There is no greater agony than bearing an untold story inside you #MeToo

Today I spoke to Sheffield Health and Social Care about sexual safety. I was approached far back in August in light of winning the RCNi Mental Health Nurse of the Year, for the project that I was leader of, 'Lets Talk About Sex.' Thank you to Andrea, Vin, Laura, Susan and all at SHSC for giving me this opportunity. But also for the trend setting work they have already started to embark on in this area - I was truly impressed.

More recently, I was asked if I was likely to know of any service users/survivors that would be willing to share their testimonies, their experiences on inpatient units or of those affected by sexual violence. SHSC hadn't had much luck in this area, which isn't surprising given that it is such a sensitive/emotive subject. I approached a few, whose stories I knew little about, but I followed/interacted with on twitter (which obviously meant they were great!) For them  to generously trust me with being their voice I owe a lot. I hope I did both narrators justice. I also managed to 'recruit' Emma, to speak about her journey from being the victim of an assault to her role as Independent Sexual Violence Advisor, and Sexual Safety Lead in East London Foundation Trust; oh and employee of the year too!

In the last few weeks and after hearing a particularly moving testimony at the launch of the national collaborative on 21st October, I decided that I too had an untold story inside of me.The fact that you are reading this on my blog, the 'twist in the plot' will not be as powerful as it was (I hope) for the audience today.

Trigger warnings abundant here; self harm, rape, trauma, EUPD, BPD etc etc . Here goes...

"I have been under the care of mental health services since the age of seventeen, however, beside assessments and a brief period of cognitive behavioural therapy most of my treatment has come from my GP. I was originally diagnosed with an eating disorder not otherwise specified, (I couldn’t even get anorexia right) and then with cyclothymia (a lesser form of bipolar disorder). I am unsure what age I was when I acquired this diagnosis. Probably in my early twenties. I have since had group and individual psychotherapy, but it is only recently that I told a psychiatrist what had happened to me when I was 19.

At the age of 19, I experienced what I now come to accept was a gang rape. However at the time, I convinced myself that as I had not fought back, had not been adamant in saying no, or stop, that they were men of ‘status’, that it wasn’t what it was, how could it be? Surely if it was a sexual assault I would have fought, I would have said stop, shouted it, I would have tried to leave? Surely 'real victims' of crime report it to the police and provide forensic evidence... (This is actually rare, with only 13% of the British public reporting their rape or abuse each year. The remaining 87% do not report to the police (BCSEW, 2017)...  I mean I even embarked on a brief relationship with one of the ‘attackers’. I think that was my way of convincing myself that I had been an active participant in what had happened that night. Needless to say it did not last. 

I blamed myself. Is it any wonder when there is so much victim blaming in society? These same messages told me that I wasn't a victim; I had chosen this, I deserved this. It was not a gang rape but a ‘gang bang’. I was dirty, damaged, disgusting. And so I repeatedly put myself in similarly dangerous environments and situations. Just to enforce this message. This allowed me to feel that I deserved what had happened. My purpose was for others gratification.

I understand now that when someone is being sexually assaulted or harmed in some way they have different ways of responding immediately, and in the days, weeks, and months afterwards. That there really isn’t a right or wrong way. For me, my response has spanned years and most probably will last my life time, re traumatising, self harming, trying to escape the pain, or trying to feel something, anything.

It is only now, as I start reframe/ rephrase my experience and understand more about my response that I can say the word rape. I can see how that one night changed the trajectory of my life and many of the choices that I made afterwards; the way that I view myself and the way that I view the world. It is only now that I know that there tend to be five responses to trauma, fight, flight, freeze, friend or flop. I flopped and I friended, this is why I allowed my body to be violated. These are normal responses to trauma.

I know now that it is common for people of all ages to question whether what happened to them was 'really' rape or abuse. Unfortunately, this is due to the myths and stereotypes in society about rape and abuse. From an early age we are told that rape is when a strange man attacks a woman in a dark alley at night, and most of society still believes that those types of rape are the 'real rapes'. So when someone is assaulted and it doesnt fit the stereotype they will question whether their experiences really constitute a 'rape' and whether anyone will believe them.

How do I know these things? Was I informed by a healthcare professional? Perhaps my NHS therapist? A psychiatrist? Was I offered trauma informed therapy? CBT/DBT? Was I listened to in a non-judgemental way. Was I offered support, did I hear  “I believe you.” “It’s not your fault.” “You are not alone.” “I’m sorry this happened.” “I care about you and I am here to listen or help in any way I can.”...

For the last few months I have been undergoing private therapy (no nurses are not paid enough for such a luxury) and I am slowly starting to see myself as a whole person, and a person whose views and behaviours were shaped by external factors; small traumas in childhood and larger traumas in adulthood, how my patterns and behaviour were a response to trauma. That I was not born flawed, or damaged or with self hatred or destined to be. Neither am I flawed or damaged now. Instead I am beginning to accept that what I have spent years trying to deal with alone is complex trauma. Who I am, who I was, was shaped by external influences and not because I was 'worthless' 'selfish' 'self centred', not because I am a bad person. That both good and bad experiences shape you and make you to be the person that you are.

A doodle I did after a therapy session in which I actually allowed the 'T' word to be introduced.

But before that, for the past 13 or so years I have avoided telling ‘them’; the professionals, what had happened that night. This was in an ever increasing attempt to avoid the pathologization and the label of borderline personality disorder, the stigma and rejection that comes with that. Cyclothymia, depression, EDNOS, I could cope with those labels. Just anything but BPD/ EUPD.

I have avoided it even more in recent years. Why? Because I know that as soon as someone is diagnosed with EUPD they are seen as irrational, an irritant, they are rejected, they are dehumanised and they are misunderstood. The compassion that they receive from mental health professionals will be lessened because of that diagnosis alone.

To be given the message that I had a disordered personality, that I was too complex, that I was too difficult, that there was no cure and no treatment and my inability to regulate my emotions, meant that I was going to engage in impulsive behaviours, be unable to maintain relationships. To be given the impression that I was broken beyond repair, and would be for the rest of my life, but not broken enough to qualify for specialist support from a personality disorder service, when I already had to cope with my own self criticism and judgement would have been too much. It would have only reaffirmed those thoughts; that I was damaged, that there was no hope. That things wouldn't get better.

But they can. And they do...

Ironically, only last month I was told that I have a confirmed diagnosis of EUPD! Perhaps knowing this will be liberating, as I now have nothing to lose and I can talk about what happened to me freely and try and challenge some of the misconceptions and the injustice.

I have heard many stories from ‘victims’ and ‘survivors’ in developing the Sexual Safety Standards. The bravery of these women and men to share their stories, has inspired me. That I feel such anger that their experiences were often medicalised, seen as the product of physiological factors, that the person was seen as the problem rather than the perpetrator, and their responses to traumatic events seen as 'behaviours' that allowed them to be let down again and again and again, by people by services has forced me to apply some of that same care and compassion to myself to my own story. 

That many of these incidents took place in inpatient units is both a tragedy and a travesty. And should be to any person that works in inpatient mental health or learning disability settings.

About one in five women experience sexual assault), false reports are rare (2 to 8 percent). Those that have mental illness are more likely to experience sexual assault, coercion and domestic violence. If a person comes forward about being assaulted they are probably telling the truth. You can be the help. Or you can be the hindrance.

What someone needs to hear is that it is healthy to be fearful and scared of the abuse and the memories of it. It is normal to respond in ways that that person can not even understand or explain themselves. That there is no right or wrong way, and that what the person has lived through has been traumatic. But that they are not alone. Do not doubt or question a person’s story. Do not ask them for details or what they were wearing that night. Do not ask why they didn’t stop it from happening, why they didn’t call the police and do not expect them to ‘get over it’. 

Being subjected to sexual violence does change us, and does have an impact on us - but it does not stop us from being who we are. I am Rachel, I am RCNi Mental Health nurse of the year. The last few months have been a journey. Where I have begun to slowly treat myself with some of the same kindness and understanding that I give to my patients. To start letting go of every negative thought that I thought was true, and start believing some more of the positive.

There is a line in a book, The Sellout by Paul Beatty, ‘who am I? And how do I become myself?’ After almost 13 years I feel that I am ready to accept who I am, who I am not and who I have the potential to be."..

I ended the talk with a ‘dossier’ to those in the room, titled the importance of getting it right

1. If you do not think that your service has a sexual safety problem, that is the first problem you are going to have to overcome. 

2. Consider sexual safety on an individual basis in the context of trauma. This includes knowing a person’s individual triggers and what helps them feel safe. 

3. Acknowledge the person’s choices and give them control around their care, where they are nursed, whether it be in a single or mixed sex environment

4. Encourage a culture where someone feels able to speak up if a sexual safety incident takes place; whether that be staff, service user, student, volunteer or visitor and where there are means for them to do this anonymously.

5. Listen, to patients. What they are telling you. But also what they may not be. Don't ask them what is wrong with them? Ask them what happened to them.

6. If someone tells you that they have been a victim of sexual assault talk to them about who will and will not be told. And respect their wishes.

7. Challenge your own, your colleagues, your patients and societies attitudes and assumptions. For far too long victims have been blamed for what happened to them. You can be part of the change.

8. But also don't forget that you have to balance the duty of care to protect vulnerable service users with the rights of these service users to live a full and meaningful life, including the right and need to explore their sexuality and forge intimate and sexual relationships - service users often learn not to expect support in this area of life and therefore struggle with the challenges of developing satisfying intimate relationships without support, alone.​ That is not good enough.

I hope that by adding my voice to the conversation I can make a difference. Challenge the way that those who read it, some of whom will be my colleagues, will view someone with the diagnosis of EUPD.

Mostly though I have done this for me.

I have done this because I had a story that needed to be told. And with people like Hope Virgo, Dr Jessica Eaton, (neither who I have ever spoken to, so this may come as a surprise to them!) Alison Cameron - who shares her experiences on her blog and who kindly agreed to me sharing her story today, the anonymous person 'the butterfly' who did the same, SS who spoke at the launch of the sexual safety standards. My therapist. HB who has helped me to see the gold that holds the broken pieces together.