Debbie

Age at interview: 37

Brief Outline: Debbie’s elder daughter started self-harming when she was about 9 years old. She developed an eating disorder and has been an inpatient, but is now improving with dialectical behaviour therapy. Debbie is positive about the future.

Background: Debbie, aged 37, is married with three children aged 16, 14 and 12. She works part-time as a midwife. Ethnic background: White British.

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Debbie’s elder daughter started self-harming when she was about 9 years old, after her grandfather died. She was head banging and pulling out her hair, and the family thought this was due to stress. The behaviour increased, so they took her to the GP, who told them it was a phase and that they should just keep talking about it. Her school noticed that she was becoming more anxious and showing obsessional characteristics, so offered her counselling. Debbie doesn’t think this was very helpful as it was focused on building her daughter’s self-esteem and her daughter felt uncomfortable talking to a male counsellor; the self-harm continued. The counselling stopped when Debbie’s daughter went on to secondary school, but she was bullied and her confidence plummeted. The school gave Debbie details of a local team who offered six sessions of counselling. When this finished the family had no support until Debbie’s daughter developed anorexia. She continued self-harming. Debbie tried to get her seen by the mental health services but the GP told her there was an eighteen month waiting list. Debbie wrote to her MP and her daughter was soon seen by the Child and Adolescent Mental Health Service (CAMHS) and eventually admitted to hospital for several months. Her eating disorder was controlled but her self-harming became worse. She is now having dialectical behaviour therapy (DBT). 

Debbie feels that all the support is targeted at her daughter and how the family can support her in getting better. She would like more support for the family and advice on how to deal with the self-harm and how much to involve her younger children. She felt that the six-week counselling course was focused on asking her daughter about family relationships in an intrusive way so neither she nor her husband took part in the sessions. She thinks the inpatient experience made her daughter’s self-harm worse – she started using blades and razors, and said that when other people in the unit were self-harming quite badly she would feel a failure if she didn’t copy them. Her daughter was prescribed an antidepressant which made her feel suicidal; now that her medication has been changed she no longer has suicidal thoughts. Debbie felt excluded from her daughter’s care, and thought she was being judged because she wanted close contact and information about her daughter’s progress. 

Debbie says her daughter’s self-harm has been very difficult for the family emotionally – they felt they were walking on eggshells a lot of the time, and worried every time she went up to her bedroom alone. Debbie is open in talking to her daughter about her self-harm, but her husband finds it harder to talk to his daughter about how he feels, so Debbie often acts as a go-between. She thinks her husband blames himself for not noticing their daughter’s problems earlier. He is very supportive of Debbie, but sometimes they are so worried about their daughter that all their energies are focused on her. Debbie’s other daughter is not fazed by her sister’s self-harm and can talk openly about it. Her son doesn’t like talking about it and would like to keep it secret from his friends. Debbie has taken a career break from her work for a year so she can be at home when her daughter needs her.

Debbie and her sister have been treated for OCD (obsessional compulsive disorder), so she was able to recognise her daughter’s symptoms.

Debbie has found support from families in an eating disorder group and a DBT group. Some of her friends didn’t understand her daughter’s behaviour, blaming it on attention seeking, so Debbie has lost contact with them. She has found the Young Minds website helpful with specific questions. She would like a local support group for families in the same situation.

Debbie’s advice to other parents is ‘You know your child. Trust your child, trust your instincts’. There were times when she sided with the health professionals, thinking they knew best, but wishes now that she had trusted her own instincts and listened to her daughter. To health professionals she says ‘Listen to their mums – they know their children.’

Debbie is pleased to see her daughter with more hope and positive plans for the future.

Debbie’s daughter said she felt like a failure if she didn’t self-harm because everybody else in hospital was self-harming.

I’ve had talks with my daughter because, obviously, from our point of view, when we see her going in there, we had the idealistic view, you go into hospital, get better and come out like you would with a physical ailment I suppose. But she went in and really deteriorated.  We couldn’t understand it and we were asking our family therapist at the time what,’ is this normal?’ and she was like, “Yes, a lot of young people do this.” But it, there was a tendency to have a knock-on effect that if somebody else had self-harmed in the day, it would trigger other youngsters to do the same thing. So I had this talk with my daughter and she said that she feels like a failure if she didn’t self-harm because everybody else in there was self-harming quite badly, if she didn’t do it, then she felt like a failure and she shouldn’t be there. So that’s why the self-harm then it went onto blades and razors and things like that.

When Debbie’s daughter told her friends that she self-harmed they were very supportive.

And what’s it been like at the school, do you know? I mean has there been any, has she got friends at school who do the same sort of thing or? 

No, she kept it very closed in, when she went back, because she left mainstream school when she went into hospital and then she was adamant she was going back to do her GCSEs when she came back.

Right.

And she went back but she told them all that she had glandular fever and that she didn’t have any issues so nothing was ever discussed so none of her friends, however, she left school in May and she’s got a big close-knit group of friends that have just suddenly built up again and they’re out and about all the time. And the last month she’s opened up and said that she self-harms and they’ve all been really supportive. None of them actually do self-harm but they have said, “You can always talk to me.” So…

Debbie’s son and daughter reacted differently to their sister’s self-harm.

Yes, and what about her younger siblings?

Yeah, my youngest daughter is quite the opposite to her really. She’s outgoing and confident. She doesn’t seem to be fazed by it and she can talk openly about it. She’s not they, we all know, obviously. We’ve never kept it from them. They know that she self-harms and my youngest daughter will talk to her and say, “Have you self-harmed? Are you feeling down today?” But my son, on the other hand, he is very much like his dad and closed up and he doesn’t like talking about it and he’s got an issue because they both went to schools next door to each other and there’s only two years between them.  So a lot of their friends are brothers and sisters as well.

Right. Yes.

And that’s caused an issue because my son won’t say to any of his friends what his sister, where his sister’s been, when she’s been in hospital for six months, and there’s been a big issue because he’s just kept the whole thing secret so none of his friends know. He doesn’t talk about it because he thinks that people will bully him if they say, “Oh your sister self-harms.” Or anything. They’ve been swimming a few times but he won’t go swimming with them and my daughter thinks it’s because he’s embarrassed of the scars because if his friends were about, they might ask him what’s gone on. So that’s quite difficult between them two.

When Debbie first took her daughter to the doctor he said it was ‘just a phase’. Later her treatment was delayed because of confusion about his referral.

My daughter has been self-harming for many years. She’s sixteen now but the self-harm started about aged eight or nine but, at the time, as a family, we didn’t realise it was self-harm. We thought it was a phase she was going through because her granddad died and she started head banging and pulling her hair out and we thought it was to do with stress. We got to when she was in year six, so she would have been about ten or eleven and we started noticing it was happening more and more. Took her to the GP, the GP dismissed it and said, there wasn’t a problem, it was a phase and it’s bereavement and just keep talking about it, which we did do. 

And then by Christmas, she’d lost a massive amount of weight and she started looking really ill and I said to her, “This isn’t right.” I went to the GP and said, “I want her referred. I’m not happy with what’s going on.” At that point, the OCD and the self-harm was linked as well. I could see them two were linking and he said he’d put a referral in. 

It got to February two thousand and twelve, she’d now lost three stone and she was fainting and I went back to the GP and said, “I haven’t heard anything. I’d read on websites that eating disorders should be seen quite quickly in mental health services and I’ve not heard.” He said, “I’ll put another referral in.” He put another referral in and, at that point, I just wrote to the MP and said, “Look, I’m watching my daughter die. You’ve got to help me.” I wrote the letter and within four days, the CAMH service phoned me up and she said, “I’m really sorry but your GP put the referral in wrong. He put it in as OCD and didn’t mention the eating disorder, which is why she was at the bottom of the list.” I said, “No, it’s the eating disorder.”

It was hard for Debbie to be apart from her daughter when she was admitted to a psychiatric hospital.

I struggled. I found that really hard. We’d never been apart and none of, all my children kind of always been here. I don’t go anywhere really without them and she went into hospital on this Thursday evening and they took her in. Didn’t, I was in for the first interview bit of saying what was going on and then we was told to leave. We wasn’t shown where she was, her room, we didn’t know where she was sleeping and, from that point on, we wasn’t allowed back on the ward. We had to meet in a room out on reception. I visited every day. 

We got comments that I was jeopardising her recovery because I was visiting every day. They told my daughter that she needs to get out of her mother’s womb. She needs to separate herself. We would phone every night but I’d leave because it was quite a distance so I drove, travelled home, she’d worry because her OCD was related to keeping her family safe, she’d worry on the drive home that something bad was going to happen so I would have to phone when I got home, to make sure that I was okay. She’d then go to bed. We’d get comments. They would stop her using the phone. They would pretend that she wasn’t there so I couldn’t talk to her. I’d had meeting upon meeting with the hospital saying that, “I don’t understand what you’re doing because you don’t want to stigmatise mental health yet I feel that, as a profession, that’s what you’re doing because if took my daughter into a general hospital with a physical complaint, I’d be by her side. I wouldn’t be questioned. I wouldn’t be judged.” I said, “But I feel like I’m being judged here.” I said, “I’m here because I want to help my daughter recover.” I fought so hard to get help and now it’s as if I was handing my car over for a service and they would give it back to me when it was mended.

Yes.

And they said that they would have a look into it and do meetings. We wasn’t told. We had a ward round every week. They would phone us up. They was never phoning me. They always forgot to phone. I’d have to go in on the Tuesday and say, “What happened on the ward round?” When she came home on weekend leave, we got a great diary that we had to fill in, her mood, what she’d eaten, had she self-harmed, how she, her physical state, was she clean, did she wash? But yet, she was in hospital all week and I never got any of that. I never got told whether she’d eaten. Whether she was, got out of bed. Whether she went to the school. Whether she self-harmed. 

On one occasion, she was in hospital, she smuggled a blade in. She self-harmed in the toilet and nobody told me. Only, luckily, I’ve got a relationship with my daughter, she come out that night and said, “Mum, I need to tell you, I’ve self-harmed today.” And I asked them why they didn’t tell me and they said because of confidentiality. And I said, “This is my sixteen, fifteen.” Well, at the time she was fifteen, “This is my fifteen year old daughter. I need to know.” And they said, “You don’t need to know. We can only tell you if [your daughter] kind of lets us know.” At one point she tried to hang herself in her bedroom and I was downstairs and they didn’t tell me. So bad, bad, awful time, which has probably led me to kind of do this really.

Yes.

To highlight how important it is for parents to be involved, because…

And it isn’t just me. I’ve spoken to various families now that have had this problem with inpatient services. The only good thing from the hospital was they got her into a different department so we’re not under our local CAMHS any more. We go up to London and she’s under a service up there, which is thank goodness, that she got the funding and she’s getting the treatment she needs now.

Debbie chose not to be involved when she thought counsellors were too intrusive.

And so were you involved by those counsellors at all?

No, but that, actually that was my choice not to be involved at that point because I found them very, they were kind of targeting us as I felt like as a family, they was, was their problems, they were trying to say to my daughter like, “Is there problems between you and your mum’s relationship? What’s your dad’s relationship like? How do your mum and dad get on?” Very inquisitive and it was as if they were putting words into her mouth and then I was worried that they were thinking so I was like, “Well I’m just standing back and she can do what she needs to do.” So my dad took her to them sessions for the six weeks but he just stayed outside. She went in on her own.

Debbie lost some friends because they didn’t understand.

I’ve lost a lot of my friends because they didn’t understand. I would be talking about my daughter self-harming or wanting to die and they didn’t understand it and I got comments like, “She’s attention seeking. Just tell her to get over it. She’s only fifteen. What’s she got to be depressed about?” So I just kind of pushed a lot of my friends. I just thought, “I can’t.”

Yes.

“I’ve got enough to deal with at the minute to worry about what you think about it.”