Back to the Day Unit

I met with my psychiatrist (who I shall now refer to as Superstar psych, due to his reputation and status in the field of PD) and he has arranged for me to start at the Day Unit next week. Initially, I was relieved as at last, something was being done and I needed something intensive and immediate. But I am also disappointed in myself and see it as a kind of failure, as I have not been a day patient for seven years and hoped that I would never need to return. Yes, it is better than being an inpatient, which would be pointless and would have limited therapeutic value. And if I continue self-harming in this way, the consequences could be serious.

The Day Unit is a specialist PD service, based on group therapy following the Mentalisation Based Therapy model. It runs from 9 to 2.30 on weekdays, with 2 groups a day and one individual therapy session a week. It has changed since I was last there - there are much less patients now, probably only about 6 rather than 12. I know two of the staff quite well, and my therapist is someone I have had groups with in the past.

There is an art room that I can use outside of group times, and although my creativity has waned during this depressive period, maybe I can start to do some art again.

The therapy can be intense and difficult at times, and there is often conflict and tension in the groups, as we are encouraged to explore the impact we have on other group members, and the impact they have on us. Most of the patients are in their 20s and 30s and have the diagnosis of BPD. I hope I am not the oldest, at the grand old age of 36.

I start on Wednesday, after the Bank Holidays. Unil then, I have to manage by myself as the service is closed from Friday, and Superstar psych is on leave for a couple of weeks.

Drifting into dangerous waters

I'm trying to keep posting regularly even though I'm not sure I've got anything worth saying.
I am slightly zonked out on Chlorpromazine; also, I didn't sleep well and dreamt that I was at the dressings clinic at the Burns Unit. A doctor was asking me lots of strange, personal questions and implied that I was a liar. Then I woke up. Any kind of implication or accusation that I am a liar upsets me. Ok, I lie, sometimes. Doesn't everyone? Mainly it's to protect people, or to avoid revealing something that I am ashamed of. But about the Big Stuff - I do not lie.

I know where this comes from. The 'allegations' of abuse that were apparantly a lie, according to family members and social services. I allowed them to bully me into retracting them and thus branding myself as a liar and a fantasist. Now, I often worry that people don't believe things I am telling them. Sometimes I don't even believe myself. I even think that my whole life history could have been a lie, a story that I made up.

This post is not going where I thought it would. I feel like I'm drifting into subjects that I am not sure I can deal with at the moment. I am struggling with the desire to go and buy some more acid to burn myself with. I don't think I'll use it straight away but I feel like I need to have it just in case.

The damage I do *trigger for self harm*

Why do I not take the harm I do to myself seriously enough? I remember a therapist telling me to imagine that the these injuries were inflicted by someone else, to someone I care about. How would I feel? Not only would it be a crime but it would make me angry, distressed and wanting to do anything I could to help.

When it's me doing it to myself, I find it hard to feel anything other than annoyance at myself, and sometimes regret. Sometimes I'm even strangely satisfied with the injuries, if I feel they are "bad" enough. But if they are too bad, it scares me and I do worry about what will happen if one day I go too far and do damage that is permanently disabling. It's too late to worry about scars, about 20 years too late. But if I were to lose the use of any part of my body, especially my hands/arms, I would be devastated.

My latest bout of self harm has scared me as I haven't burnt myself for ten years. I have cut myself, but managed to stay away from A+E for self harm. But the burns are too serious to treat myself - I hoped I could, but as there are now 3 quite large 3rd degree burns on my arms, I am facing months of dressings at the Burns Unit. I didn't want skin grafts, and the Burns Team were concerned that I may not be mentally well enough to cope with surgery. So it's goodbye arms, hello bandages.

I don't actually like the blood and gore aspect of self harm so every time I see my arms, I feel disgusted and freakish. Part of me wants to wake up tomorrow and to be completely healed. But another part of me wants the pain, the punishment, the hospitals and the care I receive.

I hope this is just a blip. My psychiatrist has upped my meds, and I am considering becoming a day patient if things don't improve, just for a couple of months to get me back on track.

I am not sure if I'm mentally "unwell" or not. I don't know how to describe how I'm feeling exactly, and this frustrates me. I have days when I'm lethargic and feel disconnected from the world. I have days when I am agitated and fearful and anxious. I seem to flip from one state to the other, maybe a couple of weeks of the lethargy and then few days of the agitation.

Today I'm lethargic. This is safer - I'm more likely to harm when I'm agitated. Today, I haven't got the energy.

To blog or not to blog?

How do I begin? I used to keep a diary (the old-fashioned notebook and pen) and write daily, just a splurge really, just to get stuff out of my brain and on to the page. I am not always the most articulate person and even though people say I express myself well, I feel like I struggle to say what I really want to say and that I won't understood.

At the moment, my head is a jumble. My thoughts are not following in sequence and I find myself drifting into strange places and not able to focus on one idea. Maybe writing them here will help. Maybe not. I stopped the diary-writing after 10 years as I worried it was becoming self-indulging and not getting me anywhere. Maybe here, I can be more balanced in what I write as I want it to be interesting as well as honest and emotionally raw. If it tips over into "oh wo is me, my life is crap, everyone hates me and I wanna die" terroritory then I will stop!