"I want to extend my deepest apologies to anyone and everyone that has ever been on the receiving end of poor attitudes. It’s not your fault. I do believe you. You are worth it. For a while there, I got swept away, purely because it was the only way to survive in the establishment."
I’m Jaded.
Whilst we had the name of our blog, we had to decide who would be Jaded and who would be Shaded. It took all of 2.5 seconds to decide this, as we were both on the same page. I am so tired of the systems – my experience of them as a service user, and my experience as a professional. My dream of becoming a clinical psychologist was cut short within three months of commencing in the NHS as a mental health support worker. It would take me another 21 months to openly acknowledge this and leave the misery of my job.
I’m not entirely sure what made me think going into that type of profession would be something I would enjoy. I have had very few positive experiences of different systems as a service user. All of my observations, worries, and concerns as a service user would simply be solidified within the first week of my role as a professional.
As a survivor of the UK care system, CAMHS, and adult mental health systems, I have much to say. The very idea that I identify as a survivor of these systems, as opposed to recovered or simply discharged, speaks volumes. What I have to say, however, has been metaphorically beaten out of me. Much like the individuals that abused me, systems have drilled into me that I am wrong, I am a time waster, I am not important, and no-one will listen. How is it that the very people charged to help – whether as an adult or a child – do in fact repeat the cycles of abuse?
Whilst there are many problems with current mental health approaches in the UK, the one that has felt like the biggest injustice is that I could never possibly be ‘right’ when challenging the professional. With a label of Borderline Personality Disorder (BPD) (now fondly known as Emotionally Unstable Personality Disorder (EUPD)), I was always going to be viewed as difficult, argumentative, manipulative and a general nuisance. That I would automatically be viewed this way would mean the practitioner delivering any intervention with me could never learn from me.
I am not without fault. I have the BPD label for a reason, and there was a time where I fit all of the diagnostic criteria as set out by the DSM. That doesn’t mean I actually had or have ‘BPD’ – it means a collective have decided that my responses to the trauma I experienced should be labelled as a disordered personality, as opposed to a normal response to abnormal circumstances.
I once suggested this to a clinical psychologist, and she was able to silence me with her reply: it’s those responses that are the problem. I agreed with her then, and I agree with her now. Knowing her how I do, and reflecting upon this experience, I suspect she had similar thinking to me, but wouldn’t voice it, for whatever reason. Another issue in the system – ‘professionals’ will not be transparent.
I have been Hard Work to be around; I should know, I live with me. However, rather than being ‘recovered’, as is the ultimate goal for the professional delivering the intervention, I am burnt out. Burnt out from myself, and burnt out from the systems. This will be welcome news for many mental health workers – one less PD to contend with. I ask you to re-read my words, however – I am not recovered. I am tired. Yesterday, my spouse squeezed a shampoo bottle, and it sounded like an alarm. I violently startled, froze, then dissociated. It was a shampoo bottle. I am far from recovered.
I have received a lot of therapy, and there was a time where I wholeheartedly appreciated this. Without asking to go onto a waiting list, I once received a letter ordering me to therapy. I laugh at this now, with a lingering sense of misplaced pride: I was the best at being crazy. Try not to roll your eyes at that; I can do that for all of us. What I would ask is for you, the reader, to consider what may have led me to that point, the point of wanting to be the ‘craziest’. I have had enough trauma to be validated, without needing to go out of my way to ensure you see my hurt. I sit and reflect, wondering if it has merely been a feeling of invalidation, as opposed to actually experiencing it. I go with the latter – the professions have all invalidated me, turning the guilt, shame, and actions of others onto me. Whilst I am to be held accountable for my responses, I am also to ‘move on’ and ‘respond differently’. Those who have hurt me are not being held accountable, and not only does that hurt, the injustice sits there like an open and festering wound.
I have self-harmed four or five times in the last 12 months; I sought treatment once. I have technically overdosed on paracetamol; I have been so desperate to be in a different state, I would swallow up to 20 co-codamol at a time. I have not sought help. When I had to go for a blood test, I ensured to have milk thistle and avoid the co-codamol for the week running up to my blood test, because I don’t want people finding out. Had I sought help for any of those incidents, I would have been labelled further. For not seeking help, I am making a choice for I have capacity. The obvious answer is to not self-harm and to not overdose. All of the therapy thrown at me, however, has done nothing but shut me up. I am still in pain.
When I sought treatment for a burn, it was on the back of my spouse threatening to call an ambulance. I feel I have to tell you this in order to justify myself – this is what the system has done to me. I am not worthy of treatment. I attended an A&E department in a different trust, as I worked in our local trust. To give credit where it is due, the nurses were fantastic with me. I suspect it was as I was a first-time presentation to them; there was another person in with a suspected overdose, who was a regular – I heard them talking about her, how she wanted attention, how she would be, ‘back in next week’. You know, it’s fine to have these thoughts – can you talk quietly amongst yourselves, however? Can you not let the traumatised individual, and every other patient, hear you?
The burn took around four months to heal. Minor injuries saw me for the first two weeks, then told me to attend my doctors surgery. I left it a week or so because I was anxious – I’m wasting their time. My spouse asked me to go; my arm was sore and itchy, and badly infected it would turn out. Initial contact with the nurse was as expected – she was short, rude, and abrupt with me. I snapped at her, informed her I was happy to go away. When she saw the injury, she softened. That’s not ok, though – just be nice to your fucking patients. It was reminiscent of a minor injuries visit last year, due to a dental abscess. 111 (an out of hours non-emergency health phone service in the UK) informed me I could attend my local minor injuries for antibiotics. After much internal anguish, and encouragement from my spouse, I plucked up the courage to go. I arrived, and the attitude was shit – I shouldn’t have been sent there, they’re not a dental surgery, what did I expect? Why do they do this? If you have a problem with the advice I have been given, take it up with the people giving the advice, not me.
Upon asking where I worked, and my replying with my role, attitudes changed – ‘oh, you’re one of us!’ Firstly, no, I’m fucking not, ‘one of you’ – I do not treat people based upon a perceived status. That visit culminated in them wanting me to attend another hospital as my face was drooping and my eye was bulging. Would they have demonstrated such concern had I not shared my profession?
These experiences highlight that attitudes in general have been and continue to be poor within systems, and not just to mental health patients. I have spoken of just two experiences – one mental health, one general – and I have received similar attitudes. Why is this? I suspect it’s because the people working in these systems are utterly miserable; miserable of the shit they have to put up with, and not just from patients. Individually, the professionals are typically genuinely nice (with exceptions). Collectively, however, a mob mentality sets in; I know this as I’ve been a part of it. I’ve rolled my eyes and laughed along with the others when a regular service user pops up. I’ve agreed when colleagues have expressed their doubt regarding an account of abuse, an episode of self-harm, or even suicidal ideation. If me, the person who has been on the receiving end of such attitudes can behave in such a way, how can we possibly expect others to not behave that way?
Whilst I went along with and didn’t challenge attitudes and practice, I was utterly miserable within my roles. I didn’t understand why people were the way they were, why they seemed to hate the service users, and why they only cared about their pension. I didn’t understand when I was constantly being told, ‘it’s not our responsibility’ when someone was facing homelessness or struggling with addiction. I didn’t understand how people could be cruel to those who had already experienced a lifetime of hurt. Mostly, I didn’t understand how I could so quickly ‘become one of them’. Much like the nurse I spoke of earlier, I was one of them, for a brief time and I hate myself for it.
Whilst I was never horrible or dismissive directly to the people I worked with, I want to extend my deepest apologises to anyone and everyone that has ever been on the receiving end of poor attitudes. It’s not your fault. I do believe you. You are worth it. For a while there, I got swept away, purely because it was the only way to survive in the establishment.
To the unhappy professional working in the system – I don’t hate you. I know how unhappy you are, with everything. I know you feel trapped by the money, the pension, by the fact you have committed your life to this. I know how hard you worked to get your degree or work your way up to band seven. I know how hard it is to say, ‘I don’t like my job. I feel like I made a mistake in going into this work’. I took me almost two years to acknowledge this out loud. I’m not asking you to leave, or revolt. I’m just letting you know that I understand, and probably many of your colleagues do. Just please, try not to take it out on the patients. Just be kind.
I now work in research and am much happier for it. I research such things as wider system change, government policies, and a number of other things. I work towards the change I so desperately want to be a part of. I honestly believed I could help implement change on the ground, but I couldn’t. I had to come out, for myself and for the patients. Had I stayed, I would have lost my sense of self, my passion, my sense of justice. I would have helped no-one.
And that, my friends, is why I am Jaded.
Wow what a powerful piece and well written - I was a MH mentor in the charity sector and met many an overworked, jaded NHS professional. Some admitted it and looked utterly miserable as they dealt with another incident with a patient they cared about but were too burnt out to really help. I also met jaded but brutal workers who made no attempt to hide their disgust with a recurring client. I also met some of the most wonderful, caring professionals who somehow weathered the storm.But the overall effect of dealing with NHS MH staff on my clients was traumatic.