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Loss of trust

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Wonky

Guest
This thread is prompted by comments made by a number of people in Shaun3210's thread about MH records.

That thread is in no way unusual in the way it shows a lot of sceptism, cynicism and suspicion of MH professionals and MH services based on experiences people have had.

I am absolutely in the same boat.

My question is when a patient has lost trust, how does that affect their engagement with MH professionals and MH services? And does it make effective treatment more difficult to achieve?
 
tjo73

tjo73

Well-known member
Joined
Jul 24, 2009
Messages
82
Location
Plymouth, Devon
I have had alot of problems with my local MH services on the several occasions that I have been involved with them. They have taken me off waiting lists for treatment(usually because they have sent the appointments to the wrong address), I was discharged from the service because my then CPN was sick for ages and when I rang to speak to her I was told I'd been discharged. I've also had problems with other CPN's who have promised me ringbacks/information which has not been forth coming, and when I have tried to ring them they are never there/ in meetings etc.
The current shrink i am seeing has after 2 meetings dianosed me as having borderline personality disorder, but hasn't actually bothered to tell me this I had to hear it from a CPN at the hospital.
If I am honest after all that I have very little faith in the service and even less in a shrink who makes a diagnosis after only seeing me twice, I find the shrink in particular very difficult to trust and i am seriously considering asking to see someone else, becasue without trust how can I actively engage in treatment if I don't trust the doctor, I think it isn't possible.:mad:
 
W

Wonky

Guest
Thanks for your reply, tjo73.

Your description of how you were discharged, echoes an experience I had in the past. My community team had two new Consultant Psychiatrists installed, taking over from the old one. I was promised in writing an appointment with one of these Consultants and a care review (I hadn't seen anyone at the team for a number of months and I hadn't had a care review for over a year). I never got the appointment - I was discharged by one of these new Consultants, someone I had never seen in my life!

I think you are right to be dubious about a diagnosis of BPD after just two meetings.
 
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Apotheosis

Guest
I am of the general opinion that I have not been genuinely helped by orthodox MH services. I am openly opposed to their practices. The LMHT & the MH practitioners are well aware of my attitudes, opinions & ideas to things.

What would the help have been had I embraced the orthodox MH 'care'? From my position I would have been far worse off. As I would have been given more drugs & in higher doses - as that is their main paradigm of care. I don't want that.
 
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Wonky

Guest
I am of the general opinion that I have not been genuinely helped by orthodox MH services. I am openly opposed to their practices. The LMHT & the MH practitioners are well aware of my attitudes, opinions & ideas to things.
Apotheosis, I am interested when you say they all are aware of your attitude and opinions. Do you still have contact with mental health services? If you don't, are there any practical disadvantages to being outside the system? Is your GP helpful and supportive?

Hope you don't find my questions intrusive, but this is an important issue for me.
 
tjo73

tjo73

Well-known member
Joined
Jul 24, 2009
Messages
82
Location
Plymouth, Devon
Thanks wonky
That same shrink who diagnosed me as BPD in just two meetings along with my STR worker who had come along with me for support to my last appointment made me feel very pressured and that I didn't want to get better because I refused medication. I have good reasons for not wanting to take medication, but was made to feel that I wasn't helping myself by refusing. How am supposed to have trust in them when they make me feel that I am in the wrong for having a different view to them on my treatment.
 
G

GrizzlyBear

Well-known member
Founding Member
Joined
Sep 22, 2008
Messages
971
This thread is prompted by comments made by a number of people in Shaun3210's thread about MH records.

That thread is in no way unusual in the way it shows a lot of sceptism, cynicism and suspicion of MH professionals and MH services based on experiences people have had.

I am absolutely in the same boat.

My question is when a patient has lost trust, how does that affect their engagement with MH professionals and MH services? And does it make effective treatment more difficult to achieve?
I am generally of the mind that GP's, pyschiatrists and psychiatric nurses (such as the woefully bad ones I encountered in hospital) are useless. There really is other way for me to say it (not without swearing anyway). So, when meeting new professionals I already come along knowing it is most likely I will find them unhelpful or annoying in some way.

However, I allow for the possibility that I will enounter someone who is intelligent, decent, understanding and respectful....because they are individuals like the rest of us, after all.

I have one GP who I've not felt compelled to swear about - or to (even if he hasn't been able to offer much help or support). I have a CPN and psychologist that I trust. My CPN respects my decision not to medicate even though he has often felt I would benefit from medication....and my psychologist made me feel similarly supported. I don't think it is down to luck....but it may be down to my openness. I am open to the idea that even though most of the people involved to date have been useless (including some I have made formal complaints about and some that have brought me to swearing at them in public) there remains the possiblity that someone better will come along.

All I ask for is respect and someone intellgent enough to grasp what is going on....and someone with an ounce of kindness and compassion (without breaching the serious nature of the professional/client relationship). They exist the world over. I always say "Keep trying" to anyone faced with disillusionment in this area. But stay open. If the door is locked shut no-one can ever get through to help.

I don't consider myself difficult (although they may have written that in my files)....because I am always responsive to the the qualities I mentioned earlier. I wasn't rude to anyone who treated me with some genuine respect.

I would say, again, never give up (IMO) but don't waste too much time with anyone who you intuit to be fundamentally unhelpful/disrespectful.
 
A

Apotheosis

Guest
Apotheosis, I am interested when you say they all are aware of your attitude and opinions. Do you still have contact with mental health services? If you don't, are there any practical disadvantages to being outside the system? Is your GP helpful and supportive?

Hope you don't find my questions intrusive, but this is an important issue for me.
Hi - At 17 I was sectioned. I spent 4 months on a locked ward & thought that psychiatry was nonsense. I did everything I could to get away from psychiatry - I left hospital; stopped the meds, & went into full time work. 4 years later I was again hospitalised. I did the same things again; but it took longer. Then I had another admission, & another. It got harder & harder to stay off psychiatric drugs, & away from the 'system'.

Some 8 years ago I made a huge effort to make certain changes in my life. I moved area, stopped drinking & taking illicit drugs, & made every effort to get off prescribed drugs. Over a 4 year period with no contact with psychiatric services & largely going it alone; I had two of the worst psychotic breakdowns in my life. After that time I have been back under the LMHT. I have had minimal contact - seen a CPN, a couple of Occupational therapists; & had 3-4 monthly psychiatrist appointments. I also keep taking a low dose of one med, & refuse any suggestion of any other meds.

To be fair; the support over the past 4 years; although very thin on the ground; has been the most I have had in my life from psych services. The people I have met, have generally been amicable & polite.

I have become better able to articulate certain things over the years; & also assert myself more.

The problem for me is that the help I want is not available. I feel harmed & damaged by psychiatry. However; given my present circumstances; it is a lesser evil; to presently continue taking the tablets; & have what little contact I have with services. The alternative is to have no help, & risk severe psychosis again.

I am relatively polite & respectful with people. I speak with psychiatrists & MH workers; in much the same way, as I talk about certain things on here. As far as I can gather; people are not silly; & MH 'professionals' are I think as fully aware as I am that the present paradigm of care is woefully lacking; & that drugging people; while doing little else; is genuinely not really helping anyone.

Quite how things change, or what accessible alternatives can be found (for me personally); is difficult to address. So I plod on in a kind of semi limbo. Given different social circumstances &/or money; then things could well be very different for me.

As much as I can I try to let go of the resentments I have, & try to not get too wound up with this whole situation. What else can I do?

I don't find the GP's very helpful at all; & rarely see them. I don't raise MH issues with them.

I hope that answers your question.
 
W

Wonky

Guest
Thanks wonky
That same shrink who diagnosed me as BPD in just two meetings along with my STR worker who had come along with me for support to my last appointment made me feel very pressured and that I didn't want to get better because I refused medication. I have good reasons for not wanting to take medication, but was made to feel that I wasn't helping myself by refusing. How am supposed to have trust in them when they make me feel that I am in the wrong for having a different view to them on my treatment.
Tjo73, you have a right of choice and a right not to consent to any particular treatement.

I don't consider myself difficult (although they may have written that in my files)....because I am always responsive to the the qualities I mentioned earlier. I wasn't rude to anyone who treated me with some genuin
GrizzlyBear, I know that I am difficult in their eyes. But if I can see that the individual is genuine and has integrity and is trying then I well behaved if still assertive.

After that time I have been back under the LMHT. I have had minimal contact - seen a CPN, a couple of Occupational therapists; & had 3-4 monthly psychiatrist appointments. I also keep taking a low dose of one med, & refuse any suggestion of any other meds.

Quite how things change, or what accessible alternatives can be found (for me personally); is difficult to address. So I plod on in a kind of semi limbo. Given different social circumstances &/or money; then things could well be very different for me.
quote]

Apotheosis, thanks for saying how you manage to stay in the system but keep it at hands length - that's very interesting.

And yes, if only we could be helped to change our circumstances and had the financial resources to do things for ourselves, I am sure there would be hope of improvement!
 
W

Wonky

Guest
NICE Guidelines for BPD (January 2009) say -

"
Person-centred care
This guideline offers best practice advice on the care of adults and young people under the age of 18 with borderline personality disorder.
Treatment and care should take into account people’s needs and preferences. People with borderline personality disorder should have the opportunity to make informed decisions about their care and treatment, in partnership with their healthcare professionals.


Autonomy and choice

• Work in partnership with people with borderline personality disorder to develop their autonomy and promote choice by:
− ensuring they remain actively involved in finding solutions to their problems, including during crises

− encouraging them to consider the different treatment options and life choices available to them, and the consequences of the choices they make.


Developing an optimistic and trusting relationship

• When working with people with borderline personality disorder:
− explore treatment options in an atmosphere of hope and optimism, explaining that recovery is possible and attainable

− build a trusting relationship, work in an open, engaging and non-judgemental manner, and be consistent and reliable

− bear in mind when providing services that many people will have experienced rejection, abuse and trauma, and encountered stigma often associated with self-harm and borderline personality disorder. "

Tjo73, if I was you I'd get a copy of NICE BPD guidelines, read it throughly, take the copy to every meeting and quote it as necessary.

[FONT=Arial,Arial] http://www.nice.org.uk/nicemedia/pdf/CG78NICEGuideline.pdf[/FONT]
 
tjo73

tjo73

Well-known member
Joined
Jul 24, 2009
Messages
82
Location
Plymouth, Devon
Thanks for that Wonky I certainly will do that, although I don't think I am seeing him again for about 3 months. I can't let them bully me into what they think is best, I might have a mental illness but I am still a human being who deserves to have my wishes taken into account.

Teresa(y)
 
A

Ainsworth

Guest
Thanks for that Wonky I certainly will do that, although I don't think I am seeing him again for about 3 months. I can't let them bully me into what they think is best, I might have a mental illness but I am still a human being who deserves to have my wishes taken into account.

Teresa(y)
hmm, i had one who when i asked for CBT he told me i could only be put forward for it if i went for group sessions for my anxiety and speak openly about it in front of lots of other people :eek:

as a person who either doesnt talk much or needs to write things down to communicate with most MHP you can guess i never went or got the CBT.

ive been told since this is called 'flooding' where they chuck your biggest fear at you and see if you sink or swim. very old school now and hope not many still do it.
 
G

GrizzlyBear

Well-known member
Founding Member
Joined
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Messages
971
hmm, i had one who when i asked for CBT he told me i could only be put forward for it if i went for group sessions for my anxiety and speak openly about it in front of lots of other people :eek:

as a person who either doesnt talk much or needs to write things down to communicate with most MHP you can guess i never went or got the CBT.

ive been told since this is called 'flooding' where they chuck your biggest fear at you and see if you sink or swim. very old school now and hope not many still do it.
Places for CBT are in high demand. I imagine they would prefer to send someone who will be able to talk since that is the nature of CBT.

It is worth bearing in mind that many people will have agreed to the group sessions and found them beneficial. Worrying about doing something nearly always feels worse than actually doing it. The 'sink or swim' thing actually works for a lot of people.
 
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Ainsworth

Guest
yeah your probably correct on all of that, im not a very good patient when it comes to therapy and trust and ooohh alot more things to do with life itself and i would of sunk fast

:innocent: :evil:
 
W

Wonky

Guest
Places for CBT are in high demand. I imagine they would prefer to send someone who will be able to talk since that is the nature of CBT.
I would have thought a one-to-one therapy would have been better for someone who has difficulties talking. Personally I would have told them to f**k their flooding nonsense (in a polite way ofcourse) and have stated that I was interested in one-to-one. I would also have found out if CBT was a recommended therapy for my problem and then shoved that in their face. (Red flag to a bull, this, I am afraid).

The problem is that the f**kers use so many things to ration services. They do not tell you about the range of treatment options. They ration information not just referrals. When they act in this way they do not deserve the respect of their patient.
 
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