The Discouraged Borderline

Content Warning: Hospitals, Self-harm, risk-taking behaviour, and suicidal thoughts/actions.  

“I know that I do have quite a few traits of it, but I still don’t feel as though this diagnosis fits me fully. It’s just that, each time that I’ve been admitted onto one of the psychiatric wards, I’ve met several other people with this diagnosis – and whilst they’ve all been very similar to each other, in their personality traits, I felt as though none of them were similar to me.”

Being diagnosed with Emotionally Unstable Personality Disorder (EUPD – also known as Borderline Personality Disorder, BPD) felt like a huge kick in the face at first, but that’s because it wasn’t handled appropriately – or at all sensitively – by the clinician.

I had been admitted onto a psychiatric ward for the first time in my life, this was in December 2016. For the first 36 hours, I hid in my hospital bedroom wardrobe, too anxious to come out. I only spoke to say “thank you” four times per day, when a nurse would bring me my medication in a little paper cup, or to say “no, thank you” when someone would come in to tell me that dinner was ready and ask me if I wanted anything. The only person I could talk to was my partner if he came to visit. And yet, despite the complete lack of interaction between myself and anybody working on the ward – the consultant psychiatrist on the ward insisted that, from the staffs observations of me (sitting in my room doing nothing) over those 36 hours, he had enough evidence to draw the conclusion that I had ‘Borderline Personality Disorder.’ Not only that, but he also tried to deny the existence of my anxiety issues, uttering nonsense such as: “You are not anxious.” I remember thinking that was a ridiculously odd thing to say to someone; after all, no one can truly know exactly how another person is feeling. Besides – I was shaking with fright, fidgeting, tapping my foot, not making eye contact –  I was anxious, just like I always am, just like I had been for 7 years. Every doctor I’d seen throughout those years had recognised and attempted to treat my severe anxiety and panic attacks. So who the hell does this man, this ‘expert’, think he is – denying a significant part of my mental health difficulties, having only spoken to me for less than 3 minutes?

The EUPD diagnosis stuck to me like a stubborn plaster; I desperately wanted to get rid of it, for two reasons:

1.) Because it didn’t seem to fit me accurately. A few years previously I believed I may have EUPD, but the more I researched it, the less I agreed that the symptoms matched my experiences. Plus, it didn’t explain my anxiety, my main symptom – the psychiatrist just dismissed it.

2.) Because there is such a terrible stigma associated with personality disorders, specifically EUPD. People with EUPD are often regarded by others as being impulsive, unpredictable, self-destructive; inconsiderate, angry, attention-seeking.

I was completely aware of the fact that, by rejecting the diagnosis based on the attached stigma, I was inadvertently contributing to that stigma – and as a person who campaigns against mental health stigma, I hated myself for this – but for some reason I just couldn’t seem to let myself accept it. I felt less desperate to escape from the diagnosis as soon as I had a consultation with a different psychiatrist (on a second admission to a psychiatric ward the following month), who spent 90 minutes with me, going thoroughly through my life history. He acknowledged my co-existing difficulties, diagnosing Generalised Anxiety Disorder as well as EUPD, so I felt as though I had at least been listened to. But something still didn’t seem quite right. Every person I had met in the hospital who had told me they had EUPD seemed to be a relatively loud person, who enjoyed being at the centre of attention. They had visible mood swings and outbursts of anger, which involved shouting at other patients and being rude to the nursing staff. There were some displays of violence, too; as though there was a constant conflict, a fight that needed to be won. It’s very important to me that I make clear here that I did not see anything inherently wrong with these behaviours – they are all just symptoms of illness, something that everyone in the hospital displayed in their own way. But these EUPD-symptoms that I’d noticed were symptoms that I did not share.


Fast-foward 8 months.

This week I had an appointment with my community psychiatric nurse (CPN) and we were discussing whereabouts I’m at, mentally, right now. It’s been a rocky year, and I’ve had several hospital admissions to both the general hospital and the psychiatric hospital; with the most recent psychiatric admission being for two weeks at the beginning of last month. I’m up-and-down, but I am definitely making some progress. I said to my CPN: “It’s been 9 months since they said the dreaded diagnosis. I’ve sort-of accepted it now, but I still don’t feel as though it fits me fully.” When she asked what I meant, I described the EUPD patients that I’d seen during my hospital admissions, and the behaviours that they seems to have that I didn’t have. “The shouting, the rudeness, the violence, the disruptive behaviour. They’ve all been very similar to each other, with their personality traits, but I felt as though none of them were similar to me.”

We discussed my personal symptoms; the numbness, the depressive mood, that never-ending sense of hopelessness. The fluidity in my identity. The self-harming behaviour, about a dozen overdoses. The low self esteem, the low sense of self-worth, the self-loathing… And then we discussed the traits I do not display; instead of having unstable relationships, my relationships with others – particularly with my partner – are rock solid. Instead of fighting to be the centre of attention  I hide away from it unless I am very comfortable with the people I’m spending time with. I don’t take recreational drugs, I’d never do dangerous or drink-driving. I barely touch alcohol at all, really. I wouldn’t hurt a fly, let alone another person – and I don’t feel as though I’m in conflict with society (apart from hating the current government – but who doesn’t hate the tories?!) I don’t have any issues with authority. I don’t believe that I act to manipulate others. I’m not often very passive-aggressive. I just don’t display the stereotypical behaviours that people with EUPD are assumed to display. 

But now, after my CPN explained something to me, I understand why I felt so confused about the diagnosis; why I felt as though it didn’t fit me properly. She said that there are four sub-types of EUPD – Impulsive, Petulant, Discouraged, and Self-Destructive. The four different types are not concrete; a person diagnosed with EUPD probably has some traits from all or most of the types, and some people might not really fit into any of the types solidly. But for most people with EUPD, their main symptoms and behaviours will usually fit into one or two of the types more than the others.

Here’s a brief description of the typical symptoms arising within each type.

The Impulsive Borderline type:
This is probably the most stereotypical view of someone suffering with EUPD. The impulsive borderline may act without thinking, often endangering themselves and/or others, due to having a lack of control on their impulses. They may over-spend, take drugs, drive recklessly, self-harm, or regularly engage in sexual activity without using protection. Strong feelings of anger, severe mood swings, or episodes of violence and conflict with others are not uncommon. The Impulsive type may find that they switch between feeling very energetic and happy, to very angry and cold. They may feel resentful of other people and think that others are to blame for the pain they are experiencing. These feelings and beliefs can often disturb relationships or prevent them from forming at all. On the other hand, the impulsive borderline may instead seek approval in any way possible in an effort to avoid abandonment or disapproval.

The Petulant Borderline type:
The petulant type may feel irritable, and pessimistic, and the fear of disappointing others or being abandoned by others could be very strong. They are often a more passive-aggressive character, and may feel that they need to self-harm or engage in dangerous behaviour in order to be noticed by others. This is often because they struggle with assertiveness; they have difficulty vocalising their feelings and needs in a clear way that makes sense to others. They may also have a very unstable sense of who they are, what their values are and what they believe in; this could change depending on who the person is with, in order to seek the approval of others. The Petulant type may find that they have a tough time soothing themselves, and as such may develop substance abuse problems or eating disorders due to failed attempts at consoling themselves whilst upset.

The Discouraged Borderline type:
The Discouraged type may feel empty or numb for long periods of time, and may choose to deprive themselves of things they enjoy instead of indulging themselves. They may present at first as suffering from severe depression. It’s likely that they have feelings of anger that manifest as self-loathing, often resulting in tearful episodes (rather than the typical anger presentation of shouting / arguing). Feelings of anger, or the perpetual empty feeling, may also result in self-destructive action or suicide attempts. Short periods of psychosis may occur at times of high distress. They will typically have very low self esteem, resulting either in avoidance of others due to believing that they are not worthy of any attention, or being highly dependent on others – sometimes trying to seek a sense of self-worth from those who they are dependent upon. The Discouraged borderline might also struggle with securing their sense of self / their identity. It is not uncommon for the Discouraged Borderline to struggle with chronic or repetitive physical complaints alongside their mental health problems.

The Self-Destructive Borderline type:
The Self-Distructive type perpetually struggles with feelings of self-loathing, and as the name implies, they engage in a lot of self-destructive action such as self-harming, overdosing, reckless driving, unsafe sex, and suicide attempts. They may also experience mood swings; this is all as a result of emotions being so unstable. Often a Self-Destructive borderline believes that no-one cares about them or that they are not worthy of other people’s love, and therefore they react by not caring about themselves – and being self-destructive as a way of showing that they don’t care about themselves. Their identity is blurred and uncertain and as such it is not uncommon for the Self-Destructive type to not have a sense of who they are. Depression often co-exists in this type. They may find that because they have a lack of feelings and a lack of identity, taking harmful action against themselves is a seemingly effective way of making themselves feel something (instead of feeling empty or numb).


Across all of the types, there seems to be a notable lack of regard for our own wellbeing (hence the self-harm or destructive behaviours), as well as a fear of being abandoned or hated by those around us. I think low self-esteem probably fits in with every type as well, though the way in which this presents can be very different across the types.

Thinking about it now, it seems that I am mostly the Discouraged Borderline type at present. I only struggling with the Self-Destructive type characteristics when I’m in a state of crisis, but I feel like the Discouraged type most of the time. I am most dissimilar to the Impulsive type, which explains why at first I felt as though the diagnosis of EUPD did not make sense for me (as the Impulsive Borderline is the ‘stereotypical’ view of what EUPD patients are like). The characteristics the Discouraged Borderline typically displays are not exactly unique to EUPD, or in fact personality disorders in general – which also probably contributed to my initial rejection of my EUPD diagnosis. Many of the symptoms of the discouraged borderline type could be caused by depression alone. However, I believe the combination of those symptoms with the easily-identifiable root cause (which, in the case of many EUPD patients, is trauma), is the reason that the discouraged-type symptoms result in the diagnosis of EUPD rather than a depressive disorder.

From my personal experience, I think it must be possible to shift between types over long periods of time. I think in the fairly-distant past I displayed many characteristics of the Petulant Borderline type, because I really didn’t know how to assert myself or express my feelings and needs in a valid way. As such I’d self harm, and without me having to work out what my needs even were, I would be noticed – and then helped – by others, which resulted in me feeling better. I also used to struggle very much with eating disorder symptoms: I would binge, then purge, and repeat, particularly if I felt low at the time though I would never tell anyone about it. I still relapse very occasionally with this disordered eating but it’s nowhere near as much of a problem as it used to be. I feel that I’ve managed to develop myself in such a way that I no longer act in the way the Petulant borderline typically does, because I’ve managed to unintentionally learn to trust people again – meaning that I can communicate better with people about what my needs are. I suppose this gives me hope that I can also lift myself away from the traits I do still display, and heal from EUPD almost completely. I know I’ll need to tackle the root cause (through EMDR therapy, which I am currently waiting for) and change my behaviours (via DBT – which I’ve been going through a workbook to learn!) in order to heal properly, though.

I’ve found it interesting to learn about the 4 different types of EUPD. It has helped me to accept my diagnosis, and I finally feel as though everything makes sense. My CPN actually said that the way in which my illness presents also makes her question the presence of complex-PTSD; the root cause of PTSD and EUPD can be fairly similar, and when someone is presenting as the Discouraged type there are questions to be asked about a crossover between the two diagnoses.

I hope this brings a little bit of new info for some of my fellow EUPD-sufferers!

  • Do you have a diagnosis of BPD / EUPD? Did you accept the diagnosis straight away?
  • Do you feel that the diagnosis fits you well? If not, did you know about the 4 different types, and do you feel now as though maybe you do fit into one of these 4 types? 
  • Like myself, have you noticed a change in the ‘type’ that you are, over a long period of time?
  • Do any of my readers struggle with their mental health and think that maybe the characteristics of this personality disorder are in line with their symptoms? 
  • If you are a health professional, did you know about the 4 different types of BPD/EUPD? Many of the health professionals I’ve spoken to don’t seem to be aware of these subtypes, so I’m intrigued!

I’m very interested to know about others’ experiences of receiving their diagnosis and, if necessary, the process of acceptance that they had to go through. I’m also eager to talk about the 4 different types of EUPD / BPD and whether or not other people believe they fit into one, all, or none of the sub-categories. Please do feel free to message me using the contact form, or just comment on this post below 🙂

Lots of love,
R / DisabledCatMom
xxx

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Two weeks as a patient on a psychiatric ward

TW: Psychiatric Ward, Hospital, Deliberate Self Harm, Suicidal Ideation, Overdose.


 

The thing about being admitted to a psychiatric ward, is that I’m never completely sure whether I’m ready to leave when it comes to “D-Day” (discharge day). It’s nerve-wracking; the prospect of home is exciting, as I’ll get to be with my partner and cats again, yet the idea is also suffocating – will I be able to successfully stay well enough to be out of this hospital? Will I cope at home on my own during the day time, every day? Will I manage to keep myself safe – when the inability to do so is the exact thing which landed me here in the first place? What will happen if I get overwhelmed again?


Two weeks ago I took an overdose – certainly not for the first time, and if I’m speaking truthfully, probably not for the last time. My brain is a complicated place – once I get an idea, a thought about a way in which I could harm myself, I feel that I have to do it. It’s almost a compulsion; my levels of anxiety increase ten-fold if for some reason I can’t carry out my ‘new idea’. Sometimes the harmful idea is to break my skin with something sharp, to make it bleed; or hit my fist against the brick walls of our home until my knuckles are grazed, red and swollen. Other times, I feel obliged to save up the tablets that treat my sinus tachycardia, in order to take a week’s worth at once to slow my heart down to a dangerously low rate. On this most recent occasion, two weeks ago, the idea was to take a lot of hypnotic and sedative medications, alongside handfuls of paracetamol. A short while later, I confessed to my partner that I’d taken too many pills, and as a result I landed myself in a hospital emergency department 20 miles away from my home (the hospital closest to me doesn’t have a 24 hr A&E department). 42 hours of nausea-inducing treatment, 8 needles, 20 lots of physical observations, and too many tests later, it was decided I was medically fit to be discharged. However, the psychiatric assessment team found that I wasn’t mentally stable enough to look after myself safely if I went home; I had ‘persisting suicidal ideation’. They liaised with my community psychiatric nurse (CPN), and it was decided that a short psychiatric hospital admission might be helpful.

So that’s how I ended up here, on a 19-bed acute psychiatric ward. The hospital is only a couple or three miles from our flat, and it’s near enough to the train station that my partner can visit me every-other-day on his commute home from work.

Work. I feel a deep-set sense of failure, and I know it’s partly – or mostly – because here I am, an inpatient on a ward run by the very same NHS trust that I used to work for. I was a project manager and health informatics trainee in the IT department, just 9 months ago, before I had a full nervous breakdown and was forced to go on long-term sick leave. My old office building is visible from the front door of the ward; my stomach knots whenever I see it.

I’ve been a patient on this exact ward before, around 7 months ago. I’ve also been a patient on the neighbouring ward a couple of times, which I absolutely despise (the psychiatrist is horrible) – so I’m very glad to have been admitted onto this ward instead. I recognise most of the staff here, so I already know which ones I get on well with. Many of them vaguely remember me, which I find reassuring. It’s a friendly place, with welcoming staff, but when any new patient first arrives they naturally still feel very anxious. Coming into a psychiatric hospital voluntarily (i.e. without any mental health act sections in place) sparks mixed feelings – have I made the right choice? Am I really ‘ill enough’ for this? Am I ready to have my privacy compromised in order to ensure my safety? I can’t imagine what it must feel like at first for those who have been sectioned under the mental health act, and have been brought to a ward against their will.


Some people have strange, outdated ideas in their mind about what a psychiatric ward may look like, or sound like. People often think of a psychiatric ward as being similar to an old-fashioned ‘mental asylum’, full of hysterical institutionalised patients who are just shadows, ghosts, silhouettes of their previous selves. A place where people go to, and don’t come back from for a very long time. They assume that the majority of the patients there have been sectioned for their own safety; that they are a risk to both themselves and others, and that they are all angry and distressed; shouting and screaming. This is so far from the truth, at least where I am.

Of course, we all have our moments. Psychiatric inpatient or not, we all sometimes get distressed, or angry, and we sometimes shout and scream. The ward is not a quiet environment all of the time – at times patients (or their visitors) do kick off and unsettle things slightly. But this is surely natural. We, the patients, also have times where we chat, smile, and laugh; this isn’t necessarily impossible when you’re ill and in hospital. I, for one, hide my anxiety and deep depression by making jokes, listening to others talk about their lives, and trying to laugh along. We are all encouraged to take part in activities that can help distract us from our torturous minds, and groups that may equip us with skills that help us to cope with those bad thoughts. We share conversations with each other at mealtimes, we sit outside and chat when it’s sunny; we play games of scrabble, or pool. We read books, we learn origami or take part in painting sessions. We have movie nights, complete with popcorn and dimmed lights, and breakfast groups complete with croissants and chocolate brioche rolls. We have as much fun as we let ourselves have. It’s very difficult to try to engage in ward activities, especially when all of your instincts are telling you that you should hide in your private bedroom and not talk. But, as most of us who are (or have been) mentally ill know all too well, engaging in activities helps, and that’s why psychiatric inpatient wards always have (or should have) a multidisciplinary team of occupational therapists, psychology experts, qualified nurses, and healthcare support staff.

The bedroom is alright, quite cozy; the picture behind the header for this post is one I took of my (rather untidy) bedroom on the ward. The bed is comfier than those you find in a general hospital. On the wall is the nurse-call button, which I’m told I can press should I need to talk to someone. The bedroom door has a window in it, with slats that can be opened and closed from both inside the room – and outside of it, with a special key. The light can also be switched on from outside the room; every 5-to-60 minutes (depending on your level of risk and need), a member of staff checks on you – during the night too, so sometimes you wake up briefly when your bedroom light flashes on and off – to make sure you’re still there, are safe, and still breathing. There is a doorless wardrobe, with no clothing rail, just shelves. I can fit inside the main wardrobe space – I tested this as soon as I saw it – which is a useful piece of information to know for when I get overwhelmed; I feel safer in enclosed spaces. A desk, which I sometimes sit at to do colouring or writing, and a chair which is too heavy for me to lift. I’m told by staff that that way, the chairs are less likely to get thrown or overturned. There is a bed-side cabinet, with apt room inside for all of my books, and all of my favourite snacks, which my partner has brought to comfort me. Red Leicester flavoured Mini Cheddars, Alpro Soya Milkshakes, Pink Lady Apples, pouches of Cadbury’s Chocolate, and a bottle of Pepsi Max Cherry. There are curtains, a nice, calm blue stripey pattern; the curtain rail is attached by magnets, designed to fall if any pressure is applied. There is an en-suite bathroom cubicle – a sink with no plug. A shower, again with no plug, set to automatically cut the water supply off after about 20 minutes,, and not let you restart it for half an hour or so. And a toilet with no seat, the rim cold to touch every time you sit on it. The cubicle door has gaps of about 18 inches at the top and bottom, and it doesn’t lock, nor does it have a right-angled corner or any visible hinges. Every possible ligature point, or other danger zone, has been thought through and replaced with something that it would be near-impossible to harm yourself on – it’s impressive, really.

But it does set the ideas going in my mind; the cogs of my depressive, self-loathing brain are turning, searching for ways that I can hurt myself despite all of the preventative measures. Despite the fact that they’ve taken all potentially-harmful devices away from me – my pocket mirror in case I smash it and self harm, my tweezers which I innocently brought with me simply to keep my eyebrows under control, my nail varnish – and put them inside my locker, to which I don’t have a key. I ‘can ask for them at any time’, but my ‘use of them will be supervised’. I respect and understand their safety policies, though, perhaps far more than any of the other patients do. After all, I did once work amongst the people that designed them, so I can see my admission to hospital from a professional point of view.


My first week here was a bit of a blur. When I arrived after the overdose, I was tired, and a bit muddled, so I spent the first couple of days just sleeping, eating, and sleeping some more. I have various problems with my physical health, including seizures, and on the 5th day of my admission I had 7 or 8 seizures in the space of 24 hours, hitting my head in three different places on three separate occasions. Understandably, the staff on this ward were worried, and called an ambulance after the last 3 seizures occurred one after the other. The nurses and doctors on the ward hoped, and expected, that the investigation into what is causing my seizures (an EEG) would be brought forward as a matter of urgency.

And so, even though I hated the idea, I was shipped back up to that same hospital 20 miles away, alone, frightened, and tired. In the ambulance I had gas and air – luckily – because y pain was at a level I couldn’t cope with, and the paramedic wasn’t the most gentle of drivers. There are too many pot-holes on the roads around here! When I arrived at the hospital emergency department, I waited for 5 hours – in the middle of the night – in an A&E corridor with no one around to look after me. There were queues of patients, not one of us being treated, parked on trolley beds at the side of the longest hospital corridor I’ve ever seen. Finally after 5 hours I was taken to a cubicle, and I thought my treatment would begin – I was in a hell of a lot of pain, to the point that I was writhing and crying – but again, I was just left for an hour without anyone approaching me or asking me how I was. About 6 and a half hours after I got to A&E, someone was sent to take my bloods and insert a cannula, and I was given some IV anti-sickness medication. And two paracetamol tablets to take. Paracetamol. I was thankful that my nausea had been treated, but paracetamol is a huge kick in the teeth when you’re on regular morphine and dihydrocodeine to manage your pain, so of course I wasn’t very happy. I was left alone for another 2 hours, and then someone finally came to actually talk to me about my condition and examine me, and look at the bumps and bruises on my head. 13 hours after I arrived at A&E (and half of a book later), I was sent back to the psychiatric ward, having had no investigations other than blood tests and urinalysis. I suspected this would be the case, but I was so tired and frustrated, and I hadn’t slept a wink, so it felt extra-dreadful that the overnight trip to hospital had been a waste of everyone’s time. I was physically weakened to the point of needing a wheelchair (I can usually mobilise with two walking sticks), and so emotionally scarred from the entire lengthy experience that I’ve sworn to myself that I’ll never voluntarily go to that hospital for treatment ever again.

I cried when I got back to my bedroom on the psychiatric ward – and at the time, I couldn’t really explain why I was so upset. I guess I was just overwhelmed, but there was also a definitive sense of relief in the mix too. I was relieved to be back in a place where people actually asked how I was doing – and actually listened to, and heard, the answer. I was shaking, shivering, sweating, squirming – all due to the exhaustion and the terrible pain I was in (and had been in all through the night). Finally I could have my regular prescribed medication and feel a tiny bit better, but I still couldn’t sleep. My mind was wired, busy, far too alert to everything that was going on with my body, so every time I closed my eyes I would just have to open them again. So I got up. I kept occupied just by doing colouring, all day, because I couldn’t manage anything else. Luckily one of my favourite healthcare support staff members was on the ward that day, and she kept a close eye on me and made sure I was alright. It got to the following night before I could start to wind down; I’d been awake for 40 hours when I finally fell asleep thanks to a Zopiclone tablet. Those 40 hours were a complete nightmare full of seizures and pain, but luckily things got a little better from here onwards. I still had seizures, quite a few of them, but not so many, and not so close together.


This week has been much better. I’ve attended psychology groups, and had a 1:1 session with the psychologist about how to cope with the occasional auditory hallucinations I experience. I’ve spent a lot of time chatting with other patients, and swapped numbers with them so I can keep in touch. I’ve learned new coping skills, and drawn up a “Crisis Survival Plan” that I can go to if I’m feeling overwhelmed.

Now it’s almost time for me to be discharged, and I feel quite worried about that. As I mentioned at the beginning of this post, “D-day” is quite scary – even if you have only been admitted for a relatively short period of time. I have no idea how things will be when I’m back at home, spending time alone, fighting through each day to try to keep myself safe. I’m going to occupy myself as much as possible, but sometimes depressive symptoms or heightened anxiety stops that from happening.

I just need to keep reminding myself of what is good about going home. I will get my freedom back. I will be able to cook nice food, and eat it at times that suit me. I’ll get to spend every night with my partner; I can lay next to him on our memory foam mattress, and snuggle up to him instead of sleeping alone in this hospital bed. I’ll be able to see my cats, and force them to give me cuddles and snuggles, (even if they try to pretend they don’t like it). I will drink tea, coffee and hot chocolate from a mug instead of a plastic cup – for some reason, the plastic cups are something I really despise, despite understanding that they are safer than ceramic or china and therefore completely necessary. I’ll be away from any drama, as like I said above, it’s natural that in this hospital environment there will be people kicking up a fuss from time to time.

Oh, and another thing – I’ll be able to sit around in just a top and my underwear, without worrying that anyone will see me!

The mother of all breakfasts

I’ve found myself to be a little bit obsessed with oats at the moment, and so I’ve been making a lot of baked ‘oatmeal’- type things for my breakfasts this week. I’m not one for exquisite presentation because to me it’s all about FLAVOUR: 

That beauty right there is what I’ve called Baked Apple and Cinnammon Oatmeal – and it’s really simple to make! See below for a recipe that doesn’t need weighing scales.

What you need (for 1 nice and big serving of any baked oatmeal brekkie): 

Porridge oats 

Banana, chopped

Milk 

Sugar

Sultanas (optional)

Ground Cinnammon (optional)

Cashew nuts, chopped (optional) 

Honey or syrup (optional)

Plus any topping you fancy!

What to do:
– Preheat the oven to around 200 degrees celsius

– Pop a couple of generous handfuls of oats, a little sprinkling of sugar, and a few sultanas (optional) into an ovenproof dish.  ~The dish shouldn’t be much bigger than about a 5-ish-inch diameter circle; if it is then the cooking time for the oatmeal mix may be shorter~

– Add a good splash of your favourite type of milk, and a chopped banana, to the oat mix, then mash it all together until it is fully mixed and resembles the consistency of a thick porridge

– Mix in a few chopped cashew nuts (optional) and a 1/4 teaspoon of ground cinnammon (also optional) – or more if you love cinnammon as much as I do!

– After ensuring it is all well-combined together, flatten the oatmeal in its dish and bake for 35-40 minutes

– When the oats look golden brown, take the dish out of the oven and drizzle honey or syrup (optional) over the top. Leave to rest for 10 mins whilst you prepare the topping of your choice! 

– You can then either eat it straight out of the dish (careful if it’s hot!) or, if you’ve made more than one serving then spoon them into separate bowls before adding toppings.
Topping ideas:

The topping I used for the oatmeal photographed above was diced apple with a bit of sugar and a bit of cinnammon; 

– Dice one apple into small chunks, add a splinkling each of cinnammon and sugar, and then   bake in a separate dish to the oat mix for around 30-40 minute

But there are plenty of other ideas:

– You could grate some lemon or orange zest (and squeeze a little bit of juice, substituting for the milk) into your oat mix before baking, and then top with blueberries – Yum!

– You could top the freshly baked oatmeal with more chopped banana and a dollop of nut-butter – such as peanut butter or almond butter 

– Top with strawberries, raspberries or cherries; with a spoonful of chocolate spread (or Nutella if you fancy it – I have a slight obsession with Nutella!)


– Go tropical by topping with diced pineapple and/or mango and a spoonful of coconut butter (or Bounty spread!) If this is your kind of thing, you could add a sprinkling of dessicated coconut or coconut flakes to the oat mix before baking 

– If you’re a chocoholic like me, you could swap the sultanas for choccie chips 😛 

Happy brekkie! Let me know if you make this or anything similar – or just comment with your own favourite breakfast food at the moment 😃

If you have any questions then don’t hesitate to ask!

Love & Hugs, 

Rachael (DisabledCatMom)

Mindfulness for the Many (1)

‘Mindfulness’ – it’s being mentioned absolutely everywhere at the moment. But what actually is it? How ‘mindful’ are we? And perhaps most importantly, how can regularly practicing ‘mindfulness’ benefit us? 

What is mindfulness?

Many people have the misunderstanding that mindfulness is some sort of religious or spiritual practice – and whilst mindfulness is taught as part of a number of different faiths, it is certainly not solely a practice used by religious or spiritual groups.

Being in a ‘mindful state’ simply means that you are fully aware of the present moment – along with the thoughts, feelings and sensations that come with it. In your mindful state, you completely accept all that is happening to you and around you, without judging or criticising any of your experiences. ‘Mindfulness’ can then be described as achieving this mental state, in which you are being ‘mindful’.

Being ‘aware’ of the present moment may sound fairly easy, but most of the time it’s actually much harder than you might think.

How much of your time is spent thinking about what needs doing once you’ve finished the task you’re currently completing, or wondering how things may be different if something in the past had taken a different turn? How many times have you put down an item and immediately forgotten where you’ve put it, or walked into a room only to find that you have no idea why you went to that room in the first place? On your commute to work or travelling to somewhere familiar, how often do you ‘zone out’ and forget which roads you’ve travelled along, or which train stations you’ve passed through? When talking to another person, how often do you find yourself focusing on what you will say next – even when the other person hasn’t finished talking? Or, on the other hand, do you sometimes lose track of what has been said and forget the topic of conversation?

All of these occurrences, plus many more similar things that happen to us all on a daily basis, can be described as ‘mindless‘ experiences. They all go to show that our focus is often fixated upon the future, or preoccupied by the past. These mindless experiences aren’t harmful of course, but there are a number of positive differences we can benefit from if we learn to better focus our mind on the present moment.

How can practicing mindfulness benefit me?

Mindfulness has been shown to be effective at reducing anxiety levels and chronic pain, as well as increasing a person’s tolerance and resilience in situations that are distressing for them, and increasing a person’s ability to fully relax. In today’s society, life can pass us by very quickly, and therefore proper relaxation is extra-important to maintain mental and physical well-being. Along with a new type of relaxation that’s good for your mind, you might also benefit from an improved attention span, an enhanced awareness of your emotions and thoughts, and decreased stress levels. What have you got to lose?

My next ‘Mindfulness for the Many’ post will give details of a few really quick mind-exercises you can do that will help you to practice mindfulness. Look out for it and give them a go – you might be surprised!

Thank You

Content warning: Suicidal intent, Overdose, Self-harm

 

(Post transferred from my old blog, brainpainoutlet. Original publishing date and time have been matched).

 

I remember a long time ago, I encouraged a friend to stop apologising so much and start using “thank you” in it’s place. She told me that it made everything sound so much more positive, and that less apologising really helped her get her gratitude across properly, instead of everything sounding like an expression of guilt.

After publishing my post this morning, which was entitled ‘I’m Sorry’ and contained a letter of apology to my partner, I recalled that ‘thank you’ is sometimes more suitable than ‘sorry’. So this blog post contains my letter of apology, transformed into a letter of gratitude. 


To my partner,

I’m sorry.Thank you.

I’m sorry about my mental illness. I’m sorry that my struggle has caused life to be so tiring for you, especially over the last few months.Thank you for supporting me whilst my illness has been particularly challenging. Thank you for helping me through my struggle, particularly as it must have been tiring for you. 

I’m sorry that you’ve had to take on so much – I’m sorry that the upkeep of our home, the laundering of our clothes, and the payment of our bills, all became things that I couldn’t face keeping on top of.Thank you for taking on the household chores that I couldn’t keep on top of. I’m sorry that you’ve had to do all of the work to look after our cats, when I was the one who was so desperate to adopt them.Thank you for feeding and looking after our cats, even though it was me who so desperately wanted to adopt them. I truly believe they’ve been therapeutic for me whilst I’ve been ill, so I hope you still agree that adopting them was a great idea.I’m sorry that making important phone calls, organising my sick notes, collecting my prescriptions, and filling in the paperwork associated with my leave from work all became solely your responsibility. Thank you for making important phone calls for me, even though you find making phone calls difficult yourself. Thank you for signing my paperwork as my carer and for emailing my work about my sickness leave. Thank you for going to the pharmacy on your way home from work to collect my medicines, even though it’s a significant diversion from your usual route.I’m sorry that my income has dwindled down to nothing, and your income has had to become ‘ours’. Thank you for supporting the two of us financially whilst I’m not well enough to earn money myself. I’m sorry that on top of full time work, you’ve spent hours by my side in various hospitals, and almost as much time travelling to and from said hospitals on public transport.Thank you for travelling a lot just to sit with me in hospital wards, playing scrabble or doing puzzles with me. Thank you for listening to me tell stories about the patients on the ward with me, and for holding my hand to comfort me when I’d had a bad day. Thank you for bringing me chocolate to cheer me up, and fruit to satisfy my ‘vitamin cravings’. I’m sorry for the amount of nights you’ve had to sleep in our bed, cold and alone, with no one to keep you warm. Thank you for waiting patiently at home whilst I was in hospital, keeping the cats company until I was deemed well enough to be discharged. 

I’m sorry that when I’m not in hospital, you have to spend ages looking after me, checking that I’m OK, making sure that I’m as safe as possible. I’m sorry that sometimes, I’m impossible to keep safeThank you for doing your best to keep me safe, even when it’s very difficult to do so. Thank you for always checking whether I’m OK, and for looking after me.I’m sorry that you went from just being my boyfriend, my lover, to being my next of kin and my emergency contact. I’m sorry that you involuntarily had to take on the role of my ‘carer’Thank you for being my carer as well as my partner and my team mate. It means more to me than you’ll ever know. 

I’m sorry for lying about how I felt sometimes. I’m sorry that I didn’t always tell you when I felt unsafe and suicidal, or when I was stockpiling spare medications ‘in case I wanted to use them in an overdose at a later point’.  I’m sorry that you now know the process of phoning for an ambulance better than the back of your own hand. I’m sorry that I disappeared in the middle of a suicide attempt whilst you were out of town, and I’m sorry that you had to call the police that day to report me missing. I’m sorry for the times I took overdoses whilst you were in the flat with me, instead of talking to you about how I was feeling. I’m sorry that I once stole the keys to the medication safe whilst you were sleeping, so that I could take too many pills. I’m sorry I lied and said I didn’t have any medications stored in secret places, when in actual fact I did. I’m sorry I sneaked out when you were at work, to buy painkillers from the corner shop only to hide them in my sock drawer. Thank you for understanding that my mental illness sometimes causes me to behave in an undesirable way, and for seeing that I don’t always have full control over my actions. Thank you for seeing things from my point of view, and for getting why sometimes I lied or held back the truth. Thank you for always forgiving me for the poor choices I’ve made, and for being on my side no matter what. Thank you for being on-the-ball and calling the emergency services whenever it was necessary. You always seemed to know when I was in danger, even when you weren’t physically anywhere near me.

 

I’m sorry I ran away from home late at night several times and made you worried sick; I’m sorry you then had to come to collect me from the railway bridge in the cold wind and rain to bring me home, when you had to be up at 7:00AM the following morning for work.Thank you for calmly and reassuringly talking to me when I got myself into a state and ran away from home to stand on the railway bridge. Thank you for understanding and never being cross with me. Thank you for giving up time that should have been spent sleeping just to make sure that I was safe.I’m sorry that you’ve had to come home from work to find me unconscious (or near-unconscious) repeatedly. I’m sorry that the responsibility for saving my life fell onto you so many times. Thank you for saving my life, even when I said I didn’t want you to.

I’m sorry you’ve had to ride in an ambulance to A&E with me so many times. I’m sorry you’ve had to sit in A&E whilst they ran tests and decided what treatment I needed. I’m sorry that you’ve sat with me, bored, lonely, whilst I’ve fallen unconscious from the overdoses I’ve taken. I’m sorry if every overdose felt like deja-vu for you. I’m sorry you’ve had to call your manager at work and book urgent unplanned leave from work, just because I’ve fucked up and needed you with me. I’m sorry for the states you’ve seen me in.Thank you for repeatedly keeping me company in the emergency department for hours upon hours. Thank you for fetching me water when I was thirsty, for helping me to the bathroom, for helping me to get changed into comfy clothes and for going to buy food when I was hungry. Thank you for packing my hospital bags for me and always including something that would comfort me, like one of my cuddly toys. Thank you for holding my hand during ambulance rides. I’m not sure if this is the case, but having your hand there to hold has always been very important to me in those situations; it felt like you were reassuring me that even though the situation my illness had created was a bad one, you didn’t resent me for it. 

I’m sorry that I’ve locked myself in the bathroom to self-harm. I’m sorry you’ve known I was self-harming and had to just let me do it, because there was no way of stopping me. I’m sorry for the times you’ve had to help me clean and bandage the wounds I’ve inflicted upon myself. I’m sorry that I’ve made myself so grossly unattractive, covering myself in scars that will fade but never quite disappear. Thank you for understanding that sometimes, you can’t keep me safe from myself. Thank you for letting me learn my own lessons about how to express my pain, and for helping me to make sure my wounds are sterile and safe. Thank you for never judging me for my scars. I remember I had scars all over my legs before you ever saw me in few-enough clothes for them to be visible, and I’ve always appreciated that you’ve never looked twice or questioned them. Thank you for doing your best to ‘get’ it. Thank you for telling me that I’m beautiful, scars ‘n’ all. 

I’m sorry that you’ve stayed awake with me in the small hours of the morning whilst I’ve cried, and cried, and cried, and you’ve lost sleep. I’m sorry that when I was writing a part of this blog post at 4 in the morning because I couldn’t sleep, I started crying and it woke you up. I’m sorry for soaking your pillows and your T-shirts with my tears. Thank you for staying up late with me just to comfort and cuddle me. Thank you for not being grumpy when you woke up to the sound of me sobbing into a pillow during the early hours of this morning; thank you for instead just holding me close and trying your best to make things seem as OK as possible.

 

I’m sorry that I’ve made you cry.
I’m sorry I wasn’t there to comfort you whilst you cried.
Thank you for letting me know that you’ve cried about everything. It broke my heart to picture you crying alone, but in a way it made me understand a bit more how all of this has been making you feel. I feared you resented me, but the fact that you got upset and not angry reiterated to me that actually, you just care about me. A lot. 

 

I’m sorry I’m so withdrawn sometimes. I’m sorry about the days where I barely talk to you, because I’m feeling irritable or depressed, or because I just have nothing to say.Thank you for keeping a close eye on me whilst giving me the space I need when I’m feeling irritable or low.I’m sorry about the nights where I’ve refused a cuddle or a kiss goodnight, just because I’m feeling down.Thank you for understanding that sometimes, I don’t really feel like cuddling, and that my refusal doesn’t mean that I don’t love you.I’m sorry about the mornings and the afternoons that I’ve just spent lay in bed, unable to get up, incapable of wanting to ‘do the day’. Thank you for letting me rest when there’s time for me to, and for gently encouraging me to do what needs doing when there isn’t time for rest.I’m sorry for the times that you’ve reached out to hug me or reassure me and I’ve cowered away, refusing all physical contact.Thank you for understanding that me ducking away from your hugs is nothing personal.I’m sorry that I’m not the same as I used to be.Thank you for never losing confidence that the ‘real me’ is still in here somewhere, even though I feel that I’ve lost myself.

I’m sorry you’ve had to lie for me to my family because I asked you not to tell them how ill I am. I’m sorry that you’ve had to keep my friends updated on my condition when I’ve tried to kill myself and worried them all in the process.Thank you for letting me choose who to share information about my condition with, and for understanding the complicated reasons why I don’t want to tell some of those closest to me what’s going on. Thank you for keeping my friends who do know up to date so that they don’t worry too much. 

I’m sorry that I pulled you away from your home county when I got a graduate job nearer to my own home county, and I’m sorry I then ended up failing to cope with the job anyway. I’m sorry that you got a job near(ish) to here, too; I’m sorry that you’re so far away from all of your friends and your family. I’m sorry that you have to do a frustratingly lengthy commute on rubbish public transport to and from work every day, because there wasn’t any work for you in the town we live in. I’m sorry I’ve trapped you here. Thank you for moving away from your home county with me when I got work near to mine. Thank you for understanding that my long term sickness leave from work wasn’t planned or predictable, and for not resenting living in the town where my work was/is based. Thank you for getting up early and commuting to the next county over for work, so that we can keep living independently from our families, and so that we can keep renting our cute little flat with our two cats. I know that sometimes it feels a little lonely here for both of us, because we don’t have any friends that live locally, but hopefully we can resolve that somehow. 

I’m sorry I’m so erratic. I’m sorry for being incapable of doing anything anymore. I’m sorry that I’m boring. I’m sorry that I’m difficult to be around. I’m sorry that I’m ill.  Thank you for accepting my flaws, and understanding that I am poorly.

I’m sorry that, out of all of the humans on this planet, it was me that you fell in love with.
Thank you for choosing me when you could have had anyone. 

It’s bittersweet, really; every single day I spend time reflecting upon how lucky I am to have you in my life, and yet at the same time I question why you didn’t run a mile back when we were still ‘just friends’ in 2013. I tell myself that you deserve better. I wonder why you chose to be with me, despite knowing I had so many health problems. It says a lot about the type of person that you are, because not many people would stick around after all I’ve put us through. After all I’ve put you through. Thank you for sticking by me through all of my health problems and challenges, and reassuring me that those things don’t change the love we share. Thank you for reminding me that my opinion of myself is not the same as your opinion of me. Thank you for understanding, and regularly reiterating, that it’s not all my fault that we’ve been through more than our fair share of difficulties recently. 

I guess all of this is why they say that love hurts? Sure, it hurts, but I think we’d both rather feel the pain that love brings than never love at all. Right?

To my partner, my other half, my team mate; to the one I love

I’m sorry that loving me hurts so much sometimes.
I’m sorry that my mental illness gets in the way.

I love you,though, so much, and for now I can only hope that that’s enough.

Thank you for loving me back.

with love,
from your Sweetie-Pie x

I’m Sorry

Content warning: Suicidal Intent, Overdose, Self-Harm.

(Post transferred from my old blog, brainpainoutlet. Date and time of the original publishing has been matched).

This blog post is a letter to my partner. Over the last four months, I’ve spent around 60 days as a patient on several different hospital wards. He has always been there for me, be it physically or at the end of the telephone. My mental illness has always been present in our relationship, but since the start of December I feel that it has stretched our alliance to its limits.

Sufferers of mental illness sometimes feel the need to apologise profusely about their behaviour or ill state. Now, if it were anyone else, I’d insist that an apology wasn’t necessary, but when the ill person is me I feel as though I definitely need to. As usual, it seems I’ve set one rule for myself and another for everyone else. My partner surely deserves to hear the words ‘I’m sorry’ at the very least, after all that me and my mental illness have put him through? I’ve apologised a lot before, and he’s told me that it isn’t my fault and so I needn’t apologise. But a lot of this – it sometimes does feel like my fault. So here we go.

To my partner,

I’m sorry.

I’m sorry about my mental illness. I’m sorry that my struggle has caused life to be so tiring for you, especially over the last few months.

I’m sorry that you’ve had to take on so much – I’m sorry that the upkeep of our home, the laundering of our clothes, and the payment of our bills, all became things that I couldn’t face keeping on top of. I’m sorry that you’ve had to do all of the work to look after our cats, when I was the one who was so desperate to adopt them. I’m sorry that making important phone calls, organising my sick notes, collecting my prescriptions, and filling in the paperwork associated with my leave from work all became solely your responsibility. I’m sorry that my income has dwindled down to nothing, and your income has had to become ‘ours’. I’m sorry that on top of full time work, you’ve spent hours by my side in various hospitals, and almost as much time travelling to and from said hospitals on public transport. I’m sorry for the amount of nights you’ve had to sleep in our bed, cold and alone, with no one to keep you warm.

I’m sorry that when I’m not in hospital, you have to spend ages looking after me, checking that I’m OK, making sure that I’m as safe as possible. I’m sorry that sometimes, I’m impossible to keep safe. I’m sorry that you went from just being my boyfriend, my lover, to being my next of kin and my emergency contact. I’m sorry that you involuntarily had to take on the role of my ‘carer’.

I’m sorry for lying about how I felt sometimes. I’m sorry that I didn’t always tell you when I felt unsafe and suicidal, or when I was stockpiling spare medications ‘in case I wanted to use them in an overdose at a later point’. I’m sorry that you now know the process of phoning for an ambulance better than the back of your own hand. I’m sorry that I disappeared in the middle of a suicide attempt whilst you were out of town, and I’m sorry that you had to call the police that day to report me missing. I’m sorry for the times I took overdoses whilst you were in the flat with me, instead of talking to you about how I was feeling. I’m sorry that I once stole the keys to the medication safe whilst you were sleeping, so that I could take too many pills. I’m sorry I lied and said I didn’t have any medications stored in secret places, when in actual fact I did. I’m sorry I sneaked out when you were at work, to buy painkillers from the corner shop only to hide them in my sock drawer.

I’m sorry I ran away from home late at night several times and made you worried sick; I’m sorry you then had to come to collect me from the railway bridge in the cold wind and rain to bring me home, when you had to be up at 7:00AM the following morning for work. I’m sorry that you’ve had to come home from work to find me unconscious (or near-unconscious) repeatedly. I’m sorry that the responsibility for saving my life fell onto you so many times.

I’m sorry you’ve had to ride in an ambulance to A&E with me so many times. I’m sorry you’ve had to sit in A&E whilst they ran tests and decided what treatment I needed. I’m sorry that you’ve sat with me, bored, lonely, whilst I’ve fallen unconscious from the overdoses I’ve taken. I’m sorry if every overdose felt like deja-vu for you. I’m sorry you’ve had to call your manager at work and book urgent unplanned leave from work, just because I’ve fucked up and needed you with me. I’m sorry for the states you’ve seen me in.

I’m sorry that I’ve locked myself in the bathroom to self-harm. I’m sorry you’ve known I was self-harming and had to just let me do it, because there was no way of stopping me. I’m sorry for the times you’ve had to help me clean and bandage the wounds I’ve inflicted upon myself. I’m sorry that I’ve made myself so grossly unattractive, covering myself in scars that will fade but never quite disappear.

I’m sorry that you’ve stayed awake with me in the small hours of the morning whilst I’ve cried, and cried, and cried, and you’ve lost sleep. I’m sorry that when I was writing a part of this blog post at 4 in the morning because I couldn’t sleep, I started crying and it woke you up. I’m sorry for soaking your pillows and your T-shirts with my tears.

I’m sorry that I’ve made you cry.
I’m sorry I wasn’t there to comfort you whilst you cried.

I’m sorry I’m so withdrawn sometimes. I’m sorry about the days where I barely talk to you, because I’m feeling irritable or depressed, or because I just have nothing to say. I’m sorry about the nights where I’ve refused a cuddle or a kiss goodnight, just because I’m feeling down. I’m sorry about the mornings and the afternoons that I’ve just spent lay in bed, unable to get up, incapable of wanting to ‘do the day’. I’m sorry for the times that you’ve reached out to hug me or reassure me and I’ve cowered away, refusing all physical contact. I’m sorry that I’m not the same as I used to be.

I’m sorry you’ve had to lie for me to my family because I asked you not to tell them how ill I am. I’m sorry that you’ve had to keep my friends updated on my condition when I’ve tried to kill myself and worried them all in the process.

I’m sorry that I pulled you away from your home county when I got a graduate job nearer to my own home county, and I’m sorry I then ended up failing to cope with the job anyway. I’m sorry that you got a job near(ish) to here, too; I’m sorry that you’re so far away from all of your friends and your family. I’m sorry that you have to do a frustratingly lengthy commute on rubbish public transport to and from work every day, because there wasn’t any work for you in the town we live in. I’m sorry I’ve trapped you here.

I’m sorry I’m so erratic. I’m sorry for being incapable of doing anything anymore. I’m sorry that I’m boring. I’m sorry that I’m difficult to be around. I’m sorry that I’m ill.

I’m sorry that, out of all of the humans on this planet, it was me that you fell in love with.

It’s bittersweet, really; every single day I spend time reflecting upon how lucky I am to have you in my life, and yet at the same time I question why you didn’t run a mile back when we were still ‘just friends’ in 2013. I tell myself that you deserve better. I wonder why you chose to be with me, despite knowing I had so many health problems. It says a lot about the type of person that you are, because not many people would stick around after all I’ve put us through. After all I’ve put you through.

I guess all of this is why they say that love hurts?

To my partner, my other half, my team mate; to the one I love

I’m sorry that loving me hurts so much sometimes.
I’m sorry that my mental illness gets in the way.

I love you,though, so much, and for now I can only hope that that’s enough.

with love,
from your Sweetie-Pie x

Smile, and pass it on

In a previous post, entitled Life and Death, I wrote a lot of praise and positive words about one of the ward sisters on the medical unit I was a patient on at the time. The day after the events that Life and Death focused on, I went to the PALS (Patient Advice and Liaison service) office within the hospital. Through PALS you can ask for advice, make a complaint, or pass on a compliment, and it can be addressed to the hospital as a whole, a particular ward, or even a specific member of staff.

I wrote a letter to the ward sister whilst at the PALS desk, expressing my gratitude for the amazing compassion and kindness shown to both me and the patient next to me. I told her that her actions that night had directly made a positive difference to how I coped with the situation and that she had really helped me. I said to her that I was certain the patients’ family would have been grateful that such a kind ward sister was in charge of their loved ones’ care on her final night. I thanked her sincerely for her wonderful attitude towards me and all other patients. When handing in my letter at the PALS desk, I wondered whether it would ever actually make it to the individual that the letter was about. People are more inclined to make complaints about poor services; were the compliments deemed less important, less constructive? I hoped not, but I tried not think too much about their protocols and just quietly wished for the ward sister to find out how grateful I was.

And she did!

In unfortunate circumstances, due to a heart problem & the sudden onset of seizures, I found myself once again a patient on the acute medical unit just under a couple of weeks ago, which was probably around a month following the hospital admission during which I’d written Life and Death. I was upset one afternoon, when I noticed the lovely ward sister from last time was on duty. She approached my bed, sat down, and told me she’d just seen I was on the ward again, and that she’d come to find me because she’d received my complimentary PALS letter the previous week; she was really grateful for it and it had nearly made her cry. I was so incredibly pleased knowing it had gone through PALS and actually reached her that I smiled for probably the first time that week. And the fact that she had remembered my name and taken the time out of her busy schedule to come and say thank you to me personally, at my bedside, was enough to cheer me up from my ill, upset state. Being able to tell her after that I truly believed it was completely necessary and well-deserved positive feedback was lovely.

I suppose that little moment just reinforced to me how important it is to focus on and compliment the positives, no matter how small, of any service – particularly a healthcare service. The ward sister made things feel OK for a moment during a very difficult time for me, and the least I could do was say thank you, if not face to face then via a small statement through PALS. But that seemingly tiny expression of gratitude via PALS allowed for the ward sister realised how special and important her actions were on that night, which in turn made her smile and realise the positive impact that she had on the hundreds of people she cared for in her role. And the fact that I could see her again, and be told directly that she’d really appreciated my letter, just continued the sense of warmth generated by her caring attitude in the beginning.

Compassion really does make the world go around.

I found out the next day that the ward sister was leaving, that this was her last shift on this ward and that she was going to work at a different hospital in the palliative care services. From the wonderful nursing practice I’ve witnessed, I’m confident that she’ll do fantastically in her new role.