Friday, 31 May 2013

Some thoughts on self harm

I've had many conversations with people over the years about self harm. I've discussed it with friends, family, doctor's, nurses and therapists. I've discussed it with a line manager at work and I've even discussed it with a stranger on the train once, after they noticed the scars on my arms. So, I thought I'd take the time to share some of my thoughts based on my experiences both of self harming and of talking about it.

Firstly, I would like to make it really clear that self harm is not a failed suicide attempt, nor is it necessarily an indication that someone is contemplating suicide. People self harm for a whole variety of reasons, often the same person engages in self harming behaviour for different reasons at different times. I know that I've harmed myself in different ways, at different times for a variety of different reasons.

Sometimes it's been a way to cope with overwhelming emotion or racing thoughts that seem beyond my control. At other times I've self harmed simply in order to feel something, to prove to myself that I still could. Then there have been the times I've dissociated so heavily I can't remember what I've done or why. There is very little more upsetting than 'coming round' somewhere to find yourself with clearly self inflicted injuries and no idea why they are there. Finally, I've self harmed when the suicidal thoughts became too much to deal with, when I was truly afraid I would give in and act on them. Somehow, hurting myself seems to hold those thoughts at bay, reduce them for a time. I have quite literally hurt myself in order to keep living. For me, self harm is often the direct opposite of an attempt on my life.

Something which comes up often when talking about self harm is the idea that it is wrong, a maladaptive behaviour which is only ever harmful. I am not entirely sure this is true. Certainly, it looks like an unhealthy behaviour. I would accept that a mentally healthy person doesn't engage in self harming behaviours. Where I would argue is that it is automatically maladaptive. There are times when I have tried very hard to engage in more 'healthy' behaviours to control my thoughts and emotions, to get back to a place where I can fight them again. There are times those techniques - many developed in conjunction with a therapist - haven't worked. At that point, I would argue that harming myself is in fact a valid response. Particularly if the only remaining alternative is suicide.

For me, suicidal behaviour can be a compulsion which I find it very hard to fight. There are times it hasn't been, times where it has seemed like the best way out. On those occasions, as soon as any other alternative has been found the desire to take my life has ceased. There are other times though where that isn't the case. Where the compulsion is so strong there simply isn't time to think. Times where the compulsion is so powerful I can't simply sit and wait for the feeling to pass. On those occasions, self harm can help alleviate the compulsion. It's almost like by giving in a little, the urge is lessened to the point I can fight it once more. To the point I am able to put into practice the techniques and tools I've been given to keep myself safe. There have also been times where suicide seemed like the best option and I wasn't in the position to seek advice or help in finding another.

I am thinking now about when I was much younger and being abused by my father. I was too young to move out, running away hadn't worked and I had nobody to talk to. No where I could go for help and advice. At ten years old, I didn't even have the language to talk about what was going on even if I had found someone to talk to. By thirteen, when I made the first attempt on my life I had the language but my depression had deepened to the point that things liked talking to people seemed entirely beyond me. In situations like this, where any form of help or support seem impossible suicide can seem like a frighteningly welcome idea. At times like these, self harm provided a temporary relief from such thoughts and feelings. Temporary, but accessible as often as I needed it. It allowed me to maintain a degree of functionality, it allowed me to continue living until I reached a point that alternatives became available.

I am writing this now as someone who hasn't hurt herself on purpose for three years. It's the longest I've ever managed and I'm pleased to report that I have developed many other ways of fighting suicidal urges, of dealing with racing or intrusive thoughts and emotions so strong I struggle to cope with them. I still remember very strongly being that other, younger girl however. The one who turned so often to self harm because she didn't yet have tools to handle things any other way, or found herself in situations where those tools didn't work. I can say with a hundred per cent certainty that my life is better without self harm, but also that I wouldn't be here to realise that if I hadn't had this tool at my disposal.

I guess I want three things from this post. Firstly, to address the assumptions which can be made about self harm - it's not a suicide attempt, and whilst it can be connected to suicidal ideation or thoughts that's not necessarily the case. Secondly, some understanding that self harm serves a purpose, it can work, albeit temporarily and that for each person, each time they self harm the reasons can be different. Finally, I want anyone who reads this and identifies as a self harmer, there is hope that one day in the future you won't need that particular tool any more.

So, if you are reading this and know somebody who self harms, please try not to assume you understand and please don't judge. Anybody who self harms would be happy to find a safer, healthier way of dealing with things but there will be times this really is the best option they have available. Understand and accept that and you'll find helping them reach a place where it's no longer necessary will be easier for everyone involved.

Thursday, 30 May 2013

Listening, an often underrated skill

One of the things I hate most about talking to my friends and loved ones about my mental health is this: they often assume what I want or need from them is advice and a way to fix things. There are times when that is what I'm asking for, sure but most of the time all I want is someone to listen. There are times when I need to just talk, to get thoughts out of my head and to share my experience. 

What often happens instead is a horrible cycle of frustration and upset for everyone involved. I try to talk, my confidant jumps in to offer advice. I become upset and frustrated because I'm not being listened too, because someone is trying to 'fix' me and tell me what I should be doing. They become frustrated because their advice isn't being taken on board, it can feel like I don't want to get better and ultimately they are trying to help but clearly aren't. Not a nice position for anybody to be in. We both tend to walk away from such conversations exhausted and unhappy, often with each other. 

I understand that sometimes it can be overwhelming to listen to me talk. If you don't think you can listen right now, much as that might be painful for me to hear it's also OK for you to say. If you think you might be able to listen at a different time please make that clear, though also don't assume or expect I will be able to talk at the same point you are able to listen.

When I am telling you I don't know what to do, that I feel lost, alone or helpless that's not me asking you to tell me what I should do or how to fix things. When I say I don't know what to do, have you got any ideas? Or when I ask what you think I could or should be doing, that's different. 

 Sometimes people tell me in a slightly injured tone that they don't feel they get the chance to add anything to the conversation. This is simply not true. By listening to me you are doing so much, providing something I need so very badly. Every time you start to think that not having something to add, by not having magical answers that will fix everything you aren't helping please take a deep breath and remind yourself of this fact. Listening is the single most useful and helpful thing you could be doing, taking time out of your day to hear me - someone who has spent so much of her life not being heard - is showing me that you care, that you want to help, that you are there for me in the ways I need you to be. Not many people are able to do this, so when it feels like you aren't doing enough I need you to know you are doing everything.

It's hard to just listen, I get that. I've been there too. I understand that you might also be having a tough time, that you might want to talk too. Or that you simply can't sit back and listen right now. I understand too that it's really hard to sit and listen to someone you care about in pain when all your instincts are telling you you must be doing something, when you really want to just make it all better.

That's in part why I'm writing this. None of us get it right all the time, I'm no more able to simply listen every time than you are. I think we need to be kind to each other here and simply try to understand. Every time you are able to listen, that's a time I will treasure. Every time you aren't, I will do my best not to be hurt and angry. I won't be able to do that every time but I'll do my best, you do the same and hopefully we can help each other. 

Wednesday, 29 May 2013

Love and hurt, a post about child abuse

I've spent the last hour trying to come up with a title for this piece instead of just getting on and writing it. A delaying tactic if ever I saw one. Thinking about the abuse I suffered growing up is always difficult, but the hardest part for me is thinking about the fact that it was missed by those who loved me. It's taken so many years to recognise that no one knew I was being abused, but that this didn't mean no one loved or cared about me.

Some of this comes down to understanding how and why I was vulnerable, which ties in to why the abuse was not noticed or stopped. As a child, my understanding went something like this: My parents are meant to love and look after me but one of my parents hurts me and the other one doesn't stop him. They both tell me that they love me, but yet they aren't looking after me. So they must not love me like they say the do or else this hurt is the same as being looked after.

I am sure it doesn't take a genius to figure out how this was a damaging idea to grow up with, that I had to chose between the idea that I wasn't loved, or that what was being done to me was right and proper even though it hurt. I wonder at times how much this idea that pain = being looked after contributed to my self harming behaviour.

As a teenager my understanding changed again. I knew what was being done to me was wrong, and I couldn't understand how someone who claimed to love me could do it. I spent a lot of the time convinced that my father therefore couldn't possibly love me. Then he would go and do something kind and thoughtful, he'd look out for in the way that I really wanted him to and I was conflicted once again. For my mother's part, I understood by now that her illness had contributed a lot towards her missing what was going on. There were weeks at a time where she was in the hospital, longer still where she was home but effectively bed ridden and reliant on us to tell her what was going on in our lives. I told her lots of things but I didn't tell her about this. To my mind, she already had enough to deal with. Then she died, and it was too late to tell her anything.

So, by my teens there was an understanding as to how I was vulnerable to abuse. One of my parents was my abuser, the other was fighting a long term, painful and ultimately fatal disease which made it much harder for her to see what was going on. I was so worried about making things harder for her that I went out of my way to keep quiet about things which might trouble her. It did become apparent in my teens that I was unwell and struggling to cope, but given my mum's illness and death there seemed an obvious reason why this would be the case.

As an adult, I can finally look back and say I was loved and I was hurt, the two aren't mutually exclusive. The hurt wasn't right or OK, it should never have happened and certainly wasn't a sign of love or care. I was failed, in that neither of my parents were able to look after me properly however only one of them was to blame for that. The other did everything she could, and to this day I think if I had felt able to confide in her then she would have done everything in her power to protect me.

So, there were a number of reasons I was vulnerable. I had a parent who was frequently absent from home or restricted to a single room due to illness. I didn't have the language to talk about what was happening to me because I was a child.  I didn't want to upset a woman who was already unwell and had a lot to deal with, and whom I loved very much. I was conflicted about my feelings for a father who was at times a monster but other times everything I wanted from a dad. By the time I had the language and knowledge to talk about what had happened to me I had been silent on the subject so long that I was afraid to speak out. There was so much fear around the idea, it would distress my mum, I might not be believed, people would think less of me for letting it go on for so long. These vulnerabilities were things my father took advantage of, then added to. He told me he'd kill himself if I told, or fought back. He told me it would kill my mum if she found out, that my siblings would hate me, that we'd all be put into care.

I wonder now how different things would have been if I'd been able to break that silence and speak out. There's no real way to know, but I have my belief that my mum would have done right by me because I know, without a doubt, that she loved me after all. As an adult, that's the one thing which seems clear and for now that will have to be enough.

Talking about suicide

After many years of dealing with mental illness I’ve reached a point where I’m quite open about my mental health. I’ve had negative experiences when sharing my story but I’ve had many positive ones as well. Perhaps the best thing to come out of it has been the way that my openness has helped other people to talk about their experiences too. Learning that I’m not alone, whilst in some ways sad has also helped me overcome some of the isolation which seems to be the lot of a person with mental illness. Helping other people by providing a listening ear or supporting them while they access professional help has done wonders for my self-esteem too.

Yet there is still something I find it difficult to talk about. Suicide, whether that be relating my past experiences or discussing the still recurrent ideas or urges that pop up, is a difficult topic to tackle. Firstly, there are other people’s reactions to is. Far too often I face a lecture on how selfish it is. Frequently instead of being able to talk about why I feel like I do I end up having a discussion about how my suicidal ideation is upsetting and distressing for those I’m talking to. I’m sure that it is and I’m happy to talk about that, but right then in that moment what I need to talk about is me.

There is a common belief that if you are talking about suicide you aren’t at risk of taking that step, but that’s not true at all. If I’m talking about it, thinking about it, contemplating it then what I need is someone to listen. To set aside their distress and help me work through mine because when I’m at that stage I’m simply not in a place to be offering support. I’m in desperate need of it myself.

I can honestly say that I don’t want to die, what I want is to no longer be in the situation I’m in. There are times when my depression and anxiety become so bad I honestly can’t see any way out that doesn’t involve death. What I need at those times is another option, another way to improve my lot. In talking about it that’s what I’m seeking.

It’s not about being selfish, or wanting attention. It’s not about having given up. It’s about not wanting to live with things the way they are and being unable at that moment to see a way to change my life. Sometimes it’s about being so afraid of my suicidal thoughts that I fear I will give in to them, simply to make them stop. Thoughts of suicide can be horribly intrusive, hard to deal with and often times come with a compulsion to act on them.

All I ask is that if I – or anybody else – talks to you about suicide, listen. Take them seriously, but don’t panic. Keep listening and keep me talking. While I’m talking I’m still fighting, still seeking an alternative. It may be that I’m not safe to be alone. Perhaps I need to be seeking professional help and support. You can help me do those things and I’m not saying that you have to deal with the situation alone. All I’m saying is that if I’m talking about this it’s because I’ve recognised that I’m not coping alone.

Later, when I’m coping better I will be happy to listen to your side of the story. I think it’s important to do so. I just need you to recognise that in the moment, I’m not able to help you. All of my energy and ability to think is taken up trying to survive until this current urge passes.

A bit about OCD

When I tell someone I have OCD I am often met with disbelief. Anyone who knows me will tell you that I'm far from the tidiest person. I don't obsessively wash my hands, compulsively clean up after myself/other people. This is part of the problem with the common misperception that OCD is a disorder categorised by cleaning. Whilst it can present that way for some that isn't what this disorder is about.

I've met and spoken with a number of fellow sufferers, only one is a compulsive cleaner. She cleans because she can't escape the thought that if anything in her home is out of place then the rest of her life will fall apart. For me, my experience of OCD is different but it does share some common factors. Namely intrusive thoughts of things going wrong and the compulsion to repeat a behaviour which helps me to feel calmer about this possibility.

It started when I was a kid, after the loss of someone very close to me. Much like any other child faced with death and grief for the first time I was upset and worried. If one person I loved could die, so could another. So could I. In fact anybody could die! It was someone of a revelation and it was an idea which has haunted me ever since. I have been calmly walking into town when suddenly I am plagued with the image of myself being run over, or slipping off the curb and dashing my brains out. This image will not go away, it sticks in my head and it feels so real I have found myself reached up to touch my head and check for blood before now. Or I will struggle to get to sleep at night because I can't get the idea out of my head that someone I love is dead. At times this has gotten so bad I've phoned someone up at four in the morning just to make sure they are OK.

Since this first started happening I've developed little rituals, things I can do to 'banish' the thoughts, or somehow prevent them from happening. I know that there is no way my bizarre little habits can actually stop events occurring, in the same way as I know that I can't cause something to happen simply by thinking about it. Yet I can't stop these thoughts, these fears from happening and I haven't yet been able to fight the compulsions that accompany them.

I have a ritual that involves light switches, which I have to engage in every night and every morning. I have a set of numbers which has to be repeated a set number of times, in a particular order to prevent harm coming to my loved ones when those thoughts occur. Then there is another one where I have to pull at my hair until the thoughts have faded away.

This is what OCD is like, for me. It's not always visible to other people - in fact, quietly tugging at hair is something commonly written off as just a nervous tick, counting happens in my head not aloud, you'd have to be around to witness my light switch ritual in order to know about it. Yet it is always with me, it is something I deal with on a daily basis.

The thoughts aren't always about physical harm or death, I have many more rituals or compulsions than I've listed here but the general theme remains. Each person's experiences of OCD will be different, just as we are all different. Yet there are some commonalities. OCD is often about anxiety, always about compulsive thoughts or behaviours and only sometimes about cleaning.

Thursday, 23 May 2013

I have spent ages now trying to write this post and have deleted it several times. At this point I have no idea if I will manage to successfully get across what I want to say. Here goes, I'll give it one last shot.

I want children, I really do. I always have. I don't have any yet, partly by choice (the time isn't right) and partly because it's just worked out that way. I've been pregnant before and I would have chosen to keep that child despite the situation not being perfect but that choice was taken from me when I had a miscarriage. It sucks but there you go.

As a woman with mental illness I get hit with a lot of mixed messages about becoming a mother. On the one hand, my mental illness has interfered with my ability to develop a career and achieve any degree of financial stability. People keep telling me to sort out my career before I have kids. On the other hand, I'm not getting any younger and more often now people assume I've decided against having children or urge me to have them asap before the choice is taken away from me. Then there are the people who tell me having a child would be the best thing I could do. It would 'give me something to live for',  a reason to get better (apparently my own happiness and well being aren't good enough reasons). There are also the people who tell me the opposite, that as someone with mental illness I should never have children. It wouldn't be fair. I couldn't look after them. I could pass on my mental illness.

Now I'm not saying that these aren't things I should think about, of course they are. I do think about them, a lot. Particularly the stuff about my mental health and ability to be a good parent. I just don't think that other people's opinions are the best way for me to decide whether or not I'm ready to be a parent. Really, there are only two people who's views matter in this situation. Mine and my partners, as we'd be the ones going on to try for a child if we decided that was something we both wanted and felt ready for.

So then, career and finances. In an ideal world I'd have a career I loved and a steady income. It's not an ideal world and I don't. I might never achieve those things. In terms of having children this provides me with a difficulty as I'd like to provide my possible future children with an ideal life. One that's stable, where I can afford to provide them with everything they need. It's certainly something I give a lot of thought to. Right now I'm doing what I can to change my working situation. Stable employment, in a job I can stick with for more than a year or two at a time is the goal. Though I'll be honest and admit that this isn't something I'm trying to do just so I can have kids. It's more for my own benefit. It would be lovely not to have to worry constantly about money. Not to feel worthless because I have spent years at a time unemployed.

Let me tell you about my mum. She was physically ill and unable to work. In my mind, she was still a good mum. OK, so I was abused by my father and she didn't know about it because she was ill and bedridden or in hospital much of the time but I still think she was a good parent. In that situation it was my father who was the bad parent. Incidentally, my father also had a long term, steady job for the entirety of my childhood. It turns out the ability to work and provide for your children doesn't automatically translate into being a good parent. My mum wasn't well enough to work, she didn't bring in much if any money. Yet despite her illness she was always prepared to listen to us kids. When she couldn't get out of bed to play with us she used her awesome imagination to invent games we could play with her. She was the one who went through our homework with us, helping us find ways to figure it out when we got frustrated. She was the one we went to to have our knees plastered, to talk about our day and to read a bedtime story with. She wasn't perfect but she was an amazing mum. It turns out there's more to being a parent than providing financial support.

What about age? Well, age bothers me. I'm less than a decade away from the point where I can expect my ability to conceive and carry a child to start on a sharp decline. I'm not convinced I'm less than a decade away from establishing myself in a career, managing my mental health to a point where I'm happy and feeling ready to take responsibility for bringing a person into the world. That upsets me, because I want children. That said, more than half a decade is still a long time. For all my worries and concerns it is possible to achieve what I want to in that time, and if it takes a few years longer so what? My granny was having children into her early fifties. Her last pregnancy was problematic, but that was due to a non- age related illness. I know other women who have had children later on in life with no problems too.

Besides, what are these problems I could face? An increased chance of becoming infertile. That would be sad, but not the end of the world. I want children and I would be very upset if I can't have them. There's lots of things I've wanted in my life and not been able to have however. I didn't want to be abused growing up and it has had a long term negative effect on my life, but I'm learning to deal with it. I wanted a very specific career since a fairly young age and it's taken me time to make my peace with the fact that for various reasons I can't have it. It hurt and it continues to hurt, but I've still managed to have a life beyond that loss. People are amazingly adaptive. If I can't have children that will hurt, it will take time to come to terms with but I don't think it's impossible for me to do so if I'm faced with that possibility.

I could be at an increased risk of complications. That's a scary thought, but as with anything else in life you weigh up the risks versus the benefits. If the benefits seem worth the risk, then you do it. If the time comes then along with my partner I'll look at the risks, make sure I'm well informed and then make a choice. What about increased risk of disability in my child? Well, again I will make sure that I am as well informed as I can be but I imagine I'll go ahead anyway. I don't think a person with a disability is a person incapable of having a meaningful, fulfilling life. I know that not to be true. So I don't see why I would decide not to proceed just because there is a risk of having a disabled child.

So, moving on then. Should I have a child because it will give me a reason to live, because I think it will act as a miracle cure for my mental illness or so I have a purpose? No. Really, just no. Children aren't 'cures' or 'fix alls.' Children are people. Plus, I have a reason to live: Me. I've spent a whole lot of my life feeling like I didn't matter, I'm only just learning that I do. So please don't ignore me when we're talking about my life.

What about the opposite view? Should I not have children at all because I'm mentally ill? There's a lot to think about with this one. I need to consider how I'd cope with difficult times - and I know that there will be some. I have to think about how my mental health could impact on a child's mental health, quality of life and so on. Given that there are times I can't look after myself I need to think about whether I could look after a child. Of course I do. So should anybody who is thinking of becoming a parent.

Let me ask you something. Do you think people who have ever been physically ill shouldn't have children? I mean, they got better but they might become physically ill again. It's a risk isn't it? Mental illness is the same. It can improve, people recover and/or learn to manage their symptoms and mental health. Not everyone who has a mental illness will be mentally ill for the rest of their life. Most people aren't. My mental illnesses have been with me for most of my life, though I think they are better now than in my teens. More importantly, I've gotten better at recognising when I need help or support or to reconsider my treatment plan. I know how vital a good support network is.

I've never harmed or endangered anybody else, despite my mental illness. I've managed to care for and look out for other people, even when I've failed to look after and care for myself. I recognise that there is a difference between doing this on a short term basis and doing it long term, but I don't think the fact I have poor mental health should mean I will automatically fail at these things.

So there you go. I am not 100% sure I have really said what I wanted to but I've done my best. My basic point is simply that as a woman I already face a lot of pressure and judgement about my choices regarding parenthood. When you also factor in the fact that I'm mentally ill that seems to increase a whole load. And I don't think that's fair or right. Having lived with mental illness for a long time I'm much better equipped to judge how it affects my abilities and choices than a stranger.

So believe, if I ever decide the time is right to have a child I will have considered all of these points and more at great length. I will have weighed up the risks and done everything in my power to reduce them, as will the person who decides to become a parent with me.

Today I have been thinking about racism, sexism and other isms

It's difficult to think of yourself as someone who could discriminate against somebody else unfairly yet it's important to understand that this is something we're all capable of and have probably done at some point in our lives. Harder still to think that we might be doing it right now or will do it in the future. Yet to my mind it's really important to be aware that we can, to be concious of this possibility. How else are we going to catch ourselves thinking or behaving in ways that need to be challenged or changed?

Let me explain. In this instance I'm going to be using racism as the example. I grew up and live in a big city in the UK. I have friends and acquaintances of many different ethnic and cultural backgrounds. I certainly don't think of myself as a racist. I do however live in a society where racism is sadly endemic, a part of my culture and background that I've absorbed without even being aware of it.

Growing up, some of my close friends were subjected to racism. I've seen them called names for the colour of their skin and I've defended them. Even as a child it upset me when I witnessed such behaviour and I can't remember a time I didn't know it was wrong. But racism isn't only present when it shows itself so openly. It's a subtle pervasive thing.

As a teenager and young adult, walking down the road alone at night I was often quite anxious about being followed or harassed. I had good reason, it was something that had happened to me on more than one occasion. What it took me a while to realise and address was the fact that if I came across men of colour my anxiety jumped up a notch, in a way that it didn't when I was faced with a white man or even a group of white men. Why? Because at some point I had internalised and taken to heart the idea that men of colour were more dangerous than white men.

Where did that idea come from? No one in my family had taught me such a thing, but the general media did. Conversations at school with my friends did. I certainly wasn't alone with that fear. Yet I had no evidence to support it. Sure, it was all too easy to remember the times men of colour had followed me for a while in their car cat calling and making suggestive comments. Why did I find it so hard to bring to mind the time a white guy followed me all the way home doing the same thing?

I was raped in my teens by a boyfriend, who happened to be black. So that might have accounted for some of my anxiety. Only, I experienced sexual violence on a far more regular basis at the hands of my white father. I was sexually assaulted at school by two school mates, one white and one black. I was raped by an ex boyfriend in my late teens who was white. I had a stalker for a few years, he was white. Our house was broken into several times. On all but one occasion there was at least one white person involved. In fact, most of the objectionable or dangerous behaviour I've been subjected to the perpetrator was white. Yet my anxiety still increased when faced with the prospect of walking past or in front of men of colour.

This is racism, pure and simple. It might have been happening on an unconscious level but it was still there, still present. Once I realised what was going on I then had to work to change it. I had to confront myself with the facts every time I was faced with that situation and eventually, after several months it worked. It was only by being concious of what I was doing and what must be behind it that I was able to alter my thinking.

I had to do something similar in regards to my anxiety and paranoia around strange men in general, but that's digressing slightly from the point. The point is that recognising my racism in this instance wasn't comfortable. It didn't make me feel good about myself and the temptation to try and justify it, or ignore it as something I couldn't change was huge. I didn't though because I like to think of myself as a good person, and to my mind good people confront their prejudice and deal with it.

In terms of sexism, I've experienced similarly sexist ways of thinking and have tried to challenge them too. I still remember the times I felt uncomfortable around girls who didn't wear make-up or like clothes shopping because I had no idea what to talk to them about. The days before I realised that other girls were in fact people, just like me and might therefore have a white variety of interests outside of their appearance. I didn't find myself lost for topics of conversations with my male classmates, who I never discussed make-up with so it was silly to be limiting myself when it came to chatting with the female ones. I've been guilty in the past of thinking that if I ever became a wheelchair user I'd be miserable and hate my life. That was something I wasn't even aware of really thinking until I first got to know a wheel chair user and found myself being surprised at how happy they were. That there is disablism.

This is why I think it's so important to be aware of the potential we all hold to discriminate, to hold prejudices we're and let them affect our thinking and behaviour. It's important to fight this when we see it in other people, when we realise it happens on an institutional and societal level. I just think it's equally important to challenge and fight it within ourselves. It is not possible to live in a society which holds such prejudice without absorbing some of it ourselves. If we really want a society free of these things then we ourselves need to be free of them and that's only going to happen if we avoid falling into the trap of thinking it's impossible for us be prejudiced.

Wednesday, 22 May 2013

Feel like I did something good today

Today I wrote a guest blog for The F Word. As part of my social anxiety I find it really difficult to judge whether anything I have to say is useful or relevant. I find it even harder to put my ideas out there for public consumption and therefore judgement. So, I'm really proud of myself right now. For starting this blog in the first place and for being brave enough to fight down the anxiety long enough to submit something to another, widely read blog.

I did it not because what happened to me was awful (though it was) but because I know I'm not alone. It's pretty well established by now that someone who reports sexual violence or other forms of abuse and isn't believed has their risk of facing similar in the future increased.

At the time I first told I was believed, but after that any further disclosures I made were dismissed as me being 'over sensitive.' The end result was the same as if I hadn't been believed in the first place. Then there is the fact that it wasn't just me experiencing that negative effect.

I've stated a few times now that as a result of speaking out about sexual violence other people often see me as someone they can talk to about their own experiences. I'm not going to lie, at times that's hard to deal with. I'm not always able to hear such things without becoming emotional, upset and angry in a way which isn't helpful for the person talking to me or myself. Yet over all, I kind of love that this is the case. That something I've said or done helps other people feel able to open up.

More than once I've found myself in the situation of being the first person somebody discloses their abuse, assault or rape to. When that happens, the person talking to me often wants advice on how to get help, how to report it or whether it's even a good idea to talk to people about it. I want to be able to help them and I like to think that I've been able to.

What hurts, so much, is when what should be a positive experience, breaking that awful silence becomes something else. When instead of being met with emotional and practical support instead that person's story is met with derision, when that person is assumed to be lying. Not because of anything they've done but because other people don't feel comfortable with the fact that it's possible for me to know so many people who've had these experiences.

I don't know why it's so hard for people to recognise that a person who talks openly about sexual violence is likely to attract conversation about sexual violence, and as an off shoot of that will meet other people who've experienced sexual violence. My hope is that my guest blog will help at least one person realise that this happens. That it's possible for more than one person in the same social group to have suffered sexual violence or abuse, and that it's possible for one person to experience sexual violence more than once in their life. It it does that, and they are then able to use that knowledge to provide support for people then today I've done a good thing.

Binary Gender, it's a problem

I know I've only just posted my piece about gender but I failed to mention something else I think is important. Here in the UK, as a society we only recognise two genders: male and female. Everything about our society enforces the idea of binary gender. Which is a problem because not everyone fits into those two categories.

Yeah, that's right. Not everybody feels comfortable or happy living their life as either a man or a woman. Some people don't identify that way. Maybe they feel like a mixture of both male and female, maybe they just don't feel like either. Maybe they do identify as male or female, but don't conform to current social expectations of either. 

It turns out it's a complicated issue. Personally, I hate binary gender. It leads to and enforces the idea of gender roles. Women as one thing and men as another. It doesn't allow for individual differences and preferences. It makes it harder to do something which isn't considered normal or appropriate for your perceived gender. 

I'm talking about things like men being home makers and stay at home dad's, or women working in male dominated industries. 

I'd write more but I'm tired and worn out and I've been writing on other projects already today. So I'll leave this here for now. Mostly I wanted to acknowledge that not everybody falls into the neat little categories of male or female, and a society which fails to recognise or accept that is problematic.

A bit about gender and 'real' women

Just lately it seems like I've come across a whole new set of memes, adverts and such like going on about 'real' women. On the one hand I support the idea that women who aren't skinny are still beautiful and attractive. On the other I really don't think yet another way of telling people how they should look is the best way to get that message across.

There's another issue here too. By telling people that there is a way to be a real woman that's sending the message that anyone who doesn't conform to whatever ideal is being pushed isn't in fact a woman at all. Seriously, this is not OK.

In my view anybody who identifies as a woman is a woman. It's really that simple.

I was lucky, the gender suggested by my sex is the one I happen to feel comfortable with. Luckier still, I happen to have the physical characteristics that other people identify with being a woman. Namely, breasts, curves, a womb and ovaries. I've never had to fight to be accepted as a woman. So for me, these 'real woman' messages are upsetting because they just seem like another way to dictate how I should look, but that's it on a personal front. Of course, there are other discussions about being 'real' women going on. I'm thinking now not only of the aesthetic side of things, but debates about non cis women.

I particularly hate the idea that to be a woman you have to be born a woman. Gender is a social construct, often confused with biological sex. It's impossible to be born a social construct.

Now I want to talk to you about two women I know and how messages like this upset them. One of them, who I shall call B was like me, born female and identifies with the associated gender. However, when she was in her late teens she found out she was infertile. She couldn't have periods or carry a child because her reproductive organs hadn't developed properly. When discussions about 'real' women pop up, she tells me she still feels a bit uncomfortable. She identifies as a woman and lives her life as one, is accepted by people as one. But, when people start saying that in order to be a 'real' woman you have to have been born with the right set of genitals and reproductive equipment that's when she starts to feel bad. Is she only half a woman? Part 'real' and part made up?

Then there is a woman I am going to refer to as Anna (not her real name). Anna is a trans woman. She spent most of her childhood and adolescence being told that she was wrong. The things she wanted to wear and do were 'inappropriate'. As an adult, she decided to change her name and start living her life as a woman. Years later she's happy that she made the right decision. As a woman she feels right. Yet still she's faced with the message every day that her choices are somehow inappropriate and wrong. She's often banned from women's spaces and discussions about what it means to be a woman because apparently she's not real enough for those.

It sickens me, it really does. Anna faces the same issues that other women do, she shares many of the same concerns. She's an active feminist and advocates for women's rights and equality. She just didn't happen to be born with the right parts. But then again, neither was B.

To my view, both B and Anna are woman and therefore 'real' women, since both of them exist because they both feel most comfortable living their lives as women.

As I said earlier, it really is that simple.

Tuesday, 21 May 2013

Difficult times

Today is a day on which I am struggling. It can be very hard to get through the day when you live with a chronic condition, whether it be physical, mental or some combination of the two. I don't think many people who haven't been there really understand that.

When it gets too hard for me, a few different things can happen. I can try and kill myself - thankfully that's not where I'm at right now. I can hurt myself, which again I haven't done yet. Or I can hide from the world in any number of ways. That's what I'm doing right now. Hiding away, where no one can see me.

Sometimes, when I'm hidden I hide so well I'm an entirely different person. Today, I am a small, uncertain person who finds it difficult to use words. I've been her for a few days now and right now it feels safer to be her than it does to be me.

Hopefully, in a day or so I will feel better and find my words again. Then no doubt I'll have lots to say, as usual.

Saturday, 18 May 2013

"If I had your life I'd try to kill myself too"

Today has reminded me of one of the most useless and hurtful things someone said to me. Picture the scene, if you will. I had been referred to a CPN (community psychiatric nurse) after attempting suicide. It was our first meeting and I was being assessed to see what help and support I needed. Part of that involved a risk assessment and part of it involved talking about why I had tried to kill myself. I'd just finished talking about the child abuse, the rapes, the eating disorders and the anxiety about everything ever. It was at this point that my CPN reached out, placed a comforting hand on my arm and looked into my eyes, her own brimming with sincerity and stated 'if I had your life I'd try to kill myself too.'

I think she was trying to express sympathy with the way I was feeling, trying to let me know that she understood where I was coming from and that it was OK for me to feel that way. I get it, she had the best of intentions. Yet here's the thing. I already knew how bad my situation was - that's why I was there, trying to find another better option than suicide to change it. What I didn't need to be told was that actually, my life really was so appalling it wasn't worth living. Thankfully she was able to arrange for me to see people better equipped than she was to help me out.

So, why has this whole experience reared it's ugly head again? I'll tell you. It's because of this post. It's because today I was reminded that we live in a society where a large number of people think being disabled is so awful they'd rather be dead than live with a disability. It's because we live in a society where people think it's OK to tell other people that they think they'd be better of dead. OK, so I don't think most people realise that's what they're saying, but it is.

If you tell someone you'd rather be dead than live their life then you're saying you don't think their life is one worth living. I can tell you first hand that being told that hurts. That being made to feel you should want to be dead is no fun at all - particularly if you already feel that way.

I was lucky. There were people around who felt that my life was worth saving, there were services around which provided me with the help and support I needed to realise that myself. To help me get to a point where I could look at my life and say 'well, I live in pain everyday which sucks but there are benefits to being alive which make dealing with the pain worthwhile.' Without that help and support, from mental health services and from friends and family I wouldn't be here today. I absolutely believe that.

Now I can't help but wonder what the situation would have been if I was not only severely depressed but also had a physical impairment. Would those services still have helped me? Would people still have been so supportive and determined to help me see I had reasons to live? Or would the combination of mental illness and physical impairment have been considered too much for anyone to live with?

Human beings are amazingly adaptive. Seriously. We do all kinds of things every day to make our lives work. If we move to another country we learn the language to enable better communication. If we find ourselves in pain we take medication to ease it. If we lose someone close to us we grieve, but we survive their loss. As a teen and well into adulthood I experienced a lot of emotional distress and I dealt with it, not always in ways that other people would recognise as healthy or well adapted but in ways that nonetheless allowed me to keep going. When those ways became problematic, I was given help to find new ways of coping and was able to carry on with my life.

If you have a disability, you might need to find ways to manage it. Such as using mobility aids, having your house adapted or taking medication to help with pain and bodily functions. The point is that it's possible to manage your disability and live with it. We know this because people do it every single day. People lead productive, fulfilling and worth while lives AND have a disability. Because a disability doesn't mean your life isn't worth living. Except when people make it so, by denying access to places, services or necessary equipment and treatment. By treating people like they aren't people because they have a disability. Or by telling someone they are better off dead.

Rant over for now. Thanks for reading.

Getting ready for summer

So, I have become infuriated by the number of 'how to get a bikini/summer body' adverts that keep popping up everywhere. This happens every year. Along with the 'how to lose X weight in X weeks' adverts I find them kind of triggering. It's taken me years to be able to gain weight in the first place without having some kind of horrific melt down. Now that I have gained weight, it takes a lot of will power not to turn to unhealthy habits to get rid of it all again.

Learning to love your body shouldn't be a difficult thing, but it is for me and many other people out there. We are constantly bombarded with the message that our bodies should look a certain way. Hey, for that matter we're also sent the message that our bodies should be able to do certain things, yay for disablism. That's a whole separate post though. It's not exactly news that I don't like my body, but that's something I really want to change.

Lately, I've come across this awesome blog. It's pretty inspirational. I want to feel that confident and happy in my self and my body, I want to be able to wear the clothes I like and go outside without living in constant fear of what other people think. Without worrying if I'm pretty enough or slim enough to look 'right' in them. I'm not there yet, but I'm pleased to report that I'm making progress.

Guilty confession time, I used to visit pro-ana websites and chat rooms when I was really ill. Until recently, I still had a folder of 'thinspiration' pictures to remind me what I thought I should look like. Part of my progress has been in deleting that folder and looking around the web for more positive ideals and role models. Given that I fully support the idea of health at every size, and given that I have found any number of women of all different shapes and sizes attractive it's time to start applying those beliefs to me.

So, here's my plan for summer preparation. I am going to formulate a new exercise regime. Which is a tricky one for me as in the past I've tended to over do it. However this time my focus is going to be different. I won't be exercising to make myself lose weight. No, instead I am going to be concentrating on making my body more able to do the stuff I want it to. Regular exercise, coupled with food will mean I can do more awesome stuff without become exhausted. Like dancing for longer when I go out, spending the whole day outside in the sun with my friends. That's the goal here.

Next, I am going to dare myself to do a few things. I want to leave the house without covering up my upper arms. Sounds simple but it won't be. Given how anxious I get leaving the house at the best of times leaving it with one of my 'problem' areas exposed is not going to be fun. But, if I can do it once and realise that I'm more comfortable physically, maybe I can do it again. And maybe by doing it over and over I can learn to stop worrying about doing it. That's the plan anyway.

Finally, I am going to enjoy the sun. I love the sun and here in the UK we just don't see enough of it. Sunshine makes me happy, which is a huge incentive to get out into it. A really sunny day is often enough to make me brave the outside world. So, I'm going to use that to my advantage and get myself outside, in summery clothes despite the anxiety.

With luck, by the end of the summer I'll have taken some huge steps towards feeling comfortable in my own skin.

Thursday, 16 May 2013

I was raped whilst trying to avoid being raped.

Today I have been listening to blaming the victim, a radio documentary by Grace Chen. It's well worth listening too. Then I got into a conversation with some friends about it. Sad to say one them responded by claiming that women should be taking precautions against rape and that, in their opinion many rapes could be avoided if women were more careful. Naturally this made me very angry. I don't do well in debates when I'm angry and upset at the same time as I tend to become a bit incoherent and tearful. So, I let my other friends take over for a bit.

Now that I am a little calmer I want to talk about one of the many reasons that women 'being more careful' isn't a good way to prevent rape. For a start, it won't do anything to stop men being raped, so there's that. Also, as long as there are people vulnerable to rape rape will continue to happen. It's not possible to remove all vulnerability by 'being careful'.

When I was 15 I was raped by a boyfriend. I was alone with him in his house, we'd been drinking and I was wearing make-up. My parents didn't know where I was, they didn't want me dating and drinking at that age so I hadn't told them. All of this is fairly standard teenage behaviour but I can see that I had put myself in a vulnerable situation, by lying about where I was, by drinking, by dressing up nicely and by being alone with a boy. However, I have a few questions. Is it unreasonable to want to look nice for a date? Is it unreasonable to spend time, alone, with someone you trust and who is supposed to care about you?

Sure, I shouldn't have been drinking as I was under age. Sure I shouldn't have lied to my parents. Let's look at why I was doing those things, shall we? I had a bit of a drinking problem when I was 15. I had turned to drink as a way to cope with my constant anxiety, in a huge part triggered by the ongoing sexual abuse by my father. I didn't tell my parents where I was going because if I had they wouldn't have let me go out. I desperately wanted to be out because when I stayed at home I was at huge risk of being raped by my father.

I could have hung out on the streets but I had had it drummed into me from a young age that this put me in danger, of rape or other violent assault. I could have been with my female friends. Earlier in the night I was, we all hung around in a nice big mixed gender group. Only it was a school night and one by one people went home. My boyfriend was the only person I knew who's house I could stay at that night. Since going home put me in danger of being raped, this seemed like the safest option.

So, I drank in order to over come my anxiety so that I could bring myself to leave the house. I needed to be out of the house to ensure I wasn't raped by my father. In order to stay off the streets, which is a dangerous place to be, I agreed to go home with my boyfriend. This meant being alone with him, but he'd never previously raped me, I trusted him and he'd promised to always take care of me. So, everything I did - aside from wearing make-up to look pretty for my date - was designed to protect me from rape. Yet I still ended up being raped that night.

I wasn't raped because I wasn't careful enough. I was raped because my boyfriend wanted to rape somebody.

Now, I know this is only my story. Not everybody who is raped shares my experience. The point remains though that being careful didn't stop me being raped. The only thing which will protect people from rape is by creating a culture where rape is not acceptable. Part of that can be achieved by not blaming the victim, or telling people that they can stop rape by being more careful and instead focussing our attentions on the people who want to rape.

Why I don't like the whole 'survivor' thing

I mentioned in an earlier post that I don't really like the term 'survivor' when it's applied to people who have experienced sexual violence. Now seems as good a time as any to talk about why.

For those who aren't familiar with it, 'survivor' is used in place of 'victim' and is supposed to be empowering. Well, for me I have never found it to be empowering, quite the opposite. Whilst I was being abused I was most definitely a victim, calling me something else couldn't change that fact. Once the abuse stopped I certainly didn't feel like I had survived the experience, at least not intact. In fact, I took matters into my own hands to try and do quite the opposite. I tried to kill myself several times.

When people refer to me as a survivor it feels like they are making an assumption that I did something to survive, that I am exceptionally brave or heroic of something. Which was entirely at odds with my actual lived experience. It might be more appropriate these days, when I have a vested interest in being here and having a life. But here's the thing, for years before I reached that point people kept insisting that I was a survivor despite the fact what I felt like was a victim.

They kept telling me not 'let myself' be made into a victim. Which was an idea that struck me as ridiculous. I hadn't allowed myself to be made into a victim, I had been victimised by someone who had power over me. It wasn't something over which I had a choice. I understand that what people were trying to do was help me change how I viewed myself, to present me with an option that seemed more positive. Instead, they made me feel that by acknowledging the fact I had been victimised I was showing weakness and letting my father win.

The truth is, it was vital for my recovery that I accepted how powerless I had been. It was the only way for me to realise that I hadn't been in any way responsible for what happened to me, which I needed to do to let go of the guilt I felt about what had happened. It was only then that I could start the lengthy process of moving on. The constant pressure to relabel myself a survivor rather than a victim seemed designed to skip this step.

It also seemed to deny and dismiss the way I felt. The fact that for many years I didn't even feel like a whole person but rather a broken, fracture being. Which is not to say that all people who have experienced sexual violence feel the same way I do. Of course they don't, we're all different. For me though, the survivor label didn't fit and when I tried to object to it I was made to feel that I was doing something wrong.

Lets skip on a bit, to a time where I started to feel able to move forward with my life. Where I'd had extensive therapy and was starting to accept that my father was 100% responsible for what he did to me. Where I was no longer determined to die and had started to build a life for myself beyond the abuse. Such as now. As I said earlier, survivor might be a more appropriate label these days. A victim is what I was but it doesn't need to be who I am now.

Only, I don't want to be a survivor either. I don't want who and what I am to be defined in any way by what happened to me as a child. It's already the case that much of who I am has been shaped by my early experiences, as is true for everybody. I don't really see the benefit in granting my abuser any more power to dictate who I am.  I'm not a survivor, I'm a person who happened to be abused growing up and who happened to live beyond that experience. I am so many other things; a feminist, a writer, a lover, a friend, a daughter, a carer, an activist, a goth. A person. That's how I chose to identify myself.

If other people find the label helpful then great, but please stop applying it to everybody who's ever experienced sexual violence. Not all of us find it helpful or useful, some of us find it quite the opposite.

Saying goodbye to Ana and Mia

I was always an anxious and insecure child. I used to chatter to anybody who'd listen, mostly out of a fear that if I wasn't talking or making noise I would be ignored or forgotten. When I was ten my father started to sexually abuse me, at that point I stopped being quite such a chatter box. I preferred to be ignored, the more invisible I felt the safer I felt. The last thing I wanted was to draw attention to myself. I never did feel invisible enough however, my father still noticed me on a regular basis.

Somehow, I lost my ability to talk to people easily and make friends. By the time I started secondary school I was a bit of a loner, though I made a few friends with some other shy, socially awkward girls. They weren't friends I could talk to though, not really. I didn't have the words to explain what was going on, how unhappy I was or my secret desire to vanish. It was during my first year at secondary school that I made the aquaintance of Ana.

I could tell Ana anything without fear of judgement. We'd make up stories together about how I'd already eaten, then we'd sit in my room until all hours unable to sleep but full of ideas. Ana held me close and promised to save me when my father abused me. Ana gave me the ability to smile and laugh at lunchtime, the confidence to appear a happy girl so that no one noticed or asked why I didn't eat. Ana was with me when I stood on the scales and watched the numbers go down, watched me get closer and closer to the dream of being small enough to hide.

By the time I started my second year people were starting to notice Ana. Ana hated the attention, the interference. We were worried that people would start to try and split us up. Ana was even more private than me. So Ana introduced me to somebody else, a new friend to add to our trip. Mia.

It was Mia who stuck with me when I ate to put people off the scent. Mia was with me late at night when I snuck downstairs to raid the cupboards. When I ate still frozen cheese cakes. Mia and Ana stood on either side while I threw everything back up again. Mia soothed me when the numbers on the scales went up again, Ana delighted when they went down.

For the next five years we played this see-saw game. Mia helped me get the numbers up, until people stopped caring. Ana helped me drop them again until the attention became too much. Then my two friends started to fall out. Mia let me get too big, Ana wanted me smaller. Mia thought it was perfectly OK to eat and eat and eat, so long as I got rid of it afterwards. Ana thought Mia got in the way, stopped us reaching our goal. They fought for a year.

The year I started university, Ana won the war. It was Ana that guided my steps as I dropped out, then moved out of home to avoid awkward questions. It was Ana who shut me away from life with just the scales and bottles of diet coke.

It was Mia who came to my rescue, when Ana had left me too weak to even leave my bed. It was Mia who picked up the pieces, who made it OK to eat again, as much as I wanted. So long as it didn't stay in me for too long. It was Mia who let me live a semblance of life, who helped me make new friends. I loved Mia so much. Mia stayed with me for the next decade, giving me permission to stay at home and eat instead of go out to work. Mia who encouraged me to end relationships when I was caught being sick after meals. Mia who said I didn't need to vanish completely, but just stay thin enough to feel like I could if I wanted to.

So it continued until one day I realised that it was Mia who denied me a career. Mia who denied me love. Mia who was never going to deliver on all those promises of happiness and a future.

Saying goodbye to Mia was hard, particularly with Ana waiting in the wings, hoping to step back in to the best friend spot. But I had finally realised something important. Ana had never been able to keep me safe or make me invisible, any more than Mia had been able to ensure happiness. Neither of them granted the promises they made so easily, yet I had given over half my life to them.

I needed new friends and real support. So I told people, I dragged Ana and Mia out into the open everybody could see them. I made myself visible again, and in doing so I found a world of hugs that were only hugs, safe and loving offered with no expectations. I found people willing to listen to what I had to say about things far more interesting than the numbers on the scale.

Ana and Mia still hang about the place, they aren't ready to go away without a fight. I argue with them every day and slowly but surely I'm getting there, with the help of my new friends.

Wednesday, 15 May 2013

A rant about A&E

OK, first off I want to say that I don't come close to understanding the high stress of working in an A&E department. I've never done it, I've only ever been there as a patient or with a patient. I recognise that it's a difficult and sometimes dangerous job and in general I have a lot of respect for the people who take it on. That said I have had some really distressing experiences in A&E departments and I doubt I'm alone. The one time I went it with a physical injury they were awesome, likewise when I've attended with somebody else for physical issues they've been pretty damn good. Not that I've never encountered issues on that front - I have, particularly waiting times - but my experiences have been better than when I've been in with mental health based issues.

I once went it because I was feeling suicidal, was genuinely scared I would act on that urge and was told by the out of hours service that it was the best place for me. When I got there I was told that I hadn't harmed myself so they had no idea what I thought they could do. Not reassuring.

I've been taken in via ambulance twice, post overdosing. On both occasions I was tutted at and told off. Once a nurse even told me that if I was really trying to kill myself I wouldn't have chosen those particular tablets as 'everyone' knows they don't kill you. There was also a running commentary on the scars and cuts on my arms, which included a doctor poking at one and asking if I could feel him doing so. Yes, I could feel it. It bloody hurt.

Here's the thing. Not every overdose is a suicide attempt. Overdosing can also be a form of self harm. Self harm is self harm, not a suicide attempt. They are, in fact, different.

In both cases, someone else phoned the ambulance. I didn't really want to go in but was persuaded to by lovely ambulance people who made me feel looked after. Only one of my hospital trips was post a suicide attempt. I was made to feel stupid that it hadn't worked/left me with permanent damage. Apparently that meant I wasn't trying hard enough and was thus wasting time. Not a good way for a suicidal person to feel.

I have been in with other people post suicide attempts and seen them treated in similarly appalling ways. It enrages me, it really does. In A&E your job is to treat people, not judge them. I think there are some simple rules people need to remember.

1) If someone is taken into hospital after harming themselves, whether in a bid to end their life or not, there is obviously something wrong. To find out what is wrong, talk to and listen to your patient with sympathy and understanding.

2) Alienating and upsetting your patient will make things harder both for them and you. It makes it harder for you to do your job and may lead to you missing something important and getting them the right help.

3) Nobody hurts them self with the intention of wasting your time, creating extra work for you or making it harder for you to treat other people. In fact, their actions before entering A&E had absolutely nothing to do with you and so shouldn't be taken personally.

4) Curtains are not walls and your voice will carry through them. If you really are annoyed with your patient and feel you must vent, do so out of earshot of both them and other patients.

5) There was a reason the person did this to them self, it may be a symptom of a mental illness. Blaming people for their symptoms is not on. Would you blame someone else for having an asthma attack or having a cough?

Every time I think about this subject I get choked up. I once wrote a very nasty letter to an A&E nurse, though I never sent it. This was after a friend of mine killed herself. It was the last of multiple attempts, on the previous attempt she was told by a nurse that if she really wanted to die she'd have done it by now and to stop wasting everyone's time. I've always wondered if the nurse knew that my friend did indeed stop wasting everyone's time. Forever.

To be fair and balance this out, I want to briefly talk about the time I went to A&E with a friend of mine who had taken a potentially fatal overdose. I went with her in the ambulance and stayed with her until she was admitted several hours later. The nurse who saw her was brilliant. She was calm and efficient, and constantly reassured my friend that they were doing everything they could to save her life and make her comfortable. After the doctor had seen my friend, she stopped by to make sure we'd understood what was said and what was being done. She popped in often to see how we were getting on. She held my friends hand and listened when she was off oxygen and talked about being angry that her life had been saved. She got her talking about why she was so determined to die and asked what would make my friend not want to die. She never once made her feel guilty for being there and in fact did quite the opposite, assuring her she had ever right to be treated.

So there are absolutely people out there doing it right and it's entirely possible I've just been unlucky. Only I've had a lot of people share similar experiences with me. Personally, I think there should be mandatory training aimed at raising awareness of mental health and giving staff the tools they need to handle it. Not only when they first train but on an annual basis.

It's not my fault, dammit.

I have just been reading this post on a blog I found last week. It's an interesting and insightful read which I think basically everybody should read. It reminded me of so many instances where I've been held accountable for my illnesses or been told that I'm not doing enough to get better. This isn't really something I should have to justify but I'll try, just in the hopes that someone reading this will realise that their words and action can be hurtful and uncalled for. Or that it will make someone feel less alone.

I remember the very first time I went to see someone about my mental health. I had not long left home and since moving in to the dingy little flat I shared with some friends I had barely left. I was jumping at shadows, suicidal and pretty much cried all the time. One of my friends pushed me into going to the GP, helped me register and make an emergency appointment all on the same day. They even came with me for moral support.

So then, here's what happened. I told the GP what was going on. That I'd felt low in mood for as long as I could remember. I self harmed, had tried to commit suicide multiple times, didn't eat and hated the way I looked. That I was scared of leaving the house or even being seen. The response was that I was young, attractive, had friends and a partner. Therefore there was no reason for me to depressed, so I should just stop being sad and concentrate on the good things in my life. Then I could go get a new job (I'd just lost one since I was too scared to leave the house and go to it) and all would be right with my world.

If only it was that easy, but it isn't. Depression hits despite the good things in your life and it makes it very difficult to appreciate them at times. Being told to focus on all the things I had going for me just made me feel awfully guilty about the way I was 'wasting' them by being mentally ill. This made me feel worse and in no way improved my mental health. So bad to the GP I trundled. This time they got annoyed with me and outright told me that I had no reason to be ill and just needed to grow up and accept everything wasn't going to be perfect all the time. At this point I broke down. I said I thought my mental health problems might have something to do with my father abusing me. Cue attitude change.

This time I left with a prescription for anti-depressants, a follow up appointment to see how I was getting on and a leaflet about the different services I could be referred to if necessary, which included talking therapies and support groups. Now that I had 'proved' that my illness had a cause it was accepted as real and the long process of treatment began. Of course, not everyone is lucky enough to be able to pinpoint a reason for their mental health issues, or isn't able to share them right off the bat. Thankfully most GP's in my experience don't demand that you have an explanation before they will consider your illness to be real.

I wish I could say that from this point my mental health was a) taken seriously and b) I wasn't blamed for being ill. Sadly, that hasn't been the case at all. After years of counselling, therapy, group therapy, various drugs, diets and exercise plans I am still ill. Now, my past is apparently something I should have dealt with by now and the fact I haven't is clearly my fault. I haven't been trying hard enough. I've had unrealistic expectations. I'm obviously lying about complying with my treatment. The message is always the same, if I wanted to get better I would. Since I clearly don't, there isn't any more that can be done for me and presumably I therefore deserve to feel like this.

I started with the medical side of things because that's where I foolishly expected people to be the most understanding. And I should be clear that some of them have been. My current GP is amazing and I used to have a really good CPN. They've been the exception though. A&E have been particularly awful but that's a whole other rant and post I'll no doubt make in due course.

So then, let me tell you about my least favourite conversation to have with people. The 'why aren't you working' conversation. I mention it's for health reasons, hoping it will be left at that. It rarely is. There is nearly always follow up, starting with how I don't look ill. Which means explaining that it's my mental health. Then there is everything from 'Oh I used to be depressed then I did X and now I'm better' to 'work is the best cure for depression' to 'well, depression doesn't really exist.'  More recently there's also been 'maybe if you lost weight you'd be happier' which is just an astonishing thing to say to someone recovering from an eating disorder.

The 'why don't you try' conversation is frustrating. I am delighted to hear that you/your friend/someone you read about on the internet tried a new drug/diet/sugar pill/therapy and that it worked for them. If I explain that I've also tried X and it didn't work for me, please don't assume that I am lying to you or didn't give it my all. If X costs more than I can afford to pay and isn't available on the NHS, please don't bang on about how if I wanted to get better I'd find a way to pay for it. If X happens to be nonsense, there's every chance I've still already tried it or something similar out of sheer desperation. Different things work for different people, and sometimes a treatment IS worth re-visiting but please don't assume that because it worked for someone else it should also work for me.

Work. Working can do amazing things for mental health. It helps with the sense of self worth, with feeling useful and valued and part of something. However, it can also be a major cause of stress. And, whilst you may not want to hear this there are times when someone (including me) is not well enough to work. This doesn't mean I don't want to work, and when I am well enough I do.

As for the idea that mental health disorders don't exist... I don't know how to argue with people who refuse to acknowledge decades of research and evidence that says otherwise. I tend to find they don't have any interest in what I'm going to say anyway and simply want to lecture me about how there's nothing really wrong with me.

Here's the thing, I shouldn't have to justify my illness. I shouldn't have to explain endlessly that I am already doing everything I can to improve my health and situation in life. So, please just accept as fact a few things: my illness is real and I really have it, I'm am trying, probably more than you'll ever know and I don't owe you an explanation for why I'm like this.

I am mentally ill for a whole exciting mixture of reasons. Mental illness runs in both the paternal and maternal sides of my family, so there's every chance genetics plays a part. I lost an important relative at a very young age, and many more people I loved dearly since. I was sexually abused as a child. I experienced domestic violence and rape as a teenager/young adult. There is almost certainly a reactive element to my mental illness. I never once chose to be mentally ill, nor do I chose to remain so.

Tuesday, 14 May 2013

Simple things which become hard when you're mentally ill

I try to be open about the fact that I am mentally ill, mainly because I think it's important to fight the stigma attached to mental illness. Also because honesty is absolutely the best way to fight 'the lying disease.' That said, there are times when I simply am not up to dealing with conversations about mental illness. When I don't have the energy to grit my teeth and explain for the nth time why I can't 'just snap out of it.' Times when I simply don't have it in me to try and prove to someone that my illnesses even exist in the first place. There are times when even the simple things in life seem to take energy, motivation and skills that I just haven't got.

When I say simple things I really do mean simple. Things which people do every single day. Take the morning for example. A fairly normal morning routine might go as follows: Get up. Shower. Get dressed. Eat breakfast. Brush teeth. Simple, right? Wrong. Let me talk you through my morning.

Get up

I wake up tired and sort of blank feeling, with the thought that nothing really matters. I consider the fact that this thought should bother me but somehow I can't care enough to, well, care. I know I should get up but I don't see the point. Plus my limbs feel heavy, too heavy to move. I try, but I can't move my legs. Panic sets in. I can't move! I concentrate on moving my foot and manage to twitch it a little. I'm not paralysed, there is nothing wrong with me. I can move. For some reason this fact has bursting into tears. I sort of wish it was impossible for me to move, then no one could expect  me to do such impossible things as get up and go out and do things that seem, in this moment, to be beyond me. I cry myself back to sleep. Next time I wake up I manage to drag myself out of bed but once I've done that I don't know what to do with myself.


Today is not a day for being naked. I don't want to see my ugly flesh, my stretch marks, my scars. I don't want to have to touch and handle the fat which I know will have make me quite literally sick. I am not sure today that I will have the strength to resist the urge to take a razor to my hated body. I skip the shower for the third day in a row. I am starting to smell a bit but again, I can't summon up enough energy to care.

Get dressed

I still haven't managed this today. Partly it's the thought of being naked again, even briefly. Partly it's because being in my bed clothes is sort of my safety net. It's like being snuggled up in the safety of bed all day long and I'm not ready to give it up yet. Besides, now that I've missed work (again) there's no reason to go out so what's the point?

Eat breakfast

Meals are difficult. First you have to go to some effort to make them happen. For me to eat breakfast this morning I would have to first wash up. I stare blankly round the kitchen for a bit. I know I need to eat. I can't afford to skip meals without risking a fall back into my disordered eating patters, plus I am meant to take my medication with food. I do some washing up but can't summon up anything even close to an appetite. Instead of eating I take my tablets with a sip of water and go back to bed.

Brush teeth

I realise I haven't done this yet after I have climbed back into bed. What's the point? I haven't eaten anything. I am never going to eat anything again. Or do anything again. I am going to just lie here and sleep until I am dead. On some level I know this isn't true but it seems to make sense at the time. I go back to sleep.

On a day where I do have the energy and motivation to do these simple things they are still hard. By the time I have left the house in the morning I am often already worn out. Some days, like today, they seem beyond me.

When I was skinny...

I once passed out five times in a week. I felt dizzy all the time. I ached all the time. I was frequently sick, even the thought of food made me nauseous. Hunger made me feel nauseous too, so that was basically a lose lose situation right there. I didn't sleep for days at a time, then I'd sleep a whole weekend away. My teeth hurt. My stomach hurt all the time, which I kind of liked as it reminded me to hold it in at all times. I self harmed on an almost daily basis. I smoked too much, drank too much and took too many diet pills.I spent hours every day putting on make-up, doing my hair and changing my clothes. I spent hours every night doing the same thing. I had seizures caused by low blood sugar and electrolyte imbalances. My chest ached and there were often times I struggled to breathe. I ran late every night and early every morning. I did star jumps and burpies and sit ups. Hundreds of each every day.

Then there were the times I couldn't resist food. The times I spent all my money on cigarettes, fizzy drinks and junk food. So much junk food. Then I ate it, all of it. Too quickly to really taste it, certainly too fast to enjoy it. I ate until I felt like I was going to burst, then ate some more. I ate until I hurt too much to fit anything else inside me. Then I made myself sick. I didn't even need to stick my fingers down my throat. Then back to the food. Rinse and repeat until all the food was gone.

All these memories aren't happy. I wasn't happy. I was miserable.

So can anybody tell me why some days, I miss being anorexic. :(

Monday, 13 May 2013

Providing a bit of balance.

Something amazing happened today! I had decided I wanted to write about the risks of being underweight, just to try and balance out the 'fat is bad' message we're inundated with every day. Before starting I figured it would be a good idea to do some research, particularly as I could recall reading somewhere that being underweight posed greater immediate risk to your health than being overweight. Well, I didn't manage to find  the piece of research I was thinking of but I did find this.

Now this really shouldn't be news. Of course being underweight is unhealthy - that's why it's called underweight. Yet we never seem to hear about it. Unless it's in relation to starving people elsewhere or possibly in relation to anorexia.

But let me tell you something, it's much quicker to starve yourself to death than it is to eat yourself to death. I've never known anyone die within a few months of over eating, but under eating? Sadly, I am all too aware that can happen, so very quickly.

OK, now I'm going to do that thing where I relate this to my own experience. Which is absolutely useless as science but I hope it might illustrate some of what I'm trying to say. Currently, I'm over weight. In fact I'm the heaviest I've ever been. Yet, I'm also physically, the healthiest I've been since I was a young kid. My blood pressure, heart rate, temperature, lung capacity, blood levels and so on are all within the normal, healthy range. The only thing which isn't is my BMI.

The only physical problems I have are those which have been linked with the damage I did my body during my years of eating disorders. When I was underweight. So, some digestive issues and some muscle/ligament damage gained by exercising whilst being underweight.

What about when I was underweight - or even on the lower end of 'healthy' - how was my physical health looking then? Well, not great. I suffered almost constant headaches. I used to bleed, basically all the time. Seriously, lean on my elbows for a bit? They bled. Bumped into a desk/doorway/whatever? Bled. Fainted, a lot. Caught every single flu or tummy bug going around. Was constantly fatigued. Couldn't concentrate, which had a huge knock on effect in the quality of my school work. Also my ability to hold conversations with people without seeming rude. Lastly my absolute favourite - seizures! Yeah! Nothing more fun than 'waking up' in a hospital bed with no idea how you got there, feeling sick, sticky and terrified. Then falling over when you try to get up because every single part of you hurts, which you didn't realise until you tried to move.

Now, here's the thing. I'm not saying obesity isn't a health risk. There seems some relatively conclusive evidence out there that it is. All I'm saying is that it isn't the only one. Being a bit overweight is, according to the article I now can't find (fail) healthier in both the short and long term than being a bit underweight. So why don't the risks associated with being too thin get the same amount of attention? Maybe it's because more people are overweight than underweight in the west. Maybe it's because we're socialised to view fat as wrong so it's much easier to focus our attentions there. I don't know.

What I do know, is that when I worked in a hospital it was the underweight patients we worried most about. Particularly children, the elderly and pregnant women.

Sunday, 12 May 2013

I've been thinking about lifestyle choices and health

So, here's the thing. I've made choices in my life that I know could have a negative impact on my health. I'm not going to include here the stuff that I think are symptoms of my mental health disorders. So, I am going to be talking about yo-yo dieting, smoking and drinking but not binge eating, purging, starving myself or self injury. I guess the thing I'm interested in here is about the right to judge others on their lifestyle choices, specifically blaming people for their health problems. Particularly those linked to obesity, smoking and alcohol.

So then, the message that these things are unhealthy is pretty much everywhere isn't it? I find it hard to believe that anyone living in the west can really claim to be unaware of the idea that smoking is linked to cancer, or poor diet to obesity and so on. So why do we still eat food that's bad for us? Why do we keep dieting, when it's been fairly widely reported that people who diet tend to end up gaining rather than losing weight in the long term? Why do we smoke when it smells bad, costs loads and has been linked to cancer? Why do we drink when it leads to making rash and sometimes dangerous decisions, can lead to liver disease and in the case of binge drinking can kill you in a matter of hours.

I certainly know all this stuff, yet until recently I not only drank but often drank to excess. I smoke on occasion and have been a heavy smoker historically. And I'm on a diet right now, despite knowing it won't really work, except in the very short term if I can even stick with it that long. So, knowing all of this why would I still do it? Simple. After a quick risk assessment, these things seem a viable option.

OK, let me talk you through it. I haven't been out in ages, my friends are beyond annoyed with me cancelling at the last minute and have started drifting away. I'm genuinely worried that I'll soon lose them, which would mean losing most of my support network. Plus, humans are social creatures, we don't function well without the company of others. Having been in 'hide from the world mode' for a while now, my mental health is starting to further deterioate. Now, I know when I drink I can also engage in risky behaviour - such as spending my taxi money on more drinks - and will almost certainly end up throwing up. I also know that since I'm likely to end up binge drinking there's a chance of passing out, injuring myself and/or ending up in hospital. Or having an alcohol induced seizure. This is never fun, Never. But, without the temporary confidence alcohol gives me I know I'm not likely to leave the house, never mind make it to the club and actually engage in that whole social interaction thing. So, despite the risks drinking seems like a viable option. The risks to my health, if I further damage my friendships and continue to remain socially isolated and lonely seem greater. They include suicide, for a start.

What about smoking? Well, I'll be honest. I don't think I'm going to live to a ripe old age anyway. Plus, as part of my anxiety I tend to imagine I have every single serious illness I've ever heard of. There are weeks I think I'm about to die from a heart attack, have a brain tumour or MS on an almost daily basis. Worrying about long term or terminal illnesses is so normal for me that the genuine risk from smoking doesn't really change anything. On the other hand, nicotine can act as a mild anti-depressant, it's one of the few things I enjoy when in a depressive or anxious state and in the past when I smoked heavily, needing a cigarette was sometime the only thing that would get me out of the house, even if was only to go as far as the off licence across the road.

Smoking has often been my go to place when I feel the urge to self harm or kill myself. Killing myself has the most obviously damaging effect on my health. Self injury often calms down or removes the urge to take that step, so I consider it the better option. Self harm can get out of hand though, it's possible to cut too deeply and end up needing stitches or permanently damaging something. It's possible to make a mistake and kill yourself by accident. Smoking can often reduce or remove the urge to self harm, or so I have found. Plus, sometimes self injury isn't enough to help me fight off the suicidal urges. And sometimes smoking isn't enough to stop me self harming. I find it's better to start with smoking, as if that doesn't work my go to place is self harm. And at that point, if I still feel suicidal I'm at least more likely to be calm enough to get some help. Given the choice to definitely hurt myself right now or to do something which is probably harming my health long term, I'll chose to avoid the immediate danger. Because protecting my long term health only matters if I'm going to be here in the long term.  It's sad that so much of my life is spent finding ways to fight the urge to end it, but there it is.

Dieting is the same. I know I'm picking the short term benefit over the long term health problems. I do know that, but the thing is that wanting to lose weight is a more immediate concern. The thinking behind this one is that once I start losing weight, I stop feeling quite so anxious and that makes it easier to get on with doing more useful stuff - such as dealing with the underlying anxiety, getting a new job or not giving in to the urge to hurt myself.

Now, I'm not saying everyone is in the same situation. Of course they aren't. What I am saying is that people make these decisions for all kinds of reasons which aren't obvious just by looking at someone. Heck, a lot of the time they aren't obvious to the people making them. I just find it difficult to believe that anyone wants to be unhealthy, so I never think that what they are choosing is to make themselves ill. I think what people are doing is choosing to fulfil a current need over worrying about a future one and we shouldn't judge them until we know their reasons. Maybe not even then.

Friday, 10 May 2013

Body hate and me. Triggers for talk of body issues, eating disorders and brief mention of abuse.

I spent ages trying to come up with a clever title for this post, at the time of writing it is still without a title. I think I've been doing OK with this so far. I've posted more than one thing which is a good start. Well done me. Anyone at all has read something I've written and I'm not freaking out too badly. This is good.

So then, what do I want to talk about now? Well, I want to talk about hating my body. I want to talk about why I hate it, the ways that hatred manifests and how I am hoping to stop hating it sometime soon. With luck, someone out there will find this useful or interesting or something.

So then, why do I hate my body? Let me tell you the whys! There are many of them. Firstly, as previously mentioned I was abused growing up. It's kind of hard to love the thing which was the focus of abuse. Secondly, I have the misfortune to live in a society that places a disproportionate amount of value on how a female looks. Which is kind of pressuring. Not only that, it's a society which has ideals I can never match up to. Even with my head start (gained by being pale skinned, light eyed and thin) doesn't make it easy to achieve beauty within such narrow definitions. Thirdly, my body is a bit broken which makes it often an uncomfortable or painful vehicle to transport myself in. Finally, my body does things I don't want it to. It has internal workings that lead to lots of strange things happening inside me and then unpleasant things leaving me.

Essentially, my body is this thing which never seems to be the right shape or size, often hurts me, keeps doing things I don't want it to and it can be harmed and touched by other people. Really, the only good thing I can say my poor old body is that's it's still here, going strong despite everything I (and other people) have done to it over the years. In many ways it's actually kind of marvellous. On days I feel suicide, the survivability of my body is not a point in it's favour. Have I mentioned how much I hate being mentally ill?

So then how does my hatred manifest itself? Well, there's my distorted view of my body. I'm literally incapable of seeing it in anything but a negative light. All I can see are flaws and imperfections and the hilarious thing is I have no idea if the things I see are real or not. Like, I know the facial scar I have is real but to me it seems huge and other people hardly notice it. But the other stuff? Am I exaggerating, is it as bad as I think it is, is it even there? No idea. All I know is that when I see myself everything looks wrong, from my proportions to the length of my neck, the symmetry of my face and the size of my eyes. All wrong. All of it. In my head I like some weird deformed insect lady. Not pleasant.

Then there's my issues with eating, which are three fold. Hurrah! Firstly, trying to get rid of the 'thinner is better' message is really difficult. I know I wasn't actually happier when I was underweight but my brain just goes 'Oh well, better to be miserable and thin than miserable and fat.' Which is ridiculous and not a sentiment I am happy with at all. Being an advocate of fat acceptance and health at every size, it's hugely upsetting that I apparently can't help subscribing to this view on some level.

Then there's my digestive issues. OK, so these were probably triggered or caused by my eating disorders but they're certainly another reason I dislike eating. Food makes me ill. Honestly, it does. I've tried various techniques and diets but I've not been able to identify anything in particular which makes them worse. So, I avoid the usual suspects (dairy, gluten) take my medication and hope one day I can eat something without experiencing pain and nausea for hours afterwards.

Then there's the last eating based issue. Remember that bizarre hatred of bodily functions? Well, if you eat that food needs the be digested, and then it has to leave your body. It's a process accompanied by odd bubbling sensations and gurgles and ugh. Even thinking about the fact that digestion is happening is making me feel sick so I'm going to stop and move on.

Self injury is another way my body hate shows up. Now, there are various reasons I have engaged in self harming behaviour and I'm sure at some point I'll write a post all about it. However, one of the reasons is body hate. I have tried to cut the fat bits off. I have od'd on laxatives and slimming tablets. I've sat and punched myself in the mouth until my lips swelled because I think my lips are too thin. I've taken a cheese grater to my thighs in an attempt to 'scrape off' my stretch marks. The really weird thing here is that I KNOW I can't cut the fat out or get rid of stretch marks like that, but there are times when that knowledge apparently hides and I just have to do something.

Then there is the anxiety. Now I'll be honest here, I don't know how much of my anxiety is caused by my body hate and how much of my body hate is caused by my anxiety. I do know that they definitely interact in a way which escalates both. This is not fun to deal with. I've already written about how I can become so anxious about my looks I refuse to leave the house. There is a huge fear that other people will see me the way I see myself, and judge me accordingly. And that they will use my disgusting body as an excuse to hurt me.

On some level, because my body disgusts me so much I sort of think it deserves to be punished. I've certainly punished myself for having such a disgusting body. It makes it really hard to accept that someone else can like it (and me). I spend a lot my day trying to convince myself that people aren't simply pretending to like me as some kind of cruel trick. It makes interacting with people, especially my nearest and dearest really hard.

So, moving on to the moving on part. I don't want to keep hating my body. It's pretty rubbish. I'd like to learn to tolerate it, maybe even love it. Which is hard, because right now for the first time in my life I am over weight. Not by more than a few pounds but that doesn't matter, given that for me gaining weight feels like failing, being over weight is a huge deal.

So, I am refusing to go on a diet. Seriously. It's taken me three years to get to the point where I can eat every day, so the last thing I want to do now is start restricting what I can eat. What I am going to do is try and create a new relationship with food. I'm going to experiment with it, try new things and cook from scratch. I actually enjoy cooking, even if I don't enjoy eating. So that's the plan. And since I'm going to be doing this, I am going to be using recipes which are well balanced and healthy. It may sound weird, but I think 'operation expand my diet' is going to be a lot better for me than any attempts to restrict portion size or narrow down what I'll eat.

Then, I have already started trying to incorporate exercise back into my life. Only, I don't want to do what I did in the past which is take it to extremes. I am doing it slowly and with a focus on health and strength rather than weight loss. I'd love to do it with a personal trainer, one who understands poor body image and eating disorders. Such a thing costs money however and that I have none of. I have banned myself from running and swimming involves being seen in a swimming costume, which I can't face right now. Instead I am focussing on stretching and core strength exercises, with some (but not much) weight training. We'll see how that goes.

Finally, I am doing a lot of reading of feminist blogs and news articles. Sounds odd perhaps, but steeping myself in a culture that recognises qualities which aren't beauty based, which includes pictures of beautiful women of various shapes and sizes and gives me tools with which to fight back against the 'thin good/fat bad' messages endemic in society (and apparently in my head) is probably the single most useful thing I have ever done.