All mental health care, all health care, needs to be TRAUMA INFORMED CARE.

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I’m feeling frustrated about the barriers to receiving high quality, publicly funded, trauma informed mental health care.  Especially the barriers faced by trans and gender non-conforming folks.

I know that I’m blessed to live in a country that has free universal health care, but we still have a two-tiered system.  Psychological care, social work and counseling that happens outside hospital settings is fee-for-service.  There are many barriers for those without finances or work place insurance in terms of accessing mental health care.  Based on my own experiences, I believe that medication alone should almost never be the first line of treatment for mental illness, and that medication should never be used without corresponding counseling of some type.   This does not mean that I’m anti-medication or anti-choice or even fully anti-psychiatry.  It just means that I see mental health as more than just a chemical imbalance in the brain.  It means that I know that supportive, validating counseling can be helpful in treating most illnesses.  I highly value feminist based counseling, intersectional approaches, peer support models and any type of counseling where the patient has a say in what happens and is treated like the expert in their own lives.

I’m personally quite negatively biased against cognitive behavioural therapy.  That does not mean that I don’t think it has a place, or that it can never be useful.  I believe it can be helpful with certain types of issues, such as OCD.   But CBT leaves a LOT to be desired in relation to trauma therapy.  It focuses too much on the individual thoughts, feelings and behaviours and too little on trauma, societal oppression and practical barriers.

When I was younger, and I first entered into the mental health care system, my parents found a clinic and doctors that supposedly were experts in the field of eating disorders.  Now, maybe they were good doctors, but I can say with absolute certainty that they were not trauma informed.  I don’t really remember every being asked exactly WHY I had developed anorexia, or if anything had happened to me.

I’m not an expert, by any means, but I know that young people rarely (if ever) develop eating disorders and self harm just on a whim, out of the blue.  Generally eating disorders are symptoms of a larger problem, generally eating behaviours are coping techniques to deal with something.

I was a smart teenager.  I knew to some extent why I wasn’t eating.  I had learned that it was an effective way to zone out, feel lighter, feel empty and take up less space.  I became addicted to that feeling of zoning out, it helped me cope with the sexual abuse I was experiencing.  It wasn’t about my looks, it wasn’t about losing weight and it wasn’t about existential angst (per se).   I’m not sure if anyone actually ever asked me why I wasn’t eating.  And after a certain amount of time had passed, it became irrelevant to everyone.  Nobody cared why, they only cared about me eating so I wouldn’t die.  I didn’t believe I could die.   I’m not sure I REALLY cared if I died. I think I did at that time, but I certainly didn’t care by the time I started taking anti-depressants.  I pretty much welcomed the idea of death and started to think about suicide at 17.

These psychologists I went to see worked from a CBT model.  I remember being 16 and sitting in the psychologist’s office while he drew diagrams of how thoughts impacted feelings which impacted behaviours which further influenced thoughts and feelings.  I quickly picked up on the pattern of it.  I realized that a very specific set of responses were the desired outcome.  I followed the pattern and started saying what he wanted to hear.  I didn’t internalize any of it.  It became a game to me, not a game to manipulate or hurt anyone, but a test to see if I said what was expected if I’d be allowed to go back to school and stop missing music class for the appointments (which to me appeared pointless).

Fairly soon after that, I became physically starved to the point my brain wasn’t really working rationally anymore.  The physical side effects of the disease confused my brain and the restricting and exercising became obsessive to the point of OCD.  The behaviour self perpetuated and I lost track of why I started doing it.  I lost track of what happened to me.  I lost track of the abuse.  I lost track of everything.  I felt panicky most of the time.  I was always cold.

When someone is that sick, no type of therapy is going to work.  Eating is the only treatment.  I went to an inpatient program, started the process of weight restoration and my mind gradually cleared.  I don’t remember being asked in treatment why I starved myself to the point of near death.  I think people were relieved that I was eating and that I returned to some level of semi-normalcy.   I was still thin.  I still had strange eating habits and anxiety around food.  I still avoided eating with most people.  But I was well enough to “pass” as recovered.

I began to recover some memories around the age of 18.  But they weren’t concrete at first.  They were flashbacks, physical reactions, nightmares.  I remember talking about it indirectly to my boyfriend at the end of high school.  Telling him that something had happened with my last boyfriend.  I don’t remember if I shared many details.  I think the idea was only slightly formed in my head.   I didn’t connect the dots and fully disclose until I was 20.

Then I was thrust into the psychiatric, medical model.  I was drugged and drugged and drugged more.  The worse I got, the more drugs were given.  I was medicated to the point I could barely stay awake during the day time. I felt foggy.  I gained weight.   I was diagnosed with PTSD, but I still didn’t receive trauma informed care.

I did an inpatient program for PTSD.  It helped a LOT.  I learned a lot.  But I couldn’t fully actualize the learning because I was on too much medication and I was in an abusive unhealthy relationship.  I knew by then that the trauma piece was at the centre of my struggles, but I didn’t fully comprehend that my current situation was a major factor.

All this to say, that my life story is a testament to the perils of practicing medicine without considering the impact of trauma on physical and mental health.

I’m so passionate about looking at the roots of why people cope in the ways they do.  What societal circumstances and traumas caused them to cope in the ways they do?

Now I’m a parent.  My children struggle with anxiety.  My younger child is transgender.  She has secrets.  There are things she won’t talk about to anyone.  She struggles with focusing sometimes.  I see a lot of signs of trauma and of the impacts of things she has lived through.  Experiencing transphobia in and of itself is trauma.  Being misgendered, people using her old name, being treated as less than a real girl, being told that her mom is crazy for “forcing her” to be a girl….I could go on, but it’s a lot.  A lot for a child.  Rejection by a parental figure is one of the clearest predictors of mental illness in trans children and youth.  Acceptance is the highest predictor of mental health.

Again.  It’s not rocket science.  Of course a child will feel safer if they are accepted.

Now I’m the one trying to find the doctors, trying to access the care, trying to get referrals, wait on lists, be taken seriously.  20 years later, I’m still fighting to find a mental health care provider who truly understands the impact of trauma on a child and who is willing to practice trans positive, trauma informed care.  I don’t want her forced into CBT.  I don’t want her to be medicated.  I want someone to help her feel safe enough to express what is on her mind.  I want someone to hear why SHE uses the coping she does.  I don’t want doctors to guess and assume.  I don’t want them to misdiagnose her as well as mis-gendering her.

She deserves to be heard.  I don’t want her to be writing a post like this in 20 years.

Kids will say what they think adults want to hear.  They may do it consciously, or unconsciously or for their own reasons.  They do it to please, to stay safe, to feel a sense of control and many other reasons.  It takes a special type of doctor or counselor to help a child feel safe enough to tell their truth.   Because after enough time hiding, even she will be confused about what her truth is.

Mental health care for children should be free.  The practitioners should be trauma informed.  There should be enough funding that kids can access the care they need without lengthy wait lists.  There should not be a two tiered system where those who can pay can access things those in poverty cannot.  Poverty is a risk factor as it is, without it also limiting access to care.  Ideally there should be a system that is easier to navigate, where parents don’t feel they are fighting and advocating to the point of exhaustion.

Mental health care is a right, not a privilege.

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Photo: https://makingmomentsmeaningful.blog/2017/04/13/trauma-informed-care-values-youth-worker-values/

Living Outside the Binary.

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There have been an enormous number of changes in my life over the past 3 months.  I haven’t been blogging as much, but I hope to create some new posts about those changes soon.

I’ve been reflecting a great deal recently on how much society wants to squish people into binary boxes and categories.  Either/or.  Society doesn’t promote the shades of grey, the spectrum, the people living at the intersections of multiple gradient scales and who do not fix neatly into categories.

It’s quite difficult at times, being a person who doesn’t identify with many binary categories.   I sometimes feel invisible, different, crazy, or like my identities are not real or valid.  In some situations, I don’t even feel safe or comfortable challenging the binary norms which are coercively placed on me.

In terms of sexual orientation,  I’m non-binary.  I identify as queer, which means I’m not exclusively heterosexual or gay.  I’m open to relationships and dating with people of any gender.  I don’t fit neatly into a box.

In terms of gender identity, I’m non-binary.  I identify as genderqueer, which means I do not feel exclusively like a man or woman, but something else.   A different place on a spectrum, and outside the realm of female or male

In terms of sexuality, I’m non-binary.  I identify as demisexual, which means I’m on the asexual spectrum.  Not entirely interested in sex, but not completely disinterested in it either.

In terms of my health/disability status, I’m non-binary.  I identify as having both physical and mental health disabilities.  But I don’t “look sick” and I am extremely “high functioning” despite the level of symptoms I experience daily.  I’m able to work, but I don’t always have the energy to do all the things.  Some days I feel pretty good and others I feel barely functional.

The reality is, I think a huge number of people identify as non-binary in some ways.  Maybe you haven’t explicitly thought of it this way, but very few people exist solely in all the normative, expected boxes and categories.  No person has just one single identity.  Life happens at the intersections of our identities.

I’ve experienced some level of not being believed or validated for my identities.  I’ve felt not queer enough to fit in with gay people, but not straight enough to exist comfortable in heteronormative spaces.   I feel too feminine to be non-binary.  I feel like I’m “lazy” if my symptoms cause me to struggle on a given day.  I feel like I SHOULD be something very specific and it’s definitely not what I am.

The worst part of it is how I don’t consistently believe and validate myself.  Internalized oppression is something I struggle with constantly.  I tell myself that I’m not “queer enough” or that I don’t “look non-binary enough.”  I tell myself that I’m not functioning well enough to be normal, but I’m way too “able” to identify as disabled.  I put myself down.  I tell myself I don’t belong. I tell myself that folks won’t believe me.  I tell myself that one day I’ll be found out, and that others think I’m a fake or a fraud, or lying to get attention or to gain an advantage.

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Internalized oppression leads me to gaslight myself.  Internalized oppression means I don’t often accept myself.  Some of the worst pressures to fix into the neat clean boxes of normal society comes from my own internal critic!

I don’t believe in binary systems.  I don’t believe the messages of ableism, homophobia, transphobia and patriarchy.   On one level I don’t believe them or believe in them, and yet I put so much pressure on myself to “pass” as “normal” when I don’t even know what normal means.

I don’t actually want to be normal.  I want to be myself.  I want to be accepted as the person I am.   On one hand, I love the fact that I’m diverse and have experiences that can exist on a rainbow spectrum, rather than in black and white boxes.  But at the same time, I feel pressure to confirm, to choose, to fit in, to pick sides.

I’m not going to fit neatly into boxes.  It’s not possible.  I would have to deny so many aspects of myself that I wouldn’t be me.  I would have to compromise my own deeply held truths, just to be fully seen by society as valid.  I reject that option.

Instead, I’m creating communities and groups of friends who do accept me as I am.  People who do see me as valid, just the way I am.  People who aren’t trying to place me into categories that don’t fit, like uncomfortable outgrown clothing.

The spectrum is beautiful.  I like to think this is part of the symbolism behind the rainbow pride flag.  We are all part of a spectrum, like the light spectrum which creates a beautiful rainbow. Without each individual colour, the spectrum would be incomplete and neither the bright light or the rainbow would exist.  Spectrums are all around us and within us.

Embrace the non-binary.  Embrace the intersections.  They are beautiful and valid.

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Vulnerability Hangover.

I’ve been feeling generally better over the last month.  I cut my hair short and have been expressing my gender in more neutral and androgynous ways.  It feels lighter and more authentic.  I waited a long time to cut my hair and I don’t regret it.  It’s a pixie style cut and since I got it I’ve felt less self conscious and physically awkward.  I’ve had some days where I felt more confident, less hesitant and less full of self doubt.  It’s felt good.

Since getting custody of my children, after a four year long court battle, there have been slow positive changes.  My kids are happily settled into new schools.  I get to spend more time with them.  Their mental health is generally more stable.

It’s Fall, the leaves have started changing and the world around looks beautiful.

But today I woke up with an intense and familiar feeling: that I’m taking up too much space.  The desire to take up less space is tightly bound together with my battle with anorexia.  The feeling of wanting to disappear or be invisible means that I’m more comfortable when my weight is lower.  I feel internal pressure to be thin, thinner or eat less, not because I care so much what I look like, but because the sensation of taking up too much space becomes unbearable.  I don’t feel like I deserve to eat enough to take up my full amount of space. Restricting food and controlling weight symbolically feels like taking up less space.  I’m not sure how to describe the feeling.  Worthless? Shameful? Self critical?  Useless?  Annoying?

I could go on, but I think you get the point.  It feels awful.

Over time I’ve noticed that there is a pattern to the days I feel this intense desire to take up less space, hide or disappear.  Days when my body feels wrong, too big…too much!  These feelings are linked to trauma and abuse, to my boundaries being crossed and to me pushing myself, challenging myself to do more (i.e take up space).

I posted on facebook today about feeling like I was taking up too much space.  Someone I know referred to it as a “vulnerability hangover” and they were exactly right.

Yesterday, I took on a piece of very personal advocacy work.  I attended a mediation meeting with an organization that has not played a positive role in my family’s lives.  I was scared.  I felt alone.  I felt threatened and scared.  And yes, I felt incredibly vulnerable.  I’m not able to write very much about the meeting, because it was confidential.  But it lasted many hours and I left feeling disassociated and numb.  I wasn’t upset, but I wasn’t fully present either.   I didn’t really want to talk about it.  I just wanted to sleep.

I woke up this morning and I felt like I was taking up too much space.  I wanted to hide and disappear.  I felt like crying through most of the day.  I felt irritable and angry over tiny things.  I felt stupid and useless.  I felt like I wasn’t going to be able to do a good job at anything.  I was doubting my abilities.

The familiar feeling of not being important was racing through my head.  Feeling like nobody likes me, that people merely tolerate my annoying presence.  Like a buzzing fly which someone feels too guilty to swat dead.  I felt too big.  Too much.

It was incredibly helpful for this person, who I don’t even know that well, to point out that the strong feelings were likely related to how vulnerable I was yesterday.  How exposed I felt.

So, today I have a vulnerability hangover.  It feels awful.

But I’m hoping that the advocacy was worth it.  That it was more effective and healthier than staying silent.  I’m hoping it makes a difference in another family’s lives.

I spoke my truth.  It was risky and terrifying, but I did it.  I wanted to run away, but I didn’t.  I faced some fears and came out the other side in one piece.

Just hungover.

What to do when PTSD tells you that the entire world is unsafe?

I don’t know what to do when PTSD tells me that the entire world is  unsafe.

Trust no one.  Trust no one.  Trust no one.

Everyone will let me down.  Nobody understands me.  It’s not safe to trust.  It’s not safe to open up.  The system is broken.  Nobody believes me.

Maybe it’s me.  Maybe I’m the common link.  Maybe I’m so deeply flawed that people are better off away from me.  Maybe I deserved to be abused.  Maybe I’m the real abuser.  Maybe I’m broken and selfish.  Maybe I am controlling.  Maybe I am incapable of loving someone.

PTSD lies a lot.

PTSD makes me push people away over tiny mistakes.  PTSD makes me feel like a small vulnerable child, when someone says one harsh word.  PTSD makes me freeze in a conflict or do anything to get out of it, even if that course of action doesn’t make long term sense.

PTSD at its root tells me that the world is unsafe.  PTSD tells me that I’m unsafe and that I’ll never be safe.

It also tells me that situations are either perfectly safe or completely unsafe and dangerous.

PTSD doesn’t find a middle ground easily.

I need to get safe and grounded before the middle ground reappears.

When I’m triggered it’s all or nothing.  All the fear.  All the self criticism.  Pushing people completely away.  Feeling hopeless and that nothing has meaning.

PTSD makes me feel like trust is completely destroyed when someone makes a mistake that hurts me.  PTSD tells me that person can no longer be trusted because they will only hurt me again.  PTSD tells me that I’m safer alone.  Or that others are safer away from me.

PTSD is not a realistic judge of anything.  It doesn’t accurately assess danger.  It doesn’t accurately assess me.  It doesn’t analyze situations clearly.  It doesn’t forgive.  It doesn’t forget.  It never forgets ANYTHING that makes me feel unsafe.  And it all gets tied together in a giant clump of tangled unsafe, danger.

On the other hand, PTSD tends to forget the good times, the moments of safety.  The moments of laughter.  The moments when life has so much meaning it hurts.  It forgets the perfect moments, or tells me they are worthless because they ended.

I’m not a perfectionist.  PTSD is a perfectionist.  I’m not a control freak.  PTSD is a control freak.   I’m not a judgmental person.  PTSD is judgmental.

PTSD changes me into a person I don’t even like.

I know people have limits and boundaries and are fallible.  I know I have limits and flaws.  I know that life has good times and bad.  I know that it’s important to be grateful and see the joy in little things.

I know.

But I don’t believe.  PTSD doesn’t let me believe.  PTSD doesn’t want to risk losing the good things, so it doesn’t want to get attached to them.  PTSD is always expecting the next crisis, the next drama, the next danger, the next heart break and the next pain.  PTSD is a child cowering in the corner waiting to be hit. PTSD doesn’t let me “just calm down” or “just smile.”

I’m always waiting to be abused again.  I’m always expecting to be hurt again.

Deep down inside I’m scared that I deserve it.  That I’m not a good person.

PTSD makes me believe that I’m not a good person and that I don’t deserve happiness and health.

PTSD makes me neglect my health, because “what’s the point anyways?”

PTSD tells me that nobody believes me.

PTSD is the combined voice of all the people who have abused and hurt me over the course of my life.  PTSD isn’t me.  It’s not my voice.  It’s not random and it’s not a character flaw.   It’s the cumulative result of years of gaslighting, emotional, physical and sexual violence.  It’s the result of a broken system, systemic/institutionalized abuse which did not validate my experiences.  It’s the result of the psychiatric system, the legal system, the police, child protection and violations of trust by people in authority.

PTSD is the reason I’ve spent more than half of my life not really caring about living (at best) or actively wanting to die (at worst).

Sometimes when I’m triggered it’s not just Ana (my angry teenager) who is on the scene.  It’s a much younger child, almost pre-verbal.  All that younger part wants is to be wrapped in warm quilts and be held.   She wants her hair stroked as she cries.  She wants to be cradled and rocked and shushed.  Gently and patiently, like a parent with an infant.   That part isn’t angry like Ana,  she’s just a deep well of unmet needs.  She just wants to be safe.  This inner child has been around a lot the past few weeks.

I just want to be safe.

But I’m an adult.  And I have to take care of my needs myself now.

You are fine…until you aren’t. Life with PTSD.

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Today was a rough PTSD day.  Sometimes that’s the way it is with PTSD, you are fine, fine, fine…until you aren’t.  And then you real aren’t!  Nights like this I love my medication so hard.  Nights like this I don’t even consider the choice of going off psychiatric medication.  Nights like this I know that I’ve been staying up too late, not listening to my body, pushing myself further than I can reasonably go, ignoring early warning signs and just generally not trusting my own inner wisdom about what I can handle.

I dropped the kids off with their Dad this morning.  That’s always difficult.  It always lowers my capacity and PTSD coping bar by easily 50% by 9AM.

I had a difficult phone call at work.  Had to support someone around a type of abuse experience that I find triggering.  I dealt with it well, but it lowered my capacity bar by another chunk.

I met a friend for coffee this evening.  There was a traffic mess and the person was late.  While I was waiting, a car with a souped up muffler purposefully back fired it, reving the engine suddenly right in front of me.  I was looking at my phone and the loud noise and vibration startled me a LOT.  Before my heart stopped racing, the car back fired again.  I jumped again.  I almost burst into tears.  My PTSD coping bar was now at 0-5%.

This level of startle response is NOT a warning sign of PTSD issues for me, it’s one of the clear signs that I’ve been ignoring warning signals for a while.  When I feel like crying after being startled in an otherwise safe situation, PTSD is on the scene in a major way.  It’s time to get safe, do some grounding, probably get home and away from crowds.

But I didn’t listen.  I had plans to see a show later and I knew it was no longer the right choice.  The sign said there were “loud noises and flashing lights.”  The self aware voice inside me said “Not tonight.  This isn’t going to work tonight”  but I ignored it.  I pushed myself.  I tried to be “normal.” I tried to have a full PTSD tank, when it was really running on fumes.

The person I was meeting there was in a different space, relaxed and ready to enjoy the show.

I needed some help to get grounded and attempt the experience.

I didn’t get it.

I was already inside the show.  There were strobe type flashing lights which I know can trigger migraines for me.  My anxiety got worse.  I started to feel trapped and afraid.  I didn’t know what to expect and my anxiety was escalating.  I knew a panic attack was coming.  Generally, there’s a tiny bit of warning before it goes to 100km panic.  I have a few moments where I’m thinking clearly enough to know I need to exit.  I need to get outside NOW.  I need to be outside 5 minutes ago.

I can feel my chest tighten.  My breathing is coming faster.  I can feel the panic rising and rising like a tsunami wave of fear.  I start to walk as fast as I can without running.  I don’t know how to get out.  I just keep walking forward, sliding past people.   Mentally I know that if the tears start before I get outside then I’ll need help to get out.  I don’t want to ask a stranger for help.  I don’t want to slow down.  I know I need to get outside NOW.  My chest is painful, the tears are in my eyes.  The dizziness is starting. I feel like it’s taking forever to find the door in the darkness.  I feel embarrassed.  I feel ashamed.  I feel afraid.

My hands are on the door, I can see the outside and then I’m out.

I’m hyperventilating now.  Walking as fast as I can.  Crying and breathing in choked breaths.  So dizzy.  I want to slow down, catch my breath, but my feet keep going forward.  I’m downtown, in the dark, alone.  I pick up my phone and dial a friend.  He picks up.  I’m sobbing now, into the phone not able to speak.   He’s asking me what’s wrong.  I’m still walking, trying to catch my breath, manage to blurt out “I’m having a panic attack!”   He knows I’ll be okay, I’m not in physical danger, just emotional.  He speaks in a soothing voice, encouraging me to breathe, until the tears subside enough for me to speak.  I’m gradually slowing my breathing now.  It’s taking a focused effort, but I’m doing it. My chest hurts so much it feels like it might explode or collapse or both.

I walk around for 20 minutes before I’m calm enough to drive home.  The panic subsides but I know it’s only a tiny distance away.  I’m not sure if it will stay away, or return, out of control, taking me back down into tears.

I get home safely.  Take my pills as soon as I’m in the door.  I know that within 45 minutes I’ll feel calmer, so I start typing this as I wait.

I’ve noticed that abelism towards mental illness looks like this:

Folks can understand the triggers I have which are directly linked to the violence.  They understand how to be careful with sex.  They understand why I can’t fall asleep unless I’m alone.  They understand aspects of PTSD.  But they don’t REALLY understand.   A lot of people don’t understand that any situation where I don’t know what is happening, feel out of control, feel a sense of danger or feel that my environment is too unpredictable can be a trigger and can remind me of the feelings of being abused.

They don’t understand that in the moments when a panic attack is happening, the danger is real to me.  Logic doesn’t stop the fear.  Intellectual reasoning doesn’t stop the fear.  Being impatient with the person doesn’t stop the fear. The only way to stop the fear is to be believed and validated and gently helped through grounding techniques like breathing (or whatever the person finds helpful).  Or when it’s really bad, just holding space for the person until the panic attack ends.

In those moments of panic, telling someone to “just calm down” is like telling a person who uses a wheel chair to “just walk.”  In those moments of panic, PTSD is a disability.  It’s a real physical and physiological reaction based on experienced trauma that has changed a person’s brain.  Just as a wheel chair can help some folks with physical limitations get around,  grounding skills can be a vehicle to help someone with PTSD get around.  Without these skills and coping techniques many things just aren’t accessible or possible.

Someone having a panic attack or flashbacks isn’t doing it on purpose.  They aren’t misbehaving.  They aren’t lazy or controlling or seeking attention.  Their brain is literally misfiring.  The person is experiencing a safe situation as an extremely dangerous one.  If the panic attack and flashbacks are happening at the same time, the person might not be fully present in the moment, they might be in the past or mentally re-experiencing the time of the original trauma or abuse.

A lot of the time PTSD is an invisible disability.   A lot of the time when I tell people I’m not okay or I’m struggling it’s not visible on the outside.

Panic attacks can be visible or invisible.  For me the scariest ones are the visible ones, where I know I’m acting erratically, because then I feel shame AND panic.  These scary ones are most likely to happen when I’ve missed too much sleep and when I’ve been ignoring early warning signs and pushed myself too far.

Another thing about panic attacks and flashbacks is that when you have them, you start to be afraid of having them again.  I’ve learned to live with flashbacks and anxiety, but when I have severe panic attacks with flashbacks the physiological hyper arousal can take 5-7 days to fully diminish.

If someone you know experiences flashbacks or panic attacks, a compassionate response can be extremely beneficial.  I know it’s hard to be patient all the time.  Nobody is perfect, but your response in these moments of high anxiety can make all the difference.  Even if it doesn’t fully relieve the anxiety, it can reduce the guilt and shame and fears of rejection.  Some people with PTSD, myself included, have a deeply held internal belief that they are freaks or crazy.  Treating someone compassionately can help counteract this negative internal PTSD dialogue.

I’m going to bed.  Hopefully I can sleep this off.

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How to accept a compliment.

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I went to the dance tonight to celebrate the end of an almost 4 year long legal process.  A 4 year long ordeal of leaving my ex-husband.

I danced.  I felt happy.  I enjoyed the music.  I smiled.  I forgot about my problems.  I lost myself in the moves, the beat and my dance partners.  It was a good night.  Swing dancing is an amazing healer.

Friends and strangers alike knew I was celebrating tonight.  Swing dance events usually include a birthday jam, a song where those who are celebrating something or visiting from out of town get “jammed” inside a dance circle.

Tonight, I celebrated freedom and victory with a jam I’ve waited for for almost 17 years.  It felt incredible.

After the dance, someone I’ve danced with over the years came up to me and started talking.  He told me that 3.5 years ago when I started coming to the dance I looked like “someone coming out of a long illness.”  He went on to explain that I looked healthier now and that I’d changed for the better.  He said that I had been much thinner and looked fragile.

It was a genuine compliment.  He was right.  I was coming out of a long illness and a long abusive relationship.  I was going out as a single adult for the first time since I was a teenager.  He was also right that I was thinner then.  I’ve gained about 10-15 pounds from the low end of the weight I’d been hovering around for about 3 years.  He’s probably right that I look healthier.  I am healthier mentally.

But as anyone who battles an eating disorder knows, compliments can be treacherous.  Any comment about a person’s weight, size, shape or healthiness can be interpreted by the eating disorder voice as an insult.

I tried to be present as he gave me this kind feedback about my health.

But inside my head Ana was screaming at me to get away from the conversation.  Ana was telling me…”he thinks you are fat.”  She was telling me “it’s so obvious you’ve gained weight even a stranger can notice.”  She was telling me “you are fat. you are disgusting.  you have no self control. you are weak. you are shameful.  you are ugly.”  She was having a yelling match in my head as this shy man struggled to explain what he’d noticed.

I’m trying to sit with the compliment.

Factually it is true, I have gained weight.  No, I’m not comfortable with it.  Yes, I’m constantly thinking about restricting and exercising and ways to lose weight.  Yes, I put myself down far more than anyone would realize.

But honestly F#@K Ana.

That man wasn’t telling me I looked fat.  That man was telling me that I look healthier after escaping from an abusive relationship that almost killed me.  He was telling me I looked more alive and happier.  He was complimenting me, even if Ana couldn’t understand.

People in recovery from eating disorders might always interpret compliments about their health or their body in a negative light.  Generally it’s safer NOT to talk about a person’s weight or size.  It can be a trigger and very uncomfortable, especially in early stages of recovery.

But for tonight, I’m happy that I’m still alive.   My body is okay.  It allowed me to dance for almost 3 hours tonight, despite my chronic pain issues.  My body has been through so much.  It’s okay to give Ana a break once in a while and just appreciate the steps I’ve taken towards health and recovery.

Your body is okay too. Whatever your shape or size.  You are beautiful and strong and you deserve to love yourself.

Banish body shame.  It’s okay to accept the compliment.  You are worth it ❤

Body distortions.

I’ve struggle with distorted perceptions of my body since I was 9 years old. I vividly remember the first time I felt hatred towards my body.  I was 9 and I was sitting on the floor in the upstairs hall of my parents’ house.  I must have been getting ready to get into the shower.  I was sitting with my legs out in front of me and all I could think about was how fat and ugly my stomach was.  I thought it looked disgusting.

I remember during my years as a dancer how much I envied the other girls who were thinner and had more delicate frames.  I was always cast in the role of the boy in the group choreography and I assumed this was because I was the largest, tallest and least delicate.  Intellectually I knew some of the girls were younger and hadn’t gone through puberty yet, but emotionally it hurt.  I didn’t want to be in the boys costume, pants, vest and button up shirt. I wanted the flowing dress.  The main reason was because I assumed my body shape was to blame.

I remember feeling slightly more confident in my body for a few years, at the beginning of high school.  My style changed fairly dramatically over the years, from dresses, to jeans and baggy sweatshirts, to grunge plaid shirts and doc marten boots, to short kilts and boots, to hippy long skirts…in high school I wore skirts and dresses the majority of the time and I never felt comfortable in shorts.

When I was sexually abused, I started linking my female body with being assaulted.  I wanted to take up less space.  I wanted to disappear so I couldn’t be abused.  I changed my style again, and stopped wearing skirts and dresses and more feminine items, expect for special occasions.

It took many years for me to make the link between being abused and hating my body.  I believed all the negative thoughts Ana was screaming at me.  I believed I was fat, even when I was deathly thin.  I saw things that weren’t there.  I struggled with body dysmorphia and distorted body image, never seeing myself as others saw me.  I became so used to this that I stopped questioning why it happened.  I became increasingly invested in hating my body and blaming my body for being abused.  I forged an even stronger link by engaging in severe self harm for many years and abusing my body by overdosing and attempting suicide.  All my destructive behaviours distracted away from the root causes of my eating disorder and self harm.

I remember the moment the link became crystal clear to me.  Up until that moment it was a complete mystery to me how my view of my body could change so drastically from day-to-day.  One day I might see myself as thin, or even worry about my weight and health and the next day I’d wake up feeling obese, disgusting and unwilling to eat.  I had a hard time intellectually believing that it was impossible for my body to change that much over night.  I tried to control the dysphoria by altering my eating habits and/or exercise.

Around 2011-2012, during the years leading up to me leaving my ex-husband, I had a sudden realization.  My weight was low towards the end of 2011, partly due to the ECT treatments and lack of appetite and partly due to Ana and depression.   I remember feeling like I’d lost too much weight.  I remember feeling concerned about how low my weight was (this was during the brief time period I owned a scale).  I went to sleep one night and my ex-husband touched me sexually when I was asleep and drugged.  Quite likely after I’d said no while awake.  I remember us fighting about it in the morning.  I went into the en suite bathroom and got ready to shower.  I remember and overwhelming feeling of being fat. I hated my stomach. I felt massive and ugly.  I wanted to harm myself and restrict food.  I felt disgusting and shameful.

Then a light bulb went off in my mind.

Wait a minute, just yesterday you felt you were too thin.  Just yesterday you were worried about your weight being low. It’s impossible that you have gained that much weight over night.  These self-destructive thoughts are linked to being assaulted and to the argument.  You feel fat and dirty and shameful BECAUSE of what happened.  It has nothing to do with your weight.  Your weight hasn’t changed.

Things started to shift for me after that realization.  I suddenly had a clear intellectual understanding that I needed to try living alone before giving up and completing suicide.  I realized that I hadn’t truly “tried everything” to recover because I hadn’t tried removing myself from my marriage.  I think this realization saved my life.  I began to slowly get stronger, to seek different types of help (from a rape crisis centre) and to talk to a few trusted folks about what was happening in my marriage.

It took me a full year to get strong enough to leave.  But the leaving started with that realization.  For a moment, I stopped blaming my body and myself and started blaming my abuser for my ill-health.

In the last two days I’ve had some incredibly frustrating text interchanges with my ex-husband.  Trying to co-ordinate co-parenting with a narcissist is impossible.  It is like pushing a spiky boulder up an icy hill, where you are blamed for the ice, the spikes and for not succeeding in getting the boulder up the hill.

Yesterday, Ana was screaming at me.  Ana did NOT want me to eat.  Ana was telling me I was fat and I’d gained too much weight.  Ana was telling me to hurt myself.  Ana was making me paranoid that my ex could see things on my computer, or hear things we were talking about at my house.  Ana was activated and was not letting me rest.  Noises startled me, I had a hard time relaxing to sleep.

All of this happened because of a 5 minute text exchange with him.

Co-parenting with an abuser is enough to make anyone miserable.  But I need to remember that my body is not to blame.  In fact, the healthier I am, the stronger I can be at resisting his abuse.  I need to be healthy to take care of my kids and protect them as much as possible from his lies.  Ana tells me to hurt myself, to shrink myself, that it’s my fault.  But Ana lies.

I’m willing to bet that if you have an abusive voice in your head, it is lying to you too.  Ana never makes us stronger.  We are not to blame for the abusive patterns of another person.

I read a quote once…

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This was certainly true in my case.  I realized that hurting myself was not the way out.  There was another way, a sometimes more difficult way, but a more productive one!

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Another abandoned hospital.

I visited another hospital where I spent time as a patient.  This is the now abandoned Regional Mental Health Care Centre, otherwise known as the LPH, or prior to that the Asylum for the Insane.  There has been a psychiatric hospital on this site since 1870.

I walked around the large property.   Back in the late 1870s, asylums were located on large properties where patients lived and worked.  This property included a farm and a separate chapel.  For a time, there was a type of treatment known as “moral therapy” which included involving the patients in activities such as farming asylum land.  This site also witnessed many tragic and scary “cures”, like surgeries and electroshock treatments.

When I was a patient at the Regional Mental Health Centre, the facility was already operating at a much reduced patient capacity.  It has now been closed altogether and patients relocated to a modern, newly built site.

This site was creepy then and it is even more creepy now that it is abandoned.  I felt the energy around the property to be cool and sinister, despite the beautiful sunny day.

When I was a patient, we used to go for walks around the property.  There are long tree lined roads, which provide shade.   There was also the abandoned insane asylum.  The new building stands in it’s shadow.

This is what the building looks like today.  10+ years ago, it was even more run down.  The ceiling was falling in.  The glass in the windows was shattered in many places.  At night it was frightening.  I imagined ghosts and spirits of dead patients haunting the property.   On this visit I noticed that the city has added a new roof and boarded up all the windows.  Today, the building looks more like a museum.   The chapel and barns have also been boarded over and trees and grass are beginning to reclaim the entire site.

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It’s strange to think that the hospitals where I was treated are now torn down and abandoned.  I wonder what will happen to the brand new build in another 50-75 years time?

The time I spent at this hospital was a turning point in my recovery.  The mood disorder specialist who treated me recognized that I was being made sicker by the psychiatric drug cocktail I was on.  He changed all my medication, and within 5 weeks I was released from the hospital a significantly more stable person.  This marked the end of the 4 years I spent in and out of hospital.  It marked the beginning of the next chapter in my life.  It allowed me to become a parent.  My mood disorder specialist followed me closely during both my pregnancies and postpartum periods.  Without him, I would probably be dead and I certainly would not be a mother of two healthy children.

I have mixed feelings walking around the site.  I’ve always been fascinated by the history of medicine in general, but more specifically the history of psychiatry.  I feel captivated by the old building, while at the same time frightened and ill at ease.  I feel thankful that I was able to get the care I needed to begin my recovery.  But I feel unsettled that I had to spend time in a place like this.

the truth is hard.

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I owned a set of fridge poetry magnets when I was 15.  They were stuck on the fridge in the house where I lived with my parents.  When I was 15, I wrote this poem with fridge magnets about being sexually abused:

Time together

Alone with thy soul

There is always my body.

 

I smile at nothing

But desire

Fire craving winter.

 

Take when you want.

I could never

Disdain it enough

to break your heart.

 

the truth is hard.

In my 15 year old mind it was clear what the poem was about.  It was direct, it wasn’t even thinly veiled.  The double meaning of the word “hard” was intentional.  To me it was a message, it was a cry for help.  It was an attempt to communicate that all was not well.

Reading back to my journal from 1996, it was clear that I knew something was wrong.  I can hear myself trying to justify X’s actions, trying to defend him, trying to believe that everything would be alright.  I can hear myself blaming myself for not being comfortable.

Less than 1 month into the relationship with X:

May 2, 1996

He moves very quickly though, and is very persuasive when he wants to be.  That worries me a little bit, because he’s very forceful. I think that if I said no and meant it he would respect my choice…X turns into this totally different person when we are alone. He talked me into going under the covers.  At first I felt really uncomfortable…he can be so different, his different personalities are very drastic.  Like Dr. Jekell and Mr. Hyde…it worries me a little…the intensity of it scares me.

May 7, 1996

I’m not sure I understand X. He can’t seem to behave in public. He always wants to be physical with me, even when it isn’t appropriate.  I’m going to have to tell him that holding hands and kissing are OK in public, but anything farther isn’t.  He also doesn’t always stop right away when I ask him to. It’s as if he doesn’t believe I actually want him to.  Then he apologizes a lot after and seems to feel guilty, but he does it again…I’m sure after I talk to him he’ll act more appropriate.”

I wrote a lot about how it was my fault that I wasn’t comfortable.  I wrote about being too worried about other people’s opinions of me. I wrote about being seen as “Ms. Perfect” and struggling to live up to those ideals, especially when I didn’t see myself as perfect at all.  I wrote about the sexual relationship as a conflicted way to challenge people’s ideas that I was perfect, but really I was filled with guilt and shame about what was happening.  I couldn’t possibly be “Ms. Perfect” because if people really knew what was going on between X and I in private, they would be ashamed of me and hate me, the way I hated myself.

Looking back on it, I blamed myself for the abusive behavior of another person.  I thought that I was doing something wrong.  I thought his parents would hate me, my parents would hate me, my friends would hate me, and that generally everyone would think of me as a slut if they knew the truth.

So I didn’t tell anyone.  I didn’t tell anyone for 5 years after the abuse ended.  When we broke up, we started being “friends” and I fell into the deep abyss of anorexia.  The whole trauma which set this into motion was essentially erased, my hurt abused self was replaced by a frail skeletal figure, drifting though the halls of our high school, detached from everyone.  In order to make the abuse disappear, I tried to disappear.  I almost succeeded.

5 years later when I met my ex-husband, I fell into the same patterns.  I convinced myself it was my fault.  It was my issue that I wasn’t comfortable with the sexual stuff.  If I tried harder and was less depressed he would change his behaviour.  I blamed myself a thousand times more than my abusers every blamed me.  I abused myself a thousand times more than all of my abusers combined.  This is what trauma does to a young person.   By the time I even considered talking about the abuse, I was already caught in a second abusive relationship.  I never really had a chance to heal.

It wasn’t my fault.  I believe that abusers see vulnerable people like me a mile away.  They see us and they target us.  They know that we are less likely to fight back.  They know they can exploit our tendency to blame ourselves. They know they can build empires of abusive lies on the backs of our low self esteem and desire to please.

It wasn’t that I didn’t know I was uncomfortable.  It wasn’t that I didn’t know I wanted the sexual abuse to stop.  It wasn’t that I didn’t recognize that my boundaries were being pushed past and ignored.

It was that I blamed myself for the transgressions.  This was due to a mixture of the abusers gaslighting and confusing me, and my own lack of self confidence and self esteem.  My desire to please others was pre-existing and abusers knew they could use it to their advantage.

I didn’t scream or fight back because I believed it was my fault.  I felt so much shame, that I didn’t want to create a fuss.  I wanted to disappear and be invisible.  I turned to anorexia as a coping technique and a way to take up less space.  I tried to shrink my guilt and shame.  I tried to decrease the dirty feeling, by decreasing the size of my body.

I blamed my body because in my teenage mind, if I didn’t have a body I wouldn’t have been sexually abused.

 

 

 

Trusting my younger self.

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I’ve been reading through my journal from the first year of the relationship with my abusive ex-husband.  I’ve been reflecting on how I was gaslighted and how, in a way, I gaslighted myself.  I used the same coping techniques I did when I was abused at age 15. I found myself in another abusive relationship and I immediately began self harming, restricting food, and thinking about suicide.  As a distraction it worked, just as it had when I was a child.  I did what I needed to do to survive. I turned to creative (if self destructive) coping techniques that got me through very difficult situations.  But my inner self, my younger self did know something was wrong.  There was a part of me, healthy me, which was separate from “the voice” or “Ana.”  That part of me knew that my new relationship was deeply and integrally connected to my relapse and worsening psychiatric symptoms.  My wise younger inner self knew that I was in trouble, but she asked for help in ways that distracted and confused other people, even her own healthy self.

This is a concept that is often very difficult for those who have not survived abuse to understand.  It can be challenging to understand that the survivor will do whatever it takes to survive, even if those coping techniques may look like self destructive behaviours from the outside.  The survivor may feel she has limited or no options.  For various reasons she has been conditioned not to scream, tell, ask for help, run away, fight back etc…or maybe she tried those things and they didn’t work. So instead she turned to disassociation, self harm and eating disorders as a way to modulate and live with the abuse and all the symptoms of PTSD.

I was conditioned, maybe almost from birth, not to make a fuss.  I was conditioned, maybe almost from birth, to be a “good girl.”  I internalized this in a way that led me to blame myself for the abusive behaviours of others.  If I was being hurt it was because I wasn’t a “good girl” and if I wasn’t a “good girl,” then I must be a bad girl, maybe a very bad, shameful, dirty and disgusting girl.  Thus, Ana/”the voice” was born.  There was a part of me that split off and became self abusive and self critical.  A younger self, a part that never ages or matures.  A 15 year old frozen in time.

This is how I described “the voice” when I was 20 years old (ironically the description came right after mentioning intimacy with my ex):

February 21, 2001

My body feels too big and uncomfortable right now.  I know it’s because I’ve been eating more normally and feeling hungry.  The sensation of hunger is not an easy one for me.  It is frightening. Like I feel afraid of losing control of myself. And yet I know that the E.D is out of control. It is a part of me that often deceives and betrays me. I know that in the end, though it feels comfortable, it cannot be trusted.  The voice which tells me not to eat, tells me to cut my skin, to smash my head against a wall, to step out in front of traffic all sorts of dangerous hurtful things.  It speaks to me in persuasive ways.  It is a part of me and yet foreign.  My ally and my enemy, my strength and my destruction. But after so many years it is the way I know.  A method of ridding myself of unwanted feelings”

When I was 20 I was able to recognize some of the signs of abusive behaviour in my ex. I was able to identify that I felt afraid.  But I didn’t draw the right conclusions from there. I blamed myself, I thought I needed to work on my depression, my recovery, get better at coping with anger etc.  My younger self tried to problem solve by changing herself, just as she had at age 15.  Just as she had for her entire life.

March 12, 2001  [written after being asked to swing dance with and dancing with a friend, a man I’d briefly dated]

So the evening was going well until one crucial moment…asked me to dance.  I figured one dance wouldn’t hurt and I didn’t think [he] would mind…but [he] did get upset and left the room.  I followed after the song was over. [He] got angry at me saying that I couldn’t stand up for myself and say NO.  He totally misunderstood and overreacted.  I got terribly upset and started crying totally uncontrollably…I was so disappointed that my night was ruined.  I felt so much like hurting I became filled with intense suicidal thoughts. I hate feeling my independence threatened by a relationship. I want the freedom to choose who is in my life.  When [he] gets angry it just terrifies me and makes me want to hurt, with him is when I feel the strongest feelings

My younger self clearly articulated that she felt uncomfortable with being controlled and with the jealous behaviour.  She clearly made a link between the angry jealous behaviour of her boyfriend and the suicidal and self harm impulses.  My younger self was wise on a deeper level, and yet she stayed with that man for 13 years.  It’s difficult to make sense of.  My adult self wants to travel back in time to that night, to go back to the dance with my friends, to tell him in no uncertain terms to F*#K OFF and leave me alone.  My adult self wants to protect that younger me, give her the strength to listen to her instincts and fight back rather than turning to a downward spiral of self destruction that would lead to 4 years in and out of psychiatric hospitals.

The next day, March 12, 2001 I was admitted to the hospital.  I wrote in my journal again, but made no link between the previous evening and my suicidal obsessive thoughts.  The self destruction worked as a distraction from his controlling behaviour.  The hospital was a place to get away from him.  The routine and the process of hospitalization was an escape.  I would feel safer in the hospital for a few hours or a few days, then I’d realize that the hospital wasn’t a solution and I’d want to be home.

I think what I really wanted was to be safe.  What I needed to be safe was to exit the abusive relationship in those early stages, when I still had the chance.

Because within a few short weeks I was already beginning to convince myself it was my depression and PTSD causing the issues in our relationship:

March 26, 2001

“The things that I thought were stable and unchanging have become uncomfortable. I can’t tell if it’s my depression pushing [him] away or actually me. It’s so hard to face that possibility. I want things between us to be simple again. I miss how easy we used to be together.  Now I feel distant from our relationship”

April 4, 2001

“I don’t feel as easy around [him] lately. Mind you I haven’t felt easy around anyone lately. I feel withdrawn, like I have built up the walls around me for protection from the storm.  But this is so ineffective because my storm is coming mainly from within. I don’t know how to protect myself from myself. I really am my own worst enemy”

Maybe I was never my own worst enemy.

Maybe the storm was never “mainly” from within.  Maybe I was confused and living with emotional abuse and gaslighting.  Maybe I bought into blaming myself as a coping technique, as a way to survive, and as a way to feel more in control of a scary situation.  I blamed myself and my mental illness rather than facing the reality that I was in an abusive relationship.  It was “easier” to seek help through psychiatry than it was to leave the relationship.

Looking back it all seems clear.  But my 20 year old self had less wisdom, less experience, less resources and less knowledge.  My 20 year old self did the best she could.  She did try to express herself, she just didn’t have the skills to listen to herself or to ask for the type of help she truly needed.  And those around her weren’t able to interpret her self destructive behaviours as, not a cry for attention or a manipulation, but a message.  A red flag waving, signalling that all was not well.  Help was needed, but psychiatry wasn’t the correct tool for the task.

Unfortunately, my younger self wouldn’t cross the threshold of a rape crisis centre for another 12 years.