The Difficulty Of Talking About Anything Other Than Mental Health When You Are An Inpatient In A Psychiatric Ward

I have an amazing family and, since being in hospital, my mum has visited me nearly every day. During visits there are a variety of activities we try to do to distract me from my current situation, sometimes we watch TV programs mum has downloaded to her tablet, we have been known to dabble in a little scrabble and once a week my mum will help me edit these blog posts that you love so much, to let me know if there are any glaring grammatical errors (that’s right. If you ever see a grammatical error on this blog feel free to blame my mother…only kidding…thanks for the help mum). When it comes to conversation however, there is little to no variety in topic and usually, if not every visit, we will end up talking about something mental health related which understandably can get rather tiresome.
It is therefore no wonder that the other afternoon my mum asked if we could possibly “talk about anything else” and lord knows I can see where she is coming from. Anyone would get fed up talking about depressing brain nonsense all the time and I do not blame her at all for asking for a different topic once in a while but at the same time I don’t think people realise how difficult it is to talk about things other than mental health problems when you have mental health problems, even if you are trying really really hard.

I hate admitting that because it makes me sound incredibly boring and self obsessed to say that I am frequently caught up in conversations regarding my head demons but the thing is, when your head demons are in your head 24/7, it is practically impossible to think about the “anything else” that other people wish to be discussing. Which part of your brain is supposed to be free to think about this supposed “anything else”?
When you are lost in your mental health problems, asking such a question is pretty much the same as asking someone who is being repeatedly smacked on the head with a wooden pumpkin to say anything other than “Oww”, “please stop hitting me with that”, “that hurts” or, if the person is a particularly articulate fellow “My frontal lobes are in a state of great pain so please desist with your actions and then tell me where on earth you were able to find a root vegetable carved out of the finest mahogany”.

I think this is especially the case when someone is in hospital because not only are your mental health problems all you can think about but they are all around you and you are in a location in which forgetting them is impossible, like trying to forget the smell of fresh bread in a bakery. I know people are always telling me that I am “more than” my mental illness and that it isn’t my entire identity which should mean I do have other things to talk about, but I think when in hospital you are often treated as an illness rather than an individual, and psychiatric units, though helpful, can make you start to feel like you are not a person at all.

It is like the problem I am currently facing being on 1:1 Observations.
Now, considering I write a blog on the internet all about how I am a flipping lunatic (or “Marbleless Marvel of mysterious Marblelessness when being addressed formally), you could say that I am perhaps not the world’s most private person. I talk about my mental health problems publicly every week and whenever I go into hospital for treatment I no longer ask friends to make up excuses to explain my disappearance in day to day life (my favourite of which was when I was 16 and to cover up my detainment in a psychiatric unit a rumour was spread at school that I was working on voicing a rat in the Disney Pixar sequel to “Ratatouille”, a rumour that was regrettably untrue in that I have never voiced a rat for Disney, nor has a sequel to Ratatouille ever materialised). However, as open and honest as I am, like any regular person, I still do like a reasonable amount of privacy in my life and unfortunately, for the past few months, privacy is something that I have been severely lacking due to the nightmare that is 1:1 and 2:1 observations.

The terms 1:1/2:1 observations in hospital are probably self explanatory and in explaining it I apologise for offending your intelligence, but basically it means that wherever you go, there will be at least one member of staff staring at you (aka 1 or two staff to your 1 patient ratio). It doesn’t matter whether you are going to the toilet, having a shower or having a snooze, the staff member will be with you (possibly within arm’s reach if that is stated in your care plan), and they will be watching every move, almost like a real life version of that song “Every breath you take” by The Police with those creepy lyrics (seriously if you haven’t heard that song look it up. It is weird and is a perfect summary of the 1:1 inpatient experience.) That song and indeed that experience has been my life for the past two months and to be blunt, it is incredibly humiliating. More than humiliating though, it is dehumanising and that is one of the things that takes me back to the question as to how you can talk about anything else other than mental health problems when you are being treated as a new species of disorder that is able to walk and talk. You are not a person, you are a thing that needs to be watched and observed. I am constantly hearing staff in the corridor ask each other “who is watching Katie?” or “who is with Katie for the next hour?” as if I am a ticking time bomb that people are just waiting to go off.

I suppose in fairness everyone loses a certain level of privacy when they are admitted anywhere. Even if you aren’t on 1:1 obs in hospital, you will be on some kind of observations, just as I was initially on 10 minute observations meaning that every ten minutes a staff member would appear at my door to see what I was up to. Therefore staff knew what I was doing all of the time but still in that ten minutes of unobserved time there was an element of privacy that I am sorely missing today, and I think that having just that ten minutes again would make me feel more human and less like a living issue in need of being managed. In those ten minutes I could hum a jolly ditty if I wanted and nobody would know, but now I can’t even convert oxygen to carbon dioxide without a beady eye watching to make sure I do it appropriately.

It is just so humiliating to be watched all of the time, even in the “private moments” that people take for themselves just to respect their own decency. Take urinating for example. Sure I have learnt over time to manage it and can now pee with staff even if I don’t have music playing on my phone (although in the early days such an activity was practically impossible and it is safe to say that I have publicly urinated to every song in the current top 40 charts…have fun getting that image out of your head when you next listen to Ed Sheeran on the radio), but it is still something that I want to do on my own. Worst of all though is showers and I think that is where my main issue lies with this whole 1:1 thing.

Imagine absolutely hating your body, despising every ounce and seeing it as nothing but a source of shame and then having to parade it around naked in front of a different stranger every day whilst you wash yourself. Surely that would be a challenge for even the most body confident person out there but for the person whose body is a constant source of torment and torture? How can anyone feel human or respected then? How can you feel anything other than dehumanised, humiliated and not respected as a proper person with their right to their own privacy whilst they have a good lather? How can you see yourself as, let alone discuss, “anything else” other than mental health problems?

I suppose I know on paper that if I were to print this blog post out and give it to any of the members of staff looking after me right now they would say that they do 1:1 Observations to look after people and keep them safe rather than humiliate but it is a lot harder to believe that when you are the one standing naked in front of a complete stranger whilst you frantically look for a pair of pants (hypothetically of course…this has never actually happened to me… Trust me, when you are on 1:1 you always have your clean pants prepared for after a shower!)

So, when you have mental health problems how easy is it to talk about “anything else”? Well, not very, when you don’t have the brain space or power to think about these “anything else’s”. Sometimes though, the biggest challenge isn’t thinking about anything else, but, when you are on 1:1 observations and have no say in your treatment, it is about trying to see yourself as anything other than a dehumanised circus freak in a constant humiliating parade.
Take care everyone x

TalkAnythingElse

 

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The Pressure Of “Perfection” On Mental Health

World War 2 started in 1955.

See that? That statement is wrong. It is a mistake, an error, and you know what? I am going to just leave it there for us all to deal with together.

It is fairly well documented that people with mental health problems like anorexia and anxiety are perfectionists, and I can certainly say that I am one of them.
To be honest the whole population is a bit obsessed with perfection, and magazines are constantly splattered with articles on how to get the “perfect body”, “perfect life”, “perfect relationship”, even “perfect eyebrows”. Seriously? Who needs perfect eyebrows? What even is a perfect eyebrow? I keep seeing loads of people shaving their eyebrows off and drawing them on again with pencil but how is that perfect? THAT ISN’T EVEN AN EYEBROW! It’s a line of charcoal or whatever the hell they put in make up these days. It can’t be the perfect eyebrow at all because it isn’t an eyebrow! The real eyebrow was shaved off! I can’t just doodle a nose on my arm and start sniffing through my elbow! Anyway back to my point…

People want perfection, most people fear failure and we all want everything to go smoothly, a nice idea, but not exactly a realistic one because perfection does not exist and I think it is time we all tackle it before our brains explode from the mental health damaging stress caused by trying to reach something unattainable.

Being a perfectionist affects my mental health on a daily basis in a variety of ways. With OCD I am always washing until I feel “perfectly clean”, with my eating disorder I am weighing myself or food to a “perfect” number and when it comes to the fear of abandonment caught up in my personality disorder, I am always writing and rewriting text messages or emails until they are “perfect” because I fear that one wrong word will make the recipient of my message hate me forevermore.
Being a perfectionist has also stopped me from doing a lot of things in life, from serious things like certain choices at university, to unimportant hobbies in my free time. I used to play video games all the time and found the act of roaming around fictional digital landscapes helpful in giving me a break from real life problems that were bothering me. Because of this obsession with perfection however, even that coping mechanism has been tarnished and I rarely ever pick up a control these days because the perfectionist in me found the pressure too hard to handle. When I was a kid, playing Pokemon on my original black and white gameboy was easy enough. I knew I could catch the required target of 150 Pokemon if I tried, but these days there are 802 Pokemon in total which makes it infinitely harder to “CATCH EM ALL”. I fear starting up the new games purely because I worry that I won’t be able to complete them “perfectly”, so for this reason I don’t play at all, don’t end up catching anything, all because I am scared of not living up to the task and hating myself for it.

Perfectionism is even slowly making it difficult to post anything on this blog, as with every Monday that arrives I am worried that what I am planning to post for the day won’t be good enough and that everyone will think that I am an idiot, hate me, refuse to ever read my blog again and send round a crowd of people with pitch forks and flaming torches to destroy the fool who dared post such nonsense to the internet.
I can guarantee that after I have put this blog up I will be reading it again and again, worrying that it is rubbish, seeing all the flaws, all the imperfections, hence why I made that initial mistake on purpose about World War Two. Yes it is there, I do not like it and there are probably many others, but I am trying to fight this neurotic need to make everything perfect so I am going to damn well leave those errors where they are! Queen Elizabeth is my sister and I turn into a saucepan at nighttime. YEAH. That’s right, two more errors (I actually turn into a teacup), LOOK AT THOSE ERROS AND DEAL WITH IT.

The really ridiculous thing about it all and the thing that makes the quest for perfection so futile is of course the fact that the “perfect” anything doesn’t even exist. The only thing close to perfection is Helena Bonham Carter and even in her case I am sure she must have a flaw somewhere (if you are reading this Helena please forgive me for making such an assumption but I am trying to make a point).
The word “perfect” itself is an idea, a concept that simply cannot be in the real world because what it represents is utterly subjective. A spatula is “a thing”, so we can all talk about spatulas collectively as a society (and oh how we love to talk about spatulas these days), because when two people say the word spatula we know we are referring to the same item. When it comes to “the perfect…” however, everyone is referring to something different so we cannot relate or talk meaningfully about it as a solid thing or goal to aim for.

It is like when I watch the Great British Bake Off (before Channel 4 rudely stole it and destroyed a summery British tradition whose absence will forever leave a doughnut hole deep within our hearts). Whenever it used to be pie or pastry week, Mary and Paul would often use the word “perfect “ to describe the base of a tart if it was crisp and there was no sign of “a soggy bottom”. To them, a crisp base was the epitome of pastry perfection, but that is the complete opposite to how I would see a pie as perfect.
When my grandma used to bake apple pie, I would have a sizeable bowl full of it, drowned in thick yellow custard. Had I ever found the base to be crisp I would have been very disappointed. I liked it when the pastry was all gooey, had soaked up all the apple juice and custard and turned into a mushy mess with no crunch or chewing required whatsoever. That was my perfect apple pie, and I would pick a pie like that any day over these crisp bottomed tarts I see praised on cookery programs like Bake Off, tarts with pastry more suited to building a house than squishing about on a spoon for a bit of deliciousness. Aiming for perfection in anything is therefore like trying to make a universally acclaimed “perfect apple pie”, a futile pursuit because it is searching for something that doesn’t exist.

Ok being a perfectionist can be good in some settings. If I undergo surgery I would very much like a surgeon with a perfect success rate rather than one who has been known to give people a few extra lungs or a bonus forehead nostril, but in life on the whole this quest for perfection is nothing but an unnecessary strain of pressure on our mental health, with anxiety so crippling that it leaves you unable to do anything for fear that something will go wrong.

If you are reading this as a perfectionist like me, and if you find that perfectionism is leading you to avoid something or you are buckling under pressure, sadness and anxiety, scared that you won’t do something perfectly, I urge you now to go ahead and do it anyway, just as I am uploading this post now, knowing that as a perfectionist, I will NEVER be satisfied.
Let the anxiety come and fight against it by knowing that if you are a perfectionist, no matter what you do, you will never feel your performance is good enough. Do what you are avoiding and make mistakes, revel in them and appreciate them being there. They are important and more real than any perfection you are chasing because mistakes can exist and be found in the real world, unlike a concept like the “perfect” apple pie.
Make errors and leave them in as I have done with this bog (OH LOOK ANOTHER ERROR), and fight this building pressure and anxiety provoking burden of perfection in everything you are and everything you do.
Don’t keep all your eggs safely in the basket for fear of making a bad omelette and end up starving to death with no omelette at all, crack the little buggers and get whisking before they go stale because ANY omelette, just like anything you could possibly do in life, is better than not making or doing anything at all.

Take care everyone x

Perfect

Why Praise Makes Me Panic

Whenever I am praised for something people think I have done well, I panic. Even if the Queen of England herself (Hi Elizabeth if you are reading), were to turn up on my doorstep with a party popper and a handful of corgi shaped confetti to congratulate me on achieving something, I would probably have started hyperventilating before a single streamer had hit the floor. Contrary to popular belief, this is not because I have a fear of brightly coloured canine shaped bits of paper flying through the air, but because any positive feedback from anyone feels like a terrible mistake.

Take my A-level results day for example. It was 2011 and was around the time everyone started rioting around England…remember that?..Not that they were rioting about my A-level results…I am just setting the scene…
Anyway, after months of stress and exams, I was handed the envelope that would tell me whether or not all my hard work had paid off. Upon reading the string of letters on the page presented to me, I was a little relieved. I had got the grades I needed to get to university so I thought I had no need for any immediate worry. That was until I turned the corner and bumped into some of my teachers who were all hovering around the corridors.
As I passed, each one turned to me, all of them smiling, all holding their arms out to offer a hug, and with a sinister sparkle of pride in their eyes, they all muttered those immortal words to me…”Well done”. Good lord, just the memory sends tingles of terror to my very core! Stephen King himself is incapable of inspiring such fright with so few words! Grab me a cushion to hide behind and for the love of God someone take me home!

Don’t get me wrong, if I honestly believed that I had done well I would appreciate being congratulated, but in my head I am incapable of doing anything well, so any statement suggesting the contrary is terribly confusing and thus makes me panic. People were looking at my grades and calling me clever, yet inside I knew I wasn’t clever in the slightest. I felt that any of the marks I achieved must have been down to luck.
Maybe I had a really generous person grading my paper? Maybe they made a mistake and added the total up wrong, or maybe I hadn’t taken the exam at all, had dreamt the whole thing and someone else put glasses on and took the test for me? Part of me even worried if I had somehow smuggled a textbook into the exam hall and cheated without knowing it. I wanted to cry out to all the teachers and tell them the truth, tell them that I wasn’t really clever or capable of those grades and was in fact a fraud with a lot of luck and possibly a lookalike somewhere who was the one really in need of praise for the success.
It was like in movies when someone whips out a gun and the person at whom the gun is being aimed throws up their hands and says “You’ve got the wrong guy!”. That is how I feel every single time I am told that I have “done well”, only with me it is when people start aiming trophies at me rather than a gun. I would probably react the same way if I was ever aimed at with a gun too to be fair, but thankfully I haven’t had the experience to confirm this hypothesis (neither do I want to thank you very much.)

Again I don’t want this to come across as the idea that I panic because I don’t want people to think good things of me. Even if people are mistaken I have no problem in being thought to be good at something. My teachers could have followed me around for the rest of the day with a brass band trumpeting my success if they wanted (for some reason they didn’t want. I blame the recession). No, what I fear is the consequences of someone holding that belief and the weight of expectation that goes alongside it. If you do well in education, sport or anything else that can be ranked competitively, you are branded as good at that sport or subject and are therefore expected to perform well the next time, which might not be possible. That is what I fear.
I fear that people will mistake any success I have in life for talent and that they will then expect me to carry on performing at whatever level, when in reality I am incapable of doing anything well and doomed to let them down.
I don’t fear them thinking well of me, I fear the inevitable disappointment when they realise they are wrong, the chance of being discovered as a fraud and made to stand up in court to defend myself against a judge with a hammer and a silly little wig. It is a problem I even struggle with on my blog, as if anyone gives me a nice comment about a post I am initially thrilled, yet at the same time worried that I have misled people into thinking I can write. After every good comment I wonder what the hell I am going to do and how I am ever going to write another post without exposing myself as an imposter.

The other day however, I was so fed up with feeling like this, scared that I was genuinely crazy or just ungrateful when people are nice to me, that I decided to google it to see if anyone else felt like this. They say you shouldn’t google something you think might be wrong with you because if you type in “I have a headache” the internet will automatically diagnose you with some horrendous disease/convince you that you somehow have a badger lodged into your temple which is causing all the pain, but this time I have to say that I am glad I did google this because it has made me feel so much better.

It turns out that this whole feeling like a fraud when praised is an actual thing, and was named as “imposter syndrome” by some clinical psychologists in 1978. Upon this discovery I set about scouring the internet on a grand research quest for knowledge (by which I mean I read some articles on Wikipedia), and it turns out that a lot of people feel like this! Apparently two in five people struggle with it, and though not a mental illness itself, more a psychological phenomenon, it is one that can in turn lead to genuine mental health problems like anxiety and depression. Therefore, knowing that others experienced this problem too, I looked to see if there was a solution or way for people to manage this “imposter syndrome”, and there is! According to some professional psychologist people out there, the main problem is that people who experience imposter syndrome are unaware that others feel inadequate in their achievements as well. However, “once the situation is addressed, victims no longer feel alone in their negative experience”, so talking about it openly with likeminded people is a key to “overcoming this burden”.

Basically then, what I learnt is that a lot of people feel the way I feel, that any success is luck and that they are a fraud undeserving of real praise, and the only way to deal with it is to talk about it. Upon my discovery I immediately wanted to grab a megaphone, climb to the tallest tower in all the land and shout this message to all the other people out there who feel like a fraud, in order to let them know that they are not alone in hopes that it might help. Unfortunately though, I was unable to find a megaphone and there aren’t many tall towers about where I live, so I thought it might be better if I wrote a blog about it instead, which funnily is the blog you are reading now. WHAT A COINCIDENCE.

Therefore I wanted to use this as an opportunity to write a message to anyone out there who has related to this in any way whatsoever, to let them know that feeling this “imposter syndrome” way doesn’t make you weird. More importantly though, the fact that a lot of people feel like it suggests that if you feel that everything you achieve is luck, you are probably wrong.
Ok, luck has it’s part to play in life and the opportunities available at a certain time, but “luck”, by definition isn’t a thing that happens all the time to everyone in every second of every day. The thing that makes finding a “lucky” four leaf clover so exciting is that doing so is rare, and that is what “luck” is about. It isn’t about a common occurrence in the general mundanity of day to day life, it is about those special unlikely moments that pop up infrequently and out of the blue. You cannot put everything good that you have ever achieved down to luck because it just doesn’t make any sense, and if a lot of people feel this way then we can’t all be this lucky, nor can we all be imposters.I know that people out there will probably read this and think the classic “I am the exception, I really am an imposter” but the truth is you are wrong. If we were all imposters and frauds where the hell would all the real people on whom we are basing ourselves be? Either way, the fact that this imposter syndrome is a common experience has made me feel a little less alone, so I have written this in the hopes that someone who also struggles with it will read this and experience the same reassurance I did on Wikipedia. None of you out there are “freaks” or “ungrateful” for struggling with praise, it happens to a lot of people, and hey, if we are all freaks together, then I feel I am in some damn good company. Well done us!

Take care everyone x

Imposter

The Difficulty Of Losing A Therapist

Over the past few weeks, I feel that I have been going through what is commonly referred to as “a break up”, one of those horrible experiences that, in popular culture, is often portrayed as a situation that can only be remedied by much crying into tissues and several tubs of ice cream. Now I know what you are thinking, “but Katie, how can you be going through a break up when you yourself admitted the day before Valentine’s Day that you haven’t been in any kind of romantic relationship for over two years” (alright don’t rub it in guys…Jeez).
Well if you thought that, you would be right, no, I haven’t been in a romantic relationship for a very long time (aside from the one I am in wth Helena Bonham Carter that she isn’t aware of…yet), but in the world of mental health there is a common experience that is very like a break up, that being the loss of a therapist.

Now, before I go on I would like to preface this by saying that I do not mean for this to imply that I am caught up in any romantic entanglements with the therapist I am referring to and who is currently in the process of “leaving me” for a new job.
Indeed our relationship is very much the standard “patient/psychologist” affair (perhaps affair wasn’t the best choice of word there…). However, what I don’t think a lot of people understand is just how attached one can get to a person who only hangs out with you every week because they are paid to do so.
It a very odd situation, and whenever a therapist leaves I feel I should deal with it easily, without being particularly bothered. This is after all not a new experience for me, as I have literally lost count of the number of therapists that have left me over the years, (seriously if you rounded them all up you would have more than enough of a cast to put on a performance of Les Miserables and trust me, from someone with a theatre background, you need a lot of people to perform that show). That said I know a lot of people find this a very difficult thing to go through, and rather than it mean we are clingy or weird, I think it makes a lot of sense.

Yes, a relationship with a therapist is strictly professional and should, on paper, be the equivalent relationship to someone you have hired to be your private chef (who is paid for by the NHS because you are mentally unable to sustain yourself alone….I need to work on my analogies…)
The chef turns up at your house because it is their job just like my therapist turns up for our appointments, but when you are talking about your deepest darkest secrets and fears rather than how you like your eggs cooked, it can’t help but become more personal whether you intend it to or not.
In every other professional relationship you have with someone who is being paid to spend time with you, like a chef or a plasterer in your house, the reason for their being there is in reference to something separate, aka food or dodgy walls. With a therapist though, unsurprisingly, a lot of it is about talking about your life. How can that not be personal?
Ok other professional relationships have personal aspects to them as well, a private chef for example may eventually grow to know how much milk you like in your cup of tea without asking every time, yet with a therapist there grows a level of intuition that is less about knowing how you like your tea and more about being able to simply look at your face and know automatically that it is time to put the kettle on (although I would like to clarify that my therapist has never actually made me a cup of tea at all…if you are reading this dear therapist, maybe work on that in your new job). It is that deep connection of being understood as a person, and for that reason of course it can be like a relationship break up when a therapist retires or leaves to get a new job.

Again, of course I am not saying that it is in any way romantic and unlike romantic relationship endings we are not going to be left wondering who gets custody of the kids (we already decided in our first session that I get them Monday to Friday and then she has them over the weekend). Nevertheless I am left wondering what I will do without this person who is currently a big part of my life.
When you see a therapist for a long period of time, discussing your mental health problems/building a therapeutic relationship is sort of like building a house. In the beginning you have an empty plot of land and the patient has a hell of a lot of bricks (bricks that in terms of this analogy represent secrets/thoughts/things that make you as a person). The patient is standing in the middle of this messy pile of bricks without any idea of how to deal with it, so the therapist is there as a sort of builder/tidier to help sort it all out. Every week you both turn up at this plot of land and gradually, the patient hands the bricks individually to the builder. Together you try to construct something that is a little less of a mess, and a little more something you can work in. The more you talk, the more bricks that come out, and eventually the house is finished at which point you can go inside and start trying to make the place liveable. You try things out, experiment with fuchsia walls, checkered wall paper or new therapies and you see what works for you.
Then finally you get to the point where you can both walk into the house (aka brain), and know the insides and outs of it so well that one of you can reference something within the house and the other will know exactly what they are talking about. Refer to the “plant thing in the bathroom” and they know what that plant thing is as well as when in your life you bought it and why it is in the house, just as a therapist will eventually grow to know all about the way your mind works as well as any life events you simply reference to as “that time with the giant squid”. If anyone else comes in the house and you reference the plant thing, they don’t understand exactly what you are talking about. Even if you take them to the room to point it out they cannot have the same level of understanding as the person who helped you build the bathroom in that particular way and find that particular plant at the gardening centre. You can tell a new therapist about what happened during “that time with the giant squid”, but to them it will just be a story rather than an experience you have lived through together.
Getting a new therapist then is not as simple as the professional transition involved when you get a new plasterer for example (I have just realised there are a hell of a lot of interior design analogies in here which I think is in reference to my love of 90’s TV show Changing Rooms. I miss Carol Smiley. Where did she go. She was so Smiley). No, instead of a new therapist coming in to help you in the house you had made earlier, it is like having to smash all of that “brain internal understanding relationship” stuff to the ground and having to start again. Once again you need to start passing them all the individual bricks they have never seen before, so you actually have a long time of simply building up enough of a rapport/understanding before you can get on with any of the serious stuff.

Like the end of any romantic relationship you find yourself wondering if you will ever find someone you will get on as well with or who will understand the way you work in the same way, and the first sessions with a new therapist are very much like all the first dates you have to go on to try and find a new partner. Conversations go from deep personal investigations into the meaning of life to the cookie cutter “so what is your job”, “where do you live” standard statements that you have to go through before you can get to anything of real interest or value.
Unlike a first date of course, a new therapist will probably have all of your notes from the previous one and thus a rough knowledge of your history, but nevertheless, with or without these notes they will always say that they want to hear about your history “from you”. Admittedly this is a good idea. Obviously I can explain something that happened to me when I was eleven better than a therapist was able to jot down in a word document, but having to go through all that stuff is exhausting. Maybe if you don’t have a huge mental health history this “tell me about you” question can be answered relatively quickly, yet for me it is a question that is incredibly daunting. Tell me about your experiences with mental health services?! How can I do that? We have nearly 14 years of appointments to catch up on! I can’t get through all that in one hour!? DO YOU HAVE ANY IDEA HOW EXPENSIVE HOSPITAL PARKING IS?

This entire blog is probably just one long incoherent ramble so half of you reading will be probably wondering what the hell I am talking about and who the hell Carol Smiley is. I guess I just wanted to raise some awareness of how difficult it is when a member of your therapy team has to change and why it feels so much more impactful than a change in any other strictly professional relationship. If I was ruler of the world I think I would probably make it law that therapists are unable to ever get new jobs, retire, change jobs or go on maternity leave (sounds ridiculous I know but in terms of fair/rational leadership I would still be doing a better job than Donald Trump.)
Luckily as you will know if you have been around my blog for a while, I do have a whole team of therapists so it isn’t a total break down of my psychological support and only one person is changing. I also know and like the replacement very much so it is as “good” and manageable a “break up” as it can be. Nevertheless I can’t help but feel as though in a few weeks when it is time for our last session (on the 21st of March, put that in your diary folks), I will be losing someone very important, someone who I can trust and rely on, so naturally, this isn’t going to be easy.

Take care everyone x

therapistchange

6 Tips For Managing Public Transport When You Have Mental Health Problems

As you read these words I will hopefully be hot footing my way to London. I say hopefully because, as the idea is so terrifying, I cannot be sure I will go through with the journey (I am writing this a week in advance. Call me Mr Organised. Actually don’t, make that Señor Organised…has a bit more of a flourish don’t you think?).
Going to London/leaving the house at all is scary for a multitude of reasons such as managing food, being in unfamiliar environments with uncontrolled levels of bacteria, generally being around people, but one of the top scary things on the list of ultimate London scariness (it is a very long list), is the fact I will have to use public transport, and I am pretty sure that will be on many peoples’ lists of scary things about leaving the house.
Therefore, today I thought I would write this blog post to help anyone out there who is overwhelmed with terror at the mere thought of bumbling along on a bus or trundling track via a train. I can’t say these are the best ways to manage public transport anxiety issues, but they are at least the tips I will be using to get me through…if I manage to leave the house to get to the public transport stage that is…All aboard the mental health travel tip train! Here we go!

1. Make alternative routes: If there is one thing you can rely on when it comes to public transport, it is the fact that it will be unreliable. Buses break down, flights have to stay grounded because it is cloudy and I am yet to have a train journey which hasn’t started with a good half hour wander up and down the platform listening to the woman on the tannoy tell me that my train is delayed in a frustratingly calm voice (she always says she is sorry to announce the delay but if you ask me she doesn’t sound sorry at all. HOW DOES SHE SLEEP AT NIGHT?). I once even had a train cancelled with the explanation that there were “slippery leaves”…That’s right, slippery leaves. Not even going to try and make a sarcastic joke about that. I think the phrase “slippery leaves” makes the point. Anyway, due to multiple reasons much like the aforementioned soggy foliage, it is likely that any route you plan to take will be interrupted. This is enough to make anyone frustrated, but when you are already anxious and stressed it can feel like the end of the world and make you run back to your home wondering why you ever bothered leaving the front door. For this reason it is always vital to have an alternative route to fall back on incase any slippery leaves rear their ugly heads to get in your way.

2. Customise your route: When trying to look up directions, pretty much all of us will turn to the internet (dear young readers, did you know that maps actually used to be things you could find on paper rather than apps on your phone with floating blue dots. They called these maps “The A-Z”. They were marvellous things, I really wish you could have seen them), and when you look up directions on the internet it will often tell you what it thinks is the easiest route. However, this “easiest” route is the route judged as easiest by a computer, it is a purely rational decision and unlikely to fit with what is “easiest” for the irrational fears in your head. Of course we must all push ourselves and challenge our mental illnesses lest they control every aspect of our lives and sometimes there is only one way to get from A to B. Nevertheless if there are options on a journey that may not be the quickest route on paper but that will help you manage anxiety better, go with them. Walking a few streets along may take longer than hopping on the London underground, but if the tube is likely to cause a paralysing panic attack in the end, walking may actually save time and a hell of a lot of stress.

3. Do not rely on the internet: Another thing in life that can be as unreliable as the number 44 bus is internet signal. It is all well and good to entrust your travel plans into the route calculating hands of an online computer but if you find yourself in the middle of nowhere with no internet, Siri is going to be of little use in helping you out of that predicament. Even if you do have signal, phones and other pieces of technology are always at risk of running out of battery (especially if you have spent too much time playing Pokemon go…ahem), so regardless as to whether you found your route online, make sure you take a paper copy. Paper doesn’t require signal and paper does not run out of battery leaving you in an anxious heap. In short paper is awesome, so don’t forget to use it.

4. Listen to audiobooks: When on a train or a bus I often find my anxious thoughts speeding around my mind faster than the mode of transport I am riding, so fast that they are little more than a blur that I cannot decipher. Every bump in the road is a potential earthquake to my terrified brain, every new passenger a potential murderer, and for this reason when anxious on public transport it is vital to have distractions. A lot of people listen to music in order to help soothe them and if you are one of those people then make sure any journey out of the house involves earphones to listen to your favourite tunes. Personally though I struggle with listening to music on public transport, as when you put music on shuffle it can be unhelpfully unpredictable. It is all well and good to be on the bus nodding your head to a relaxing ballad from Adele but seconds later you can find yourself being bashed about the ears with the drums of heavy rock which is not relaxing at all. For this reason then, I often listen to audiobooks which I find are a lot easier to get lost and calmed by, so I thoroughly recommend them as a distraction technique (especially Harry Potter books on trains. That way you get the dulcet tones of Stephen Fry and you can pretend you are on the Hogwarts express as you listen).

5. Buy tickets in advance and get money ready: To buy tickets you need to queue. Queuing is stressful. People with anxiety and mental health problems do not need added stress. The solution? AVOID QUEUING (by booking tickets in advance at quiet “non rush hour” times or online, not by whacking everyone else in the queue out of the way with your hand bag.) Personally when it comes to buying tickets I also find touching money to be a challenge, so if you also struggle with this may I suggest getting your fare ready prior to the moment some ticket officer asks for it so that you do not have to suffer the money touching stress with the “oh my goodness I cannot find the right change why is my purse full of pennies people are staring at me” stress. When I prepare a bus fare in advance I always like to antibacterialise it and then keep it in a separate pocket to lower anxiety further. It isn’t ideal in terms of trying to fight things like OCD, but if needs must, in my eyes it is better to do whatever you need to to get out of the house.

6. Give yourself time and plan every step that is difficult: The final thing that I would say makes travel difficult is the general panic and hysteria I find myself getting into when I am in a rush/under a strict time limit. For this reason to reduce anxiety I always leave a lot longer for my journey than might otherwise be necessary AND I plan in travel breaks whenever I need them. It makes more sense to hop from train to bus to train and on again until you reach your destination, but incase the anxiety gets too much it is important to plan pit stops to release some tension and take a break from all the mania. Personally, with planning breaks I also like to plan toilet breaks because the idea of an unplanned unexpected public toilet experience freaks me out, so if it scares you too, maybe find loos along your journey that would be easiest and fit them round your ticket times.

So there you have it! The six tips that I use to help me get through the fear of public transport and the six tips I will hopefully be carrying out right now on the way to London (like I said it is a week in advance but already I have planned every safe toilet along the journey. PREPARATION IS KEY.).
Of course they won’t take the fear of public transport away, but hopefully they will make it a little easier or at least doable.
I wish you all safety and relaxation during any upcoming travels and promise to keep my fingers crossed that you are never faced with the horror film inspiring added obstacle of “slippery leaves”.

Take care everyone x

transportanxiety

Why It Can Be Scary Having People In The House When You Have OCD

In two days time, on the 5th of October 2016, I am having an assessment with a new OCD service that I have been referred to (just clarifying the exact date incase you have invented a time machine and are reading this somewhere in1912 which would make “two days time” a lie. I don’t want to ever lie to any of you. Also if you are in 1912 maybe warn the Titanic to look out for icebergs). I have been waiting for an assessment date for several months now so it should be a relief that the day is finally near and more intense support on the horizon, but my God I am terrified.
Funnily enough, none of that terror comes from the fact it is an assessment where I will be meeting two strangers and having to talk to them openly about my mental health. Over the years I have had hundreds of assessments, I have even had assessments to see if I am suitable for other assessments (seriously, mental health services LOVE assessments. They even sprinkle them on their cereal in the morning), but there is something slightly different about the assessment that is only a few days away. Normally an assessment involves going to a new building, getting lost for several hours down some poorly labeled corridors, and then turning up in a stark room with chairs, a psychologist and a table topped with a box of tissues which I think is supposed to look friendly and welcoming but to me it is intimidating, more a threat of “I WILL MAKE YOU CRY”.
With Wednesday’s assessment however, I don’t have to go anywhere, the two assessors are coming to my house, and THAT is the reason for my currently heightened levels of anxiety.

Like many people who suffer from OCD, I really struggle with people coming to “my” house. I am sure for each individual, the reasons for this vary, but for me it is because my house is my “safe” place. Leaving the house is difficult because I am entering an environment that I have no control over. I do not know who has touched the door handle to whatever building I am in, or when the chair I may be required to sit in was last occupied. Maybe the floor was mopped with antibacterial industrial cleaner minutes before my arrival, maybe it has never seen the bristles of a broom, either way I don’t know, hence why for me, touching things out of the house is more difficult than in my own home. I can’t actually remember the last time I opened a pull door in a public place and I have lost count of the hours I must have spent standing on the side of a road, waiting to cross yet unable to press the little button to alert the traffic light of my presence and inspire an appearance from the little green man. We need more Zebra crossings in this country!

In my house then, it is easier, because I know when everything was last cleaned, who has last used it and I also know that cleaning products are mere moments away should I challenge myself too far and need to whip out the bleach. When other people come into my house however, an element of that control slips from my grasp. For the duration of their visit I cannot control what is touched, moved or anything else people may do with items in my home.

These OCD people (I am sure they have names but for now that is what I shall call them) have said that they want to do the assessment in my house because they need to see me in “my natural habitat”. To be fair that makes sense (although it does make me sound a bit like a tortoise on a nature program being visited in its personal hovel), and as a lot of my rituals take place in my household it will help for them to see the “scene of the crime”, yet in anticipation of their arrival all I can think about is what they will touch during their stay and where they will sit. I have honestly been having nightmares that one of them will have been drinking a lot of tea that morning and need to use the bathroom, aka the holiest of holies, “my tap” (please God let the OCD people be dehydrated just for October 5th).
Of all the people I should be able to be honest with about these kind of difficulties, people from an OCD service would logically be high on the list. If anyone is going to understand my fears it is them, and they are the least likely to come back at me with a dagger of stigma that leaves me feeling like a total freak. Nevertheless I feel I can’t say anything out of the fear that it will be inhospitable.

If it was up to me, whenever anyone comes to my house I would like to put them in one of those little carts you get on a roller coaster, where the bar comes down and you hear that voice asking you to “please keep all arms and legs inside the vehicle at all times”!…I wonder if you can get those installed within less than 48 hours…or maybe I could just tie their arms to their sides with tape…is that legal?…I feel like that would be illegal…or at least frowned upon…
Even if it wasn’t frowned upon though I couldn’t do it because like I said it seems too rude. I want to greet these people with the gratitude they deserve for coming all the way to see me for the afternoon, but how can you do that or appear hospitable when you are terrified of the people you are supposed to be greeting? What am I supposed to say? “Hello lovely OCD people, welcome to my humble abode, please make yourself at home but for the love of all that is holy in this world please don’t touch anything because I don’t know where you have been”. Oh dear God what if they want to shake hands. AHHH.

I find it stressful even when friends come over to the house too, but at least my friends know “the rules” prior to their visit. I really hate having to issue guests with a list of requirements alongside their cup of tea, yet I know that if I were not to do so I would be crying hysterically within five minutes which would be even more embarrassing.
Thankfully I am incredibly lucky to have friends who accept my difficulties and respect my level of anxiety. It is a tough balance, as obviously people can’t give into everything when it comes to my OCD. That would be inconvenient for them and would arguably perpetuate my beliefs that their germs are a genuine risk. Nevertheless, there is a distinct difference between following the dictations of my illness, and challenging me whilst not pushing me past my breaking point. My friends know not to take their socks off in the house, not to sit in “my” safe chair, and they know that I will probably take a ridiculously long time if I go to the bathroom due to the necessary washing routines that entails (picture a surgeon preparing to remove someones kidney, soap up to the elbows etc.)
They know that none of my requests are personal, that I don’t think they are dirty people who are infected with a contagious disease, because they know me. Some friends have been in my life since the day of my diagnosis so they grew up with a knowledge and acceptance of my conditions that few would comprehend. One friend was even on holiday in Greece last week and she literally texted me from across the Atlantic (is that right…is Greece across the Atlantic…screw it lets keep it this way, it sounds dramatic), to tell me at 10pm to stop fiddling with my hair as she knew that I was home alone and probably stuck in a hair routine that often takes place during that time (which I was). With friends then, it is ok to tell them not to touch anything, but with strangers no matter how kindly you say it there will always be (in my eyes at least), a little resentment on their part. I know if I went to somebody’s house and they told me to keep out of the lounge for fear of contamination I would probably feel a little offended myself.

It really is a tricky balance trying to be a friendly host whilst trying to manage my anxiety and for this reason I know many people with OCD refuse to allow people into their houses at all, just one reason as to how this illness can be incredibly isolating. If my friends weren’t aware of my mental health I know wouldn’t be able to manage them in the house either.

I guess what I am trying to say is that when it comes to OCD, it isn’t always the behaviour of the sufferer that causes the anxiety, but also the behaviour and actions of those around them. It isn’t just my hands I worry about when it comes to germs, it is everyone nearby. Most importantly though, in feeling this way about others, it is in no way a suggestion that a certain individual is dirty and no personal judgement on a bystander’s levels of hygiene.
Equally then, if you struggle having people in the house, you are not a bad person or rude, just as I am trying to convince myself now that I am not a horrible person for wondering if it is socially acceptable to tie my assessors up with tape in order to restrict movement. Obviously I am not going to do that, I am as always just going to deal with it and hopefully get the courage to speak out so that they are aware of my anxieties rather than suffering in silence, which would consequently make them worse.

If for some reason my assessors are actually reading this prior to our appointment, please know that if I appear inhospitable at any point in your visit I truly am sorry and trying my best. I really do appreciate you making the effort to come to my house and hope you feel welcome and relaxed in my home…JUST PLEASE DON’T TOUCH ANYTHING OR I WILL HAVE TO TIE YOUR ARMS TOGETHER AND WRITE THE NOTES ON MY MENTAL STATE FOR YOU.

Cheers… See you Wednesday!

ocdhouse

Preparing For University With A Mental Health Problem

In a few short days it will be September, aka the month in which all of the leaves turn orange and everyone takes this as a sign that everyone should probably go back to school, or, potentially, to university. What with leaving home, meeting new people and learning to use a frying pan, going to university for the first time is stressful for anyone. With mental health problems however, the experience can be a whole new level of terrifying, and although your chosen institution may provide a handy welcome pack with maps and phone numbers of who to call when the oven explodes, they never seem to offer any advice on how to deal with the whole thing when you are a new student without marbles, a situation I found myself in several years ago.

I think part of the problem is that before people have even stepped onto campus, they have built up an image of what their first year at university is “supposed to be like” and anticipate having to be involved in various situations they may not be comfortable with.
People expect that they will have to drink copious amounts of alcohol, attend wild house parties where somehow everyone ends up naked, make best friends with everyone living in their accommodation, share a kitchen with people who never wash any dishes so that by month three the sink is covered in plates that have rapidly been growing some kind of blue fungus, carry out crazy pranks with their hilarious roommate Colin, get entangled in a passionate one night stand with a mysterious moustachioed stranger, live off kebabs/Pot Noodles/Pizza, experiment with drugs, and capture all hilarious moments on a polaroid camera to place carefully in a scrapbook which will then provide unforgettable memories of the university experience that will forever be heralded as the best three years of your life.
That university image, so often portrayed on social media, is understandably a nightmare concept for various mental health conditions. People with depression and social anxiety may fear attending all these wild parties when they are often unable to get out of bed, let alone party and interact with strangers. People with OCD may struggle with the wild unstructured “anything goes” attitude and questionable hygiene or lack of ritualistic order associated with student living, or people with eating disorders may fear having to drink alcohol and eat pizza to fit in at any social gathering.

Well, if that wild carefree party life described above matches your expectations as to what you think university will be/require you to live up to, I would like to invite you to place those expectations or ideas of things that are “supposed to happen” in a box, and then smash that box with a fairly large mallet. Nay, lets go wild. With a flipping colossal mallet.

Admittedly, my description of what people envisage before they go to university, really is the experience had by some students (bar the bit about hilarious pranks with roommates called Colin…people called Colin don’t tend to like pranks), but it isn’t the experience that you have to have or feel pressure and stress to be involved with. I would love to say that going to university with a mental health problem is easy, and it is true that some people find the new environment beneficial to recovery, but that doesn’t happen for everyone and it is important to acknowledge that so we can deal with it.

Indeed, when you embark on your university journey whilst dealing with a mental health issues, it is likely that it is not going to be straight forward and you may not have the same experience as everyone else. It isn’t pessimistic to think this way, it is realistic, and being aware of potential difficulties from the outset is a far better way to go about things than charging forth unprepared with deluded optimism, pretending you don’t have mental health issues in hopes that they will just go away. Denying them will not make university any easier and not dealing with them could make difficulties you thought wouldn’t be an issue come as quite a shock. The key is to accept early on that you are going to university in perhaps a different situation to most people (after all it isn’t every student that goes to get a degree whilst fighting an unrelenting mental health gremlin), and that is ok, not something to feel ashamed or guilty about.
You don’t have to pressure yourself to live the “expected” university life of gay abandon if that is something you cannot manage right now…

…That said, I am not trying to tell you all to go to university and allow your mental health issues to take over entirely, as whilst you must acknowledge the issues are there, it is good to challenge yourself and try new things. TO AN EXTENT.
University can provide opportunities for millions of new experiences, and though you may not be able to join in with all the things that are on offer, if there is something you would like to try that challenges your mental health problem in a manageable way, (whether that be going to a society, or saying hello to someone in your accommodation), go for it. I know I avoided all challenges in the early weeks by totally isolating myself (aka I lived under my desk for a month covered in a blanket in fear another student might see me through the peephole in my door and want to say hello), and it made things a hell of a lot worse for me in the long run.
Eventually however, I came out from under my desk, and over the three years I managed to go clubbing/ to a party a few times and live with some lovely girls in a shared house. I didn’t want to do any of these things and was terrified for various OCD, anxiety, ED reasons, but on days where I felt a little stronger, I pushed myself to try and join in with others. Of course it was difficult and I can’t say it always went to plan, but by dipping my toe into the waters just outside of my comfort zone occasionally, I managed to have some fun that I would have missed out on had I kept myself locked away in my rituals and bubble of safety.
What I mean then by saying you should challenge yourself to an extent, is to be aware of your difficulties and know when a challenge is manageable and when one is not. It is great to give scary things a go, but do not blindly leap so far out into the waters of your comfort zone that you end up drowning if you are not ready, just because you feel you should/feel pressured to. It is not weak or boring to say no to things everyone else is doing, so don’t be too hard on yourself. Nobody “fails at life” just because they didn’t manage to go to that foam party with UV paint being splattered into the crowd and needed to spend the night curled up under a blanket for a good cry instead.

It really is key that people remember the fact that when going to university with a mental health issue, you are ill, and have to put as much time into prioritising care for your mental health as you do for prioritising attempts at socialising or writing essays.
For example, if you have an eating disorder, it is important to make time to eat, follow any prescribed meal plan you have and not let things slip just because you are away from people at home who “know”, so if you miss bits nobody will notice. If you have depression and can’t get out of bed for a few days, take care of yourself and keep yourself safe rather than beating yourself up or feeling guilty about it. Prioritise taking your medication, make time to go to the Doctor, seek out mental health services available to you and take up offers of appointments. Equally, inform lecturers of your issues so that they can support you if you miss a lecture or require essay extensions, as although scary, being honest with staff and the support I received in return was vital for my experience.

Most importantly and the most difficult thing to accept though, is to know when enough is enough. It would be great to go to university with mental health problems and for it all to go swimmingly, but if that doesn’t happen and if you going to university has such a dramatic impact on your mental health that you find yourself becoming increasingly unwell, accept that this might not be the right time for you to be there. Allow yourself to drop out or defer until another year. Maybe in a few years time when you are in a better place you can try again, or maybe university just isn’t right for you, but either way it is fine, not a sign of failure, and no degree is worth sacrificing your health for.

There are a million other things I could probably go into when it comes to university and mental health or more specifics in terms of how to deal with it with specific illnesses, but I have waffled on too long and as a basic overview, I guess this is my advice:
It will be hard, it will be scary (much like an old toffee wearing devil horns), but the most important thing is to just try your best, take care of yourself first and never give yourself a hard time for being unable to live the “typical student” lifestyle.

That said if anyone would like more specific information or tips on managing university with certain illnesses or situations, feel free to comment or message me privately and I will do my best to help. To all those going to university in a few short weeks, good luck, I will be thinking of and supporting all of you. Take care.

University