DBT

Two lessons

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“He loved me in the purest sense and I loved him. That’s how he kept me alive.” says Marsha about Ted, a catholic priest.

This relationship taught her two important things that she applied to her work as a therapist for seriously suicidal people. She wrote about these things and taught them to her students, the future generation of therapists.

  1. ‘I was unable to say thank-you then. Now I can.’

If you’re giving unconditional love to help someone cope with the hell they are in, if you’re holding them emotionally and physically, don’t interpret their absence of ‘thanks’ as a sign that you are not giving them what they need. You probably are.

2. ‘Keep loving them.’

When someone sees no point in living, they are like someone walking in a mist. They don’t see the mist. They don’t see that they are getting wet. If you’re walking with them, you may not see it either. But if they have a pail of water, you can collect the water that was mist, in it. Each moment of love adds to the mist, which adds to the water in the pail. By itself, each moment of love may not be enough. But ultimately, the pail fills up and the person in hell can drink that water of love and be transformed.

Like Marsha, I know this to be true. I’ve been there and drunk from that pail.

(Inspired by Marsha M Linehans’s book: ‘Building a life worth living’.)

I was so wrong.

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I thought that if his doctors would have recognised how sick Saagar was, they would have known that the best thing to do was to refer him to the Psychiatric services. They would admit him to the hospital, look after him and keep him safe.  He would recover fully, return home and resume his life as normal – play the drums, read and speak French, play cricket, go out with his friends, go to the gym, make me laugh till I had tears in my eyes and soon, return to University.

Now I know, that I was so wrong at so many levels.

  1. Recognise?

The GP didn’t think his condition was life-threatening, even after he told him it was. How much more obvious did it have to be? They didn’t believe him. If at all they did, they didn’t take him seriously. Or maybe they simply didn’t know what to do.

GPs are not trained or supported in looking after suicidal patients.

  • Refer?

If they would have made a referral to the Mental hospital, he would have waited for a long time to be seen. Maybe he would have died while on the waiting list, like many others.

GPs are dis-incentivised to make referrals to specialist services in various ways.

  • Admit him to the hospital?

No chance! That would not have happened as there would have been no beds. If there were beds, there would have been others much sicker than him, ahead of him in the queue.

Hospitals have very poor capacity and very high thresholds for admission to inpatient beds.

  • Keep him safe?

490 patients died while detained under the Mental Health Act in the year up to March 21. At least 324, for non-COVID reasons.

Ref: https://www.bbc.co.uk/news/uk-politics-59336579

Being an inpatient does not mean –  safety.

  • Recover fully?

Many patients report traumatic experiences while admitted to mental hospitals. The treatment is often not conducive to recovery. Concerns include coercion by staff, fear of assault from other patients, lack of therapeutic opportunities and limited support.

There is little understanding of what the patient needs, to recover.

(Ref: https://www.cambridge.org/core/journals/the-british-journal-of-psychiatry/article/experiences-of-inpatient-mental-health-services-systematic-review/C5459A372B8423BA328B4B6F05D10914)

I am presently reading a book – ‘Building a life worth living’ by Marsha, M Linehan. She is the psychologist who developed Dialectical Behavioural Therapy, to help suicidal individuals to build their lives. Much before she did that, she was a seriously suicidal and self-harming young adult.

I am learning so much.

Marsha M Linehan – Author of ‘Building a Life Worth Living’

An immersive experience.

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I have felt safe outside lakes, rivers and oceans as opposed to inside. Shoes and woolly socks keeping the feet warm and dry, a scarf wrapped around the neck, jeans and jackets keeping me secure. These water bodies are a source of calm but I am suspicious of their invisible currents, innocent iciness and deceptive cleanliness.

Ten days ago, we drove to a little self-catering rental cottage at Constantine Bay in Cornwall, 100 yards from the beach. After a quick cup of tea we took a walk on the windy sea-face, almost swept off our feet. Its playfulness hit my face like multiple mini-darts. It must have hit some obscure part of my brain that suddenly came to believe that it would be a great idea to have a soak in the sea. This was strange given I can’t swim. I splash my arms and legs enthusiastically without staying afloat or traveling any distance. My breath gets all confused and erratic. I choke and splutter and cough. I am clearly a creature of the air. Not water. But this had to be done.

The next day, high tide was at 1834. We took our wedding rings off and left them at home as they are known to slip off in cold water. The  winds were low. Air temperature 10 degrees Celsius. Water temperature same. Sun, in and out. No rain. We changed into our improvised swimsuits, got our towels and walked to a quiet lagoon at one end of the bay that we had spotted the day before. A steep set of steps led down to it. At the bottom, sloping slate-grey rocks lay dry. Welcoming. The force of the waves was dampened by an intervening row of irregular black rocks, making the water as still as possible, lapping gently to the beat of the sea. The salty air resting on my lips and in my chest. My heart preparing to be stopped.

With my eyes focused on the sharp horizontal line between the blues of the sea and the sky, I walked straight into the Atlantic. I wanted to be neck deep in an instant and I was. An involuntary squeal escaped my throat. Coming to myself I breathed slowly with my eyes wide open. Counting. Smiling. Shaking. Completely inside that stark moment. Everything else dissolved. All of me was covered in acupuncture needles. Every swish of the waters stole some more heat away, deepening those needles infusing energy. The shock of it. And the delight of being alive. Woohooo!

40 seconds… once… and again. Then 2 minutes and then longer… and longer every day.

(Ref: TIPP Skills to modulate emotions: https://www.manhattancbt.com/archives/1452/dbt-tipp-skills/)