Diagnosis Shaming from Mental Health Professionals – (collaboration with PsychAssist)

Good evening! Long time no see! I have been experiencing a long depressive episode since coming down off the hypo-mania I experienced with my med change a few months ago. I am super sorry for my absence.

However, here we have an article I’ve written in collaboration with PsychAssist. PsychAssist is careers service for psychology graduates to help them get their foot in the door. They have worked with qualified psychologists to bring you tips and tricks to increase your employability within the profession.

If you’d like to learn more about PsychAssist you can find them on Twitter @Psych_Assist and Instagram @PsychAssist.

Now, for the content…

 


 

For the last ten years, I have lived knowing that I have a mental illness. Living with an invisible illness has meant I experience stigma from all corners of life. From friends and family. From teachers and bullies. People who don’t understand. However, the last place I thought I’d be discriminated against was in therapy, by the mental health professionals who were paid to support me.

Three years ago, I was referred to my local community mental health team (CMHT.) This is known as a “secondary care service.” This is where you’re referred to if you need more long-term care than “primary care services” (counselling) offer, which typically offers 6-8 sessions. Sometimes your GP might refer you straight to secondary care services, but not as often.

During my time with the CMHT, I was thrown into treatment with no explanation of what they were actually treating. They were talking about me buying a workbook for dialectical behaviour therapy and attending weekly group therapy sessions. Were they not taking my social anxiety seriously at all? I could barely speak to my community psychiatric nurse (CPN) one to one, let alone to a group of strangers.

My GP had put me on antidepressants, so I took a wild guess they thought I had depression, although it was never formally diagnosed. I have never understood how you can medicate someone without a diagnosis. How can you give a person therapy without naming the issue you need to resolve?

So, naturally, I decided to ask my CPN what they were treating me for.

My memory of her response is hazy, but I do remember she would pass on the responsibility, so to speak. I’d ask her why I hadn’t been diagnosed with anything, and she would say she wasn’t responsible for diagnosing people. Which is of course true. CPNs do not diagnose people, only doctors can do that. So why was she treating me then if there was nothing wrong with me? Her responses were always defiant and accusatory. Why was a diagnosis so important to me? She’d say there was nothing diagnosably wrong with me. But if she wasn’t qualified to diagnose me, why was she qualified to make that judgement? Eventually she referred me to a psychologist and, finally, a psychiatrist.

One of the worst cases of diagnosis shaming I have experienced is from the psychologist she referred me to.

Let me clarify what I mean by “diagnosis shaming.” I mean someone who is insistent that diagnoses of mental illnesses are not important, do not exist, or should not be considered during your therapy sessions.  Someone who makes you feel ashamed for having a diagnosis, talking about it, or wanting one so you can better understand yourself.

Now, back to this psychologist. We’ll call her Lyn.

Lyn and I did not see eye to eye to say the least. From the get go, she would pick apart my body language. Instead of trying to use conversation to have me loosen up and trust her, she told me to take my coat off, take deep breaths, stop shaking my legs, and uncross my arms. Granted, this is all good advice. But this is not appropriate advice to give to someone who is clearly in distress and doesn’t trust you.

If she had read my notes, or even had any concept of how to start up a conversation, she could have asked me things like, “What music do you like?” or, “What’s your favourite movie?” Small questions that don’t feel like an attack on you as a human being. Questions to warm up the conversation rather than an someone taking jabs at your personality.

One session, Lyn decided to ask me about my friends. I explained to her that I am very lucky because most of my friends have mental health issues and disabilities. This makes them incredibly understanding if we have to cancel plans because of our mental health.

This is when Lyn asked, “what’s wrong with your friends?”

Okay, Lyn. Weird phrasing, but okay.

“I’d say more than half of my friends have autism, and most of my friends have anxiety disorders. Then a couple of my friends have personality or mood disorders.”

Her response?

“Have you tried finding friends who don’t have problems?”

My face fell. “No,” I told her.

“Why do you think you surround yourself with people with autism or anxious people?”

“…”

“Well I think you should start to look for friends who don’t have autism, or these other ‘diagnoses.’ It would be good for you to go out and look for normal friends where you don’t have to talk about all your problems and you can just talk about other things.”

At this point in the “conversation” I stopped responding. I’m fairly sure this is one of the sessions she decided to video record. I have never felt so much anger as I did in that session. After that, I made the decision to stop seeing her. Each time I left her appointments I felt more invalidated. More like the problem was with me as a human being, rather than an illness caused by trauma making biological and chemical changes in my brain.

Eventually, after going through several other CPNs and several psychiatrists, I was finally diagnosed with emotionally unstable personality disorder, post-traumatic stress disorder, and recurrent depressive disorder.

Finally. I cried when the letter came through. They believed me. I was taken seriously.

It was as if all these years I’d had a broken leg that wasn’t healing properly because I’d continuously been told by professionals that it wasn’t broken. At last, they’d decided to set the break and I could begin to heal.

Then they discharged me.

Apparently there was nothing more they could do for me. This is in spite of the fact that the psychiatrist had only just diagnosed me and made changes to my medication.

Although I had had dialectical behaviour therapy, I had had no treatment to help me cope with my flashbacks. I hadn’t even finished my sessions on coping with panic attacks. (And that’s not even getting into how I told my CPN my problems were with anger management and not panic. But no. She was an expert in me. It must be panic attacks that are the problem because that’s what it is with most people.)

Since May this year I have been discharged from the community mental health team, attempting to cope on my own.

Yesterday I returned to therapy. This time it wasn’t with the NHS, but a family friend doing my relative a favour. From hereon in I will be referring to the psychologist I saw as “Therapist.”

Therapist is a fully trained and qualified psychologist, counsellor, and hypnotherapist. Okay, I thought. Hypnotherapy is the only one of those I haven’t approached before and might help me cope with trauma. Sort of like EMDR therapy or something.

The session was in Therapist’s home, and my relative drove me there. I’ve been struggling through a deep depressive episode lately, but with EUPD that doesn’t always mean I’m depressed.

She asked me to sit down, went through the formalities and asked me to talk about myself. I explained my diagnoses, and this is what she said.

Her words were that these “labels” have only been about and used for the past 100 years or so. By that logic, any advances in medicine and medical understanding are redundant?

Therapist believes that labels make people worse, causing the person to only see the world through this lense of depression, or anxiety. Labels put you in a box.

I explained to her that I am not my diagnosis. I am not emotionally unstable, I have emotionally unstable personality disorder. I have accepted that I may never be without my illness, and I will likely have cycles of depression my whole life. This does not mean that I am powerless to the illness, as she is suggesting.

Diagnoses are not fences around you, they are a starting point on your recovery map. They are acknowledgement that, “okay, these are your symptoms and these are the most common treatments that are successful for that, but if they don’t work we can try something else.”

Now, I have decided that if I am offered the opportunity to see a psychologist again, I could only work with someone who acknowledges my belief in diagnoses. I wouldn’t even need them to believe in diagnoses themselves. I just need to know I am being taken seriously. That my illnesses are acknowledged as just that, rather than seen as character flaws.

If this experience sounds like something you have faced in the past, please know that you are within your rights to ask to be seen by a different mental health professional. There is plenty of research to say that patient-therapist relationship is a key element of recovery. If you feel you need to file a complaint against a healthcare professional, you can do that through PALS (Patient Advice and Liaison Service).

 

Stay safe, stay well, stay alive.

Rowan.

Sun, sea, and self harm scars (part 2)

Hello again folks,

Long time no post, yet again. I can’t seem to keep myself in a routine at the minute. Graduation through my mood completely out of whack but here we are! Back with the second part of my tips on how to cover up in the hot weather without actually melting into a fleshy puddle.

As I said in my previous post, scars from self-harm affect so many of us. Whether we have scratches, scalds, or stitched up cuts, the act of showing them is a personal choice.

I am a huge advocate for being transparent when it comes to mental health, however many of us choose to hide the history we have on our skin.

DISCLAIMER: This post is in no way intended to be body-shaming. You can wear anything you feel comfortable with, no matter how your skin looks, your shape, height, or size. These are simply suggestions I use for myself to help cover-up and stay cool.

Skirts

Midi Skirts

Calf-length skirt - Dark blue/Patterned - Ladies | H&M GB 1

Image Source: H&M, 2018.

Midi skirts are fantastic for summer. You can find them in most charity shops for under £10 (I once found one for £2.50!) and they keep your upper thigh covered. This one here is from H&M for £19.99.

Skirts this length can be found in a range of different styles, like pencil skirts and body-con so it’s super easy to tailor this tip to your own style. However, I find that the floaty type like the one pictured above is the most summery, and is typically my favourite style to go for when I’m trying to cover scars and stretch marks on my thighs.

These skirts are wonderful. You can dress them up or down, depending on the occasion. They don’t raise questions, as they are often worn in summer anyway. You can guarantee if you wear jeans someone will crack the old,

Aren’t you hot in that?

Yeah, I bloody well am hot in these jeans, but that’s none of your business!

 

Maxi skirts

Image source: Boohoo, 2018

Another life-saver in this weather is the maxi skirt. Obviously I’ve chosen to display this black jersey skirt from Boohoo because I’m still an emo kid at heart, but again you could find an alternative for cheap in Primark or a charity shop.

These are great if you have insecurities about your calves and aren’t ready to show them off just yet. They’re elegant and perfect for whatever occasion. Going somewhere fancy? Pair it with a fitted crop top. Heading to the shop? Sling on a t-shirt and tuck it in.

The added bonus of these skirts is the control you have. If you’re sitting in the garden at a sunny barbecue, you can keep your legs covered up. Then if you find yourself alone for a few minutes you can take the opportunity to get your legs out and show them the sun.

Tips:

Being a short-arse

Are you like me and 5 foot nothing and find maxi skirts drag on the floor?

Maxi skirts with an elasticated waist can be rolled over at the waist band without looking weird. If you fold it towards you it can take the skirt up a couple of inches.

Alternatively you could pair it with some platform shoes, sandals, or boots, depending on your style and where you’re walking that day.

https://images.asos-media.com/products/raid-wide-fit-alma-black-flatform-ankle-tie-sandals/9335894-1-blacksuede?$XL$?$XXL$&wid=300&fmt=jpeg&qlt=80,0&op_sharpen=0&resMode=sharp2&op_usm=1,0.4,6,1&iccEmbed=0&printRes=72

Image source: Asos, 2018

These RAID “flatform” sandals from Asos are an example of a flat but raised shoe – far easier to walk in than traditional heels. I’ve seen some similar in Primark which were about a third of the price of these, which are currently being sold at £29.99.

“Chub rub”

I know many of you will hate the phrase “chub rub.” Some of you lucky devils might not even know what it means.

This is a rash that occurs when there is friction between your thighs as they rub while you walk. It can be incredibly painful, and often deters people from wearing skirts at all.

That being said, there are two tricks you can try which I have found to be particularly helpful.

1. Roll-on antiperspirant

I’m no scientist so I can’t explain to you how this works, but for the past two years I have been using this trick to help combat my thighs from chafing when I wear skirts.

It doesn’t feel very flattering to be rolling moist deodorant on your inner thighs, but I believe it reduces sweating and also acts as a protective layer to reduce the friction of skin-on-skin. Roll-on deodorants are fairly cheap and usually small so they’re easy to carry about with you so you can reapply in the loos later if you feel the effects wearing off.

2. Cycling shorts

For some people, the deodorant trick simply doesn’t work. An alternative to this is to wear form-fitting shorts underneath your skirt to prevent chafing.

Image source: Sports Direct, 2018

These LA Gear body-con shorts from Sports Direct are really cheap, costing only £4.

Can’t afford to buy something extra? You could instead cut up a pear of tights or old leggings to just above the knee. Though this is not an ideal solution, nor one I’ve tried myself, it seems to be an effective way to tide you over until you’re able to buy some actual body-con shorts.

Trousers

Although I previously mentioned in this post about how jeans can raise the ridiculous “Aren’t you hot in that?” question, wide-legged or light weight trousers are a good choice in hot weather. They keep you covered, but are far more breathable than jeans.

These outlandish but amazing trousers from Zara are a prime example of the style of trousers I wear when it’s boiling outside.

Though these may not be something you usually go for, wide-legged trousers like these are currently in fashion, and are unlikely to make you feel as uncomfortable as jeans or leggings would.

Alternatively, if you don’t feel quite ready to wear something so wide legged, or are self-conscious about them being too long for you, harem pants are a great alternative.

Harem pants - Black/Floral - Ladies | H&M GB 1

Image source: H&M, 2018

These floral harem pants from H&M retail at £12.99. Wearing them feels like pyjamas. They’re thin, airy, and comfortable. You are also able to roll them up to your knees should you want to, so they look like cut-offs. This is great if you only want to cover your calves some of the time.

Tops

Finally, we come to the thing that is my biggest difficulty in summer. Tops.

Most of the tops I own are band t-shirts from when I was younger and in my prime emo years. These are no good in 30°C heat. First off, they’re black. Secondly, they do not cover my scarred up arms that I don’t always want to have out on display.

So if you’re like me and vest tops and t-shirts are a no-go for you in summer, here are a couple of suggestions that I have found useful.

Crop tops and bardots

Long sleeved crop tops and bardot tops are both beautiful and covering.

Image source: New Look, 2018

This cropped bardot top from New Look would look excellent paired with a long skirt or high-waisted trousers. Plus, the tight sleeves on these is great as it means you won’t have the awkward moment where your sleeve accidentally rolls down and your scars are on show to the bartender in Spoons who you weren’t quite ready to reveal your life story to.

I know that often because it is marketed as a crop-top and usually models who wear these have flat stomachs and defined abs, people are often uncomfortable about wearing these or even trying them on.

If you have a muffin-top like me, a sad belly button, stretch marks, scars, whatever, you can hoist your skirt right up to where the bottom of the top is as if it were a dress.

There is NO SHAME in having these things. I absolutely am not body shaming. However, I do understand than not everyone is ready to show these parts of themselves that they may be self-conscious about.

Blouses

The market is rife with thin, baggy shirts at the minute. Especially longer shirts.

Image source: New Look, 2018

This beautiful pale green shirt from New Look retails at £14.99 (but you can usually get 10% discount on non-sale items if you have your university student card with you in store). It would look gorgeous paired with skinny fit shorts, whether they’re mini or knee-length.

You could also tuck it in to some chino-style trousers, or a midi skirt for a smarter or more formal look. Alternatively, you could wear the shirt unbuttoned over a cami-top, however this causes me anxiety as I’m often worried someone will tell me to take the shirt off because they think I’m too hot.

Remember:

You do not owe anyone an explanation.

It is your choice if you want to show your scars, and if you don’t want to, you do not have to justify that because someone is asking questions.

Stay safe. Keep hydrated. Autumn will be here before we know it.

All the best,

Rowan x

 


GIF sources:

Sun, sea, and self-harm scars (part 1)

Scars from self-harm affect so many people. Regardless of whether you have scratches, scalds, or stitched up cuts, the act of showing them is your choice. I am a huge advocate for being transparent when it comes to mental health, however for one reason or another some of us need to hide the history we have on our skin.

In winter, finding clothes to cover up isn’t such an issue. Come summertime, however, finding clothes that don’t make us feel like we’re being slow roasted by the sun can be a problem.

For years I wore hoodies and skinny jeans in 30°C so that the people around me wouldn’t see my scars. Some days, I wouldn’t even leave the house if it was hot, which becomes increasingly difficult as you get older.

So here are some outfit ideas that you can take inspiration from that won’t cause the ‘aren’t you hot in that?’ fiasco. All these outfit ideas are fairly affordable, and variations of them to suit your own style can be found in Primark, H&M and charity shops around this time of year.

(DISCLAIMER: I am not a fashion guru. These are ideas you can tailor to your own tastes.)

Swimwear

I’m gonna be honest, this is a difficult thing to combat. Normally when you go swimming people see almost everything. But it doesn’t have to be that way.

Long sleeved swimsuits come in all sorts of colours and are suitable for all sizes. If you have scars on your arms, these are perfect for going to the pool or swimming at the beach.

Fancy Palm Leaf Print Plus Size One Piece Swimsuit  This one piece swimsuit from Rosegal is pretty, covering, and most importantly: subtle.

This particular suit costs $22.41 which currently is about £17. Rosegal offers free shipping internationally and have a plus size range if you are a fuller bodied person like me.

One thing to watch out for, however, is their sizes. Make sure to use the size charts they have and remember that US sizes differ from UK sizes. For example, a US 14 is the equivalent to a UK 18.

Sarongs and long skirts

If you have scars on your legs or thighs, it is quite easy to find a sarong. Sarongs are a skirt-type wrap that people often wear to the beach.

Sarong - Black - | H&M GB 1

This is a simple black sarong from H&M costing £4.99.

Despite the dark colour, the material these items are made of are intentionally thin and airy as they are designed for beachwear. Black is also simple and versatile.

The simplicity of a sarong is that it is easy to remove, so if you get a few moments away from the group, you can still move it off your legs to catch some sun.

Unlike a white sarong, it is unlikely to be see-through.

Board shorts

These items cover beachwear, but there is still the issue of hiding self-harm scars on your legs when you go swimming at indoor pools. If this is an issue, which it might be if you are on a family holiday,

Board shorts are a great way to cover up your thighs if they are an area you wish to keep hidden.

Honestly, the board shorts in the ‘male’ swimwear section are usually better, like these AMAZING pineapple shorts from Sports Direct costing £4.

 

 

 

Next week I will be posting the second part to this blog, which will be all about other fashion ideas you can wear to stay cool but covered in this ridiculous summer heat.

Remember:

You do not owe anyone an explanation.

It is your choice if you want to show your scars, and if you don’t want to, you do not have to justify that because someone is asking questions.

 

Stay strong, my lovelies. It’ll be dropping cold again soon!

All my love,

Rowan x