How to ask for help? If mental illness was treated like physical illness…

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Photo credit Hyperbole and A Half Blog

I’ve been struggling recently with trying to figure out how exactly to ask for help.  How do you even tell people around you that you are not okay when you are struggling with an invisible mental health disability?  How do you tell people that the disability which you live with daily and generally “manage” is currently in a crisis state?  How do you tell people that you are struggling with thoughts of harming yourself?  How do you tell people that you need help because you are suicidal?  How do you even bring up the topic of suicide?

It’s not easy.  Half the time I drop the topic casually into conversation the person I’m talking to thinks I’m joking.  They might even laugh, then awkwardly realize I’m not laughing and say “Oh wait, were you serious?” and when I say “Kinda” I hear…

<crickets>

That’s right…nothing.

A lot of the time when I disclose thoughts about harming myself I hear:

<crickets>

Or people keep talking.  Or they assume this is normal for me and say “that’s too bad” and move on with the conversation.

I’ve learned that most people don’t know how to handle disclosures of thoughts of suicide.

If I walked up to you right now with a serious physical medical emergency, for example signs of a heart attack and said “I need help, I think I’m having a heart attack”  I can pretty much guarantee the response would not be:

<crickets>

Someone would do first aid, they’d call 911.  They’d drive me to the hospital.  They’d stay with me.  I’d get flowers and cards, meals delivered.   I’d get time off work, more cards.  People would visit me at home as I recovered.  Friends and family would be so glad I survived the heart attack, they’d offer to help with child care and housework and cooking.

People KNOW how to help with a medical health emergency.  So why do they respond with

<crickets>

to disclosures of thoughts suicide, self harm or other signs of a mental health emergency?

Why is it so hard for me even to disclose the struggle?  Why is there SO much stigma?

I’m afraid to ask for help because of the risk of two things

  1. The person will overreact (call 911, police, hospital, panic, lock up dangerous items)
  2. The person will under react (see <crickets>)

What I really need when I ask for help is for someone to:

  1. Believe me that I’m actually suicidal and that things actually feel THAT BAD
  2. Trust me that I’m not actually going to do anything dangerous, but that I need some help in the moment to achieve that
  3. Listen to me.  Validate my feelings.   Let me know that they can hear I’m in pain.
  4. Remind me that I might be experiencing flashbacks, triggers or emotional flashbacks and that they are real, but I might not be seeing things completely clearly and I might need time to get safe and get grounded
  5. Keep me company (text, phone, go for coffee, take a walk, cuddles)
  6. Remind me that people care about me and that I’m not a bad person.
  7. After validating my feelings, offer some hope that things will improve one day and that I have the strength to carry on until then.  Remind me of some of my strengths (but be realistic, don’t go over the top with praise)

I really believe that you can help people around you who might be struggling with suicidal thoughts.  You can help them by listening to them, believing them and keeping them company.  You can also offer to do some of the same things you would for someone who is physically ill.   Offer to help with child care, meal preparation, cleaning, picking up groceries, running errands, drop by for a visit (ask first), call to check in, text to say hi, send a thinking of you card, send flowers etc.   In my own experience, the worst thing you can do is…

<crickets>

I wanted to share my favourite  blog Hyperbole and a Half and their post about depression:

http://hyperboleandahalf.blogspot.ca/2013/05/depression-part-two.html

How to cope with chronic suicidal thoughts…

People who don’t struggle with chronic suicidal thoughts sometimes imagine suicide as the type of crisis that happens in the movies.  And it can happen this way, but not for everyone.  You know the cliched scene (we’ve all seen it) someone loses their job, breaks up with their partner, makes a terrible mistake, suffers the loss of a loved one etc. and they spend a dark night contemplating ending it all.   Maybe they reach out, a friend comes over, makes them tea, stays up all night and talks them through it.  Or maybe they are taken to a hospital emergency room, where staff admits, them and they are released a few days later, on medication and thankful that they are still alive.

Yes, single episode suicidal crises happen.  They are terrifying and frightening and can be medical emergencies.  If you are struggling with this type of crisis, you are not alone.  Suicide is a permanent solution to a temporary problem.   There is help available, even though reaching out can be scary.

But what if this isn’t your experience.  What if, like me, you struggle with chronic suicidal thoughts, on and off, for decades?   What if suicidal thoughts and suicidal impulses became, during times of trauma, part of your coping mechanisms?  What if suicidal thoughts, ironically and paradoxically both threaten your life and help keep you alive?  What if it isn’t just “one long dark night”?  What if it isn’t something that a trip to the local emergency room and a short psychiatric admission can even touch?  What do people like me do when they hit a rough patch?

It’s complicated.  It’s complicated for a number of reasons.

  1. It’s very hard to even talk about suicide.  It’s not an easy subject to bring up.  I’m always afraid that people will either overreact (ie. treat it like the suicidal crisis described above and call emergency services) or under react (and ignore my disclosure or not offer support).  Let’s face it, most people aren’t comfortable talking about suicide.  If someone asks me: “How are you doing today?”  they don’t want to hear “Actually I’m dealing with suicidal thoughts at the moment, thanks for asking.”  It’s just not something I can say.
  2. If I do disclose that I’m having suicidal thoughts, most times people just sit there awkwardly.  Try to figure out if I’m joking or serious.  And then change the subject.  Meanwhile, I’m sitting there, just as awkwardly, feeling guilty for making the situation awkward and not just saying “I’m fine.”
  3. See point #1.  Talking about suicide is a societal taboo.  I’ve had these thoughts for 20+ years.  I’m still alive and I’m still finding it difficult to talk about them.  There is something about this that doesn’t quite make sense.
  4. There is an incredible amount of shame related to this societal taboo.  This means that not only do I feel suicidal, I also feel ashamed about it.  I also feel afraid about the consequences that could occur if people find out and misunderstand what chronic suicidal thinking means (aka…911 calls, police, hospitals).
  5.  Suicidal thoughts are not a “cry for help” or a “way to get attention.”  Most of the time I deal with suicidal thoughts alone and people aren’t even aware that I’m having them.  Even when I do disclose, I generally minimize how bad they are.  I try to cope by myself as much as possible.  Self harm has also been a very private thing in my life.  For something to be a “cry for help” generally other people need to actually know about it!  It would be more accurate for me to describe the suicidal thoughts as a way to gain control, the ultimate control, over an overwhelming or out of control situation in my life.  It’s also related to obsessive compulsive thinking, and in that way can be circular and very difficult to control.  Sometimes I have intrusive thoughts about suicide that are obsessive and not related to anything in particular in my life.  They are disturbing to me and they are  unwanted, arriving in my brain suddenly and then leaving.

So how do I cope with these chronic, obsessive suicidal thoughts?  I use some combination of the methods below, depending on what type of thoughts I’m having, how long they last and how severe they are.  It can be helpful to make your own “safety list” with various ideas that you can use when your suicidal thoughts make an appearance.  I suggest that you create a variety of coping ideas, because chronic thoughts of self harm are very persistent and won’t likely go away with the use of just one distraction or grounding technique.  If you are lucky enough to have a supportive partner/friend you can give them a copy of your safety list and they could help you use some of the skills in a crisis situation.  For some folks, taking medication or calling a support line can be items on their lists.

  1. Delay. Delay. Delay.
  2. Distract. Distract. Distract.
  3. Remind myself of reasons why I need to stay alive (aka my kids)
  4. Listen to nature sounds on Spotify.
  5. Get in a safe space (aka my bed, under lots of warm blankets, away from anything potentially dangerous.  This works best for the most severe thoughts when other techniques may not be safe)
  6. Take a walk outside, ideally in nature.  Breathe, move my body.
  7. Drink a hot beverage (tea, hot chocolate, coffee)
  8. Reach out to a trusted friend (I may or may not tell the person I’m struggling)
  9. Blogging (others may use journaling, art or other creative outlet)
  10. Helping others, volunteer work, helping a friend in need (this works very well for me, but caution as it can lead to burn out if this is your only coping tool)
  11. Disassociate or zone out (ensure that it is safe to do so)
  12. Pay attention to your environment.  Count things you can see, feel, touch, hear.  Ground yourself in the present moment.

If you are coping with chronic suicidal thoughts, I hope that reading this post helps you to feel a little bit less alone.  If you don’t struggle with them, I hope it helps you to understand them a little bit and maybe allows you to help others around you who might be living with them.  Many people live with suicidal thoughts for years, it’s exhausting.  So very exhausting and nothing at all like what is presented in the movies.  But it has to be better than the alternative.  So I keep trying and keep breathing!  Keep hoping that it will get easier for all of us!

How are you?

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How are you?  How are you doing?

Fuck.   They feel like SUCH  loaded questions right now.

99% of the time people want to hear the standard answer:

I’m fine thanks, how are you?

But I can’t lie.  I’m not fine.  That being said, I know that 99% of people don’t have the time or energy to listen to how I’m really feeling.  Maybe they don’t care, maybe they are busy, maybe they don’t have spoons, maybe they are at work, maybe they were just asking to be polite.

I’ve started answering this question with:

The same.  It’s always the same.  I’m always the same.

Until I get the verdict, I’m not going to be fine.  I’m probably not going to be feeling better, and I don’t have the energy to lie about it.

I’m feeling grumpy today.  I’m feeling grumpy because I just want to cry when people ask me how I am.  I want there to be space for me to not be okay.  I want there to be space to just not function for a while.

I came home after a long day.  It’s cold outside, unseasonably cold for May.  I was shivering.  It was time to eat.  I decided to make myself grilled cheese. Comfort food.  What could be simpler?

I burnt the shit out of that sandwich.  So burnt it wasn’t even possible to scrap the black bits off the edges.  Throw it in the garbage burnt.   I wanted to burst into tears.  “You can’t even make a simple sandwich!” screamed the self critical voice in my head.  Somehow this burnt sandwich became a symbol for everything I feel isn’t going right today.

It’s difficult feeling lonely.  It’s difficult feeling like the one who is never “fine.”  I feel like I’ve been losing friends or driving people away from me because my life is complicated and I’m not always easy to be around.  I feel like I’m whining, complaining, self-absorbed, wallowing, not being grateful…lots of self criticism.  I know I’m doing the best I can.  It just never seems like enough.

In all likelihood, there are only a few more weeks of waiting left.  Things are going to shift in my life soon.  Potentially in major ways.  I’m so close to the end of this chapter of the journey.  I’m so close I can almost see the finish line.  I can almost reach out and touch my new life.

But it’s just out of reach.  It’s blurry and uncertain.  After 3.5 years in court and almost 14 months of waiting…a 16 month long total (and counting) trial process…it’s actually no longer possible for me to clearly visualize or imagine it being over.  I used to fantasize about getting the verdict.  Where will I be when I get the call?  Who will I tell first?  How will I feel?  What will happen from there?  So many unknowns.  In a way, waiting has become normal for me.  In another way, it has never felt normal.  I’ve never adjusted to having so little control over my own life.

It’s a unique situation.  Very few people in my life can relate.  It’s gone on for so long, very few people still have time to listen to me talk about it as much as I feel I would like to or need to.  Everyone around me is tired and frustrated too.  Nobody knows quite what to say. I understand.  It’s been a long journey.

I’m so close to the end.  But I’m not fine.  I’m burn out and I’m afraid.

You need a lot of energy to be sick.

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Another stereotype or stigma that I’d like to debunk right now is that people living with disability or chronic illness are lazy.  That they have SO much free time and can “do whatever they want” because they are unemployed.  We’ve all heard versions of this abelist stereotype.

It’s just not true.  People living with chronic health issues are as varied and different as people who are well, healthy, neurotypical or able bodied.  They are not lazy.  Being disabled is not a lifestyle choice.  Some people with disabilities are able work/volunteer/attend school and some are not.  Some have varying abilities depending on symptoms on different days.  Some people (like me) are “high functioning” (I HATE this term) and work full time, parent, take care of a house all while living with a high level of chronic pain and various chronic symptoms of mental illness.

But whether you are working or not, raising kids or not, volunteering or not, on social assistance or disability payments or not…I can say with 100% certain that being chronically ill is a lot of work.  I’d even say that it’s a full time job.  So we aren’t lazy, we are warriors.   Our work just isn’t valued by society, and a lot of it is invisible labor just to survive.

Please don’t perpetuate this stigma.  And please trust that each individual person knows what they can and cannot do.  If someone with a chronic illness is not working/volunteering/attending school it’s probably because their symptoms are too severe and they are not currently able.  Or maybe their workplace/school is not accessible for someone with their particular health issue.

It’s NOT because they a) don’t want to, b) aren’t trying hard enough, or c) are lazy.

Tonight, I have almost no spoons.  I drifted through the day, feeling foggy and having trouble concentrating.  I crashed on the couch and struggled to get up again.  I feel mentally and physically exhausted.   I didn’t run a marathon today, I didn’t work out…but I DID expend a great deal of energy coping with my health.

Before work I had a doctors appointment.  It was a new doctor, so there was stress and anxiety last night and this morning.  I got test results that weren’t what I was hoping.  I got requisitions for blood work.  I booked two follow up appointments.

Then I went to work.  Tried to focus, tried to get things done.  Took a break, got the blood work completed.  Went back to work for another hour.  Left at 3:30pm for a counseling appointment.

I see my counselor every 2-3 weeks.  I’d like to see her more often but it’s difficult to fit in around my other appointments, my work schedule, my kids, kids activities and kids medical appointments.  Again, as I mentioned, people with chronic illnesses aren’t lazy.  We often have numerous medical appointments that need to be juggled and fit in around already busy schedules.

Counseling is work.

If you are a survivor of trauma, and your counselor is pushing you, even gently, in the direction of healing, counseling can be exhausting work.   At the end of the hour I feel incapable of more than curling up in the fetal position on her couch and crying.  But instead I drive home and carry on with my day.

My counselor has been fairly patient with me.  She’s realistic about the fact that I have a LOT of current external stress in my life and she’s let me talk about that.  But in the past 6 months she’s begun to push me to talk about my past, my childhood, my core beliefs, and my trauma.  She’s also started to call me out when I disassociate in the session as a way of coping with feelings, memories and flashbacks.

I like disassociating to cope with feelings, memories and flashbacks.

It’s kinda my thing.

Most people don’t even realize I’m doing it.  Even fewer people would point it out.  Nobody else would purposefully try to stop me from using it as a way of coping.  I’ve always thought of disassociating as a self preservation, self protection mechanism.  I always thought I was coping if I zoned out to make a flashback less intense or make it stop.  I was coping.  It helped me survive, but maybe now there are other options…

My counselor wants me to stay present.  She wants me to TALK ABOUT what’s happening for me.  She wants me to describe it.  Or at least she wants me to stay with her in the room while it’s happening.  It’s very uncomfortable.   “But I LIKE disassociating!”  I whine…  “But it works!” I attempt to convince her.

She reminds me that I’m not alone.  That she is there to help me out of the feelings, body  memories and sensations.  That I don’t need disassociation and that maybe by zoning out I’m not actually allowing myself the space I need to heal.  Maybe I’m just stuck in a constant space of just surviving.  Maybe disassociating is actually taking up an intense amount of spoons to maintain.  Maybe zoning out is zapping my energy.

Chronic complex PTSD is exhausting.  Chronic pain is exhausting.

But maybe, just maybe doing the work of counseling and trusting the process might help restore my energy in the long run.  It’s draining work at the moment just trying to convince myself to TRY to approach my healing without disassociation.

I might have many flaws, I know I am not lazy.   Neither are you.  Keep fighting that stigma and keep surviving and thriving.

 

 

Justice.

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I took this photograph today.   I lived in this city most of my life and I’ve never been drawn to look at this sculpture before.

Justice.

This statue embodies exactly how my life feels at this moment.

Grey. Solemn.  Frozen in time.  An unknown, robed figure holds a sword over me, about to make decisions that will alter the course of my life and the lives of my family members.

I feel like one wrong move and the sword will pierce my heart and all will be lost.  I’m walking on a tight rope, on egg shells, on the edge of where the ocean meets the land, on a wire at a circus…fill in the metaphor or analogy of your choosing.  I’m barely breathing.

Justice for who?  How is this justice?  Years of my life spent trying to prove things that seem self evident.  Years of him being believed and me seen as crazy, or potentially crazy.  Years of my privacy being breached and shattered to the point I’m hardly sure what privacy means anymore, except to trust no one.  Is this justice?

Interpersonal violence doesn’t end the moment she walks out the door.

Domestic violence doesn’t end when she leaves.

Family violence doesn’t stop when the relationship is over.

She might be physically safe now, but she still looks over her shoulder.  She still watches herself.  She still fears that anything she says or does might get her or her children into trouble.  She lives in fear of SOMETHING happening, even though she doesn’t always know what that vague threat might be.  She rarely sees him, but he impacts almost every aspect of her life.  He calls her crazy.  He tells her kids she is crazy.  He tells anyone who will listen that she is crazy.

But if she is crazy, than every survivor is crazy.

I don’t think we are crazy.  I think the entire system is broken and set up for us to fail.  We don’t have a justice system, we have a legal system.

Wake up.  Justice doesn’t exist for women like me.

I’m reclaiming “crazy.”

I’m so tired of crazy being used as an abelist, stigmatizing slur against me by my ex-husband.  I’m fed up of being called crazy as an insult, as an excuse for his abusive behaviour.  I’m tired of gaslighting which blames my PTSD for the sexual violence he perpetrated.  I’m tired of being seen as less than, being labelled with things that don’t apply to me.  I’m tired of the implicit assumption that having a mental illness is a terrible thing, something I should be horribly ashamed of.  It’s problematic on so many levels.  He accuses me of having borderline personality disorder (which I don’t have) but even if I DID have it, so what?  Would I be “crazy?”   Would this warrant being mistreated and shunned and ignored?  Would it mean everything I say and do is suspect?

I reject all this.  I want to reclaim crazy.  I want to fight mental health stigma.  I don’t want to be ashamed that I’m not neuro-typical.

I’d like my ex-husband to stop spreading awful rumours about me in the community, but I don’t have control over that!

Things I would like to stop hearing as I reclaim crazy:

-Be more neutral

-You are too emotional

-You are too sensitive

-Tone down your feminism

-Your past is impacting your parenting

-That was a long time ago, why don’t you get over it

-Just relax

-Calm down

-Don’t worry so much

-You are over-reacting

-Why didn’t you just say no?

-Don’t you know how to defend yourself?

-Why didn’t you just fight back?

-She’s crazy (from anyone unless they are also reclaiming the word)

I celebrate being crazy in a positive way, because it means that I’m NOT neutral.  It means that I am an advocate, a social justice warrior, an ally and a support worker.  I’ve harnessed some of the energy of the bad things I’ve survived and I’m using it to help others, to fight injustice and to try to leave the world a better place than I found it.    I’m proud of my feminism.  I’m proud of my anti-oppression principles and the way I strive to unlearn and learn in my daily life.  I don’t want to calm down.  My feminism gives me energy and it keeps me alive.

And if that makes me crazy, then I embrace it.  But let me define crazy.

Nevertheless she persisted.

 

Medication Fog.

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For whatever reason, my migraines have been out of control the past few weeks.  It’s been incredibly frustrating and painful.  I started seeing a neurologist about 9 months ago and have been getting nerve block injections which had been significantly reducing my number of severe pain days per month.  I was really pleased.  The neurologist is a great doctor, he believes me, doesn’t treat me like a drug seeking addict, and the treatment he offered was helping.  A rare positive medical experience for me.

This month the pain came back with a vengeance.  Last Monday, I came home from work and cried for over an hour.  I took my emergency codeine pill to take the edge off the pain for a few hours and it made me feel a pleasant sort of relaxed high.  Taking any type of medication is always risky for me, because what will relax me one day could agitate me another day.  Anything that has the potential to be psychoactive can cause unwanted adverse effects.  I don’t like feeling high and I if I use substances it’s in an attempt to feel normal.

Tuesday by the end of the work day I wasn’t feeling well.  The pain was terrible, my heart was racing, I felt weak and dizzy and dehydrated.  I had pain at the base of my neck which was new for me.  Normally my migraines are around the supra orbital nerve and focused behind my right eye, blurring the vision there and causing visual distortions.  To be honest, I was a bit scared I might be having a stroke.  Often by the 3-5 day mark of a severe migraine I begin to worry that something is really wrong, it seems hard to believe that SO much pain and so many strange symptoms are caused by “just” a migraine.

I was afraid and a bit desperate for the pain to stop so I drove myself to the ER.  I have a lot of trauma around the medical system (see earlier posts in this blog) and I was pretty reluctant to seek care at the hospital.  At triage my file was marked as emergent (I think they were worried about stroke too!), and I didn’t wait too long before seeing a doctor.  Luckily, the doctor reassured me that there wasn’t likely anything more serious going on, “just” a bad migraine.  He offered some IV medication and IV fluids because my heart rate was really too high.  I was relieved.  He believed me.  He didn’t treat me badly.    The nurse came to start the IV and I figured things would be pretty much okay from there.

I was wrong.

About 5 minutes after the IV medication ran through, I got suddenly hot.  I had an intense sense of panic and agitation and I knew I had to leave.  I couldn’t really think clearly.  My IV was attached to the ceiling and I couldn’t walk around.  I knew intellectually I could ring the bell and a nurse would come and probably unhook the IV or move it onto an IV pole so I could walk around.  But in my panicked mind, I became triggered to times I had been held against my will in hospital.  I started thinking that maybe the nurse wouldn’t let me leave, or that she’d make me wait for the doctor and that I’d flip out.  Then she’d know I was completely panicky and wouldn’t allow me to leave.  I was afraid.  I pulled out the IV and I ran away.  I fled.  I just left the ER and didn’t look back.

That was a rough night.  I was scared they would send the police after me so I got a friend to call the ER to explain that I’d left due to a panic attack.  It took a full day for all the anxiety symptoms to resolve.

And the migraine was back within 3 hours!

Two days later I saw my neurologist for another nerve block.  He told me that severe anxiety and agitation is a side effect of one of the IV medications in about 2% of people.  He told me not to take that medication again.  No shit!  I was angry that the doctor at the hospital hadn’t informed me that there could be potential psychoactive side effects. I would not have consented to the treatment as I know that I’m extremely sensitive to this type of adverse effect.  I’ve experienced versions of the same from SSRIs and from anti-anxiety medications.

My neurologist wants me back on another medication that can control migraines.  It’s called topamax and it’s one I’ve taken before.  I reluctantly agreed because it can also help with some of the other chronic pain I have which might be fibromyalgia.  The only problem with this medication is that it causes a lot of side effects, especially at the beginning.

My body feels like a toxic soup of drugs.  I have a hard time processing it all.  And I still have a headache.

The side effects when starting medications that cross into the brain can be triggering for me.  Not only do I feel dizzy, nauseous, off balance, foggy and exhausted, it also brings me back to times in my life when I was taking high doses of psychiatric meds.  It brings me back to times I overdosed on them.  It brings me back to the nights where I was sexually assaulted.  When I woke up, drugged, half asleep to find him touching me.  Fighting to stay awake, but the drugs dragging me back into sleep.  The feelings of confusion between my nightmares and what was really happening to me.  I don’t like that feeling.

So the side effects and adverse effects aren’t just unpleasant.  They aren’t just an annoyance.  They don’t just impact my ability to function smoothly at work.   They are frightening and they remind me of being completely unable to control being abused.  Being helpless, frozen, confused and afraid. They remind me of not having control over my body and not having the capacity to consent.

So if I’m complaining about adjusting to this medication or if I seem not quite myself.  It’s more than just a bit of dizziness.  It’s a lot of vulnerability and processing not feeling in control of my own body, both the pain in the present and the abuse in the past.   It’s all interconnected.

What does “fully recovered” mean?

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I’ve been reflecting on what it means to be “fully recovered” from an eating disorder.

The best books I’ve read on this subject are “Life Without Ed” and “Goodbye Ed, Hello Me” by Jenni Schaefer.   These books promote the message that it is possible to be “fully recovered” from an eating disorder.  They give me hope that anorexia isn’t something I will have to struggle with for the rest of my life.   I’ve read the books at various times when I’ve felt overwhelmed or hopeless and they have always helped me stay positive.  I truly admire the author’s dedication to having a life free from ED, or in my case Ana.

But if I’m 100% honest with you, I’ve never even TRIED to be fully recovered.

I’ve been in imperfect recovery for years.  At times this has meant being at a healthy weight, but still struggling with unhealthy thoughts and habits related to food and restricting food.  At times, this has meant slipping back into controlling my body,  purposefully eating less and obsessing about taking up less space.  I know how imperfect recovery works.  It keeps me “functional” and sometimes even “looking healthy,” but inside I am never truly free.  The thing with imperfect recovery is that Ana still controls my life to varying degrees, depending on how much I’m struggling.

It’s not possible to tell by looking at a person whether or not they have an eating disorder.  Being at a “healthy” or “normal” weight means nothing.  Being at a “healthy” weight doesn’t even mean a person is medically stable or in recovery.   In my current situation, my weight is higher than it’s been in  years, but my eating disorder is causing me MORE trouble, not less.  I feel exhausted mentally and physically most of the time.

I’ve been in hospital treatment programs in the past.  Inpatient programs where I was “forced” to eat large quantities of food.  I was supervised after eating, a staff member watched me to make sure I ate all of my meals and snacks.  I followed the rules because I had to, even though I was there voluntarily, I was able to comply because it was required.

But let’s be honest.  I never attempted to be fully recovered.  I have never, in 20 years, been even willing to CONSIDER giving up Ana as a coping technique.  I’ve used it to varying degrees at various times, but I’ve never committed to letting Ana go.

I stayed in treatment until I was functionally recovered.  Until I could eat without panic and physical discomfort, until I could have the energy to get through a day, until I could think more clearly and re-engage in life.  Then I discharged myself every time.  I wanted to be healthy and eat, but I didn’t want to gain too much weight or give up my obsessive compulsive thoughts and habits.  I wanted to be in control, even of the recovery process.  I told myself I could do it by myself, I could do it my own way, I didn’t NEED the program.

I was told again and again that I needed to follow a meal plan and eat mechanically for at LEAST a year before trying things on my own.  I was told again and again that I needed to gain to my goal weight and maintain it for a year in order to recover.  I was told again and again that I needed to stop controlling food and my body in order to heal.  But what did I do?  I poured out my juice when nobody was looking.  When I got out of treatment I stopped drinking juice altogether because it was unnecessary!  I cheated in a million little ways.

When I was younger, I thought I knew better.  I thought I could do it on my own.  I thought I could let go of the horrible life threatening aspects of Ana, but hold onto the comforting habits that kept me slim.  I thought I would be happy about 10-15 pounds below my “goal weight” and that I would be medically stable.  I thought Ana and I could dance together this way forever.  I thought I could have Ana on my terms, not hers.

But I’m not a teenager anymore.  I’m pretty close to my “goal weight” now, but I feel worse physically than I have in years.  I can’t push my body the way I used to.  I get migraines, physical body pain, exhaustion and lack of patience.  I don’t dance with Ana anymore…instead we are plodding, dragging through life, in a way that has very little meaning to me.

Because I have never embraced “fully recovered,”  I have instead remained sick.  Because let’s be honest about this too, if Ana is driving, I’m sick regardless of my weight.

For a long time, imperfect recover was enough for me.  It was such an improvement, I was proud of myself.  People stopped bugging me about gaining weight.  I was able to eat most things without panic.  I was able to eat around other people.  I was able to attend social events.  I was more relaxed.

But even at the BEST of times, there were always rules, calculations.  I always felt that I deserved to eat only as much as I needed to survive each day.  Never more.  I wasn’t starving myself literally, but I was starving my soul.  I was depriving myself of more than food, I was depriving myself of joy, connection and abundance.

Recently the stress in my life has been almost more than I can bear.  I’ve been waiting for 5 months for the outcome of a year long family law trial.  I’m waiting for a stranger to decide the future of my children.   Many important aspects of my life are quite literally out of my control.

I struggle daily to accept my body at this weight.  I struggle daily feeling like I am too big, seeing parts of my body as fat, living with body distortions and hating myself.

I struggle daily with the lack of control and the waiting.

And quite honestly, I CHOSE to let Ana start driving again.  I saw it as a necessary evil, to help me keep functioning and keep moving forward through each day.  I opened the door and let Ana right back in.  I welcomed her. I almost felt happy that I had a way of modulating and distracting from the unbearable stress.

I changed a few things here, a few things there.  Nothing drastic, but small changes.  I felt okay about it.   Maybe I could lose just a few pounds.  But it isn’t really about the weight, though I might say that it is.  It’s all about feeling in control of my body and thus, my life.

Irrational.  Magical thinking.  Self-destructive.  Self-punishing.  Illogical.

But even though I’ve let Ana drive many times before, always with varying degrees of disastrous results, I STILL believe deep down inside, that she is my friend who will NEVER leave me.  I love Ana for getting me through years of sexual and emotional abuse.  I love Ana for never letting me down, for always being there.

But Ana is an abusive partner.  She isolates me.  She makes me say no to eating dinner with friends because she makes me ashamed and afraid to eat in public.  She makes me tired from restricting food.  She makes me impatient and she makes me struggle to connect with those around me.  She helps me to disassociate by numbing out through the physiological effects of semi-starvation.  Ana is abusive even when I let the door open a crack.  Ana is abusive even when I’m not emaciated.  Ana is abusive even when you see me eating.  Ana is abusive right now.

Ana tells me that I don’t deserve to eat.  That I don’t deserve to take up space.  That I’m bad or weak for needing food to survive.  Ana tells me that the high of restricting food means I’m strong.

Ana lies.  She lies like any abusive partner.  She gaslights me.  She lulls me into thinking she is caring for me while she is trying to destroy me.

Today, I am at the stage of contemplating full recovery.

When Ana drives, I eventually feel like life is not worth living.  I can’t imagine living another 20 years this way.  Half living, half dying.  I’m tired.

To me, full recovery means more than changing my eating habits.

Full recovery means letting go of giving meaning to food.  Letting go of believing my food intake or weight has anything to do with my worth.  Letting go of trying to control my body as a means to feel safe in this world.  Letting go of believing that being thin will protect me from being raped again.  Letting go of trying to disappear to stay safe or avoid hurting anyone.

Fully recovered means eating when I’m  hungry and stopping when I’m full.  Fully recovered means going out to dinner with friends, even if I ate lunch.  Fully recovered means eating lunch daily. Fully recovered means eating 3 cookies.  Fully recovered means breaking all my food rules, even drinking juice!  Measuring nothing, counting nothing, giving food no value other than nutritional.  Fully recovered means not cheating, by holding on to “just one or two habits.”   Fully recovered means committing to staying alive until my natural death.  Fully recovered means learning to like myself, then learning to love myself.  Fully recovered means reconnecting with the world, trusting myself and opening myself up to others.  Fully recovered means healing from years of abuse, by self compassion rather than self hatred. Fully recovered means accepting my natural body shape, no matter what size that turns out to be.

Fully recovered means letting go of fear.

I hope fully recovered means living with joy.  I hope that one day I will experience fully recovered and it will be wonderful.

Today, I still feel lost and stuck in survival mode. If you have tips for finding “fully recovered” please share them in the comment section below.

Celebrating One Year of Hopeforsanity Blog!

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It’s been one year since I started writing this blog.  If you are a new reader I encourage you to go back and read the first few posts of this blog.  To all of you who are reading, following, liking, sharing and commenting: THANK YOU!  I’m writing this blog for the dual purpose of expressing myself and connecting with others who are struggling, letting them know they are not alone.  You are not alone.   Though this blog has dealt with graphic and dark topics, I aim for the overall message to be one of hope and resilience.

Twenty one years ago tomorrow (April 12, 1996) the entire course of my life changed.  I was 15 years old and I entered into an abusive relationship that altered my relationship to myself, my friends, my family and my body.  I went from a relatively happy, self assured, popular 15 year old girl, to an anorexic, withdrawn, self-hating, 16 year old young woman.

I believe Ana was born at this time.  It’s no coincidence that Ana is 15 years old.  Ana is my traumatized child self personified.   Ana is angry in ways my younger self could not be.  Ana is all the fear, shame, guilt and hopelessness personified into a rebellious teenager who only wants to hurt me and say a giant F U to the rules of the world.

Sometimes I wonder how my life would be different if I’d never dated X.  If I’d never tried to befriend him.  If I’d never believed that I could help him feel better about himself.

I also wonder how my life would have been different if I’d been taught as a child that it’s okay not to be “nice” to someone who is hurting you.  I wonder how my life would have been different if I’d been less concerned with being “perfect” and more concerned with protecting myself.  I wonder how my life would have been different if I’d realized that saving myself was even an option.  I was an easy target for perpetrators of abuse.  I played the role of rescuer, helper, caretaker and I never wanted to let anyone down or disappoint anyone.

People who don’t understand normal coping reactions to sexual violence have asked me:  Why didn’t you just scream?  Why didn’t you tell someone?  Why didn’t you push him and run away?

All I can say is that the answer is so complicated.  The answer lies in the social conditioning of some women living in a patriarchal, rape culture.  The answer lies in being taught to be “good” rather than to be true to oneself.  The answer lies in physiological responses which caused me to freeze and disassociate rather than fighting or fleeing.   Those physiological responses were not random, but were connected to the socialization of being a “good girl.”

My 15 year old self never would have considered screaming or fighting back.  Because she was ashamed, blamed herself and never wanted to make a scene.  My 15 year old self was confused and inexperienced and it took her a while to figure out that she didn’t like the sexual experiences that were being forced on her.  It took her a while to figure out that she wasn’t really choosing.  By the time she realized it wasn’t right, she was already coping by disassociating to lessen the impact of the abuse.  By the time she started firmly saying no, the pattern of abuse and the cycle of violence was already firmly established.   And because she was not naturally an assertive child and had not been taught to fight back in self defense, when her no wasn’t listened to, she began to shut down even further, withdraw further and develop other ingenious coping techniques such as anorexia, self harm and disassociating completely.

These reactions weren’t accidental.  They were conditioned from a young age.  Adults have to teach children to fight back.  Adults have to teach children that being nice can stop when someone crosses a boundary.  Adults have to teach children to fight like hell to escape a dangerous situation.  And even if a child learns all these things, it is still possible that in a violent situation freezing can be the only available option.   Many people being abused feel that fighting back would only result in further violence and physical injuries.

In my case, what kept me frozen was guilt and shame.  I thought I was doing something shameful by being sexual.  I thought that his family and my family would judge me.  I thought that my friends would judge me for neglecting them (as I was being socially isolated by the abuser).   Self blame kept me frozen and not fighting back.

Even as an adult, 21 years later, I still cope with conflict and stress by freezing or disassociating.  I’m still not skilled at saying no.  I also have difficulty saying yes or asking for what I need.

I think for a person who has experienced sexual violence it is difficult to say no.  Because in the abusive situation no was ignored and pushed past.  So staying silent feels less painful than having no not respected.  If I never really say no, I can’t be abused again.  It’s warped logic.  It is not productive or helpful, and it also prevents me from comfortably saying yes.

For someone whose boundaries have been consistently violated, setting boundaries can become a life long struggle.  A skill that must be learned or relearned gradually and with patience and self compassion.

Quite simply, I survived in abusive relationships for many years because I literally felt I had no other option.  I didn’t even feel like I deserved to be respected and I was gaslighted into believing the abuse was my own fault.

It’s never helpful to ask a survivor “Why didn’t  you just leave?”

Keep those thoughts to yourself.

They would have left if they could have.  And if they did leave, they are successful.  It doesn’t matter how long it took.  It took as long as it needed and not a moment longer.  Celebrate the reality, don’t question why it didn’t happen sooner.  “Why didn’t you just leave?” is a type of victim blaming statement.   If you don’t understand how someone could be trapped into an abusive relationship, educate yourself.  Don’t ask the survivor to educate you on their own painful lived experiences.  Survivors need to feel believed and validated, not questioned into justifying their existence.

Every year on April 12, I count another year of my life that has been impacted by sexual violence.  It is a grim reminder that for many survivors, myself including,  that the abuse was not “a long time ago” and we can’t “just get over it”  or “just move on.”  For people living with PTSD, time is a slippery beast.  Ana is still 15 years old.  Ana is me, she’s a part of me.  A part of me that never really grew up.  A part of me that needs parenting.

I’ve never parented a teenager before. I have no experience.  But I guess I’ll have to start somewhere.  And starting with acknowledging she is here, and she has unmet needs, is as good a place as any!

 

The Voice.

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I’ve been feeling very young recently.  I feel like Ana is around more than I am.

There is a book (which I haven’t yet read) which talks about structural disassociation and describes the experience of having an “apparently normal part” and one or more “traumatized child parts.”    My apparently normal part seems to be quiet this past few weeks and Ana, my traumatized teenage part is very loud.

Sometimes when Ana is around I do things that don’t make a lot of sense to my apparently normal part.  And my apparently normal part doesn’t make sense to Ana.

I was trying to figure out if there were any particular triggers, anniversaries or memories surfacing for me recently, ones that would bring Ana to the forefront.

Next week will be the anniversary of when I first started being abused.  It will also mark the one year anniversary of this blog!

I started reading through an old journal from 2001:  the year I first was hospitalized, the year I tried to kill myself multiple times and the year I began cutting daily, sometimes multiple times a day.

Reading the journal, my 2001 apparently normal self seems extremely young.  But even at that time, I clearly identified having  a traumatized child part.  Back then I called it healthy me and little girl me.  I also called it “the voice.”  I’ve found multiple segments where I speak about “the voice”  and I recognize what she is saying as Ana.

February 21, 2001

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 and 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…I feel like a stranger in my own life.

I don’t know what to do to help my traumatized child part heal.  What does Ana need?

The answer that comes to my mind is love.

She needs love.  She needs acceptance.  She needs to be believed.  She needs to feel safe. She needs to be forgiven for all the years of self abuse.  She needs to forgive her own body.

But I rail against it.  My apparently normal adult self doesn’t feel capable of parenting an angry teenager.  Ultimately, she is me…both the apparently normal adult self and the traumatized child parts are me.

Even in 2001, I can read in my journal signs of this inner battle.  The battle between health and self destruction, between hope and despair.  I’ve been fighting for a long time.

I can read myself trying desperately to convince myself that my engagement was a good idea.  That I loved my partner.  That my own PTSD and issues were the root of the stress in our relationship.

March 18, 2001

I miss having him around me and yet I’m also afraid of our intimacy.  He is at the same time my motivation to get well and my trigger to feel upset.  The strong emotions I have toward him complicate and simplify my life

I can read my younger self trying to convince herself that things would be okay.  I can read between the lines that a deeper part of her knew the relationship was wrong and unhealthy.  I can read how I desperately continued hurting myself, longing to be SEEN. Truly SEEN and accepted for who I was.  I can read my self blame, self hatred and confusion.

And a good part of this fight has been internal, between parts of myself that can’t seem to make peace, forgive and start again.