Psychotherapy Assessment

Well this morning at 9.30am was my long awaited appointment with the outpatient team at a psychiatric hospital in Bristol, for a referral to a psychotherapy program. The day didn’t start too well, despite getting up early enough to go for a 6 minute run (I can’t manage any more yet!), pack for tonight (I am staying at Jens as I have a training course near her house tomorrow) and have a shower, wash my hair and shave (pole dancing tomorrow night… say no more!). I left on time, but unfortunately got held up in really bad traffic, then I couldn’t find a parking space, and because I am so disorganised I didn’t have the letter telling me which part of the hospital I needed to go to. I started to panic, started to blame myself for being useless.. but thankfully then came across a sign pointing to Psychotherapy outpatients and knew I had found the place.


I was sat in the waiting room with several other people who didn’t seem quite ‘normal’ … I know this sounds judgemental but you know there are some people who are ‘with it’ but suffer from a condition or disorder, and then there are some people who actually have a physical problem/disability. I felt quite awkward sitting there whilst they were both talking to themselves and rocking. I wasted a little time wandering around the waiting room and looking at this thought tree:



When my psychiatrist came down for me my first impression was good, she is called Sarah and came across as very approachable and friendly. She took me through a maze of corridors and doors to a small room with two chairs, a coffee table in between and a window. We started to speak about my life, and problems I am currently experiencing. I explained that I have worked hard over the past 18 months to find coping mechanisms which are not self destructive, and that I had not cut since October last year. I explained that my biggest problem at the moment is my interaction with people, that most of the time I don’t know how to act/behave/what to say, and as a result I can be seen to be rude, or isolated. We went into some depth about where I thought my BPD may have come from, and we spoke a little about my relationship with my parents, and in particular, my mother. I also told her that although on a day to day basis I can remain functional, and hold down a full time job (even though there is a lot of leeway made for me), there are phases of time, in particular the evening, that I start to feel vulnerable, and get strong urges to harm myself, or worse, to end my life. I explained that I have two friends that are very close to me, Jen and Kim, and it because of them that I do not do anything to myself – because I know the pain that they would feel. Them feeling like that is worse than anything I could feel. I told her about this blog, and she seemed to be quite impressed that I had come so far on my own, which did give me a little sense of pride.

She told me that unfortunately there are no places on the DBT program at the moment, and won’t be for quite some time as there is already a waiting list. However, there is a space available on the MBT program, which is available now (Mentalisation Based Therapy). She said that although she agreed with me that DBT is suitable, sometimes DBT can be more useful for those in urgent need of distress tolerance skills, which I am not. She said she felt that the MBT would really help me – it is for 3 hours per week (1. 5 hours of group and 1.5 hours of individual therapy) for 18 months and based at the hospital. The only problem I have is money. When I got back to the office, I told my mum about the program offer and she told me that if I wanted the time off, I had to take it unpaid. Although because we have the NHS in the UK, taking time unpaid, with travelling time this means I could lose up to as much as £200 a month wages, and that doesn’t include time that would be lost if I am unable to return to work after the group session (she said this might happen). With all my outgoings such as the mortgage, insurances, food etc, I really don’t know if I can afford to lose another £200 per month, especially as I have just last month stopped receiving DLA, which meant I lost £400 per month. I just don’t think I can justify the cost, and I feel like giving up.

I feel very lost, like I have been desperate all this time for the help I need, and now I have been offered it, I’m not even sure I can take it up. I have another appointment with Sarah in two weeks to discuss my options and whether I would like to enter the program.


  1. On one hand you have to, you know yourself how hard it is to get mental health help from the NHS. On the other I completely unrest and the money. I struggle to make ends meet but can’t do the things that would help me because I can’t afford it but don’t think I qualify for any DLA help. Would the reduction in hours make you eligible again for it? Maybe speak to the spelled in the know on that for advice. If you are aware of hospital time they can’t force you to take this as unpaid. They have to look at other options for instance work the time at starts or ends of other days. Legally she cannot say you have to have it unpaid.

  2. That’s a good thought actually. I don’t think I would qualify for DLA anymore. I was on the high rate care and low rate mobility but it ended last month and didn’t bother to re-apply because I have been doing so well and don’t require the help. But you have made me think I could ask to work late on the day I have the group, so although I miss 3 hours of office time, I could potentially finish at 8pm instead of 5pm – probably not the best idea seeing as the psychiatrist told me I might not even be able to work after the group session let alone do a longer day – but guess needs must and I will have to cross that bridge when I come to it. xx

  3. I think it is always worth at least applying for DLA again. You may not get it at the same level you were getting it at; but any income at all is worth it? It sounds like this MBT is a great offer and it would be a real shame to miss out on it. I hope you aren’t feeling too wired after a long intense assessment like that! x

  4. could you not make up the time an extra hour on the other days of the week but I have to say that times it seems like your mum is the one that should be in theory not you I know some people are not naturally maternal but most at least make the effort to put their kids first

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