I felt. I’d live week by week thinking “only 2 more days until I see my CPN” and I’d go with an expectation that I’d feel better afterwards. Sometimes I did, by talking things through, but nobody ever ‘changed’ how I felt. Only I did that. Only I could do that.
Anyway, my attachment to mental health services has kept me trapped in the system for way longer than I should have been there. I just wish I’d been able to ‘see’ all this much earlier, rather than repeating the same cycle that ended with an admission to inpatients. At the time I just couldn’t ‘try’ anything new – I was too scared. My fear was that I’d start to feel better and then services would pull back and that part of me that I’d rarely shared with non-professionals would be alone again, then I’d be back at square 1. I didn’t really think anything different could come of it until I started practicing the theory they were teaching us in SCM. It was obvious that I could not assert myself very well, because of my lack of self-confidence. I never confronted things if somebody hurt me by saying/doing something. I’d let my feelings towards those people build up inside me like a pressure cooker. The higher the pressure, the more likely self-harm was. And if I felt I was about to literally explode like a pressure cooker under too much pressure, I’d be feeling like it was the end, I couldn’t handle this pressure and wanted out! So an obvious thing would be to work on asserting myself. I’ve tried and tried with this but my fear of upsetting or hurting others was always too intense. I always subjugated my needs for the sake of other people’s needs.
So, starting off safely, I started to try being more open and honest with my family and close friends. They took it well which makes me lucky; if they’d not reacted well to my sudden change in confidence I could have easily started feeling worse about myself.So I practiced and practiced, standing up for myself when necessary (and in the necessary place/time), I’d explain if somebody had said something that pissed me off or hurt me. And letting out these little irritants as they happened meant the pressure cooker was under a lot less pressure, because the little things weren’t building up. This also meant that when more serious events happened, I had more ‘capacity’ to hold my emotions. I coped much better with things, and, my then-recent relationship with Bex had really helped me. I felt loved for me; I felt safe to show her that side of me that I’d hidden away for so long. Bex was the first (and at one point) only one who regularly saw my highly emotional states. And this helped me to feel safe enough to share more of my “hidden” personality with others. I started to feel ok to say some days if I wasn’t ok, mentally. Not only was I admitting that part of me to others, I was admitting that part of me existed and I was able to reintegrate that “part” of me into the “whole” of me. Instead of being “This part” or “that part” of myself, I just became myself. I gave a little of all aspects of my personality, in the right situations. I accepted my emotions, I learned what works for me when I feel like my pressure cooker is getting a bit full. In the last year there’s been a handful of occasions where I’ve had that feeling that I wanted to hurt myself. But I’ve learned what it is I actually feel at those times, and that’s anger. This is an emotion I have always denied having, felt guilty for having. I realised that we all experience anger, sadness, happiness, excitement and that whatever we felt, it was never wrong or bad. I made myself aware of how anger makes me feel physically, and whenever I feel so angry that I get an urge to hurt myself, I remind myself that my body is starting to react to the intense emotions. Sometimes it just takes a few deeeeeep breaths to calm me down. Other times, I feel safest in my bed. And I always try to tell somebody when I am feeling angry, which usually triggers me to cry, which acts to relieve the pressure cooker! Making sense?? I bet I lost you at the first line!
So, I’m hoping to be back here more often again now. I’ve had a pretty hectic and exhausting few months and things have been difficult. But, despite this, on 1st March 2016 I was exactly 1 year free of self harm. Now over a year free, I believe that the urges to self harm will come and go for the rest of my life when my emotions are very intense. But I also believe I can overcome it by using what I’ve learned so far and by letting those closest to me in more. I’m still learning, and will share what I learn hopefully here, and I’ll learn til the day I die.
I’m lucky. Some aren’t. But nobody deserves to feel such self-hatred, depression and whatever else; not even me!
Never give up the opportunities that life brings your way. Live for now; not the past and not the future. What’s important is that right here and right now, all is well.
I’m so happy to feel happiness again. I had forgotten how good it feels. And I wish everybody nothing but happiness, because we all deserve it!