Scattered pieces

Note: This entry may trigger due to issues around suicide being discussed.

I’ve been fairly open about my levels of suicidal ideation on this blog over time. But the last week or so, I’ve been dancing around the subject. The reason why… on the 2nd and 3rd of August I tried to commit suicide.

I’m still trying to make sense of the attempts, and the triggers which precipitated them.

The main things I remember about Monday, are that I didn’t work my usual late shift, and that I was very tired… very, very tired. So tired, that it made perfect sense to come home, empty a pill bottle into my hand and swallow them down with a caffeine drink.

I vividly remember looking at the pile of pills in my hand, and thinking… “This will help me sleep”.

This terminology is significant… “This will help me sleep”. Usually, my suicidal ideation and intent is termed “running away”, so I wonder if the change in phrasing was an indication that different ones were driving the attempt, or whether I was just really tired?

In the past, whenever there has been even a suicidal gesture, a protector has come forward and immediately called for help. But not this time. This time, I climbed into bed and waited for sleep. That was at about 6pm. The next thing I remember, is waking in a panic at 2.45. I wasn’t panicking about the pills that were now well absorbed into my system…  Oh no, I was panicking because I wasn’t sure if it was morning or night, and I was worried about missing work!

The details are fuzzy, but somehow we ended up in ER. ER’s always seem so bright… so well lit… super bright… I know this is a medical necessity, but it’s also about our fears. We hate hospitals. We feel ourselves get smaller, younger and more tongue-tied in hospitals… It’s hard to hear what people are asking of us, and we become more robotic.

As an indication that there was still come cognitive thinking happening, we’d remembered to bring our iPhone with us. Hours of playing Boost 3D, Euchre, Hell’s Kitchen… Anything to try to keep calm! Then the unspeakable happened, the iPhone battery ran out… This tipped the scales back to crazy.

• We removed the lure ourselves and went to the nurses station, asking to leave. They took us through to the observation lounge instead. Yay… power points for recharging the iPhone :)
• WPT came and visited us in the ER, and we brushed him off… told him we were fine and not to worry about us…
• When we were assessed by the psychiatric team… I say “assessed”, but to the system, it felt like a grilling.  They asked about family relationships, abuse history etc.
• By the end of the assessment, angry protectors were up front and they ripped up the discharge papers as we walked away from the nurses station.

Yes, we were released with no follow-up or safety options mentioned.

When we got home, there was still the need to sleep. I think one of us called the crisis team, but gave a fake name… I remember the crisis person yelling at us that they were sending the Police around. This was the wrong threat to make, as it gave the protectors hope that help was on the way. They became less vigilant…

We sat down at the table with enough pills for a fatal overdose. It was very mechanical and quick. Again, there was a need to have enough pills to “get some sleep”. Once these were consumed, we went to bed. Again, a panicked waking a few hours later and a ride in an ambulance.

This time it was serious… I knew that because of the number of nurses around. I remember looking over when they took my blood pressure, and saying how good it was (53/45). Usually my blood pressure goes through the roof in hospitals due to anxiety (the next day it was 195/146). I asked if I could go home, because my blood pressure was so good, and it was all just a silly mistake…

I remember the nurses being nice.
I remember them wheeling me down corridors to a ward.
I remember a nurse sitting in a chair at the end of my bed all night.

We called the mother, asking her to come up because we needed help. Our cat needed food…

We were kept in for a couple of days, and again had a psychiatric assessment, this one was much more gentle. They asked about safety and stressors. They gave us options – they suggested hospitalisation, or respite. But the psychiatric ward was fairly full, and the respite place would be different to the one I’ve been to previously. Instead, we were released to the mother (a former nurse) at home.

The thing that blew me away about the medical ward, was their compassion and understanding. I was there for an overdose, but they didn’t judge. They had almost no knowledge of mental health issues (I had to tell them how to spell “dissociative”), but they were respectful of me as an individual…

It’s now over a week since the attempts, and I’m still on shaky ground. Last night, R was very present. I know it was him, because I could clearly see what he wanted – to be wearing just jeans, standing in the middle of the road, in the pouring rain, arms up, yelling (in pain, release, anger???).

I’m very aware that I’m still walking along the cliff edge. One little push will send me over.

It’s times like this that I realise how amazing the people around me can be… WPT came to see me in hospital (twice); while my blog friends have been a steady, calm voice of reason when I needed it desperately… thank you!

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Now playing: The Freshman – The Verve Pipe
via FoxyTunes

So, long time no posting…  I wish I could report some wondrous reason for my absence, but unfortunately not.  The only reason is pure dysfunction.  The reason for the dysfunction are my lessons for the week…

Lesson 1: Remember, listen and pay attention

I’m often reminded of the ripple effect any incident can have in a dissociative system.  Something that doesn’t even register as a ripple to you, can be tidal wave to another part of the system.  So when I briefly posted an entry on this blog that contained the words “good girl”, I had no idea what the consequences would be.  I didn’t sense any real warnings about the meditation when I read the original entry.  But then, I don’t think I was really listening and paying attention to what was happening internally.  I was thinking of sharing what I thought was a valuable resource with others – librarian mode in full flight.

The first hint that things weren’t right, was a message from S:
“I’m no ones good little girl”

Once I saw this message, I edited the entry to something I thought was safer. Ellie tried to reassure S -
Ellie: “it’s been changed”
S: “too late… pay the consequences”
Ellie: “it’s been removed, no need for consequences”

The thing is, I should have known not to use that phrase – it was listed in one of the original trigger inventories that I did early in my healing journey.  But I was arrogant, careless and disrespectful.  I was thinking of sharing a resource, more than I was thinking of the ones who carry the wounds.  There were consequences to using that phrase, and it’s impossible to blame her.  I trampled all over S and her triggers, so why should I expect niceties in return?

Yes, it would have been great if S could have dealt with the situation differently.  But, it also would have been great if I’d thought about what I was doing.

Did I really pay attention inside? No.
Did I think about the phrases I was reading and using? No.
Was I being a self-important pompous twit by finding something that others might find useful? Yes.

I was thinking of myself more than the system.  No wonder they don’t trust me.

Lesson 2: Be responsible for your own safety

Yes, the consequences of my actions meant that S lashed out.  The flashbacks were horrific and all consuming. This allowed the ones who are dangerous to come forward and, for want of a better word, play with the body.  But before we reached this point, I had the opportunity to ask for help from Allison and the crisis team.  That would have been the sensible thing to do, but what did I do instead?  Basically, I set Allison up for failure.  I was unable to say the words “I need help”.  Instead I buried the message in emails from M and the young ones tried to tell how scary it was within therapy.  It wasn’t surprising that Allison couldn’t work out how bad things were.  But her inability to read all the messages that seemed obvious to us, meant that she had failed.  So after therapy on Monday there was a dangerous incident that meant we ended up in respite care for two nights.

The truly sad thing, is that even after the incident, I wasn’t able to communicate to the crisis team that I was still in danger.  Both Sophie and M were telling the team that we were in danger, but also didn’t want to cause a fuss, so were going along with their plans to send us home.  When it became obvious that this was going to happen, a very restrained Frank came forward and indicated how unstable we were.  At least some part of me was willing to step up and protect us.

So this is what I’ve indicated to Allison that we need to work on immediately, my inability to communicate the level of danger I’m in.  I need to know how to read the signs within the system and communicate it clearly.  I know I’m hampered from this free communication because so many of the young ones are triggered by hospitals, and our fear is that if we are honest about how bad things are, we’ll end up there.

If I’d been honest today, I probably shouldn’t have been released from respite.  But respite was different this time.  I was in the same place, but the carer in charge for the week was different, as were the mix of the clients.  This threw the dynamics off to the point where it didn’t feel safe.  It felt like my house growing up; rather than the healthy, vibrant place that the other carer made it.

I know I’m not out of danger yet.  I’m seeing the crisis psychiatrist today, so I’ll get another chance at trying to be honest about my level of danger and establishing what options are available to me.  I’m almost resigned to a hospital stay… some think this would be a good idea, especially in the secure ward where we can release some of the pent up emotion in a safe environment.

So at the moment I feel like a complete and utter failure.  I put the system under more stress at an already stressful time, and I didn’t take adequate steps to protect us once the damage had been done…  Yup, a failure.

Note: Please be aware that I am getting support, I’m not putting this out there and expecting readers to save me… although donations gratefully accepted (especially therapy vouchers) – you know, just saying :)

“I always thought there was something going on.”

Those are the words my mother has repeated to me several times about one of the sisters boyfriends who was abusing me.

“I always thought there was something going on.”

Those words are possibly meant to validate what I experienced… sort of a vote that the mother believes we may have been hurt…  But this is what those words say to some of us…

“You were not worth worrying about.  I suspected you were being hurt, but you weren’t as important as the sister… our reputation… my feelings… anything… you are, and were, worthless and meaningless.”

Because of how we view that sentence by the mother, I think there is a deep seeded feeling of resentment towards her.  I don’t know if it is anger, maybe it is.  I don’t know what anger feels like…  Liz tried to explain to me that my feelings of anger drive my self-injury and suicidal ideation.  If this is the case then I’m in trouble, as the mother is coming up for a two week visit over the Christmas break.  Already the craziness has started…  Last night I spent a disastrous night in the local psychiatric ward because I felt so unsafe.

Last nights experiences again raises the question of where I can get effective help in keeping myself safe.  I talked to Liz about my safety last week and she suggested respite care places I’d never heard about before.  This might be my only hope of finding somewhere I can go to stay safe and have the space to work on what I need to internally.  Last night has shown me that I won’t find that environment in our public health system.  So my only hope is to work this through myself with the basic level of assistance that Liz can offer.  I realise that I can’t do this with the mother here.  I could try to cancel her visit, but this is unlikely to occur as she has sold her house and will effectively be homeless over Christmas.  So, my devious side has come up with a plan to use her to feed our cat while we go into respite care.  I’m not sure if I can work it – it will depend on the psychiatrist saying that it is necessary, the respite places having an opening and me being able to cope with the place without necessary things like my computer – I will have the iPhone though, as long as they have wifi or 3G…  I’ll also have the camera…

I realise that the people in the respite care won’t have any specialisation in trauma or DID.  But, as a friend suggested, I need to work on this stuff internally or else I’m in trouble.  So, if I can’t look for external sources for that help, then I’d better find some way of facing the internal chaos in my own way.  I won’t necessarily find the answers or get the insight that would come with an external opinion, but it’s better than treading water in an ocean rip like I’m currently doing.

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Now playing: Hollie Smith – Bathe in the river
via FoxyTunes

In the town where we grew up, there was a psychiatric hospital.  It was spoken about in hushed whispers as a scary place where crazy people were fenced in and tortured.  In reality, the hospital catered predominantly for those who were institutionalised during a time in our history when those with even minor problems were often hidden away.  We were told as part of our abuse, that if we told the secrets we would be sent to prison or this hospital forever.  So our early contact with psychiatric hospitals was negative.

If you place these experiences within the context of our rather traumatic experiences with the medical profession, you get a picture of someone who has deep seeded issues and fears about all things medical.  The young ones especially react with terror even when driving by a hospital.  We avoid dentists, doctors and nurses where at all possible.  In many ways this fear enabled us to appear high functioning for many years – if there was a threat of having to ask for help through therapy or medication, well that just wasn’t acceptable.  Time to stamp it all back down into The Basement and carry on being invisible.

Then arrives the dissociative train wreck we experienced when about 34.  Our coping mechanisms fell apart.  Then there was the final straw – we were teaching a group of 40 students when something about the interactive whiteboard markers caused Angel to come forward.  So there you have a 5 year old drawing pictures of flowers on the whiteboard while a group of adult students look on.  M comes back to find half the board covered…

So back to therapy we went.  We were in the throes of an abusive marriage and suddenly facing a childhood that wasn’t as perfect as we’d convinced ourselves it was.  These factors led to constant suicidal ideation and intent, which in turn resulted in us needing to find some support to keep safe.

In New Zealand there are a few support lines for suicide help – Lifeline, Samaritans, Youthline, the emergency number or the local mental health hotline.  Lifeline, Samaritans and Youthline are confidential – unless they feel you are in danger, in which case they will try to get your details and send around the Police.  Emergency services transfer you through to the mental health hotline, unless you are already need emergency care.  Once you’re in the mental health system, you are told to call the mental health hotline.  Usually you wait for 5-10 minutes on hold before the phone is answered – ever been suicidal during the Christmas season and had to listen to Christmas carols for 20 minutes while waiting to see if someone can help you stop killing yourself?  You can at least double the waiting time if you call after midnight, as that’s when they go down to one or two operators.

If you do manage to get through to a human, you’re asked for your details – name, phone, address, caseworker and then why you’ve called.  If they consider you to be at risk, they will send around the local mental health workers to assess you.  If they consider that you aren’t at risk, they will discuss grounding skills you can use before sending you on your way.  The problem with this is that at any one time we can have up to 5 suicide plans – apparently that means we don’t really mean to die as we’re not focused on one plan (we consider it covering our bases in case one doesn’t work).  We can also begin the phone call with one who wants to reach out for help; but by the time we get to actually talk to someone, we’ve switched to one who either won’t talk or says that everything is fine.  So in many ways the service doesn’t suit us (and a majority of the population).

If you are considered at risk, you get the joyful experience of being escorted up to the psychiatric ward of the local hospital.  Where you begin the wait for some poor registrar who has been working for at least 10 hours and is surviving on a combination of adrenaline, coffee and sugar.  This person then has to assess your level of danger.  Most registrars haven’t dealt with anyone with a dissociative disorder, let alone tried to understand if there really is a risk.  They have a thankless job of walking a tightrope – is the patient telling the truth?  To make this job more complicated, during our experiences with registrars they’ve encountered -

• Aimee (9 yrs old and carefree) who smilingly told the nice young registrar that she was too young to drink.  Quite forgetting that the body she shares is in it’s mid 30′s and sitting cross-legged on a hospital bed while drips are hanging from each arm to pump us full of drugs to counter the drugs we’d OD’d on.
• Sophie (16 yrs old) who is our safest bet for these assessments – no one would section Sophie.  The main problem is getting close enough to hear her as she talks very quietly when scared or worried.
• M who is the other safe bet.  She’s confident and knows how to work the mental health system to ensure that we are released.  Release is always her goal as the young ones she protects are violently triggered by hospitals.
• Ellie who won’t be sectioned as long as she can keep her swearing and scorn for the medical profession under control.
• Frank who is the worst one to front for an assessment.  He doesn’t get suicidal, but doesn’t understand what constitutes aggressive behaviour as seen in the eyes of a psychiatrist.  He doesn’t actually get aggressive, but his anger at being in a hospital is seen as aggression.

It’s at this point where we’ve usually been sent home.  But on two occasions we’ve been admitted or sectioned under the Mental Health Act.

Event 1:  Sectioning with two nights in hospital.

1. Night of admission, put into art therapy room with triggering artwork around the walls.
2. Given a single room across from an alcoholic man in his 40′s (the father is an alcoholic).
3. As punishment for being admitted W used all of her strength to try and break the arms by bashing them against the storage unit in the room.
4. A miracle was there in the form of a part-time night nurse.  She realised we wouldn’t sleep so asked if we wanted art supplies and then she sat and talked to us.  She didn’t care who she talked to, she just sat on the floor and let us talk and draw.  She got us Arnica cream for the bruised, swollen mess that was now our arms without a fuss.
5. Then there was the daytime registrar.  We had asked to be released as the hospital was too triggering.  He went through the whole assessment again.  He asked why our symptoms made us special.  We tried to explain that we weren’t special, just sometimes experienced dissociation.  He dismissed the dissociation saying it wasn’t important.  Then when returning after talking to the consultant, said that the dissociation made us too unpredictable to release.  Yes, the one symptom that he totally dismissed, became the thing he used to keep us in.
6. That night the same part-time nurse told us how to get out – say the words “I have no intent”.
7. The following day a different registrar got the consultant to come in and talk to us.  He was going to let us out for the day, but M came forward and dazzled him with a veil of sanity.  We were outta there.

Event 2:  Admitted to the secure unit with one night stay.

1. Saturday afternoon attempted suicide through an overdose and was taken to ER by the husband.
2. Put on a drip and was overwhelmed by the dissociation.
3. Overheard the nurses say that we hadn’t really overdosed, but were just attention seeking – our bed was right beside the nurses station and strangely enough the curtains aren’t sound proof.
4. As soon as we were coherant, we asked to leave.
5. After a 5 hour wait, we were assessed by the same psychiatrist who once picked up the phone while we were in the room and told the DBT specialist that “the borderline actually turned up, do you want to come meet her?”
6. Because of all the triggers, Ellie and Frank weren’t able to control the anger very well.  We were escorted to the secure unit by the Police.  We didn’t threaten anyone or even raise our voice, but we were considered to be irrational and dangerous because of the barely contained rage.
7. We were released the next morning.

If we are ever sectioned again, we’ll request to go to the secure unit.  It was comparatively peaceful and safe.  If any of the half a dozen patients even raise their voice, they are immediately surrounded by about four staff and taken away to be calmed down.  The only downside was that the cups of tea were lukewarm – hot water being a dangerous weapon.

This is a very light hearted look at our experiences.  In reality, during the sectioning Sophie was nearly destroyed when her twin came from The Basement to tell her why they were created.  The day after we were released from the secure unit, the ex-husband tried to kill us.  Other incidents have occurred while we’ve been waiting to be assessed, including one I’d like to forget where a patient masturbated while looking through the window at us.

We sit in wonder when people say that they voluntarily go to hospital.  It’s a concept that we don’t understand – why would you volunteer for torture, ridicule and scorn?  We know our perception is warped and that hospitals help people every day.  But it’s not something we identify with.  It was once recommended that we go to Ashburn Hospital for a minimum of six months to try and break our cycle of destructive thinking.  Just the thought of that was terrifying.  I wonder if part of the reason is that in New Zealand the focus within the psychiatric ward seems to be on holding you in a safe place until the suicidal intent goes, rather than helping you in a long term way.  It’s reactive rather than proactive.

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Now playing: Dixie Chicks – Wide open spaces
via FoxyTunes