survivors

Burn the systems to the ground.

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I don’t feel inclined to stay quiet and feel ashamed about this anymore. I’m struggling too much with the recent news and the state of the world for survivors. For others who have been through this, you are not alone. I talk about it to let others know that it isn’t their fault.

CW: sexual violence, systemic violence/oppression/disbelief
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Why am I triggered right now in the wake of the Kavanagh situation?

Why do I often wish I HAD stayed silent about my experiences of abuse and NEVER told a soul?

Because of the Children’s Aid Worker who asked me “Don’t you know how to protect yourself? Are you afraid for yourself or your children?” in a sneering, sarcastic voice

Because of the Judges who told me that my experiences of violence were irrelevant to family law, who implied I was lying because I hadn’t reported to the police, then accused me of making accusations to gain an advantage in court (after I reported)

Because of the OCL Social Worker who told me that I needed to get counseling for my anxiety and heavily implied that if I didn’t stop “coaching” my daughter to say bad things about her father that she’d have grave concerns about me creating conflict and that I’d lose custody.

Because of the OPS detective who closed my case TWICE without telling me and completely failed to investigate or take notes and then lied to cover himself.

Because of how traumatic it was to have my confidential psychiatric records photocopied and handed in an envelope to my abuser in a court room.

Because the trauma of testifying in court to get custody and protect my children was so intense that I barely remember the three days I spent doing it.

Because the trauma of listening to my psychiatrist speak about the abuse and its impacts in court was so much that I had to leave the courtroom crying due to the intensity of the flashbacks.

Because our family Doctor lied in court and then discharged me and my kids from her practice accusing me of being a bad parent with terrible boundaries as a result of the “parental conflict” that was being caused entirely by my ex. As a result my kids had no family Doctor for 18 months.

Because of the school principal who blatantly lied in court to support my ex saying she “didn’t recall” my daughter crying and screaming and refusing to leave with her father after a particularly stressful incident at home.

Because of the Children’s Aid Worker who told me that I should be “calmer and more neutral” about the transphobic behaviour of my ex.

Because of the Children’s Aid Workers who implied that if I didn’t stop reporting (and if other’s didn’t stop reporting) that they would get ME into trouble for making too many reports.

Because of the judge who clearly wrote in her final order that she didn’t believe I was abused.

I’m tired of the world implying that I’m “too crazy,” “too emotional,” “too sensitive,” “too angry,” “too anxious,” “too controlling,” “too whiny” “too radical” and just plain TOO MUCH when I talk about my experiences.

#whyIwishIhadnotreported  #whymetooisnotenough

 

On being a survivor.

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It’s very difficult to know how to exist in a world where it is made clear at all levels of society, that perpetrators’ experiences and rights will always be prioritized over those of survivors (particularly women, children and gender non-conforming folks).

What happens if your perpetrators aren’t politicians or religious leaders, or people with power and status? Does anyone even care? Do those cases ever proceed to court or hearings? Do they get media coverage? Or are they, for the most part invisible, silenced even in cases where the victim DOES come forward, does report and does seek assistance?

How does it feel for survivors to turn on news or social media and be constantly bombarded with how little society values their pain and suffering?

How can any survivors ever really heal and feel safe in a world where their experiences are invalidated, discounted, silenced and disbelieved…not just once, not twice but OVER AND OVER AND OVER for the rest of their lives?

How to make sense of the level of victim blaming and responsibility placed on survivors, while those survivors simultaneously watch excuses be made for their perpetrators? Not just once, but daily and at all levels of society, nationally and internationally. How to understand that your perpetrators’ pasts were just the folly of youth, and his future is too bright to spoil, while you are grappling with severe PTSD on a daily basis as a result of the violence? How to understand that for him it was a “misunderstanding of consent” while you knew what you were doing and were responsible for staying with him?

How to exist when EVERY post about sexual violence reminds you of how your own experiences will NEVER be validated by official society (court, media, child protection) and that your perpetrators will continue to exist without meaningful consequences until the end of their lives?

How to exist when parental rights are prioritized over child protection and the rights of children?

These issues are not just happening in the USA. It’s easy to criticize America and feel morally superior as Canadians. But we have these problems here too. Survivors are not believed here too. Perpetrators have high level, successful jobs here too. Gender based violence is a society wide, structural, social problem here too.

There should be more stigma and consequences associated with being a rapist, than stigma and consequences associated with reporting/surviving rape. Until we not only BELIEVE survivors, but CARE about and prioritize survivors, not much will change.

Sick Days.

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I’ve been home sick the past few days and sick on and off for a while now. It’s really difficult sometimes to separate physical and mental health symptoms.  Everything is all blurred together and it’s hard to tell when to push myself harder and when to rest.  This past week has been an explosion of physical and mental health struggles that are creating a storm of symptoms and have forced me to (uncharacteristically) stay in bed.

I haven’t met very many people who understand the complex intertwined experience of having both physical and mental health issues simultaneously.   Most doctors aren’t very trauma informed and also struggle to validate that both physical and mental health issues can occur simultaneously, and be either linked, not linked or both linked AND not linked to each other!

One of the things I’ve been coping with in the past few weeks is a urinary tract infection.   Obviously, an infection is caused by bacteria and isn’t a mental health issue.  But I was also really triggered in the past few weeks and this made me extremely reluctant to seek medical care.  I was afraid to go to a walk-in clinic, afraid to see a doctor, afraid to be examined.  This was linked both to past trauma around the medical system AND generally high levels of panic and anxiety related to stress with my ex and my kids experiencing abuse.   Thus I waited for over a week to go to the doctor, by that time my symptoms were much worse and I felt pretty awful physically.

This is an example of how physical and mental health issues can be both separate and linked at the same time.  The infection itself was physical, but my avoidance of the doctor was mental health and trauma related.   Of course you might also argue that my high levels of stress and anxiety also generally lower my immune system and make it harder for me to fight off infections.

By the end of last week I was on antibiotics, but I also developed a sinus cold.  I had a migraine related to receiving a nerve block to treat the migraines, but the sinus congestion put pressure on the nerves that were being treated.   My anxiety was causing panic attacks and making me afraid to leave the house for fear of running into my ex.

Thus again, my high levels of stress probably didn’t help any of these physical issues that I was dealing with.

When someone has an infection, generally they are advised to rest.  But resting is difficult when you are also struggling with severe anxiety and panic attacks.  My head gets filled with worries about work and what I’m missing and what people think about me being away and creating all sorts of worries and fears, many of which are not realistic.

Anxiety causes me to feel like a failure.  It causes me to feel like making a mistake is a terrible thing which can’t be recovered from.  It causes me to feel like everyone around me hates me and thinks I’m doing a terrible job.  Or worse, they think I’m faking being sick to avoid responsibilities.  A lot of my irrational worries centre around feeling like nobody believes me and that nobody likes me.

Experiencing abuse, and extending periods of emotional abuse, as well as abuse within systems, has lead me to fear and avoid conflict of any kind.  I want everyone to be happy all the time.  I get very anxious when there are disagreements and I’ll often apologize even when I’m not sure I have done anything wrong.   I’ll do what I can to avoid conflict, because when interpersonal conflict levels are high around me, my anxiety levels feel unbearable.  Because ongoing interpersonal conflict is a trigger.  I try to keep people around me happy because I want to feel safe and BE safe.

Unfortunately, in the real world, conflict is unavoidable.  Disagreements are part of life.  As the saying goes, you can’t please everyone all the time.

But I want to!  I need a lot of reassurance from people around me that I’m doing an adequate job.  I need reassurance that conflict isn’t dangerous.  I need reassurance that people believe me, that they believe I experienced abuse, that they believe I’m trying my best.  I need reassurance so badly because my internal dialogue is so self critical and judgmental.

I know it’s not the responsibility of those around me to constantly reassure me.  I know I’m an adult and I have to take responsibility for my own feelings and fears.  The difficult part is that while I’m experiencing ongoing abuse and conflict which is outside of my control, my self esteem is constantly being eroded and challenged.  I need reassurance because I haven’t yet learned to fully believe and reassure myself.

I believe this is very common for survivors who have experienced long periods of gaslighting or complex emotional abuse.    It’s hard to build up a stable sense of self when you are being confused, beaten down and made to feel like you are crazy and nobody will believe you.

Survivors need a lot of patience.  Sometimes you might get frustrated with me.  Sometimes you might feel like I’m being unreasonable.  Sometimes you might not understand why I’m SO upset over something SO little.   Please remember that it’s not little to me.  My reaction could be related to feeling triggered and that trigger is making me feel like a failure.   If you have the energy and patience to reassure a survivor, please do so.  She might need to hear thousands of times that you believe her and that you don’t think she is crazy.

I need to hear it a thousand times.  Especially on weeks like these where I feel crazy, broken and like a failure.

Being physically and emotionally sick at the same time isn’t a lot of fun.  Taking sick days when you are struggling with severe anxiety and PTSD isn’t fun.  It’s not relaxing.  It’s not “a break.”

I guess sometimes we have to carry on, try to move forward, even if we don’t believe or have faith that everything will work out for the best.

On Valentine’s Day, Celebrate YOU!

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Valentines against white supremacy
By Kate Madeira

On Valentine’s Day this year celebrate yourself!  It’s perfectly okay to take a day to acknowledge yourself and all the work you’ve done.  Celebrate yourself and all your awesome qualities!  Feel proud of the fact that you are a survivor.  You are surviving like a boss.

I’ve been doing a lot of self reflection and taking a long hard look at my life recently.  I’ve been confronted with accepting the fact that it’s not my abusers standing in the way of my recovery (at least not entirely).  What is standing in my way are my own negative, self hating, self-destructive core beliefs.  If I don’t believe that I deserve recovery, health and happiness, then I can’t expect those things to just fall into my life with the wave of a magic wand.

I’m not ready to let go of lifelong core beliefs.  Not yet.  It’s going to be a long journey.

But that journey is beginning with a single step.

Acknowledging that maybe, just MAYBE, my core beliefs aren’t true.  Maybe, just MAYBE, there is another option for me.  Maybe, just MAYBE, I could live a life where I do celebrate myself, I do believe in myself and I do believe that I deserve good things.

This Valentine’s Day, I hope that you find love.

Trust me, self love will last a lot longer than that box of chocolates.

Though you deserve chocolates too!  Buy them for yourself tomorrow, they’ll be 50% off!

 

September 10 -World Suicide Prevention Day

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

I am a suicide survivor.

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

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

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

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

Realities

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

 

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

The moment you know…

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I think for every person who experiences ongoing abuse there is a moment:  a moment when the person knows it is over.  They know they are not willing to take even one more minute of lying, gaslighting, physical violence, sexual assault or devaluing of their humanity.  At that  moment the survivor becomes empowered and powerful.

Some survivors are forced to stay with their abuser after this point.  Do not equate what I’m describing as “just leave” or “why didn’t you just leave?”   Leaving is complicated.  There are lots of reasons why someone is not able to leave.  Never judge a survivor for how long it takes them to walk away from violence.  Everyone has access to different options at different points in their lives.  Even if they are still living in violence, do not judge, for at that time they need your support more than ever.

I’m not talking just about leaving.  I’m talking about the moment of realization “enough is enough!”  After that point the survivor begins to take her power back, even if it is just internally.  She realizes she is worth more than the abuse and that a good portion, if not everything, the abuser tells her is untrue and designed to control and confuse.

Everyone has a breaking point, and after that point they begin to grow stronger in the broken places.

I remember the moment I decided that I couldn’t stay married any longer.   I’d played around with the idea of leaving for about a year, seriously for about 13 months.  I tried to leave 6 months before, but was lured back with promises of him attending counseling.

The sexual assault followed a predictable pattern.  It always involved me saying no when I was awake, or saying nothing when I was awake.  Later in the marriage I wrote my “no” in letters, emails and discussed it verbally during the day.  I explicitly spelled out in numerous ways that I did not consent to sex or sexual touching when I was asleep.   During the majority of the marriage I took varying doses of psychiatric medications that made me tired, sleepy, drugged, slower to respond, and quicker to fall back asleep.  I would fall asleep and wake up 45-60 minutes later (at the time when the medication was at it’s peak strength) to him touching me sexually or initiating sex.  I won’t get into all the details here, but it was non-consenting by definition, since I was asleep and drugged.  He knew I would say no if he asked me when I was fully conscious, so he just waited until I was asleep and impaired.  The medication also can make it harder for me to form thoughts or speak clearly and quickly, it delays my reaction times, especially around speaking.

When I did wake up I sometimes said no again, I sometimes froze and he eventually stopped, sometimes I moved his hand away, sometimes silently went along with it, and rarely I said yes once I was awake.  Even when I said yes when I woke up, I still experienced it as assault, because my body was already reacting physiologically by the time I was conscious.  Then it sometimes felt easier to go along with it because it bought me more time before he would ask or take again.

The last time we had sex was the end of our marriage.  Yes, ironically I can say that the sex was so awful I left him because of it.

I’d already been thinking about leaving, many times when he assaulted me I lay there thinking “This will be the last time”  or “I could just get up and walk out”  but I stayed because I had kids and I was afraid.

The last time was in early July, around July 7.  It was one of the times where he started touching me while I was asleep and when I woke up I decided to say yes.   We had sex.  I felt awful.  I knew it was over.  I realized that if I felt violated even when I said  yes, then there was no hope.  And I still felt upset that he couldn’t understand that if the sex started while I was asleep I didn’t have the chance to consent.

The next few days I spoke to my counselor at the abused women’s centre.  I spoke to one of my best friends, who had consistently been giving me the advice to tell my parents, get help, consider leaving.  Everything just clicked and a few days later I told him it was over.

From then on I never really looked back.  It took me 7 weeks to move out into a place of my own.  Those weeks were a living hell.  But I was never confused again.  I never wondered if I was doing the right thing or not.   I felt empowered to take some action to reclaim my life.

Sadly, in my story moving did not completely stop the abuse, and this week almost 3 years later, I watched someone else hit that breaking point.  Someone very close to me.  My own child.  I’m not sure whether or not to be absolutely devastated at what she’s been going through, or glowing with pride and inspiration at how empowered and strong she is.  At such a young age she is more self assured, confident and has better self esteem that I do as an adult.  She’s learned things as a child that I was taught in therapy as an adult.

At the same time I feel like the world’s worst and best parent.  I feel like the worst parent because I feel responsible for what they’ve gone through, and I feel like the best parent because I have, on my own, created empathetic, strong, caring and brave children who care about social justice and equality.  Sometimes I feel we are good people in spite of, despite and almost to spite him.  Being a kind person is one thing he can never take away and that empower us.

I’m not sure whether I’m triggered or inspired.  It’s been an emotional, upside down week.  I feel like I’ve been fighting to justify my entire existence for 3 years, probably longer.  I’m tired.  I’m so tired.  I sometimes feel I don’t have the strength to carry on, but I also don’t have the option to stop.  It’s a marathon.  Sometimes the decision to leave can happen in a split second, but the leaving can take a life time.

Post-it notes

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

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

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

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

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

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

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

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

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

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

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

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

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

Suicide survivors walk among us.

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

Connection is the opposite of depression.

Misdiagnosis.

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This is the piece of paper I was given as a “formal” diagnosis back in 2001.  It was the first time I learned about PTSD.  It was also the first time I was misdiagnosed with Borderline Personality Disorder.  In reality, my PTSD is severe, my current Dr told me it was one of the worst cases he had ever seen.  But Dr. X, in his wisdom, after knowing me for a only a few months decided the impact of my trauma was “mild” and instead the main factor in my illness was untreated borderline personality disorder.  As far as I can see, this assumtion was made due to my self cutting behaviour.  He failed to take into account that before being abused I had no mental health problems.  He failed to take into account that self harm and anorexia are common coping techniques for sexual abuse, especially in young women.  He failed to notice that my out of control self harming behavior and suicide attempts began only AFTER taking a cocktail of psychiatric meds. He failed to see that I have almost none of the diagnostic criteria for BPD, except the self harm.  I had long term friends, stable relationships in my life.  I was not impulsive or risk seeking, except with regard to the self harm.

Over the next few months Dr X also placed a value judgment on this misdiagnosis of Borderline.  He was the first person I talked to about the sexual abuse, and as such I trusted him and looked to him for support.  This was a mistake.  I didn’t have a choice as to what psychiatrist I saw, he was the one assigned to me.  He gradually saw me less and less in his individual practice.  I would show up for appointment only to find he had left for the day or was on call in the ER.  Then he changed his practice to work solely in the urgent psychiatry clinic.  The only way to get an appointment was through the ER.

I had no family Dr and nobody to renew, monitor or change my medications.  He told all the psychiatrists at South Street that I was borderline and so they would not take me on as a patient.  He refused to give me a referral to a community psychiatrist and I had no family doctor.  I felt betrayed.  I felt rejected.  I felt worthless.

I started to use the ER on a regular basis, mainly after cutting myself.  I would ask for a psych consult about 50% of the times I cut myself.  I would ask the doctor on call to please assign me a regular psychiatrist to follow me.  I begged.  I pleaded.  I was rejected.  I was sometimes given an appointment at the urgent psychiatry clinic, where I knew I would see Dr. X again.  No way to break free, systemic barriers and misdiagnosis kept me trapped.  The more I protested, the more I harmed myself, the worse the situation got for me.

The treatment that I received at South Street was appalling. I know I am not the only one and I know this hospital is not the only one with issues.  Women survivors of childhood sexual, emotional and physical abuse are often misdiagnosed with borderline, a diagnosis I see as basically a wastepaper basket label.

I remember during my second last year at South Street, 2003, I attempted suicide again.  This time I cut myself extremely deeply, diagonally across my arm.  I remember lying on the floor in the hallway of the apartment I shared with my boyfriend.  I was dizzy, almost blacking out.  I felt the quiet empty feeling in my head and I tried to decide whether or not to keep pressure on the cut or let it bleed and let myself give in to the pull of unconsciousness.  I lay there for a while, I’m not sure how long.  I finally decided to go to the hospital.  I think I took a cab, but I’m not sure.

At the hospital, the medical doctor that first assessed me actually put me on a Form.  He got a security guard to sit in my curtained area to watch over me.  I remember I was studying for my 4th year Health Sciences exams.  Somehow the irony of this was lost on me at the time.  I had just tried to kill myself, I had a security guard watching me and I was studying for a university exam in the ER.  The medical doctors fixed up my cut with stitches.  By this time the routine of receiving stitches was, just that, routine.  I had received hundreds, sometimes as many as 50 at a time.  After I was fixed up I was transferred to the psych section of the ER.  I don’t remember too much about what happened but I do remember I was told that there were no beds, that I could not be admitted.  I told them that the cut had been a suicide attempt, not “just” self harming like I usually did.  I begged to be admitted. But the psychiatry doctor was firm, there were no beds for me.  I couldn’t understand it, the medical doctor had thought I was a risk to myself, so much so he had security watch over me, but psychiatry released me.  I learned over the years at South Street that as soon as a doctor had access to my past charts I was treated very differently.  I was generally taken seriously when a health care provider spoke to me and listened to me.  When that same health care provider saw my chart, I was turned away, disrespected, ignored and mistreated.  This is what misdiagnosis with BPD means to me.

I remember being discharged from the ER that day.  I was desperate.  I still wanted to die.  I remember standing in between the double doors of the ER crying.  I didn’t know where to go or what to do.  I felt hopeless.  It was late evening, it was spring or summer and it was still light outside.  As I stood there crying a door opened, it led out to the ambulance bay right beside the place I was standing.  Our of the door came a gurney, with a black body bag on it.  The door led to the morgue which was also in the basement of South Street.  The body was loaded into a funeral home vehicle and drove away.  The image impacted me and haunted me.  I wondered if my friend Darlene was wheeled out that very same door a year before. I was preoccupied with death.  I felt scared and I felt lost.  I just wanted someone to help me.  I’m not even sure I really wanted to die at that point, I just wanted the pain and confusion to stop.

Eventually I left.  I took the bus home, back to the apartment where I’d tried to end my life a few hours earlier.

I think that people often conclude that because an injury is self inflicted, that the person chose it.  That they are not traumatized by it or impacted by it.  But I believe that self inflicted trauma also needs to be recognized as a contributor to PTSD.  I think that my experiences within the psychiatric system alone could have caused PTSD in a healthy person.  In a person who was already traumatized they were that much more severe.  Sometimes comfort and sympathy are not provided to self injuring people.  We are treated as though we “knew better” and are essentially “wasting time and health care resources” or taking away care from those who “really need it.”  I believe that every person who self harms would have chosen a different option if they felt they truly had a choice.  Self harm isn’t cool, it’s not fun, it’s not something to envy or idolize.  It’s dangerous, it’s terrifying, it is not glamorous in any way.   It leaves lasting scars.  Scars I will live with for the rest of my life, and scars that trigger memories of times in my life I would much rather forget.  I get flashbacks around my self inflicted trauma in the same ways I do to the abuse inflicted on me by others.  And because I was abused in the health care system the two are not distinct.

There is no easy solution to these problems.  People who self harm need and deserve compassion.  PTSD should be taken seriously and not dismissed as a disordered personality.  PTSD is treatable.  Believing survivors is the first step.  Yes, this means as a society we all have to step up and acknowledge that violence and abuse is much more prevalent than we ever imagined.  We need to collectively work to end victim blaming and shaming and fight rape culture.  Because powerful white male doctors, with all their privileges, labeling my personality as disordered is rape culture.  I became sick and disabled because of abuse; I’m not disordered, I am a survivor.

 

No, you don’t have the right to torture me

/ hopeforsanityblog / 2 Comments

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This is what the stigma of being misdiagnosed with borderline personality disorder means to me.  Trigger warning for description of self harm and abuse.

Monday November 8, 2004

I presented to the Emergency Room at South Street Hospital with a self inflicted cut on my arm.  By this time I had been using hospital psychiatric services for over 3 years.  I was a frequent flyer, a regular, a repeat customer and I was not popular.  I had experienced many unpleasant experiences in the ER.  I had grown accustomed to medical students poking at me and asking ridiculously offensive questions.  The worst was “Why don’t you cut yourself deeper so it would hurt more?”

I’m only going to say this once.  In my opinion someone who uses psychiatric services heavily is actually in MORE need, likely MORE desperate and experiencing MORE complex issues that someone who is visiting for the first time.  As mental illnesses progress folks become sicker and more marginalized by society.  What is needed are more individualized care plans, more compassionate care, more empathy and more listening to the survivor.  The survivor themselves is the expert in her own healing.  One size fits all models of care do not work, they have never worked, and will never work.  Each person is unique and experiences a unique mix of oppression and marginalization as they live with their illness.  Social and structural factors are an important thing to consider.  The survivor does not exist in a vacuum.

Believe me, if someone truly had options, they would NOT choose to spend their lives in psychiatric institutions.

Part of the reason I used the Emergency Room so frequently at that time was because I had neither a family doctor, nor a psychiatrist seeing me for ongoing care.  Lack of access to primary and preventative mental health care is a huge issue.  Another major barrier is the existence of a two-tiered mental health care system; whereby folks who have financial resources are able to access private care from psychologists and social workers and economically marginalized people (the sickest and most at risk) often face long waiting lists, lack of affordable housing and gaps in services.

By that time Dr. X had stopped seeing me.  This happened over a period of months.  First he would cancel appointments, then not show up for them.  I was busing across town to meet him and he just would not be there.  Then he switched from an outpatient practice and seeing inpatients on the 7th and 8th floor to working full time in the Urgent Psychiatry Clinic and the ER.  When he switched his practice I was not assigned to another doctor, nor was a given a community referral.  Thus, my only option was to attend at the ER to get a psych consult and an appointment with Urgent Psychiatry.  I begged and pleaded and searched for a new doctor but I was not able to find one.  I found out later that Dr. X had essentially blacklisted me at South Street and no psychiatrist would take me on because I had “borderline personality disorder.”  I was also denied access to the PTSD treatment program, after waiting on their list for 18 months.  I was told I didn’t meet the criteria for the program.  Ironic since PTSD is my main, if not only, diagnosis.

But I digress…back to November 8, 2004.

I waiting in the waiting room for about 1 hour before being brought back into the curtained treatment area known as OR 2.  When I was directed to a bed I began crying and was visibly upset.  A nurse arrived to take my history, but she was interrupted by Dr. P who dismissed her saying “you are wasting your time.”   Dr. P spoke to me in a curt and derogatory manner, asking to see my laceration.  He took a quick look at it and said he was going to staple it.  I began crying and asking him to please stitch the cut instead because staples really scared and triggered me.  Dr. P laughed at me and asked me to lie down and proceeded to quickly clean the cut.  He then held my arm down and proceeded to place 8 sutures into my forearm without using any local freezing or pain relief.  I was sobbing and screaming and he continued offering no sign of sympathy or concern.  I couldn’t understand why he was not following procedure and I was confused and distressed.  I felt as though I was being purposely targeted and tortured because my wound was self inflicted.  I felt like Dr. P wanted to “teach me a lesson.”  I was known to him from previous visits and I got the sense he did not want to see me in “his” ER again.

After he was finished the nurse came back and tried to calm me down.  She reported the incident to the charge nurse who also comforted me and offered me Advil.  I was then taken to the psych waiting area to meet with the doctor on call.  I was very upset, triggered and in a lot of pain.  I remember curling up into the smallest ball I could make in the uncomfortable plastic chair which was bolted to the ground.  The floor was covered in green tiles.  All the furniture was bolted down, presumably to stop patients from injuring themselves of others.  It was a cold room, I remember I was shaking and probably in shock.

I reported the incident to the College of Physicians and Surgeons a few days later.  The treatment I received was abusive and was physical assault.  I came to the hospital (already living with PTSD) and I was traumatized in a time of crisis.  I firmly believe that if my cut had not been self inflicted and if I had not been labelled within the hospital as a “hopeless case” this assault would not have taken place.

Procedure allowed Dr. P to write a response to my complaint.  In his response he actually admitted to speaking with Dr. X who told him that I “had long standing borderline personality disorder and that none of his colleagues would take [me] because of this.”  Incredible!  Psychiatrists in the hospital were actively denying me care due to a psychiatric misdiagnosis?  I wouldn’t believe it except I’ve seen my charts and I know it to be true.

Dr. P’s explanation for not using freezing was that he thought my arm was so full of scar tissue that I would not be able to feel the sutures.  This made no sense since I was screaming while he stitched my arm.  He wrote that he offered me anesthetic which was a lie.  Luckily the two nurses who were working supported my account of events.  Also the Dr did not note in the chart that I had refused local anesthetic which is standard protocol before proceeding without it.   I found out later that my complaint was not the first one made to the College about Dr. P and his behaviour in the ER.

The College upheld my complaint and Dr. P was ordered to appear before the College for discipline.   I’m not 100% sure what that entailed but my complaint was heard.  I did feel validated by that, but it did not undo the trauma that I experienced.

I experienced torture within a Canadian hospital.   This happened because of the label of borderline personality disorder.  This happened because I wasn’t getting better quickly enough, because I wasn’t acting in a way that was expected of a survivor of violence.

But this should not have happened, not to me, not to any person.  Especially not to a survivor of abuse.  Self harm was a normal coping reaction for me.  My personality is not disordered, I survived ongoing sexual and emotional abuse; as well as dangerous side effects to the very medications the hospital kept pushing at me.

My message to the world:

Please treat folks who harm themselves with care and compassion.  Chances are they are already judging themselves far more harshly than you ever could.  Self harm is a misunderstood coping technique, it is not a way to get attention.  If you haven’t harmed yourself, please don’t judge, you haven’t walked in our shoes.  The reasons why people turn to self harm are complex and layered. By showing love and compassion to the self-injuring person you could be literally saving their life.  We don’t want or need to be saved, we just want to be respected, heard, and valued.

If you do harm yourself, please know that you are loved and important.  I hope one day you will find other ways to cope.I support you and I am glad you are fighting rather than giving up.

The world is a better place because you are in it.

 

 

Don’t judge me. I’m coping.

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hope-hero

The most important thing to remember about survivors of sexual, emotional and physical abuse is that if we are alive chances are we are coping and that’s a good thing.

One way the psychiatric system as a whole fails survivors, especially women, is by labeling our normal coping reactions as “symptoms” of various psychiatric illnesses.  Please consider this: it was the situations I survived that were not normal, the ways I coped were normal healthy reactions.  I did what I had to do to survive and that’s okay.

Yes, you are normal!  No, this is not your fault!  I believe you.

If you turned to “disordered eating” as a way of coping with your trauma, you are normal.

If you engage in self harming behaviours as a way of coping, you are normal.

If you take drugs and alcohol as a way of coping, you are normal.

If you zone out or disassociate as a way of coping (either voluntarily or involuntarily), you are normal.

These are all examples of common coping reactions that women utilize to survive the abnormal and terrifying situation of experiencing abuse.

You did the best you could at the time to survive and that was enough.  If I had known better or had other options, I might not have used anorexia, self harm and suicide attempts to cope.  Those tools worked for me for a time, until they didn’t.  When they stopped being useful to me and started causing more harm to me than good, I became motivated to learn new methods of coping.    I don’t have borderline personality disorder, I don’t harm myself to manipulate others or to seek attention.  I do it because I am a survivor of trauma, doing what survivors do best: surviving.

If you are working towards recovery be proud of yourself.  We aren’t aiming for perfection here, because it doesn’t exist.  Your best is enough.  You are enough.

I identify with the label PTSD and my experience with it is that it is chronic and more of a disability than an illness.   Living with PTSD takes an incredible amount of energy.  If you regularly hear me say “I’m tired, I’m so tired” I’m not whining.  I am fatigued and tired almost all time, some days worse than others.  And no, taking a nap won’t help but thanks for thinking of me.

Let me explain why living with PTSD is so exhausting.  It’s an invisible illness, for the most part you can’t see my struggles, but that doesn’t mean they are not real or valid.

Facts about PTSD and why it sucks away a massive amount of my energy each and every day:

  1. Even though I might be in bed for 8 hours in a given night I’m often experiencing nightmares.  Sometimes these nightmares cause me to wake in a panic attack, unsure what is real and what was just a dream.  I sometimes wake up covered in sweat, making sounds and fighting off imaginary threats.  When I wake up I often do not feel rested and I sometimes avoid going to bed at night when the dreams have been particularly troublesome.
  2. One word:  hypervigilance.  This means my danger sensors are on high alert 24/7, 365 days a year.  I can’t “just relax.”
  3. Hyperarousal and exaggerated startle response.  Every time there is an unexpected noise, or sometimes even an unexpected movement I jump about 10 feet in the air.  This is a symptom that people around me tend to notice and comment on.  Again, I cannot control it. Reassuring me that there is no danger does not stop the response.
  4.  Depression and anxiety.  Obsessive compulsive worries.  Yes, PTSD impacts my mood.  No, I can’t just “cheer up” or “think positive.”
  5. Flashbacks and body memories.  Yes, intellectually I know it happened “a long time ago” and that I’m “safe right now” but my body and my physiology haven’t caught up. I can go from feeling perfectly fine to crying, terrified and in physical pain within seconds and the trigger can be sometimes as inconsequential as a touch, a word, a memory crossing my mind.  Intense flashbacks are accompanied by panic attacks, rapid breathing, hot and cold sweats, disorientation, confusion between past and present.  After a particularly bad one it can take up to 7 days for the residual effects to pass.  And though technically, in the present moment, nothing bad has happened to me, I often feel as though the abuse has occurred all over again.  I feel exhausted, scared and sometimes hopeless about how little control I have over the memories.
  6. Flashbacks, body memories, hypervigilance etc are not the same as day to day worries.  They are not something I spend time thinking about or worrying about, it’s easier to understand them as physiological reactions, rather than connected to specific thoughts or behaviours.   This is not an intellectual problem, so no, I can’t just “look on the bright side”
  7. PTSD is often accompanied by deep shame and sense of self as being damaged, broken or somehow faulty.  Even though you might not see me this way, and struggle to understand why my self concept is so “distorted” please hear me and believe me.  I really do feel that internalized shame as a result of being abused.  Be patient with me, I can’t just “love myself.”  It’s more complicated than that.
  8. PTSD causes actual changes in your brain.  In the military it is referred to as an operational stress INJURY or post-traumatic stress INJURY and this makes perfect sense to me.  My brain was injured by the trauma I survived.  The eating issues and self harm behaviours are symptoms of PTSD, they were the ways I reacted and coped with the initial injuries.

For those of you who do not live with PTSD, I hope this explanation of my experience makes sense.

Last night I had a new flashback, to the original abuse with X, 20 years ago.  It wasn’t a lot of fun.  It led me to think about how PTSD uses up a massive amount of spoons (google spoon theory of chronic illness for more information).

I’m trying to be compassionate with myself tonight.  My hope levels are staggeringly low.  I’m tired of life, but I won’t give up.

Tonight I’m coping.  I hope you are coping too.