mental health

Don’t look at me.

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One of my clearest memories of the abuse with X, is also one of the memories which triggers the most flashbacks.

It’s the reason I don’t like to be looked at, why I sometimes wish I was invisible, why I have hated my body for 20 years, and linked to why I started down the road to anorexia.

It was evening, that time between the brightness of day and the deep darkness of night.  We were in his room, listening to music and…I don’t know what words to describe it with…if it had been consensual I would describe it as “fooling around” or “making out”  but in this case those words don’t have an accurate feel.  We were alone in his room, in the dark and he was abusing me.  Sarah McLaughlin was playing on the CD player “hold on, hold on to yourself, for this is going to hurt like hell…”

I remember the blinds were dark,  maybe navy blue, they were shut, but a small amount of light came in between the cracks.  The head of the bed was directly to the right of the window.  I remember the bedspread being navy as well.  There was a dark mood to the space.  So often when we were in his room, his family was home.  Technically if I had screamed, yelled, or run away, someone would have heard.  We were rarely completely alone.  But I felt so much shame, I blamed myself, I felt dirty and I felt like it was my fault.  It never really occurred to me to tell his parents, I felt they would blame me, or not believe me, that they would tell my parents, that somehow I’d be in trouble.  So I learned to disassociate, I stayed quiet, I did what he wanted.   Sometimes I said no, but I never fought back or physically resisted.  I learned quickly that my “no” meant nothing to him.

That evening, he wanted to look at me.  He made me take off my clothes, except my underwear which I always stubbornly refused to remove.  I was afraid to get pregnant and I somehow felt like keeping them on would protect me.

He made me stand across the room from him.  He lay, semi-reclined, on his bed, staring at me.  Just staring.  I felt like an object.  I felt like this one moment solidified the sense of shame that had been growing and building inside me, like dark twisty vines blocking out all the light of my once bright self esteem.  I crossed my arms across my chest, trying to hide myself from his prying eyes.  I felt his actions were motivated by lust. I didn’t feel loved or cared for.  I felt afraid and I felt ashamed.   I don’t know how long I stood there for, but it felt like an eternity before I was able to hide under the duvet again.  I don’t really remember what happened before or after.  I only remember those moments of exposure.

Years later, much more recently, I was dating someone.  The first time I took my clothes off, in my own room, safe and because I wanted to.  He looked at me, and I had flashbacks so intense that I almost passed out.  I had to sit down, suddenly on the bed.  The room was spinning, my heart was racing, I was so dizzy I felt blackness around the edges of my eyes.  And I was trembling, shaking really.    It took a few minutes of lying down for my body to return to a normal state.   This is what PTSD means to me.  The rapid trip between enjoying a sexual moment and being almost paralyzed with extreme physical symptoms.  The panic/flashback is often followed by tears, physical pain and nausea.  I sometimes have difficultly talking or expressing what is happening.

Because of this I have to take time to educate people who are going to be close to me. So they know what is needed to help in those moments when it’s difficult for me to help myself.  It’s important for others to realize that in the midst of a flashback I can’t consent, I can’t think, I can’t communicate clearly, and I need help getting grounded, or I need the space to do so myself.

I often wonder, if people who commit acts of sexual violence realize the impact they are having on the victim’s life.  I wonder, if abusers knew that years later mere reminders of the abuse could have such severe consequences.  I wonder if people would stop and reconsider pushing past “no.”  I wonder if all the law makers, judges, police and lawyers had to live with PTSD related to sexual violence for just one day, they would reconsider letting the majority of reported abusers walk free.

The abuse may only last a few moments, but the impacts can last a life time.

P.S.  Please feel free to share this blog if you are enjoying it!

Electroconvulsive Therapy (ECT)

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“Electroconvulsive therapy (ECT), formerly known as electroshock therapy, and often referred to as shock treatment, is a psychiatric treatment in which seizures are electrically induced in patients to provide relief from psychiatric illnesses” -Wikipedia

Basically, ECT is a treatment by which patients consent to have seizures intentionally triggered by electric shocks which are applied to the brain.

When you put it that way, it sounds barbaric and unnecessary.  Why would someone consent to have electric currents put through their brain under general anesthetic and undergo seizures?

The desperation and intense suicidal ideation that can accompany treatment resistant depression can be unbearable and even fatal.  Given the choice between suicide and ECT, some people choose ECT.  I was one of those people.

In 2011, I was caught in the grips of one of the worst depressive episodes of my life.  I was fighting off constant thoughts of suicide and severe self harm.  I was having difficulty functioning in my day to day life.  I had tried every medication known to human kind.  I was truly desperate and ECT was a last resort, something I hadn’t tried and something I hoped would provide even brief respite from my suicidal depression.

Over the course of about 8 weeks I received 15 electroconvulsive treatments.  This means I was put under general anesthetic 15 times and I had 15 seizures.  Some were unilateral (one side of the brain) and some were bilateral (both sides shocked simultaneously). I received the treatment as an outpatient, twice a week, Monday and Friday mornings at a hospital near my home.

Each morning I would report to the inpatient psychiatry floor around 6:30AM.  I would change into a hospital gown, remove my jewelry and be taken on a stretcher, by an orderly, down to the surgical area of the hospital.  I would wait in the semi-darkness, dimmed light of the surgical recovery room.  While in this room, nurses would place an IV into my hand so the necessary medications could be injected.  I was hooked up to heart rate monitor and other monitors.  There were usually 4-6 of us lying there, side by side, waiting our turn in the treatment room.  As I would wait, I would see the previous person being wheeled out of the treatment room, unconscious.  It was unsettling, as I knew my turn was coming soon.

The ECT room was a small procedure room attached to the surgical recovery room.  It was just large enough for a stretcher, the medical professionals and the necessary equipment.  It was bright and clinical.

Nurses and doctors began to work on me quickly.  I had the impression of an assembly line, a schedule being kept, patient in, treatment given, next patient in and so on.  My temples were wiped with alcohol swabs and electrodes attached.  The anesthesiologist talked to me about the medications he was going to administer.  A nurse would often hold my hand, there to keep me calm as everything was arranged.  The medications were injected one by one through the IV.  I could feel the cold fluid entering into the veins in my left hand.  I would keep my eyes fixed on the clock, trying to remember the time as I went unconscious, to later compare to the time on the clock when I awoke.  Sometimes I would lose no more than 15 minutes of time, the procedure was very quick.

I remember feeling afraid.  The nurse asked me to count backwards.  An oxygen mask was applied to my face and nose, ready to breath for me while I was unconscious.  The medications worked quickly and then nothing.  There was only one time of the 15 when I was aware of part of the process.  The medications they injected to relax my muscles began to act before I was unconscious, I felt like I was suffocating.  I couldn’t breathe and I started panicking.  I literally couldn’t breathe, but I was awake.  I could hear them talking and feel the next medication being injected and then nothing.

I would wake up 15 minutes later.  Back in a different curtained bay of the recovery room.  I could hear the nurses helping the other patients on either side of me, also recovering from ECT.   This was the part of the treatments that I hated most.  I had to stay in the recovery room for 30 minutes following the treatment, as they monitored my blood pressure and other vital signs.  I felt trapped.  I was hooked up to machines.  I often had a sense of panic and wanting to flee, to leave, to be outside.  Sometimes I would cry and I don’t think the nurses understood why.  Eventually the Doctor would come, talk to me briefly and I would be released.   The first time I could barely walk and the nurses wheeled me to the entrance to meet my family member.  I was usually home by 9 am.  The whole process taking 2-3 hours.

Usually I would stumble, drowsy and disoriented to the car.  I would be driven home and I would go straight to bed.  Usually I would sleep and rest for most of the day.  I lost a lot of weight over those few weeks because I ate so little due to missing breakfast and then being nauseous from the medications.  I also had severe headaches due to the shocks, and many side effects from the medications.  I felt like a zombie.  My short term memory was foggy as to the events during those 8 weeks.  During that time, my grandmother passed away and the experience was surreal through the state of mind I was in.  I have no memory of my own birthday that year, and few of my daughter’s.

In terms of long term side effects from the treatments, I found that the area of my brain which recalled the order of the months of the year and the seasons of the year were impacted.   If someone asked me “What season comes before Fall?”  I would feel confused and have to think very hard to answer “Summer”   Similarly with the months of the year and the order of the holidays in the calendar.

Overall I don’t think I suffered any major memory loss.   At the time I thought that the treatments helped my depression a little.

Sadly, I only realized about 9 months later that a large portion of my depression was situational, related to my abusive marriage.  In the end, the treatment for my depression was to move away from him.

If I’d realized this sooner, I probably would not have endured ECT.

Looking back on the whole series of treatments, it feels unreal.  It feels traumatic.  It feels strange and difficult to process.

In what world does it make sense to further traumatize a traumatized brain?  But desperation will make a person take desperate measures.  I survived and that is what matters.

The leaving.

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When I was 19 years old, I made the biggest mistake of my life.

This mistake potentially changed the entire course of my life until my children are adults and possibly longer.  I was a teenager.  I was in fragile recovery from anorexia and depression and had not yet been correctly diagnosed with PTSD.  I was living in a city away from my family and the majority of my close friends.  I was happy that year, doing well and enjoying life. I had taken up swing dancing and I loved it.  I’d made some friends and we often went out dancing together.  Shortly before my 20th birthday I met him.  He proposed to me after 3 months.  It was one of the worst moments of my life.  I remember physically shaking, thinking frantically in my head “oh my god, this can’t be happening, why is this happening, why is he doing this, why, what should I do, what will I say, why is this happening right now!!!”  In the moment I didn’t want to break up with him, so I said yes.  I honestly figured I had lots of time to get out of the promise, but life didn’t turn out that way.

Thirteen years passed.

Three years ago this week I made the biggest and most complicated decision of my life.

Ironically, the things that ended my marriage came together in a culmination of empowerment and decision for me.  I’d been battling with thoughts of leaving for over a year, slowly gaining strength, processing the ideas and planning.

The soul crushing depression I’d been living with for a few years slowly began to lift about a year before I left him.  I began to see options for myself.

For many years I had seriously considered suicide.  After trying ECT (electro-convulsive therapy) and slews of meds, I believed I had exhausted all options for treatment resistant depression. I was ready to give up and only my children held me to this world.  I had irrational, almost psychotic thoughts, in the depths of that depression.   But in my mind, when I was thinking more clearly, I told myself that suicide was only an option for those who had literally tried everything, people who had no other option.  Sometime in summer 2012 I realized that wasn’t my situation:  there was something I hadn’t tried.

I hadn’t tried moving. Living in my own house away from my partner.  I hadn’t tried starting over, changing my environment, removing myself from the ongoing sexual abuse which I knew was both triggering me and traumatizing me in equal measure.

In 2012, I was experiencing terribly severe migraines which at times left me unable to function.  I remember throwing up in the parking lot of a restaurant on my daughter’s birthday.  I went to the ER at times to receive IV pain meds.  Around that time I began taking a medication called Topimax for the migraines.  And suddenly, my depression lightened.  My obsessive compulsive suicidal and self destructive thoughts relented almost immediately.  I never self harmed in a way that required medical attention again. My migraines improved.  I began to see colours again.  I noticed the world around me.  I began to re-emerge into the world of the living.  And I started to consider my options for leaving my partner

As I grew stronger over the course of the next year, I started talking to more people in my life about the abuse.  I chose very carefully.  I told people who didn’t live in my city.  I told counselors and doctors who were sworn to keep confidentiality.  I was careful, but I started to talk.

I had some good friends who began to tell me that what I was experiencing was not okay.  Friends encouraged me to leave, to tell my parents, to get more counseling and they empowered me.  I started volunteering at a women’s organization. It happened gradually, slowly, almost imperceptibly.

In the end, the last time we had sex was the end of that marriage.  I made the decision the next day and told him a few days later.  That night he initiated sexual touching while I was asleep and drugged.  I woke up with him touching my breasts.  Maybe he had been touching me for a while before I fully responded.  On that occasion I woke up and was lucid enough to respond.  Because he had been touching me (without consent), I said yes to sleeping with him.  I verbally said yes.  We had sex and I felt disgusted.   Even though I said yes to the sex, I knew in my mind that I had not consented to the touching. I knew if he had asked me when I was wide awake I would have said no.   I realized that even IF I said yes, I still wouldn’t feel safe, comfortable or at all okay.  I knew it was over.  I knew that would be the last time.  So many times, when I was lying awake at night after being assaulted, I thought to myself “this could be the last time, I could get up and walk away” but I never did.  I was always afraid and I didn’t want to leave my kids.

There are a lot of reasons why people who are being abused do not leave.

And at the end of the day, it only takes one reason to decide to leave.

Leaving an abusive relationship can’t be rushed or forced.  The person being abused has to hit a breaking point and decide that “enough is enough” and that point is different for each individual survivor.

This happened three years ago, but anniversaries are always difficult for me.  I feel it all again.  I have more nightmares, more anxiety and lower self esteem.  I don’t believe in myself.  I have difficulty trusting. I hate my body so intensely that I struggle to look in mirrors or wear certain clothes. I don’t feel safe or relaxed anywhere.  I return to the automatic living, zombie like state.  I have trouble remembering things and difficulty concentrating.  I sometimes wonder if it has been worth the fight.  The suicidal thoughts creep in suddenly, ambushing me in my day to day life.

But at the end of the day, I have to remember that there were only 2 options left for me:

  1. Leaving
  2. Suicide

As difficult as my life is, and as much pain as I’m in, I believe I made the right choice.

I’m still alive.

 

Zombie.

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Pushing through trauma.  Trauma layered on more trauma.   Decades of trauma.

Brain shuts down.  Eerie quiet and an empty space inside where my thoughts should be.  Ears ringing.  Body feels heavy and difficult to move. Words come slowly, sticky in my mouth.  Sometimes movement and speech is impossible.  Days blur together.  Conversations become difficult to follow.  Confusion.  Short term memory loss.

When disassociation is the only way to get through the day.  There isn’t even enough energy left to panic.  When stress is something that can’t be changed, when there is no solution, when the fear is overwhelming and I am helpless.  Panic is scary, but there is motion there and emotion.  The blank space is less human somehow.

It’s not a choice.  It’s like a switch is flipped.  My brain says “NO!”  That’s enough, time to quiet down.  Anxiety becomes a physical reaction rather than worries, feelings or thoughts.

I feel like a zombie.  I’m walking around, doing day to day tasks.  I know from experience though that I’m only part there.  I know from experience that days or weeks from now my memory of this time will be divided into two extremes.  Traumatic memories, seared into my brain for life…and blank space, nothing, no memories at all.  Part of the day will be remembered for ever and part of it…it’s like it never even existed.

When stress levels are chronic and traumatic memories from the past are re-enacted in present life, new traumas in the present are linked in the brain to old traumas.  They are no longer separate events.  The brain stores them all together and confirms the facts as PTSD knows them:

“You are not safe”

“You can’t trust anyone”

“Nobody believes you”

This shifts along into another layer of faulty PTSD thinking:

“You are fat.  Your body is disgusting.  Your stomach is too big”

“Nobody likes you.  You are bothering people with your existence”

“People think you are doing a bad job.  People think you are not capable”

“You are letting everyone down”

“It’s all your fault”

In a way the thoughts and the blank space are flashbacks.  They are here, in the present moment, and they are flashbacks to times similar to this one.  The past and the present are linked in PTSD.  Like invasive vines taking over the brick wall of me.

I can’t cry.  I have to feel safe to cry.  There are no tears in the blank space.

I shrink away from being touched.  I jump and startle.

What I want most is to be held.  To be comforted.  To be kept safe.

What I can’t do is let anyone close enough to do this.  The blank space is so large, the buzzing is so loud.

 

 

Photograph

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I have vivid memories from very young ages of freezing in response to stress.

I remember staying at my Nana’s house while my parents were away.  One time she got sick.  It was just her and I in the house together.  She was in the bathroom upstairs throwing up loudly. I was terrified and I hid under the dinning room table.  I remember just being frozen there and being afraid.  I don’t remember anything before or after.

Pretty much my whole life since then I’ve had a phobia and very strong panic reactions when I hear other people throwing up.  Even watching it on TV bothers me.  I did get over it to a certain extent when my kids were young, but it still makes me irrationally afraid.  Even though I know intellectually that there is nothing to be afraid of, a part of me is still that little child, hiding under the table, not understanding what was happening to her Nana, or if she was okay.

Another time I was visiting extended family.  I was about 5 years old.  My Aunt and Uncle were going through a separation and he was abusive.  I remember standing on the landing of their house.  I remember hearing yelling and standing there frozen and afraid.   As with the first memory, I don’t remember much before or after.  I don’t really remember their house, I only remember the landing of the staircase.

I went to a school in a fairly central part of town for Grade 1-4.  My first experience with sexual abuse happened at that school.  It was either spring of Grade 1 or fall of Grade 2.  I know because the grass was still green and I wasn’t wearing a coat.  My best friend S and I were playing imagination games together as we usually did at recess.  We used to imagine we were characters from books we’d read.  Her favourite was Anne of Green Gables.  At that time mine was Laura Ingells Wilder from the Little House series.   We had vivid imaginations and we became the characters from the books we read.

The school had a massive play yard with different sections.  Part of the yard was a large L shaped field, the furthest away from the school, pavement and climbers.  The yard monitors rarely strayed far from the pavement and climbers.   S and I were right at the edge of the yard, by the fence.  There was a small grassy hill there and on the other side of the fence was a place large enough to park a few cars.  We could see the main road just on the other side of that parking space.

S and I were playing, deep in our imagination that day.  I remember it being warm and sunny and there were dandelions outside.  Suddenly a car pulled up parallel to the chain link fence.  It was a four door sedan, I think it was burgandy or dark brown.  The door of the car opened and a man stepped out.   He was white and had dark curly hair.  I think he was wearing jeans.  The man walked up to the fence, about 4 metres down from where we were sitting on the grassy hill.  There was some weeds and tall grass on his side of the fence, the parking area was unused and mainly abandoned.

I didn’t fully understand what happened next until I was much older.  And I certainly had no idea what it meant.  What I do remember is that I was afraid and I froze.  I think we both froze.

The dark haired man undid his belt, unzipped his pants and started touching himself.   His eyes were fixed on us, staring at us with a strange look on his face.  It wasn’t a look I recognized, or one I liked.   This was a stranger, the type of stranger our parents had warned us about, but we didn’t know what to do other than wait silently.

When the man finished, he zipped up his pants, did up his belt and walked over to his car.  He looked at us the entire time.  The car was parked parallel to where we were playing.  He got into the car and he rolled down the window.  It was the 1980s and he had to crank it open.  The car started, but before he drove away he looked at us one last time.  His hands made the shape of a camera in front of his face, one finger clicking the imaginary button.  It felt like he had captured us.  Captured a part of us for himself, and I knew that it wasn’t right.  I felt dirty and afraid.

As soon as the car pulled away the spell was broken.  S and I ran back to the paved area and to safety.  I don’t remember what happened after.  I don’t remember ever speaking to her about what happened.

What happened next?  S went home and told her mother who called the school.  The school sent home a note saying to be alert for a suspicious person and the description was there.

To be honest I don’t remember talking about it to anyone.  I don’t remember anyone talking to me.  I don’t know if I did talk to someone and I just don’t remember, but I’m almost positive I didn’t tell my parents.

Even at the age of 6 or 7 I felt ashamed and I felt I had done something wrong.  Maybe we shouldn’t have been playing there, so far away from the other kids.  Maybe we would be the ones to get in trouble.

S and I talked about this a few years ago.  It turns out she wrote a story about it at one point in her adult life.  It comforted me to know that she still remembered and that it had impacted her too.

It feels strange to write about this now, something that happened nearly 30 years ago.  What I find interesting is that my tendency to freeze as a way of coping was formed early in my life.  When I was abused as a teenager and an adult I coped in the very same way.  The first time I actually fought back physically I was 33 years old.

I don’t know exactly what makes some people fight, some people flee and some people just freeze.  I don’t know what was different about S and I, that she went home and told her mother and I don’t remember telling anyone.   This was a pattern that continued later in my life as well.  I just didn’t tell.  I froze,  I blamed myself, and I stayed silent.

Part of writing this blog is about breaking that silence.  I want other people to know they are not alone.  That they didn’t do anything wrong, even if they didn’t fight back or ask for help.

We all did the best we could to survive.

Robbery and Sexual Assault

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If someone robs your house and steals everything you own, you feel unsafe, violated and on high alert for future thefts.

If someone breaks into your house everyday and steals just one CD, you feel unsafe, violated and on high alert for future thefts.

In either case, someone is inside your house without your consent and taking something belonging to you without asking.

Sexual violence is like having your house broken into.

When I was raped, I felt unsafe, violated and on high alert for future violence.

When I was touched sexually without my consent I felt unsafe, violated and on high alert for future violence.

When I was looked at sexually without my consent I felt unsafe, violated and on high alert for future violence.

Whether the perpetrator was forcing sex without my consent or just touching me when I was asleep, the impact was the same.  Something was being taken from me without my consent.  I wasn’t freely participating so it was assault, not sex.

Sexual violence impacts survivors, it doesn’t have to be rape to impact you.

I want to break down the myth that certain types of sexual violence are “more serious” than others.  All sexual violence is happening without consent, and when something happens to your body without consent it can have a major impact.

I’ve experienced the spectrum of violence, from voyeurism, to touching without consent, to forced intercourse.  It’s just not true that the rape was always the worst.  What was the worst was not knowing if my house was going to be broken into that night or not.  Not how much was stolen during the break in.

During my marriage the sexual assault took place when I was drugged and asleep.  There was no ability to provide consent.  In fact, I often said no while I was awake.  Sometimes I said no again when I woke up, sometimes I didn’t.

If you don’t say no, it does not mean you consented.  There are many reasons why someone might not say no.  They might be drugged or intoxicated, they might be too afraid, they might disassociate or freeze as a response to the trauma or they might have learned through repeated experience that saying no is not effective, or provokes further violence.

I was impacted by all the violence I experienced.   And the impact built and multiplied together.  It wasn’t any one incident that caused me to have PTSD, or made me feel unsafe, it was a collection of experiences that took place over a number of years.   Except for in one case, I knew all the perpetrators.   Except for one of those, I had contact with all of them after the abuse.  They were friends, dates, boyfriends and my husband.  The fact that I had contact with them does not mean I consented.  In some cases it takes time to end a relationship with an abuser.  There can be further risks for women in the period when they are leaving, the violence can escalate and the abuser can become more unpredictable.  The abuser senses they are losing control and they tighten and increase their efforts to control the survivor.

I was abused multiple times and I never screamed.  I never really physically fought back except in one instance.   This does not mean I consented.  There were reasons why I didn’t fight back.  I was ashamed, I was scared, I froze…my kids were in the room next door, I was afraid of further violence.

All the assaults that happened to me except one, happened in places I knew, my home, their home, school etc.   If you go with someone to a location it does not mean you are consenting to sex.  Most violence happens in places and with people known to the survivor, it is a  myth that the most dangerous place is walking down a dark street at night.

No matter how your house was broken into and what was stolen, even if nothing was stolen, your experience is valid.  No matter where on the spectrum your assault falls, your experience is valid.  Your coping reactions and what you did to survive are all valid too.

I believe you.  I hope you believe yourself.   I hope that the thefts stop or have stopped.  You deserve to be safe.  Without consent, it is assault.

 

I don’t care if it hurts, I want to have control…

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20160522_220818[1]“I don’t care if it hurts, I want to have control,  I want a perfect body, I want a perfect soul”

-Radiohead

One of the worst parts of living with anorexia is also the part that is the most difficult for others to understand.  Body dysphoria or distorted body image.

In the context of an eating disorder, and in my own case, this basically means that I’m never really sure if I’m seeing my body accurately or not.  When I look in the mirror sometimes I see a lot of things I don’t like.  I don’t like the majority of the middle of my body for example.  Lots of people can relate to that.  But for me what I see in the mirror can sometimes change dramatically from one day to the next.  Sometimes I look at myself and I can see the parts of me that are slim, sometimes thin even.  But when I’m stressed, upset or triggered I see myself as big…too big…taking up too much space.  I hate the way certain parts of my body look and feel.  I get upset at the feeling of clothing touching my body and I sometimes have to change my clothes a few times in the morning before I feel okay to go out.

It’s important to know that 90% of this is not about how I look to other people.  It’s not about vanity.  It’s not about wanting to look like a model in a magazine or an actress on TV.  It’s not a life style choice.  It’s not a choice, period.

Distorted body image and body dysphoria are symptoms of many eating disorders.  Eating disorders are medical illnesses.  You don’t have to “look sick” or be extremely thin to be medically at risk from an eating disorder.

Sometimes I want to scream because if I could get rid of Ana and live a “normal life” around food my days would look very different.  I don’t want to waste even one more minute obsessing about my fat stomach, or how much I should or shouldn’t eat.

I’ll tell you something about Ana…she is a total bitch.  She is also incredibly boring.  Probably the most boring person I’ve ever met.  Ana is abusive too.

Who is Ana?  She is my eating disorder.  I personify her and I experience or imagine her as a young girl, maybe about 15 years old, with dark hair and pale skin.  She never looks happy and she is never satisfied.  She’s often full of rage and full of anger and she seems to want to destroy the both of us.

Ana talks to me like this:

“Your stomach is fat. You are out of control.  You are so disgusting. You don’t even deserve to be alive.  You probably shouldn’t eat very much because it’s the only way you will feel better.”

Ana lies. Ana is cruel.  I’ve been living with her for almost 20 years now and she rarely gives me much of a break.

Because of Ana I have a hard time remembering what it is like to eat and feel relaxed, just enjoying the flavours.  I have a hard time imagining eating without obsessive thoughts and rituals.  Ana has this idea that by controlling food and controlling the size of our body she will solve all our problems and make us feel in control and safe.

Ana wants to be safe more than anything.  Unfortunately, she is young and she doesn’t know that controlling food makes her MORE at risk, more vulnerable and certainly more unhappy.

If I could live one day without Ana…

  1. I would get SO much done.  I’d have more energy because I’d be eating more regularly and more healthfully.
  2. I’d be able to actually concentrate because my body would have all the energy it needs AND my mind would be de-cluttered and not distracted by obsessive thoughts about food and weight
  3. I’d be able to relax and enjoy social time.  Until you live with Ana you never realize how much of society centers around food
  4. Did I mention how much more energy I would have?  Listening to, or fighting off Ana’s abusive inner monologue takes so many spoons.  It leaves me exhausted and on bad days depressed and hopeless

But even knowing all this intellectually, I have a hard time letting Ana go.  She does sort of keep me company, and she does sometimes give me the illusion that by controlling food, I’m controlling my life and managing overwhelming problems.

At the end of the day the truth is that Ana was born during the time I was being abused as a teenager.  Ana promised me things, and she deceived me into thinking that if I was smaller and took up less space I’d be safer.  But I wasn’t safe, I almost died.  And then when I was in imperfect recovery, I was abused again and again.

Ana doesn’t keep me safe.  Eating disorders have the highest mortality rate of any mental illness, especially among young woman.  They aren’t a choice and they do destroy lives.

I hope one day Ana will leave me alone.  I hope I will be able to look in the mirror and like what I see.  I hope  I will be able to eat without fear and guilt.  I hope I will pick my clothing based on what I like and not what will allow me to tolerate the body distortions for that day.

I still have some hope that I will let Ana go, instead of fumbling along in imperfect anorexia recovery forever.

Scars.

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What is it like parenting two children when you are a psychiatric survivor?

Pretty damn scary.

I remember when I first got pregnant and for the first 2 years of parenting my kids, my biggest fear was that someone would call Children’s Aid and report me as an unfit parent.  I worried that my first baby would be taken from me at birth.  You might ask why would someone whose baby isn’t even born worry so much about being an unfit parent?

My body is covered with scars from self inflicted wounds.  I was terrified someone would see this, make assumptions about me, and consider me a danger to a child, especially my child.

I’ve been parenting for almost 10 years now and so far this fear has never materialized.  I still worry about being considered “crazy” and thus “dangerous” and thus “unfit.”  In fact, this is the weapon my ex-husband has used against me since the time I began leaving him.  Just accusing someone of being crazy tends to impact the way others view that person.  My ex-husband took moves out of Dr. X’s playbook and began telling everyone, including the children’s health professionals, our neighbours, the kids’ school AND Children’s Aid that I had borderline personality disorder.

Despite the fact that my own doctor and many other doctors have testified that I do not have borderline personality disorder, this label is still haunting me 15 years after it was first, incorrectly, applied by Dr. X.

Let’s just break this down for a minute.

In the days of insane asylums, a man could have his wife committed against her will since she was essentially his property.  I’m sure asylums were full of women who were wrongly diagnosed as “hysterical” or something, just because they spoke out against the men in their lives.  Maybe they were being abused and dared to say something, maybe they didn’t conform completely to patriarchal societal standards, but one way or another they were put away.

The days of asylums are gone, but the stigma of diagnoses like borderline personality disorder remains.

It’s a very convenient excuse to deflect responsibility for perpetrating abuse.  “Oh, she’s crazy don’t you know.  You can’t believe her story because she’s mentally ill!”

Sound familiar to anyone?  Yes, accusing survivors of being “crazy” is an aspect of rape culture.  Survivors are not crazy.  They are speaking a truth that many in society do not want to hear and thus they are labelled, marginalized and stigmatized.

Every spring when the weather gets warm and t-shirts start to appear, my fear returns.  In the winter I can usually “pass” as “normal.”  My scars are safely hidden under layers of winter clothing.  In the summer, I stand awkwardly with my hands behind my back when I meet new people and when I pick the kids up from school.  I keep a cardigan at work to throw on before meeting with service users.  I see the scars myself, day after day, and sometimes it triggers me and makes me think about a time in my life I’d rather forget.

I still worry that people will view me as an unfit parent because of the coping choices I made.  But I wear t-shirts, because it’s hot outside in the summer.  I won’t hide under clothing everyday for the rest of my life.

If you have used self harm to cope, don’t be ashamed.  You survived and that is the most important thing.  Your scars tell the story of your survival.  If I could tell you a hundred times that you aren’t crazy I would.  But honestly, I’m spending a whole lot of energy reassuring myself that very same thing these days.

My scars tell my story.  Sometimes I wish my story was different, or that I had the privilege of having an invisible mental illness, but that isn’t my reality.

And believe it or not, some people think my scars look pretty damn cool.

 

PES (Psychiatric Emergency Services)

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I’d been in the psychiatric emergency rooms at South Street hospital more times than I could count.  But that was an old hospital. The rooms were basically just regular rooms, except the chairs were bolted to the ground.  One of them had an ugly green tiled floor.  One of them had a stretcher in it.  There were chairs just outside for the security guards to sit.

In July 2011, I was in a different hospital emergency room.  This hospital was newer and had an updated PES (Psychiatric Emergency Services) department.  The door to the department was locked at all times.  There were 4 small rooms, similar to the one in the picture above except the chairs were bolted down, and one washroom.  In the washroom the toilet was metal and had no seat.  The sink was metal and attached to the wall.  In the central area between the 4 rooms there was a water fountain and two telephones attached to the wall.  In the central area there was also a stretcher with restraints on it. Separated by another locked door was the nursing station.  Each of the rooms had cameras in them (except the washroom).  The nursing station had a window which looked into the department.  The washroom reminded me of what I imagine a jail looks like.  In fact the whole experience was like being in jail.

My family was out of town visiting my ex-husband’s extended family.  I was in my last weeks of the practical placement that would complete my Masters degree.  Ironically my placement was in a psychiatric hospital.  The depression that had crept back into my life in the Fall of 2009 had worsened.  There were many reasons for this.  I felt desperate and I had tried all the medications that were available.  I began to seriously consider ECT (electroconvulsive therapy aka shock treatments).  This had been suggested to me in the past around 2004, fairly early on in my psychiatric survivorship story.  At that time I felt it was too soon, I hadn’t tried a whole class of medications.

In 2011 I felt like my options were suicide or ECT and I preferred the ECT.

I wasn’t coerced, I wasn’t pressured into it.  I sought out the treatment myself with the support of my outpatient psychiatrist.  Since he has no privileges at the local hospitals my best bet was to go to the ER and ask for a consult.

My plan was to do this as an outpatient.  But things went awry.   When I told the psychiatric resident how much I was struggling and how suicidal I was she wouldn’t let me leave.  The doctor on call told me I had to be admitted to the hospital and that if I didn’t agree to stay she would admit me on a Form, involuntarily.  At this point, locked in PES, I decided my best option was to cooperate.   I hadn’t brought anything with me, and there were no beds open on the Mental Health Unit, so I was forced to spend 24 hours locked in PES.

I can’t remember exactly when I cracked, but I phoned a friend.  I told him where I was and that I wasn’t allowed to leave.  I cried to him on the phone. He was a friend from school and I was so embarrassed to be calling him from the hospital.  I felt like it was my one call to the outside world after being arrested.   I didn’t want to tell my parents, but the next day I finally did, so they could bring me some clothes and items.

Staying overnight in PES was not a pleasant experience.  The lights were always partially dimmed in the center hallway.  There were no windows to the outside world.  This place was literally a prison.

The white sheet on the bed left lint and little pills all over my lululemon yoga jacket.  They are still there to this day!  Also to this day the smell of the soaps and sheets in hospitals triggers me.  Hospitals have this very specific smell, a mix of bleach and antibacterial soap (the cheapest kind).

Meals arrived on a tray, but there was nothing I wanted to eat.  Somehow in the morning, after almost no sleep and nothing to eat, I convinced the nurse to let me go to the cafeteria to buy a snack.  I argued that since I was a voluntary patient I should be allowed and for whatever reason they reluctantly agreed.  I ate a muffin and drank some hot coffee.

The doctors came back the next day, and eventually I was moved up to the 4th floor.  I stayed for one night on the unit.  I told the doctors what I wanted: outpatient ECT.  We called my ex-husband and discussed this with him.   Everything was agreed upon and I was given an appointment to meet the doctor the next week.  I convinced them that I would be safe at home and they discharged me.  They wanted me to stay but I wanted to leave.

The hospital always seems like a good idea from the desperation of home.  But once you are there you realize that it isn’t a very safe place either.  A good part of this is because you are at the mercy of others and have very little control over your own life.  That and the doctors have the power to hold you against your will at any time.

I wonder…why do they make PES look like a prison?

Why are psychiatric patients treated like criminals?

Surely someone could design a safe and secure section of the hospital that actually looked and felt healing.  I’m willing to bet the person that designed PES had previous experience designing prisons.

I’m not a criminal.  I would heal and relax more quickly if I was in a hospital environment that felt welcoming and relaxing.  The very environment of PES conveys a lack of respect and a perspective on the status of the patients/prisoners.  PES brings up a deep sense of shame in me.  I begin to feel crazy because I am trapped and forced to comply with the orders of the staff.  In PES, you feel you have hit rock bottom.

“You are crazy.  You can’t be trusted.  We think you are going to hurt us.  You need to be locked up for our safety and for your own.  Behave or you will be locked up here indefinitely. We couldn’t be bothered to make this place welcoming or comfortable.  Because you are crazy your comfort is not our priority.  Get used to it”

This is what mental health stigma looks like.

 

Post-it notes

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Possibly one of the saddest moments in my entire story revolves around a post-it note.

During a particularly dark time in my life, sometime in early 2011, I wrote a series of 3 suicide post-it notes.  This is something I haven’t really shared with anyone.

I was completing my Master in Social Work, I was about to start my final placement.  I was working as a Teaching Assistant, attending classes and taking care of my kids.  On the outside I was functioning, but on the inside I was consumed with depression.  Looking back, I know a good part of the darkness was being caused by my increasing unhappiness within a sexually abusive marriage.  I began to feel like I had exhausted every option for recovery, every medication, every type of therapy, every treatment program and as a parent of two young kids I felt I had even fewer options.  I felt trapped and disconnected from myself and the ones I loved.

I don’t remember why I was upset or what happened that day, I do remember I wanted the pain to stop.  I was home alone, the kids were at school or daycare.  I saw a pad of yellow post-it notes one of the kids had left in my bedroom.  On it I scrawled three separate notes, one for my husband and one for each of my kids.  The notes basically said “I love you ___” and had a heart drawn under the words.   They looked like innocent little notes, the kind family members leave for each other to wish them a happy day.

But to me those were the most tragic post-it notes in existence.  In that moment where nothing was really making sense, I was saying goodbye.

I did hurt myself that day, but I went to the hospital to get it taken care of.  I didn’t tell the hospital staff about the post-it notes or about my despondent thoughts.  I let them fix me up and I went home.  I rarely discussed my suicidal thoughts in the Emergency Room unless I wanted to be admitted to the hospital.

When I got home my family was there and so were the post-it notes, unassuming and cheerful yellow papers.  But seeing them reminded me of my dark plans.  I hated those post-it notes with great passion.  They made me angry every time I saw them, but luckily anger was at least a feeling and not just numb emptiness.

The post-it notes stuck around the house for months before I finally threw them away.  I won’t ever forget them though.  They are a symbol of just how little anything ACTUALLY makes sense when you are severely depressed.  Things that seem logical in the moment are completely ridiculous and nonsensical when you are feeling brighter.  Choices that seem like the only option are revealed as unhelpful and fatalistic when you are recovered.

It’s important to hold onto this realization.  When you are severely depressed you are not thinking clearly.  When you are starved from an eating disorder you are not thinking clearly.  When you are triggered and in the middle of flashbacks you are not thinking clearly.

Don’t make decisions that could harm you or someone else when you are not thinking clearly.  Chances are you might regret it when you are calmer.   If possible focus on grounding and self care, or get help from others if you realize you are not thinking clearly.

Suicide wouldn’t have solved the problems in my life, it would have passed them on to my children, my parents and my close friends.  I can say this now, but I know for a fact that in a dark place I just won’t care.  The only thing I will think about is getting the pain to stop.

Luckily, in recovery, I know that depression is temporary and impulses to harm myself are passing thoughts.  Suicidal thinking and gestures are symptoms of depression and PTSD for some people.  Thinking about suicide can be a normal coping reaction to surviving violence.  Just thinking about suicide is not necessarily dangerous.  Sometimes it can be a way of feeling in control of something, which is actually a method of self preservation.  It is necessary to challenge the self destructive behaviours, but I try not to judge myself for the thoughts.

At the end of the day there is no difference between a person who sometimes thinks about suicide and one who does not.  There is not a special “crazy” class of folks who contemplate dying.  Suicide doesn’t discriminate.  Anyone can have the thoughts and it doesn’t make them weird, dangerous or a person to be feared or shunned.

Suicide survivors walk among us.

Sometimes the best thing you can do for a friend who contemplates suicide is to allow her to talk about her thoughts and impulses and listen without panicking and without judgment.  Validate her, let her know that you are sorry she is feeling SO awful that she feels life is hopeless.  Allow her to explore the thoughts with you, or encourage her to talk to a counselor, support worker, crisis line or doctor.  It isn’t your job to save her, it’s your job to be her friend.  Thank her for trusting you.  Let her know you care. By letting someone talk about suicide, you are reducing shame and creating a connection.

Connection is the opposite of depression.