Meet Ana.

These pictures are of a cartoon girl called Emily Strange.  If I could draw a comic book version of Ana, she would look something like Emily Strange.

Ana isn’t just my eating disorder personified.   Ana isn’t just a nickname for anorexia.  Ana is another part of me.  I experience Ana as an angry teenage girl.  She isn’t just me as a teenager.  She has long straight black hair and very pale white skin.  She has dark eyes which are usually downcast.   Her fists clench when she is angry.  She wears hoodies, dark clothes, army boots and skirts.  She is slim and looks like she could sneak around very easily, light on her feet and quiet.  She is filled with anger and yet she doesn’t take up much obvious space.   Ana is my inner child.  Ana is my alter ego.  Ana is my eating disorder.  Ana is self harm and suicidal thoughts.  Because Ana is a scared, teenage girl.

Ana is the part of me that doesn’t trust you.

Ana is the part of me that wants everything or nothing at all.  Complete loyalty, or no friendship.

Ana is the part of me that feels like nobody believes me.   Ana doesn’t feel heard and when she is angry, she hurts me rather than expressing herself assertively.

Ana acts out, but that’s because she’s  young.  She’s probably only 14 or 15 years old.  She doesn’t have life skills.  Her anger is a mask for fears she is too afraid to share.  Her prickly exterior is a mask hiding deep vulnerability and shame.

Ana feels worthless.  Ana feels helpless.  Ana feels like punishing me is the only solution to these feelings.

Ana acts like a complete spoiled, controlling brat, when she really wants to be rescued.   She makes unreasonable rules rather than admitting she is afraid.

Ana craves safety, yet acts like she does not need protection.

Ana blames herself for being abused.   Ana feels responsible and wants to protect me by keeping me alone.  Ana tries to push people away with self harm, suicidal thoughts and eating disorder behaviours.  Ana thinks if we are smaller and take up less space we will be safer.

Ana is me.  At least she is a part of me, but I don’t know how to make peace with her, forgive her, accept her and come to a truce.  I don’t know how to integrate her, so that we become just one adult person again.  I’m not sure how to soothe this angry child inside of me.  We lack compassion for each other and for our younger selves.

I hope one day I can truly feel that Ana deserves forgiveness for hurting me.  And that she can forgive me for not protecting her.

Firsts.

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<trigger warning for graphic descriptions of self harm and eating disorder>

I’ve been thinking a lot about the “firsts” of my mental illnesses.  We all have memories of the first time we did certain things or had certain experiences, but for people who have chronic mental health struggles over a number of years, not all “firsts” are positive memories to celebrate.

When I was experiencing my “firsts” of mental illness I was a teenager.  I was 15-17 years old and I didn’t have any idea that my experiences were those of specific mental illness, let alone what those mental illnesses might be.  I thought that I was going crazy.  I thought I was the only one.  I was afraid to tell others what I was experiencing internally.  Until I was diagnosed with PTSD when I was 20 years old, most of my “firsts” made little sense to me.

The first time I experienced what would become anorexia I was about 16 years old.  I’ve written about it in another blog post.  I was physically sick and hadn’t eaten for a few days.  I felt mostly better and wanted to go to school.  I remember my mother telling me I had to eat something if I was going to school.  I took a granola bar and started walking down the street to meet my boyfriend at the time and to catch the bus.  I remember feeling light, empty and powerful.  I remember feeling the sense of white, blank emptiness that I now associate with disassociation.  I felt like I could take on the world.  I felt like I could survive without food and that I’d actually be more powerful.  I loved that feeling and I chased after it in various forms for the next 20 years.  I believe this moment is the one I chose anorexia as a coping technique for the sexual and emotional abuse I was living with.  At that time I wouldn’t have identified it as an eating disorder, nor would I have identified my relationship as sexually and emotionally abusive.  It was just a feeling I had, of realizing that disassociation was more comfortable than pain.

I remember the first and one of the few times I tried (unsuccessfully) to purge after panicking about eating.  This I described in another blog post.  I remember crying and sitting shaking on the floor of the downtown public library.  My crime?  Eating a whole cookie rather than half of one.  I remember I had been reading books about eating disorders, secretly, trying to figure out what the heck was going on.

I remember my first panic attack.  I was in Grade 12, 17 years old and extremely ill from anorexia.  I was attending school despite the fact that my weight was well under 100 pounds at close to 5’9″.  I remember feeling driven.  I remember feeling an intensity of moving forward that wouldn’t allow me to slow down or calm down.  I had to keep “doing” and trying to be perfect at everything.  I had to follow all my rules or something terrible would happen.  I remember there was one day I had a math test.  I believe it was Grade 12 Calculus or some other horrible subject.  I had been doing well in school despite my illness.  But that day somehow my brain just wouldn’t work.  I remember sitting in the classroom, the desks were arranged in rows, one in front of the other with the blackboard at the front.  I remember all the numbers and letters swimming around on the paper.  I couldn’t breathe.  I couldn’t think of how to solve the problems because everything was spinning and I felt like I was being crushed.  I felt nauseous and I realized that I was about to cry.  I remember bolting out of the room and into a stall in the girls bathroom.  I remember sitting there crying, shaking and feeling terribly upset that I couldn’t do the test.  My thoughts were racing around and I just wanted to go home.  I remember another student from the class coming in to check on me (it was a male teacher).  I remember being somehow glad she was there even though I was embarrassed.  I made up some excuse about being sick and not being able to write the test.  I think I went home.  I wouldn’t have known at the time that it was a panic attack, but it was and it was probably related to extreme lack of nutrition and just pushing myself too hard on no fuel.

I remember the first time I cut myself as a coping technique for stress.  I was about 18 years old.  I had just started taking SSRI medication for depression and anxiety after about 2 years of fighting with my parents and my doctors.  I never wanted to take medication.  I think deeply and instinctively I must have known that my mental health problems were situational, but that knowledge was too terrifying to face, so I blocked it out.  The first time I engaged in cutting I  used a pair of scissors that I kept in my bedroom.  I used to make just one small cut.  I would do it once a week in the exact same place, just under where the band of my watch lay.  So I could hide it carefully.  It was ritualistic, very controlled.  I don’t remember exactly why I started doing this.  It became part of my routine as I gained weight and somewhat normalized my eating behaviour. I needed something else to help block out the memories of the abuse.

I remember the first time I considered suicide.  I was probably about 17 years old, but I might have been 18.  I remember being at a party at a friend’s house.  Radiohead OKComputer was playing in the background.  Music I always associate with the “saddest of the sad” times.  It was raining outside.  I remember sitting on the couch looking out the back sliding door.  It was dark outside, evening.  The rain was falling really hard and there was thunder and lighting. I felt like I was in a trance.  Looking back I realize this was also an example of disassociation.  I remember feeling incredibly alone and disconnected. I was AT the party but not part of it.  I remember being at home that evening.  My bathroom had green tiles.  Small square tiles with white grout.  I remember just sitting there staring at my razor.  Thinking about cutting myself, thinking about dying and ending my life by opening up my veins.  I just sat there for a long time thinking about it.  The images of the green tiles and the emptiness of that moment are burned into my memory.

I remember my first flashback.  I was 18.5 and with my first love, my first real connection after the abuse and the severe anorexia.  I remember we were in my bedroom and we were kissing.  It was consensual and I wanted to do it.  He was lying on top of me. I think he might have been about to unbutton a piece of my clothing or something like that.  Suddenly I was crying and shaking and it wasn’t him there.  It was my ex boyfriend, who had so many times taken off or unbuttoned my clothing when I’d clearly said now.  It was him on top of me and I was afraid.  I had no idea what a flashback was, I didn’t know I had PTSD.  I just had an intense physical reaction to what was happening.  My boyfriend stopped immediately.  I remember him leaving the room briefly to give me space.  I remember feeling scared and embarrassed.  I don’t really remember the explanation I gave to him.  Some of my memories are less clear, but I think over time I had told him that my last relationship had been difficult.  I don’t think I fully understood myself at that time that it had been abusive, and that this type of reaction was a normal one for survivors.

I remember the first time I cut myself deeply enough to need stitches.  I was 20.  I was at university.  I remember buying the craft knife at the university book store. I remember walking home.   There was  a bridge on the campus and for months I thought about jumping off it every day.  I knew that I was going to cut deeply.  It was planned and premeditated.  I remember disassociating and thinking only about the injuring.  I remember wanted to make sure it was deep enough to need stitches.  I remember walking to the hospital which was on the campus.  I walked across a field to get there.  It was May or June.  I remember the doctor stitching up the wound.  It was a medical student and I remember feeling afraid.  I remember the resident coming to check the work and commenting that the stitches were incorrectly done.  I remember wondering why the resident didn’t fix them, but I assumed that because the wound was self inflicted they thought I didn’t care about scars.  In the end that wound healed badly and caused me chronic pain until it was fixed about 7 years later by a plastic surgeon at that same hospital.   I remember feeling nothing.  I remember feeling nothing about the injury and having no emotional or physical reaction until the day I went to the health clinic to have the stitches removed. I fainted when the doctor took them out.  My body felt the trauma suddenly and all at once the disassociate wasn’t there.   From then on I always took my own stitches out so I could control the process and do it in a way that I would not feel as much pain.  The ritual of the whole thing was an important part of the process of disassociation for me.

It’s a sad list.  Really sad.  Because some of these firsts are clearly in my mind that pleasant memories I would like to remember.  The way that PTSD stores traumatic memories and erases positive ones is deeply frustrating.  Because the long term consequence of disassociation is memory loss, and rarely losing the memories I wish would disappear.

Picture was drawn in September 1999

 

 

 

Healer, Heal Thyself.

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Do you ever have the feeling that you are a complete and utter fraud?

I’ve been feeling this way recently, more than usual, as I’ve been reflecting on how little of the advice I share with others that I actually follow myself.   Am I a fraud, if I truly believe what I’m telling other people, but can’t internalize it or believe it for myself?

How is it possible that everyone around me deserves health, happiness and recovery but I somehow feel undeserving of even simple things?

Someone close to me commented on one of my scars this week.  It was a passing comment, about noticing a scar on my hand that he hadn’t noticed before.  To him it was a neutral comment, just noticing, no judgment.  I told him that scar had been there since around 2002, it wasn’t new.  That was the end of the conversation for him, but I started talking about and reflecting on the amount of harm I’ve done to myself over the past 20 years.

Until 2009, I hid all my scars, all of the time, from everyone.  Even when I was home alone I would wear long sleeves and pants.  I was so ashamed of my cuts and scars that I didn’t even want to look at them myself.  In the summer, I was perpetually hot, avoiding swimming, making excuses to stay in the air conditioning.  My life was being seriously limited by my self destruction.

From 2009 on, I gradually began experimenting with uncovering my scars.  I wore t-shirts or skirts when I was hot, and started to swim again.  I still kept a cardigan or long sleeved shirt with me at all times, so I could cover up around people who didn’t know about my habit, or for situations like interviews where I didn’t want to be judged.  I used to have so much anxiety about people seeing my scars and I would imagine all sorts of scenarios where people around me judged me as crazy.  I even thought that CAS would come to take away my  kids because if someone saw my scars they would report me as an unfit mother. Over time, I  became accustomed to uncovering my scars.  I came to a place of a bit more acceptance (plus I got tired of being hot all summer!).  This was a process and today, the only time I purposefully cover my scars is when I’m helping other women at work.  I’m afraid that my scars might trigger others, especially those who are working on their own healing.

I still feel sad though, every spring when the warm weather returns and shorts, t-shirts and summer dresses flood the shopping malls.  I feel sad because in the summer I can’t hide under my clothes.  In the warm weather, I often feel exhausted when interacting with people because I am intensely aware of the visibility of my scars.  It gets a little bit easier each summer, and I think about it less and less often, to the point where there are times that I almost forget about the scars. Almost.

I can’t really forget about them. I can’t forget about them because they represent a huge, unnameable, unspeakable history of trauma and pain.  And at some points I feel crushed by the weight of the realization that I have been my own worst abuser.

I am my own most dangerous and most unrelenting abuser.

It’s difficult to know how to even approach talking about, thinking about or grieving the trauma I’ve inflicted on myself.  It’s not something others discuss or disclose to me either.  We talk about the hurt caused by other people in our lives, the betrayals, the injuries and the abuse.  We talk about being hurt and being damaged.  But how do I start a conversation or healing process around the trauma that I perpetuated?  How do I heal from situations where I was both the abuser and the survivor, simultaneously in one person, in one experience, in one breath?

My experience of surviving sexual and emotional abuse at the hands of perpetrators, is directly linked to my “decisions” to cope by self harming in various ways.  Before I was sexually abused I didn’t have anorexia, depression, PTSD, or obsessive compulsive tendencies and I did not cut or physically harm myself in response to stress.   Before I was sexually abused, I considered myself a “normal” person.  I didn’t have a mental illness, I didn’t have dangerous coping techniques, I wasn’t a psychiatric survivor or  a survivor of violence.   When I look at my scars, I see both the abuse I survived and the abuse I perpetuated.  The scars are an ever present reminder that I have survived, but they are also like a road map of the destruction and self destruction that has woven through my adult life.

Yes, my scars tell a story, but I’m not sure it’s a story that I want to hear.  I’m not sure it’s a story that I want to tell either.

But sometimes I do want to tell my story.  That’s part of why this blog was created.  There just isn’t a lot of space in our busy, day to day lives, to talk about the story my scars tell.  The person who was with me during the majority of those years (my ex-husband) is no longer available or safe for me to contact.  I don’t have anyone to share my memories of those dark years with.  The people who know me now weren’t there with me in the emergency room while my cuts were being stitched.  The people in my life now, weren’t there with me when I tried, multiple times, to end my life.   Except for a few, the people in my day to day life, didn’t know me when I almost starved myself to death.  People see me differently now.  They see me as a whole person, a mostly well person, a successful person, a good mother, a co-worker, a friend…sometimes I feel like a fraud because I can’t, or don’t know how to, talk about these aspects of my past.

And sometimes I want to talk about them.  I really want to talk about what things were like “before.”   Before I left my ex-husband.  Before I stopped utilizing the psychiatric system.  Before I decided to stay alive.

That “before” person is still me.  I’m just not sure how to heal that “before” me and this current me simultaneously.  I’m not sure how to forgive myself, or to have sympathy or empathy for the me that wanted to die.  I’m not sure how to look at my scars without feeling sadness for the fact that I permanently disfigured my body before I turned 25.  I don’t know how to grieve my smooth, scar free skin…I barely even remember what I looked like before I started cutting.

There are days when I accept my scars.  They are a part of me, they do tell a story and they do represent survival.  But there are days when I hate them.  I hate being different.  I hate having a visible mental illness.  I hate feeling ugly.  I hate worrying about what others will think when they see them.  I hate hating myself SO much that self harm feels like a reasonable solution.

Sometimes I look back on the past and wonder what my life would be like if I’d chosen a different way of coping.  Or if I’d never been abused.  Or if I’d told someone about the abuse.   How different would my life be if I’d never picked up a blade, never wished to end it all?

It’s an interesting dilemma, because there are some parts of my survivor self that I like and I wouldn’t want to change.  If I hadn’t had these experiences I would have chosen a different career path.  I wouldn’t have had my children at a young age.  I wouldn’t be as passionate about social justice and advocacy.  I wouldn’t know the majority of my current friends.

My life would be very different.  I don’t even want to change the past.  It did make me the person I am today and I’m okay with that.   What I do want to change is how much I still judge myself, berate myself and hate myself for my past choices.  I want to learn to do more than accept my scars.  I want to do more than tolerate my body, in an uneasy, fragile truce.

Intellectually, I know that I deserve more than surviving.  Intellectually, I know that a deeper level of healing is possible.  I’ve seen people around me heal and recover from unimaginable horrors.  I’ve seen people build a sense of self confidence from the rubble of their lives.  I know it is possible and that self-love and self acceptance are attainable goals.

But emotionally, I just don’t feel it.  And that makes me sad, and maybe right now, the first step in healing self-hatred is just simply grieving the loss of that 15 year old healthy self.

 Note: The illustration was drawn by me around 2004

 

It’s rude to stare.

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I’m not speaking for all people with disability here, there are my own opinions.  Trigger warning for description of self harm

I identify as a person with disabilities.  The thing is, that I live in an interesting position where some of the time I have the privilege of “passing” as a non-disabled person and some of the time, it’s obviously visible that I’m different, strange, mad, crazy, mentally ill, or whatever label people might want to put on my experience.

I experience my PTSD as a chronic disability rather than an illness.  It’s something I live with and cope with and I don’t expect it to suddenly be cured or disappear.  I don’t consider myself “sick” but I’m not really well either.

One of the ways in which I coped with having undiagnosed and improperly treated PTSD was to cut myself.  I cut myself for many years of my life.  Because I had severe adverse effects from psychiatric medications I cut myself deeply, chaotically and severely.  As a result I have visible scars over the majority of my body.   These scars are covered by long sleeves and long pants, but can be seen wearing any other type of clothing.

I have a number of close friends who also identify as having disabilities, and I work in a field where I have read, heard about and studied oppression related to disability.  What I want to talk about is the situation I encountered last night.  The one in which able-bodied, sane, or well people feel the need to STARE at, or comment on, disabled bodies.   The staring makes me feel instantly like a circus freak, instantly judged, instantly “less than” and instantly oppressed.

I was out at the dance last night and I’d invited along a woman I’ve met up with a few times.   It’s been winter weather so this was the first time she’d seen me in a short sleeved shirt.  I hadn’t mentioned the self harm to her.  I had mentioned my past abusive relationship.   When I arrived, I noticed her staring at my arms. I noticed her staring at them on and off over the course of the evening.  She never said anything about them, just looked at them awkwardly.

I was already struggling yesterday.  I was having a lot of body dysphoria and feeling self conscious and negative about my body.  I’d been at a party earlier and I was hot in my sweater but I didn’t want people looking at my arms, so I left it on.  Often I forget about my scars now, but some days I’m hyper sensitive because I don’t want to risk being under the “judgemental gaze” of able-bodied or sane folks.

Here’s what I wish folks would do when they notice my scars:

  1.  You’ve noticed my scars.  You are curious. I get it. But this isn’t about you.  Please don’t stare.  I’m not a circus freak.
  2. If you must ask questions about it, if possible wait until a quite private moment and then politely ask me what you want to know.
  3. If you absolutely have to know.  Please don’t stare.  I’d rather you ask me a question about what you want to know, even in a public place than continue to stare or sneak glances at me.  Believe me  I SEE YOU LOOKING AT THEM.  You aren’t getting away with looking at them subtly.  In general, people with visible disabilities are vigilant to noticing people staring at them.
  4. Remember, I’m still the same person I was before you noticed the scars. Nothing has really changed.  Your reaction to my scars is more about you, than it is about me.  If you are seeing the scars, it means I am comfortable showing them.  You are the one who is making the situation uncomfortable by awkwardly staring at me!

And here is a list of answers to some commonly asked questions about my scars.  Maybe this will help you to not ask these questions to other people who self injure, maybe it will help others understand a bit better.  To be fully honest, people rarely ask me questions about my scars.  I sometimes wish they did ask me.  I’d rather be asked questions than be stared at and be left wondering what the person was thinking.  But there are some common questions and questions I imagine folks have.

  1.  Do they hurt?  No, most of them don’t hurt.  There are a few that didn’t heal properly or weren’t stitched properly that do hurt.  Some of them itch or the skin pulls at times which can be uncomfortable.  For the most part they just feel the same as the rest of my skin.
  2.  Can I touch them? No!  That’s fucking creepy.  This is a trigger for me, because one of my abusers asked that question.  I don’t think it’s cool, cute, fun or sexy to have them touched specifically during intimacy.  Please just treat them as part of the rest of my skin.
  3. What happened to you?  They are scars from self inflicted injuries, mainly cutting.  I hurt myself as a way of coping with ongoing sexual and emotional abuse over a period of time in my life.  I also had serious adverse reactions to psychiatric medication, especially SSRI anti-depressants which gave me obsessive self destructive thoughts and impulses over a 4 year period of time.  I was told repeatedly that “doctors don’t give you medication to make you sick”
  4. Did you have to get stitches?  Yes.  Lots of them.
  5. Did it hurt?  Sometimes.  But a lot of the time when I was harming myself I was disassociating and I didn’t feel the pain.  A lot of the time I was doing it I was numb and detached and felt very little.  It hurt a lot AFTER and when it was healing, when the disassociation wore off.
  6.  Do you regret it? Sometimes.  It’s hard to remember a time when I didn’t have the scars.  To be honest the scars trigger me sometimes which is why I often used to hide them.  They bring back bad memories of times I’d rather forget.  But they are a part of me as well, a part of my story and a part of what I’ve survived.
  7.  What is the worst part about having self harm scars?  The worst part is the judgement I get when seeking non-psychiatric medical care.  So many times doctors have seen the scars and treated me differently.  They often make assumptions about me that are incorrect.  They assume I’m drug seeking, an addict, or that I’m unstable, lying, attention seeking, borderline etc.  I notice that doctors have the worst misconceptions about self harm.   Doctors often assume I’m LESS able than I actually am, and at times I struggle to receive appropriate medical care.  There is a great deal of stigma attached to having a mental health disability, especially related to self injury.

The take home message is simple:

Don’t stare at people whose bodies may be different than yours.

If you must ask questions, do so politely and privately if possible.  Ideally, don’t ask a lot of questions of complete strangers.  Questions as part of a friendship come across completely differently and can be more acceptable as a part of getting to know someone over time.

I notice you staring at me, and I don’t interpret it as polite concern.  I interpret it as intense othering.

I was just there for the dance.

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

Depression meets PTSD. Crash.

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.

 

Restraint

hospital-medications-patient-holds-paper-dosage-cup-medication-49355360

In the summer of 2001, I overdosed multiple times.  Some of these stories are described in other blog posts.  After the last of that series of suicide attempts, my psychiatrist put me on a Form (sectioned me, 72 hour hold).  He refused to release me from the hospital unless my parents came to collect me.   I remember my father driving down to pick me up.  I don’t really remember being released, but I ended up back home at my parents house, many hours away in another city.   The past few months felt like a bad dream.

I remember my parents had hidden all the pills in a bag in their bedroom closet.  I remember that there wasn’t a lot of trust, and for good reason.  I tried to relax, but the thoughts of self harm were propelling me forward.  I was caught in a vicious cycle, medication induced self destruction.  I would feel unsafe, hurt myself, go to the hospital seeking safety…then after a few days panic, feel trapped and beg to be released.  It went on over and over.  I always wanted to be where I wasn’t, I was chasing the feeling of safety, of quiet in my mind, of escape.

I remember walking up to the plaza by my parents house.  I bought an exacto knife at the dollar store and sneaked it into the house.  I was always buying, hiding, and throwing away tools during those years.  I often hide them in various places for safe keeping.  Intellectually I knew that having them in the house was the opposite of safe, but somehow their presence simultaneously calmed and panicked me.   It’s rare, even today that I don’t have something hidden.  Even though I don’t use the tools, I sometimes feel compelled to buy and keep them.   Sometimes I’ve called friends and asked them to help me throw them out.  I’ve handed them over to therapists and doctors.  I’ve hidden them and felt ashamed.  Even writing this brings up a feeling of shame inside me.  This is the power of addiction, the constant push and pull between the promise of safety and the threat of disaster and destruction.  Back then, I thought I was in control.  I thought the cutting kept me in control, but in reality the urges controlled me completely.

I had the knife at my parents house, I cut myself with it.  Deeply, but not deep enough to require medical attention.  I told my parents and asked them to take me to the hospital.  I told them I felt suicidal and I wanted help to control the urges.  I remember sitting in the ER waiting room, in a different city.

I don’t remember everything that happened.  I remember talking to a Dr, I was sitting on a stretcher, it wasn’t a special psychiatric emergency, just a regular bed.   The doctor agreed to admit me.  Then nurses came and gave me a gown, they took my clothes and items and put them into a white bag with a plastic drawstring labelled “patient belongings.”  This was different, the anxiety began, “why are they taking my things?”  Apparently this was the protocol at this hospital.

I was taken up to the 4th floor, to the Mental Health Unit.  It was a different layout and different style that the hospital I’d been in only a few days before.  It seemed larger and was laid out more like a large rectangle, rather than a long straight line.   I was shown to my room.   Outside the room was a cupboard and the nurse locked my things in there.   I was allowed to keep my teddy bear, but not my clothes.  In this hospital there were 2 beds to a room and each room had it’s own bathroom with a toilet and shower.

I stayed in the hospital for a few days.  It was the last week of June.  A few friends came to visit me.  I was given my clothes back and allowed to leave the hospital on passes.   During one of the passes I went to visit the psychologist who had treated me as a teenager.   To be honest the appointment was not helpful.  I don’t think she had a good understanding of me.  She didn’t understand why I was sick (because I’d been abused) and she didn’t understand why I was cutting myself and suicidal (because of the abuse and the medication cocktail).  I felt that she shamed me and threatened me to stop my acting out.  I don’t really remember exactly what was said.  I only remember feeling desperate when I left.  I think my parents dropped me back at the hospital.  I was in the lobby of the hospital, where there was a pharmacy and I considered buying a giant bottle of the medicine I had been told would kill me if I overdosed again.  I felt hopeless.

Somehow I managed to go back upstairs to the ward without incident.  I remember a few days later I wanted to leave, as was my usual pattern.  It was the weekend, I believe it was July 1 and I wanted to go home to see the fireworks.   I did as I would have in the other hospital, starting convincing them I was okay.  But somehow it backfired.  They didn’t believe me and they said I couldn’t leave until my doctor returned the next day.  I started panicking and becoming angry.   They told me they were holding me involuntarily because they thought I would just leave.  I was crying and banging my head.  I went into the washroom in my room, took off my earring and scratched my skin with the sharp end.  It wasn’t even enough to draw blood, just to cause pain and leave angry looking scratches on my body.   I remember being at the nursing station.  I was given a cup with liquid medication inside.  I was told it was Nozinan, a medication I’d used for panic before.  I drank it and soon after I realized something was wrong.  I became extremely drugged and when I asked the nurse had given me 5 times my usual dose.  They took away my clothing again and gave me a hospital gown.

Before I fell asleep or settled into my bed I realized what had happened.

I’d been chemically restrained.

They didn’t want to deal with my acting out and so they drugged me.

I felt betrayed, I felt scared.  I felt like I couldn’t trust anyone and I felt like my life was out of control.

The next day my doctor returned and agreed to release me.  The only useful part of that hospital admission was the doctor switched my medication to one that I still take today.  One of the few I’ve found over almost 20 years that actually makes me more, rather than less, sane.   For that I was thankful.

I soon went back to my home.  The cycle continued.  Looking back I realize an important lesson.  It’s not possible to keep someone else safe.  If someone is determined to harm themselves they will find a way.  Short of restraining someone and drugging them, it’s impossible.  The person has to want to help themselves, and they have to find both a purpose for living and a direction to move toward.  A goal, a passion, a reason to fight.  This is unique and can’t be forced or given to someone.  Believing in myself happened over time.  The psychiatric system is a crisis management system and nothing more.  The true help I’ve received over the years has come from other places entirely.

 

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.

 

 

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

 

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.