I find myself in a dilemma.
I have spent the past 15 years engaging in ‘recovery’. I have spent the last six years (or thereabouts) shouting about how utterly grateful I am to the services that ‘saved’ me. I have worked hard to come off benefits and pay my way. From being the most difficult patient, I have become the poster girl for the recovered individual. I have been an (unpaid) service user facilitator in a DBT group, I have a chapter in a book edited by a renowned clinical psychologist and I have delivered motivational talks to groups of professionals. The dilemma I find myself in is that I no longer believe what I have said. My dilemma is further exacerbated by the fact I work in mental health services.
I would not be writing this if my internal self was congruent with my apparent external state. I keep thinking, ‘well, I am in a much better position than I was 10, 7, 4 years ago’, and this is true to a point. I am not attending A&E every weekend; I am not getting myself so drunk, I wake up two days later; my financial situation is much more stable. I have been able to maintain a relationship to the point of marriage, and I am able to interact with others in a socially acceptable way. In all of that, however, I do not state I actually feel better.
I imagine I must feel better because I am not doing the things I used to do…although I am. Recently, my spouse went away for a few weeks and I was left to my own devices. I took a ton of codeine (not to harm myself, just to get off my head, to feel better), I drank a fair bit (a litre of whiskey in one sitting), and I self-harmed (pretty fucking badly in all fairness). Not having work to go to and actually still being as isolated as I was 10 years made brought home the stark reality of my existence. All I have done is supress how I feel, ignore my experiences and distract from reality. With work removed, I am scrabbling around, afraid of myself and wondering what the fuck is it all about?
I thought I wanted to be a clinical psychologist, but it turns many of them are narcissistic, egotistical, elitist sociopaths. Furthermore, the selection process for the clinical psychology training is based on many things, a key one having the ability to interpret statistical data. I’ve met too many clinical psychologists who are excellent with graphs yet not so skilled with people. As long as I adhere to their way of thinking, then I am doing just dandy. Any deviation from their thought processes, then we are being difficult, wilful, and defensive. Their toxicity is disguised, however, as they talk about trauma as opposed to personality disorders (which isn’t a bad thing, as at least experiences are being somewhat acknowledged). What further happens is that the good ones think, ‘fuck this shit’, and they leave. Whilst I’m definitely not a clinical psychologist, I’m at that point of wanting to leave. Everything I thought I wanted has fell around me, and I realise that recovery is but a concept coined by the professionals who have no peripheral vision.
As someone who grew up in the care system, what am I trying to recover? I was sexually, physically, and emotionally abused. I did not see my biological mother for over 20 years. My child was removed from my care. I have struggled, but been made to feel guilt and shame for my responses. I was instructed to hide old self-harm scars during DBT. We were not allowed to talk about self-harm within group, because of the risk of glorifying or romanticising it. I have been indoctrinated just as much as the people from my childhood indoctrinated me.
I work as a mental health care support worker. Some of the people I work with are genuinely nice people, but I see their limitations created by the system. Terms such as, ‘it’s personality’, ‘they’re med seeking’, and ‘they’re a nightmare’ are bandied around without thought or reflection. How offensive is it to term someone’s personality as disordered following a whole heap of childhood trauma? Why are we ok to dispense diazepam when ‘patients’ are not asking for it, but when they request it for the same problem, we no longer see it as a beneficial? What makes someone a nightmare?
What I am left with is a fear of someone finding out about me and my ‘stuff’. I work in an office with a whole bunch of mental health ‘professionals’, yet I am terrified they will find out my secret. This fear comes from the stigma I have witnessed and been subject to throughout both my non-working and working life. I was stigmatised as a service user with a diagnoses of BPD, and I am unwittingly stigmatised within my profession. There are mental health nurses who quite happily state that people with mental health difficulties CAN NOT work in mental health. When asked what recovered, ex-service users can do, they cannot answer, just that we shouldn’t be working in mental health.
Why can’t I find someone to talk to, without them trying to fix me? Why can’t I say, ‘you know, I feel shit, and there’s a good chance I will always feel shit given my start in life, but I accept that. I might self-harm from time to time, as safely as possible, I might engage in some other behaviours, but I am not asking anyone to patch me up. I’ll do that myself. I just want space to talk about it’? Why is this not acceptable? Why am I not accepted as I am, cuts and all? Why do professionals only care if you are ‘engaging’? Engaging in what? I have done everything asked and expected of me, and more. I’m lonelier than ever because I have been trained to put up and shut up.
The mental health sector does not believe in the recovery they try and push, but they do not recognise this. If difficult, PD, nightmare patients cannot recover or work in mental health, what are the mental health service doing with their service users? What are they working towards? There is such a blatant, screaming irony in the system, yet most are blind to it. I see people who have started out with good intentions, but they quickly get swallowed by the toxicity around them. At least two thirds of the employees talk about how they won’t come out of the NHS because of the bloody pension. Right now, I feel trapped by the money, and hate myself for it. I do not want to be that person. I have been that person, in the past, screaming at professionals that they are simply ‘doing it for the money’. That’s me, right now, in this moment in time, doing my job for the money. I care about the people I work with, but that care is overshadowed by the misery of what I am witnessing. I am at the bottom of the pile, sneered at for being a band 3 HCSW (I am asked ‘why don’t you go and do your nursing?’ at least twice a week). The hierarchy is real, and damaging, and people are made to feel shame.
I am in a quandary, a place of unease. I need to live, survive, so I need my wage. For a few years, I believed that people were not doing ‘this’ for the money, but we are. When our motivator is money, what have we become? Our priority is us, not the people accessing the service. It’s not a bad thing to want a wage, to have the right to earn a living. It’s certainly not a good thing, however, when the wellbeing of others is dependent on the wage being offered. Every day in work, I hear judgement and disdain, frustration and contempt for both users of the service and for the system as a whole, yet people continue to work in the same environment for many years. I am not the only one who hates their situation, but I see few, if any, doing something about it. Those in-office attitudes should remind us of how the system is run, and who is running it – a group of unhappy individuals, entrusted with the care and treatment of unwell individuals.
Mental health services need a complete reform, yet I do not see that happening any time soon. The good ones leave, the weak ones follow the crowd, and the leaders bully and intimidate. Stigma remains rife and continues to grow, and treatment is based on the egotistical needs of the practitioner. Where therapists have told me, ‘it’s not your fault’, they have instilled a deep shame within me regarding my reactions. My words are out there, on paper, as the model patient, and I cannot undo that. I was so desperately trying to please, that childlike need in me still searching for a mother, and professionals have either been blind or willing to take advantage of it. I’m trapped, and I am afraid of becoming ‘one of them’.
About the Author: I would like to be able to be transparent with who I am, but it is difficult to do so right now; Because of the institutional nature of current services – once in, you cannot have a voice, or as a service user, you don’t have a voice unless it is tokenistic. I hope to be able to come out of the NHS safely and be more open about my experiences.