My Medical Notes: Initial Thoughts

Geezer, our new friend as discussed in this post, finally sent out (some of) my medical records this week. To be fair to him, he was very apologetic about the delay in supplying me with same, so I have elected not to hate him. Given that he works in the Trust, this is somewhat surprising. Fair play to him, I suppose – that’s no mean feat.

This will be a series of posts, given the magnitude of digestion and analysis required. I’m not sure why I’m even writing this one at all; I suppose I’m in a bit of a spin about the whole thing, and am hoping for some sense of catharsis, which is indubitably a tall order. Still, I’m awake at 5.35am, and I’ve flicked through the bastarding things. To this end, a brain dump seems completely worthwhile, even if it’s 0nly to shut my head up for the few minutes it takes to type this dirge.

Let’s start with…

The Very Vaguely Non-Shit Stuff

Well. Well..? Well, nothing much really. One less than hateful remark came when C, in referring me for psychiatric assessment at the CMHT, described me as “an intelligent and articulate lady.” He had made occasional similar remarks to me in session, but of course the verbal word is so much more informal in this kind of arena than the written one. For some reason, it made me smile, perhaps a little nostalgically. A sense of external validation, perhaps? Some residual transferential shite about him actually holding me in even vaguely positive regard? Who knows why it pleases me. But it does, slightly.

NewVCB seems to have been broadly supportive of me since she took over my psychiatric care in January 2010, and reading her predecessor’s comments made me realise just how lucky I was to have my “case” transferred to her. In the letter she wrote to Lovely GP in the wake of the cessation of my therapy with C, she made it quite abundantly clear that she was annoyed that the Trust had failed to even consult her about either my long-running complaint or on what she felt the best method of proceeding was. This letter alone provides me with a fair amount of fuel, which can only be aided by the admissions of my being “significantly let down” that C made in our final sessions. I have the last six meetings recorded, though I haven’t listened to them. I don’t really give a fuck how illicit or full of subterfuge such actions may have been; when you’re dealing with such a mess of bureaucratic self-servingness, compiling evidence seems wholly necessary and appropriate. So fuck them if they don’t like it.

NewVCB also described me as “a very disturbed young girl [young girl!!!], who does struggle day to day.” She also wrote that she felt that continuing therapy would be (have been?) of benefit to me.

I was also interested to note that C had written to Mr Director-Person (utter cunt) in the wake of my original complaint, and whilst he’d (C, though Mr D-P was perennially guilty of same too) engaged in his usual self-justifying bilgewank, he did observe that my letter had highlighted a number of deficiencies in the service, and that these should be considered in future service provision. (Which is nice and all, but if I end up dead then it all seems personally rather pointless. I’m not aiming to be a fucking martyr to this cause; I just want help).

Anyhow, onto the flip side of…

Bias, Lies, Embellishment, Stereotyping, Assumption, Blah Blah Blah

My favourite piece of nonsense in the notes is possibly the following quote from the Psychiatric Liaison Nurse from last January as quoted in her follow-up phone call to C:

She was almost boastful about cutting herself with a scalpel and about how she managed to obtain it on eBay. I have no concerns about her mental health but she will probably use self-harm to up the ante as your time together grows closer to its termination…blah blah blah…[some patronising arse about my ‘using’ my diagnosis of BPD or some such]

“Up the ante”! “No concerns about [my] mental health”! I’ve been the first to admit that the incident in question was the shittest suicide attempt in the whole of creation, but according to what I hear from normals and professionals alike, people aren’t generally supposed to self-harm or ruminate on suicide in the fucking first place. So how my mental ‘health’ can be considered something unworthy of concern to a serious so-called professional is beyond me.

What galls me about this one especially is that I had no idea until tonight (last night, whatever) that the woman in question was such a two-faced cunt. She played all nicey-nicey, wearing a convincing veneer of maternal warmth, to my face. In the next breath, she was advising C to be wary of my twisted modus operandi of manipulative evil. Fuck you, love. Fuck you very much indeed.

The second most entertaining comment came from a letter from OldVCB to Lovely GP after my initial assessments with her (here and here). It is her clinical opinion that I have borderline personality disorder, with a possible differential diagnosis of bipolar II disorder (the latter, interestingly, was something NewVCB also brought up, “particularly in light of [my] family history”). Fine. I knew well before I met any psychiatrist that I had BPD. What I accused myself of, though did not honestly think was seriously considered, was the possibility that I had narcissistic personality disorder. Apparently, I wasn’t so far from the truth: I have “strong narcissistic traits”! MWHAHAHAHAHAHA!

My eyes widened in horror when I first read that, but as I sit here now at 6am, I find it bizarrely amusing. It’s inversely self-validating, I suppose; I always wanked on and on and on to anyone that would listen about what a narcissistic heap of fuckery I am, and for once someone agreed. There’s a certain twisted but likeable logic in there somewhere.

There were a few minor but deeply frustrating inaccuracies in OldVCB’s report to Lovely GP; she got the names of both my schools wrong. She also got my ‘A’ Level results wrong. In and of itself it’s no big deal, but if the boney fucking bitch couldn’t even be arsed to listen to fundamentals like that, why would I suppose she would listen to anything else I had to say? She also prattled endlessly on about my “interpersonal difficulties” as evidenced in my relationships with “friends, teachers and parents.” Oh really?

I feel like directing her to this post about one of my teachers, and seeing what she thinks then. Clearly the dynamics of a profoundly turbulent relationship, oh yes. In reality, I only had a difficult relationship with one teacher, and whilst I do accept culpability for being an awkward pupil for him, to be fair it was as much about him being a knob as it was about my assholery. Oh and yes, I had ups and downs with my friends…like TEENAGERS FUCKING DO. OldVCB contended that she was “unable to get a sense of [my current] relationships with [A, Daniel and Brian]” but her tone was one of doubt and cynicism. She seemed genuinely confused by the fact that I’d been with A for (as it then was) six years. Nevermind, though. Just slap a “bah, patient was unresponsive about this so we can therefore be certain that she actually knocks the living fuck out of her partner and friends” on my face so as it fits neatly with your nice little bit of stigma-in-a-manual.

C’s discharge letter fucked me off, not because he was offensive per se, but because either he’s the one that’s in cloud-fucking-cuckoo land or he’s just trying pathetically to cover his own arse. A position arguing that both apply is certainly arguable too. I can’t remember all of it now, but the comment that most stood out was that he felt that I had “learned methods of affect regulation and non-destructive ways to deal with overwhelming feelings.” I’m glad to hear that’s the case, because hitherto I really had no idea. It’s reassuring to know that my reality is actually false and all that, oh yes indeedy. So, I ask myself…how had God C managed to achieve this miraculous wonder, so subtle and clever in its delivery that even I had not noticed it? Aha, good readers! How else but by teaching me “techniques of mindful-breathing [sic], which seem to have had some positive results”.

MWHAHAHAHAHAHAHAHAHAHAHAHAHAHAHA!!!!!

Really, C? Really?! Could that be the same mindful breathing that I so positively reacted to and analysed here? Good to see that we were singing from the same hymn sheet throughout our time together, my friend!

I haven’t perused his hand written post-session notes in great detail yet, mainly because – as is par for the course in the field of healthcare – they’re nearly fucking impossible to translate into something that begins to approximate English. A couple of asides I did note, however, were wanky references to “anger”, “acting out”, “defensiveness”, yadda yadda. He appears to be under the delusion that because of these ‘traits’ I epitomise borderline personality disorder (despite his one time comment that “…it is not borderline personality disorder that c0mes into this room; it’s Pandora.”) Unfortunately for historical accuracy, the reason I was “angry” and “defensive” was because he was refusing to fucking treat me at least until my condition became moderately self-manageable. Go and read through the archives of my posts on him. I was, by and large, unerringly nice (despicable word) to the man until Christmas 2009 when he told me that I had to fuck off.  Duh-de-DUH! Coincidence much?!

There was one particularly irritating and condescending piece of arse that he’d obviously written in the wake of a difficult session late in our time together. I must have seen him and/or therapy as a cunt/cuntish or something, and he noted that I was engaging in his favourite little game of psychological splitting (helpfully for him and the psychiatrists, a typical “borderline trait”). Waa, waa, waa. Apparently, though, he felt it “unhelpful to break Pandora’s projections towards me at this time by pointing this out to her…for now it is best to allow her to feel [whatever it was he alleged that I felt].”

There are two things in this world that I cannot abide. Being lied to (and that includes lies of omission, as observable here), and being FUCKING PATRONISED. What a supercilious fucking cock! He knew, he fucking absolutely knew, that I understood the dynamics of splitting, projection and transference. We spent about 98.3746563% of our time navel-gazing on such issues, for Jesus’ sake! But nah, let’s just let the little borderline freak act out on me rather than try to fucking work out why she’s doing so. Let her think that she’s really furious with me, when it’s actually her uncle or her fucking father or God or the fact that she hasn’t personally discovered a curse for cancer (given, after all, that she has such strong narcissistic traits!) that’s actually fucking frustrating her. Tosser.

Let me be rational momentarily (sorry to disappoint the rant lovers, but normal service will resume anon, worry not). I can see why C may think that if he reduced everything to splitting and transference and whatnot that (a) that would be intellectualising, something he fervently sought to avoid with me and (b) maybe he did genuinely think it would be useful for me to be angry with him in a transferential sort of way, if only temporarily. The problem is that he sat down, thought about it, then went ahead and consciously decided to try to deceive me (a comment which, if he were ever to read this, would no doubt be interpreted as “a paranoid persecution complex,” which came up once or twice in the notes), rather than exploring the psychodynamics of my frustrations. I thought that was the whole fucking point of that style of therapy?

Anyway, I’m analysing, rather than reporting, here. I should leave the detail for specific posts, but you know me – I can’t help myself. In closing, I’ll note one other thing that really annoyed me, not by its belittling stereotyping, nor even its inaccuracy, but by its very omission. Only at one solitary, passing juncture was PTSD ever mentioned, and that was by C, who does not have the requisite qualifications to make any form of diagnosis, at least beyond speculation. NewVCB sat with me last March and said to my face that I “…couldn’t not have PTSD…and in case of chronic trauma like your’s, we call that complex PTSD…”

Some of the foregoing made me angry, some made me laugh owing to its inherent ridiculousness and textbook anti-borderline bias, but this – this actually hurt me. I remember Seaneen once writing a really good piece about people with post-abuse mental health problems.

She said:

There’s the “good” abuse victim (hello, PTSD) and the “bad” abuse victim (hello, BPD).

Right here, right now, that statement resonates with me like never before. To me, in much the same way as Seaneen suggested, BPD blames the sufferer; PTSD blames the perpetrator/event/whatever.

So when all is said and done, for all her apparent support, I’m still just some attention-seeking, histrionic pain in the arse to NewVCB – not someone who was or is a victim/survivor/sufferer (depending on your preferred parlance), a belief that she has on occasion led me to believe she holds. I can shake my fist at OldVCB’s brusque manner and dogmatic stereotyping; I can laugh incredulously at C’s misinterpretations of matters or questionable decisions at any given time; I can astonish myself with the shocking hypocrisy of the Psychiatric Liaison bint.

But in the end, that’s somehow little more than rant material, at least for now. They don’t hurt, not really – not deeply, not rawly. Being just another case, another fucking number, rather than a person? That hurts. Being the one apparently to blame for all of this? That cuts me to the fucking core. It really, really does.

And that, for now at least, is that.

Here We Go Again…

I am almost literally sick of having to write to / email the local Trust about their ongoing – seemingly perpetual – incompetence and utter fuckery. Once again, it has become necessary to do so…

15 December 2010

Dear Ms Serial-Insomniac

Re: Application for access to records/personal information – Data Protection Act 1998

I refer to your requests, which was received on 13 December 2010, requesting copies of your mental health notes and records and copies of correspondence relative to a complain lodged in August 2010 [the stupid, stupid fuckers.  The complaint has been ongoing since December 2009! Get it right, twatbag.]

I would advise you that your request is being processed in accordance with the Data Protection Act (DPA) 1998.  Therefore, a response to your request should be sent to you within 40 calendar days from the date it was received by the Trust.

Should you have any queries regarding the matter do not hesitate to contact me on 9–1-13–1–20-23-1-20 [as if I’m going to phone you, knobhead.]

Please find enclosed a receipt for the cheque for £10.00 that accompanied your request.

I will be in contact in the near future […!!!].  However, should you have any queries in the interim do not hesitate to contact me on 9–1-13–19-20-9-12-12–1–20-23-1-20.

Yours sincerely

Geezer

Information Governance Support Officer [what the fuck?]

All very reasonable! Yay!

Except…not so much.

13 February 2011 [via email]

Dear Mr Geezer

Re: Application for Access to Records/Personal Information, Ref: FU2KN053ND

I refer to my recent application to access the mental health notes that the Trust has kept on me and your letter dated 15 December 2010 in response to same.

It was noted in your letter that my request was received on 13 December 2010, and would be processed in accordance with the Data Protection Act 1998, the relevant governing statute.

I am disappointed to note that the Trust has not provided the information requested within the 40 calendar day limit set under the afore-mentioned legislation. Taken from the date my application was received by yourselves, I should have in receipt of the requested material on or before Saturday 22 January 2011. As of today’s date (Sunday 13 February 2011), it has been 62 calendar days since my request was received by yourselves.

I am sure you can appreciate that the late delivery of this material is both inconvenient and distressing. An important meeting with senior members of the Trust regarding the many failings of my care within the system has been substantially delayed whilst I have been waiting on the information requested, thus potentially delaying necessary treatment even further.

I should be grateful if you could deal with this matter at your very earliest convenience and look forward to hearing from you in relation to same.

In the event that this issue is not dealt with within seven calendar days, I shall unfortunately feel that I have no choice but to look into furthering this matter under the relevant legislation.

Thank you very much in advance for your time and assistance.

Best regards. [Does it really soften the blow? Probably not…]

Yours sincerely

Pandora Serial-Insomniac

If I don’t hear from Geezer tomorrow, I will break things.

Early Christmas Presents

Present One

Perhaps, finally, some encouragement on the advocacy front – almost exactly a year later?!

Hi Pandora

My name is [let’s call her Derbhla] and I work for the Northern Ireland Association for Mental Health (Charity B), as a patient advocate.

I recently received a letter from Charity A, regarding your request for advocacy support. I…meet and support some outpatients from your area.

Should you wish to meet and discuss the support you require, we can arrange a date and meet at [NewVCB and C’s] Day Hospital.

I look forward to your reply.

Derbhla

Hi Derbhla

Thank you very much for your email. I would be very grateful for any support you would be able to give me.

I’m not sure how much, if any, information Charity A gave you, but I shall give you a brief run-down anyhow.

[This, if you have been following this blog and this ridiculous saga, will be quite repetitive, but it had to be written, so there.]

I am 27 and am diagnosed with complex PTSD and borderline personality disorder with psychotic and dissociative features as well as major depression and anxiety.  I first presented with mental health problems to my GP 13 years ago, but have never secured adequate treatment (I can offer you full details when we meet, or I can forward you copies of detailed correspondence on the matter if you would prefer); in fact, I have usually been treated dismissively or even with disdain by NHS mental health services.

Finally, in February 2009, I met a competent psychotherapist within the system. The arrangement was to meet once a week on rolling contracts.  As you may know, both NICE guidelines and the NI Personality Disorder strategy advise the use of certain therapies (which, to be fair, I tried in other sectors and found unhelpful), and in their absence, generic psychotherapy (which was being offered by this therapist, and was useful).  Therapy for my conditions is recommended as taking place at least twice a week for a minimum of 18 months.  Despite this, I was advised in December 2009 that my psychologist could only offer a limited number of further sessions, which would amount to one year and 11 weeks in total rather than the 18×2 sessions recommended.

With my psychologist’s support, I appealed to the Trust for more time.  This has resulted in a year long complaint during which the Trust has promised things it never delivered, openly lied on occasion and acknowledged its services were deeply inadequate without offering me any alternatives.  Against my consultant psychiatrist’s advice, and obviously my own feelings, I was still discharged from Psychology in August 2010.  At the final session, my psychologist advised that therapy (in this case of a psychoanalytical bent) is often outsourced by the Trust to a private sector therapist on occasions on which it fails to deliver it itself.  My current aim is to achieve this sort of therapy, as I have come to conclude that my illnesses will not be adequately treated within the [my] Trust.

I have involved my MP, MLAs and the Health Minister in the matter.  They have been moderately helpful, in that the Trust have finally agreed to meet me “to discuss the way forward” (the personnel concerned are the AD for Mental Health, [Bint’s Name], and the Head of Psychology, [Bloke’s Name]).  Although I am aware of some of the issues requiring discussion in this meeting, due to my illnesses I do not feel I could viably present a persuasive argument to contest their assertions despite my evident need for further treatment.  To that end I was hoping that an advocate could possibly assist me in this encounter in the hope that future therapy, which is required to treat most of my conditions, could be ensured.

I apologise for any information overload in the foregoing!  I am awaiting various medical notes* from the Trust but also have the chain of correspondence regarding this matter, mainly between [Mr Director-Person], the Director of MH and LD services and myself, for reference.  If you would be able to assist me, unfortunately at the moment I am unavailable to meet on Mondays but any other day is usually fine; if you would like to suggest a time I would be happy to hear from you.

Thank you for taking the time to respond and indeed to read this.  I look forward to hearing from you.

Best wishes

Pandora

Hi Pandora

Thanks for providing me with these details.  I hope that I can support you in bringing forward and ensuring that yours needs are followed up.  [What does this actually mean?  I know I shouldn’t criticise, but these jargonistic terms do my head in.  *ponders*  Maybe I shouldn’t talk when I go about using non-existent words…]

I would suggest that we meet in the New Year, Monday and Tuesday mornings are best for me.  We can meet in the old ward [bin], [NewVCB’s and C’s] Hospital (now the new community mental health services building [aha, so that’s why NewVCB met me there today]) as I can organise a private room there.  Please let me know if this suits and if so what day and time.

I look forward to hearing from you again.

Derbhla

Hi Derbhla

Thanks for getting back to me.  Either Tuesday 4 or 11 January 2010 would suit me to meet; I would suggest 9.30 or 10am?

Thanks again and I look forward to hearing from and seeing you.

Best wishes

Pandora

If this works out, it could be Early Christmas Present Number One.  Well, OK, I’m not meeting her until January, but the beginnings of an alliance (as I hope it will develop into) have been forged this month.

* I think that I briefly reported this elsewhere.  After dithering for months, I have finally put in a request for my medical notes: I want all the correspondence between Mr Director-Person and myself (I keep losing copies, except the electronic ones I’ve recorded here, against which I will compare the material, because I don’t trust him not to have modified his communications); all my GP’s notes since 1998 on psychiatric, psychological and any other mental health-related matters; all of NewVCB and OldVCB’s note; and, finally, all my notes from my time with C.  Mwhahahaha!  They’re going to love me 🙂

Present Two

I should have detailed this ages ago.  Remember the huge bust-up between my mother and that fat jabba Maisie?  Well, predictably, it resolved itself in the end – maybe about October or early November time?  Alas. This was disappointing in the extreme.

In the meantime, though, A and I had arranged to go to a gig with Kevin, Maisie and Paedo’s youngest son (though he’s 42 or something like that).  As Kevin is both stupid and profoundly scared of anything outside his current dwelling in his parents’ house (Hotel California), A and I agreed to (a) buy the ticket for him (with him to forward on the payment), (b) collect him on the night of the concert and (c) return him on said night.  He is petrified of driving outside a minuscule radius of Hotel California, just like all the in-bred freaks barring Suzanne are.  So, no drinking and letting my hair down at that gig then, but meh.

A week before the gig, Kevin sent me and out-of-the-blue text message advising me that he wasn’t going after all and would I – yes, I – sell his ticket for him.  He was willing to accept £20 less than the asking price.  I agreed to this.

I put the ticket on Gumtree and quite quickly had an offer from a French bloke, which I accepted. Unfortunately this meant having to meet said French bloke in the city.  I’m pretty sure I could be diagnosed with agoraphobia these days, and I’m still desperately scared of strangers and suchlike so (saaaaaaaaaaaaaad), even though A went with me, this was the cause of some not-inconsiderable anxieties.

Anyway, the exchange was made in the end, and went without incident.  I had no immediate way of getting the cash back to Kevin, so I advised him that I’d send it to him with my mother when she was next visiting Hotel California (she was now reconciled with Maisie) or with Sarah/Suzanne, who would come to visit my mother quite often.

For one reason or another it turned out that I hadn’t been able to send the money for a couple of weeks.  One night Kevin sent me the following random message:

i fink its bout time u snt me da muni.trst me i am nt gna 4get bout it so gt it dwn r ELS!

Once I had eventually managed to translate this (I think it’s about time that you sent me the money.  Trust me, I am not going to forget about it, so get it down or ELSE!), I was interested to note the distinct absence of diplomacy and, indeed, the threat inherent in the communication.  This reminded me that during the battle that saw the commencement of World War III (as in My Ma v Maisie), Kevin had threatened my mother.  I also remember a few years back that he was alleged to have grabbed his sister, Sarah, by the throat and pinned her against the wall whilst screaming a barrage of abuse into her face.

Lovely bloke, really.  The fact that he is completely single and almost friendless in his 40s is a real mystery.

The long and the short of this inane drivel is that I deliberately held off sending Kevin his money, and eventually posted him a cheque, meaning he would have had incurred inconvenience in the form of lodgement 😉  Better than that, no one threatens me and gets a second chance, not unless they sincerely and grovellingly apologise.  And I’m not going to put myself in a situation where I feel threatened, am I?

So, Kevin has given me one of the best presents yet: since I do not want to ingratiate myself into threatening surroundings, I can now avoid Hotel California like the plague.  This is way beyond brilliant.  It is superb.  It is superlative.  It is sublime.  Any other positive ‘s’ adjectives I can use?  I just cannot emphasise enough how sweet and stunning and supremely delightful this new freedom is.  YAY YAY YAY!

Maisie and Paedo sent me a birthday card last month (with £30 inside.  Blood money?  Who cares?  £30 is always useful), and failed to sign Kevin’s name as they normally do.  When I received a Shitmas card from them yesterday (also with £30, demonstrating that they can be good for something then), however, Kevin’s name had re-appeared.  Well.  Fuck that.  He didn’t get a return card from me and he isn’t going to.  Knobend.

Though when you think about it, isn’t it strange that Maisie and Paedo did receive a card back from me..? Kevin threatened me, sure, but Paedo…well, we all know what Paedo has done.  And yet I don’t feel such bitter antipathy towards him as I do towards his son.

Ah well.  No one ever said I was normal.

Present Three

An apology from a member of staff at the cunting Trust!  Not a dramatic, “fuck, Pan, we’ve screwed you over for 14 years.  We admit it.  We’re shit, we’re sorry, and we’re giving you permanent psychotherapy!“, but any form of apology from these fuckwits is a remarkable achievement.

I saw NewVCB this morning, who was horrified I hadn’t seen her since September.  She apologised profusely for this, and was clearly genuine in doing so.

Well, fuck me laterally with a four-headed mop.  I thought it was written into the job descriptions of Trust employees to apportion blame directly onto the patient in all cases and to never, under any circumstances, admit that you or your department has had any responsibility in a fuck up.  Baaaaaaad NewVCB!  You’re going against the grain there, love – in fact, you’d better keep a close eye on your job.  Don’t forget about public sector cuts and all.  Your being vaguely competent and responsible could very well lead to the demise of your career when you’re on those cunts’ payroll, so just be careful there.

Seriously, she was very apologetic and I was grateful for it.  The appointment, despite my preceding whining on Twitter and Facebook, was fine in the end.  Details to come in an obligatory I had an appointment post in the next day or two.

Present Four

Me:  That’s a nice teddy bear, mother.

Mother:  …Ah.  It was meant to be a Christmas present for you.

Me:  Oh right.  Fuck.  Sorry.

Mother:  Do you like him?

Me:  Yes, he’s lovely.

Mother:  You may as well have him now then.  I bought him so you could cuddle up to him if you were feeling down.

Panacea-by-bear!!!  I’m sure he is an eminent psychiatric-psychological-neurological clinician!  I know he can cure my ailments!

OK, I really need to dispense with this acerbic sarcasm.  I was actually rather touched, despite my inclinations towards cold aloofness.  The bear is cute, soft and cuddly, and I will probably cuddle up to him when I’m bawling my eyes out like a three year who’s forced to eat Brussel sprouts.  I don’t know what to call him, though (I thought of ‘Psychiatrist Bear’, but don’t want to insult him); the tag says ‘Edward’ – presumably it’s alluding to the term ‘Teddy’, even though that originally came from ‘Theodore’, of course – but I’m not sure that it suits him. Suggestions welcome!

Here he is.

Teddy Bear of Joy

Taking Down the Trust – The Final Stages

It’s over two months since I last wrote about things with the Trust.  At that point, I had just discovered that NewVCB had not been consulted by the powers that be at all in the course of my long-running complaint.  (Speaking of NewVCB, my mother rang her secretary the other day to ask what was going on; I was supposed to see her in October.  It was agreed that I would have monthly meetings for a few months in the wake of the cessation of therapy with C, and furthermore, she almost doubled my dosage of Seroquel in September, and I would have thought she gave enough of a toss to see how that was working for me.  But apparently I’m on a three month review schedule, and am not important enough to be see before 15 December.  Smashing).

Prior to the September consultation with NewVCB, I had written an exasperated letter back to my MP and the Health Minister regarding the Trust’s ongoing failings, lies and pathetic dismissal and arse-covering.

The current situation is this.  Mr MP and Mr Health Minister had evidently copied my letter to Mr Chief Executive, who then wrote to me offering a meeting with the Assistant Director (AD) of Mental Health, and the Head of Psychology.  I reported this here, though not on this blog.  I panicked at the suggestion and initially point-blank refused to accept it, on the basis of the horrible anxieties that such a meeting would inevitably produce.  However, at this juncture I did not reply to the Trust.

In light of this, Mr MP wrote back saying he understood that I had been offered the meeting, and that he wished me well in it.  Health Minister said he couldn’t get involved at this stage because “it is an open complaint” – riiiiight.  So, basically, the inference was that I had to go to the stupid meeting or that would be the end of it.

I arsed about and have procrastinated the living fuck out of this issue for weeks.  Specifically, until about three weeks ago, at which point I decided I would try writing again to Charity A, the advocacy (or, rather, non-advocacy, it seems) people who I first tried to involve in this whole sorry mess.  They had originally replied to me stating that I should consult my psychiatrist on extending the therapy, as that person would be making the decision on the future as regards same.  That was not the case, and I drafted a letter to that effect – but in the end I never posted it, for reasons I don’t remember.

The Deputy Chief Executive of Charity A wrote back to me, quickly to be fair to her, stating that the organisation was “not in a position” to offer me any advocacy services.  I detest this bullshit stock phrase. Please. Just. Say. What. The. Fuck. You. Fucking. Mean. Thnxbai. It’s a term I always avoided at work, unless I specifically wanted to wind someone up.  It means damn all, and in the majority of cases in which it is used, the recipient deserves a more adequate explanation as to the reasons of the organisation’s inability to offer the requested service.

Anyway, to be fair to the woman, her letter was friendly, seemingly concerned and despite the inability of her organisation specifically to assist, desirous of helping in some way.  She told me that someone at Charity B (to whom I had also sent the original advocacy-seeking letter, and who responded stating that they didn’t cover my Trust area) was developing advocacy services, and wished to know if she should pass my details onto them.  I told her to go ahead.  I am awaiting correspondence from them, and hope that the services that they are ‘developing’ now in fact cover where I live.

Last week, I finally decided to let the Health Trust know I was intending to pursue my complaint.  Mr Chief Executive had given me the phone number of a lady who I presumed (as it turns out correctly) was the secretary to the Assistant Director of Mental Health, but of course there was no way I was going to phone her. I wrote the following instead.

Dear Secretary Woman

Re: Meeting with Mrs [AD Mental Health] and Mr [Head of Psychology] re: Access to Mental Health Services

I refer to a year-long chain of correspondence between Chief Executive [Mr Chief Executive], Director of Mental Health and Learning Disability [Mr Director-Person] and myself.

In the most recent letter I received from [Mr Chief Executive], he finally suggested setting up a meeting with Mrs [AD] and Mr [Head of Psychology], and stated that I should contact you to arrange this.

I apologise for the delay in this correspondence but unfortunately over the last few months I have been very unwell [not 100% true, but unless they read this blog (in which case they should be bloody well ashamed of themselves) they’re not going to know that]. I would hereby confirm that I would like to go ahead with such a meeting; however, I will need a little more time to organise myself in preparation for same. I will contact you after this to arrange specifics, and hope that this does not cause any inconvenience.

As you will be aware, under the Disability Discrimination Act and related legislation, reasonable adjustments to accommodate my mental illnesses are required. To this end I would ask for confirmation that it is acceptable to have at least two other individuals [Mum and A will be there for certain, and hopefully so will a third person in the form of an advocate] with me during the meeting and also that the meeting can take place at my house at the above address. Both of these measures would to some extent assuage my inevitable anxieties about the meeting.

I hope that the foregoing is acceptable to you, Mrs [AD] and Mr [Head of Psychology]. Should you require any further information, please do not hesistate to contact me at [my email address].

In the meantime, thank you for your patience and your assistance.

Kind regards, etc.

Secretary Woman emailed me this morning with the following response.

Dear Ms [Serial-Insomniac]
Many thanks for your letter which I received on Monday and wanted to confirm with you that I checked with both Mrs [AD] and Mr [Head of Psychology] and they are both in agreement to meet with you at your home.  Please contact me whenever is convenient for you to arrange a date and time.
Many Thanks,
Kind Regards, [Secretary Woman]

The email is copied verbatim; the paragraphing and stylistic errors are not mine.  Grammar Nazi?  Me?  Neeeeeeevvvvvvvvvvvvvvveeeeerrrrrrr!!!!

Seriously though, although her terms of address – surnames all the way – annoyed me slightly (I hate being addressed formally, and hate the addressing of others as such; it makes me/them sound unduly importantly), the email was reasonable enough, and I can only hope that the secretary’s apparent good nature is reflective of that of her boss too.

The ‘specifics’ to which I alluded are (1) hopefully sorting out this advocacy crap and (2) obtaining the notes that C and NewVCB keep/kept on me.  I also might be tempted to try and get my psychiatric history from Lovely GP.  The problem is, I haven’t a baldy notion as to how to go about this.  Unlike just about every other Health Trust in the whole of the United Kingdom, my lot are typically useless and fail to articulate how one goes about this on their website.  C once gave me a leaflet that he claimed detailed the arrangements – but what it actually detailed was the information the Trust keeps on its victims patients.  It gave a fucking phone number to ring for ‘more information.  What. Is. Wrong. With. Fucking, Bastarding, Twatting EMAIL?!

So, I will have to work out how to proceed with that somehow.  Of course, what the Trust don’t know is that I recorded my last five or six sessions with C 😉  So if, when I say that C said or didn’t say x, they then try to claim that he did or didn’t say x, I can present them with evidence.  Obviously I don’t intend to make use of my subterfuge-filled conduct in general, but should they try to contradict me on a point I know to be true – as Mr Director-Person did in his claim (read: lie) that “…through close working between the psychological therapies service and the CMHT it is planned that the work done with [C] will be incorporated into, the ongoing support from the team…” – I will be able to demonstrate to them that they are either wrong or misguided.  Hopefully though they will be reasonable and will not behave in such a fashion…

We shall see.  I’ll keep you updated.

General Update

I’m feeling pretty low really.  It’s partly resultant of therapy with Paul, but it’s mainly winter – or at least I think it is; I suppose I could be entering a more ‘general’ depression.  I really can’t motivate myself to anything of any consequence whatsoever, despite considerable attempts to do so.  I had to take Disraeli, my car, for his MOT yesterday, and it felt like I was wading through quicksand, which is utterly ridiculous as one doesn’t do anything in an MOT – you just sit there and wait until they tell you whether or not the car has passed (which he did, thank God – I actually think I would have killed myself if he had not done so, which is borne out of an obsessive love for my car compounded by the current depression in which I find myself).

No voices, visions or notable delusions, but I have a horrible feeling this is about to change as matters with Paul progress.  It’s intense and demanding work, and I expect to be tipped over the edge by it one of these days – particularly with bloody, fucking Aurora, my child alter, hovering about.  I still hate her, though she thankfully has only been present in fleeting moments outside of therapy.  She prefers to come out mainly in session and try to monopolise my fucking time with Paul!  Bitch.

The curious thing about the probably impending psychoses, though, is that Paul seems interested in me totally losing it when I see him and having them come out in that time.  This is in stark contrast to C, who always used to approach my moments of complete mentalism with his wanky breathing techniques in order that I regained a (precarious) sense of sanity promptly (not that it worked).  Curiouser still is that Paul wants to ‘validate’ the psychotic bullshit.  It represents an angry or scared part of me that never has been validated, he posits.  But I’ll discuss all this and more when I review Monday’s session.

It’s my birthday this weekend.  I will be 27.  I have achieved nothing in over a quarter of a century that I set out to achieve, other than to have a contented and satisfying relationship, and I am completely penniless.  Minus penniless, actually – a situation that I have no idea how to resolve.  Still, I have a roof over my head – a notable blessing in this cold, wet horribleness.  Many people, even in this area, do not have somewhere to live, and despite my fervent wishes to the contrary, I can do nothing to help.

That is all really.  I lead a fundamentally exciting life.

Failing and Winning at the Psychiatrist’s Casino

Well, against my better judgement, I told NewVCB everything that I reported here yesterday. Everything except the eating stuff, that is. I am really pretty sure that that’s irrelevant.

I am apparently in the middle of a “delusional psychosis”. This means that from now on I will now have to ingest 200mg more Seroquel daily (for a total of 600mg, a dose she had always intended to take me to anyway, apparently), if my GP’s administrators and/or Fat Pharmacist don’t fuck it up.

I tried to argue with NewVCB about this, stating that if I needed stronger drugs, then that needed to be reflected in a Venlafaxine increase and not Quetiapine. I was informed that Quetiapine should help my mood anyway, and that even if not, it was still it that she needed to amend as, “[I am] in a psychosis, Pandora.” I said that I wasn’t psychotic but she just raised her eyebrows in enraging defiance.

Three things really pissed me off. The first and second pertain to my intended ‘sexual abuse’ counselling with Nexus. Firstly, the fucking bitch rang C about my having seen them! C!!!!! How dare she consult him? He is nothing to do with me any more. I had wanted him to have no knowledge of what became of me after he came to regard me as an inconvenience and that pettiness but definite preference aside, it simply has nothing to do with him. I wanted to beat her face in for speaking to the cunt. Instead of protesting, however, I submissively and pathetically meekly just raised my right eyebrow, murmuring that perennial but meaningless word, “oh.”

Secondly, and more importantly, she does not want me to see Nexus any time soon. Apparent C(unt) had thought it a great idea, as if he’s allowed to think fucking anything. NewVCB, however, thinks that the strength of my reactions to my alleged abuse in the past would be too strong for Nexus to cope with if they re-occurred. I laughed in her face and said, “what, like they weren’t for C?!”

She said, “oh, you’re still angry about that, then.” More on this in a minute.

Well, yes, I am. That, however, is not at all the point. The point is that C is not qualified to deal with supposed psychosis either – or, if he is, he never demonstrated such abilities to me. He just went about antagonising ‘They‘ even more than I did. I told NewVCB that I had felt surprisingly positive about Nexus, unlike how I felt about her fucking Trust’s “service”, but that I would go along with her decision simply because going to Nexus would be deceitful anyway, as the problems they are there to treat do not really apply to me.

She disagreed with me and said that that was not the reason that she didn’t want me to go right now. “I think it did happen, Pandora” she told me. I looked away in disgust. That’s right, NewVCB – cos you were there after all!

The third thing to piss me off was a pile of patronising bollocks she threw at me about the Madosphere. I told her that I was only telling her half of the supposedly relevant stuff because A and a number of my blog commentators had advised me to do so, and she started whinging about “being careful with online relationships” because she had “seen it go horribly wrong so many times”, and that “people aren’t always what they seen, and can project their own issues onto you.”

What the fuck is it with mental health professionals and derision of the online community? I would literally be dead without Twitter and the Madosphere. I can hardly extend that compliment to either her or C.

Through gritted teeth, I advised her that I was perfectly well aware of the ‘dangers’ of forming friendships online, but that my contact with most people had been long-term and considered, and that I had even met quite a few of my fellow mentalists anyway. She started trying to defend herself, but when I interjected that A had also met most of these people, she backed down.

I’m sorry, but. What. The. Fuck. I’m mental, not stupid. Am I not allowed my own agency? Am I supposed to be an adjunct of A now, a proposition that he finds as abhorrent as me? I have an IQ of 148. I have been using the Internet for 12 years. I had my fingers burned by Hideous Ex and learnt my lesson. I felt that she was insulting both me and a number of people who have been instrumental in keeping me alive for months, so this served to make me want to break her perfectly formed little neck.

She asked about suicide and I said that I had planned to do myself in in early October, but that I had decided to put it on hold on a temporary but rolling basis. She asked why I had come to this conclusion, and I didn’t really have an answer. I don’t want to say I have ‘hope’ cos that’s a lie. I just feel sorry for Mum and A, and that’s what I told her; I said that I had to be certain that the positives of my proposed non-existence outweighed the negatives of hurting them. I think they do, but I feel further specific rumination is required. She seemed to be fairly accepting of this, to be fair, and I’ve managed to wrangle another month of (sort of) freedom.

She said that although I am “definitely psychotic” (bullshit), that it’s still not schizophrenic-like psychosis. It’s “dissociative psychosis,” apparently, and I need to start believing that I was abused because “it is rare for people presenting these type of psychoses to not have been abused.” OK. Whatever.

She asked why I had now gotten it into my head that no sexual abuse had in fact taken place, and I said that I’d considered it in depth and concluded that Paedo/Not-Paedo was “not very bright” and was thus incapable of sustaining such a necessarily hidden activity for so long.

Without pausing for breath, NewVCB replied, “and how, then, do you explain those two brothers in Donagh, who had abused so many over so many years but didn’t have the requisite IQ to even stand trial for their acts?”

Not easily, admittedly. So I changed tact, and said that dissociation was a load of old bollocks, and that you simply don’t forget matters of that magnitude. Or at least that I didn’t.

She looked at me sceptically. “You know perfectly well how and why dissociation takes place,” she responded, almost witheringly. So I’m not stupid when it comes to the finer theoretical points of psychological fragmentation, but I am when it comes to choosing my own friends?! Fucks’ sake.

Towards the end of the appointment, in some desperation, I said, “NewVCB, what’s wrong with me?” She started banging on that I am not schizophrenic, but that these symptoms are often seen in traumatised people. She had already said that, and I already knew it, so I just interrupted her and said, “I don’t think I have borderline personality disorder.”

Actually, I don’t know if I think that or not, but I hate the bloody thing, so I said it anyway. She asked why. I told her my relationships are stable, that I’m usually pretty submissive, that I don’t really self-harm any more (though, I realised later, I have a tell – I tapped my recently injured right leg as I said that), that I ideate about suicide but that I don’t go about taking overdoses each day and that I’m not particularly impulsive.

She said that there were almost two types of what she called “emotionally unstable personality disorder” (which, if she had bothered to read her ICD, there actually are – but anyway): you had the stereotypically ‘borderline’ types who OD every day and slash up their arms three times an hour and beg for help then don’t take it. I noted this description with interest.

“And then there’s people like you, where psychosis and dissociation is a lot more common, where you go through periods of exhibiting some of the more typically borderline behaviours, but then come out of them and into another type of period – not that you’re better, but the symptoms are different.” Apparently. Good to know that NewVCB is more knowledgeable about BPD/EUPD than the DSM/ICD, then.

I said, “this Trust discriminates against me because of the diagnosis.”

“No,” she protested. “10 or 15 years ago, maybe even five, I’d have agreed – but PDs are no longer diagnoses of exclusion [nice reading of the NICE guidelines there]. The Trust are setting up a personality disorder service, and a lot of moves are going in that direction.”

“As a current service user I do not agree that there is no ‘exclusion’,” I replied. “Do you really think I’ve been treated well within this service? And do you really think the discriminatory way in which you just described the ‘typical borderline’ is a description of inclusion?”

She looked at me sheepishly. “Yes,” she said finally, nodding guiltily. “I can see where you’re coming from.”

Positives

So, win on that, and the appointment wasn’t all bad – far from it. Mwhahaha! The best thing was this. Oh, the sweet, rapturous beauty of this. In her asking about my anger re: the end of therapy with C(unt), I somehow (I don’t recall the specifics) mentioned my correspondences with Mr Director-Person, assuming she was in full knowledge of them.

“I’m sorry for dragging you into it all in the most recent letter,” I told her. To my surprise, I was greeted with a blank expression of nothingness.

“I’ve been communicating with Mr D-P since December,” I advised. “Aren’t you aware of this?”

She asked me to outline the exchanges in more detail, which I did. She looked at me with increasing levels of disgusted surprise with each new tale. “He [Mr D-P] didn’t copy me in on any of this,” she gasped when I had finally relayed the entire story.

She picked up my file and looked through it, in the apparent hope that maybe someone had filed a letter away without having informed her. “I know they didn’t,” she said as she did flicked letters, prescriptions and my own written submissions, “but I just can’t believe this. I have to check.”

Of course there had been no such administrative error at all. Mr D-P simply had had such little regard for my case that he hadn’t even bothered to think my consultant worth…well, consulting.

‘Furiously stunned’ is the best way I can describe NewVCB’s reaction to Mr D-P’s continued negligence. She herself said the only way she could describe how she felt was to use the word “gobsmacked.”

Notably irked, she exclaimed, “I’m going to ring [Mr D-P’s first name]. I’m going to ring him, demand the chain of correspondence, and see what has been going on here.” I smiled internally at this. I wonder what excuse he’ll use to try and fob her off?

I told her that the Trust’s last letter was full of half-truths and lies, and she didn’t seem to have any doubts as to the authenticity of my claims.

So. I have caught the Trust in an outright lie, and I have caught them having such complete disregard for my condition that they didn’t even consult my psychiatrist – she who is ultimately in charge of my care, as far as I know – on how best to proceed with my treatment. This calls for a follow-up letter to McGimpsey and MP:

Dear Messrs McGimpsey and [MP]

Further to my letter of 4 September, I would like to apprise you of some new information that has come to light regarding the [my] Trust’s dismissive and potentially negligent approach to my mental health care.

Today I met my consultant psychiatrist, NewVCB, for the first time since the enforced cessation of my psychotherapy on 26 August. As you will be aware from my previous letter, my consultant opposed ending my therapy at that time, feeling it was premature and at a particularly distressing time.

In discussion with her today, it has emerged that for all their protestations that my therapy was correctly drawn to a close and that I was to recieve “further support” at the end of same (which has still not come to pass and about which I have not been contacted), the [my] Trust have not spoken to my consultant at all on this matter. In learning of my complaint, NewVCB admitted that she was “gobsmacked” that she had not been contacted by Mr D-P on this matter.

I believe that this underlines the abject indifference in how Trust management has elected to view my case and my quite reasonable complaints. To ignore a consultant’s advice would certainly be inadvisable and inexplicable; to fail to even seek said advice is, to my mind, quite honestly negligent.

I trust that, in continuing your work with my case, you shall be corresponding with and seeking answers from Mr D-P regarding this particular matter as soon as possible. As you can appreciate, my sense of feeling let down and discriminated against by the [my] Trust is even more apparent in light of this disturbing information.

Once again, may I thank you very much for all your efforts hitherto and also in advance for your continued work. It is very much appreciated and has greatly encouraged me.

Best wishes for now.

Yours sincerely

Pandora

Any thoughts?

And back to Nexus for a second – should I phone (gah!) NewVCB tomorrow and tell her, given that I forgot/didn’t have the balls to do so today, that there is a waiting list for their counselling anyway, and that I almost certainly wouldn’t see them before I next see her anyway? And promise that if I am still “psychotically delusional” or whatever the fuck it is, that I will then put the matter on hold? It had all seemed so positive, and I don’t like the idea of putting it off notably.

Furiously Determined Would-Be System-Bashing

I swear to living fuck that the Trust will not win this fight if I have breath in my body and blood in veins. I will battle them to the very death – literally, if needs be.

This is, of course, in response to yesterday’s received correspondence from Mr Director-Person. Your thoughts and comments on the letter are, of course, most welcome as always.

Dear Messers McGimpsey and [MP]

Re: Access to Mental Health Services

Thank you both very much for your recent kind assistance in communicating with the [my] Trust on my behalf. By now, you will have received the response from Mr Director-Person, the Director of Mental Health Services, dated 24 August 2010. I apologise if this letter crosses in the post with any communication from yourselves to me.

I remain very dissatisfied with the Trust’s response to my concerns for a number of reasons, and would hope that you could therefore kindly continue to assist me in this matter. I have not responded to Mr D-P directly, as such dialogue has, to date, proven to be an utterly fruitless pursuit. As you can appreciate, the Trust’s negligent and frankly dismissive stance on this matter has greatly added to my psychological distress.

I would make the following points in response to Mr D-P’s recent correspondence:

  • It is contended that Mr D-P has been informed that I was advised “early on” about a “therapy end point”. This is factually incorrect. [C] and I first met in late February 2009, at which point we worked on rolling contracts of six to 12 weeks, although there was always an expectation that unless significant progress had been made, these would be extended (which they were). I was not advised of a “therapy end point” until December 2009. Eight months subsequent to the commencement of the process cannot accurately be described as “early on” therein.
  • Mr D-P also alleges that my treatment programme with [C] was of a duration of 18 months. Technically, in a wide sense at least, this is correct – however, the impression given is misleading. I met [C] for exactly 63 weeks, which is obviously one year and 11 weeks – ie. just under 15 months. I point this out because I would not like the Trust to be allowed to overplay the sufficiency of their frankly inadequate service.
  • The cessation of therapy was against the specific clinical opinion of my consultant psychiatrist, NewVCB (of [Relevant Hospital]), as acknowledged by both her and [C] on at least two separate occasions. I am astonished that consultative medical advice counts for so little within the [my] Trust. Furthermore, [C] admitted in our final session on 26 August that I had been significantly “let down” by the Trust.
  • The aforementioned consultant psychiatrist, whilst acknowledging that I have a form of complex post-traumatic stress disorder due to significant childhood abuse, has stated to me on several occasions that she does not want to engage in diagnostic “labelling” of me, and instead wishes to treat my specific symptoms and circumstances in an individually appropriate way. The Trust’s attitude to my case would again appear to be in in opposition to her quite reasonable position; although I have never tried to hide or deny my earlier (ie. prior to NewVCB) diagnosis of borderline personality disorder, it seems clear to me from his letters that Mr D-P and his colleagues have chosen to fixate on this “label” specifically. Borderline personality disorder is probably the most stigmatised of all the psychiatric diagnoses and I must confess that I am coming to believe that I am being discriminated against considerably because this diagnosis has been applied to me.
  • Chief Executive Mr Chief Executive’s acknowledgement letter in response to my original complaint to yourselves suggested that, as well as investigating my complaints with regard to my current situation, an investigation into the Trust’s failings in my mental health care for over a decade prior to same would take place. It is evident that this has not been the case; Mr D-P’s letter of 24 August focuses solely on my present circumstances. Only the most cursory of apologies was offered for the present inadequacies, and none whatsoever proffered for the many errors and misjudgements of the past.
  • Perhaps most tellingly, Mr D-P claims in his letter of 24 August that “further support” would be “in place when [my] sessions with [C] come to a close” and that “…through close working between the psychological therapies service and the [Community Mental Health Team] it is planned that the work done with [C] will be incorporated into the ongoing support from the team.” This is categorically untrue. My sessions with [C] ceased on Thursday 26 August, and apart from my pre-existing relationship with my psychiatric consultant, I have absolutely no “further support” whatsoever, and in my latter sessions with [C] no such references were ever made. The matter of a referral to a community psychiatric nurse or a mental health social worker had previously been discussed; however, my psychiatrist and I were agreed that such a referral would probably be inappropriate in my case, at least as a sole support system. No such referral came to pass and I have not heard anything to suggest that any “further support” will come to fruition. It was certainlynot in place at the end of my psychotherapeutic treatment.

In light of the factually inaccurate statements made by the Trust, I feel that it is appropriate that you be made aware of the above to correct any misapprehensions that may have been created. I understandably feel let down by the Trust and am seeking your assistance to secure appropriate treatment.

I am aware that it is relatively common for the Trust to outsource psychotherapy to private sector third parties; indeed, I know of several individuals who have been treated in this way, and [C] advised me in our final session that it was certainly a possibility for me (we had discussed the possibility of my entering psychoanalysis in the private sector in particular). I am reliably informed by both professionals and other service users alike (within both this Trust and others) that, through your continued advocacy and support, this is something that would be obtainable for me. That being the case, I would ask that, as my political representatives, and in light of the Trust’s continued failings, you help secure assurance of this or an equivalent form of treatment for me.

I feel that I ought to note that I am the author of one of the most popular mental health blogs in the UK (currently written under an anonymous pseudonym and widely supported and read by both service users and mental health professionals) [let’s not piss about with false modesty here, people – no arrogance intended, but, y’know – it kind of is], and that as a result of the deficiencies of my experiences within the [my] Trust my case has become something of a cause celebre across the aforesaid blog and various social networking internet sites. More formally, I write occasional freelance articles for a popular online magazine, and am giving very serious thought to specifically addressing this matter therein. I would certainly prefer to keep this issue private and anonymous, but if speaking out publicly about it will help me secure the care and treatment that I clearly need, I will not hesitate to draw wider attention to the matter.

I would like once again to thank you for the interest in my case that you have shown to date and would also wish to thank you in advance for your continued support. Please do not hesitate to contact me should you require any further information.

Kindest regards.

Yours sincerely

Pandora

Utterly Pathetic (But Utterly Predictable) Trust Bullshit

In response to both my last letter to Mr Director-Person and my MP‘s intervention.

Dear Pandora

Further to my letter of 3 August 2010 [wherein he acknowledged his failure to reply to the letter first linked above, not replicated here], I am now in a position to respond to your detailed letter [ie. the one to my MP and friends] outlining the background to your situation and the treatment received from our Trust.  I am sorry that it has fallen short of your expectations and that you feel that the progress initially made with [C] has not been sustained.

As indicated in my letter of 12 May 2010* the provision of specialist services for people with personality disorder is at an early stage of development in Trusts across Northern Ireland.  The [my] Trust did receive some additional funding last year towards such services and we have appointed a dedicated practitioner**.  The major focus of our approach in using this practitioner is to provide training and support to generic services both in-patient and in the community to improve their capacity to support people with a personality disorder***.

Within the generic mental health services we make every attempt to match individual client need to an appropriate level of intervention within the resources that are available to us.  With regard to your situation, [C] made a clinical judgement that was endorsed by his clinical supervisor to offer a treatment package consisting of weekly appointments and I am advised**** that early on you were given information about session numbers and therapy end point.  This was to establish clear boundaries to treatment facilitate the working through of any concerns that ending therapy might arise, and prepare for any potential transfer to CMHT colleagues.  This has resulted in the delivery of a package of assessment and treatment over an 18 month period******.  During that time it was recognised that you could benefit from further support and this will be in place when your sessions with [C] come to a close*******.

Given these inputs from our services the Trust believes that it is appropriate that this phase of your treatment is brought to a conclusion.  However through close working between the psychological therapies service and the CMHT it is planned that the work done with [C] will be incorporated into, the ongoing support from the team******.

The Trust is continuing to work on developing services for people with personality disorders as resources become available.  Thank you for your offer to provide service user input to this service development, which we will be in contact with you about in the future, and we appreciate your support with this.

Yours sincerely

Mr Director-Person
For Mr Chief Executive

Copy to:  Michael McGimpsey [NI Health Minister] and my MP

I have tried to retain in the above replication the multifarious punctuation and grammatical errors, though I’m sure some have slipped past me.

* Yes, I know: I did receive your letter of 12 May, after all.  Why are you repeating your self?  I am mentally ill, not fucking braindead.

** Wow, a whole practitioner?!!!1!!11!!!!eleven!!!one!!!!three!!!26!!!!  He or she will indubitably serve thousands of people quite eminently fabulously by themselves!

*** Jargon designed to confuse, Mr D-P.  But what you are, in essence, saying is that your appointment of this individual is already failing, because generic mental health services are apparently fucking scared of people with ‘personality disorder’ and thus do not seem to want to bother to treat them.  C admitted to me in one of the sessions about which I have not written that I was at least in part being discharged because of my wanky diagnosis of borderline – “the service cant continue to fund personality disorders,” apparently.  This is clearly a fail.  What a surprise.

**** You were advised incorrectly in that case.  C and I always worked on rolling contracts – until Christmas anyway – so there was no way that I could have been advised “early on” even in a vague sort of way about treatment ending.

***** This is incorrect.  I had a total of, I think, 63 sessions with C.  That equates to just under 15 months.  One year and 11 weeks.

****** Who?  My sessions with C have already ‘come to a close’ and I am not in receipt of ‘further support’.  None at all.  Admittedly, NewVCB and I agreed that a CPN or mental health social worker was essentially pointless in a case like mine, but the point is that Mr D-P either doesn’t know or doesn’t care (or, in all likelihood, both) about the accuracy of his claims.  So he may say that ‘further support [would] be in place’ when things with C ended, and that ‘through close working between…psychological therapies…and the CMHT it is planned that work done…will be incorporated into ongoing support from the team’, but this would be (and is, obviously) absolutely untrue.  His blatant fallacies (or at least ignorance) are, of course, to my considerable advantage: he has been caught in the throes of an outright lie on paper 🙂

Other observations:

  • I note with interest his failure to acknowledge that NewVCB, my consultant fucking psychiatrist, railed against the end of therapy at what she (and I) perceived to be such an early state.  C and his ‘clinical supervisor’ apparently therefore actively ignored direct, consultative medical advice, but of course Mr D-P wouldn’t like to admit to this.  Well, that’s OK with me.  His lie-by-omission will be openly highlighted in my response to my MP and Michael McGimpsey.  Mr D-P had better not say this is a borderline manipulation of the truth or something, because let’s just say that I have evidence that NewVCB’s disapproval of C’s actions is absolutely factual.
  • As usual Mr D-P completely ignores my references to complex post-traumatic stress disorder and my retraumatisation at the hands of C.  ‘Progress initially made…[having] not been sustained’ merely suggests I’m mildly annoyed – perhaps not much better, but not much worse either – and does not in any way, shape or form grasp the levels of trauma that psychotherapy at the shocking mercy of his Trust has put me through.
  • What is really galling, what is really really fucking galling, is that he has completely ignored everything that I had written about my frankly appalling experiences within the health service prior to my meeting C.  About how I was pushed from pillar to post.  Regarded with open disdain.  Left in the lurch with no support by resigning members of staff.  Referrals not being made.  Referrals that were made then being ignored by those to whom they were made.  Over the course of 12 fucking years.  12 years!  So many of them formative ones at that!  No wonder I’m a complete fuck-up at the age of fucking 27!  He doesn’t care about any of it despite the possibility that (as pointed out to him), if I had received adequate treatment back then, I might have been reasonably well recovered by now, and functioning as a normal member of fucking society – ergo topping up his own bastard of a salary with 11% of my own earnings.  He doesn’t have to be altruistic about it; it would have been in his own best fucking interests.  Regardless, does he actually think that is acceptable?  Remotely acceptable?  Does he think that is an adequate response from the NHS to serious, life-threatening health concerns?
  • There was something else about which I wanted to rant but in the course of the rage of the last point I’ve forgotten what it was.  I will add it in the comments later if I remember.

Now.  Is it time to craft my reply?  Or just relax and work on it with A tonight?  And is it too early for red wine?  Red wine and a Pot Noodle, methinks.  With extra burning hot chillis.  Oh yes.

Cunts.  One and all!