Reflections of an MHN
I am a mental health nurse with many years of experience and I have worked in a variety of different settings. When looking back over my career I now feel that I was ill equipped to care for patients under my care at that time. My early experiences were possibly very medical model orientated working on the in patient unit. I felt that I was compassionate, caring, respectful but did not have a good understanding around psychological models, and rather than really thinking about drivers, such as strong emotions, I would be more focussed upon “fire fighting” so dealing with the presenting behaviour/ problem and managing this.
I fear that I did not have a good view of people with a EUPD or BPD diagnosis, as could only see the challenging behaviours and was possibly less focussed on the emotional distress and the individual’s pain from this and inability to be able to contain this.
I would collude with idea that people were; attention seeking, manipulative or just enjoyed giving staff a hard time, or in making then late in leaving. All of this was possibly a degree of transference of working on very difficult and often understaffed acute wards, with a high level of very unwell people.
During my work within the community team, I completed my DBT training and possibly the thing that had the most impression upon me was learning that the level of emotional pain can be comparable to the pain from a third degree burn. I have never suffered from this and the most severe pain I have experienced was from a tooth abscess, at that time all I could do was wrap my arms around myself and rock, and was intolerant of others and any external stimuli. Thinking of this and relating this to an individuals experience of emotional pain, gives me an understanding to why this can generate challenging behaviours or lead to self-harm, all of which is often seen as making this individual as unpopular to medical staff.
Additionally’ if you throw this emotional pain into a mix of; a history of extreme invalidation throughout their early stages of life, poor attachment within relationships and therefore difficult relationship dynamics and a reel struggle to trust. When recognising this It soon became obvious why when receiving a call from a distressed client at 4.45 on a Friday afternoon, when I finished at 5.00, it was no just to annoy me or make me stay late, but the fear of feeling isolated, vulnerable and with little other support over a weekend, and a kind word or feeling understood or validated may give that individual the strength to cope with the weekend.
This may seem obvious but it is my experience that people do not think in this way, it has helped with me being none pejorative in my approach, with reflecting and seeking to see the other side of the coin rather than just the presenting situation.
Possibly the most important DBT tool I have learnt is validation, and now when I carry