About What the Notes Don’t Say

People keep moving. The notes don’t.

What the Notes Don’t Say is an independent publication exploring mental health, therapy, trauma, and treatment from the patient’s side of the therapy room.

There is a paper version of our lives in mental-health care: diagnoses, treatment plans, progress notes, assessments, and interventions. They capture important moments. But they cannot capture everything it means to live through them.

People change. Our thoughts change. Our behaviours change. The ways we cope change. The professionals we encounter may understand us through different therapeutic or clinical lenses, while the fields of psychology and psychiatry continue to evolve too.

Somewhere between what is recorded, what is understood, and what is actually lived lies another story.

That’s the territory this publication explores.

Why What the Notes Don’t Say?

Mental-health treatment is rarely a simple story of something either working or not working.

Treatment can help enormously while still leaving difficult questions behind. A therapeutic approach can give us skills we carry for life, while individual experiences within that treatment can be challenging and, sometimes, damaging. We can make progress that nobody else notices. We can also look back at an earlier version of ourselves and understand our behaviour very differently.

Both things can be true.

That idea — the ability to hold seemingly opposing truths at the same time — is something I encountered through Dialectical Behaviour Therapy (DBT), and it has become part of the philosophy behind this publication.

I’m interested in the grey areas: what helps, what doesn’t, what changes, what gets misunderstood, what we learn, and what happens when clinical theory meets the considerably messier reality of being human.

From the patient’s side of the therapy room

I’m Elizabeth Bell, a pseudonymous writer with lived experience of mental-health treatment.

I use a pseudonym deliberately. Mental health asks us to reveal extraordinarily private parts of ourselves, and I believe it’s possible to write candidly about those experiences while maintaining boundaries around the parts of our lives we choose to keep private.

The name also carries a small piece of the story.

During DBT, the sound of a bell could mark a shift in attention — an invitation to return to the present moment. That image stayed with me.

In some ways, that’s what I want this publication to do: pause, pay attention, and look again at experiences that can become compressed into diagnoses, clinical language, and treatment outcomes.

Not to prove that one version is right and another is wrong.

To ask what else there might be to understand.

What you’ll find here

I’ll write about therapy, trauma, DBT, psychiatric treatment, diagnosis, therapeutic relationships, and the changing ways we understand mental health.

There will be difficult experiences.

There will also be positive ones.

I want to write about the ways in which therapy has supported me, as well as what happens when therapy goes wrong. The treatment that changes something. The skills that unexpectedly stick. The absurdities of navigating mental-health systems. The humour that somehow survives in waiting rooms and ward corridors. And the small pieces of progress that might never warrant a line in anyone’s notes but can feel enormous when they’re yours.

I’ll also explore psychological theory and research, particularly around trauma, through the eyes of someone who has encountered those ideas from the other side of the consulting room.

This isn’t an anti-therapy publication.

Nor is it an advertisement for therapy.

It’s somewhere in between.

Because that’s usually where the interesting stories are.

A lived-experience publication

I am not a clinician, psychologist, or psychiatrist.

When I discuss psychological theories, therapeutic approaches, or research, I do so as a writer and patient engaging with those ideas. This publication is not intended to provide diagnosis, medical advice, or clinical guidance.

It is something different.

A record of what theory, diagnosis, and treatment can look and feel like when you’re the person living inside them.

And a place for the stories that don’t always make it into the notes.

— Elizabeth Bell