To be beyond frustrated my MH trust told me I’m too complex?

[Sillyquestion123]

I had my assessment call today, and the lady albeit very nice and understanding told me that they spontaneously be able to help as the talking therapies within my trust don’t deal with complex trauma.

As I’m also not currently depressed nor anxious, and only get symptoms when triggered I’m no way a priority.

Ive already contacted Mind which were nice, and NAPAC who were super helpful.

apparently the next step is my GP to ask to be referred to a psychiatrist.

I've only heard about his via the charities.

So AIBU for feeling so let down by my local trust?

Thank you for your kind words.

yes I had a very shitty life/past. However my current life is a happy fulfilling life. Sure many people won’t “get” me but I don’t live my life in order to please others or even fit in. I don’t get triggered that often, and even then I don’t have panic attacks it’s more like start crying or maybe I get caught in my own thoughts for some time, but it all goes away.

the flashbacks, I feel there’s only one very particular trigger, and again it rarely happens. The fact of it is that it doesn’t affect my day to day life, only when my mum is around but I feel like cutting off my mum is a bit too extreme.

my mother failed to protect me but she also wasn’t equipped with the best tools either. Even today you should see her face when I told her about my suspected autism, it looked like someone had died.

back to the therapist…. She’s a clinical
psychologist and she knew everything but she really failed to untangle what could be trauma vs neurodivergence.

the lack of attachment, the vivid imagination, etc….

and she really focused on what my father did.

the most helpful thing she ever said was that what we’ve been through was a tsunami and the end goal was to turn it into sea foam.

I think that looking to disentangle the causes of symptoms on such a fine grain level might actually be an impossible task for any clinician as most things have complex multiple interacting causes. You would be very lucky to find someone who could both diagnose autism and do say EMDR. That’s going to be a rare skill set I think.

I agree with your DH that, as you do seem to have had quite a lot of focus on trauma stuff already, you might be best off to get a private autism assessment and get that question answered and that would then inform any future formulation and therapy.

I thought everyone knew the NHS word for ‘go away’ = complex.

Old person they’re keeping breathing-at-most but refuse to look after = complex

Sick person who doesn’t fit into ticklist as impertinently human = complex

Disease not covered on Google = complex.

Have you heard of integrated family systems/parts work? Might be worth looking in to. There’s a book - No Bad Parts, by Richard Schwartz.

It does sound confusing for you - you know something happened but you can’t work out what. It has an effect on you but not to a disabling degree. I wonder what you wish to gain by doing the therapy? Is it knowledge? A better relationship with your mom? More peace in your heart? One of the things I was asked first in my PTSD therapy was “what’s the end goal here? What does your life look like when we are finished with the therapy”?

It’s a good question. Often the end is where we start from…

I’m sorry that you could not get treatment on the NHS but I hope you might be able to see it not as you being undeserving but as the NHS not having the resources to fund the right services for everyone.

It’s not just therapy. There are other good effective treatments in mental health like TMS or esketamine for depression that the NHS doesn’t offer for no other reason than that they can’t afford it and people are having to go private.

I imagine it is the same in other fields that there are people who could benefit from treatments that are not funded.

It’s not you personally being rejected or seen as undeserving it’s that the right service doesn’t cost because it has not been funded. Long term 1:1 psychotherapy will always be an expensive thing and that’s really the only reason the NHS barely offers it.

I also agree with this. From a patient perspective, it wasn’t until I was medicated and educated and understood my ADHD better that I got clarity on my PTSD and which was which. Without that, I don’t think my EMDR would have been successful.

It’s mostly my kids TBH sure I’ve already messed up to a degree with my eldest. (Like with my sister I struggled to have any feelings for her, and I still don’t like it when she hugs me in particular ways) but I do TRY my best and I think we have a much healthier relationship.

My 6yo on the other hand is a complete blank slate, and I want to protect him as much as I can.

ive done the opposite of my family and basically my family beyond my mother doesn’t exist to him. But is that the correct choice? Thank goodness I did t have the attachment issues that I had with my daughter, however hearing children crying still puts me on edge and borderline paralysing.

That’s a pretty big assumption - I’ve worked in MH for several years and rarely see GPs complete the assessment - it varies by area and GP

You’re right, it is an assumption. Just going by my experience as a patient and staff (two bordering trusts), but might be different in others. My bad!

Find yourself a proper psychiatrist (doctor with medical degree then years specialist training)

Problem is early trauma and neurodivergent have massive crossover and can be almost impossible to unpick

Speaking of neuro divergence.

It is more common than you think for people with neuro divergence to struggle with making phonecalls and speaking on the phone. Particularly autism and this is recognised.

People who are neuro divergence have much higher rates of mental health problems.

So a trust having a service where they will only do initial assessments by phone is discriminatory and absolutely insane as it means a key group can't access services.

The fact that mental health services don't recognise this cross over is appalling.

That is very true. I also found a published scientific paper that linked intergenerational trauma with neurodivergence.

i think in my case my suspected autism actually helped me cope but obviously then made me very one of a kind which is not bad per se, but many people definitely don’t get me

You sound similar to me in so far as I am in my fifties and have had CPTSD from childhood due to it being scary, chaotic, abusive and terrifying.

I'm getting schema therapy on the NHS which sounds really good for me. It's about changing maladaptive coping mechanisms and being reparented.

Can I ask what type of therapy you got?

Also what do you mean by 'an episode' and what help do you get when it happens. Hope it's not too intrusive to ask that?

The problem with MH is that talking therapies are actually not very effective, and in many cases little better than having a vent (very expensively). Very few people have had a couple of courses of therapy then felt consistently at least 80% better. People with this level of MH seem to have it as an ongoing issue pretty much for life, with various therapies and meds and diagnoses and burnouts along the way.

I think mental health has exploded in terms of the number of diagnoses and profiles recognised in the last 15 years, and it makes sense that psychiatry is rushing to catch up in finding out how to actually help people.

I’m in the category above btw. I had some NHS treatment but managed to find a space in my head to live in where I manage, and now I just live in it. Is there anything that helps?

I found this clinic: https://www.berkeleypsychiatrists.co.uk/fees?_gl=119keakb_upMQ..gs*MQ..&gclid=CjwKCAjw-3GBhAYEiwAjh9fUJ00xsIxUXjfmKt-8wA1xKVmp4EdNghVYPIJ5Fp6e5iiXfBE9gqRkhoCfpEQAvD_BwE&gbraid=0AAAAABH4K-3awg2_5WQ8kC9pJlYl-JNDi

has anybody heard about them? A psychiatric assessment is around £1k (which is fine) but at the same time seem very commercial/for profit

That seems incredibly expensive for a private psych assessment.

Look at Psych UK (they also work with the NHS, so if you wanted autism assessment you might be able to do it through their right to choose scheme).

psychiatry-uk.com/fees/

psychiatry-uk.com/right-to-choose-asd/

Mmmm I would have to get it transferred. Is that even possible?

I do have the paper work that says I’ve passed the initial “checks” .

That’s a question for your GP, no harm in asking! It’s a very good service.

I just started listening to this as an audio book (the Richard Schwartz one) but ultimately- and I think that’s where I don’t really fit into a box….

I don’t have low self esteem, never had. I’ve never felt worthless or not good enough. If anything it’s quite the opposite I’m super awesome and I’m my biggest fan.

to many I might even have delusions of grandeur.

Ultimately, I think this it was has helped to not have depression , but as with anything it’s a double edged sword.

See what you think when you’ve finished it. It’s really interesting concept/theory/method, that can help us to connect with traumatised “parts” of ourselves that are buried, or protected by other parts. It could help you to understand the trauma. It’s hard with autism though, I imagine, if one of your traits is that you take stuff quite literally? Parts work might be a tough way to work in that case, I don’t know?

yes, that’s one of my struggles. Not necessarily in that I take things uber literally, but that I seek accuracy above it all.

so for example, since he started talking about the “worthlessness” knowing that it doesn’t apply to me, started to make me feel very irritated. Then he moved to something about the “feeling anxious” and feeling embarrassed and that sort of thing. But again, I genuinely don’t have a lot of leftover weight from the many years of being bullied.

for example the anger side of things, I’m pretty certain was more from copying the patterns around me than than a way to protect myself.

In many ways I feel like I’m almost “cured”?

Yes I suffered a lot, but I’m not suffering any more. I’ve chosen to break from the past and divorce it, thus re-inventing myself.

I’m also extremely impatient, which doesn’t help.

I don’t even know if I’m making sense anymore!

local mind were somewhat unhelpful, but it’s ok I think I potentially misunderstood what they can do for me