Last night when I was struggling to sleep I decided to write down things that were on my mind. I also decided I was going to share the things on this list with my care coordinator in our appointment today.
Most of our appointments so far have been a bit of a battle in terms of me and my stubbornness. I’ve mentioned before how I feel I should be able to cope with all of this alone and yet I know I can’t do it alone. This has been my own internal battle and depending on which side is winning when I see my cc, depends on how successful that visit is.
Obviously this can’t go on, and so last night one of the things I wrote down was parts integration. I’ll explain briefly what I mean by that. Basically, as just mentioned, there are two parts of me battling with each other; the one wanting help and the one saying I can help myself and do this alone. Parts integration is a process to find out what they have in common. So I kept asking ‘why?’. Why do I feel I should do it alone versus why should others help me as an example.
What happens is that eventually you get to the purpose of each side which turn out to be the same. So the purpose of both sides is to change things as they are now, and it’s just the ‘how’ of changing that is different.
So today, I spoke to my cc about this and the fact that I do want to change my life but the 2 options were just different ways of doing this. When I do it myself, the answer I come up with is suicide as I can’t see a different route. When the other option is explored, it’s about going through a process that the NHS has in place i.e. medication, therapy, social help etc. My point today was that as they are both options, both can be explored and whichever one wins, then the purpose (which is the same) has been achieved.
We spoke in a very blunt way (I prefer this as you know where you stand and my cc understands this), and she explained her side. One of the things the trust is run with in mind is money and if I died and they were proven to be negligent, it would cost them money. And so a number of systems and processes are in place to stop this from happening (there is obviously duty of care etc but we were talking in more resolute terms).
So far in my case, I have been allowed to keep control even though they know I am high risk. This is because my cc thinks we (as in her, myself and psychiatrist) can manage this risk and work through the suicidal thoughts. However, she said if I did kill myself, the coroner’s court would see it from a completely different perspective. They would look at my case notes and see that I had been honest with them about my suicidal thoughts and ask why I was left alone to kill myself. My cc had mentioned that before to me briefly but not the next bit. She said from a personal perspective, she would be shown to have been negligent as she has had so many opportunities to use the mental health act (she’s an amhp) and also to break my confidence and inform my nearest relative, and basically has never done any of these.
I am eternally grateful she hasn’t because I don’t think either of those things would be of any use to me – in fact I think it would make things worse. I believe both her and my psychiatrist can see that and agree and that’s why they’ve stuck with it so far.
Today she explained they are already over muddy waters in terms of me and my risk. She mentioned if I say I’m pursuing both options at the same time (like I spoke about earlier) then they need to look at if they are doing the right thing.
I think it’s left me feeling a couple of things. Firstly, I totally understand where she is coming from and in no way would I want her or my psychiatrist to take any grief for my actions. In my eyes they have done everything they should have and treated me with respect. However, the fact that if I carry on saying how I really feel might leave me vulnerable to them having to do things differently, makes me think I need to keep my mouth shut. I don’t want to go in to hospital. I don’t think it would do me any good.
I’m feeling very confused as anyone who knows anything about me (just from twitter and this blog), I am a very honest person and so if I’m asking myself not to be honest in my feelings when I see not only my cc but also my therapist, then I might as well not be in the service at all. I feel that we are at a point in my care where what would happen at the coroner’s court is guiding where it goes from here!
Any advice appreciated!