Susan Z

Susan’s younger daughter cut herself in her early teens. She now lives in Australia, where she has been depressed, has overdosed, and was recently diagnosed with borderline personality disorder. Susan is anxious about her, but hopes her therapist will help her develop better coping strategies.

Susan discovered that her daughter was cutting herself in her early teens, probably in the context of volatile relationships with her friends. Her daughter said cutting helped her feel better, and Susan thinks she wasn’t doing it to attract attention because she had been doing it secretly for a while. Susan took her to their GP, who reacted by scolding her and telling her that she would regret the scars when she was older, which made Susan’s daughter furious. The GP arranged for the family to see a counsellor. Susan thought that her daughter might have preferred to see the counsellor on her own, as she didn’t open up very much and said she didn’t want to continue. Susan now thinks that further treatment at that stage might have been beneficial. Her daughter stopped cutting but still had problems with relationships and occasionally suffered from depression. Her parents paid for a private psychologist who was helpful. She was on a waiting list for a mental health support group for over a year but didn’t hear anything back.

Susan felt very scared when she discovered the cutting, and confused about why someone would put themselves through physical pain in order to feel better. She also felt guilty that she might be doing something to cause the behaviour, and very sad that her daughter had not been able to confide in anyone. Susan thinks her husband felt the same, but he doesn’t show his emotions very much and tends to get angry rather than upset, although he never expressed this to his daughter. Susan says her elder daughter finds it hard to understand, and sees her sister’s behaviour as attention seeking and manipulative. The main impact on the family was that they were very anxious and kept a close watch on her for a while.

When she was aged 22 Susan’s daughter decided to move to Australia, and seemed very happy there at first, but then moved to a more remote area where she couldn’t get a job and ran into financial difficulties. Susan and her husband were in regular Skype contact with her, but although she told them that she was depressed and having trouble with her boyfriend, she did not let them know that she had started cutting again. She told her friends that her parents didn’t care about her and weren’t supportive, so they hadn’t contacted Susan. Eventually one of them did tell Susan that her daughter was cutting herself. Her flatmate and boyfriend had looked after her when she was cutting, but she didn’t tell her doctor or go to hospital.

Susan’s daughter was treated with various antidepressants, none of which seemed to be effective, and had started seeing a psychotherapist. She came back to the UK to visit her parents for several weeks and had a happy time. She told her sister that she had been diagnosed with borderline personality disorder (BPD) but did not agree with the diagnosis. Susan and her husband looked up the criteria and thought she matched most of them. On her return to Australia she found a new boyfriend with whom she had a volatile relationship. After a row she cut herself and took an overdose and was admitted to a psychiatric ward. The boyfriend contacted Susan and her husband, and since then has been in touch with them when another episode occurs. They didn’t know what they could do friends advised them to go and bring her back, but they thought it would be better if she could be enabled to cope for herself. Susan’s husband went over to stay with their daughter for four weeks and for most of the time she was very happy, but would become emotional and out of control when arguing with her boyfriend, who tended to react violently. One week after her father’s return she took another overdose and texted her parents to say that she was worthless and couldn’t handle life any more.

Susan and her husband had joined a mental health support group, where they were advised to contact the therapist who was treating their daughter. They did this, and let her know that they would do anything they could to help. They have found this a great support, and have been able to ring the therapist when their daughter is in crisis. The therapist keeps them updated about their daughter, who has agreed a crisis plan and is a lot more settled. Susan suggested that her daughter’s boyfriend went with her to the therapist, and this has been very helpful.

Susan says it is a huge relief to be in contact with the therapist as she and her husband were feeling pushed away. They had wondered if they had been at fault, but after reading more about BPD they wish they had known earlier and could have understood better how to deal with it. Susan is still anxious, especially as her daughter is so far away, but thinks she is much better at validating her daughter and being compassionate and sympathetic, and is pleased that she is now able to help her. She says it is reassuring to understand that her daughter’s behaviour is not malicious. Her husband prefers Susan to deal with the emotional aspects of self-harm. Susan sees the overdoses and cutting as two different things. The cutting is there to relieve pain, and Susan hopes the therapy will provide alternative ways to do this. Susan says I can’t tell her to stop it because I think in the moment it’s all she’s got, and I don’t like it but I just don’t feel I can say Don’t do it. Susan is more scared about the overdoses when her daughter feels that life is not worth living, but holds on to the fact that her daughter tells people she has taken the tablets, even though she hates going into hospital.

Susan’s daughter has had long-standing pelvic pain which doctors in the UK did not appear to take seriously, but she has been referred for an operation for endometriosis in Australia, which Susan hopes will solve the problem. She is moving into a new flat with a flatmate, which will help with her financial situation. Although her daughter is still anxious, Susan tries to reassure her that she will benefit from the Dialectical Behaviour Therapy offered by the therapist. Susan is going to visit her soon.

As well as the mental health support group, Susan and her husband have joined a group for carers of people with complex needs. They have found this very useful in providing information and hearing other people’s perspectives and advice. Family and friends have been supportive once they understand the situation. Susan has found help through books, websites, and several YouTube videos for people with BPD. She would have liked more information on mental health issues earlier, and thinks it would be useful to have short flashcards summarising the main points.

Her advice to other parents is to find out as much as you can and try not to feel guilty, to develop a thick skin and not take your child’s behaviour personally. She recommends joining a support group or online forum, and that parents should liaise with the health professionals who are treating their child. She advises clinicians to try to understand self-harm rather than see it as attention seeking, to take people seriously, listen to them, and be compassionate.

Susan Z was disappointed with her doctor’s response to her daughter, but pleased that the doctor arranged for them to see a counsellor.

Age at interview 58

Gender Female

We took her along to the doctor, you know, because we obviously realised there was something emotionally, you know, wrong and she needed some help.

And I was very disappointed when, as was she, with the response of the doctor. I think I got the impression that the doctor was, well, I know this doctor is particularly good with dealing with people with depression. Shes been really good with my neighbour, who had who had problems, and she spotted it and she helped her and she did a really good job. But her response with my daughter, was just to tell her off. She just said, Oh, you mustn’t do that. You mustn’t cut yourself. You know, you’re going to leave scars and when you get older, you, how do you think you’ll feel about that? And I know [my daughter] was absolutely furious. Yes. I know my daughter was really furious about that.

Yes.

And but she did organise for us to go and speak to a counsellor so we all went along to to that and she seemed very good and [my daughter], my daughter felt, my daughter seemed quite comfortable with that.

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A diagnosis of borderline personality disorder meant Susan Z’s daughter could now receive dialectical behaviour therapy (DBT).

Age at interview 58

Gender Female

But she was also going to, having been referred to another psychiatrist so she was having another consult there. So she went back in October and I think it was about January this year that she had the diagnosis again of borderline personality disorder.

And she started off again, you know, saying, It’s not that. It’s not that. And but then, she started to settle down and she said, shed you know, shed looked online and shed looked into it and, actually, she, you know, had to admit that, you know, she fits the, she fits the criteria and what have you. We did look into it to see what kind of therapy she was already getting because we knew she was being treated for depression and we weren’t sure whether that was going to be the right kind of therapy for the new disorder. But, apparently, the therapist she is seeing does do dialectical behavioural therapy* [DBT] so, you know, that seemed spot on.

* This is a form of therapy (using individual and group work) that helps the young person to learn skills to manage their emotions, cope with distress and improve their relationships. DBT helps the young person see that their suicidal and other unhelpful behaviours are part of their way of coping with problems and encourages them to develop more helpful behaviours and solutions.

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Susan Z’s daughter enjoyed kinesiology, but Susan was upset when the kinesiologist suggested that parents could be the cause of their children’s problems.

Age at interview 58

Gender Female

I had a friend over here, who had suffered from depression, and she had had kinesiology, which she found really helpful. So [my daughter] had, so my daughter has just been to a kinesiology session and, apparently, they diagnosed that she was she had a vitamin B12 deficiency.

Yes.

Which is interesting because some of the symptoms of that are lethargy and depression and personality changes so hopefully, you know, that might help a little bit as well.

What is kinesiology?

It’s connected with, it’s a little bit like acupuncture, yoga. It’s to do with energies in the body. They’re supposedly, not that I’m a sceptic, they supposedly can detect, you know, energy flows in the body and blockages and things like that. And I wouldn’t necessarily sort of go with it except that my friend almost had a miraculous recovery from depression because of it and another friend was diagnosed with gluten intolerance through it and, you know, and that helped her a lot. And I thought, well, won’t hurt to try it. Won’t hurt to try and but again, we had a bit of an experience with kinesiology over here, which I think she quite enjoyed, she quite liked it but I hated it.

We went to the kinesiologist that my friend had been to, and I went with my daughter and I was a little bit early so I just sort of was waiting in the in the room and then I said, Oh well, I’d better go now then, you know. You don’t want me around. And she said, Oh well, no, I can’t handle it because of, you know, I’m dealing with energy flow so I can’t handle another energy. That’s fine but then she also said, And, you know, we really, it’s really hard for young people to sort of open up in front of their parents because, despite our best intentions, were often the cause of most of their problems. [laughs]. So I thought that was, well, I was, because I was feeling guilty and anxious and already so I felt terrible so I, just, I was really upset about that but I didn’t say anything to my daughter, you know. And she seemed to get something out of the session but at least didn’t dislike it. So she obviously was confident enough to go back and have another session in Australia and that seemed that seems to have turned something up and that’s good.

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Susan Z would like clinicians to take young people who self-harm seriously and be more compassionate.

Age at interview 58

Gender Female

I don’t think enough professionals understand what, where self-harm is coming from and what it’s a response to and I’m absolutely convinced if they did, you know, they would be they would be responding a lot better and I just think, you know, that some that, it’s just such a shame that somebody, you know, goes to somebody in pain and they’re being treated as if they’re not, you know. They’re being treated as if they’re just attention seeking and I think that’s, it’s just belittling. It’s just, you know, and it and given that these are people who feel bad about themselves anyway, I think what they need to be doing is the same as, you know, I’m trying to do, take them seriously, listen to them, take them seriously, do what you can and help them do whatever they can and just be a bit more compassionate I think.

Yes.

But understanding is what it comes down to, doesn’t it.

Yes.

And I think, you know, to be fair, a lot of professionals, and you can understand people in a hospital, they’re rushed off their feet. They’re seeing people coming with all sorts of not self-inflicted injuries and somebody comes in who’s done themselves harm and they think, oh, you know, just attention seeking. But I think if they understood better, they would respond better.

Yes.

And I think if everybody was responding better to somebody in that situation, that’s people close to them and the professionals as well, then I think just being taken seriously and and feeling as if you are understood, I think is the big thing and I think that’s for everybody.

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Susan Z felt scared and confused when she discovered that her daughter was cutting herself.

Age at interview 58

Gender Female

How did you feel at that time and what sort of impact did it have on you?

Well, very, very scared and confused because somebody cutting themselves, oh it’s just beyond, you know, and I supposed a little bit like the doctor, you know, I I was aware that it was going to, it was going to leave scars and she wouldn’t she wouldn’t like that but also that it was dangerous and very confused as to why somebody would put themselves through physical pain and deformity or, you know, defacement to feel better. It – so confused and scared and guilty because, you know, again you think is it something that I’m not doing right that’s making her do this? And the fact that she didn’t come to me before she did this and, you know, work it out that way rather than. And very sad, you know, that that she, that that was her only way to get some sort of release. I mean, you know, that she didn’t have friends she could talk to, that she couldn’t talk to her sister, that she couldn’t talk to us.

Or that she didn’t see that would help.

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