Let’s Talk…

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So you want to talk about mental health and stigma?

Let’s talk about:
-how few mental health care services there are for children under 12
-how long the waiting lists are for any of our vastly inadequate publicly funded mental health services
-how Canada has a two-tired mental health system and those who are economically marginalized are often completely unable to access any long term mental health care
-how few mental health care services are truly trauma informed
-how people who cope through substance use, self harm, suicidal thoughts or other “negative” coping techniques are stigmatized, blamed and often thought to be manipulative or attention seeking
-lack of services for eating disorders and long wait lists which exclude everyone except the most ill
-abelism
-the capitalist idea that people’s worth is directly defined by how productive they are (which contributes to the stigma faced by mentally ill people who are not able to work)
-lack of affordable housing options which keep survivors of violence from being able to leave
-poverty: it’s not easy to recover from mental illness when you don’t have the money for food
-racism, colonialism, transphobia, homophobia, sexism, classism and oppression which impacts people’s ability to access services and to recover
-the idea that mentally ill people are lazy and need to just try harder or cheer up
-the fact that many treatments and medications actually make people worse and the fact that it is often an extremely difficult and painful process to find a medication that helps (and whether or not these medication are affordable)
-how few psychiatrists there are and how short their appointment times are
-the lack of publicly funded counseling services, especially ones that are not just brief, time limited sessions (which often aren’t enough for trauma survivors or those with a serious illness)
-how people with mental illness still face discrimination in the workplace
-the whole “but you don’t look sick” issue which feeds into stigma
-the fact that most people don’t qualify for services until their situation is severe, chronic and urgent
-the lack of preventative care for mental illness
-how the school system is not trauma informed and how children with mental illness are often viewed as “problems”
-sexual violence, violence and intimate partner violence:the majority of people living with severe mental illness have experienced violence
-how lonely and isolating it can be to live with a mental illness
-how people who are “high functioning” are often not viewed as having a real illness, but those who are not able to function adequately in society are viewed as lazy or crazy
-high rates of suicide for trans and gender diverse people, specifically those who are not affirmed, accepted and supported
-how difficult (if not impossible) our fragmented mental health care system is to navigate
-high rates of burnout for staff working in the system which is overworked, underfunded and under resourced
-lack of culturally appropriate care for Indigenous folks
-the problematic aspects of the DSM
-media stereotypes which present people with a mental illness as violent, unpredictable and scary monsters (most recently the movie Split)
-horrible stigma perpetuating “games” such as the asylum escape rooms
-stigmatizing use of language (using mental illness related words as casual descriptors)
-joking about suicide
-the silence and isolation that family members, caregivers and the person themselves faces because their illness is a mental illness not a physical one (nobody is bringing casseroles after you attempt suicide)
-how hard it is to be a parent with a mental illness and the fears that child protection might take away your children because you have a history of self harm
-how hard it is to ask for help or be honest about struggling with mental illness because of the fears of stigma and exclusion
-how little funding there is for ending gender based violence
-how people with mental illness can become criminalized due to interactions with the police

This isn’t just about ending stigma.
#letstalk

 

13 years ago…my last admission at South Street

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Photo credit: http://www.lhsc.on.ca

For me, PTSD is extremely linked to anniversaries of dates.  January into February is a difficult time, with the memories of my last extended hospital stay in 2005 and my family law trial in 2016.  I often have flashbacks, memories and symptoms, and then notice the date and realize what is triggering them.

My last admission to South Street was in early January 2005.  I was there for about 5 weeks, my longest admission at that facility.  I was transferred in early February to the Regional Mental Health Care facility, the former London Psychiatric Hospital, where I stayed until sometime in March.  Since then, I’ve largely been free from in-patient admissions.

In my mind, I can walk through the buildings at South Street, especially the main building.  The large stone steps which led to the main entrance.  The single stall washroom off the lobby where I cut myself on a number of occasions, with sharps I brought back inside from walks.   The smell of institutional brown paper towel, and the cheap, strong soap found in hospitals everywhere still brings me back to South Street.  The smell of adhesive first aid tape and band aids, bring back the rusty smell of blood harden on towels during long emergency room waits.

Past the lobby was a small gift shop on the right side of the hall.  I would go down there to browse sometimes or to buy a magazine.   Just past the shop was a cafeteria.  It was more of a snack bar, I suppose they had meals there, but at that time I rarely ate more than a muffin or rice krispie square.  Being in the hospital was an excuse for Ana to get away with restricting more, when nobody was watching me eat or expecting me to do so.  I remember walking through the line style cafeteria.  I’m not sure what I bought, maybe cookies.   A little further, past the first set of elevators was a Tim Hortons kiosk.  It was small and didn’t carry a full selection of items.  It was open longer hours than the cafeteria, which shut at the end of the office hour work day.  I remember it being more dimly lit in the evenings.  There was a second set of elevators, the only ones which went all the way to the 7th and 8th floor: psychiatry.   If you kept walking to the rear of the building, there was a door to the “patio” which was where people went to smoke.   It was also the place where psych patients who had off unit privileges but not full privileges to leave the property, went to get fresh air.   The hallway split into a Y shape at this point.  To the left was the admitting department.  You could walk down a long hallway and exit there as well.

That last time I was admitted, I was a patient on the 7th floor.   There was an orderly who sat at a desk at the entrance to the inpatient unit, which was to the left side of the Y.  The stem of the Y had offices and the right hand side of the Y had other departments, like occupational therapy, and a patient dining room.   The hall was carpeted.   The carpet was dirty, even though it was vacuumed daily.   Patients and visitors had to sign in at the desk.   As a patient, passes off the unit were awarded in increments.  Maybe a 15 minute pass, lead to 30 minutes, led to 4 hours and then to an overnight pass.  Smokers were given 15 minute breaks at intervals throughout the day.  Visiting hours ended at 8pm and at that time the orderly went home and the door to the unit was locked.  Patients returning after 8pm had to ring a bell which alerted the nurses to let us in.  I remember coming back after an evening home, or out with my ex-husband.  The hospital was quiet, the main floor abandoned with the exception of security at the main entrance.  The elevator ride was quiet, the halls semi darkened.  It was easy to believe the building was haunted.  I would be buzzed back onto the unit, check in with the nurses to get my evening medication and then get ready for bed.

The rooms all had reinforced glass windows, many of them had metal grills covering them.  Some of them opened a tiny crack and others did not.   The hallway seemed impossibly long, with the nursing station 3/4 of the way towards the far end.  For all intents and purposes, it wasn’t all that safe.  The nurses were quite far away from most of the patient rooms.   They didn’t search us when we came back from passes.  It was quite easy to smuggle in anything.   On a different admission, I had a roommate who used cocaine and cut herself in our shared washroom. Another time, a patient who was supposed to be recovering from an eating disorder continually smuggled in laxatives which she took by the handful.   A third patient, being tube fed and struggling with bulimia would order large amounts of food and then purge.

It wasn’t exactly a safe place.

I spent a lot of time sleeping, resting and talking to other patients.  I filed out my menus and looked forward to the muffins and cereal at breakfast.   I ordered peanut butter and jam sandwiches for lunch.  The vegetarian and vegan options for dinner were largely inedible.  Sometimes I went home for dinner, sometimes I just didn’t eat.  The meals arrived at 8am, 12pm and 5pm on trays, covered with burgundy or dark blue coloured domes to keep the food hot.   There was a fridge with cheap Colt Ginger ale cans (regular and diet).   Sometimes I brought cereal from home.  I often went for a walk to the Tim Horton’s down the road where I would order caramel coffee cake and black coffee.   They don’t make that cake anymore, but you could order extra caramel sauce drizzled over it.

I coloured and read books.  I waited, sometimes what seemed like endlessly, for the doctor to arrive.  Sometimes the doctors checked in with you ever week day.   Sometimes they didn’t appear for days.  They appeared at unpredictable intervals.  Much of the time they spoke to us in our rooms, even in ward rooms with 4 beds, affording us little privacy.   If we were lucky we might get 15 minutes to talk to the Dr.    That last admission I had a very kind doctor.  He spoke to me in a private room.  It wasn’t his office, just a room for meeting with patients.  He believed me.  He talked about referring me to the mood disorders program at the RMHC.  He didn’t think I was borderline.   Sometimes there would be medical students or nursing students.  I liked them because they were allowed longer to talk to us.  It was lonely and there was little actual treatment in the hospital, aside from medication and medication adjustments.  The medical students gave each patient a physical exam within 24 hours of being admitted.  Even when I was in and out of South Street, I got the check up every time.  In reality, these 1st year medical students were just using us to practice doing physical exams.  But I didn’t mind.  I liked the attention and the chance to speak to someone.  The days were often long, and even the nurses were busy, assigned to multiple patients each shift.

Sometimes, if I was having a rough night, my nurse would bring me into a small room attached to the nursing station.  We would talk about how I was doing.  Mainly I talked about the urges I had to self harm.  Even in the hospital I generally harmed myself on an almost daily basis.   Looking back it’s hard to see exactly how I was helped by these admissions.  Once I even ended up needing stitches, while I was admitted.  I cut myself in the ground floor washroom, then went up to the 7th floor to confess.  A different medical student, maybe a psychiatry resident stitched it for me in my room.

In the sad, lonely state of mind I was in, there was something about the ritual of having my cuts sutured, that comforted me deeply.  I think it was a moment of literal relief to have something FIXED.  The inner trauma I was struggling with was coming back to the surface with frightening intensity.  I was in a new relationship that had rapidly become all consuming, emotionally and then sexually abusive.  I felt trapped.  I felt numb, depressed and hypomanic, agitated and anxious all at once.  I was in a frantic state which was triggered by SSRIs and other antidepressants.  I wasn’t thinking clearly for over 4 years.  I was afraid all the time, and yet I felt invincible in a way.  I knew only peripherally that my impulsive self harm and suicide attempts were extremely dangerous.  I both wanted to die, and felt like I was not at risk from the self harm.  I felt torn, tangled and pulled down, like I was drowning in trauma and suicidal thoughts.  I felt like a mechanical robot, and a wind up toy spinning out of control.

When I look back at myself during those 4 years, I barely recognize any aspects of my true self.  I was changed, and not in a positive way.

I was so young.  I was 20-24 years old.   I felt like a child, colouring, whining for help, begging for someone to SEE me.  I didn’t feel truly SEEN by anyone at that time.  I think I’d felt invisible and misunderstood for so long, that I actually was disappearing, even to myself.  I felt like I’d aged decades in a few short months.  I felt like a child trapped in the body of an older person.   My health was poor, due to medication side effects, self harm, self starvation and lack of structure and routine.  I became more and more socially isolated.  I lost connection with the “normal” world and I became a full time psych patient.  I filled out and inhabited the role of a sick person.  So much so that I no longer realized I was playing a role.  It became all I knew of ME.  I lost myself.   I lost myself in more ways that I can express in words.  I wanted to be rescued.  With all my heart I wanted to be rescued, but I learned to carefully shut people out.  I was also being isolated by my abusive partner.

That last winter in South Street, I was so suicidal I couldn’t leave the hospital alone.  I was perpetually compelled by thoughts of throwing myself in front of traffic on the busy road near the hospital.  I didn’t trust myself to walk anymore.  I knew all the train tracks that criss crossed the  neighbourhood, and all the shops which sold sharps I could use to harm myself.  I was a dead person walking.  I was more than half dead, I had more than one foot out the door of life.  I had 95% given up.

But somehow that last doctor who admitted me, he didn’t see my case as hopeless.  He didn’t see me as someone who was just “trying to get attention” or “manipulate the system”   I think he realized that it was possible the medication was making me worse.  I think he realized, and actually believed me that my next suicide attempt would be a completion.  He quietly talked to me, and quietly sent the referral to the specialist.  I didn’t have much hope, but I sensed that things were different.  Instead of lying to get myself discharged, I stayed there until the bed became available on the mood disorder unit.

5 weeks later, I was off all anti-depressants and on a new mood stabilizer.  The mood disorder specialist retrieved my life from the purgatory and hell of anti-depressant side effects, including medication induced hypomania.

Less than a year later, I was pregnant with my first child.

I never had another extended hospital admission.

South Street has been demolished for years now.  I visited the site last summer to see for myself that it was gone.

But South Street haunts my memories.  The images are so vivid, but in the faded colours of a worn down, dirty building.  Those years were brightly intense simultaneously to being muted and grey.

I expect they will be with me always.  But 13 years ago, I never imagined I would even get out alive.

All mixed up.

It’s been a long time since I’ve written a blog post.  Even tonight as I sit down to type this, I’m not clear on what I’m going to write about.

I’ve been focused on my children and my family for the last few months.  It’s been difficult to connect or find the energy to do much other than collapse on the couch to watch Netflix at the end of each busy day.  I have my children with me full time now.  Their father moved to another part of the country and they haven’t seen him since October.  He didn’t plan a visit for Christmas.

We are all of us coping with this abandonment in different ways.

For me, there has been an incredible amount of anger.

I don’t feel comfortable in the anger.  I don’t feel comfortable with how little patience I have and how quickly I snap at people or shut them out if they cross a line from support into offering advice.  I’ve isolated myself more than usual.

The anger is just barely covering a deep well of sadness and fear.  Sometimes I feel completely overwhelmed with the amount of trauma my small family has endured in the past few years.  I worry about the impact it will have on my children.  I worry about not having the right help for them.  I worry about not being patient enough.  I worry about being a solo parent, all the responsibility on me.  I worry about the lifelong impact of parental abandonment after years of emotional abuse and neglect.

I think about the research that has been done about adverse childhood experiences  (ACEs) in relation to trauma theory and the negative impact on health.  For those who might not be familiar with the research, here is a visual representation:

 

My kids have experienced emotional abuse and neglect and physical neglect at times.  I don’t know for certain about physical and sexual abuse.  I may never know.  They have a parent with a mental illness.  Their parents are divorced and their mother is a survivor of family violence.  There is a history of substance abuse on both sides of their family (though not with either parent).

I try not to think about it.  I try to think about the research on resilience which shows that if children have even one positive, consistent and stable adult in their life, it mitigates the impact of ACEs.   I try to believe.  I need to believe it is true in order to function on a daily basis, rather than fall into a pit of hopeless despair.

My older child was recently diagnosed with learning disabilities.  This did not come as a surprise to me.  For two years her father refused to consent for the testing to be re-done.  Earlier testing had been inconclusive for a number of reasons and it was recommended to be repeated.  He refused to agree.  He denied she had any learning issues and blamed me for instilling anxiety in both my children.

Yesterday, as I listened to the feedback from the psychologist.  I heard her saying again and again how different aspects of the test results, including some of the discrepancies between the recent and prior testing, could be linked to the impact of trauma on a developing brain.

Essentially, she was talking about the impact of ACEs on my child’s brain.

I felt numb.  What reaction is normal?  How can a caring parent just accept these things?  How to function and keep moving forward, filled with the knowledge that my kids have experienced trauma?

Intellectually, I know it isn’t my fault.  I know I’ve done the best I could.  But the dark voice inside tells me that it is my fault.  That I never should have had children.  That someone with a mental illness like mine should never have been a mother.  That I never should have had children with an abusive partner.  That I should have left him sooner.  That I should have stayed with him to protect the kids…

All the ways…all the blame.

I push it all down.   Try to keep busy.  Try to block out the thoughts and worries.  Turn on the TV.  Pick up my cell phone.  Browse the internet mindlessly for hours.

In the evening, I feel a sense of panic.  I’m a fraud.  I’m not capable.  I find myself thinking old thoughts, falling back into old thought patterns.  “I can escape my responsibilities by hurting myself”  and “It’s too hard.  I can’t do it. I’m a failure”  I think about self harm and suicide.  Then berate myself for how literally insane it is.  I can’t die.  I’m simultaneously gripped in a tight knot of constant fear and terror about dying and leaving my kids alone with their father, and desperate to escape from a life that often feels TOO painful to endure.   I think about suicide and actively wish I was not alive, while at the same time worrying about getting sick or having an accident, and the consequences on my children if I’m not here 100% of the time and 100% functional.

It’s exhausting.  I honestly want to sleep and watch TV, curled in warm blankets, for many days.  I want to escape from SO much responsibility.  But I can’t.  I get up each day, and I function.  I do ALL the things.  I keep going, because I have to.

My mind is a bit all over the place recently.  Instead of having a certain set of trauma memories and flashbacks which bother me consistently, I have been experiencing mixed up flashes of a whole spread of my traumatic experiences.  Memories popping into my mind, unexpectedly, and me pushing them back down again.

I started a new job, teaching a course at the university I went to during the years before my separation.  Going back to the campus brought back memories of those two years, when I was so unwell, cutting myself and ending up in the emergency room on a regular basis.  I received ECT the week I completed my last semester.  I felt depressed and trapped and I hadn’t yet made the connection to my abusive marriage.  During those years, it was still JUST ME.  I felt like I’d exhausted every treatment option and I was ready to give up.  I wrote a post-it note suicide notes to my children but then went to the hospital and had my injuries treated.  I felt like I was falling into pieces and not able to put them together again.  I never felt calm or safe.  I had nightmares and woke up screaming and trying to escape from imagined abusers.

My brain also dredged up memories and flashbacks of the undergraduate professor who sexually assaulted me in my apartment, less than a year after my graduation.  It happened in December.  I sat frozen on my couch while he touched me.  I didn’t fight back, I didn’t say no.  I just froze and disassociated, my eyes fixed on his black and gold scarf.  I was powerless to stop him. The only reason it ended was that at some point he noticed that I was completely gone and even he didn’t want to touch a statue.  It took what felt like hours before I could even speak to ask him to leave.  I remember crying, but as a statue would cry, tears moving over a frozen face.

In a way, I feel safer now that my ex-husband doesn’t live in the city.  But I still tense up when I see a car like his.  I still get jumpy at night sometimes, thinking I hear someone in the house.  I still get anxious about something happening to the kids, even a minor injury, that he might get angry about.  I am in equal parts afraid he will respond to my mandatory email updates about the children, and furious that he ignores me so completely.  I feel at the same time invisible and caged.   I feel trapped in a cage.

The cage of abuse and trauma.  I don’t know how to escape and I don’t know how to release my children from the cage either.  When abuse has gone on for so long, the abuser doesn’t even have to be in the same city, or have contact with you, to control you with the fear of what MIGHT happen.  The bars of the cage are memories, fears, and what ifs.  The fear alone is enough to modulate our behaviour, even with little or no contact from him.

I’m tired.  I get tired of hearing myself say that I’m tired.  But I’m tired.  I’m always tired.

Yes, there are good days and things to be thankful for.  This post isn’t ungrateful or dismissive of the blessings in my life.  It’s more to say that no matter how bright the joys and how wonderful the blessing, I still feel caged.  I still wonder how it can be possible to “live a normal life”  or “be healed” or “recovered”  after so much trauma.

I know it’s possible.  I know that ACEs aren’t a death sentence.  I know that our family has a lot of support, a lot of strengths and a lot of STRENGTH.

But some days PTSD makes it hard to be optimistic.  Is a bird in a cage optimistic about escaping?  Or in captivity do they gradually stop singing and lose their vibrancy?  A bird doesn’t belong in a cage.

And neither do I.

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Not my art.  Taken from Pinterest online

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

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

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

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

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

PTSD lies a lot.

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

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

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

PTSD doesn’t find a middle ground easily.

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

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

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

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

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

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

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

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

I know.

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

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

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

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

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

PTSD tells me that nobody believes me.

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

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

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

I just want to be safe.

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

4 years out…still trapped

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Photo credit: http://www.katewmak.com/

This week marks the 4 year anniversary of the separation from my ex.  Four years since the night I told him it was over and I was leaving.  Four years since I made the biggest and most difficult decision of my life.  6 weeks later, I moved into my own home and started my new life as a single mother of two.

If I had known back then how difficult leaving would be, I would probably be dead.  If I had known 4 years ago that the court process would still be ongoing.  If I had known he was going to abuse my children and I would be helpless to prevent it.  If I had known that after four years, I would still be caught, living my life trying to prevent him from hurting us.

If I had known these things I would have stayed.  If I had known that leaving would become a marathon of epic proportions, with no end in sight, I would have ended my life.

In the past four years I have endured all of my worst fears.  I have had to face the fact that my absolute worst fear (my own children experiencing abuse) has not only occurred, but is ongoing and society refuses to step in to stop it.  I live with things I thought I could not survive and I live with them daily.

I’ve had to survive things that no person should have to survive and so have my children.  Leaving didn’t save me.  It didn’t save them.  It didn’t cure my PTSD because I’m still being abused by him.

Some days, even recently, I have wanted to give up.  When I started to feel as suicidal, as hopeless, as trapped and as depressed as when I was living with him, it felt unbearable.  Many days feel unbearable, but each day I survive.  I have to survive to create a safe home for my children.

It’s crucial to help people and support them in exiting abusive situations, but we have to stop perpetuating the destructive myth that “just leaving” is the solution.  We have to stop perpetuating the myth that “just leaving” will solve all the problems.  If your abuser is the parent of your children, you can never “just leave” because you are forced to interact with them on a regular basis until your children are adults and possibly longer.

Of course I had to leave.  I wouldn’t have survived there much longer.

Of course it’s better for my children to have a happy, healthy mother 50% of the time rather than a dead mother 100% of the time.

Of course I made the right decision, the only decision.

Of course there are a number of things in my life that have improved since leaving and I’m grateful for them.

But that doesn’t make it any less painful to look back over 4 years of struggling to fully extricate myself from narcissistic abuse.  4 years of betrayals and incompetence by every major social program I’ve interacted with (CAS, legal, court, police, hospital, school).

So let’s support domestic abuse survivors to leave, but let’s also support them for as long as it takes after.  Let’s recognize and acknowledge that the abuse does not end the moment she walks out the door.  Let’s support survivors who regularly doubt whether or not they should have left, because the legal process is so traumatic and inaccessible.  Let’s support survivors who have to co-parent with narcissits.

Create a community of support circling the survivor and keep it in place for as long as she needs it.  Because she will need it, especially at the times she feels as bad, or worse than she did in the relationship.

So this week I mark 4 years down, a life time of healing to go!

Body distortions.

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

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

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

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

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

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

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

Then a light bulb went off in my mind.

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

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

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

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

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

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

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

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

I read a quote once…

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

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Another abandoned hospital.

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

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

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

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

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

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

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

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

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

Trusting my younger self.

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

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

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

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

February 21, 2001

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

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

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

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

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

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

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

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

March 26, 2001

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

April 4, 2001

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

Maybe I was never my own worst enemy.

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

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

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

The roots of an abusive relationship.

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Through some parts of my youth I kept diaries.  Never entirely consistently, but consistently for periods of time, especially when I was in treatment or in hospital.  I’ve been thinking back to this time of year in 2001.  My first year with my abusive ex husband.  My first year in psychiatric care.  My first year engaging in severe self harm.  My first psychiatric admissions (aside from eating disorder treatment).  My first suicide attempts. It’s interesting how all these “firsts” coincided so neatly in time with my new relationship.  At the time I thought it was because memories of the abuse I survived as a teenager were triggered and surfaced when I became sexually active.   That was part of it.  But there was more to it than that.  There was subtle abuse in my relationship with my ex husband that started very early on.  The seeds of gaslighting and emotional abuse were being planted.

It started with showering me with affection and attention.  It started with making me feel special and loved, almost to the point of making me uncomfortable.  It started with planning for the life we’d have together, the kids we’d have, the marriage…within months of meeting me (I was 19!).  It started with gifts, cards, flowers, spending all our time together.  It started with gradually isolating me from my other friends and social outlets.

Then some lies started.  And the lies were repeated so often I believed them to be true.

These lies were focused around my mental health problems and their link to my feelings about his abusive  behaviours.   He would tell me that it was because of my PTSD that I was uncomfortable with something.  He would tell me that a “normal woman” would be okay with it.  He would make me feel guilty, tell me that he felt like there were three people in the relationship: me, him and X.  He made me feel like I was CHOOSING to have flashbacks, like I was CHOOSING to think about X rather than him.  Almost like X was someone I never quite got over, a lost lover, rather than an abuser who had traumatized me to the point I often had flashbacks during any type of intimacy.  Over time, the lies were repeated to the point that I felt crazy.  I felt like I was to blame for the problems with intimacy in our relationship.  We even sought out support from a sex therapist to talk about this.  I had blood tests and was checked to ensure my hormone levels were normal.  I was completely manipulated into believing that the issues in the relationship were entirely my fault.

Today, in 2017, I realize I like some types of sex just fine.  I just prefer consent to be a factor in that sex!  In other words, I like sex, but I don’t like sexual abuse!  It turns out, I’m not physically broken.  I have PTSD.  I have flashbacks, but with a safe, trusted and patient partner I can be okay.  But because of the lasting impacts of gaslighting, I struggle with saying no. I struggle with blaming myself for anything that might go wrong. I struggle with identifying and communicating what I want or enjoy.  And I still fall back into patterns of believing that I’m crazy.

When I left my ex husband, I mainly remembered and talked about the sexual abuse that happened in the last 5-6 years of our marriage.  These were the incidents I felt most comfortable labeling “sexual assault” and “rape.”  When asked, I couldn’t really describe when the sexual abuse started.  I couldn’t really remember the first time.  I couldn’t really say when things started to go wrong.

But reading back in my diary from 2001, the first year we were together, there are so many red flags.  I can hear my 20 year old self trying to convince herself that things were okay.  I can hear my 20 year old self trying to believe that she loved this man she barely knew. I can hear my 20 year old self trying to rationalize that things would be better with him when SHE was better, when SHE stopped cutting, when SHE stopping being so depressed.  I can hear her trying to convince herself it was the right choice, and I feel deeply sad for her.

June 8, 2001

“The evening went well until the car ride home.  Before getting in the car I was feeling panic starting. [He] tried to kiss me but I pulled away.  He got offended.  I tried to explain but he got angry and said he felt stifled like he couldn’t be spontaneous.  He said I only make love to him out of duty.  I got really upset and started crying and I couldn’t breathe. It was like a panic attack and I couldn’t stop hyperventilating. I just was so very scared.  I’m terrified of being with [him], but I do love him too.  It’s such a dilemma all the time. I feel like it would be easier for me to get better without the strong feelings of a relationship.  But on the other hand [he] is my support.  I don’t know.  It’s so tough right now.  I’m so scared of my life and everything in it”

Looking back on the things I wrote, I realize that I was barely more than a child myself. Just turned 20 years old.  I had just disclosed the abuse from my childhood, just started counseling.   I was talking about abuse I’d kept inside for 5 years.  I was in full PTSD crisis mode, complete with flashbacks, hyper vigilance, anxiety and nightmares.  I was on psychiatric medication cocktails for the first time.  I was self harming almost daily and had recently attempted suicide.

It was perfectly normal that I didn’t always want to be intimate with someone.

Perfectly normal.

Today, I choose to forgive my 20 year old self for not knowing this.  I choose to forgive her for not knowing that she was having normal coping reactions to trauma and that she was not crazy.  I choose to forgive her for being tricked into a situation where, instead of healing and support, she found gaslighting, confusion, entrapment and more sexual abuse.

I know I’ll wake up tomorrow, or the next day and feel confused again.  I’ll wonder if the abuse was my fault.  I’ll think that I’m exaggerating or that I’m making things up.  I’ll start to feel the thoughts creep in that I’m not normal.  I’ll start to wish that I had died all those years ago when I attempted suicide.  I’ll start to believe his lies again, because a long term emotionally abusive relationship includes an element of near brainwashing which can take years of healing, therapy, patience, self love and self forgiveness to recover from.

But just for today, I want 20 year old me to know that her reactions were normal.  That she was allowed to say no to that kiss for any reason.  She was especially allowed to say no to that kiss when she was triggered.  She had the right to say no without consequence, without anger, without bullying and blaming.  She had the right to have needs and preferences and anxieties.

It wasn’t her fault that he didn’t understand consent.

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

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Photo credit Hyperbole and A Half Blog

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

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

<crickets>

That’s right…nothing.

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

<crickets>

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

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

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

<crickets>

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

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

<crickets>

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

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

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

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

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

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

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

<crickets>

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

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