Why won’t I accept help

I have been in therapy for a long time and under the care of CMHT for even longer so why am I no better? Why am I still desperately suicidal? I still self harm and I still battle depression on a daily basis. I have tried more medications than I can count and for periods of time some have worked, others not so much. I have had times when I have not needed CMHT or therapy but not many. We have dealt with and resolved a lot of things in therapy but even though I trust him implicitly I still won’t let him loose on the issues that cause me the most pain and distress despite agreeing to at times. The reality is that when it comes down to it, I back away. I still think that he isn’t seeing the real me and that if I tell/show him who I really am, he will be as disgusted as I am, that he will see me for the monster that I am. In the many years I have known him, I don’t think I have ever looked at him in a session because I fear he will see the real me. Yet I continue to see him.

I see my care coordinator often and I try to be honest with her about how I am feeling but for many months I hid the fact that I was suicidal and that I had a plan in place. When she gets worried and voices that concern, all I am thinking about is how I can talk my way out of a hospital admission if it comes to that.

I am lucky to have a fantastic team around me and I am so so grateful for that but I often feel that I should walk away if I won’t let them help me.

Why won’t I let anyone help me? Mostly I believe that I am broken and unfixable. Last week I sat in front of my therapist sobbing, telling him that I couldn’t tell him what was wrong, partly because I was afraid of the consequences but mostly because I don’t think he can help me anymore. He can’t make me want to live, that has to come from me. But what if the desire to die never leaves me? I don’t remember a day when I wouldn’t have chosen life over death. Unfortunately for me last week, he was concerned enough to call my care coordinator so I had to allow her to put home treatment/crisis team in place – it was clear it was the only option. They have been told that I won’t call if I’m desperate and that if they call, I will say that I’m ok, so visits are needed. I am trying to be honest but while I am talking my mind says “careful, don’t say too much or you’ll end up in hospital” and I am working out if I have time between visits to put my plan into action. So will I tell them if I am planning my death? The answer is probably not.

The professionals can only help me if I allow them to, if I am honest. I know that. I have been in the system long enough to understand how it works and I know when I need to let my care coordinator put safety plans in place. I know that when she starts talking about hospital, the best thing to do is to agree to a plan that may include taking time off work and seeing the crisis team so that I can stay in the community. But perhaps things would be easier without this knowledge. 15 years ago it never occurred to me to be anything than honest with the professionals but my admissions to the local ward convinced me to say never again. There was nothing approaching therapeutic about it, all it achieved was containment until I could convince them I was no longer a risk to myself. The ward is now closed but my belief that hospital can’t help remains and that leaves me with precious few options.

If I cannot help myself, who can?

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