Chronically Suicidal & no trust in Psychs

[Ovait]

Hi, so I’ve been diagnosed with MDD, PTSD & chronically suicidal for the past 6 years. I have attempted a number of times l. I know I need help but I’ve been through hell at the hands of a particular public psych ward over a number of inpatient stays which has completely eroded my trust in the psychiatric profession. I did have a private psychologist who was the only one I trusted but unfortunately he has become ill & has had to stop working. He knew I have a plan & means etc but never forced me to give anything up. It’s my safety net. I’ve finally found a new psychologist (after 6 months) who is talking about us having to have “trust” in each other & a safety plan. That plan will involve going to the hospital that has traumatised me. 
How can I have trust in a person I don’t know & who has links to the hospital that has traumatised me? I can’t give up my plan - that’s my “get out of jail card”. He won’t treat me unless I agree to a safety plan which I don’t want to do. 

[white knight]

Hi, welcome,

Firstly before I answer your post we are here 24/7/365. Once you post sit back and wait a while until your post is answered. Community champions like myself have a list of unanswered posts when we log on and we will see you have posted. So feel free to utilise this site to answer your questions. Also we have a good library so just use search above.

I was mistreated at a workplace once by an older man. Then he was replaced. The next manager I didnt trust and told him, based on my previous experience. He said "But I'm not him". From then on we became good working buddy's and friends. The best boss I ever had. Goes to show, in your case hospital staff and psychs are all different. IMO you're better off going along with your psych and taking precautions with coming into contact with staff. If they are staff that mistreated you then lodge a complaint, furthermore object to them directly- remind them of the last time they cared for you. This entails a defensive approach and turning it into a objectionable response.

Some people dont have this objectionable ability especially unwell and sensitive people- it is something you need to develop and it isnt easy. Standing up for yourself is a requirement in society, no different to surviving in the animal world where animals fight back in order to keep on living. 

So you could write down what to say if you meet up with a toxic staff member to remind you of what to say. eg  "last time you cared for me you were blunt and nasty, I prefer you do not take charge of my welfare and be replaced. If you are not replaced then kindly treat me with respect and we will get along better". 

We all dont want to do some tasks in life. Not all of a task is bad news. Some tasks have difficult parts we have to swallow in order for the big picture to succeed. So try to accept this and get well which is your aim

What do you think?

TonyWK

[therising]

Hi Ovait

A good plan is typically a plan we can relate to in some constructive way, otherwise it can be a triggering and completely unrelatable plan, technically. Seriously tough with your psychologist having to take leave, especially seeing the plan they had for you may have been one you better related to, one that suited you, as opposed to it being a typical or general kind of plan that may tend to suit others.

I've found open minded people tend to have the most effective plans. Not sure whether you'd be able to open the mind of your current psychologist. Can you lead them to imagine what it would feel like to go to a hospital they fear or dread? If they start to feel stressed or anxious, you know you've been somewhat successful in leading them to feel how you feel.

If it has to be the same hospital and there's no choice, maybe a different plan could look a little like you having to have a quite yet supervised room on your own with specific music playing, as opposed to being taken to wait in a noisy highly triggering public hospital ER. Certain comforting food may need to be allowed. You should be permitted to take in a bag that contains a specific self soothing collection of things. The person treating you in hospital has to  appear to care, not be in too much of a hurry, not lead you to feel like you're an inconvenience and definitely not be permitted to speak to you about personal matters with other patients in the room (been there, done that and it definitely makes it feel like an overall shameful experience). I should add there is absolutely no shame in not being able to cope with life at times. No shame at all. Some days just feel so impossible to live through. So, in a nutshell, the plan for that hospital has to appear as different from a standard run of the mill kind of traumatising plan.

Trust often comes down to promises that can be kept. A common promise (aka compromise) between 2 people could mean you promising to attend the hospital under circumstances your psychologist promises to have in place for you. What the hospital promises to deliver may need to be worked out between them and the psychologist.

[Ovait]

Thanks for your reply.

I could pretend to play along with his safety plan but I know that I cannot keep a promise to attend this particular hospital if it’s going to mean an admission to the AAU & that makes the whole safety plan fall apart. “Treatment” over a number of admissions has contributed to PTSD symptoms, so much so I’m feeling anxious just writing this. 

I live in a town where I haven’t worked in over 6 years, I’ve lost contact with everyone I knew, I have no friends or family I’m comfortable in contacting in an emergency and the place I should go for help has traumatised me so much that I’m anxious just driving past it. I’m not even comfortable fully disclosing things with psychologists (or even having in person appointments in case they section me) - trust is a huge issue for me when it come to psych professionals! Just going to see this psychologist for the first time was stressful. 

[Eagle Ray]

Dear Ovait

I feel for you in this situation and how vulnerable it is for you. It sounds like you had a sense of trust and safety with your previous psychologist.

 I wonder about a couple of possible approaches. One would be to explain to the current psychologist about the PTSD symptoms in relation to the specific hospital and how much it’s affecting you. You may have done this, but I thought just in case he isn’t fully aware, this may prompt him to look at an alternative approach. Maybe he’d consider a different hospital (if there is one as an option) as part of a safety plan. The best approach will always be one worked out with you rather than for you.

Another possibility, if you intuitively feel unable to trust the current psych, is to actually research to find one who is a better fit. This obviously takes effort and isn’t easy when dealing with mental health issues, but it might be a way to find a psych you connect with. I’d had some not so good experiences with therapy and ended up doing a lot of my own research. I came across a trauma processing approach I really wanted to try. I tried a few practitioners of it that weren’t the right fit. But eventually I found a psychologist online whose description of her approach really aligned with me. I started working with her and she has been excellent. It’s via telehealth so that’s an option too if you can’t find a psych near you. Sometimes  just following your intuition and continuing to search can lead you to the right help.

I think if you can stay in touch with yourself and sense what you intuitively need to survive and heal, that is where some empowerment comes from and the capacity to turn things around. It greatly helps, however, to have someone such as a good psych who can support you in that. Co-regulation with another human being who is witnessing your feelings and experiences and is empathic and present with you can really facilitate a healing process.

Sometimes expanding your horizons beyond the options on the table in front of you is a way out of struggle towards healing. I hope things improve soon and you can be supported in a way that aligns with you and is sensitive to your experiences.

Take care and all the best.

[Ovait]

Hi Eagle Ray,

Thanks for your reply. 

I’ve been on the waiting list of just about every psychologist in my regional town and it’s taken 6 months to get into see this new one (that I have to travel 30kms each way to). I needed to find someone who was willing to see me under workcover (& not everyone will do that). During my first couple of triage appointments with him he seems ok & on the ball - definitely better than some I’ve seen. Problem is my deep mistrust of the psych profession. My old psychologist was there from the start before I had been completely messed up. He was nice to chat to, not much therapy but he was benign. Even with him I held back but we had an understanding. 

There is no other hospital in town. The next closest with a psych service is 120km away. I’m stuck with this one unfortunately. 

After all the psych trauma I really just want to not see anyone, even though I know I should / need to, but I have to as a condition of my professional registration. 6 years of it hasn’t been helpful & keeping my registration is a slim shot anyway. 

[Eagle Ray]

That’s really tough Ovait. At least the current one seems on the ball and better than some others. It seems like maybe the best thing is to be open with him about the impact of the PTSD issues in relation to the hospital experiences. You may be able to constructively work through those things and it may help alleviate some other issues too. I’ve worked on a few traumatic experiences with my psych and sometimes once one issue is successfully processed, other related issues/experiences start to heal as well. It’s like the nervous system starts to learn it doesn’t have to be hypervigilant because the charge is taken out of the experience, and it can kind of reduce the impacts of other experiences too.

 I knew I had unresolved trauma and did a lot of my own research to try and find answers. Sometimes it’s finding approaches that align with you and then you could see if your current psych knows about them and is willing to work with them, or a similar approach that he knows.

 I’m wondering about other sources of potential support too. There was something on TV tonight about a men’s fitness group who meet to support each other with mental and physical health at sunrise at the beach once a week. I’m just wondering if there is some kind of interest group you can join that is informal and supportive? It could be a mental health-related group or it could just be something you enjoy such as a hobby or interest. It might help you to feel supported beyond just the psych, like a kind of safety net.

 I totally get that sometimes with mental health it’s really hard to reach out and do such things, because I’ve felt that too. But sometimes just even something one hour a week being amongst others can lift you up a bit and start to shift things.

Sometimes we aren’t alone as we feel we are. It’s something I’m slowly learning myself. I hope you can find some healing and support and feel better soon.

[therising]

Hi Ovait

Completely understandable how we can develop trust in someone over time but can't always trust the systems/resources they use, such as a particular hospital. So many broken systems around these days (some aspects of those systems), such as with hospitals, schools, government support networks etc. If you want to know where all the faults in those systems are, just ask the people who are pulling their hair out in frustration, feeling stressed or depressed. They can easily tell you.

I know it's not everyone's cup of tea but have you ever explored a holistic kind of approach? While attending experts in mind and body may be a must, under requirements that have to be met, I've found what tends to link the 2 together at times can be helpful in certain ways. So, while 2 parts of the triad can involve working through inner dialogue and mental programs (psychology) and trying to work with chemistry that can be causing major issues in the way of anxiety and depression (biology/chemistry), there's a 3rd element that can often be overlooked. If that 3rd piece of the puzzle's missing, the overall picture may not be entirely clear. Psychology and biology/chemistry don't necessarily cover what can feel naturally 'soul destroying'.

Perhaps Swiss psychiatrist Carl Jung phrased it best when he said 'People will do anything, no matter how absurd, in order to avoid facing their own souls. One does not become enlightened by imagining figures of light, but by making the darkness conscious'.

[Ovait]

Hi Therising

... and therein lies the problem.... I am fully cognisant of the darkness. Making the darkness conscious makes me feel physically ill. Heaven forbid I let anybody else get an inkling of the darkness inside - they’d be horrified of the things I’ve seen / thought / done & feel about myself. I must stuff the darkness deep down into its box. The darkness overwhelms me. The darkness makes me less than. I’m not a valid person. I hide behind a mask to convince the world I’m not a freak. The darkness makes me suicidal. 

Now I don’t know how cluey this new psychologist is. Will he catch on? Will he see through my well practiced mask & force me to open the well tied up box that contains the darkness? If he does he’ll have me sectioned faster than I can blink & I’ll be straight to the place I have nightmares about. 
 

[therising]

Hi Ovait

While the freedom to verbally express our self (no matter how dark our thoughts or beliefs) can be liberating, I completely agree with how this can pose problems. If you fully express yourself, you'll be judged in a way that leads you to where you truly don't want to go, back to a place that perhaps does everything other than help shed light on what's so dark and torturous.

Soulful expression's a tough one to master. I'm still trying to understand and master it myself. I've had a few people say to me over the years 'You should go to uni and study psychology'. Problem is I don't like some elements of psychology. While I love a lot of it, there are parts that do the opposite of promoting certain forms of soulful expression. Soulful expression's not always some gentle soft pretty thing, it can involve screaming, raging and so much more. The DSM-5 can be quick to label what's natural and necessary in some cases. I figure, if we're going to open Pandora's box, we'd better be prepared to not suppress (stuff things back in). Management over suppression. There are not just experiences/memories within such a box, there's a heck of a lot of emotion/energy packed in there too. While I'm in no way an anti med kind of gal (some are extremely helpful), medication prescribed to calm us and stop us from screaming can be acting as a suppressant in some cases. The screams stay inside. Years of tension remains in our muscles, years of heartache continues to sit in our chest and while our nervous system may become desperate for some form of purging, it remains simply coping. When years of certain types of energy in motion or e-motion become stuck and/or churning, this definitely has a feel to it.

Can recall saying to my daughter some time ago 'If I could afford to create some place where people could go to scream and release rage and sadness, that's exactly what I'd do'. I was surprised when she told me such places exist. While rage rooms can be constructive, it's important for some that there be a mental health professional available to help make sense of such an intense vent before and after the experience. 'Where did that come from?' requires an answer.