Argh FFS - crisis team judgement

[elementofsurprise]

Trying not to completely lose it here. Just had ridiculous conversation with woman from the crisis team. She asked what would help, usual script, I said I thought therapy. Had to explain TWICE that primary care IAPT won't see me ('too complex') and secondary care repeated ignore referrals and have asked my GP not to re-refer because I'll only be disappointed.

For 5.5 years I have been trying to access therapy. Since I broke down. I was almost there once, but services kept getting cut and rearranged.

Explained this to her.

Her response was "Well, if you're not willing to try to access the services..."
ARGHHHHHHHH
Explained again, I keep goingto my GP, he keeps referring, they won't see me.

Response: "If you're just going to get annoyed with me..."
FFS! Am I not entitled to sound just a tad frustrated in this situation?

Managed to remain calm and explained yet again, for 5.5 years I have tried to get therapy so am feeling a bit hopeless now. Understandably, I'd have thought. Apparently I should just keep going back to the GP (even though it makes me feel worse and more hopeless cos GP can't do anything.)
Pointed out definition of madness was doing the same thing gain and again but expecting different results.

Feel hopeless and worthless. Want pain to end. Want to be good enough to be treated nicely and loved. (I thought I was but apparently not from how people treat me. Don't want another thread about that though.)

I was brought up to be kind and nurturing to others, to be kind even when it was hard etc. So the reality of the brutal MH system was such a shock.

Sorry, got carried away there.

Anyway, no I can't self-admit - if they won't take me under the care of the CMHT they definitely won't see me as ill enough for hospital. I've only been in once, it was weird, the threatened to section me if I didnt go voluntarily, and I wasn't allowed out for a smoke without a chaperone... yet 3days later they unceremoniously kicked me out without any support in place (they didn't even seem to discharge me properly, just said I was leaving so bye). There was no help and usually no-one to talk to there, so it was a bit pointless being there really.

Mushroom I have had friends try to get involved before, but they are just not up to dealing with the system an don't expect to be lied to so don't respond fast enough. Eg. one time a friend rang up, very concerned - someone who is great at dealing with officialdom usually - and was told not to worry, my CPN would call me ASAP. Thing is, I didn't have a CPN, I wasnt on the books of the CMHT! But my friend did not expect them to lie so blatently, and was successfully fobbed off.

I tried an advocacy service too... sorry im not trying to moan here, was just bitterly disappointed. We went over making a complaint, with a view to trying to get some help finally, and he typed up a letter and sent it to me for approval. Thing is, it was awful. I know that sounds horribly ungrateful, and he was a volunteer, but they'd have torn the letter to shreds. It was pretty much a stream of consciousness of what I'd told him (I had given a fairly accurate timeline of events) but with mistaks added in, and then a bit saying "therefore I feel I havn't been treated appropriatey..." etc at the end. Having tried to complain myself before (aged 20ish) about seriously dodgy and disturbing stuff, and received a reply that basically said "we dont believe you so wont do anything", I knew that this letter was far too wishy-washy to make any impact... except make them annoyed and see me as 'difficult' for complaining. (Oh and they won't see you whilst you have a complaint in either!)

Maybe I was ust unlucky though and another advocate could help? it just seems such a fight and then even if you get taken on they discharge you ASAP anyway...

For the record, I was in a relationship a few years ago and the guy lied to me about everything - his entire identity was a fraud. He also stole money from me. When I discovered this, and ended up in front of the crisis team, the two male members I saw said not to worry "we think the relationship is repairable". That is the kind of gobsmackingly, dangerously incompetent crap I am up against.

Oh also this new GP seems more, erm, dynamic (?) than my usual one. I usually do ok at explaining to the GP, its just further on in the system things get weird.

Because they say stuff that is wrong but sort of floors me and its only later on I can coherently explain why it's wrong - at the time i'm just scrabbling for words and sort of overwhelmed and tongue-tied.

So eg. when the CMHT person last time made a sudden u-turn, I asked her why she'd changed her mind since last time. She told me it was because last time I'd said I was happy paying for therapy. This was a blatent lie - i'd never said anything of the sort. I pointed this out and she just sighed and told me the appointment was over and acted like I was the one being difficult. But it was only later on it occurred to me that we'd had no contact since the last time, so even if she was right and I had changed my mind, she'd have no way of knowing that, so it obviously can't have been the reason for her u-turn!

But I didn't think to challenge her on it at the time, I was just overwhelmed and tongue-tied cos I knew she was lying. I've never met people who confuse and overwhelm me like mental health professionals do - they will tell bald lies, draw illogical conculsions, misunderstand, miss things that seem obvious... it almost seems like they've be de-programmed as human beings... so you're always wrong-footed somehow. I have suspected I might be on the autism spectrum, slightly, but around MH staff I feel like I am severely autistic - communication, body language, everything is just completely different to interaction with anyone else (and I've travelled and met a lot of people). It's bizarre, and frightens me.

I just gave up on trying to get help from them, it seemed to be making things worse, the rollercoaster of hope only to have it shattered repeatedly. And it feels like an abusive relationship with services - the power is all uneven, I have to sick with them because I need something from them, no matter how they hurt me, and keep going back to them. I have to accept being gaslighted and accept their version of reality even when I know it is untrue.

But I am kind of stuck cos I need help. I try to make things better on my own but I keep coming up against needing support, even if Im posting on here people think I need help/therapy.

I just wish theyd helped me all those years ago - then it was just the effects of my childhood, not all the other stuff thats what I have trouble coping with now.

Feel like an unwanted fuckup but I could have been fine if only someone, once, had given me a chance and not judged and rejected me. Its too late now.

Sorry to write so much, I really appreciate being able to write it all out though, thank you.

Hey your worth fighting for. If you don't think your worth it why should they.

I have met some shocking professionals, sounds like you have too. I remember having therapy and opening up about intrusive thoughts just after having dd, which I knew were completly unfounded but still kept popping up, any way when I finished the sessions whe forwarded the write up that she was sending to my GP in which I disclosed some of the details about these thoughts. I told her emphatically I did not want that ever written down anywhere . And there is was in black and white. It wasn't even about me it was about my poor Dh. I was frosting when I phoned her because she knew I didn't want her to mention it but she 'forgot'

It really ruined my confidence with 'confidentiality'

I'd give the advocacy another go. Cigs, brew and phone and start again. If it was one of your kids you would just keep ploughing on.

how you feeling now?

keep letting it all out it's healing I've found just getting all my anger out into the open took a massive weight off my shoulders.

I agree with chocolate about giving advocacy another go you may have better luck or see if there's an independent mental health charity that offer an advocacy service.

In patient care is rubbish I've been an in patient twice now I was basically just shut in a room for weeks on end being dosed up on meds that dulled those devastating voices and feelings but no real effective treatment towards my suicide attempt and self harm.

I've found mental health services poor and I can see why you're struggling with them. I wish I could offer you some better advice but keep sounding off and letting it all out here if you can. Il pop back on the thread when I can!

Keep remembering being taken advanatge of by men. Lots. Feel dirty. And inadequate. Sorry. Its good to write it out.

Element. I mean this in the nicest possible way, you seem very intelligent so I hope you understand.

Part of your illness is sensitivity that has built due to your past. That sensitivity makes you very defensive and accusatory of the MH services. I believe you, I know some areas are awful. But please help yourself by accepting and at least trying to get access to help without dismissing it. It almost seems like sympathy is your goto, but it's not the answer. You deserve better and life can be better. But self awareness has to play a part. Could you ask your GP to refer you for counselling for ptsd first? If the GP refuses then complain till your taken seriously. Therapy for your trauma would help you come to terms with it and stop the flashbacks. Then hopefully that will lead to more help with regulating your emotions.

When asking for help dont ask for help due to Trauma from the MH services, that's like asking the police to police the police! It would only make them scared to work with you incase you become difficult. Explain what happened to you in the very begining, tell them you bottled it up as you say but now you need help to process it and move on.

at least trying to get access to help without dismissing it

I have. I have explained this numerous times - it's largely the point of the OP.

I am not being offered any help despite repeated and ongoing attempts to access it.

I didn't post on here first, I posted as a result of being unable to access help for so long.

Could you ask your GP to refer you for counselling for ptsd first? If the GP refuses then complain till your taken seriously.

As I've already explained, the primary care IAPT service won't accept me as my problems are deemed too complex. The secondary services (CMHT) also won't take me on, probably largely due to funding where they are seeing only the most severely ill. The GP has referred me repeatedly, and has done again very recently, but it is still up to the CMHT whether they see me or not. They had previosuly written to my GP asking him not to re-refer me as I would only be disappointed.

Explain what happened to you in the very begining, tell them you bottled it up as you say but now you need help to process it and move on.Explain what happened to you in the very begining, tell them you bottled it up as you say but now you need help to process it and move on

I have told them this. I have explained again and again and again over several years. The service isn't set up to deal with trauma and stuff. It just doesn't seem psychologically minded at all. But nonetheless, I have explained calmly to them so many, many times, and I seem to get nowhere.

I don't understand, when I have explained so much in my posts, why you think I haven't explained to them or haven't tried to get help. The OP is about my frustrations in doing so!

Well, I've found out why they're being so crap and why my experiences with them are so awful.

Met a trainee psychologist who works in the neighbouring area, with some overlap. She explained to me how the system works and the judgements made of people. Apparently anyone with a BPD diagnosis - even an unofficial one where they won't put it on the notes like me - is treated at arms length. Therapists will purposely make sure they come across as cold and not at all compassionate, for fear you will become attached to them. Apprently BPDers cant tell when a professional relationship has come to an end what a load of bollox.

So, no matter how much i'm hurting, how traumatised, how much I explain to them, they will speak in harsh tones and be cold and uncaring because they think they need to. I'm really shocked at saddened by this. There's a whole other bunch of assumptions too, frankly I don't think I have BPD as none of them related to me! I'm shocked at the officially sanctioned cruelty to those who have often gone through exteme abuse, awful. Feel like I'm not worthy of kindness, I'm somehow lesser. It's also horrific to know that no matter how unwell I am, no-one in the psych system would speak to me kindly.

Isn't it dreadful? All these harsh judgements and yet the only thing that's ever helped me has been the rare occasions someone's been kind, validating, and overtly or otherwise let me know the bad stuff wasn't my fault and I'm worth something. It's these little bits i've held onto to keep going - and yet apparently the pysch system think I need coldness, cruelty and blame. Just awful, I keep thinking of all the people out there in pain who need kindness and compassion, not this cruelty. God it's awful. Feel overwhelmed and powerless to stop these bullies.

Hello element I didn't see your post the other day about your thoughts. When they start get up and do something or put head phones in loudly and meditate. I have intrusive thoughts that can send me round the twist at 4am. My anxiety makes it a million times worse, I bet yours does too.

How did you meet that trainee? That's a bit of luck. What she said though is out of order, but nothing surprises me now.

What's your next step? Who do you need to be seeing? I know it must feel like banging your head against the wall but you got to keep on mithering. Is BPD the same as bi-polar? Sorry not very knowledgable. What do you think about pushing for another advocate? I don't think there is nothing wrong with saying when you ring up that you have been let down in the past so can you have some one with experience.

The trainee didn't really agree with the approach, she was just explaining how things worked, I asked a lot of questions too.

The problem with asking for someone with experience is that they have to follow the official line regardless - and actually those who consider themselves experienced are just as likely to be experienced in this cold, compassionless treatment of people. What I need is someone who actually listens to me, sees what things are like for me rather than stereotypes and assumptions. Eg. a therapist being kind doesn't make me attached to them (certainly not weird unprofessional over-attached ).

Apparently I have no chance of the therapy I need from services - even if I got as far as psychotherapy, they'd treat me in a cold, distant, disdainful way - not the validating/accepting way that is normal in psychotherapy and aids healing and helps one be open and face the past without being frightened. Not helpful. And I can't even get as far as psychotherapy, because they expect you to go through certain steps first - other short-term interventions/therapies. Which they say I am unsuitable for. Because I don't need the other interventions, I need in depth therapy.

I deal with the intrusive thoughts ok, it's just that I struggle so much everyday that I can't hold down a job or anything. I 'cope' fine; it's just that it's incompatible with 'real life'. And that, over time, makes me feel overwhelmed and even more depressed because it all seems so hopeless. I don't want to 'cope' forever - I want to get better.

This doesn't surprise me--the treatment of those with 'BPD' is just awful. Personally, I disagree with the whole concept of BPD. I think it's most often used to describe perfectly 'normal' responses to trauma. It's been shown in research that there is a strong gender bias towards women being diagnosed with BPD. In trials where men and women displayed the same behaviours, women were far more likely to be given the BPD label and men diagnosed with schizophrenia. I think BPD is another incarnation of the old 'hysteria' label.

Escapism, I hope you can hold on to the fact that the way you're being treated is not an attack upon you--as hard as that is. It's a result of a vastly underfunded system that throws labels at people, thereby dividing people into the 'deserving' and 'undeserving'. It's awful.

element try the advocate again. Some where you will have a break through. Your GP sounds as if they are trying, what have they said about the lack of response?

Have you ever thought about contacting your local MP? This is shoddy NHS treatment, it needs looking at.

Have you attended a Mind meeting? Apparently there thousand of weekly groups dotted all over uk. What about going with a very clear plan of what you want and using Mind or the advocate to fight for it with you. If you have to start all over again - do it.

dontrunwithscissors Thanks. Yeh I know a fair bit about the crappy way people with BPD are treated and the history behind it. I just hadn't realised that once you got to interpersonal therapy they still treated you like that. I thought the issue was merely getting them to give you therapy in the first place. I also din't know quite how crap services were in my area - it seems to be one of the worst (the worst?) in the country.

Chocolateaddict Unfortuntely it seems there is no point going through advocacy, chasing up GP etc (although I continue to see GP so someone knows what's going on and it's on record). The help I need is literally not available on the NHS. Not only are they refusing to see me, but even if they did, they won't offer normal psychotherapy, but some kind of weird cold distant judgemental type attitude (I was briefly assessed by one of these therapists a few years ago and it was awful, difficult to open up and triggered me so badly, I need comapssion and validation.)

I have previously tried the MP route, but rather than look at services, they personalise it. So they contact services, then get back to me with instructions to go to my GP, which is what the CMHT tell them I should do. The fact that going to the GP is getting me nowhere, as CMHT won't take me on/don't offer the therapy I need is ignored (much like it has been by earlier poster on this thread). I've also tried going through PALS, but the problem is they can just say "clinical opinion... blah blah" and do whatever they like. Me saying I need therapy holds no sway against them saying I don't or I'm unsuitable (for the limited therapies they offer). They are master of obfuscation too!

So I guess it's private therapy only. Although apparently I am too bonkers for that without loads of support from CMHT. And I'm terrified of how to find a decent therapist as the last one was from a respected organisation, recommended to me by a friend and by MIND, who assess you and allocate you to a supposedly suitable therapist. I don't see how I can go better than that...

Sorry, I'm not trying to be difficult. I just wat to be able to talk about how I feel, be allowed to be sad and remember stuff, and not feel alone with it all/leading to feeling ashamed of feeling bad.

Ok, OP I'm not familiar with any of your other threads but you sound deeply upset and I can understand why. I think the problem with mental health is that nobody rushes to help you unless you get to the point of needing a hospital admission. Nobody really bothered to diagnose me properly until I had to go and spend some time in a psychiatric ward. Since then, I have no problems getting people to listen and refer.

I have been wrongly diagnosed with both bipolar disorder and borderline personality disorder in my 20s. It turns out that I actually have AS. I'm not saying you have AS but I really think that what you need is a correct label to be able to access the correct help. It sounds as if you need someone to untangle what is going on - it must be very confusing and frustrating. One thing to bear in mind with NHS therapy is that you tend to only get 6 sessions. For me, that wasn't enough. Another thing to bear in mind is that sometimes well placed meds can help you to access psychotherapy more effectively. I don't know if that is appropriate for you or not. And lastly, finding the right therapist for you is a very individual thing.

I'm sorry you're struggling.

Element - write a formal complaint to your local CMHT. It has to be investigated and responded to. Say you feel that you are being excluded from MH services due to X reasons. Say what you think will be helpful and be specific e.g I think I would benefit from 1:1 therapy for X problems. Tell them what you've already tried and ask what your next step is.

Be formal and as rational as you can be. Don't use the sort of phrases you use here 'no-one cares, everyone gets help except me it would be better for services if I was dead etc'. Even if that's what you truly believe.

And I agree that often these threads don't seem to help you. Lots of posters 'know' you and have seen your numerous other threads which all take a similar course. But other posters don't so they give well-meaning advice and you get angry and upset because you've tried all of it.

You desperately want people to care and listen and that's understandable and lots of people do. But it's not okay to respond to people with 'fuck you' or essentially say they make you want to die etc.

You will be losing support with each thread and then that reinforces your view that people don't care, don't understand, you're not good enough etc. It's a vicious circle and I think you find it difficult to step out of that victim, abuser, rescuer triangle.

And that's not a criticism - lots of people get entangled in that.

lifesagas
They won't take any notice of a complaint. They can just say I don't meet the CMHT criteria. Even if they did agree to give me individual, indepth therapy, they'd do it in the inappropriate, cold way that sort of defeats the point, as detailed in my post a few days ago.

Someone doesn't have to have seen any previous thread by me to read my OP. Advising XYZ when my OP has already spelled out why XYZ doesn't work isn't helpful. On any other subject, the OP woudn't be expected to be grateful for advice that was contraindicated in the openng post, but for some reason mental health is different - same in real life!

These threads would help if people took in what I wrote before responding. And in fact have helped and do help with regards the peope who do that, and understand I need someone to 'get it' or a space to write stuff down and be 'heard'.

You also seem to be under the impression I am 100% with it and in control at all times. I dissociate, get overwhelmed with pain etc. I'm not an idiot, I'm just not well and can't always act how I'd choose.

On the plus side I have discovered an organisation for service users and would-be service users in this vicinity... it's a local grassroots one. Seeing them soon. They can't do anything but nice to not be alone with it all.

Are you under the care of a psychiatrist OP?

My psychiatrist refused to refer me for therapy once because she felt that I was too ill to cope with it at that time. Is it possible that in your case that's why they are not accepting referrals?

Do you have a family member or friend who could try to intercede for you and say that you need to be under a psychiatrist (if you're not).

It's great that you have found an organisation locally. I think the social and local connection could be very helpful overall. It might take a while for you to get used to it.
Not all forms of therapy are the same. And certainly not all therapists are the same. Your mind seems to have a pattern of instantly categorising things and quickly filing them away as 'oh well it won't be any good anyway so stick that in the Useless Suggestions pile'. Probably a defence mechanism to prevent you being disappointed again so a very understandable approach in your circumstances. However, you could have the thought that all therapy they offer will be in an inappropriate and cold way...and also then have the thought maybe it won't be like, maybe it might help.

sadie Your mind seems to have a pattern of instantly categorising things and quickly filing them away as 'oh well it won't be any good anyway so stick that in the Useless Suggestions pile'.

If it is something I have already tried, numerous times, and hasn't worked, then that is sensible and logical to think it won't work next time. This isn't weird or unreasonable, it is perfecly normal.

I don't know how to explain this any clearer! If someone says "I have tried X,Y and Z, and it hasn't worked for these reasons", someone suggesting "try X, Y and Z" isn't helpful, only infuriating.

However, you could have the thought that all therapy they offer will be in an inappropriate and cold way...

The reason I know (not think, but know) therapy will all be done in a cold way is because I have had an indepth conversation with someone who works with these actual therapists. A week ago I didn't know about this, now I do. Apparently anyone diagnosed, or unofficially diagnosed, with BPD, or traits of BPD, is treated differently, and coldy, during therapy. This is the policy of the therapists in my local NHS services. They purposely treat these patients like this to make sure they don't get attached to the therapists. So this isn't something I'm imagining, this is actually their policy, heard from the horses' mouth, as it were.

(This is for longterm psychotherpay - I am deemed unsuitable and too complex for shorter interventions, IAPT etc.)

I'm not sure why posters expect me to put aside everything I've learnt about the system and blindly expect it to work differently. It may be shit, but I'm still better off understanding how it works. Apparently it is particularly shite in my area!

lottielou Unfortunately, it seems only those on psych meds are under a psychiatrist, in this area. Because the psychiatrists are so few and far between! I've not seen one for years, just get assessed by nurses and social workers etc.

In this area you have to go through CMHT to get longer term/more in depth therapy. And the CMHT say I don't meet their criteria. I'm just not entitled to any support at all other than my GP.

I'm just trying to keep going right now tbh.

OP. Your 'friend' or whatever is either misinformed or has simply had a conversation with someone on the very outskirts of therapy that has had an appalling, unprofessional and unethical conversation with someone and is repeating that nonsense.

I have almost 20 years of working in MH including involvement in DBT groups - which as you know; are considered helpful treatment for people with a diagnosis of borderline PD.

I guarantee there is no 'policy' in any MH services in the UK to treat service users with a confirmed or suspected diagnosis of BPD differently or 'coldly' in comparison to service users without a diagnosis of BPD.

To have such a 'policy' would be in breach of any MH service/therapeutic service policies and guidelines and in breach of the governing bodies of MH qualified nurses, Dr's or therapists. Professional membership of all governing bodies is that any service user; regardless of ethnicity, background, diagnosis etc is treated equally. HCPs CANNOT discriminate.

Shit HCPs may have that ingrained 'fear' of working with people with a diagnosis of BPD and have ill-informed and unethical views (as seem to have been related to the person that repeated it to you). There are no 'policies' discriminating against people with BPD. It would be unprofessional, unethical and illegal.

If I was being kind and generous to the person who gave you this info (or who gave it to them) I would say that a feature of BPD is an intense fear of abandonment and a tendency to put people in their lives who are helpful or appreciated on a pedastal for a time and then feel intense emotions if feeling 'let down ' or rejected and then feel that person is therefore awful and damaging (idolising then demonising). As an example, I've experienced this simply because I was sick on the day of a planned appt and this provoked an extreme reaction in the service user.

These dynamics create fear in unskilled practitioners who experience strong projective identification/transference with people with PD and don't know how to manage it. I.E - the service user has tried numerous interventions and rejected them, the practitioner feels they have nothing else to suggest so they feel like the service user feels - helpless, nothing will work, I have nothing to suggest, nothing will help, nothing will make a difference. The service user thinks that and the HCP thinks - I can't help, I CAN'T help, this isn't an acute state where medication or intense intervention will help so this is the end of what I/services can offer

A skilled and experienced HCP understands this and works with it and an end to therapy with someone with BPD should be carefully worked towards to minimise feelings of abandonment.

That does NOT mean being cold towards people with a BPD diagnosis. That is nonsense.

I realise you have mh problems so I am trying to be kind but your posting shows exactly why there are issues.
People on here are trying to help. And yet nothing suggested is good enough.... we are accused of not reading the posts etc. It's a hugely self centred approach.
I get your problems dominate your life but have you ever thought a different approach might do a lot for you? How old are you? How many years have you spent on this merry go round?