I don't feel safe

Last week I cut the artery in my wrist whilst dissociated. I managed to phone an ambulance as I'm assuming the bleeding brought me back. This is the second time in about 6 weeks that this has happened, with the police treating my house as a crime scene as the paramedics did not think I was going to make it. I'm still feeling weak from the blood loss, but I fear that it's going to happen again. Everyone I feel my heart beat or pulse, I feel like it needs to stop. I don't want to die, but I feel like it's going to happen. I just don't feel safe. I told my psychiatrist this today, but I feel like she isn't helping, she knows I dissociate but states I still need to be responsible for my own safety. It just doesn't feel that easy.

I am sorry you are not feeling safe. just wanted to let you know that I have read your post. when I am not feeling safe I call my treatment provider and then go in to the nearest emergency room/ crisis area.

you are new here so maybe now would be a good time to point out a few things for you.. down at the bottom of every page is psych centrals disclaimer. to me it says we cant be each others treatment providers or diagnose problems. there is also a few "sticky" postings around the forums that you will see, that say psych central isnt for things like crisis situations. for crisis situations we have to contact our own treatment providers or go to emergency / crisis places in our own off computer locations....

let me give you an example... what if I posted I was suicidal. then a few days later someone does a post letting the community know that I was successful in my attempt and was no longer around. how would that make others feel? Im guessing my suicide would hurt people here and make them want to do it their self. the same with when I am self injuring. it could make others have bad reactions.

Im not saying you are doing anything wrong by posting how you are ......"feeling".........

just letting you know that there is a very firm line of what we can do and help each other with here on psych central...

we can read your post, let you know if we have felt the same way in the past and what we and our own treatment providers have done about it. We can suggest you contact your doctors or go to the ER, but thats as far as we can go when someone is in crisis mode here.

bottom line is only you and your treatment providers can help you when you are in crisis modes. and thats the way is should be. Im not you, Im not in your location and Im not your doctors so trying to help someone in crisis mode here can actually do more harm then good.

please contact your treatment providers or go to your nearest emergency room.

This is making me angry. Not you, them. Why cant they just help you. Im worried about you. I think that you need to find a better psychiatrist if you can. Dont that understand you cant control when you dissociate? You need to have this talk with them. Tell them that is not unde r your control and you need help.

Thanks for replying, it makes me feel better that someone else understands. I am seeing my psychologist tomorrow so I'm going to sit and write some stuff out tonight for her, as I often dissociate during our sessions. My psychologist seems to understand dissociation much better, but the psychiatrist is the one 'in charge' of my care. My psychiatrist's answer is just to increase my anti psychotic medication and give me diazepam for anxiety. I don't want meds, they don't work for dissociation. My psychiatrist also doesn't want me to see my own GP, despite me telling her how much she (my GP) helps. I just don't know what to do, it's horrible being scared of yourself.

I'm so sorry, Angie84 That sounds terrible. I'm so sorry you're not getting the help you need. Can you find another psychiatrist? I agree she doesn't sounds too helpful. I'm so sorry, please don't give up. Things can and will get better. Try to hang on. You deserve much better than this, and hopefully you'll get it sooner or later. Try to find some distractions. What do you like to do in your free time? If things get worse, please go to the hospital, although I understand it's not a pleasant experience. Stay safe and take care of yourself. You can do this! You're strong, I know that. I hope writing here helps a bit. Feel free to PM me anytime. Let me know if I can do something to help you. Sending many hugs to you

I don't think it's easy to change psychiatrist as they are linked to the GP surgery I'm registered with. It does help writing here in the sense that others understand me. I'm really trying to stay strong and keep my mind active. I wrote a new crisis plan with grounding techniques and mindfulness in the hope I don't dissociate so readily, but I can't help feeling that it's going to happen regardless, and feel I need to prepare myself for it.

I'm so sorry, Angie84 I understand what you mean. It's good that you're making a plan. Let's hope nothing will happen, but at least you're preparing yourself for it. Be proud of yourself for that. And yes, keep trying your best - that's all you can do, after all. I hope your psychologist will be able to help as well. Keep writing here if it helps. Wish you good luck! Let us know how it goes. Sending many hugs to you

Thanks. I'll let Yous know how I get on tomorrow.

Well I think that your Psychiatrist just doesnt get it. Can she/he talk to your Psychologist?

Ye, they do speak to each other. That's why I'm hoping my psychologist can help her to understand.

If you feel unsafe can't you just go to your local emergency room and be evaluated and maybe admitted for awhile?

What you're going through sounds pretty serious and needs immediate attention I think.

If you have nearly died a couple of times, it is serious. Can you go inpatient for a while just to make sure you're safe?

My psychiatrist won't admit me because I self harmed the last 2 times I've been in the hospital. They have a no self harm policy so if you harm yourself then you get discharged. It's clear to see how this health board ranks the lowest in Scotland for mental health.

When I was in the emergency room last week following the arterial laceration, even the doctor said there was no point getting psych involved as they won't do anything because it's not the first time I had done it.

I'm so sorry, Angie84 I hope your psychologist will be able to help you. Wish you good luck! Let us know how it goes. Sending many hugs to you

Anti psychotics are very sedating, which often makes dissociation worse! I agree with whoever suggested you should find a different psychiatrist!

That policy is so ****ed. Do they not care?

I agree, you need a new psychiatrist.

I could not get this thread out of my head so I did some checking on this in general.... Scotland made some changes to their mental health system in 2011 around the issue of self injury. After a period of gathering statistics and talking with those that were inpatient and outpatient that self injured they came up with a plan that is reducing the amount of time people stay inpatient and how they address self injury, which is reducing how much patients are doing it.

their first step is to treat the present wound.
then they assess whether the self injury is deliberate/ intentional (repeating the negative behavior)
they supply the client with therapy options so that they can learn other coping tools then acting out in self injury (meds, talk therapy, grounding, breathing, stress reduction,...)

if they find that the negative behavior is repeating and escalating with treatment rather than decreasing with treatment they deescalate by removing the focus from the self injury behavior. instead require the person doing the self injury to take steps their self to control their deliberately self injury by taking their meds, and using their stress reduction tools.

the mental health system in scotland no longer takes responsibility for curing someone of their self injury behavior, just like with any other mental problems they expect the patient to own their negative behaviors and do whats needed to control that behavior.

America does the same thing just in a different way. american treatment providers can not be with us 24/7 forcing those of us that self injure or have alters that self injure to stop. they offer meds and talk therapy to talk out our problems but ultimately each of us has to decide for ourselves whether we want to continue to self injure or stop and when not in the therapy sessions use what we learned in therapy.

one thing about DID is that it begins in childhood, before the age of 5, which means self injury alters have been there all a persons life, but yet the person with alters who self injure still grow up to being adults, they survive. which means that a persons system of alters is set up for survival, even in self injury behaviors of alters.

Which is why scotland does not do anything major in response to repeat self injury behaviors even with those with DID. with DID patients they already know from that persons life history whether the behavior is new and for attention (repeating and escalating with treatment) or old and the internal system of alters already have ways to handle this.

my suggestion is since treatment providers have decided to leave this situation in your control with you and your system of alters maybe you can look back on your life and see how your system of alters handled this before.

meds.... contrary to what you find in books and on the internet medications do help dissociation. it all depends upon what the triggers are that is causing a person to dissociate. This is why here in america meds are being prescribed to people with DID and other dissociation problems.

another suggestion is if you have been prescribed medication take the meds for about 6 weeks then report back to your doctors how the meds are working or not. they will be able to help you get the correct meds and dosages for helping you to control what ever is triggering the self injuring alter to do this.

attend your appointments with your treatment providers and talk about your problems, they can help you to develop a treatment plan of what you need to do on your own to control the self injury by you understanding how and when it happens and what you need to do about it. then follow through with what your doctors tell you to do about it.

the treatment providers cant control you, your alters or the self injury. if you dont want it to continue you will need to follow what they are telling you to do, including taking the meds when they prescribe them.

if its any consolation here in america they do the same thing when someone's self injury is escalating not getting better. they stop treatment from focusing on the self injury and leave it up to the self injurer to control it their self.

Thanks for all of your replies and messages of support. I've now seen my psychologist, I told her everything I've posted on here. She advised that both herself and the psychiatrist are very concerned for my safety (which isn't very reassuring), and advised me to continue with the grounding techniques and mindfulness that I have on my crisis plan. I said that I have no bother doing that, even when I feel I'm losing track of reality, but my concern is the times when the dissociation is instant, when I am unable to ground myself. She did not have an answer for this, so I'm still at a loss really. I told her I feel that even though I'm fighting, I need to leave myself a little room to try to accept that I am going to die. I even asked her if I should speak to friends and family so that they are prepared.

I always attend my appointments with my psychiatrist and psychologist, and I feel I'm very open to trying their techniques and heeding their advice. My psychologist agrees that Viktor was developed in childhood as a protector, even though he started planning an 'exit' when I was around 9 years old. Subjugation by persons throughout my life, and never focusing on me has kept him somewhat 'dormant', until I became massively triggered and tried to seek help from professionals.

With regards to medication, I do take my medication. I've been on the maximum dose of an antidepressant for around 6 months. Even though it doesn't help, the psychiatrist doesn't want to change it until I'm 'more stable'. My antipsychotic is now being changed due to current side effects.

great job of following your treatment plans, this is good. the losing track of reality... have a suggestion that may help....

I wonder if your treatment providers definition of losing track of reality is different than yours....

in psych terms losing track of reality means a person is hallucinating (seeing, hearing things that can not possibly be real) and having delusions (having beliefs that can not possibly be real, believing they are fictional characters, famous people and so on that is not in reality)

with DID reality/ reality testing remains intact.. which means a person and their alters are not losing track of reality. their realities may be different than each others but they dont have hallucinations and delusions.

a person can have more than one diagnosis which cant cause a person with DID to also have symptoms of their other disorders losing track of reality (hallucinations/ delusions)

example...

Rainy's reality was who and what she was... my alter that took care of storms and depression.

my reality was /is wife , mother, employee, and the things I do in those roles.

regardless of whether I was dissociating or not those things never changed. I never when dissociating believed I not married, didnt have children didnt have a job to do. and when I was rainy her reality did not change she was always the alter that handled storms and depression.

That said I also have a mental disorder called Bipolar disorder which causes me to have hallucinations and slight delusional/ paranoid ideas. when my bipolar meds are not working I will hear and see things that are not real and react very paranoid about those around me.

sometimes its hard to tell the two problems a part so my treatment provider and I before I was integrated went on the diagnostic criteria that with DID reality testing remains intact. if I or my alters were having hallucinations/ delusions it was because of other mental problems not the DID,Dissociation problems.

Thats not saying I didnt lose tract of .......time..... time continues whether a person is dissociated or not so when I would switch back from being an alter it would naturally be a different hour, or day or week or month than what I remembered.

my point is losing track of time and losing track of reality are two different things. maybe you can talk with your treatment providers to discover which it is for you and if its the losing track of "time" that you are worried about maybe they can find ways to help you with that. if its losing track of reality, just keep following the treatment plans and this will get stabilized eventually.

my meds always get my losing track of reality back on track and what my treatment providers and I did about my losing track of time was keeping calendars and journals about my daily activities. that way when I had those time losses I could fill in the blanks much easier.

This all seems so cruel. I find it hard to understand why proper trauma-informed therapists would essentially treat SH like a "bad behavior". It is a coping mechanism. It is there because it serves a purpose. With compassion and detached observation it could become understood and thus properly addressed.
I am sorry your therapists are abandoning you to your own devices. I would think there is a better way.

I know that it seems like your treatment providers wont help you anymore. believe me it felt the same way with me when a therapist told me that I had to take responsibility for stopping my and my alters self injury. but then a really good therapist explained something to me....

by my own words to my therapist the self injury was getting worse with therapy, not better...

what if I had a special kind of allergy and hives and the treatment was taking allergy meds. but no matter what allergy meds were prescribed, the hives get worse.. would the doctor tell me to keep taking allergy meds... of course not, they would say since allergy meds make me worse they cant give me anything for the hives. that it was up to me to take cool baths and not scratch.

my past therapist explained to me mental health treatment is the same way...

if working on trauma issues is making a person worse not better the treatment plan is changed so that there is no more talking about trauma issues.

if working on self injury problems is making a person self injure more treatment plans are changed so that there is no more working on self injury problems.

mental health treatment focuses on getting better. there are even laws and ethics that say treatment providers must help a person not harm them by making them self injure more.

for some reason my self injuring was getting worse even though I was in therapy. since therapy for self injuring was making things worse the therapist legally and ethically had to back off and not focus on my self injury. they had to wait until I was more stable and able to work on it with out self injuring more and worse.

for some reason your self injury is getting worse not better. so the treatment providers have no choice but to stop working on it, just like when a medication makes someone worse they stop that medication.

maybe someday when you are more stable and able to work on your self injury with out treatment making things worse your therapist will be able to legally and ethically help you on this again.

maybe you can keep track of when and how you self injure and figure out why, while in treatment your self injury gets worse not better. this may give you an idea of what needs to be done to stabilize you so that while in therapy you dont get worse, and instead get better.

I am sorry that you are not getting better care, and that the system seems to prevent you from getting different care.

Can Viktor write? Or draw? I found that having the self destructive parts draw or write when not triggered, just to explain their views of things and why/when they act helped my system to calm down and be less triggery. Inviting them to express themselves seems to let off some steam.