We need to talk about… shame

CW: emotional pain, bullying, emotional abuse, self-destructive behaviour, anxiety


Why do we need to talk about shame?

Shame is a normal human emotion that most people feel in varying degrees.

It becomes problematic when it starts to negatively affect our thoughts, emotions and behaviour, and so also our mental health, our self-esteem, and how we function.

I only recently discovered the extent to which shame has affected me. I realised it had fuelled the majority of my actions, emotions, and thoughts for a vast chunk of my life, and was most likely what kept me in cycles of self-destruction and pain.

Learning how to recognise and take control of this powerful but elusive human emotion has made a huge difference to my self-esteem, how I deal with anxiety-producing situations, and how able I am to engage with other people and feel confident to reach for the things I want in life.

It can be painful to learn about at first, but I think it is important that more people are aware of shame and how it affects them, and that we talk about it more. If I had learned about shame years ago, I might have been released from cycles of pain long ago.


What is it?

I realised recently that I didn’t actually know what shame was and how important it can be. I had always equated it with embarrassment and self-consciousness. It is similar, but much more powerful and potentially damaging to your self-esteem and mental health.

Feeling shame is feeling really bad about your worth and adequacy as a person, and often incredibly self-conscious about it at the same time. It is a disabling and debilitating emotion that can lead to us feeling that we are intrinsically flawed, bad, and unworthy of love or inclusion by others.

Feeling shame doesn’t mean you have done something bad. If you are feeling bad about something you have done, that is more likely to be guilt. Guilt can be easier to deal with because it tends to be due to something specific that has happened, and we are more likely feel an urge to talk about it with others and perhaps try to make amends in some way.

Shame is more often felt when you haven’t done anything wrong, for example feeling it due to how you look or for who you feel you are as a person. We are much less able to talk about shame because it is so tied up with our feelings of the bad or flawed person that we might feel we are inside.

Shame makes us want to hide away or hide parts of ourselves, because it is such a deep and painful emotion that makes us feel incredibly vulnerable.

It is important to know that shame is not about blame. It is not because of something you have done. We can feel bad about ourselves due to strict standards we hold ourselves to, but shame more often starts due to how we are treated by others or due to difficult situations we have found ourselves in.

If you feel deep shame, it could be due to having been mistreated, put down, made to feel small, or like you are in some way unacceptable, undesirable, unworthy, or defective. If this was particularly painful, you can internalise the shame and it can stay with you for years, even a lifetime.

Shame is such a powerful emotion that it can cause us to react in strong ways in order to cope with how painful it feels inside us.


The Compass of Shame

These strong reactions are best explained using a model called The Compass of Shame (Nathanson (1992)).

This is one of the most useful concepts I have come across and I was able to recognise myself in it instantly.

It shows four ways that people tend to react when feeling shame. You may find you do any number of these in any combination and also may react using different ones at different times.



  • Withdrawal – wanting to isolate yourself, avoiding relationships, people and situations
  • Attack Self – negative self-talk, being mean to yourself, self-hate and self-loathing
  • Avoidance – denial, self-destructive actions, thrill-seeking, substance abuse
  • Attack Others – blaming others, lashing out at others

We all feel shame but when we have internalised shame over a long period of time it can have a much bigger hold on us and our reactions on the compass are more likely to have become ingrained coping mechanisms.

I immediately related to the ‘attack self’ and ‘withdrawal’ compass points, and I had definitely spent a large part of my life using ‘avoidance’ to cope.

All that time, I hadn’t consciously known what it was I was avoiding, what I was withdrawing from, or what I was attacking myself over.  All I knew was that I was in pain and that I felt really bad about myself.

Understanding what has been going on all these years has made such a difference to how I am able to function today, and how I treat myself.


How to spot shame in yourself.

I have had terrible social anxiety for over 20 years now, but I only just discovered that shame has actually been a major driving force behind it.

It was a personal revelation.

The thing about shame is that it is sneaky and that it likes to keep a low profile. It hides underneath other emotions such as anger and anxiety. It stays powerful by staying hidden.

It was only when I learned about shame in my psychology sessions that I discovered how to spot it.

This is what I discovered shame looked like for me:

When I was around others, whether they were strangers or good friends, I would begin to feel really bad about myself and my inadequacies as a person. I would get loads of negative self-talk going around my head, criticising me and telling me what a worthless person I was, beating myself up for the things I had said and making me feel like crap.

I would feel physically sick with self-disgust and self-loathing so intense that I couldn’t even look people in the eye. I would desperately want to leave the situation, not out of fear I realise now, but out of feelings of such deep inadequacy and unworthiness to exist, let alone be around others.

I used to think this was all just part of my anxiety, but after looking at The Compass of Shame, I realised that it was deep-seated shame that was leading me to ‘attack self’ and ‘withdraw’.

Noticing that was the beginning of a process of slowly removing and releasing the shame I had internalised and had been feeling for so long.

I still get anxiety. It still makes me feel hot and shaky; my heart beats fast, and my mouth goes dry. I can’t stop moving my body and I feel awkward and uncomfortable, but it is much more bearable than it used to be. This is because now it is largely a physiological reaction and not an emotional one.

Separating shame from anxiety has radically changed how I am affected by social situations.

Are you able to recognise any of the actions and reactions in the Compass of Shame as underpinning your emotions?

If yes, you may be carrying internalised shame.


How I began to release internalised shame.

Name it and acknowledge you’re feeling it.

Learning to spot shame was the first thing. Next, I began to label it as such and acknowledge that I was feeling it.

Whenever the negative self-talk would start up in the middle of a situation, or feelings of self-loathing, I would note it and then say to myself: “I am feeling shame”.

Acknowledging the fact that you are feeling shame in the moment immediately takes power away from it.

This is because shame works though opinions, such as ‘I’m a worthless person’. If you reject opinions in favour of a fact ‘I am feeling shame’, the opinions lose their power.

It also puts it into context: I am not thinking/feeling this stuff because I am a bad, unworthy person, I am thinking/feeling it because I am feeling shame.

And remember, feeling shame is normal and human and is not your fault. It doesn’t mean anything is wrong with you.

Shame thrives on being unseen and as soon as you start to notice and point at it, it weakens. It also thrives on (crappy) opinions, so when you start to challenge them, they don’t tend to hold their own for long.


Challenge the ‘shame scripts’.

My psychologist and I made a list of all the things that my negative self-talk (also known as my ‘shame scripts’) was saying. It included:

“You’re weird and no one will ever like you”, “you’re a joke”, “no one cares what you have to say”, “you don’t deserve to be here”, “you’re nothing” … etc.

When I looked at what I had written in front of me, I noticed that all these phrases were things that I had been told or made to feel when I was a child and young teen. Decades later, I was still being plagued it.

It made me realise how long I had carried all this stuff, which was never mine to begin with, and how it had continued to affect me most of my life. It had been with me so long, constantly battering away at me, that I just assumed it must all be true. I had never sat down to analyse it or challenge it. It was something that I had simply got used to as a part of me.

Now, I took time to pick apart each phrase to see if it was fact or just an opinion. I also looked at whether it was helpful to me or my mental health – and then I argued with it.


Example 1: “You don’t deserve to be here”.

Is this a fact?

No, it’s not a fact, it’s an opinion, because there is actually no proof to back this up. I also think if you asked people who know me, they would disagree.

Is it helpful?

No, it’s definitely not helpful, in fact it is actually a really horrible thing to say to someone.

In fact, why don’t I deserve to be here, in this social situation? I feel like everyone else deserves to be here. I’m a good person with things to offer, so why the hell can’t I be here with everyone else?!

Example 2: “You’re weird, and no one likes you”.

Is this a fact?

Actually, no, it isn’t a fact at all because people on the whole don’t dislike me. I tend to get on well with most people. I’m friendly and kind and compassionate and I have friends who definitely do like me.

I have a unique look with tattoos, piercings, and pink hair, but that doesn’t make me weird. I’m sensitive, and sometimes I hear voices and sense things others can’t, but that doesn’t make me weird either.

Is it helpful?

Definitely not – it is rubbish spouted by people decades ago and I refuse to believe it anymore.


I found that getting annoyed with the words and phrases and telling them how I refused to believe them actually helped me fully reject them, but you could do it in any way you like really: whatever works best for you.

You could even write them out on paper and rip each one up after you challenge it or burn them – safely! This way you are truly saying goodbye and good riddance!


Keep at it.

Now when I’m feeling anxious and uncomfortable and I start noticing the ‘attack self’ scripts starting up again, I silently tell them to go away and that I just don’t believe them anymore (though usually phrased as ‘piss off, you know that’s bullsh*t’).

It does take practice, and you have to expose yourself to some uncomfortable situations a bit in order to do the practice (go gently at first) but I have found it does work.

Even when I wasn’t practicing it, I would reflect on it, and just try to notice it popping up here and there. I began to notice it when I was just walking around in public and when I went into shops.

I had always felt really self-conscious, but now I could see it was shame making me feel that way because the script was telling me I looked weird, and that people were all judging me and hating me.

I understand now that the emotional abuse I suffered when I was young was the cause of me always feeling so uncomfortable around other people.


Combat it with something you know is true about yourself.

Sometimes I repeat things to myself inside my head to double-down on keeping the shame away. I do it when I’m sitting in meetings feeling anxious or even when I’m walking along the street feeling self-conscious.

I repeat to myself:

“I am a good, kind person with a lot to offer other people”.

I want nothing more than to be kind to people and help them – that is who I am deep down. This is a fact, not an opinion. This is my fact about myself.

Reminding myself of these intrinsic good qualities always makes me feel instantly stronger.

If the self-talk is saying I’m ugly, or weird, or I don’t deserve to be somewhere, I’m basically arguing back and saying that even if those things were true (which they are not), I am a good, kind person with lots to offer other people, so who cares what you think!

You will have to find what phrase works best for you. It could be ‘I am kind and loving to animals’, ‘I am a good parent’, ‘I always try my very best to do the right thing’ etc. Search deep inside for one thing that you know is good and true about yourself – you don’t have to share it with anyone, so it doesn’t matter what other people would think or say about it. It is a fact about you that you know to be true, so search deep inside yourself – you will know it when you find it.


I still find social situations uncomfortable and anxiety-producing, but now I mostly just have the anxiety itself to deal with (the body reactions of racing heart, dry mouth, feeling shaky). It isn’t pleasant, but it is manageable now, compared to when there was deep shame attached to it, where I sat there in severe emotional distress, wanting to cry, and run away.

I still feel shame, too, in areas of my life, but I have managed to tackle the shame that was disabling me the most – the shame I felt in social situations. As I notice shame pop up in other situations, I use the skills I have learned. I spot it, acknowledge it and then later write it down and analyse it.

None of this has been easy, but it has definitely made a big difference in my life.

The reason I decided to write this is because I think it is so worth sharing with others.

We need to talk about shame more, even if that can feel hard to do.


Why is it so hard to talk and think about shame?

Talking and thinking about shame can make us feel extremely vulnerable. It can make us feel more ashamed.

It is an emotion tied up with very personal thoughts and beliefs about being unacceptable and unworthy and so we automatically feel we need to keep it to ourselves and not share it with others, in order to protect ourselves. That is a natural way to feel.

After my first psychology session about shame, I felt withdrawn for quite a few days as I needed to process the fact that I felt it at all. I realised it had been there my whole life, ruling me in so many situations, massively affecting my mental health, and yet I had not even known it was there. It was difficult to accept at first.

I recently read ‘The Gifts of Imperfection’ by Brené Brown (2010), and in it she says that shame has the most power when it is in the dark. To make it less powerful, the best thing you can do is drag it out into the light.

You can do that by doing what I have described in this article, but Brené says it is also useful to talk about it with someone who you can trust to listen and not judge.

After a week of reflecting on the whole situation, I was talking on the phone to a friend and began to tell her about what I’d been doing in my psychology sessions recently. It felt too difficult to just dive into the subject, but leading up to it generally seemed to be a good way in. I went on to say something like this:

“Last week I learned about shame – it’s actually not what I thought it was at all. You know those times when you feel bad really about yourself, that you’re not good enough? That’s actually shame talking. I’ve started to realise all those times when I’ve felt bad about myself in front of others, I was feeling shame. I realise that it was shame making me attack myself with all the negative self-talk, making me do so many self-destructive things, and also why I’ve found it so hard to be around people so much. Do you think you’ve felt it sometimes too?”

I know not everyone has someone they can trust to talk to about their deep feelings. If you have a psychologist or therapist, they might be happy to look at it with you.

If not, just having conversations about shame in general, even without talking about your own personal experiences, helps to raise awareness of this emotion. I think this is a topic that should be more acceptable for people to think and talk about and that it could lead to many of us understanding what really lies behind our strong emotions. Perhaps it could help more people heal more quickly.

Spotting it, naming it, and talking about it gets it out of the shadows where it prefers to be and helps reduce the power it can have over us and how much it can rule our lives.

Even once we release internalised shame that has been there a long time, shame can still come along here and there through future experiences. Learning to notice when we are feeling new shame and to recognise it for what it is, as it happens, can make it much less likely to become internalised again and to have such a hold on our lives as in the past.


And finally.

Please remember – shame is not your fault.

You have no need to feel ashamed if you recognise shame in your emotions or in your life. It could mean that you have not been treated very well at times in your life.

Shame can become overwhelming and can really affect people’s lives, but it is a normal human emotion that everybody feels to some extent.

Nothing is wrong with you for feeling shame.

In fact, noticing it and being aware of it makes you one step ahead of the many, many people who still have no idea that they are feeling shame and continue to be ruled by it.


I recommend reading anything by Brene Brown. Her work on vulnerability, courage, and shame, researched and written as both a professional and as someone who has intensely felt both, is incredibly heart-warming and honest and I have gained so much from her.

This is her website: https://brenebrown.com/


References

Brown, B. (2010). The Gifts of Imperfection: let go of who you’re supposed to be and embrace who you are. Center City, MN: Hazelden.

Nathanson, D. (1992). Shame and pride: Affect, sex, and the birth of the self. New York, NY: Norton.

Nathanson, D. (1997). Affect theory and the compass of shame. In M. Lansky and A. Morrison (Eds.), The widening scope of shame. Hillsdale, NJ: Analytic Press.

Papercuts: restorative approaches and cumulative harm in mental health care

The cynicism and hope of a long-term service user

(Please note: there are academics and practitioners actively studying this topic who will have more knowledge about this subject than me. I write as someone who has personally experienced trauma within mental health services and has had glimpses of ways in which restorative practice could help to tackle it.)


How it began for me

A couple of years ago I was asked to be involved in a participation project with mental health staff called ‘Reducing Restrictive Interventions’.

We split into separate groups (one of staff and one of service users), each with a facilitator, to brainstorm. One member of staff misunderstood the instructions and joined our group. None of us said anything, assuming there was an unspoken reason for her joining.

We talked about restrictive practices on the ward and how they affected us, from small things like not being allowed to congregate and chat in the corridor, to more painful things like restraint and seclusion. The staff member listened intently to what we said and acknowledged our experiences, saying it was very helpful to hear. She then tentatively told us about how imposing restrictions upon us sometimes made her feel, and we listened in return.

It hadn’t been planned. Out of nowhere a safe space materialised where testimony was heard and acknowledged on both sides. For that 20-minute slot, we were no longer staff and service users – we were human beings, equal to one other, listening and acknowledging with empathy and compassion.

The whole group agreed that it had been an enlightening experience, including the member of staff. I thought about how incredibly helpful it would be to have opportunities like this occur more often. It wasn’t until I recently came across a piece written in in the British Medical Journal by Dr Sarah Markham, that I realised what had emerged that day was the kind of space and situation that restorative practice (also restorative justice/approaches) works to create.


What is restorative practice?

Restorative practice can take many different forms, and for more comprehensive explanations, please see the links at the end of this piece.

The way I understand it is as a coming together of people who have been involved in a conflict, difficult experience, or trauma, in order to share the impact it has had upon them.

It can be used to repair specific relationships or harms that have occurred, or it can be a more general expression of thoughts, feelings, and needs in a mediated safe space where everyone is listened to without interruption or judgement. The idea is to create empathy, enable mutual understanding, and to then work towards a satisfactory resolution for the benefit of all.

Restorative practice and approaches are already used in various forms in a number of sectors, such as criminal justice, community mediation, and in schools.


Why might we need restorative approaches in mental health?

Restorative approaches could help by:

  • Reducing the impact and level of trauma felt by those within mental health services.
  • Improving staff/patient relationships.
  • Improving mental health outcomes and quality of life for all.

Despite it being a contentious issue that not all are yet ready to accept, harm occurs regularly within mental health services and on psychiatric wards.

Many are harmed by the most obvious major practices of Mental Health Act detention, coercion, restraint, forced seclusion and sedation (which is another article in itself!) but harm also occurs in smaller, more insidious ways.

These include verbal abuse, gaslighting, neglect, withholding care, lying, making decisions without the patient, breaking trust, not listening, ignoring, being dismissive, and acting without care or compassion.

When cumulative, these can become more painful than the bigger harms. They are thousands of papercuts that never heal.

They are also inflicted upon us by individuals, with faces and voices that we never forget.

It is these cumulative harms that I would like to focus on in this article, because it is these that I feel are most unacceptable, most avoidable, and also could be most easily tackled by restorative approaches.

Of course, mental health staff are also harmed by what they experience at work. This could be directly through violence and abuse from unwell patients, high-stress work environments, or by being implicit in restrictive interventions or practices that they do not necessarily feel comfortable with.

Staff are not subject to coercive and restrictive practices, and they implicitly have more power than a service user even at the lower end of their pay grades, but they are certainly still vulnerable to stress and trauma.

Psychiatric wards are trauma machines: harm is recycled and passed from person to person in an enclosed space within a rigid, heavily bureaucratic, emotionless system, totally unfit to deal with the complexity that is humanity and human emotion, let alone that of mental distress.

Relationships between staff and service users are often strained. Each views the other as an oppositional unit which they should be wary of and therefore protect themselves from. This creates huge rifts that undermine the therapeutic benefit of services.

Mistrust stops people reaching out for help in the future. Although I am engaged with certain staff in community services, I definitely think twice about calling the office in crisis in case I speak to someone who is less than kind. I have learned over time that this happens as often as not, and mine is not an unusual experience.

A lack of trust also adds to service users’ issues with healthy relationships in general: feeling suspicious or afraid of others can lead to further isolation from peers and greater society and worsening of the original mental illness.

Of course, there will always be those who find their interactions with mental health services supportive and helpful. This must be acknowledged, and I am happy that those people certainly do exist.

Where trauma is felt, however, patients are dealt an extra burden to recover from in addition to the illness or condition that brought them to services in the first place.

In this way, mental health services actually perpetuate mental illness and distress.

In particular, those deemed to have a personality disorder (a contentious label at the best of times) have often been on long journeys through services, experiencing exclusion, gross misunderstanding of needs, verbal abuse, threats, coercion, prejudice, not being believed, and a stark lack of compassion. All of this mirrors and reinforces trauma already experienced in personal lives and outside of mental health services.

Like a snowball rolling down a mountain, trauma and pain and their associated difficulties stick to the original, core problem as you as you go, eventually making you so heavy with pain that you become formidable, dangerous, and impossible to treat in the eyes of those who helped make you this way.

Those who have spent years in services can find it impossible to detangle the trauma that existed originally from that gained since.

It doesn’t make sense to be healing and hurting people at the same time, particularly if you want them to thrive and get free of the revolving door of repeated discharge and re-admission.

Only months after being discharged from mental health services, I was referred back again by my GP for serious dissociation triggered by memories of what I had experienced as a psychiatric inpatient. I displayed many symptoms of PTSD, including flashbacks, nightmares, hyper-vigilance, and numbness, and needed another round of psychological sessions to help me work through them.

Not only was this extremely distressing for me, but it set back my recovery by at least another year, something that I’m still working on. It also meant I used precious mental health resources that could have gone to someone else had I not suffered the trauma in the first place.


Are restorative approaches feasible in mental health?

Formal Approaches

In a dreamworld, everyone who has been cruel and neglectful to me in a healthcare setting would come and sit with me and we’d use restorative approaches to work it through. We’d have conversations about how it affected me, and they would listen. I would ask the ‘why?’ questions I’ve always wanted to ask and listen to them in return, hopefully they’d apologise or at least reflect, and we’d repair things and find a way through that felt better.

This is an unlikely situation for service users.

There is rarely a single ‘perpetrator’. We often hurt from many actions from many different people, that have chipped away at us sometimes over decades of damaging interactions with mental health services, when we were already at our lowest and most vulnerable: those papercuts.

We have no chance of facing all of those who hurt us. Would they even remember the nasty comment they made years ago? Would they remember a single situation even months ago, during yet another busy, understaffed double shift?

(Most likely not but, rest assured, we definitely do.)

They might not even see what they did as wrong or negligent, or may not want to admit it.

One of the underpinning principles of restorative practice is that it must be voluntary – everyone has to consent to join in and so there needs to be a willingness to engage.

Services and staff may feel that restorative practice will involve some admittance of mistakes or of neglect and abuse, and it is unlikely they will be happy (or able) to do that.

Due to this, I feel that more formal restorative approaches like those used in criminal justice, with an obvious victim and offender, are most likely not feasible in mental health services.

Grassroots Initiatives

Spandler and McKeown (2017) suggest that grassroots truth and reconciliation initiatives might indeed be what is needed, particularly in the absence of the interest or enthusiasm of services and psychiatry.

They describe instances of grassroots and service user led mental health organisations in the USA that have made use of community-based models and healing circles to hear testimony from those harmed, whether staff or patient, and also to hear from those who did not feel harmed – all viewpoints being equally welcome and compassionately acknowledged.

Perhaps something like this could be helpful.

I know from the experience I described earlier that if you can turn a room of service users and staff into a room of human beings, even for a short while, amazing things can happen.

There would need to be a level playing field offered, and a space of safety for all to be able to speak and listen, wearing no official ‘hat’ of service user or staff member.

There would need to be no repercussions for sharing, and it would need to take place in a neutral space, so not in a hospital meeting room.

There already exist initiatives amongst service user only communities where testimony is heard in safe and non-judgemental spaces, providing those who have been hurt a forum in which to express pain and anger, and for that to be acknowledged.

I am currently involved in project ‘For The Record’ with the grassroots service user group #MadCovid, where experiences are shared via closed-group presentations of writing and creative pieces on the theme of iatrogenic harm.

Supporting each other in this way is helpful, and for some it is the only forum in which they feel safe enough to truly express their feelings. However, it is no surprise for us to hear the trauma of our fellow service users. We know it only too well.

There is absolutely a place for this work, but for true restoration I feel that those with other viewpoints, perspectives, and experiences need to be included and need to listen, or we risk remaining in a well-meaning echo-chamber, with no real movement towards remedying the situation.

I like to think that there are staff and patients who would genuinely want to take part in informal initiatives that aim for better understanding for those on all sides.

Service-user led initiatives may not be impartial enough for this specific task. We need projects formed by both ‘people who work as staff’ (a distinction from ‘staff’, which is their official capacity whilst at work) and service users, and/or by allies who are completely impartial.

As it would be a voluntary activity engaged in outside of work time, that could be off-putting to staff who already work long hours, but if touted as an exercise that could enrich them personally, rather than a work-related box-ticking exercise, it could perhaps be more attractive. There will always be those who are not at all interested, but I believe there will always be those who are.

Meetings or circles should be trumpeted as positive, welcoming, healing spaces that are not about apportioning blame. The idea is to enrich understanding and empathy on all sides, which could go some way to better relationships within services and hopefully to change opinions and behaviour towards those previously seen as an oppositional group.

They would need to be closely guided by restorative principles, impartially managed, and only joined by those distinctly wanting to work towards restorative ends.

An important question at this point is: do we need to come together with specific people who were involved in our own individual experiences, or is hearing testimony from anyone, even people we don’t know, still helpful? In an informal meeting like this there would be no guarantees about who might attend.

As I said earlier, we may wish for the opportunity to face those who wronged us, so we can ask specific questions, understand particular instances, maybe even share apologies, but the chances of this are low.

Hearing from others who have been in similar situations (on either side) might not give us that, but it could still help expand empathy for and understanding of each other, break down oppositional barriers, and help us see each other as human beings, all with capacity to hurt and be hurt.


Will restorative approaches actually make any difference in terms of harm?

Despite me advocating for restorative practices, there is a dark, hurt voice of cynicism deep inside me, one which most long-term service users will know well. It says that nothing will ever be enough to make up for the pain that has been inflicted.

I’m trying not to listen to that voice, because I want to be more hopeful than that, but I acknowledge that there are many who have been hurt so badly that these drops in the ocean will seem nowhere near good enough, and I fully respect that.

There will be many people who won’t like these ideas. They won’t want to relive their traumas or remember certain times of their lives. Some understandably won’t feel able to be vulnerable around the ‘opposite team’ who has caused them so much harm. Many will be afraid of repercussions and further victimisation.

We need to acknowledge and be mindful of this.

I do think, however, that proactive restorative approaches could go some way to lessen the cumulative harm that occurs within mental health services.

If we deal with each papercut as it occurs, we can help to stop it building up into trauma.

Proactive Approaches

A difficult interaction occurred recently between myself and a professional within services. She made a mistake that broke trust and at the time it really upset me. Trust of mental health staff is already something I find difficult.

When we were next in touch, she set aside a good 15 minutes of our appointment to talk about it. She apologised and completely owned the mistake. She didn’t make excuses and she listened to me explain why it hurt me so much. We talked through it. She did not rush me or minimise my emotions or reaction.

The fact that she had the courage and integrity to initiate this conversation made a huge impression on me.

It may seem obvious that someone would do this, but it is not something I have experienced from a member of staff before.

She was so demonstrably honest and compassionate that we quickly repaired the relationship and the hurt I had felt disappeared. I also apologised to her for how I had reacted when it happened, and we were both able to agree to move on.

Just a single restorative interaction like this can give a service user hope and a renewed faith in services in general. It creates a welcome contradiction against the idea that ‘all staff are bad’, or ‘I need to protect myself from staff’.  

The more examples we are shown of compassion and kindness, the more that serves to challenge ingrained views of staff and services as a homogenous group of cruel, neglectful people.

This experience has helped me to believe it is possible to have the restoration we seek with those who have directly hurt us if it happens as soon as possible after the incident.

Apologies are probably best left to occur in organic and spontaneous ways in order to protect their sincerity, however proactive restorative approaches could be part of a new way of working. Examples include improved communication styles and time set aside for restorative and reflective catch-ups with service users, as the need arises.

Restorative approaches in schools often include the use of restorative communication. Staff and pupils are encouraged to make ‘affective statements’, where they communicate to each other how they have been affected by the actions of the other, both positively and negatively. They also use ‘affective questions’ to explore things that have happened and how they could be best resolved as they arise, avoiding the use of blame or accusation.

Time is taken out to have restorative talks, as needed, which could just be a couple of minutes or longer if needed.

Something like this might be really helpful if it was embedded within mental health services, for both staff and service users to make use of.

It might be viewed as more work for already under-resourced staff teams, but I genuinely think it would be worth it in terms of improved relationships and outcomes for all involved.

It could also help improve communication skills, assertiveness, and skills for dealing with confrontation on both sides.

I acknowledge that issues of mental capacity, distress, and illness are factors to consider that aren’t as relevant in the school environment, but ways in which proactive restorative approaches could improve the mental health environment are definitely worth exploring further.


In conclusion

In believe that informal restorative approaches, utilised as we go, may be the best format for mitigating cumulative harm within mental health services. These have certainly made the most difference to me personally.

In addition, there could be grassroots initiatives that bring people who work as staff and people who are service users together voluntarily and on equal grounds, in order to learn more about each other’s experiences.

Restorative approaches may seem too meagre to make a dent in the impact of harm caused by mental health services. There is no doubt that social action aimed at general reform of mental health services and legislation is desperately needed in addition to any restorative work.

Bloom & Farragher (2010) call for organisations to be “trauma-informed systems” run to be more like living organisms, “capable of all the same emotions, processes, learning, disease and change that any other organism experiences”, instead of cold machines.

I think restorative approaches, especially proactive communicative ones, should be a key part of that vision.

I don’t have all the answers, but I know that ignoring the fact that trauma occurs within our services isn’t working and is a ticking mental health timebomb.

I also know that the interactions I have had with staff on a human level have made the biggest impact on my ability to heal and have faith in people, more than any psychology session or medication ever has.

Those interactions have expanded my own capacity for empathy with those who care for me and have most of all allowed me to feel hope that things can change.

I do think it is important to bring restorative approaches to mental health services, even if the efforts at first seem small. More opportunities, spaces, and interactions like those I have described – informal, voluntary, human – would contradict negative experiences, foster better relationships between staff and service users, and make small but solid steps towards repairing harm.

To achieve this, big work desperately needs to be done, but I personally believe enough small, reticent stones cast out in hope could cause enough ripples to begin to rock the boat.


References:

Bloom, S. and Farragher, B. (2010), Destroying Sanctuary: The Crisis in Human Service Delivery Systems, Oxford University Press, New York, NY.

Markham, S. (2018), “Dealing with iatrogenic harm in mental health”, British Medical Journal Blogs website, available at: https://blogs.bmj.com/bmj/2018/12/04/sarah-markham-dealing-with-iatrogenic-harm-in-mental-health/ (accessed 26 Mar 2021).

Spandler, H. and Mckeown, M. (2017), “Exploring the Case for Truth and Reconciliation in Mental Health Services”, Mental Health Review Journal, Vol. 22 No 2., available at: https://www.researchgate.net/publication/316848109_Exploring_the_case_for_truth_and_reconciliation_in_mental_health_services/ (accessed 26 Mar 2021).


Links for further reading:

What is restorative justice?

Principles of Restorative Practice

Restorative Justice and Restorative Practice

Restorative Justice in Everyday Life

Restorative Approaches in Schools in the UK

Time to Think: Using Restorative Questions


Copyright 2021 Zoe Layton. All rights reserved.

Protecting yourself from harm in emergency housing: an essential guide

Emergency housing is accommodation that is provided to people who are homeless and seen as in being priority need (in the UK). The idea is to house you for a temporary period whilst you wait for more permanent housing to become available.

You can read more about how emergency housing is allocated here.


I spent nearly two years in emergency housing.

The first couple of months was in what was called a bed and breakfast (B’n’B), though it was really a bedsit in a converted, disused pub (definitely no breakfast!). The rest of the time, I was in a studio flat in a large, damp, old Victorian house converted into flats. Both were in different towns at least 40 minutes from anywhere I was familiar with, and I didn’t know anyone at all in those towns.

If you are being housed in emergency accommodation, you are vulnerable, even if you do not think of yourself that way. You can easily become the target of coercion, abuse, or even violence.

You are meant to be safe from harm in this type of accommodation, but this is unfortunately not always the reality, due to a number of unstable and/or distressed people being housed in one place.

I am writing this in the hope it might help someone falling into some of the many traps that can present themselves.

It is up to you if you choose to follow my advice, of course, but this is what I learned (often the hard way) through my own experiences.

I don’t want to make anyone feel overly afraid or paranoid: I simply want to encourage healthy vigilance and awareness.


Other Residents

– Be discerning about who you make friends with

Everyone has their own reasons for being housed in emergency accommodation.

There were a mix of people in my building: single mothers with young children, people with mental health difficulties, and people with drug and alcohol issues, or a combination of those.

Most people seen as being in priority need are vulnerable and that can create a hotbed of issues and emotions in one building, particularly when drugs and/or alcohol are a factor.

I found the best way to act around my fellow residents was to be friendly when I bumped into them in the hallway or in the town, but to not stop and chat. I was never rude: I was always pleasant, but I made it obvious I wanted to keep myself to myself. As long as you’re not rude, people tend to accept that’s just how you are.

After some time, I got to learn who it was okay to stop and talk to a little more. Eventually I made friends with one of the single mums, and we would go for walks into town together.

You may feel you want to get friendly with the other people who live there, particularly if you don’t know anyone else in the area. I would recommend that you get to know people what the people are like slowly over a period of months before you do this, and sometimes it might be best avoided altogether.

You don’t want to end up in a situation where you feel coerced to do things for people, where you are harassed and not left alone, where you feel unsafe, or where you will come to the negative attention of the housing association. When this is going on where you live, you can’t get away from it without forfeiting your right to accommodation.

Being discerning can be tough when you are vulnerable, but it is important to safeguard yourself from getting drawn into other people’s issues or into volatile situations, particularly if there are drugs or alcohol involved.

– Be selective about what you tell others

It is best to avoid giving out any personal information, or details about your personal circumstances. Definitely do not give away any information about possessions you have that might be valuable, or anything to do with money, which benefits you get, how much you have, when you are going to get some etc. Just play dumb and say you can’t remember.

You may also want to be careful about sharing where you live with people who don’t live there either. Often people in the town will know the address as where vulnerable people live and may use it to their advantage. I had a stalker from the town at one point, who wouldn’t go away and once managed to get into the building due to my neighbour letting him in. Luckily, I was out that evening. I had to report him to the police for harassment.

– Keep your door locked

Even if you are just going out to the bin and will be minutes: lock it behind you. Don’t leave anything in the communal areas as it is at risk of being stolen.

– Don’t lend or give out possessions

If you lend things, be prepared for them not to be returned. Also be wary of giving out things like cigarettes, unless you are sure you can trust the person not to hound you from then on. My neighbour would drunkenly bang on certain people’s doors in the middle of the night demanding tobacco.

Don’t allow yourself to be indebted to anyone.

– Don’t invite other residents into your flat

There are some people who will be very interested to see what you have in there. Keep valuables away from windows, and keep the curtains drawn in rooms where you can easily see in.

– Always lock your door at night

I used to keep my door locked even during the day when I was in there. Always make sure your keys are nearby, so you can escape in case of a fire.


Residents’ Visitors

– Avoid answering the main door unless you are expecting someone

Our front doorbell would ring all the time, and because I was in the front ground floor flat, I ended up getting lumbered with opening it all the time.

I opened the door on two separate occasions to some men wanting to find people who lived here due to drug debts or thefts in the town. I just played dumb and said I didn’t know because I didn’t want to be involved. I was lucky that no one forced their way past me, as they easily could have if they wanted to.

– Don’t leave your own door propped open when you are inside your flat

Try not to let visitors see inside your flat, even just a quick glance. Visitors are complete unknowns because the housing association will not even know who they are, and they will know that you are an easy target.

– If there is an incident, keep your involvement to the minimum (where you can)

Incidents can happen a lot in this kind of accommodation: drunken fights, anti-social behaviour, criminal damage, domestic abuse, thefts, overdoses etc.

You may have to make judgement calls about whether to intervene if an incident occurs in the communal areas. I’d say that most of the time it is best not to get involved in anything and to stay in your room with the door locked. You may decide to call the police, and by all means do. It might be best to do this discretely, if possible.

One evening, a female neighbour was being attacked in the hallway by one of her male visitors. She was banging on my door screaming to be let into my room so she could escape him. It was a really scary situation.

I had already called the police, but then had to decide whether to let her into my flat to safety and risk him coming into my room too, or to keep my door locked and let him keep attacking her. I eventually let her in. Luckily, he didn’t follow her in, and I locked the door behind her. The police arrived minutes later and arrested him. It is the only time I let someone into my room.

I can’t tell you what to do if something like this happens, as every situation is different, and it is up to you to make judgements in the moment. I exposed myself to violence when I opened the door for her, and although I feel now that I made the right decision in that particular moment, it could easily have played out very differently and I could have been hurt too.


‘Official’ Visitors

Be aware of people who come into your flat to perform maintenance or work duties, even if they are from an official company or service. Most will be friendly and professional and there will be no issue, but they will know that you are vulnerable because of where you live, and some may see if they can use that to their advantage.

If any maintenance person uses your contact details to send you private messages, they have crossed a line, and you should report them to the company they work for, if you feel safe enough to do that. At the very least, they are breaking data confidentiality if they are using your name or number to add you on Facebook/Snapchat/any other social media, or to text or call you.

Block them. Don’t let them flatter you into engaging with them. Anyone who solicits you, knowing that you are living somewhere for vulnerable people, is not the sort of person you want to respond to or meet up with.

This includes the POLICE. I am sad to have to say this, but my friend in the accommodation was contacted by a (married) police officer who made a series of advances towards her, after he had attended an incident there. She complained and he was taken to a tribunal, which she had to give evidence at and found a very distressing experience. He ended up resigning.

That this happens at all is so wrong and incredibly inappropriate, but it does happen. Please be aware of everyone who is in your space, no matter who they are.

Keep any texts or messages and make written notes of anything not stored by your phone, whether you are planning to complain or not – you may change your mind down the line and decide you want to. If you have a support worker or professional who works with you, it may be a good idea to mention to them anything untoward that happens, if you feel able to trust them.


Housing Staff

It is a sad state of affairs that I need to include warnings about the housing staff themselves, but unfortunately it is a reality.

I was bullied by individual members of housing staff in both of the places I lived at. When I stood up for myself, they used their position of power over me to be further abusive and to threaten me with the loss of my accommodation.

Threats to have you ‘thrown out’ if you do not comply are NOT ACCEPTABLE. I’m not talking about official warnings from the housing organisation if you are breaking rules. I’m talking about individual staff members making off the record threats in order to wield their own personal power over you when you try to stand up for yourself.

This is abuse and it sadly happens more than you think.

I have been spoken to like shit over the phone by housing officers, too, as was my one friend in there. The general impression we got was that they saw people who lived in this type of housing as low life scum who should be treated accordingly.

This is not acceptable!

Please do not think that because you are in emergency housing that you do not deserve to be treated with humanity and dignity.

You are not a second-class citizen. You have the same rights to fair treatment as everybody else.

– Keep notes

You can do this on paper or in a notepad app on your phone. Keep records of any interactions where you are not treated unfairly or badly. Include dates, times, and details of what was said both by you and them. If it keeps happening, having a timeline and ongoing record of the incidences will really help if you decide to report it.

I understand if you don’t want to report anything while you live there, but if you collect notes, you can complain about them once you leave. Even if it is too late by then for the complaint to benefit you, if every person these people bullied made an official complaint about them, a pattern would emerge that their organisation/the council wouldn’t be able to ignore.

If you have a social worker, care co-ordinator, community nurse, or any other supportive person who works with you who is not part of the council or housing association, it can be a good idea to share with them about any bullying or abuse that is happening, particularly if you trust them.

– Try to stay as calm and assertive as you can

Try not to get abusive back, no matter how upset or angry you are. Your true power isn’t in giving them crap back, but in making a record of how you are being treated, and then getting support to challenge them.

Don’t stoop to their level – you are better than that, and you are more likely to get somewhere by taking the higher ground, getting support, and going through official channels.

I have included contact details of some really helpful charities at the bottom of this article.


Housing Services

The services that run the emergency housing, both the council and the housing association, have a lot of power over you, and they are not always fair. This relative position of powerlessness that you are in is another way that you are vulnerable.

There are a couple of really important tips I want to share to help you retain your power as much as possible.

– Make a photographic record immediately after getting the keys

Despite me leaving the flat cleaner than when I went in, and the woman I handed the key back to saying verbally that it was all fine, I was sent an invoice a year (!) down the line saying I had not cleaned properly and demanding hundreds of pounds in compensation.

Luckily, I had proof, and they had no choice but to waive the invoice in the end. I still have no idea why this happened suddenly a year after I had left – no explanation was ever given to me by them, despite me requesting one.

When you move into your room or flat, the first thing you should do is take photos or video of the whole place – floors, ceilings, walls, all appliances, all the bathroom and kitchen amenities like the toilet, bath, sinks, cupboards. The more you photograph the better. Make sure you include any already-damaged areas or items (a common one is kick/punch holes in internal doors).

You want there to be a record of how the flat looked when you moved in, so they cannot charge you later for damage that was there before you arrived.

Save these photos/video – your phone should automatically record the date of your moving-in day on them. Do it as soon as you get the keys and ideally before you’ve moved any of your things in.

Do exactly the same when you move out, on the actual day you move out, after you have cleaned and emptied the place of your stuff, and ideally just before you hand the keys back. Your phone should record your moving-out date on the photos.

When you move out, the important thing is to show how clean you have left it. Clean it well, and then get close up evidence of how clean it is!

Keep all of these photos and videos for up to a couple of years after you move out. As I say above, I was challenged on how I left things a YEAR after I had moved out, so it is best to hold onto those pictures as long as you can. If you need them off your phone, email them to yourself, or download them onto a memory stick or a laptop etc, if you have access to one, or perhaps to a friend’s one.

You might even ask the person who is collecting the keys from you to put in writing that the flat was fine when you left it, rather than just giving a verbal okay. They might refuse if it isn’t their policy, but it could be worth asking.

– Stick to the rules!

Avoid bringing drama or issues to the accommodation, because those in charge of it have a lot of power over you and can make your life very difficult. They can keep you there longer by temporarily removing your option to move into more permanent housing, and they can evict you. If you are evicted, it can make it harder for you to be housed again in future and you could end upon the streets.

You definitely don’t need any extra stress to worry about! Protect yourself from this by playing by the rules of the accommodation as much as possible.

Remember, your situation is temporary (even if it feels like forever) and eventually you will be housed in a place of your own, where you will feel much safer and more stable, and you won’t need to follow as many rules.


Where to go for help and support

If you need help with any of what I have discussed here, I recommend you:

  • Speak to your support worker, social worker, or any impartial professional who knows you and who you feel you can trust.
  • Speak to the housing association or the council, depending on what the situation is. Be careful as they may close ranks – it might be best to get the support of one of the below organisations first.

Here are some very good, impartial organisations you can go to for advice and support:

You used to be able to walk into a branch near you, but due to current coronavirus restrictions, this has been moved to telephone support.

Their website has lots of information to read, plus numbers to call and details of web chat etc.

Their contact information page is here.

They have a free national helpline you can call to speak to an adviser, or you can find information on their website that may be of help.

Both are a good place to start and they will be able to signpost you onwards if you need more specific support. They will have the most up-to-date information available.


And finally…

Of course, people will have different experiences in emergency accommodation, and I do hope yours is better than mine.

I still think it is important to be aware of possible issues that can arise.

Stay aware, maintain boundaries, and keep yourself to yourself as much as you can: those are probably the best bits of advice I can give.

Record everything and keep those records for a couple of years.

Get help from people or organisations that are impartial and that can support you. You don’t have to go through anything alone.

You will get through this and it doesn’t last forever, even if it feels like it at the time.

What is it like to live with Visual Snow Syndrome?

Living with visual snow is not just about dealing with the symptoms. It is also about trying to get people to care or understand when your symptoms are 100% subjective and disbelieved by almost all the professionals you see.

This article is my personal account of living with Visual Snow Syndrome. It is split into three sections: When I realised something was wrong, Trying to get help, and Living with it.


When I realised something was wrong:

Everything began when I looked at the carpet one day and there were lots of black dots dancing all over it, like the static on an old TV screen. It was a bit strange, but I didn’t think too much of it at the time.

But it didn’t go away. Even weeks later, every time I looked at the carpet, I would see these dots.

Then when I looked at the walls, the dots were there too, but in pink and green. I began to notice vague bands of shadow all over the walls. It looked like there were grubby, grey, rectangular patches all over them.

Again, I carried on without giving much thought to it.

It was when I was watching the darts on TV a few months later, that I realised something was definitely not right.

When I looked at the dartboard on the TV and then I looked away, I could still see it in front of my eyes. I would look at the TV and then look at the wall next to it, and there would be a ghostly image of the dartboard for about 10 seconds, before it slowly faded away.

10 seconds sounds quick, but when you think that your vision is normally instant, as you look from one thing to another, 10 seconds is a long time for an object to remain.

The more I noticed it happening, the more it bugged me. It happened with other things on the TV, too. When I watched the news and looked away, and I could still see the newsreader and their desk in front of my eyes.

It wasn’t an exact image, with colour, but an inverted, negative image in black and white, like this:

The TV became more and more difficult to look at, and I avoided watching it. But it wasn’t just the TV that was causing the images. When I looked at pictures on the wall, or pieces of furniture, they’d still be there when I looked away.

I began to notice mini flashes of light going off in front of my eyes, like those you get if you stare at a naked lightbulb and look away. I was feeling dazzled just from looking at a lightly coloured wall, or walking into a room with a window, even when it was not sunny. The TV became unbearable.

My eyes had become really sensitive to light, and I had to wear sunglasses whenever I went outside, even when it was cloudy.

If I got up in the night, the bright spots seemed to crowd in on me and block my view in darkness, and when I was in a brightly lit room, I could clearly see what looked dark blobs and lines right in front of my eyes, and they moved around as I moved my eyes around.

When I sat in my living room in the evenings with my partner and my cat, at times it became hard to make out the features of their faces in the dim lamp-light.

All these things were beginning to get uncomfortable, upsetting, and disturbing.

As most people do, I began searching online for my symptoms, to see if I could understand more about what was happening. I think I probably searched for ‘fuzzy dots in front of eyes’ or something like that, and I ended up coming across something called Visual Snow Syndrome.


These are the main symptoms of Visual Snow Syndrome:

  • Moving dots over your entire field of vision, like snow or static
  • Bright flashes of light or colour
  • Small objects appearing to float in front of your eyes
  • Being sensitive to light (known as photophobia)
  • Images of objects remaining, even after the object has left your field of vision (known as palinopsia)
  • Shadow images of floaters, that move as you move your eyes
  • Starbursts around lights, such as car headlights

I was immediately sure that this was what I had: I could relate to all of it.

I discovered that the images that stayed when I looked away were something called palinopsia.

The blobs in front of my eyes that obscured my view were things called floaters.

I was glad to find a name for the symptoms I was experiencing, and that I was not the only one reporting them, but I was dismayed to see it was a condition that was not yet fully acknowledged by many medical professionals.

I read that there were doctors who thought it could be linked to migraine. Although I did get these, the eye symptoms were there all of the time, not just when I had a migraine.

From what I read, it seemed to be some sort of neurological disorder, but other than a few doctors that had showed an interest, it was largely unrecognised.

I had so many questions. I wondered in particular what had caused this to happen to me now.

I was also afraid that there might be something physically wrong with my eyes, and that my eyesight was deteriorating in some way. I knew I needed to get my eyes checked out.


Trying to get help

The first thing I did was see an ophthalmologist at my local Specsavers, and I paid to have as many tests done as she felt were necessary. I was continuously blinded by the lights she was shining in my eyes. The whole experience was disorienting and verging on painful, and I was embarrassed about coming across as a high maintenance customer, who had to keep stopping and waiting for their sight to recover.

The ophthalmologist was great, though. She told me that she could find nothing physically wrong with my eyes, which was a relief. She could see that there were some floaters there, but she said that was quite normal for someone who was approaching middle age, like me.

She went away to speak to her boss, and then came back and told me that they thought it was probably Visual Snow Syndrome. I had not mentioned it to her, because I hadn’t wanted to affect her opinion, so it was extremely validating thing to hear her say it. She said she would write a letter to my GP, asking her to review my medications in case anything could help.

I was hoping I might be referred to a neurologist. I had seen one when I was diagnosed with fibromyalgia, only the year before. I was wondering if this was perhaps linked, especially as it was all coming after I had had a serious, long period of mental distress.

Unfortunately, I came up against some resistance when I finally spoke to my GP.

After I pressed the issue with her again, my GP said it might be best to refer me to the mental health team, which I had only just been discharged from.

I tried to explain that I didn’t think it was connected, but she still made the referral. I had no choice but to back down and just go through the motions, so we could rule out mental health as a cause, in a process of elimination.

I waited about four months for my referral to go through and during that time I went back to my doctor yet again, because my eye symptoms were beginning to really upset me.

I had told a couple of my friends about what had been going on, they were quite shocked at what I was having to deal with. They encouraged me to go back to my GP and demand more firmly to see a neurologist. I did exactly that, but I was denied again. She said that there was like a psychological element to all this. Once again, I gave in and decided to just go with that idea and see it through.

Around this time, I had also been having increasingly severe dissociative episodes, which would occur when I became overwhelmed with emotion. I would get a sudden need to lie down, and my body would go numb. It felt as if my mind were separating from my body and floating away. It wasn’t nice at all.

These episodes became a more of a priority than what was going on with my eyes. When I was finally allocated a psychologist, she suggested we focus on them instead. It was fair enough, as the dissociation was by then causing the most disruption in my life at the time.

I was allocated the same care co-ordinator I’d previously had for about 5 years. I told her about my issues with the visual snow. I mentioned that it was quite a rare condition that doctors did not know much about (big mistake!). On hearing that, she instantly dismissed it.

She told me that she thought it was to do with stress. I didn’t feel at all stressed, and I didn’t agree, but once again I decided to just go with what the professionals were telling me. There wasn’t much else I could do.

Even if you know in your heart that the professionals are wrong, you often have to go along with their version of things, for as long as it takes to finally disprove it.

After a few sessions with my psychologist, I reminded her about my eye issues again. She said that she thought it was likely happening along with the dissociative episodes. I told her that the symptoms didn’t tie in with the other episodic dissociative symptoms, because they were there all the time.

A few sessions later, she once again attributed my eye symptoms to the dissociative episodes. Frustrated at having to correct her again, I said extremely firmly:

“They are there…” (deep breath) …”ALLLL THE TIIIME!!”

I felt rude, but it worked because she did listen, and she finally acknowledged that perhaps it was due to something unconnected after all.

I felt glad that she was finally listening to me, but what actually happened was that the eye symptoms were completely swept under the carpet – lost in amongst a number of other more pressing issues.

I am still having psychology to help with the dissociation, though it has been slow progress due to the lockdowns. It has helped quite a bit already, though. I still dissociate, but nowhere near as bad.

Unfortunately, my eye symptoms have not improved at all. They have been the same for well over a year now.

Although it is slow progress with the mental health team, I’m hoping that once I get the dissociation sorted out, we may be able to come back to the eye issue. Maybe they will listen to me then and we can look at other non-psychological factors? (I’m not holding my breath for a magic cure though, obviously.)

I do think that if you have had a lot of contact with mental health services, everything you experience gets attributed to your mental health, especially things that are harder for medical professionals to understand or solve easily.

In the meantime, I have no choice but to get on and live with it.


Living with it:

The walls are still covered with moving pink, green or black dots. Everything lightly coloured looks permanently dirty and cobwebby, and I’m dazzled and disoriented as I go about my day.

It is like I’m looking through mist or a smudgy, dirty window all of the time, and I often need to frown or squint to see detail. I’ve started wearing glasses when I read, use the computer, or watch TV, and although they sharpen up a little of the fuzziness, they don’t do anything to help with the visual snow symptoms.

A lot of the time I try not to dwell on it, because thinking about it too much can make me feel hopeless, trapped, and overwhelmed. Writing this has been difficult, because focusing on it makes me hyper-aware of how much it affects me, and it is a little depressing.

Lying in bed at night is probably the most difficult time of day for me, because when I look around the dimmed or dark room, I feel surrounded by moving swirls of dots, shadows, streaks, and shapes. The tiredness at the end of the day makes it feel all the more exhausting.

The most distressed I have felt through all of this was the moment I realised that the dots, shapes, and lights did not go away when I closed my eyes. Lying in the dark in bed, I realised there was no escape. I couldn’t get away from it, ever.

I felt suffocated and terrified beyond words, and I knew that there was nothing that anyone could do to help me, including myself.  I had to get a grip on myself quickly: being that terrified made me feel like I really could lose my mind.

It is near impossible to truly convey what it is like to experience this every waking moment of the day.

I sometimes describe the symptoms to people as ‘tinnitus of the eyes’, in that it is a constant ‘noise’ in the background that you can’t turn off. At least with tinnitus, however, you can put on some white noise or music to block it out.  There is nothing like that for my eyes.


In the absence of medical professionals’ input, I have my own theory about why I have developed Visual Snow Syndrome. It began not long after a period of severe stress and trauma, which I experienced over an extended period of time.

I believe that my neurological system became so painfully stressed, that I developed fibromyalgia, visual snow syndrome, and tinnitus, all around the same time.

The common denominator for all these things is that they are neurological.

Fibromyalgia is a neurological condition that was not acknowledged for quite some time by the medical profession. There is still not consensus on why it develops, but it often occurs after someone has experienced mental ill-health or a traumatic experience.

Your neurological system works overtime and tells your brain that you are in pain when you aren’t. I’m not an expert, but my theory is that, in the same way, my neurological system is working overtime when it comes to the input from my senses.

My sight is altered, because the signals carried by the nerves between my eyes and my brain are not working properly and going off in ways they shouldn’t, and the same is happening with my hearing, causing the tinnitus.

The hunches or theories of patients and sufferers rarely hold much weight up against the opinions of medical professionals.

Although I have had Visual Snow Syndrome diagnosed by an optometrist, I continue to remain in limbo as no other health professionals will acknowledge it.

I continue to live without any support in terms of how to cope, but I do cope.

I hope that one day more will be understood about this condition so people like myself will finally be believed, validated, and given more support.


9 key principles working in customer service taught me about supporting people in crisis

Customer service is often viewed as menial, low-skilled work, but there is an art to doing it well.

I have had a number of customer service jobs, including working for various auto breakdown services, and a private pathology lab. I was often on the phone to distraught people: perhaps they’d had a smash on the M25, and they had 3 terrified children with them, or they were waiting for a breast cancer test result that was running late and were petrified the delay was due to bad news.

Those calls were much trickier than the average; however, through them I learned some fundamental principles that have continued to help me help others, including work with prisoners and rough sleepers, for many years since.

Whether you are dealing with a vulnerable person in crisis or a customer on the phone, they come in handy.

Here are 9 that I see as the most important:


1. What people define as a crisis is relative

A crisis can be an enduring situation where your whole world is literally falling apart, or it can be a sudden, short-lived incident that causes acute stress but is able to be resolved within a day, or even a few hours.

What one person experiences as a crisis may not be the same as another.

Timing is also a consideration – someone might normally cope well with a situation, but they might not have the emotional resources to cope with it other times.

All reasons for distress are valid and relevant because of the meaning they have for the person experiencing them.

It is best to avoid judging someone coming to you in crisis, even if their issue does not resonate with you, or you see it as minor or silly in comparison to others.

People need to feel like their problems are not just valid, but that the extent and gravity of their problems as they see them is acknowledged.

People, understandably, need to feel like they matter, and that their problems also matter.

2. You can make a big difference in just one interaction

When someone is already stressed out, whether it is because their car is damaged, or they’ve dropped their phone down the loo, or they’ve found themselves suddenly homeless, the last thing they need is a difficult interaction when they reach out for help. This only makes people feel more stressed, angry, and frustrated with their situation.

We all know what a relief it can be to have a problem sorted out speedily and adeptly. The call handler is friendly, empathetic, and competent, immediately putting you at ease. They give you opportunities to ask questions, explain what you’re not sure of, and tell you what they will do to help. You come off the phone feeling lighter and less worried about your problem, now it is in someone else’s capable hands. Your stress levels decrease immediately.

Most of us have had experiences at both ends of this spectrum and can remember how differently we felt after each of them.

You can radically affect how stressed someone feels in quite a short space of time, depending on how you approach their issues and how you treat them.

Make the most of those opportunities.

Lessen their burden, instead of adding to it.

3. Anger is fear and a need to be heard

When someone in crisis appears angry, it is often fear in disguise.

Understanding this is key to being able to help someone whose stress comes across as anger.

If someone seems frustrated or angry, I stop talking and listen. I let them do all the talking.

After they get their initial rush of frustration out, most people begin to relax, especially if they aren’t coming up against resistance from you, and it is obvious that you are listening.

A calm, attentive reaction often takes people by surprise. They’ve most likely been expecting a battle, and it doesn’t happen.

You will notice their relief emerging as they begin to slow down, take some breaths & eventually stop talking. Sometimes they even start to feel a bit embarrassed at their outburst, and they apologise. So many times, I have heard the words:

“Sorry, I know it’s not your fault – I’m just so worried about it all and I don’t know what to do.”

People often just need to be heard and have their fears acknowledged. They need to be able to share the impact a situation is having upon them and have someone be a witness to that. They need to feel the emotions they are having are externally valid.

Anger is rarely about you as the helper: it is more about the person’s situation, and how afraid and out of control they feel because of it.

(N.B. I am not saying anyone should have to tolerate aggression. It is not okay for someone to get abusive. I have found that active listening, followed by focusing on joint problem-solving, is very effective in deescalating anger. If it isn’t working, it is important to be assertive and possibly end the interaction if they are being aggressive towards you.)

4. People need allies

Someone in crisis who is reaching out for help longs to feel that they aren’t alone anymore.

Being distressed and alone is something no one should have to experience.

Knowing that someone somewhere is helping to shoulder the weight of their problem (especially someone who has access to resources to help them fix it) can make a huge difference to how powerless someone feels.

It doesn’t mean that you should do all the work for them, or that you should step outside professional boundaries. Just ensuring someone has a positive interaction with you will help them feel less alone.

Even if there’s little you are able to do, sometimes just listening and acknowledging is the best way to be an ally.

5. Be reliable

This is one of the simplest, but also most powerful, of these principles.

I cannot stress enough how important it is to be reliable when you are working with someone in crisis.

It is likely that you represent a glimmer of hope for that person, so don’t just throw that away.

If you say you’ll do something, you must do it. If you forget easily, make a note, or put it in your calendar.

If you’re not able to do what you said you would, let them know. Get in touch and tell them that you’ll need a couple more days to find something out, or that you’re going to be trying something else instead.

Not doing something when you said you would (especially when someone is relying on you to help), shows that person that they don’t really matter – even if that is not your intention.

Don’t just leave someone in limbo, wondering what’s happening – they will most likely be worrying. Call them. Get in touch and let them know.

It might feel easy to get lazy about these details, but don’t let that happen.

If you can’t commit to things, it is probably best not to make those commitments in the first place.

6. Be honest

Don’t take the easy road and tell people what they want to hear, just to make your life easier. Honesty is everything – even if it means delivering less than satisfactory news.

People appreciate being told the truth.

Most people prefer news that isn’t the best to lies given only to placate. This is otherwise known as ‘fobbing someone off’, and most of us know how that can feel.

7. Move people forward

A manager and trainer at Citizens’ Advice taught me this:

You may not be able to solve someone’s problems in one go, but you should aim to move them on a step further than when they walked in.

Openness, warmth, and a listening ear may be helpful in the moment, but you should also think about what you could give the person that they can take away with them.

It might be something tangible such as an information leaflet or a telephone number to call, but equally important are hope, the relief of a problem shared, the courage that comes from having an ally, or even some restored faith in humanity.

We can all think of times when we’ve walked away from an interaction feeling more hopeful, whether it was from a medical appointment or a call to the insurance company.

People feel better when they can see where they are going, or what steps to take next. It is like finally receiving a map to somewhere when you’ve been completely lost.

8. Everyone can benefit

We could probably all do with more customer service in our lives! You don’t have to be in an official ‘helper’ position.

I use these principles in my daily life to support others, even my partner, my parents, and my friends. I regularly ask myself:

“What can I do to help this person? How can we sort this situation out? Will letting them talk while I listen help? How can I help take them from feeling stressed to feeling a bit better about things?”

9. Be human

I’m not suggesting by using customer service principles we should all become call-centre robots. Not at all. Good customer service is warm, supportive, and validating. Everyone is treated as an individual equally as important as the last, and everyone’s plight is as valid as the next.

I was once assessed over on the phone by a mental health worker who sounded like she was reading questions from a script. I later gave feedback about this to a manager, and was told, ‘yes, that’s because she was reading from a script’.

My point was missed completely: I knew she was. The point was that she was not in any way bothering to disguise it. That felt impersonal and hurtful when I was already feeling vulnerable and being asked such sensitive questions. I needed to speak to a human, not a robot.

Nurse, doctor, receptionist, call handler, or friend: any of us can make a difference to other people’s distress by thinking about how we interact with them, and what effect it might have on them.

It doesn’t matter who you are or what position you hold.

Often it is just about being a human being talking to another human being.

The simplest things are often the most powerful.


8 ways long-term trauma can affect someone physically

Experiencing trauma activates our stress response as our brains and bodies gear up to deal with threats. If you are exposed to severe stress and trauma that goes on over a long period of time, your body and brain will constantly be reacting to threats, and will actually begin to change in order to be able to cope. Over time, your systems become fatigued and physical effects begin to develop.

Examples of situations that can cause this include growing up in a stressful or abusive environment, being in an abusive relationship, having a long-term mental illness or disorder that means you get stuck cycles of trauma (such as ‘BPD’), sleeping rough and being homeless, working in the sex industry, and being detained for extended periods of time.

I would like to demonstrate this by sharing 8 ways I was personally impacted by experiences of long-term trauma.

All of these symptoms began to occur about a year after a serious mental health crisis, which was just one in a series of traumatic experiences I have had in my life.

Although I had begun to feel much better mentally a year or so after this, my body and physiology continued to remain in a stressed and traumatised state, and I developed the following:


1. Fibromyalgia

I was diagnosed with fibromyalgia by a neurologist after I began to experience chronic pain all over my body and fatigue. I found it hard to move around or do daily chores without being in a lot of pain. I was exhausted all the time.


What is fibromyalgia?

Fibromyalgia is a neurological condition that is mostly experienced through chronic pain all-over body pain and fatigue, but can also include cognitive (thinking) problems, sleeping issues, migraines, and other symptoms.

Although doctors aren’t completely sure why it happens, they have found that it often seems to be triggered by a physically or emotionally traumatic event. It involves changes with how the nervous system processes pain.


2. Dissociative ‘Attacks’

About a year after being diagnosed with fibromyalgia, I began to have dissociative episodes that would happen in response to certain environmental triggers.

Whilst I had experienced various forms of dissociation on and off throughout my life, it had always been more of a mental experience. These new episodes affected me physically.

My body would become rigid and I would be unable to walk properly, move, or speak, for hours at a time. It felt like my brain had completely disconnected from my body and got stuck, and I was waiting for it to come back again.

Even after they dissipated, I would feel exhausted for days afterwards.


What is dissociation?

Dissociation is when you experience a feeling of detachment and disconnection from either your own body or your surroundings. It is something most people experience in mild form, such as when you are daydreaming or going into ‘autopilot’ when driving a car. It becomes a problem when it is going on for longer periods, seriously affects your perception, and when it makes you feel distressed – all of which can affect your daily functioning.


3. Chest pain and rigidity

When I found something upsetting or emotional, I very quickly got really bad chest and upper back pain. It felt like I had a rock inside me trying to get out. The ache and the tension was so severe that I’d have to lie down and take painkillers. It could last for days.

It was a very specific pain and rigidity that only seemed to happen when I felt strong emotions, such as hurt, anger, and sadness. I would often get the rigidity in my face and jaw too, making it hard to smile, be expressive, or even talk properly, for days.

4. Cognitive Issues

My memory increasingly got worse, from me constantly forgetting where I’d put things or what I was doing, to causing stranger and more worrying things to happen. These included finding things done around the house that I didn’t remember doing, like hot cups of coffee sitting on the kitchen counter when it was only me in the house, or fresh washing hung up in my wardrobe!

I had difficulty concentrating, being able to understand and retain verbal information, and being able to respond to people verbally in a way that was timely or made sense. This could vary according to the circumstances, such as where I was and who I was with, and also on my levels of anxiety or emotion, but was one of the most difficult things I had to deal with.

I actually wrote about how cognitive issues like this can affect your ability to have a conversation. You can read it here: 5 reasons why having a conversation is so tricky when you have anxiety

These issues are one reason why I like writing so much – the written word is so much easier to manage!

5. Visual Snow Syndrome

This is an interesting one, and apparently also controversial because most of the professionals I see think it is a transient stress reaction or hallucinations.

I have had it diagnosed by an ophthalmologist and I’m pretty convinced it is not due to transient stress as the symptoms are there all of the time, from the moment I wake up until I go to sleep. They are even there when I have my eyes closed, and it has been that way for over a year and a half now.

It is a condition that not much is currently known about, and after further research I have found that most people have trouble getting it acknowledged by professionals.

Visual Snow Syndrome involves changes in your vision, such as seeing static everywhere, seeing traces when you look away from objects (palinopsia), light sensitivity, night blindness, and flashing colours and lights.

It is not a problem with the eye. The issue is thought to be how the brain is interpreting the information and the messages coming from the eye.

I call it ‘tinnitus of the eye’ because that is one of the best ways I’ve been able to explain it to people so they understand.

If you are interested in finding out more, read my other post: What it is like to live with Visual Snow Syndrome.

6. Tinnitus

About the same time that the visual snow started, I also began to get tinnitus, which for me is a constant high-pitched ringing in my ears.

Tinnitus is quite common and is the perception of sound when there is no actual sound. The exact cause of tinnitus is not known, though it is believed that it has to do with changes in the signals going to the brain via the hearing nerves.

It can get overwhelming, especially if I am already feeling stressed, or if I am in a very quiet room. I tend to listen to white noise when I’m trying to get to sleep, or if I want to relax and read a book, so the noise doesn’t disturb me as much.

7. Migraines

I have always been a headachy person, but along with the fibromyalgia I began to experience really bad ones, which then turned into migraines. I was getting them nearly every other day, though with medication I have managed to get them to a point where they only happen once or twice a month at most.

Migraines are thought to be a neurological condition, and I have found them to cause severe head pain, light and noise sensitivity, nausea, and issues with speaking and seeing properly.

8. Random physiological reactions

Although I have suffered from anxiety for over 20 years, it tended to be more about social situations, crowds, or feeling embarrassed and awkward in front of people.

These new ‘random’ anxiety attacks began to happen when there is no obvious trigger. I would be doing something that doesn’t normally make me feel anxious, like having a shower, or eating breakfast, and not thinking about anything bad at the time.

I got hit with waves of anxiety out of nowhere. I wouldn’t experience it as anxious thought, but in terms of my body and my physiology. My heart would thump, I’d feel like I wasn’t getting enough oxygen, and I’d have to take deeper breaths and sit down. I’d feel sick and afraid and find it hard to think properly. It usually lasted hours, sometimes days, so it wasn’t like a ‘simple’ panic attack.


These are 8 things I personally experienced, though I’m sure there are others I have not included that other people will experience too.

I’m very glad to say, that other than the fibromyalgia, visual snow and tinnitus, I no longer suffer with these issues on a daily basis. It is possible to over come physical issues that have been caused by trauma. I did it by looking after myself and my working with a psychologist to overcome the emotional traumas. When your mind is feeling better, your body begins to get better too.


Despite my mental health radically improving after my crisis, my body continued to suffer. I believe this is because I did not do any work on what had caused my trauma/s. Once I did start addressing this, with the help of a psychologist, I improved radically.

I think this shows how important it is that trauma is recognised, and that people be given the opportunity to work through it with professionals in a safe way, in addition to learning coping mechanisms and healthier ways of living.

I think going deeper into what had happened can often make the most lasting difference to someone’s quality of life.

I believe that most people with a serious mental health condition, especially those who experience repeated crises, and those who have been detained, will most likely have been affected by trauma, whether that was via an earlier stressor that brought them to services, or the result of repeated and long-term interactions with services.


10 ways you might feel LONG AFTER being sectioned under the Mental Health Act

Being detained under a section of the Mental Health Act is an experience that is difficult and stressful.

It involves being removed from familiar surroundings, against your will, and being placed on a mental health ward for the safety of yourself or others.

Not only can it cause a lot of stress at the time, but it can also have profound and lasting effects on a person, which may continue to have an impact long into the future.

This is something people don’t tend to talk about, and it can be difficult to know where to turn for help if you have been affected.


Although different people may feel differently about this experience, here are 10 ways you might feel.  Everything I have written here is based on personal experience.


1. Ashamed or embarrassed

No one should have to feel ashamed or embarrassed by needing urgent mental health care, however due to continuing stigma around serious mental health issues, this is a common experience for many people.

Those feelings could be about things you said or did that were out of character for you. Perhaps you feel that you let yourself or other people down in some way. This often goes along with feelings of guilt.

Maybe people around you who aren’t your closest loved ones, such as your neighbours or work colleagues, know that you were sectioned, and it makes you feel embarrassed, and you worry about what they think of you. This can cause you to lose self-esteem and confidence, and not want to be around those people.

2. Guilty or sorry

Feeling ashamed is often tangled up with feelings of guilt. You may wonder why you acted a certain way, or why you didn’t do enough to stop it happening.

Perhaps you did or said things that you did not mean because you were so unwell, and now you feel bad about it. Maybe you caused other people to be distressed or upset, or even broke the law, because you were not your usual self, and you are carrying feelings of regret.

You might even want to say sorry to certain people, but you don’t have the opportunity, or you don’t know how.

3. Alone

The experience of being sectioned is one that not a lot of people go through and it is also deeply personal. It is not something that is easy to talk about with other people.

Your loved ones may be too close to the situation for you to want to talk to them, or perhaps you feel that they won’t understand because they have not been in the situation themselves.

Because your experiences involve services or professionals, you might not feel you can talk to them about this, or you may feel like the last thing you want is to be involved with mental health services again.

4. Like you don’t belong

You might find you feel differently around other people now. You might feel that you don’t fit in anymore because you have been through something that has changed you so much that you can no longer relate to others in the same way.

You may prefer to be alone and away from other people because of how you feel.

5. Angry

You might still feel angry about what happened, and even harbour resentment about what you experienced.

This could be due to feeling let down by loved ones or people you thought you could trust. It could cause you to avoid these people.

It could be due to what happened whilst you were sectioned and how professionals or services treated you. It might lead to you not wanting to engage with services in the future.

6. Afraid

You may find that bad memories of your experience come back to you, even years later.

You might be triggered by something on the TV, such as programmes about mental illness or movies where people are trapped, held against their will, or coerced into doing things they don’t want to.

You might get flashbacks or nightmares about things that happened, or physical and physiological reactions when you are reminded, such as panic attacks or dissociation.

7. Numb

You might not feel anything at all.

Sometimes when things are too much to bear, your brain may try to cope by shutting off in some ways, and that can make you feel numb.

You might be unable to properly feel happy or sad about anything. You might feel indifferent about everything and find it hard to connect with other people because of it.

You may prefer not to be around other people and might lose interest in a lot of things you’d usually enjoy.

8. Confused

Things may have happened during your experience that still don’t make sense to you. Things may have been said or done by people around you that you don’t really understand.

Wondering ‘why?’, and not having any opportunity to ask or find out, can lead to thoughts, images, and questions that continually bug you. That can make you feel uncomfortable, confused, and make it harder to come to terms with your experiences.

9. Helpless

Being restricted and having your freedom taken away can make you feel helpless, even after you have your liberty back again.

It is very hard to forget that feeling of helplessness once you have felt it.

You might not have the mental strength afterwards to even think about your experiences, let alone talk about them, and prefer to push them to the back of your mind.

Unfortunately, intense feelings and emotions don’t just go away, and may continue to affect you deep inside.

10. Any way

Everyone can have different experiences whilst they are sectioned, due to many different factors, and that will have a bearing on the way you feel afterwards. Everyone is different too, and people deal with things in different ways.

It doesn’t matter if how you feel is differently from other people who have had this experience. There is no one way you should or should not be feeling.  

You might be feeling all or none of these things, or some that I haven’t even mentioned.

However you are feeling, it is ok to feel like that, even after a long time.


Even if you went through the experience of being sectioned some time ago, you have been through something very personal and difficult, and it is okay if you are still not over it.

I want to raise awareness of the fact that there is a need for specific support for people who have been sectioned, on top of the support you might get for your mental health condition.

Being held against your will is an experience that can affect you very deeply, and it is important that is recognised.

It is important that mental health treatment does not add to the trauma or distress that people are already experiencing, and that they don’t continue to carry that burden into the future.


You might also like to read 8 ways you might feel when you’ve been sectioned under the Mental Health Act, which looks at how you might feel during your time of being sectioned and detained in hospital.


8 ways you might feel when you’ve been sectioned under the Mental Health Act

Being detained under the Mental Health Act and confined to a psychiatric ward is something that is supposed to be done in your best interests, but it most likely won’t feel like that at the time.

Of course, everyone will feel differently, but here are 8 ways you might feel.


1. Powerless

Being free to mostly do as we choose is vital for us as human beings in today’s society. Being told that you cannot leave somewhere, or go out for a walk to stretch your legs, or being forced to do things and go places you do not want to, can have a profound and lasting effect on how you feel about yourself and about the world.

2. Angry

One of the most natural emotions to feel when you are no longer in control of what is happening to you is anger. You might feel angry with the professionals who assessed you, because you don’t agree with their decision. You might feel angry with your family if you feel that this has happened because of them. You might be angry because you feel you are not being listened to, or because you feel the staff are against you.

There are many things you might feel angry about, and often other emotions, such as fear, can feel like anger.

Sometimes anger can lead to you lashing out and becoming aggressive, which is fairly understandable if you are stuck in such a confined and powerless situation. Aggression might not necessarily be interpreted in this way, unfortunately, and may lead to further restrictive interventions or negative staff attitudes towards you, making you more angry and creating a cycle.

3. Afraid

You may not even be sure what is happening, know where you are, or know who these people are who are stopping you from doing what you want to do. You might be scared of the other patients, or the staff, or what you think is going on.

The way you feel and act when you are afraid can often feel and look the same as anger.

4. Ashamed

No one should have to feel ashamed if their health has led to them needing urgent mental health treatment or support, but stigma in society around serious mental health problems continues, so it is not surprising if you do feel this way.

Your feelings might be about how you perceive yourself, and also about what other people might think about you.

5. Alone

You may only be able to see or speak to your loved ones at certain times or for short periods. You might not get along with any of the other patients, or be interested in them, so you spend a lot of time on your own.

If you are moved to a hospital out of the area, it may be impossible for you to have anyone visit you, and you may feel very far from anything and anyone familiar.

You might not even want anyone to visit or call if you are feeling ashamed, or if you are angry with them seemingly playing a part in your current situation.

You can still feel lonely, even if you have purposely decided that you don’t want to see or speak to anyone.

6. Irritated

When you are feeling irritable, you can get annoyed or stressed out at things very easily. This can happen for many reasons, such as in response to outside stress, or because you feel bored and fed up.

Psychiatric wards are often not calm places. They can be noisy and uncomfortable, and also boring if there are few activities, or if you don’t feel like joining in.

Other patients can be noisy or disruptive because they aren’t very well. Being stuck in a fairly small area, with people you would not normally choose to be with, can lead to you feeling irritable and agitated.

7. Worried

You may have children, a partner, or pets, and be worried about how you being away from them is affecting them. You might be worried about how being sectioned will affect your life in terms of your job or your reputation.

8. Trapped

If you are an informal patient on a mental health patient, you will often be allowed to come and go as you please throughout the day.

As a patient on a section, however, you cannot go out for leave unless it is legally agreed to and signed off by a psychiatrist. This is called section 17 leave. If the psychiatrist is not in over the weekend to do it, or if they decide you won’t be allowed it yet, then you cannot leave the unit.

This means spending all your time in just a few spaces – a bedroom, hallway, lounge area, dining room, a small yard, maybe a quiet room, and occasionally activity rooms – sometimes for months on end.

Feeling trapped can make you feel irritable, stressed, and angry, and more likely to feel aggressive towards others.

It can also have lasting effects on you mentally because of the stress it can cause.


These feelings are all very natural responses to the experience of being detained under a section of the Mental Health Act.

Although I have set them out individually here, these emotions do not happen separately, but are all entwined with each other. Feeling one will often make you also feel many of the others.

You may not even be able to tell which of them you are feeling because they all get so easily tangled and jumbled up together.

Your stress levels can affect the way you act and how you come across, which in turn might affect the way others respond to you and the care that you receive.

All of this can lead to an extremely stressful experience, the effects of which you might carry with you sometime into the future.

It is quite normal to feel any of these emotions, or any others, when you are in this situation.


If you are currently on a section on a mental health ward of any kind, it is highly likely that you are legally entitled to an advocate.

This is someone impartial, who is not part of the staff who are caring you, that will listen to you and support you to be able to express your views, and who will help you stand up for your rights.

If you would like to speak to an advocate, let a member of staff on your ward know. They will be able to organise that for you.

Alternatively, you can find one and contact them directly by searching online.


Here are some great UK charities with resources to get you started:

Mind

Rethink

Voiceability

POhWER


You might also like to read 10 ways you might feel LONG AFTER being sectioned under the Mental Health Act, which looks at how the experience of being sectioned can still affect you some time afterwards.