a long rant -just because i haven't had one on here for a bIt...

I can't tolerate sounds, mostly normal sounds like people eating, breathing, sniffing, coughing, repetitive noises, certain words etc...pretty much any noise really. its been like this for years but seems to be getting worse just lately, the slightest sound makes me furious, can't control it the anger, and end up hurting myself instead of someone else! it gives me physical pain though, especially chest pain and can't breathe properly...you know like the feeling when you hear nails on chalk board or something? makes me feel so sick...toot toot *Madville* has been reached!

clocks, hairdriers, hoovers, neighbours, drunks outside, my hamster in his ball, my hamster in his pen,when i'm wheezing (that one REALLY annoys me...esp if it lasts more than a few hours even when using meds or is painful becuase i know it means i have to take action...and then THAT means leaving the flat....and i have agoraphobia -badly...then i get lovely new annoying sounds depending on where i end up -sirens on ambulance for example -feelings like my head's going to burst with that one...

***

i have that itchy skin need to hurt me feeling today...brain has shut down, words are failing me and it's taking over....aaargh stupid brainless brain!
Distractions...been going round in circles of distractions for soooooooooooo long and now i'm so tired -in every possible way you can be tired...i wanted to do a wee bit the other day but fought and fought coz i know i'll start a war with my skin again....but this time....aaargh...
i feel numb...that's when i sh -so i can feel anything...
my brain has left my head -i'm just a shell again...a nothing...a ghost of a person...or a person living a half-life...i dunno -because my brain left...
 I WAS driving crazily but had a wee bit of sense enough to pull over and STOP but I didn't think I WAS going to kill someone, but I knew driving like that made me more likely to kind-of-thing...
***

And, just so we're clear, I feel JUST AWFUL for making anyone worry ever in my life...I...yeah...feel just terrible -I know many folk try to help each other but I don't want to be upsetting folk or having them worry unnecessarily. I'm having another 'unseen illness' spell as well whereupon I'm REALLY feeling the pain I (not literally) managed to contain to my left toe yesterday in order to be outside my flat for as long as i was....normally I can't stand up for more than half an hour but I was outside for quite a bit yesterday and now my Complex Regional Pain Syndrome CRPS has taken FULL HOLD -I feel pain EVERYWHERE basically right now and haven't managed to move from the spot I lay down in last night -not even for the loo...on these days I just hold it til I can move...hopefully that'll be soon as I (naughtily) took ONE extra painkiller...but no need to freak it's not an overdose as such...I'd just quite like to go to the toilet...oh, ok it was 2

***

The next GP that asks what my CPN says...well...i can't be held responsible for my actions as my brain will have left my head again...

READ THE F*&kn notes - I DO NOT HAVE ONE - THEY SAY i DON'T NEED ONE...

Had another meeting with a psychiatrist and there was the man from last time who said i didn't need one, sitting in on the meeting...like he's gonna turn round now and say "oh, ok, hands up, my mistake she DOES need one"..that was the last resort and they're having some big 'secret' meeting' if they say I don't need one again like they did last year...aaaargh........argh nothing -they're going to say it -FK this -what's the point....i'm on my own and i'm a ba$tard -what's the point in hanging round with me for company, fk, hardly anyone else can tolerate me for longer than an hour -or they don't at all...whatever....i'm out .... FK this....https://www.youtube.com/watch?
http://www.youtube.com/watch?v=2vFJo8rJqbg
http://www.youtube.com/watch?v=rOHlnV5fcsQ





https://www.facebook.com/groups/520571744640037/permalink/595183120512232/?comment_id=595411980489346&offset=0&total_comments=23

i feel AWFUL i'm so so sorry -words are just words....i am so so sorry....words, are just words....
 i do feel really bad -like i just came along when the rest of the world was having fun 'til i spoiled it....going to shoosh now...

when r u due in court?Can u make an appointment with ur GP today, u can get a letter to state that ur housebound, also ask to be referred to a mental health advocate, explain the stress this is causing u.
Gp is en route -I cannot move and it feels like someone has poured petrol on back and lit it! Yeah I'd get legal aid. No dates no nothing I don't understand what even happened to be honest -I've never been in trouble before that date (nor, may I add have I been asked if is wished a lawyer since!!!)What I mean to say is, it's not like I for into trouble on that date then just went out and started wreaking havoc!!Not been to court -wasn't allowed his statement or anything...
a few folk were worried as to why i went quiet again and were asking what happened...to which i said 
-nothing happened -just a bit of confusion...plus I was a bit (MASSIVELY) impulsive whilst driving ...was a bit...dunno...think I was fighting impulsive thoughts to hurt me and voiced that fact on here which made folk worry...and ...I didn't mean for folk to worry I was just getting that off my chest and I fought it but had tried to stay offline coz I was being triggered (and triggering others too I guess)    = (

***

Was going to buy a book about BPD so i can better understand things and remind myself that i am not alone and that i am not as crazy as i think i am...

***

Back hardly eased all weekend -it was either 9/10 on the pain scale or beyond 10....it honestly felt like i WAS ON FIRE at points...I usually feel bad for having to have the GP come to me, but I didnt fel bad in the slightest this time -I COULD NOT MOVE...not even to go the toilet...it felt like i was glues to the fiery bed...so i didn't feel bad for the call out this time-but on call outs before, from my old GP practice, when it's been because agoraphobia has kicked in...and i KNOW i have a chest infection or whatever but they still insist on coming out (which i understand) ..i end up in tears coz they'll talk about the wee bed-ridden man they'd just been at or whatever....ach...plus the receptionist will ask more than once "and you've A-B-S-O-L-U-T-E-L-Y  N-O  W-A-Y  O-F  G-E-T-T-I-N-G  H-E-R-E?" as though i'm either stupid,  pretending or both...

***i managed to record a song to try to distract myself as i HAD to sit up for 3 lots of 10-20 mins today = ( ...it was so difficult to get into a sitting position, and felt nigh-on impossible to stay there...so recording really helped to try to take my mind off it. Earlier, when the dr came i couldn't even hold a book to read to distract myself...'twas a LOOOOOOOONG day!!!!!!!!!!!!!!!!!

crisis team asked me to get off the phone

it seems to be only me who is into this page but i'm going to give it a shot...i've got nothing to lose....Christina -you've NO IDEA...you sent me a text when i had just opened a bottle of bleach to drink...i'm typing this, several hours later, and as you probably have guessed i didn't do it...i called the crisis team  yesterday (technically i mean Tuesday) and they were 15mins from swapping to out of hours so said "is it urgent or can you wait?"...i'm SURE you guys know how much it takes to make those calls for help....after a minute or two of silence on my end she said she'd get the duty worker to call me in the morning...i didn't sleep...
i didn't believe they'd call, but they did at half 10...by then, English totally failed me and i couldn't explain things...she said since it was all "long-standing things" they couldn't help..i've started drinking -and setting stuff on fire....and another really bad thing -stealing....utter rubbish, stuff i don't need...just totally impulsive and....i don't know.....i'm scared....and if they find out about the stealing...God help me, another period of time in a cell and i WILL hang myself..............


guys, i'm so so sorry..........


i don't know what to do -and now i'm burdening you and how would you know either -i don't mean that derogatorily ...i just....i don't know.....

i don't feel like me....




i don't know me i don't think anyway -but i DO NOT ;normally' feel like this -something's wrong and crisis aren't listening...

what would happen to any bills etc i have if i died...or debts...

**I called crisis again when i gave my name the woman straight away shut down and was almost like a robot ...she said "i understand it's long-standing things"...didn't even give me a chance to try to explain...then she said how i had a respiratory appointment and i said i knew that and that was freaking me out -the door was making feel PHYSICALLY SICK and i'd already wet myself twice and it was hours before i needed to leave...she said "well, anyway, we need to keep this line clear for people in ACTUAL crisis so if you could get off now and get in touch with *some acronym  i've never heard of" tomorrow ...then she said "will you do that?"
i said no...
she right that's great bye"

...she mentioned in the call how i had a psychiatric appointment in a fortnight and that, that wasn't long...i said it was if you can't sleep and a rope is calling you...





i don't think i'll last a fortnight...

things i wanted to do before i died

(i haven't done too badly on my list really)

*see an Aurora Borealis
*visit Auschwitz
*swim with dolphins
*have a baby at the age of 30 so that there'd be 30 years between my gran and mum, 30 between my mum and me, and 30 between me and my baby
*have twins
*Make another Sacrament
*bungee jump
*return to cantoring/choir
*go to the top of the Eiffel Tower
*go to the top of Blackpool  Tower
*travel to Australia
*take a trip somewhere overnight alone
*ride a horse
*have friends
*get a degree
*paint things for charity
*ask for help when i need it
*stop self harming
*visit New York
*go on a blind date
*donate things to charity
*forgive the people who ...
*be happy being me
*work in another country
*let someone love someone me without worrying if they have ulterior motives
*help someone else in a way they couldn't themselves
*be the cantor a funeral
*be the cantor a wedding
*compose a new Mass setting
*Return to work
*learn guitar properly
*visit Anne Frank's hide-out
*be in a band
*be a DJ
*be a KJ
*Do karaoke again
*help at a homeless shelter

Psychosomatic pain ~Stephen Tyrer

As a psychiatrist working in the field of pain, it is commonly assumed that I devote most of my attention to people who have pain as a result of stress or psychological difficulties. Indeed, 24 years ago when I first started seeing individuals in chronic pain who had been referred to me in a pain clinic because it was thought that organic factors were insufficient to explain the complaint of pain, I looked carefully for psychiatric and psychological explanations. Despite the fact that one-third of people attending our clinic had evidence of psychiatric illness (Tyrer et al, 1989), it has become clear to me from those I see that such psychiatric morbidity is largely a result of chronic pain and is not a forerunner of a painful state. The vast majority of people I see in a multidisciplinary pain clinic have a clear organic cause for pain either in the present or past, and it is rare to have a patient with pain arising purely from emotional causes. There is evidence of environmental and social factors affecting the exhibition of pain. Psychiatric illness is more common in people with pain referred to psychiatric out-patient clinics (Merskey, 1965; Merskey et al, 1987), but in total the evidence for organic factors leading to distress in vulnerable individuals is overwhelming.

A sizeable number of people in distress from chronic pain do not have enough signs of illness to persuade doctors that organic factors are sufficient to explain their symptoms. These individuals usually show intense conviction of disease, strong adherence to mechanistic explanations of their illness and considerable functional disability arising from the painful complaint. They are undoubtedly in distress and they score highly on symptoms of depression and, to a lesser extent, other psychiatric illnesses. Why these people present in the way they do cannot be deduced solely through application of the medical model.

***

PAIN AND MIND-BODY DUALISM

 

The word pain comes from the Latin poena, which means punishment or penalty, after the Roman goddess of punishment. The term was originally used for the punishment of an offence against the law. Over time the word was increasingly used to denote suffering, particularly if this had resulted from a blameworthy act. 

Early writers equated emotional suffering with pain and the words were used interchangeably. This psychological dimension to the experience of pain was largely forgotten following Descartes' observations illustrating pain as a signal of physical pathology:

 

‘quand je ressens de la douleur au pied, la physique m'apprend que ce sentiment se communique par le moyen des nerfs dispersés dans le pied, le pied, qui se trouvant tendus comme des cordes depuis là jusqu'au cerveau, lorsqu'ils sont tiré dans le pied, tirent aussi en même temps l'endroitdu cerveau d'ou ils viennent et auquel ils aboutissent, et y excitent un certain mouvementque la nature a institué pour faire sentir de la douleur à l'esprit, comme si cette douleur était dans le pied’ (Descartes, 1647).

Although not anatomically precise this work convinced scientists of the relationship between the integrity of sensory nerve conduction and the experience of pain. The experimental work then conducted supported the views of doctors that pain was due to tissue damage, so in those complaining of pain there must be a source of injury. The concept of non-organic pain was not considered important at this time. It was not until Breuer & Freud (edition 1957), in detailed case histories originally published in their studies on hysteria in 1895, suggested that pain could be a manifestation of a psychological problem, that the contribution of psychological factors to pain was reconsidered. The profound influence of Freud shaped the belief in psychological and psychiatric circles that persistent pain associated with emotional distress in the absence of organic findings is primarily due to a psychiatric illness. This was not generally acknowledged by physicians although a number of pain specialists have realised the importance of psychosocial factors in the presentation of patients with chronic pain (Fields & Price, 1994; Livingston, 1998). Dr Livingston, a surgeon writing in the middle of the past century, disagreed with the concept supported by many doctors at the time that pain, without physical findings, is hysterical or due to malingering.  

***

PSYCHIATRISTS AND PAIN

The concept of ‘emotional pain’ occupied a select group of British psychiatrists in the 1960s and Erwin Stengel proposed a variety of mechanisms to explain this phenomenon. Stengel was born in Vienna as an identical twin and came to England in 1938 following the occupation of Austria by Hitler. He was intrigued by those who seem to be impervious to pain and described case studies of this phenomenon. More than most, he understood that mechanistic models were inadequate to explain the gamut of experiences described by people with pain. The controversy between Stengel and Eliot Slater about this issue, published in the British Journal of Psychiatry 40 years ago (Stengel, 1965), neatly encapsulates the mind-body dualism that was adopted by most practitioners in a more convergent explanation of the origin of pain (Slater, 1966).

Stengel's work in this area led to a sprouting of interest in Sheffield, where he was the first head of the university's Department of Psychiatry at this time. Three junior psychiatrists in his Department have since become prominent researchers in this area - Harold Merskey, Izzy Pilowsky and Sir Michael Bond. All have contributed massively to the contribution of psychiatric and physical features to the perception of pain, an area into which, sadly, psychiatrists in the UK nowadays rarely venture.

At the same time that Stengel was articulating his views in England, psychiatrists in the USA developed psychological theories to assist in the management of pain in the New World. The established physician and truncated phonemic associate George Engel believed that, although pain may originally develop from an external source, it often becomes a psychological phenomenon (Engel, 1959). He described risk factors for developing chronic pain, including a history of defeat, significant guilt, unsatisfied aggressive impulses and a history of real or imagined loss. Later, Blumer & Heilbronn (1982) described a group of patients who developed chronic pain who had a strong work ethic and were preoccupied with their pain. As these individuals later developed many of the vegetative symptoms of depression, these authors unwisely generalised that chronic pain in such people is a manifestation of depression. 

***

EFFECTS OF PAIN ON PERSONALITY

Although Engel (1959) and Blumer & Heilbronn (1982) correctly described factors predisposing to the genesis of chronic painful syndromes in a selected group of patients, the generalisations they made dissuaded colleagues working in this field that the biopsychosocial model espoused by these psychiatrists was necessarily relevant (Engel, 1977). Later studies showed that the development of psychiatric illness more usually follows the development of the chronic painful condition, and ‘pain-proneness’ is not demonstrable in most patients (Gamsa, 1990). The reason why most people in pain complain of distressing symptoms is because of the debilitating and demoralising effects of the pain itself. This contention was supported by an intriguing study carried out 20 years ago. At that time the Minnesota Multiphasic Personality Inventory (MMPI) was a widely used tool in the investigation of those with chronic pain. The typical profile of an individual who had developed chronic pain and had the psychological disposition to do so was a component of high scores on the neurotic triad, the depression, hypochondriasis and hysteria sub-scales, of this instrument. This picture was found in a large proportion of a group of patients being assessed for backpain surgery. By chance, a number of the individuals concerned had previously been tested with this instrument in an earlier epidemiological study. In these people it was found that their premorbid profiles were within normal limits, strongly suggesting that the painful condition from which they were suffering was responsible for the apparent change in the personality picture (Hagedorn et al, 1985). Love & Peck (1987) later showed that this particular MMPI profile found in patients with chronic pain did not represent previous personality functioning but was a consequence of disability.

***

SOMATOFORM DISORDERS

 

A minority of patients with chronic pain do fulfil the criteria for the diagnosis of a somatoform disorder. In such conditions there is continued presentation of physical symptoms together with persistent requests for medical investigations despite negative findings of organic illness and reassurance by doctors that the symptoms have no physical basis. The diagnosis par excellence of a somatoform disorder is somatisation disorder, where pain is just one of many symptoms exhibited by the (usually) female patient. This diagnosis is not common, ranging from 0.2% of patients referred to a liaison psychiatry service (Smith et al, 2000) to 5% of medical patients (Fink et al, 2004). This figure is higher than the previous figure of Smith et al (2000) because Fink et al (2004) used ICD-10 criteria. The ICD-10 diagnosis of persistent somatoform pain disorder was 1.5% in this same population (Fink et al, 2004). This low figure is not too surprising, as the latter diagnosis can be made only if the pain described by the patient ‘ occurs in association with emotional conflict or psychosocial problems that are sufficient to allow the conclusion that they are the main causative influences’ (World Health Organization, 1992: p. 168). Contrast this with the diagnosis of pain disorder listed in the somatoform disorders section in DSM-IV (American Psychiatric Association, 1994). For this diagnosis to be made, ‘psychological factors are judged to have an important role in the onset, severity, exacerbation, or maintenance of the pain’ (p. 461). Although cases largely due to physical illness are excluded, as also are cases where the pain is ‘better accounted for by a mood, anxiety or psychotic disorder’, more cases with pain and emotional sequelae achieve this level of diagnosis on the DSM-IV schedule than on ICD-10.

The differentiation of the somatoform disorders has been questioned (Wessely et al, 1999). The problem with the diagnosis of somatoform disorders in general and of somatoform pain disorders in particular is the judgement required that the symptoms manifest are due to psychological factors. It is not easy to determine this objectively and most psychiatrists working in the area are aware that physical and psychological factors both contribute significantly to the presentation (Mayou, 1991; Merskey, 2000). The evidence of psychological causation cannot be assumed from a history of previous risk factors. The reporting of unexplained pain symptoms as due to previously experienced psychological trauma has been found to be an artefact of retrospective self-report rather than a consequence of actual events (Raphael et al, 2001). This being said, there is evidence that some non-organic pains arising in adolescence have a psychogenic basis (Hotopf et al, 1999).

The value of the present classifications of these syndromes has been brought into question because of the imprecise categorisation of such disorders and the fact that many patients fall into the category of undifferentiated somatoform disorder, a watered-down version of somatisation disorder (Bass et al, 2001; Sharpe & Mayou, 2004). Dimensional assessment of pain on the axes of nociception, evaluation of pain, mood consequences of the pain and pain behaviour (Karoly & Jensen, 1987; James, 1992) may be of greater clinical relevance.

***

BOOKS ON PSYCHOSOMATIC PAIN

Edward Shorter, the prominent medical historian, has shown how the symptoms of psychosomatic illness have changed over the years. He believes that these symptoms are presented according to the prevailing culture. In the early 1800s, for example, a current concept to explain back pain was spinal irritation, caused by pressure at specific spinal tender spots, leading to nerve and muscle pains. Shorter's contention is that psychosomatic symptoms are selected carefully from a culturally determined symptom pool to give the impression of origin from an underlying organic disease, thus avoiding ridicule (Shorter, 1992). This assumption is supported by the changing terminology of diagnostic labels such as hysteria and neurasthenia.

A recently published book argues that fear of pain explains the high prevalence of psychological distress in patients with chronic pain (Asmundson et al, 2004). There are two schools of thought to explain why a minority of people behaves in this way; these are interrelated. One claims that a catastrophic meaning is placed on the experience of pain because of the fear of injury or re-injury. The other suggests that fear of pain is due to fear of anxiety-related sensations associated with painful episodes. This hypothesis has led to treatment by graded exposure to such situations to enable individuals to learn to manage both anxiety and pain together (Vlaeyen et al, 2002). For more general reading on psychosomatic disorders, books by Chris Bass (1990) and Peter Manu (2004) are recommended.

As is usually the case with a medical condition that is imperfectly understood and has no established cure, there is a plethora of books for sufferers from pain. One that has received considerable plaudits from patients is The Mindbody Prescription, on treatment for back pain (Sarno, 1998). Dr John Sarno believes that tension is the underlying cause of many back problems. He states ‘ Pain serves to smother the emotions so they don't break through to the conscious mind. The brain produces these symptoms as... a distraction to make sure your internal rage does not come out’ (p. 39). Although treated with scepticism by his medical colleagues Dr Sarno is clearly appreciated by many pain sufferers in North America. A useful part of the therapy process is educational, in the form of a lecture presentation in which the temporal relationship between emotional feelings and pain is recognised. 

***

THE FUTURE

The specialty of pain has grown considerably over the past 25 years and the influence of the psyche on painful symptoms and vice versa has become much more widely recognised. The difficulty in disentangling the mechanisms involved in this relationship will be clear to those who have read to the end of this piece. Those wishing to obtain more information are recommended to contact the International Association for the Study of Pain (IASP; http://www.iasp-pain.org).

It is in many ways paradoxical that in the UK the vast majority of doctors working in the pain field are anaesthetists, with only a scattering of pharmacologists, neurologists, orthopaedic surgeons and psychiatrists. The value of psychological assistance is more widely recognised. The IASP recommends that all first-class pain clinics should have at least four healthcare professionals on the staff. This is a rare situation in Britain. Until the field of chronic pain is recognised in liaison psychiatry job plans, there is unlikely to be major input from psychiatrists in the UK into chronic painful conditions. If a Faculty of Pain Medicine or similar organisation were to be designated, this might change.

• © 2006 Royal College of Psychiatrists

***

References

all found here:

http://m.bjp.rcpsych.org/content/188/1/91.full

***Psychosomatic pain by Stephen Tyrer***Department of Psychiatry, University of Newcastle upon Tyne, Leazes Wing, Royal Victoria Infirmary, Newcastle upon Tyne NE1 4LP,UK. E-mail: s.p.tyrer@ncl.ac.uk
(EDITED BY SIDNEY CROWN, FEMI OYEBODE and ROSALIND RAMSAY)

 

 

i DID NOT choose this -i want to be 'ok' / 'normal'

i have no milk or anything fresh and can't get out the blasted door...how can anyone live like this?...and as for stupid social workers and a SAMH worker telling me I'm not trying??...is it ALWAYS wrong to punch someone (i wouldn't, i just feel like it...they make me so so SO angry with their statements like that....WHO WOULD CHOOSE TO BE LIKE THIS?Who would choose to worry about what mental health support workers are going to say because last time she stormed out and left me so angry i smashed a glass in a rage and hurt me? Who would choose to worry about getting in touch with their social worker -who is their only point of contact - because she'll say stuff like "people have it worse than you" ... "i have a big case-load and can't keep dealing with you all the time"..."do you expect me to drop everything for you?" -I KNOW THERE ARE PEOPLE STARVING TO DEATH IN THE WORLD....I KNOW I'M NOT WORST OFF...but WHO WOULD CHOOSE TO be SO SCARED to go outside that they wet themselves when they near the door??????!!!!!!!What kind of existence IS THAT to CHOOSE?!!!!!! I DID NOT CHOOSE THIS....but them, telling me i did -over, and over, and over....DID I???!!!!

no help for the wicked

mental health teams are filled with thee least compassionate people i've come across
(and i've come across right swines -folk who knock me over on crutches, folk who laughed at me because i could only see out of one eye -TEACHERS who laughed at me because i could only see out of one eye!) -and i'd rather spend time in a locked room with all of them laughing at me than with some of the 'professionals' in mental health...

they make you feel worthless...

i overdosed -it was horrible and they humiliated me -they have no idea what other people are going through and inasmuch as i'm glad they don't understand that...they have no EMPATHY for others...how can you be in a caring profession when you lack the ability to care how others feel??!!!!







does it ever make you wonder if they're there to push you over the cliff in the direction you're fighting to not go??? - is THAT what they're REALLY paid to do???!!!


There should be a rally ...a group slap-in-the-face-to-all-the-lack-of-caring-folk-in-'professional'-jobs-where-they're-in-contact-with-vulnerable-people...

 
People with mental health difficulties don't speak up enough...this is where the holes in the net aren't being sealed...i'm so angry for us all right now that i have to go offline for a bit before i go into UTTER-RAGE-MODE and swear and what not..don't want to swear...

a problem shared is a burden shared...

"Asking for help when things are tough dose [sic] not mean you are weak. It is very important to recognise when things are getting serious and your mental health is low, especially when it interferes with your ability to cope on a day-to-day basis. Mental health problems range from stress and worries that all of us experience at some times in our lives.
With the right support, many people manage their mental health problems and lead fulfilling lives.

Remember: A problem shared is a problem halved"

found this quote tonight...

but
...what if every day of your life is a mental-health-low day? Do you call for help every day?
...what if every day you're unable to cope with 'normal' or 'easy' things? Do you call for help every day?
...what if every time you call for help you're not halving the problem...you're sharing it, sure, but you're burdening someone else -even if they ARE paid to listen ...you're still burdening...