Did Somebody Say DBT?

Recently I’ve been having assessments to see if I’d benefit from a therapy programme that uses DBT and Mindfulness. After many worksheets and conversations I have been put forward for a full programme. This means one skills group and one 1:1 session a week for about a year.

What is DBT?

Dialectical Behaviour Therapy is all about breaking down negative and destructive cycles and creating better ways of coping for yourself. It has foundations in Mindfulness and Cognitive Behavioural Therapy and allows people to develop a more in depth understanding of their negative thought and behaviour cycles. It involves practical skills of how to take action to avoid dangerous behaviour. It is also about helping you to accept your struggles as part of the make up of who you are, but not your whole definition.

The Assessments

What came over very strongly during the assessments was how much hard work DBT involves. It means two sessions, plus my CPN appointment and then homework on top- every week! From what I gather it seems the skills need to be practiced near constantly (even when they aren’t required) in order for them to develop into instinct at times of need. It’s about acknowledging the problems you have, why they may be valid, why they may not, and finding strategies to overcome them.

During the assessments I had to talk about some very difficult things that I find painful. The assessment is important because it ensures that you are suitable and will benefit from the therapy. I think the wonderful Ruby Etc. shows the trouble in seeking help from services perfectly in this diagram. In mental health services you are either ‘too mad’, ‘or not mad enough’. Luckily(?) for me during this assessment it appears I struck the middle ground.

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I’ve wanted for a while to include more help and advice on Upside Down Chronicles. I’d like to be able to share skills and strategies with others and enable people to try techniques for themselves. I know how hard it is to get the help from services, so maybe getting second hand skills from UDC might just help someone. Obviously I’ll be writing as a person experiencing the therapy- not as a therapist or expert myself.  I don’t know when there will be a space for me to start the course, but I am very excited to be finally offered some formal help.

If you want to have a look and a head start, the book the programme uses has been published online for free here.


School Refusal Is Far More Complex Than Just Truanting

On Thursday I was honoured to be asked to speak to a group of young people who, for one reason or another, are unable to attend school regularly. They meet in a brightly painted bungalow ominously named as home of ‘The Prevention Services’. There were five young people all facing very different issues to do with school- bullying, anger, frustration and fear being the main reasons for not regularly attending. This general anxiety surfaced in the form of long absences and sometimes exclusions.

Talking to the group was great. As someone who had a lot of trouble attending mainstream school because of intense anxiety I knew what I would have wanted to hear in their position. I told them that they may be terrified of school but they should never, ever, be terrified of learning. Hatred of school does not equal hatred of learning, and if you keep learning there is a way through the tangle of school refusal. I hope I was able to be of some use to them.

It was hard to imagine these bright, quirky and talkative young people not thriving in school. We talked about the problems in the school environment; it is too big, with too many people and holds too greater focus on discipline. One young person spoke about anger problems and how in mainstream teachers would rile up the situation more by using discipline rather than redirecting or calming down the rage. Since moving to a specialist unit this young person has access to these strategies and enjoys learning much more. Before the unit they had been excluded a dozen times. Not everyone’s anxiety showed through acting out and anger, for some it caused them to turn inwards- too scared to speak to anyone or walk through the gates.

The young people’s idea of an ideal school was surprisingly achievable. A more college-like setting where staff respected students and vice versa. They would want to be treated as individuals with different learning styles. The classes would be small and with more hands on practical learning. There would be more support because, to my surprise, some of the young people had made it to year 9 without knowing if there was any pastoral care in their school at all.

The project involves making an animated film in order to explain to professionals the miriad of reasons why a young person might not be attending school. This sounds like it couldn’t be more needed. We started styling objects out of plastercine. We made a foreboding looking school gate and a young person contributed a skull on a stick to place next to the gate. Across the table a young person made a plastercine noose. I saw how not attending school could be both a necessity and an agonising decision to make as they are intensely aware of the pressure it puts on their families. They feel immensely guilty and sad. At the end of the session taxis pulled up to take the young people back to their education providers. One young person who had pre-arranged to go home instead due to an injury went wide eyed:

“Is that taxi for me? I won’t go. I’m not going. I can’t.”

“They’ll kidnap me.”

School refusal and low attendance is not straight forward. These are not ‘bad kids’. They have anxiety, precarious home lives and aren’t equipped with strategies to get through. School adds steam to the pressure cooker. School refusal is far more complex than many would believe.

How To Fear Food Fight

 

Step One

Listen to your gut instinct. Not anxiety’s gut instinct. Yours. We’ve heard enough from anxiety. Is this food something you would like to eat? Have you eaten it before or want to try it? If you answered ‘yes’ move on to step two.

Step Two

Do it. Think no more.

… Okay, it isn’t quite as easy as that, but go for it. Find an accomplice to aid you in your tasty mission. Enjoy it. Don’t talk yourself out of it.

Step Three

By far the hardest. Do not let your mind fool you into believing this is a big deal. It isn’t. There will be things you regret in your life but in twenty, thirty, forty years time you will definitely not be regretting eating this. It will not play on your mind until your old age. The feelings you have now can be interpreted as anxiety… or excitement. You are rubbing anxiety’s face in the freedom you have found. And that is exciting. Either way this feeling is temporary. This will pass.

Distract yourself, listen to music or watch a film, read a book or go online. Do not waste a moment on anxious thoughts. If you find yourself getting anxious reread the previous paragraph.

Step Four

Later, record somewhere what you have achieved. Keep it and use it as evidence that anxiety is wrong. Nothing bad happened. Anxiety may have made you feel rubbish, but that is not the food’s fault! Your anxious reaction will get less and less if you keep fighting it. Keep challenging and gaining new territory from the anxious dictator and you will conquer. Some battles will be harder than others, but if you keep fighting you will come out on top.

Do Mental Health Awareness Days Actually Work?

Do they raise awareness or just give an opportunity to talk about how ill we are?

This year during a tsunami wave of Awareness Days for various mental health causes I found myself conflicted. As a blogger I feel almost obliged to write a summary of my story, list diagnoses and maybe share a selfie in aid of the cause. It’s what I’ve done previously along with many other bloggers, so why not this year?

This year I feel a bit sceptical over how much good some of the awareness campaigns are doing. In particular I think any social media campaigns on such days should be looked at carefully. I see a lot of people sharing their stories of mental illness in statuses and people who also suffer commenting on or sharing them. The mental health Twittersphere is enormous and very tight-knit. Sharing makes individuals with mental illness feel less alone, which is fantastic, but the message is not reaching far outside of the mental health community itself. Online communities are so important for supporting those with mental illness. On events like World Mental Health Day how do we spread the message to those who aren’t looking for it? 

According to TV Licensing 68% of the UK usually eat their evening meal in front of the TV. I’m really disappointed to not see any major documentaries shown to mark World Mental Health Day. A documentary on a major channel during prime time that someone not clued up on mental health might catch on a whim, would be really effective. Assemblies in schools which all students, mental health savvy or not, have to sit through. Big public events that  a stressed or distressed passerby might stumble across. These are great examples of awareness raising events. It is so important that we target those who don’t already know about good mental health.

There seems to be confusion in distinguishing between ‘mental illness’ and ‘mental health’- with some even using the terms interchangeably. On a mental health awareness day surely we should be stressing the health. Mental health and illness are not the same thing, in fact they are opposites. On an awareness day of mental health we should ideally see more articles and posts about how people keep, or try to keep, mentally healthy. Messages of encouragement, things that helped during struggles, symptoms you might feel too ashamed to seek help for, resources, support services. There is, after all, much more to gain from learning how to be mentally healthy than sharing what happens when you are not.

On social media are we being a little bit self serving? And is that a bad thing? Several Mental health tweeters responded to my call for a discussion on whether these days actually do what they say on the tin. Some even find the days overwhelming due to the influx of mental illness/health posts.

@bordeline_OK: "I worry that any "x day" ends up highlighting difference, not improving parity of care/esteem, not destigmatising, not removing barriers."@OCPDme: "On this account, the tsunami of MH awareness tweets was overwhelming."

@gerbillady: "Maybe on social media it enables people with mental health difficulties feel less alone. Depends what you mean by work."@WhiteCaneGamer: "If it takes a million tweets just to help one person who needed it, then let the tweets fly."

@AshleyCurryOCD: "Overall does it make impacts on improving access to right help and support from local servicesI think @AshleyCurryOCD sums the situation up well. Does it make an impact on improving access to services? In most cases no. I think our attention needs to shift to this as a goal. We should push for mental health to be a subject everyone knows about and make sure there is help so that everyone can gain it. We should support those with mental illness and treat mental health with the same urgency as physical health. People should be able to share their stories whenever they need to. There should be a day for mental illness awareness and visibility for people to learn compassion towards people with mental health problems. Days for awareness of individual mental illnesses are a fantastic idea and they should be just as well supported as the bigger events. Mental health is so important, and how to gain it should be public knowledge.

“Young People Hearing Voices; Suffering, Inspiration and the Everyday.”

I’ve blogged already about the ‘Listen Up!’ workshops for young voice hearers which I was lucky enough to take part in. All the young people from workshops previous met for one last time in Durham to finish their pieces ready for exhibition. Without further ado, these amazing pieces can speak strongly for themselves…

A small wooden box has a white plastercine figure stroking a cat. The back of the box is decorated like a garden. In the sky it reads 'Bring me to Reality'

Black letters on a white poster reads: Just Go And Get Your Facts Straight

Black letters on a white background read:

On a white background the outline of a head is in black. Inside in black letters are the words:

A purple background has many many circles in yellow, green and lilac. They cluster towards the centre where there is a white clearing. In the clearing is one single black dot.

On white paper in red bubble writing is 'Everyone has a unique story.'

Three boxes, one larger one filled with colourful circles has a circle of green fabric dolls in front. A bubble coming out of one doll reads

A girl's head in shades of blue. She looks non expressive. Coming out of her head are splashes of colour and three birds flying out. Inside a blue box are several dolls. They are white and black splattered, The one at the front of the group is looking out with big dark eyes. The box is wrapped in purple thread so it is like a thick cobweb on the front.
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Thank you so much to the Wellcome Trust and Hearing the Voice for giving time and space to simply be.

The finished pieces and more will be on exhibition from the 5th of November at Palace Green Library, Durham University.

Listen Up! Workshop #2- Pieces and Reflections

You might have seen my previous blog where I expressed my joy at going to a creative workshop especially for young voice hearers

I was absolutely over the moon to get an email saying that due to the high demand there would be one more workshop at Art Link Leeds. 

The amazing Mary Robson came prepared with canvases and mirrors to make one of the ideas from my book into a piece of art. I was (with safety precautions taken) given a mallet and some mirrors to smash. 

On the first canvas I wrote in between the glued on shards a Groucho Marx quote: “Blessed are the cracked for they let in the light”. I have always found this a really inspiring quote- no matter how damaged or cracked you get in this world, the light will still come through.

The second piece was more personal. My reflection (literally) on trauma, illness and affirmation.

“The pieces stay together because they have to. They don’t work together quite the same though. We are all still me, we just got splintered into other things too.” 

It was great to meet up with Rai, Mary and the two other participants again. Smashing mirrors was highly therapeutic; and I’ve decided it isn’t bad luck as it is for creative purposes! Next stop- the exhibition in Durham! 

Mental Health Communication Cards

A few months ago I did some work with Hannah Ensor of Stickman Communications to design some communication cards specifically to help people with mental health problems.

Hannah is amazing and one of my favourite people to throw ideas around with. She is very patient and willing to consider anything no matter how ‘Out There’ it may be. I was honoured to be consulted about these cards. 

The new cards in the Mental Health range include: 

  • “I think I need a hug”
  • “I don’t feel able to talk right now”
  • “I have depression…” (+description)
  • “I don’t feel safe right now”
  • “I have an anxiety disorder…” (+description)
  • “I have a condition which means I see the world differently…”
  • “I don’t feel able to talk right now”
  • “Please may I talk to you?”

Plus the poignant: “Cuppa Needed!”

These cards are incredibly handy and provide a quick way to indicate how you feel or what you need. I find that they are really useful if you want to discreetly make someone aware that you need some extra support. They are also great for explaining what would help on an ‘off’ day. I have a lot of cards from Stickman Communications split between two lanyards, one for home use and one for in public. Hannah has so many amazing cards in her shop that are helping people deal with a huge variety of different medical conditions.

I’m hoping that this could be the start of a great partnership between Stickman Communications and Upside Down Chronicles to get helpful products out there for people with mental health problems and other invisible illnesses.  

What would your ideal card say?