How Does This All Work?


As I start typing this, it’s 2am, and I’ve only just finished a 3 hour conversation with the person working the ‘waking night’ shift at my placement, who also happens to be one of my keyworking team. I guess I imagine people reading this out there might be wondering how exactly a long-term, specialist, residential mental health placement might work…and, to be quite honest, I frequently wonder the same thing even though I’m in and 100% committed to it! So, I thought an explanation of this evening’s events might be useful for all of us.

I’d had a shitty few hours, quite shut down, and in a dangerous state in the couple of hours approaching the start of the night shift…not only had I been having very strong urges to hurt myself, I also have been in a moral quandary as to whether me continuing to live might be morally wrong for other people, and am in a detached state where my beliefs about needing to be punished aren’t hindered by fear or emotion and so are much easier to act upon: to be blunt, I was at the point of acting to hurt myself severely or kill myself.

So how the hell does being in a place like this make any difference to someone who is at the point of acting imminently to seriously hurt themself or end their life? Well, tonight it turns out that simply talking to the right person, with the right training and approach, meant that I explored some very very confused, half-formed thoughts making them more fully formed and understandable (very important for someone like me who values logic and knowledge), as well as letting some pressure out of a valve fit to burst, getting a completely different perspective on my thoughts and beliefs, having an injection of hope, and just having even that slightest element of doubt sink in to allow me to eventually decide that I definitely wouldn’t be acting on an urge to end my life tonight and, although self harm might happen, it would be minimised greatly. It also gave me the opportunity to talk over what would happen if I do self harm (even though it’s already happened in the fortnight I’ve lived here, my past means that I can’t trust any consistent or understandable responses), and I even managed to pluck up the bravery to check in about one of my biggest worries: how that individual would feel if I hurt myself whilst they were on duty or despite them having invested so much time this evening talking to me, and me then letting them down…I know this isn’t how it is supposed to work – and they emphasised that to me, again, too – but it’s how my brain works and is important for me to understand and discuss bluntly so that I can trust the system and the person as much as possible.

What this looked like is an incredibly long conversation, the first half of which is so fragmented that even looking back just 2 hours or so ago I can’t even begin to follow the trains of thought but that my key worker stuck with patiently and admirably, the second half of which being a lengthly description the past 6 years of my life ranging from the very deep to the ridiculously superficial. When I think about the vastness of what we discussed and the different levels of apparent relevance of each topic, it is truly laughable BUT it not only worked to ‘buy me’ another night alive (and, please don’t worry for my safety, I don’t have active suicide plans, and actually trust in my current support to keep me alive for longer than a day, perhaps the first time I can say that with true conviction for 3 years), it also worked to help build a relationship with a professional who could potentially have a significant impact on my life and recovery…my key worker even said at the end that she felt like she had been on an enormous journey with me tonight that had helped her understand and know me even more. And, for some reason, that notion of ‘being known’ or ‘understood’ also makes the world of difference…it reduces the expectation of judgement and fear of abandonment dramatically, and equally impressively increases trust and future openness.

Now that’s a very brief (and probably quite nonsensical) description of the what of this evening. The how and the why are currently beyond my comprehension, especially at this level of exhaustion, confusion and inner turmoil…but I wanted to capitalise on this brief moment of me remembering quite what it’s actually like to have therapeutic input at a specialist, psychologically-informed placement such as this whilst I actually remembered what had occurred, so that hopefully it can be of help to anyone who might come into contact with or hear of such a thing in any way.

One thing I’m certain of: despite the many and constant challenges of being at this placement, I’m feeling very blessed to be here right now.

2 thoughts on “How Does This All Work?

  1. that notion of ‘being known’ or ‘understood’ also makes the world of difference…it reduces the expectation of judgement and fear of abandonment dramatically, and equally impressively increases trust and future openness.
    I connect with this on such a deep level. To feel that someone, anyone, but especially someone who is there specifically to help you, actually understands you to some extent…. I would love to have just one and I’m so glad you have had the opportunity to feel that connection.

    Liked by 1 person

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