Tuesday, October 27, 2009

Almost in bed... what bed means at nigjt

It's about 12.30, in the middle of the night. I have my ACC data tomorrow and I have just been self-harming, cutting for an hour or so. This is old stuff for me... as you would see if you have read previous post you will see if has been months, the longest ever since I've used this unhopeful coping stratagy. It's a long developed bordorline trait, it took me so long to even seek help, to name what happened to me, that there were many life-saving, but negitive coping stragies I had developed. It now feels that I am regressing with this ACC stuff going on, Every day, every media release, every time I find out something involving my care that is not coming from a caring place, everytime ACC fails to inform me of what's going on, and the more concrete it is that ACC is going to write of the (transparently financially motivated) changes to my care on judging me, what happened to me and there expert opinion on how it is for me today and what I need. I think the outcomes and the potentional level of invalidation scared the shit out of me.

Anyway, this is a brief note about me going to bed. I have to triple check the locks everywhere, the bars on the windows, let all the lights on in the house, sleep with a hammer under one pillow and my mobile with 111 pre-programed in hidden under the other pillow. I have a dog that sleeps in my room. And I still get scared, sometimes to scared to go to sleep (what happens if I am asleep and something happens and because I am asleep I cannot save myself?)... and then knowing how tired I am, how much even getting a little bit of sleep can make all kinds of things in life easier (like choosing toast or cereal in the morning), but also knowing that whether it is one hour or four hours it will end with me having a bad dream and being raped all over again, oftne waking up crying, my pillow damp with tears, screaming (my last relationship destroyed by stuff relating to this issue)....
However I know (and I mean I know) that if someone decides to do something to me, if that bad luck comes my way again, is there really anything I can do to stop it?
When children are little they are told that there are no such things as ghosts and that the mosters in the closet dont exist. Other's that have experienced similar things to what I have, and therefore qualify for a sensitive claim, can't ressure themselves... hang on I should speak from the I....I cant always reassure myself that something bad and scary isnt going to happen. Cause those things do happen. And at the end of the day that is something that I live with everyday. Not being able to reassure myself totally and so it pops up in my head at all kinds of times. Then often there can be domino effect of irrational fear.
God, this all feels so shameful to own.
I do the positive stuff... maybe I will write a list of all the years of positive hard work I have tackled and achieved.... maybe that would be good for me right now...

I got an ACC data tomorrow, and I dont feel safe about it.

Monday, October 26, 2009

Concerned Wise Friend Bangs Head Against ACC Wall

EMAILS ABOUT ME... NOT TO ME

From: CONCERNED FRIEND
Sent: Tuesday, 20 October 2009 11:04
To: Sensitive Claims
Subject: re Danielle

I am very concerned about the current mental state of Danielle who has been receiving counselling under ACC sensitive claims for a sexual assault. I am a personal friend of hers. She was advised yesterday that she has only 5 more sessions with her counsellor and will then be not entitled to any further sessions until she has a review. The date for this review is unclear. Regardless of the future goals and directions of ACC sensitive claims counselling, this woman has had 2 sessions of counselling weekly for some time. She is now dependant on this support for her well-being. ACC have a responsibility in creating this dependence and in my opinion they have a responsibility to continue this support until an alternative arrangement/treatment can be found. This woman’s life is in danger and she needs to be carefully managed if her dependence on counselling is to be reduced. I understood the ACC counselling changes were not applicable to those who were already receiving services but only applied to new cases. This woman is at serious risk of harm if she is not given adequate support and if one support is being suddenly withdrawn, an alternate option needs to immediately be put in place. I am putting this in writing to you because if there is a coroners inquest I want it noted that I warned your department of the serious likely clinical consequences of your actions.

Regards
CONCERNED FRIEND


then.....


From: Kimberleigh O'Hara [mailto:mailto:kimberleigh.o] On Behalf Of Sensitive Claims
Sent: Wednesday, 21 October 2009 9:11 a.m.
To: 'CONCERNED FRIEND'
Subject: RE: re Danielle

Dear 'CONCERNED FRIEND',

Thank you for your email regarding the above client.

I have noted your concerns about this client. Danielle has had over 240 hours of counselling to date, and a Diagnostic and Treatment Assessment is required to advise on whether the treatment she has currently been receiving is meeting her needs, and also what future treatment options will be appropriate. The aim of therapy is to teach clients the skills to manage their symptoms, and it is unreasonable to expect that clients will be free of challenges or problems following therapy. They should be able to use the skills obtained through therapy to cope and manage emotional needs and there should be a focus on relapse prevention right from the start of therapy. It is of real concern to ACC that any client still has acute issues after this length of counselling.

5 Sessions of counselling was given to assist her through this assessment process. If the Diagnostic and Treatment Assessment report indicates the need for further treatment, this will be considered by ACC. Please note that a list of suitable assessors has been provided to the client's counsellor, and the case manager is in contact with the client about this process. Approval has also been given for Danielle to attend 8 sessions of EMDR treatment.

Please be aware that ACC has the best interest of its clients at heart, and carefully considers any decision it makes so as to facilitate the client's rehabilitation. If there are concerns for the mental state of the client the provider and the clients GP has a duty of care to inform the relevant crisis agencies of this and put measures in place to address any issues - i.e. the CATT team through the local DHB which ACC funds through its Public Health Acute funding. I have also asked the Case Manager to inform the client's counsellor and GP of your concerns for the client's wellbeing.

Kind regards
Sensitive Claims


then...


From: CONCERNED FRIEND
Sent: Thursday, 22 October 2009 10:18 a.m.
To: 'Sensitive Claims'
Subject: RE: re Danielle

Dear Sensitive Claims
Thank you for your reply. I am as concerned as you that after 240 hrs of counselling Danielle remains in semi-acute state although I will state her counselling has reduced her risk factors considerably over the past 2 years. She has remained substance free and has not self-harmed now for the longest time since I have known her. Phoning her on her cell-phone when she was in the middle of a medical procedure for a kidney complaint was dangerous and irresponsible. She came very close to taking her life after that phone call. I am not saying I dispute ACC right to conduct a review process, I am however, very concerned at the process of the review process. Danielle will never go near a CATT service. She has had too many bad experiences with them over the years. She has actively self-harmed in last week for first time in 8-9 months and she is as close to suicide as I have known her to be in the 7 years of our friendship. This risk increase is due to the ACC process. Thank you for taking my concerns seriously. I don’t make a habit of complaining or being dramatic. This situation has me very worried for her safety, but I also accept any decision she makes is ultimately her choice. I only ask that the process of changing whatever treatment she is receiving happens carefully and with extreme sensitivity.


then...


From: Selena Dominguez [mailto:Selena.Dominguez@acc.co.nz]
Sent: Thursday, 22 October 2009 10:58 a.m.
To: CONCERNED FRIEND
Cc: James Du Plessis; Sue Walker
Subject: RE: re Danielle

Hi CONCERNED FRIEND,

Thank you for your email below regarding Danielle.

Due to the concerns highlighted in your email I have discussed Danielle's claim with my Branch Manager and we have contacted Danielle's GP, Dr ..........., directly and she is going to get in touch with Danielle immediately.

Regards
Selena Dominguez, Case Manager, ACC


then...


From: CONCERNED FRIEND
Sent: Thursday, 22 October 2009 11:21 a.m.
To: 'Selena Dominguez'
Subject: RE: re Danielle Martin

Hi Selena
Thank you for contacting Danielle’s GP but I think you are missing the point. It is ACC actions and process that is causing the problem here. Don’t palm this off on CATT or GP please. Take some responsibility and adjust your process. That is what I requested. You cannot phone someone on their mobile phone and announce their 2 years of therapy is going to end in 5 more sessions. That is totally unprofessional and clinically unsafe. Danielle needs to be managed very carefully and information conveyed very safely. She has asked this of you already I know and I stress, Danielle will have nothing to do with CATT services or anyone trying to assess her risk. She is an expert at telling them what they need to know and getting rid of them. She knows the last thing CATT wants is a person like her on their caseload so she makes it easy for them to assess her as “safe”.

I will be direct now: What I would like is for Danielle to be informed there will be no interruption in her current level of counselling support until after a review process decides what that level of support should be. Telling her she had 5 more counselling sessions and then a review will decide if she needs more, with no set date for the review, leaves her exposed and vulnerable and that is what is causing her risk to rise. I know you are doing your job, but please try to understand what I am saying in these e-mails and don’t make it someone else’s responsibility. It is yours.





END OF COPIED EMAILS.




I feel as though I am involved in a slow motion car crash. I am making sure as much of what is going on is as documented as possible.
There is many immediate issues that come to mind after I was copied the above...
- Why did ACC intimately discuss my claim with someone who is not one of my treatment providers in any way?
- Why is there information, decisions, directives in the ACC email responses regarding my care that I nor any of my treatment providers have been informed of? Even further there is information stating opposite intentions from an email recieved two days previously by my therapist, ensuring no disruption to my therapy during the data process!
- Who are the people (Cc: James Du Plessis; Sue Walker) who are being copied information about my claim?

I had no knowledge of these emails until I was copied the above in its entirity. I am still unsure about what level of anonymity I am aiming for, therefore the 'CONCERNED FRIEND' substituted for this persons name, not only is this person obviously someone that knows me quite well, but also someone who is well respected and qualified in the area of mental health.


More to write in another post...

I no what is happening isnt right or fair, but I know that doesnt mean that it's going to stop happening.

I'm very very scared right now.

Saturday, October 24, 2009

A piece of my life...

Okay... second post. Ive emailed a friend the link to ask her if she can check to see if it is actually anonymous, like can she work out or see my full name or email address from just looking at the blog. I would like this to be semi-anonymous right now, anyone who knows me will be able to tell it's me from what I write, and maybe at some point I'll let go of that anonymity... got some stuff to write about that, but that is not what I really want to say right now.

So if you've read my first post you'll now know I have PTSD, or Chronic PTSD, or am a survivour of sexual trauma, or an ACC sensitive claim 'customer', or just a girl in the world with many possible boxes to fit into.... or a 30 year old woman who most nights has nightmares reliving different elements of that trauma.
PLEASE NOTE THAT I DONT WISH TO TRIGGER OR OFFEND OR DISTURB ANYONE...so read on now if you wish taking that into account.


(phew...just had to take 15mins out...anxiety got a bit much, harder to write about stuff for me sometimes than to just do whatever I need to do to get further away from 'the content' below... so I shall continue...)

It's 4.30am in the morning, I have been awake now for probably about 45 minutes. My norm of late (for the last 6-12 months) is to be woken from a nightmare sometime between 1.30am-4am. I have been having my nightmares or bad dreams or whatever they are for alot longer than that, many years (once again another post if i get the chance, will talk about it). So I have these dreams. 95% of the dreams that I have involve some part of one of the sexual tramas (I still even struggle with the word 'rape', how's that for shame?), sometimes it is an accurate unaltered replay, sometimes it is portions of it mixed in with elements, situations, people or locations from other parts of my life, sometimes it's mixed in with other current things going on for me, people I've seen (the most upsetting off this recently has been my brother in them, I love him dearly and sometimes after I hang out with him for the day he will be in one my dreams as a witness).
I want to write down what happens in those dreams, hence the warning higher up in this post. Not to shock, or draw attention, but to provide some understanding, not only what it is like for me but as a voice of what I am sure some other survivours of this kind of trauma have been through. But it is so graphic and full on that I am having second thoughts about writing it right now... just because of the level of anxiety that hasnt shifted since I woke.
When I wake up I am terrified, often crying, with an adrenaline rush, like that fight, flight or freeze thing going on. Mostly for me waking from my nightmares it has always been freeze. It could used to take me up to an hour to be able to move, terrified to even make any noise breathing or even shift a muscle. It's hard to explain but it's like the real, logical world, the voice of reason in my head sometimes takes awhile to filter through enough to override the fear and be able to move. The intensity of it is totally illogicial and not only often doesn't make sense during the daytime, but I also can't understand how real the fear always feels. I would repeat to myself a mantra once I could when I woke up at night, there's no-one there, just turn on the light, just reach up and flick the switch, it's ok, there's no one there...sometimes it takes awhile.
These days though I sleep with all the lights in the house on, about 6 or so months ago I decided to take a new tactic (many different tactics over the years, maybe will discuss later)... instead of trying to have a 'normal' nights sleep every night, to for the meantime adapt around my nightmares. Hopefully not a permanent adaptation, but with the first time ever getting a couple of months up not self-harming the nightmares seemed even worse, it was like I had taken something away that took the edge off them. So the last few months I sleep with all the lights on in the house. My goal when I wake is to move as far from the fear/anxiety/emotion/memory of the nightmare as quickly as possible. So having all the lights on helps. Means I dont have as much of the 'freeze' stuff going on as long... the downside of this has been my increased powerbill on a low income. It also means having a routine as soon as I wake. As soon as I am able I get out of bed and make a couple of tea. This has two benefits, it gives me something to focus on to pull me away from the event I've just re-experienced, and also prevents me from drifting off again...in the past ive had a 50/50 chance of eventually falling back to sleep without waking up properly, often I am so overtired because of this cycle that it happens... then the nightmare of the evening either repeats itself, or worse starts up whereever it left off. In the past I have been so sleep deprived that once I manage to get to sleep and I wake from a nightmare, I know that I can't wake up properly, and I know that it will keep going once I fall asleep and I am scared but drift back into it anyway... the most that this has happened for me in one night is 5 times, 5 installments of the same event, the scariest thing is each time I blearerly wake I know what is going to be the next installment because it has all happened before.

Wow, I have written alot again, but there is so much more I feel I need to get down. Part of the reason that I dont talk about this stuff with people is the shame, shame that if they know the full story of what a 24 hour day is like that they will know the things that happened to me. Shame and fear of being judged, for what happened, and how my life is like now. Who wants to be thought of as disfuntional? Who wants people to know that you have been violated in the most intimate tragic way? Not me, not really, not right now.

Once again at this time I am writing, recording parts of my life, story and experience so maybe it might encourage further understanding, less negative stigma, removal of social taboo's that exist in owning up to this sort of thing personally...all of which are helping to contribute to the current government slide new ACC changes and guidelines through parliment, into effect... and put my future recovery and possibly my life in jepordy.

Phew, again.... will write more when I can.

Friday, October 23, 2009

There's more to me than ACC ... but not this week!

I wrote a letter to the author of the above petition about a week ago... am going to paste a copy of the letter I wrote him below. Am normally a private person, but have got to the point that I am scared about what it is happening and whether I am going to make it through alive... I decided today, that at least if something happens to me, then there is at least some record of my story... so first post, first blog, bit nervous, but see below...


12 October 2009
"Hello, My name is Danielle ..........,
I am 31 years old and am a suviviour of sexual trauma. I got your email address off the petition I signed several days ago. I have a very compelling story for there to be a much more comprehensive plan/options available for people with sensitive claims than the plan/options being suggested presently. I feel very strongly that the proposed changes are way off base, and I believe that I have an educated opinion and of course that I understand that it can't just be open ended with no guidelines. I have had an ACC sensitive claim approved for many years. It took me several years before I felt able to take advantage of the counselling available. I have now been in ACC funded counselling for four years, after about 15 years of no support, no therapy and 10-20 years of coping my own way with dealing with my life with no acknowledgement and a progressive serious of very unhelpful and dangerous coping mechanisms. If not for the therapy that I have recieved, and currently recieve I know for a fact that I would not be alive now, and there were some very close calls.
It has taken time for me to be able to learn how to stay alive and work on having a life worth living. I have a fantastic and well respected team of people now after literally begging for help from other public services years ago and not recieving what I needed or asked for 95% of the time.
Up until a few years ago I had no idea of the assistance that I could make use of and that I was entitled to to deal with the problems in my life associated with what had happened to me, it is only through desperation, tenacity and what I have lately become to see as good luck that I have ended up on the path of recovery. I say good luck because I find it hard to attribute a 'choice of disfunction' to the victims of sexual violation that end up living with shame, confusion, anxiety and fear, often leading to disfuntional lives. I don't know the statistics but from personal experience and interaction with others I wonder how many people that, live in disfuntional relationships and go on to either be victims or purpertrators of domestic abuse, become people practising illigal activites, end up in our prisons and sex industry, or are doomed to die from consequences set in motion as a result of these tragic 'events' (sexaul abuse or assult). I could probably write pages about, - my 'Chronic PTSD' and the symtoms (please note I don't support ACC's proposed requirement for a mental health diagnosis, it seems another sneaky way to 'write off symtoms' and try to claim less 'culpability' attributed to the 'event', eg, depression 'stemming' from 'other' sources, enabling less support to be offered... I think the whole perspective of having to prove what comes from where and what is allowed to be worked on a tricky issue, I can see the potentional for abuse, BUT I know for me this issue has actually added to the difficulty of my progress and added to my anxiety.)- telling you my story, my trials and tribulations with ACC, - the value to my life I have recieved after working out how I could avail myself of the services entitled to me- the expertise, qualifications and effectiveness of the 'treatment providers' that are able to assist me as a result of the ACC subsidies- the added anxiety and difficulties I have had over the last 6-12 months as a result of the pressure I've felt from ACC as an organisation- the gaps, problems in system, and propensity for decisions being seemingly driven by financial motivations instead of customer care and the denial of this motivation, that I have observed and experienced after years of being a 'customer' of ACC.
If there is anything I can do to assist in any way please let me know, anything from signing another petition to telling my story publicly (with the support of my therapists in a safe way).
I know that there is problems with the system that need to be reviewed, and that to have a total open ended system is unpractical and in situations can be unhelpful and even in some instances dangerous for the customer.
I know many of the arguements for reduced sessions, tighter restrictions etc, alot of the arguements have merit and definitly need to be considered and taken seriously, however what I always come back to is IF THE CHANGES THAT ARE BEING PROPOSED WERE IN EFFECT SEVERAL YEARS AGO WOULD I BE ALIVE TODAY AND ON MY WAY TO HAVING A FUNCTIONAL LIFE WORTH LIVING. The answer is not good. Is this system about the consumer, and helping the 'customer', or is there another directive?
I felt compelled to write this email after seeing the interview with John Key this morning on the TV3 Sunrise show. They were discussing the ACC 'Issue' and when the Herald Acticle and the sensitive claim portion of ACC was mentioned he seemed to be waiting to be able to shift the focus of the conversation, moving to talking about physiotherapy as soon as he was able. The only thing that he did say about sensitive claims was along the lines of that it needs to be about the big picture and not individual cases. I was shaking with anger. There is so much shame attached to these claims, and I believe that that makes it easy for people in power not to talk about it, whether they realise it or not they are playing on that shame, continuing the cycle of it being something not to be discussed. Part of the problem for me and I think with many people with sensitive claims is getting past the shame and fear in order to not have it rule our lives. Part of what happened was having my power taken away, losing my voice, being denied my basic human rights and dignities. It's one of the hardest things I've had to do to say that's not okay and try and deal with the repurcusions of that, and I really really don't need ACC, an organisation that is meant to be there to help, to be making that harder for me than it already is. Sometimes I get scared just looking at what I have to overcome.
I know this is a long, probably quite passionate email, but I know for many years I would not have been able to get these words out. I have come a long way, apparently I have alot to be proud of (sometimes I am able to see that more than other times), but I know how much more hard work I have to do. I worry of the consequences of me not being assisted with that, or it being made even harder than it has been. And I worry for all those out there who have not found their voice yet, who may never find there voice, and I think it would be terrible if the inadaquicy of the 'system' ended up being part of the problem and not part of the solution.
Once again if there is anything that I can do to assist that more care is taken with changes that are made, someone else that I can forward this email too, or anything else, please don't hesitate to contact me. I know that you must have alot of support, and I would just like to offer my gratitude for your efforts at generating discussion and 'shining the light' on this issue.
Warm regards
..........................."



Phew....so much more I want to say... maybe it might take a few posts and days to write all the injustices that have occurred over the last few days...