PTSD

Things to do instead of self harm

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I’d like to share some ideas for readers who have struggled with, or currently struggle with, self harming behaviour of any kind.  Self harm can include physical injuring, substance abuse, eating disorder habits, workaholism, over exercise etc.

Personally, I find harm reduction models to be the most effective in reducing self harming behaviour.  Because self harming is a coping method, and has served a purpose, it is often difficult to abstain from doing it.  I also believe that the majority of habitual self harming behaviour is shame and avoidance based in at least some ways.   I have found it easier to live with the idea that I will sometimes engage in behaviours that are not 100% beneficial to my health.  By acknowledging this openly, I reduce the level of shame I feel when I do make a mistake, slip or relapse.  Relapse is a part of recovery in a harm reduction model.  I don’t need to feel ashamed if I go back to my old way of coping in a crisis.  Those ways worked for me for a long time and they are  habitual and comfortable to slip into.

If I have a slip, I don’t make a big deal about it.  I just move forward and try to make a different more self caring choice in the future.  Removing the intense lens of self judgment from the situation has been helpful for me.

When suggesting alternatives to self harming behaviours, I acknowledge openly that not all options are available to all people.  This is not  a list that says “you should do this” but just some options that have worked for me personally.  Using the word “should” can increase feelings of guilt and shame if you do engage in self harm. I highly encourage you to use this as a model, and make your own list that feels right for you.  Give yourself permission to explore different coping options, keep the ones that work and leave the ones that do not.  Personalizing your recovery plan is another factor that will lead to greater success within harm reduction.

  1. Give yourself permission to struggle.  It’s okay that you feel bad right now.  Your feelings will have a beginning, a middle and an end and you can survive them.  Sitting with your feelings is an option, even if it is very uncomfortable
  2. Get safe.  Often urges to self harm are a red flag for me that I’m not feeling safe or I’m feeling overwhelmed.   Reduce any stress you have control over.  Relocate to an environment that feels secure.
  3. Spend time in nature.  The trees are not oppressive, nature is forgiving.  Nature can just mean getting outside, walking around the block, sitting in a park and breathing deeply.  Noticing the colours in the leaves outside.
  4. Wrap yourself up in warm blankets, quilts, cozy sweaters etc.  For me feeling safe often involves feeling warm and wrapped up tight.  Sometimes even the weight of the blankets is calming to me
  5. Prepare a hot or cold beverage.  The warmth or chill of the cup in your hands can help to ground you.  Focus on the temperature of the glass, and the feeling of the cold or warm liquid in your mouth.  Taste the flavours in your drink and take time to breathe.
  6. Draw, scribble, write, paint -express your feelings.  Artistic self expression has helped me avoid self harm.  You don’t need to be an artist to do this, you don’t need expensive art supplies.  Sometimes just a piece of paper and pen is enough.  Feel free to destroy your creation after.
  7. Reach out.  Call a friend, a family member, a support or crisis line.  If you don’t feel comfortable calling anyone, try going to a public place like a library or coffee shop and just break the isolation by sitting there with people around you.  Talking to a safe person is often a good way to work through urges to self harm.  You have the choice to tell the person you are struggling or not.
  8. Distract yourself with an enjoyable TV show, youtube video, magazine, book or music.  Lose yourself in another world for a short time.  Choose something that will cheer you, not something triggering.
  9. Exercise.  Use your large muscle groups.  Walk, do jumping jacks, stretch, yoga, lifting cans in your kitchen, anything you feel able to do and have access to.  Moving your body can help you process intense feelings like anger.
  10. Connect with spirituality, meditate, religion etc.  Connect with a higher power.  For me this means visiting nature and getting in touch with how small I am compared with the power of the natural world
  11. Spend time with someone very young or very old, or a pet.  Volunteer, connect with a family member, visit a neighbour with a new baby, offer to pick up groceries for a senior living in your area.  Walk your neighbour’s dog, take care of your own pets. Helping others, even in small ways, can be an option and alternative to self destructive coping.  For me, being able to help another person reduces my sense of shame and hopelessness and increases my connections.
  12. Hug a stuffed animal.  Sometimes I need comfort and stuffed animals are a good option for me and help me feel safe.
  13. Spend time around water.  Take a bath or shower.  Walk by the river, ocean or lake.  Go swimming.  Run warm or cold water over your hands and wrists.   Flowing water can be very calming.
  14. Use positive affirmations, ideally ones you have prepared yourself.  Sometimes self harming is driven by negative self talk and negative shame based messages you are giving yourself.  You can find ideas for affirmations on the internet and rework them to suit your purpose.  If an affirmation seems unrealistic try adding “I’m learning to…” at the beginning.   For example, “I’m learning to love myself.“
  15. Remind yourself that you are doing the best you can.  That you are surviving and sometimes that is enough.  Some days all we can do is survive and that’s okay.

These are just a few ideas I’ve worked with over the years.  I hope you find them helpful.  Please feel free to comment with your coping ideas!

Why I sometimes miss self harm…

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<trigger warning for description of self harm>

It’s a strange thing to admit, but if I’m 100% honest with you, I still miss self harm.  As a coping mechanism it has to be considered one of the worst.  Almost my entire body is covered with permanent scars.  The scars cause me to be self conscious and feel shame.  The scars also result in social stigma, and difficulty in being taken seriously by health care providers.  They itch as they heal and sometimes they hurt.  They are constant reminders of parts of my past that I’d rather forget.

Usually when I think about self harm, what stops me is remembering two things

  1. The self harm only ever helps for a brief moment
  2. I will have to hide the wound and feel intense shame about this, as well as worry about the consequences if anyone sees the injury

This usually works, but sometimes I feel bitter and angry.   Sometimes I have thoughts like “If society didn’t consider self harm to be SO AWFUL, I could just keep doing it, because I wouldn’t feel ashamed and I wouldn’t worry about the potential negative consequences on my family.”  I get angry and I feel like my coping mechanism is being taken away from me.  I get angry and think about how some people get fall down drunk on a regular basis and society thinks this is acceptable.   Why isn’t MY coping mechanism acceptable too?  I feel like having a tantrum like a 2 year old child!  I want it and I want it NOW!  But most of the time I refrain from self harming, not just for my children, but for myself too.  It’s not a lifestyle that I want to return to.

I do want to write about some of the complex reasons I miss self harm.  Some of this might sound completely ridiculous to you.  I’m worried about being honest and just writing this down.  I’m worried about being judged for liking some aspects of this self destructive habit.

Self harm gave me something physical to take care of, and be taken care of for,  when my inner pain was un-fixable and unreachable.

Even though I experienced a lot of maltreatment and abuse in the psychiatric system and hospital emergency rooms, I sometimes miss having a physical injury that could be fixed.

There were times when I was almost addicted to the process.  The care I received after self harming was almost as important, if not more important, than the ritual itself.  The trip to the emergency room WAS part of the ritual.   To be honest, without this part of the ritual, without the serious self harm, it seems almost useless to hurt myself at all.

There was a predictable ritual to the emergency room visit.  At times, I felt safe and cared for there.  At times it felt like a pause, a break from the day to day stressors in my life, which at that time felt unbearable.   I think there was a part of me that used self harm and suicide attempts as an excuse.  Not a cry for help or attention, but a cry that said: “I can’t do this.  It’s too much.  I need a break.  I need to be cared for.  I’m not capable.  I’m afraid to fail.”

I remember some of the times I had multiple serious injuries from self harm.  It took the doctor or medical students a considerable amount of time to fix the cuts.  During that time, the doctor would often speak to me.  I had their full attention.  I was being cared for and I was being symbolically “fixed.”

There was a ritual to the process.  Triage.  Waiting room.  Exam room.  The questions.  The cleaning of the wounds.  The freezing.  The sutures.  The bandaging after.  The conversation.  The questions.  For those hours, if I was treated nicely, it was like being numb and being in another world.    A world where time was stopped, my responsibilities were paused, the outside world did not exist.    I actually FELT better afterwards, like I had been healed, but the improvement was so fleeting.  So very fleeting, that often I was injuring again only a day later.

It was as if the injury gave me an excuse to stop, validation to say “I’m not well.  I’m not coping.  I need help!”  Without the injury, without the physical reason, I struggled to ask for or to accept help.  I still do.

I’ve never really verbalized all this to anyone before.

I remember one time, I cut myself on my stomach.  It was deeper than usual, maybe deeper than I intended or realized, because I was new to injuring in that spot.  Over time I had learned to hurt myself in places I could hide.   (When I first started, I was almost hypomanic from SSRIs and I cut in visible places, places everyone could see and that were very difficult to hide.)

I went to the hospital, as I usually would, alone.  At the triage desk they examined me, discovered the wound was serious and triaged me as Emergent rather than Urgent or Less Urgent.   I was put into a wheelchair and taken back into a part of the ER I’d never seen before.  I think it was the place for seriously ill people. The lights were dimmed and the bed was actually comfortable.  I had my own room, not just a curtained area.  It was quiet and comfortable.  I didn’t have to wait very long and I remember feeling safe and calm and protected.  I felt like my health problem was considered important, legitimate and I was being cared for appropriately.  I had a female doctor and she was kind to me.  She was wearing ordinary clothes rather than scrubs or a gown.  I remember her as being fairly young.  She treated me as if I had a physical health problem, not as a mad, crazy, unworthy self harming psych patient.   I felt bad because she got blood on her clothing while she fixed my injury.   I can’t really describe exactly what happened that night.   But I felt protected and the ritual had worked, my mind was quiet.  The racing thoughts were gone.  It was silent and the room was dimmed, like the thoughts were dimmed as well.  For that time I was in another world.

I’m having a difficult week.  I’m feeling overwhelmed and lonely and scared.  I’d like nothing more than to be cared for.  To be honest, the thought of that quiet, dimly lit emergency room bed is very appealing. But I don’t want to achieve this through self harm.  I don’t want to be “sick” and treated in hospital to get a break or to feel validated in resting.

I want someone to take care of me because they care about me, not because it is their job.  I want comfort because someone loves me, not because they are scared that I might harm myself.

I want to be an adult and not a misbehaving, out of control 2 year old.  This is part of what recovery means to me.  I have to use my words, not my actions to let people know that I’m not okay.

Note: the art was made in 2005

September 10 -World Suicide Prevention Day

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On this day I remember the friends I have lost to suicide.  I think of the friends I know who are suicide survivors.  I think about the service users I work with who struggle with suicidal thoughts.  I think about what it means to be a suicide survivor.

I am a suicide survivor.

I can’t speak to the experiences of other people who have survived suicide attempts, but I would like to share my own thoughts.  I think there are a lot of myths out there related to surviving suicide, how to help people who are suicidal and why people attempt or complete suicide.   It’s a taboo subject, one that people skirt around.  Sometimes the mere mention of suicide can silence a room, create uncomfortable looks and make those around you ill at ease.  I think this is mainly due fear.  It’s almost like people think that suicide is contagious.

I rarely talk about my experiences as a suicide survivor.  There seems to be a tacit agreement that it is not a suitable conversation topic.  Even in therapy there is the worry that talking about suicide will lead to unwanted consequences, trips to the hospital, worrying others, making others think that you are “crazy” or “unstable.”

Here are some of the myths surrounding suicide that I’d like to dispel.  These are my own thoughts and I don’t claim to speak for everyone who has these experiences.

  1. Suicidal thoughts and suicide attempts are impulsive reactions and pass quickly.
  2. Talking about suicide means that someone is not serious and is not really at risk
  3. Suicide attempts are always a “cry for help” and the person doesn’t want to die
  4. People who survive suicide attempts are grateful to be alive and recover quickly
  5. Talking about suicide will just “give someone ideas” and it will increase their risk
  6. The best way to help someone who is suicidal is to call 911 or take them to hospital
  7. If someone is habitualy suicidal, the experience is normal for them and they don’t feel afraid or need support.

Realities

  1. I’ve struggled with suicidal thoughts on an ongoing basis since I was 17 years old.  That’s almost 20 years.  My suicidal thoughts can sometimes be impulsive, but in my experience they are usually long lasting, persistent and even obsessive in nature.  I wouldn’t even like to hazard a guess as to the number of hours I’ve spent planning ways to die and thinking about ending my life.  In my experience, the impulsive thoughts are the most dangerous and the scariest, but the chronic obsessing about suicide is more exhausting and creates  a sense of hopelessness.   Many people struggle with suicidal thoughts over a long period of time, just because they don’t act on it or don’t talk about it, does not mean they are not at risk.
  2. I hear this a lot.  “If she is willing to talk about her suicide plan it means she isn’t serious and she really wants help.”  This is a dangerous assumption.  Every person is different, every situation is different.  Some of the times I tried to kill myself I didn’t tell anyone, I didn’t talk about it before hand, there wasn’t an opportunity to intervene.  Other times I spoke about it to many people, I asked for help, I went to the hospital without harming myself, and I often found that I was not believed or taken seriously.   It was incredibly frustrating because when I went to the hospital AFTER harming myself the doctors were angry that I didn’t “ask for help.”  When I went without harming myself, they assumed I was safe and rational and did not need help.  It was a vicious unhealthy cycle.  In my opinion, if someone is talking about suicide you should listen and you should take it seriously.  Many people who complete suicide have talked about their thoughts prior to taking the final step.  On the other hand, if someone never talks about suicide we can’t assume they are not at risk.
  3. Suicide attempts are not always a cry for help.  Sometimes the suicide survivor really did want to die and their attempt failed.  Suicide attempts are not a way to seek attention.  They are not a way to control or manipulate people.
  4. When I attempted suicide and survived, I was not grateful.  I felt like a failure.  I felt worthless and ashamed.  I felt like I couldn’t do anything right.  I felt ill and I had physical effects from harming myself.  I felt alone and I felt stigma. Even today, years later I regularly wish I had died years ago when I attempted.   Not all suicide survivors are happy to be alive.  We don’t all wake up the next day, thankful for a second chance.  It’s also common to be happy to be alive sometimes and wish you had died at other times.  The recovery process can take a long time and will last far longer than the short time someone might spend in the hospital or away from work/school.
  5. Talking to someone who you think may be suicidal will not increase their risk.  It’s far more risky to stay silent, not ask the questions, not check in with someone.  If you are concerned about someone you care about, I recommend asking them directly if they have thoughts of harming themselves, ending their lives, or wishing they were not alive.  Ask them if they feel like a burden, ask them about what connections they have in their lives, ask them if they feel hopeless.  It’s better to know the answers, then to assume someone is not suicidal.  Sometimes a suicidal person feels like nobody cares about them, and staying silent could reinforce that belief.  I can’t even remember the number of times that I was stopped from harming myself by receiving a phone call from a friend, or a connection with someone around me.  Connection is the opposite of depression.  Asking someone about suicidal thoughts is not easy, but losing them to suicide will be harder.
  6. Calling 911 or taking someone to the hospital is not always the best way to help a suicidal person.  Sometimes involving the police, ambulance or hospital can escalate a situation.  Sometimes it can destroy the trust you have with that person.  In many situations it can be helpful to give the suicidal person choices and options.  Thank them for opening up to you.  Ask them what they feel would be most helpful.  In my experience, suicidal feelings are often linked to feeling out of control and overwhelmed.  Taking away choices from someone or punishing them for suicidal thoughts can add to feelings of powerlessness.  Offering choices can be an antidote.  Maybe the person wants company, maybe they don’t.  Maybe they just want a chance to talk about their suicidal feelings without being judged.  Maybe they do need medical intervention, maybe you can take them to the hospital and stay with them.  If someone is suicidal and impaired by drugs and alcohol, or has access to lethal methods such as a gun, you may have fewer options.   But calling 911 without somoene’s permission should be a last resort.  Hospitals don’t even always admit someone who is suicidal.   I’ve been in the ER, highly suicidal and at huge risk, and just sent home.  I’ve been told “she isn’t psychotic so  she can go home, she isn’t at risk.”  I’ve often felt WORSE after unpleasant and unhelpful interactions in the ER.  It’s a myth that hospitals always help suicidal people.  Consider all your options and include the suicidal person in decision making as much as possible.  Also make sure you take care of yourself.  You are not responsible for saving anyone.
  7.  People like me, who struggle with suicidal thoughts on a chronic basis, still get scared.  Feeling suicidal is a scary thing.  It doesn’t matter that I’ve felt this way hundreds of times before.  I’m afraid.  I always worry that I will become impulsive and make bad choices.  I always feel afraid of telling someone, afraid of their reaction, afraid of the stigma.  Afraid people will think I shouldn’t be working, parenting, left alone etc.  If you know someone who chronically talks about suicide or habitually harms themselves, don’t give up on them.  Don’t assume they don’t want to get better.   Suicidal thoughts and self harm behaviours can be a coping mechanism for many survivors of violence.  Sometimes thinking about harming myself feels like the only way I can have control in an out of control and scary world.  Suicidal people need and deserve compassion.  Never underestimate how much good you can do by just non-judgmentally acknowledging someone’s struggle:  “Those thoughts sound very scary, you must feel pretty overwhelmed right now, I’m sorry you are struggling, what can I do to help?”

 

I miss my friends who completed suicide, but they are not cowards.  They are some of the bravest, most beautiful people I have ever known.  Suicide survivors are all around us.  We are regular people, living regular lives.  Suicide isn’t just something that happens to “crazy” people.  It can happen to anyone.  Breaking down the stigma helps everyone.  I think about suicide on a regular basis, but I still have an ordinary, productive life.  If you struggle with suicidal thoughts, or have lost someone to suicide, you are not alone and you should not be ashamed.  Be good to yourself, I’m happy you are alive.

Innocent Until Proven Guilty.

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I’m feeling frustrated today about how survivors of sexual violence and abuse survivors in general have to constantly justify their existence to everyone on this planet, especially to people in authority.

We have a legal system which states that perpetrators are innocent until proven guilty.

But what about survivors?  Where are our rights to be considered innocent until proven guilty?

Why is it when a survivor comes forward and says “He raped me,” she is often met with doubt, blame, judgment, disbelief and then faced with barrier after barrier to being believed and getting support?

Doesn’t this strike you as wrong?

I’m here to suggest a radical position.  Our legal system can still consider perpetrators innocent until proven guilty, while at the same time survivors can be believed, validated, treated with respect and not accused of fabricating.

It’s very unlikely that a survivor would make up claims of abuse, especially considering the lack of support and validation in our society.

A few years ago my psychiatrist told me something I’ve been thinking about this week.  During the session I had been speaking a lot about my negative self esteem, my guilt, my shame, my body hatred, my struggles with anorexia and so on.  He asked me a question “If you were guilty of committing sexual abuse how long would you go to jail for?”   I answered him “Probably I wouldn’t go to jail, and if I did it would be for less than a year.”

He looked at me and said “You’ve been punishing yourself for more than 15 years for crimes you didn’t even commit.  Even if you were as guilty as you say you feel, you would have been out of jail long ago.  Stop punishing yourself.  Even criminals wouldn’t receive a 15 year sentence!”

It was a good point and I thought about it some.  I haven’t thought about it again until this week.

Honestly, my doctor was missing something in his analysis.  Maybe survivors, myself included, would have an easier time recovering and forgiving themselves, if they did not have to spend years justifying their experience and trying to convince others that the abuse really happened.

Maybe if women weren’t labelled as crazy or mentally ill.  Maybe if police treated women who report with respect and investigated their concerns quickly, thoroughly and with dignity for the survivor.  Maybe if the legal system wasn’t founded on white patriarchy.  Maybe if sexual assault conviction rates were higher.  Maybe if sentences for assault charges took into account the amount of harm that was done to the survivor.  Maybe if our society didn’t worry about “how it will impact his career” and instead considered “how it will impact the rest of her life.”

Because make no mistake.  Sexual assault impacts people’s lives.  It is not a crime that lasts for “just a few minutes”  it lives on in people for years, maybe forever.  The impact IS that voice inside the survivor which whispers “it’s your fault, you are dirty, you should be ashamed, nobody will believe you.”

Maybe we punish ourselves because there is no other option in a society that doesn’t validate what actually happened.  Maybe we doubt ourselves because society blames the victim.

I think that a large portion of the guilt and shame carried around by people like me was caused, not just by the perpetrator, but by a set of systems which are designed to blame us.

At this point in my life, I feel I have suffered an equal amount of trauma at the hands of systems that were supposedly designed to help me, as I ever did at the hands of my abusers.   This is a part of rape culture that we need to be talking about.

It was “just” sexual abuse…

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I’ve been thinking about the barriers I faced in coming forward about being sexually abused, as a child and as an adult.  For people who have not experience sexual abuse, the most immediate response to someone disclosing is often: “why didn’t you tell someone?”  or “why didn’t you tell someone sooner?” or my personal favourite “why didn’t you fight back/scream/run?”

The reality is I didn’t even realize I was being abused until long after the abusers had intertwined their lives with mine.

The reality is that abuse in relationships does always not look the way you might expect it to.

The reality is that I spent a long time, as an adult, in counseling, volunteering at a women’s centre etc…stating to other reasonable adults “it was ‘just’ sexual abuse.”  I made all sorts of excuses for why it didn’t count, why it wasn’t important, why it wasn’t real abuse, why I didn’t deserve help, why other people had it worse off, why I was making a big deal over nothing, why I didn’t want to tell anyone and ruin his life etc.

Because they never hit me, it wasn’t abuse.  Because they didn’t threaten to kill me, it wasn’t abuse.  Because I said yes some of the time, it wasn’t abuse.

I was (and am) pretty mean to myself and a lot of my perceptions were just plain wrong.

I think it takes a lot of strength and courage to really come face to face with the fact that your romantic relationship is unhealthy, abusive and actively making you sick.  It’s not something that comes easily, turning your back on the father of your children.

I told myself the abuse didn’t count.  I knew I felt uncomfortable, I knew it very early on in both relationships.  I saw the red flags, but somehow I interpreted them differently.  I wanted to believe that things weren’t really that bad.  I wanted to believe I could help the abusers change.  That they were depressed, that they needed me.  That their needs were more important than my own.  I wanted to believe that love would be enough.

I did start to talk about the abuse.  I did tell people.  In some ways, I wasn’t really challenged by those people.  I think many of them instinctively knew I wasn’t ready to leave.  They knew I needed time to come to the realization that it was abuse and that I needed to get out.  For the most part they didn’t push me.  I was still ambivalent about the abuser and I still wanted things to “work out.”

One day someone I volunteered with called me out.  I mentioned something about it being “just” sexual abuse.  She challenged me.  She sat there and said “what you are saying doesn’t make sense.  It’s not ‘just’ sexual abuse.”  I think it was the first time someone had openly called me out on my own denial.  This was in the month or 2 leading up to my decision to leave.

At the time I left him I still believed it was “just” sexual abuse.  I told almost nobody why I was leaving.  I thought that moving would solve the problem, because since it was “just” sexual abuse I would be safe.

I was wrong.  Sexual assault is not about sex.   It’s about power and control.  It’s about a level of narcissism that exists in this world that allows one person to disregard the consent of another person.  Within any type of relationship it’s about manipulation, it’s about gaslighting, it’s about making the victim feel crazy, worthless, broken, damaged, and most of all dependent on the abuser.   The sex is a tool of control.  It rarely happens in isolation.  Emotional abuse, psychological abuse, physical abuse, threats, coercion…it’s all part of the same package.  Even if the package is wrapped in a disguise that makes you believe that sex is the only issue and that otherwise the person is “basically a good guy.”

At the end of the day, if someone doesn’t respect your consent sexually, they don’t respect you.  They aren’t “basically a good person.”  They are a person who does not value your basic right to say yes or no in a given situation.  They are a person who puts their own needs before yours, and possibly even denies your needs are real, valid or even exist.

It’s a long road back from that place.  The place where you question whether your needs are reasonable, valid or even exist.  It’s a long way back from the place where you believe that your consent is not relevant, where your needs are not relevant.  Where you are blamed for not wanting to consent, even in a situation where there is no trust, no safety and almost no relationship left.

I’m writing this to tell you:

  1. if you have been abused, it’s never “just” anything.  Your experience is valid and real.  If you are uncomfortable, afraid, hurt, feeling crazy then trust yourself.  It’s abuse.
  2.  if you have been abused and even if you have not, please remember that there is no specific way an abuse survivor looks, copes or experiences violence.  There may be no physical marks, there may be denial, there may be almost no signs at all.  Trust yourself, if you have the feeling something isn’t right in your relationship or in the relationship of someone you care about, reach out.  Get help, talk it over, ask gentle questions, be there to support yourself or the person you care about.
  3. believe the survivor.  If you are the survivor, believe yourself
  4. if you still blame yourself, or the person you care about is blaming themselves, tell them it is not their fault.  Repeat step 3.  Repeat step 3 again.  Repeat it again and again and again.

I believe you.  It’s not your fault.  It counts.  It’s is real.  You deserve support.

 

No uniformed officers please.

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It’s Pride Week and I want to write about why I don’t think uniformed police officers should be in the Parade.   The police should be welcome, but they should attend the parade as civilians, dressed in ordinary clothing.

I’m not anti-police, so much as pro-safe spaces.  There are a number of groups of people and communities that may feel threatened by uniformed police officers (no matter how nice those officers might be!).  I know some LGBTQ* folks who have declined to attend Pride this year because they don’t feel it is a safe space for them.

Some communities that have experienced marginalization, violence and oppression perpetrated by police include (but are not limited to): Trans* folks, People of Colour, Indigenous communities, sex workers, immigrant and refugee folks, lesbians, gay people, queer folks, survivors of sexual violence, people with disability and people with mental health and addiction diagnoses.  Especially people who embody any of these intersecting identities in a visible or public way.   The police have a lot of power and privilege and this has often been used against, and not for/with, marginalized groups.

My own experience, and the focus of this blog, is related to my experience of living with a mental illness that does not always allow me to “pass” as normal or neurotypical.

I will describe one of my interactions with the police, as an illustration of my own preference not to have uniformed officers at Pride.

When I used to self harm and attempt suicide on a regular basis, I used to get to the hospital by car, bus, taxi or on foot.  Near the end of the years of regular ER visits, a doctor told me she didn’t think it was safe for me to drive myself to the hospital after cutting myself deeply.  I thought about it for a while and figured she was right.  The next time I hurt myself I was suicidal, not just cutting as coping.  I was home alone and I decided to call 911 rather than a taxi.   During the 911 call I told the truth to the operator.  I told them that I had cut myself on purpose and that I wasn’t feeling safe.  I sat on the staircase in the front entryway and waiting for the ambulance to arrive.

Suddenly there was a knock at the door and I could see tall people in dark uniforms outside.  I opened the door and two huge uniformed police officers stood there.  I was confused, already upset and I started panicking.  I asked where the ambulance was, I told them I changed my mind, I didn’t need police.  They came into the house and told me to sit on the steps.  They started asking me what seemed like hundreds of questions and told me I couldn’t move.  They asked me if there were weapons in the house, if I was alone in the house, if there was medication in the house, where the tools I had cut myself were, whether I had a doctor, what medications I took etc.

I felt more and more panicked.  I knew I couldn’t visibly keep panicking because I knew they wouldn’t leave until they felt I wasn’t a danger to anyone. The feeling of being out of control and knowing you can’t properly show your feelings is an unsafe and triggering one for a survivor of violence.

I felt like I had no choice but to do exactly what they said.  They told me the paramedics couldn’t come into the house until they were sure it was safe.  I tried to explain that I had harmed myself and had no intention of harming anyone else.  I was crying.  I offered to get the things they wanted (the blade, the medication) but they wouldn’t allow me to move.  I had to explain where the items were and one uniformed officer walked around my house collecting them, while the other stood and watched me.  They both had guns.  Generally, guns do not make a suicidal panicky person feel calmer.  Just FYI.

Then they were both back in the room.  I was sitting on the couch, now in the living room.  They asked me questions about my treatment and my medication. I didn’t want to answer them.  They were taking notes in a small black book.  I was keenly aware that this information could be used against me in the future.  I was scared I might have a police record, when what I really needed was medical attention.  I was confused and I didn’t understand how harming myself was a police matter.

Finally, at some point they determined the situation was safe.  Two paramedics, one man and one woman came into the house.  At some point the police left and went outside, making further notes in their cars.  I was embarrassed and ashamed because I knew my neighbours would see the commotion.  I felt my face burning with shame as I walked to the ambulance with the paramedics.  I begged them not to turn on the sirens because I was so embarrassed already.  I’d spent every minute since I opened the door to the house wishing that I had never called 911.     The female paramedic drove the ambulance and the male sat inside with me.  He was calm and kind and he didn’t have a gun.  I felt safer once the police were gone.

In the past, I’d had security guards sit by my bed, or just outside the door in the ER.  Ensuring that I didn’t run away before being assessed by the doctor.  That was associated in my mind with feeling unsafe and not being trusted.  Being a prisoner within a hospital rather than a patient.  That’s how I felt in my own home that day.

The ambulance took me to the hospital and I received treatment for my cut.  I wasn’t admitted to the hospital, because nobody really took my self harm seriously by that point.  They had labelled me borderline and didn’t believe I would ever actually kill myself.  I was often treated like a misbehaving child.

This memory is one reason why I don’t feel safe around uniformed police officers.  The other reasons, related to reporting violence, I will talk about more in future posts.

If I have a serious mental health crisis again in the future, I hope nobody will call the police.  I can’t think how that would calm me down or de-escalate the situation.  I would feel more at risk, rather than safer.

So, for this reason and for many others, I believe there are other ways to create safer and more inclusive spaces.  And LGBTQ* police officers, please feel welcomed by me at Pride…just leave the uniforms and guns behind.

 

 

 

Depression meets PTSD. Crash.

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raw-chicken

I’ve realized over the past three years that depression is often more of a secondary problem for me.  It’s very situational and very linked to PTSD.  By the time depression flares up, it generally means that I’ve been coping with PTSD triggers for too long and I’ve started to crash into exhaustion.  Depression sometimes means feeling literally nothing, while PTSD can mean feeling everything and things that are from the past vaulted into the present, clear as day.   This can be a confusing progression.

Lately it’s hard to tease out whether I have a whole host of mental health diagnosis or just one (PTSD) causing a host of symptoms.

Abuse triggers can lead to negative feelings about my body which can then trigger my good friend Ana…yes, PTSD comes first and anorexia is a symptom.   For me anorexia is mainly a series of obsessive compulsive thoughts and behaviours which are linked to extreme anxiety around changing my food rituals.   So anorexia comes first, and OCD traits follow.

When I have a lot of PTSD symptoms and flashbacks, I start to have trouble sleeping and I have vivid nightmares.  Sometimes I wake in the middle of the night to a full panic attack.  Flashbacks can lead to panic attacks during the day as well, and also to anxiety in crowds and enclosed spaces.  So PTSD comes first, and anxiety and panic symptoms follow.

At the end of the line comes depression.  DEPRESSION.  It feels so heavy.  Depression to me leads from coping to constant suicidal and self harm ideation in what seems like mere seconds.  For me, suicidal thoughts are often the first real indicator that I’ve slipped into depression again.  This may seem backwards, but for me the most severe symptom tends to come right at the start, even if I’m depressed for only a few days.

When I’m depressed I feel like I’m walking through a thick soup of fog.  Every fibre of my being hurts and feels heavy and leaden.  Sometimes I have to lie down after just showering and getting dressed in the morning because I feel too exhausted to continue with the day.  When I’m depressed I have no energy.  I want to crawl into bed and hide.  Unfortunately, I’m a single parent and I have a full time job.   It’s not an option just to crash.

So I keep going, but the time crawls by.  I feel unsure if I can get through the day.  I feel unsure if I can stay safe, and resist the negative thoughts.  My self esteem crashes.  I start to feel a lot of feelings from the past.  Or maybe that is backwards, maybe I feel the feelings from the past and it triggers depression.

When I feel out of control of important aspects of my life, I am triggered and I think about suicide.  This is the way my life is.  It’s been this way since I was 17 years old.   It’s both normal to me, and completely terrifying every time it happens.

The depression always lifts and these days it lifts more quickly than it ever did in the past.  The lights come on again, I see the world clearly and not through a haze.  I feel connected and I feel like I am competent at some things.  When I’m depressed I feel alone and I feel utterly worthless.  I feel like a burden and a problem and someone that people I know put up with, rather than care about.  I have trouble making small talk.  I spend a lot of time silent.  I feel an immense amount of social anxiety and discomfort in social situations, especially those involving food.  Depression, anxiety, anorexia, PTSD….it’s a perfect storm of misery.  I’m caught in the middle of a storm of symptoms and I don’t know when they will abate.

Right now I’m triggered because I’m worried about my children.  I’m triggered because of the way my ex-husband treats my children and me.  I’m triggered because this is the time of year, 3 years ago, leading up to my physical separation from him, when things were at their most tense and scary.

I’m triggered today because my daughter told me that her father’s avatar/icon for me on his phone is a piece of raw meat.  Raw chicken.   The father of my two children sees me as nothing more than a piece of meat.

Fuck.

 

Inpatient bonds.

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20160727_214408[1]One of the bright sides of spending so much time in hospitals during my teens and early twenties is the people I met there.  Some of them became lasting friends and the bonds between us defied understanding by outsiders.

If you’ve never spent a significant amount of time as an inpatient in psychiatric wards and mental health treatment facilities you probably won’t understand.

I’ve had people close to me tell me that I “shouldn’t have so many friends with problems” or that I should “try to make healthier friends” or that I “shouldn’t talk to people who depress me.”

These comments miss the point for a number of reasons.

First of all, if my “friends with problems” aren’t worthy and I shouldn’t be friends with them, does that mean nobody should be friends with me either?  In case you hadn’t realized from reading this blog, the secret is out.  I identify as living with mental illness! I’m not exactly 100% well myself, otherwise I wouldn’t have been in the hospital in the first place!  Does this make me less of a good friend?  Does this make me a person who should be shunned and avoided?  I certainly hope not.  I would like to afford my other hospital friends the same courtesy.

Two, it’s hard for people who are mentally well, neurotypical, never struggled with severe mental illness to understand me.  Sure, I have well friends who empathize and who don’t judge me.  But the bonds and mutual understanding I’ve shared with other people who struggle with PTSD, eating disorders, depression and suicide are very strong.   It’s like I can breathe again, when I talk to a friend who I know “just gets it.”

Three, when you are living in a hospital ward, you naturally form friendships and alliances with the people you are living with.  Some of them become friends.  It happens and it helps us survive.

So please, don’t judge these special friendships.  Even when I’ve lost friends to suicide, even when I’ve been triggered by friends and had to set boundaries, even when it feels like listening to their struggles is too much to bear, I never regret them.

My dear friends who are gone.  I desperately miss that feeling of belonging I had when I talked to you, laughed with you.  MJ, there was never anything I shared about PTSD that you hadn’t breathed and experienced yourself.  I never had to explain myself, you just knew.  This blog entry’s photograph is a picture of all the cards you wrote to me during our friendship.

Who else could I share my strange experiences with?  When I told her one day, crying in the bathroom in my ex-husband’s house, that I was scared because I thought I was seeing X everywhere.  I literally thought I could see him all around the city.  Intellectually, I knew he wasn’t there, but it felt real and my heart skipped a beat each time.   She almost laughed and said, “It happens to me all the time.  I see everywhere too”  We breathed out together, suddenly this PTSD symptom was normal and okay.  We understood each other, we weren’t crazy.  I loved her for this and I know she loved me for it too.

When I was in treatment for anorexia when I was 17, I met another young woman named M.  She and I were stuck on the eating disorder for 5 weeks together, while other patients attended groups.  We were on “modified activity phase” until we gained a certain percentage of our goal weight and it took forever.  During this time we talked, bonded and sometimes sneaked around doing things we should not have.   She was painting rocks when I got there.  I asked her what I was doing and if I could help.  She told me she wanted to paint 1000 rocks so her wish would be granted.  Soon, we had an assembly line going.  We would fill our pockets with rocks on our 15 minute outside break, sometimes walking further than we should have away from the break area.   Once inside, I would paint the rocks a solid colour, then when they dried she would write “Expect a Miracle” in careful lettering on each one.  The final step was applying a clear glaze once all the paint was dry.   We painted so many rocks, I don’t remember how many we had finished when I discharged myself 3 months later.  I still have some of them in my bedroom almost 20 years later.  I’m still waiting for a miracle.   I often wonder what happened to M.  We lost contact and I still think of her often.  I wonder if her miracle came true and I wonder if she recovered.

I met my friend Lexi at a support group in my city.  It was the first place I really talked at any length about leaving my ex-husband and what was going on in the marriage.  Lexi loved to crochet and knit.  She loved her family.  I used to go to her apartment sometimes and we would chat about all sorts of things.  Sometimes we shared stories of our trauma and sometimes we joked and laughed about our future.  I was inspired to try online dating because of Lexi.   I lost her suddenly last summer, about  a year ago now.  I still miss her.

Darlene, whose story I recounted in another blog post, her anniversary was this week.  14 years ago I lost her.   I wish I’d had the chance to know her better, but I won’t ever forget her.

Some friends like my dear sister LJ, I have kept in contact with for over 12 years, through email, fb, text and phone.  She lives in a different country, but she calls me sister.  I miss her and I hope to see her again one day.  I have ever letter and card she has ever sent me. She has inspired me in many ways and her commitment to recovery and to survival is tremendous.

My friend John, he is also gone now.  But his music lives on and I have his CD which I listen to from time to time and remember his gentle courage.

I will never forget the stories of survival I heard and witnessed during my hospital stays.  I met so many survivors.  I met war veterans who were kind and brave enough to share small details of their own private hells with me.  I met residential school survivors who shared with me the abuse they endured.  I met childhood abuse survivors who overcame.  I met women who were admitted to the hospital in full psychosis, speaking in delusions and making little sense.  I saw those same women, mere days later, completely calm and rational again after taking their medication.  I met people who had lost family members in tragic circumstances.  I met people who had nearly died from multiple heart attacks due to anorexia and bulimia and some of those women have children and are well and healthy today.

These friends give me hope.  They remind me that I’m not alone.  They remind me that recovery is possible.  And the ones that have died, I will hold in a special place in my heart forever.

Inpatient bonds are something to be celebrated.

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.