Tuesday, 29 March 2016

"Terminology may be part of the problem"- A guest blog by Julia Harrison, Psychological Therapist

Firstly, thanks to Aimee for asking me to write this guest post. Aimee is passionate about increasing understanding of mental health difficulties and how they are perceived and treated, so it’s a pleasure to be asked to contributeI’m writing from the perspective of having worked with individuals with a diagnosis of Personality Disorder for the last thirteen years, but also with a sprinkling of experience from throughout my life.  
I thought I’d write about some of the things that I’ve learned along the way and hope others find some of this useful in their own journey to understanding more, whether as a service user or provider.

Diagnosis – helpful signpost or stigmatising label. This has always been controversial and I get that. For some people, knowing there’s a name for what they are experiencing and that others have similar difficulties has been a huge relief; in many cases diagnosis can open the door to more information, research, support and treatment. For others though, it feels like a label that takes away their individuality and makes them a ‘disorder’. I think a couple of things  contribute to this – firstly a hangover from the bad old days when personality disorder was viewed as untreatable (because professionals didn’t really know how to treat it!). Secondly, terminology may be part of the problem - if personality refers to everything we are as individuals, the term personality disorder can feel like someone saying that as a whole you’re faulty or dysfunctional. In all my years I’ve never met anyone who was like that – totally dysfunctional. I’ve met people who have difficulties that are understandable given their circumstances, but they also have skills, compassion, humour and talentsThese people have often survived a lot, and you don’t become a survivor without having some kick-ass strengths. So yes, I definitely think that terminology is something we need to improve; hopefully we’re on the right road, but for now it’s vital we never forget uniqueness, never presume, and always look for the individual!

Getting Help – this kind of ties in with the point above.Not so many years ago there was a view that a personality disorder was untreatable; this seemed to be largely because no-one really knew what to do! Happily I’m working in a time where this is no longer the case – in the last ten years there has been huge progress in developing approaches that are helpful and work. We’ve even started to listen (really listen) to the true experts, those with lived experience of  mental health problems, about what is useful and what isn’t and the development of peer support worker roles is a brilliant step forward in the NHSThere are many different treatments available now, and it’s important to find the one that suits you, however in a nut shell what I’ve found to be helpful is 

a) your worker taking time to explain the diagnosis and you both developing an understanding of how your problems developed, what keeps them going, what makes things worseand what is going to help change things.
b) treatment that uses the skills you have and helps you develop more (particularly skills that help you  to understand yourself and others better, regulate your emotions, and manage impulses/urges)

Holding on to hope - I can’t stress this last one enough as I’ve seen such change and improvement in people over the yearsthough there have been times during that journey where they’ve felt hopeless and I’ve felt uselessI came to realise though that the difficulties people experience have developed over a long period of time, and they won’t improve overnight. I think it’s important that both service users and professionals don’t lose sight of that. Expect lapses and dips – if you’re struggling, remind yourself that having a lapse is only possible because you are trying to change and do things differently. I know this is easier said than done, as those critical inner voices can be very strong but what may help is to prepare for the dips, the bleak days, the lapsesat times when you’re feeling stronger and hopeful.  Find ways to remind yourself that things do get better, that there have been times you haven’t felt like this, and there will be again. Different techniques work for different people but things like making a music play list, writing yourself a letter, recording yourself a message or video, having little ‘cheer leading’ cards stashed away  etc  - just anything that will give you hope on the days when it’s so hard to hold on.

Thanks again to Aimee for asking me to contribute and good luck to everyone in your own personal journey.