Dear Little Amanda…

Dear Little Amanda

More than anything in the world, I wish I could go back in time and rescue you. Protect you. Save you.

As I say that, I’m thinking of you as you at the age that you were sexually abused, but I know that your pain began so, so long before that. I know that your pain began when you were only a wee baby. But I actually wish I could go back to that point and rescue you. Take you away then. Before the pain started. Before any of the damage was done.

A part of me wishes she’d never given birth to you in the first place. But that feels like a cruel thing to say to you. But that’s a reflection on her. Nobody else. She wasn’t fit to take care of children, hence me almost wishing she’d never done so. But you deserve to have been born. You deserve to live. You just never deserved all the harm that was done to you.

I’m trying so hard to undo the damage for you. But I’m angry that it happened in the first place. That we even have a need to un-do it.

I’m angry, but I’m not angry at you. Never. But you probably feel angry at yourself. Cos that’s how that stuff makes a child feel. And a lot of other bad stuff about themselves too. But none of it was your fault. None.

I’m actually so proud of you. I’m the adult you… and I’m trying to heal you… but you know what… you did so much good for me. You made decisions about how to handle stuff when you were just a wee one, decisions that you never could have imagined would serve you so well as an adult. Decisions that shaped me.  I’m more proud of you than you could ever know.

I’m near crying writing this. Yet, not. Not crying. Just feeling a lot of other stuff inside. Stuff that I don’t quite understand myself. I’m not all that good with emotions, you see.

I said that I wish I could go back and rescue you. But obviously that’s not possible. But I hate that there was never anyone else to help you. I hate that there was no one else to help you, despite how obvious it was that you needed it. Despite how obvious it was that something was very badly wrong. Despite how easily it could have been prevented. Despite how many signs there were. The signs were all there. I’ve seen them written on paper. I’ve seen how obvious it was. And I’m sorry nobody helped you.

I hate how the life you were given put you at so much more risk in itself. How in so many ways the life they made for you made you so much more vulnerable to so many more bad things. I’m angry at so many people for that. It was never fair.

I hear friends talking about their more normal childhoods, and I feel so pained for you. As an adult, I know that many people had tough things happen. Yet at the same time, I know that most didn’t have it quite that bad. And I wish it could have been a little more ok for you.

You know… I remember so many facts about things that happened to you. Not all of it, but probably most of it. The details, the specifics. But I try to remember how it must have felt, and I can’t. Because I can’t even begin to imagine that level of pain. Especially as a child. At the same time, I know that there’s a good chance you found a way to shut off from it. And in other ways it was your norm, you never knew any better… but either way, it must have been so painful, and I literally can’t imagine it.

As an adult, I can see so many of the ways that it affected you. How you handle emotions (or don’t, as the case may be, at times); your relationships with people; how you feel about yourself; your inability to cope with certain things; how painful things can be; your anger; your hurt; and many other effects… I can see all this and more, and I want you to know that none of this makes you a bad person. You’re not a failure. They’re not weaknesses. Every effect of the things you’ve experienced are normal human effects. Normal reactions to abnormal experiences. And it’s ok. However you coped it’s ok. However you reacted it’s ok. And none of it, not one single bit of it, makes you a bad person.

I know that the things you experienced affected how you feel about yourself. Even from a young age, you never really stood a good chance of developing a good sense of self. Of developing self esteem, or of loving yourself. Of seeing yourself as worth something. Of believing in yourself.

But you are worth something. Worth so much, although I don’t think you feel that at all. And you are worth loving. You are lovable. You are special. You are precious. You are wonderful.

Everything in your life told you otherwise. But I really want to tell you the opposite. Please do all you can to believe me. It’s probably hard to believe, given all life has thought you, but you really are a good, worthwhile, person. I hope that one day you can see that.

I also know that similar things happened to others in your life. And that you may end up feeling weaker, that you didn’t cope as well, that you… I don’t know… weren’t as good as them. I promise you it’s not like that. Nobody is better than anyone else. You all coped differently. You all are, and were, wonderful, and you coped in your own, unique ways… perhaps the only way you knew how.

I know also that you’ve been told that ‘you just need to not think about the past’. And that that makes you feel like you’re to blame. Not for the things you experienced as such. But for how it affected you. For not just moving on. For not just putting stuff out of your head and getting on with things. I promise you that that’s not the case.

Firstly, it’s not about ‘thinking about the past’. Trauma affects a person, their mind, and their sense of being. I already mentioned that it’s normal to be affected. To not be affected would make you some kind of superhuman thing, and you’re not. You’re human. You’re normal. You were affected. And that’s ok.

And those effects – those normal effects – you’re not hiding from them. You’re confronting them. Trying to deal with them. Trying to heal from the damage them. That is a very strong and scary thing to do. There’s something wonderful about that. And it does involve thinking about the past. But I know that you’re doing it so that you can have a better life. A fuller life. A happier life. The life you deserve. And I know that it’s hard, and soul-destroying, and so so painful. I know that it’s harder than anyone could probably imagine. But I also know that you can do it, because I’m here to help you through it as best I can.

I don’t know what else to say to you. I know that as much as I wish I could do so, I can’t go back and rescue you. But I also know that together we can do what we can what we can to undo the damage. Not quite ‘rescue’ you, but maybe the next best thing.

I don’t quite know the path through healing from the damage, if I’m being honest. I know we have some good help to do it. And that we can trust that help. I know that as much as I don’t quite know the path through, that I do know a lot about us both, and have a lot of skills and strengths that will help us through.

I’m also going to do what I can to try not to push you harder than it’s safe for you to go. It’s difficult for me, as the adult you, because I so desperately want you to be ok. Want us to be ok. But I know that it’s not as simple as just ‘go and do all the work on all the stuff’. Pushing you could do more harm in itself, and that wouldn’t be good. I’ll do my best to be good to you and care for you.

The work that we do together will be hard in so many ways. But it’s precisely because you’re so worth it that we need to try to do this.

Thank you for the ways you coped that helped shape me as an adult in a good way. It’s time for me to try to pay you back, and take care of you now.

Love,

Adult Amanda xx

Posted in child abuse, childhood, emotional abuse, healing, mental health, neglect, pain, personal, self compassion, sexual abuse, therapy, trauma, trust | 6 Comments

So, I didn’t kill myself this year…

I’ve been thinking of how at the very start of this year I wrote a cheesy, silly, soppy blog post about how I had made a promise to myself that I wouldn’t take my own life this year. About how, despite how hard things felt in my mind at the time, as my friends and I rung in the New Year, I was filled with a feeling of ‘I’ve made it another year and it feels wonderful’, and so I made a promise to myself that I would do all I could to see another year through. That I wouldn’t end my own life this year.

Clearly through the fact that I’m writing this blog post, you can see that I am still here. And yes, technically the year is not yet over – but I’m as sure as sure can be that I will not be ending my own life in the next week or so.

I made that promise to myself on 1st January when I got caught up in the good feelings at the time – but thinking back what has really surprised me is quite how hard staying alive still continues to be.

Quite how painful things still get in my mind.

Quite how unbearable life can feel.

Quite how easy it is to lose hope that things can ever get better.

Quite how quickly I get caught up in the painful emotions and get super angry at myself for not having taken my own life when I was determined in the past; after all, if I had done it, I wouldn’t be feeling so much pain now.

Quite how pointless life actually is.

I make promises to myself that I won’t end my own life, yet when things happen and my mind goes into meltdown, those promises go out the window and it’s almost impossible to find that part of me that wants to live.

There was just once this year that I came close to suicide for real. Suicide note. Plans. On the verge of doing it. The works.

But I still spent so much time thinking about it this year. Many of the times I’m sure it was little more than a ‘comfort blanket’, knowing I have that option. Yet I don’t really. It’s too hard to do it. I can’t decide on how. I can’t do that to others. And so on…

But if I had one wish for 2015? I want staying alive – not taking my own life – to stop being so hard.

I want things to stop being so painful in my mind.  For things to stop hurting so much.

I probably wish for that every year, but this year I want so badly for things to start feeling a little easier. (They probably already do feel easier as time goes on – yet it’s just so hard to see / feel it at times).

In this moment, I am hopeful that I will notice things starting feeling a little easier. Yet I’m also being realistic and knowing that they may get a little harder before they get easier.

In January, my psychologist and I are going to start the ‘trauma work’. Which she has held off on starting with me, until she was sure it was the right time. The fact that she feels it’s the right time, believes that I can handle it, gives me some faith in it. I have waited a long time for this, and am optimistic that things can, through this process, start moving forward in a more positive way.

But even looking back on this year, I realise that I’ve done a lot of work on myself.

The biggest thing is that I have started to put more effort into taking care of myself and my needs. I was quite neglected growing up, and my needs were not met, so I am hopeful that through me consciously trying to take care of my needs, that this will build up my self-esteem, my self-image, reduce my sense of worthlessness, and help me develop into the person I want to be.

Many of the ‘taking care of my needs’ things are little by themselves, but together, looking back, I’ve done quite a lot.

I went to the dentist for the first time in years, got work done on my teeth, and have tried to take better care of my teeth. (As a child, I wasn’t taught to look after my teeth, and expect that that was largely why this didn’t come naturally to me, and my teeth got in quite a bad state).

I moved into a new flat – my own place, rather than a flatshare – and have been working at making a ‘home’ for myself.

I have worked hard at building a social circle in the town I live in, rather than my previous town, where most of my friends are still based.

These are just a few of the things I have been doing – but one of the big ones is that I have been trying not to put myself into difficult situations, which are detrimental to my wellbeing. (I’m not sure that all of the situations I’ve pulled back from were good decisions on my part, but that’s a whole other story). One in particular I completely pulled back from this year. Which was after looking back over the past couple of years and realising that every time I put myself back in this situation it had a very negative effect on my wellbeing. So I pulled back, put me first.

Because some situations we often do because it’s what we’re supposed to do…it’s the done thing… and we don’t even necessarily consider doing anything else but the done thing. But I tried this year to make decisions about my life by taking into consideration the impact they would have on me. Ultimately, putting myself first in my own life a little more often.

Christmas is the most relevant example right now. I – like many – struggle hugely with Christmas. The pressure. The forced happiness. The expectations. The going back home to family. The wishing things could be so different. The being on the outside looking in. The nothingness. The pointlessness. The many other reasons I find Christmas extremely difficult emotionally.

So I decided – why put myself through that? Why do we need to conform and do just what society says we should for Christmas…? Why put myself through it all when I am certain it will be too mentally strenuous, and very emotionally painful?

I’ve done the Christmas parties, the Christmas meals, the Christmas presents… I’ve done my bit of Christmas, but I’m skipping the main event. I’m heading off on a break on my own to somewhere quite different. A break in Morocco, a culture different from anywhere I’ve been previously. And I’m more excited than I’ve been about anything in a long time.

I had a choice between doing the standard Christmas things, which based on previous occasions, I knew I would find painful. Or do something for me. And I chose to put me first.

Sometimes it seems impossible to find any joy in life, any purpose, any reason for being here. And I am so hopeful that this trip will give me that joy, that excitement, that it will be a worthwhile experience.

But already – before it’s even started, I feel like making the decision to look after me, to do this really nice thing for myself, has done a lot for my sense of self-worth.

These things do make a difference to how I feel about myself.

There will be times when I lose all hope again. Times when I fail to see any point in continuing to exist. Times when I will be angry at myself for still being alive.

But right now I’m glad that I’m still here.

And hopeful. Hopeful that 2015 can be better. That the changes I’ve made in 2014, the work I’ve done on myself and will continue to do in 2015, will pay off. Hopeful that it can be a less painful year and things start hurting less.

Ultimately I want there to stop even being a need to make a promise to myself not to take my own life…

Posted in BPD, christmas, it's my life, joy, pain, shitemas, shitmas, suicide, trauma | 5 Comments

I’d forgotten how bad it feels…

Almost every week I deliver some training that includes some teaching on what it is like to live with depression.

Of course, many of those I’m training have already lived with depression themselves – but for those who haven’t, I am hopeful that the training I deliver gives them more of an insight into the reality of living with the condition.

I am certain that it does. My training is highly rated. The feedback is excellent. But, despite that, right now, I’m left wondering… how much can people really ‘get it’ if they haven’t felt it?

And I’m sure that, to whatever extent that is true, it applies to most – if not all – conditions that I train on.

The reason that I am left wondering this is that the last couple of weeks I feel like I’ve been knocked into a deep depression and I am shocked by how I’d forgotten how bad it feels.

Then again – can you really truly remember how bad something feels as much as when you are caught up in the feeling and can’t get out of it?

It’s been quite a while since I considered myself to have depression. I know that I’ve even mentioned to people on a few occasions this year that I don’t have depression any longer. Borderline personality, yes. And most of all, living with the effects of painful and traumatising life events and trying to heal from them.

But I have no doubt that during my worst period mentally – mid 2010 to late 2011 – I was severely depressed.

I remember it well.

  • How difficult just functioning was.
  • How impossible it felt just to get out of bed in the morning.
  • How pointless everything felt. How ‘little things’ like showering or doing the housework were like the most challenging things in the world.
  • How I felt no joy in anything.
  • How I couldn’t let anyone into my flat because housework had piled up so bad, and I was so embarrassed – yet completely unable to do it.
  • How practically every waking moment I was tormented by suicidal thoughts.
  • How every day I would will myself to get into the shower, ask myself ‘how hard could it really be?’ yet most days it just felt too much.
  • How I would have given anything to just not exists any more.
  • How doing the laundry was so hard so I was often wearing unclean clothes into work – so afraid that people were noticing, and of course afraid that I was smelly, but still feeling unable to do anything to fix it…
  • How I felt like the most useless failure in the world for being unable to manage even the most ‘simple things’ – which of course just left me feeling worse about myself, and I got caught in this big vicious cycle.
  • How I would go to work (usually late, as getting out of bed was so hard), focus on my work, often work late, as throwing myself into work just made it easier in a way, go home, and just curl up till morning (no housework, no personal hygiene, no anything… it was too hard)
  • How I so badly wanted to find a way to end the pain, and could see no other way than through suicide – yet didn’t have the courage for anything big, but couldn’t find another way that was certain to work.
  • How I gave myself such a hard time for not being able to do stuff ‘I have two arms, two legs, why can’t I just pop some clothes in the washing machine? why can’t I just shower?’ was the type of thing I asked myself constantly’ again just making myself feel worse.
  • How I felt so guilty for wanting to put the people in my life through my death, so devoted so much time into researching ways to take my own life which may look like an accident, hopefully making it easier for those left behind.
  • How every waking moment was just so painfully unbearable in a way that I could never describe to another person, no matter how much I wanted to
  • How, realistically, I could just go on and on with this list forever…..

I remember all of those and more. How could I ever forget it?

But… I don’t know that it’s possible to truly remember how bad it feels, except when back feeling it.

I have felt it at times since then. But usually very temporarily and not as severely.

This week in particular I have really felt it.

There are several things that may have triggered it. They’re not important. Well, they are to me, but they’re not important here.

But, as much as I tried to tell myself that it’s normal, it hurts and it’s unbearable but it’ll pass, there are things that I know I can do that will help and so on… as much as I reassure myself of anything, I’ve still being so very shocked by how bad it feels.

I’d forgotten.

How can you truly remember every day how bad a deep depression feels unless you’re actually in the midst of it?

I’m glad that I’d forgotten. Because knowing and remembering how bad it feels is unbearable.

This week I’d no training scheduled – though that’s not why I was feeling this way, but it probably didn’t help.

Most days I stayed in bed – I lay in bed willing myself to get up, to do stuff, to eat, to shower, to just not be in bed – yet couldn’t. Some days I did work on my laptop – but in bed. Because I simply felt that I couldn’t get out of bed.

I slept two nights on the sofa, because going in to the bed was too much effort, and then the next morning getting up from the sofa felt too hard, so just lay there most of the day.

I felt like everything was suddenly swamped in darkness. And this darkness was completely overwhelming me. And I wanted so badly to do things that I knew might lift the darkness, yet felt completely unable to.

I’d forget to eat, and when I did that was an effort in itself. But then I was surprised by the fact that I’d forgotten to eat – which really isn’t like me.

The flat had gotten very messy – for many complicated reasons – and I wanted so much to get up and start tidying up, yet it felt so hard.

I’m describing external symptoms, but I’m not sure I know how to describe the feeling. Darkness, yes, but it goes way beyond that. Bleakness. Nothingness. I wish I could describe how bad and unbearable everything felt, but I can’t. I really, really can’t.

The constant thought was ‘it’s all too hard‘. (I sobbed to my psychologist a week and a half ago, and what I kept saying then also was ‘it’s all too hard‘)

And those ‘it’s all too hard’ thoughts were, I’m sure, partly what lead to the suicidal thoughts. I wasn’t actively suicidal – not much more than ‘I can’t take this. It’s all too hard. I need a way out’. Yet suddenly I was googling and researching ways to take my own life that could look like an accident. That was one of the first moments that really made me take notice and see that something was very wrong.

I hadn’t really been thinking about self-harm, yet everywhere I looked I was seeing new methods, that I felt really compelled to do. Methods that intrigued me a lot. I’m pleased to say that I’ve managed to avoid doing so, but that was a massive struggle in itself.

There were two things that made this past week and how I was feeling so hard.

1. The fact that I’d forgotten how bad it feels. I truly had. And that was scary. Because it made what I was feeling so much more overwhelming and so much more painful.

2. That I knew what may help me feel better, but generally I felt unable to do them. If I was speaking to my psychologist she would reassure me of the things that we both know may help. But when caught up in feeling so bad they feel so difficult to do . That’s one of the difficult parts – and in that moment, knowing the things that may help, but feeling unable to do any of them, it makes me lose any hope that things may get better.

Where I had to go and do stuff with other people, that was easier in a way. But otherwise… no… it felt impossible to do any of the things that would help.

Today, for now, I’m feeling a bit more able. The bleakness feeling is still there (but not as strong) but for now, feeling a little more able is good. Even if it only lasts today.

And because I feel a little more able, I’m going to do some of the things that I know may help (writing this, of course, being one of those things). Hoping they will lift some of the bleakness.

But I’m still ultimately stunned by how bad it feels.

I’m glad in a way that I’d forgotten. If, every day, I’d been remembering  quite how bad it feels, I don’t know how I’d have been able to go about my everyday life.

But in another way it definitely makes it harder. Because it makes how bad it has felt the last week so much more over-powering.

And if I’d forgotten, how can anyone truly understand if they’d not felt it themselves?

 

Posted in depression, mental health awareness, self-harm, suicide | 6 Comments

Suicide prevention is not just about preventing suicides

Suicide prevention is not just about preventing suicides.

You might be wondering how that even makes sense. Of course, suicide prevention is about preventing deaths by suicide. But there is so much more to it than that.

In all work that we do in suicide prevention, there needs to be more of a focus than just saving lives. 

The focus of any suicide prevention work needs to be about so much more than just preventing suicides.

When we talk of statistics relating to suicide we focus on deaths by suicide, but suicide is much greater of a problem than just ‘how many people died through an act of suicide?’

Suicide is a community wide problem. It affects everyone in some point in some way.

  • Many people will have thoughts of suicide but will not make plans to end their own life;
  • Many people will make plans to end their own life, but will not act on those plans;
  • Many people will attempt to take their own life, but will not die as a result;
  • Some people who attempt suicide will die as a result;
  • For each person who takes their own life, many people will be affected as a result.

I’ve said ‘many’ and ‘some’, because it’s very difficult to quantify exactly what the figures would be.

How can we really quantify how many people will consider suicide, given that most won’t tell anyone? It is estimated, however, that 1 in 20 will consider suicide this year. Thinking of how many people you know in your life, that’s quite a few…

It is also estimated that only 1 in every 25 people who attempt suicide die as a result.

We are seeing that suicide is much more of a community wide problem than many could imagine, and that suicide prevention work is much more than just saving lives.

Of course that is our ultimate goal and hopefully ultimate outcome, but we also need to have a focus on easing the pain of those who are feeling so bad that they want to take their own lives.

That focus is very often there, there’s no disputing that. I’ve seen it first hand. From people who I fully believe that without their presence in my life, I wouldn’t be here today. That I would have died by suicide if they hadn’t provided the support they did.

But this isn’t about me.

We’re hearing more and more about people who are in a bad way mentally not being given the help they need. There may be dozens of reasons for this – lack of resources, lack of funding, etc… etc… – but there’s often a sense that people often need to reach crisis point before help is provided. And left struggling on in the meantime, likely getting worse… and then hopefully some kind of help / support / intervention… but did they need to reach this point? If they had been given more support earlier on, perhaps things wouldn’t have gotten so bad. Even if they weren’t at crisis point at an earlier stage, their pain and suffering is real, they still need help with that…

But… even if the person is suicidal, is at crisis point, they are not always taken seriously. Why not? I’m sure there’ll be many reasons, but it often seems that part of what lies behind them is quite simply that people from all walks of life (including professionals) often do believe the common myths about suicide.

Perhaps they are thinking about suicide very logically – perhaps even basing it on the assumption that the person wants to die.

Take, for example, the myth ‘People who talk about suicide aren’t serious and won’t go through it’. On the basis that if a person is serious about suicide, why would they tell someone, given that that person may stop them? The reality is that people usually don’t want to die – they just don’t want to live, given what they are currently feeling / experiencing. They can’t see any other way out. But usually they do want help… Remembering this is key to getting a better understanding of suicide, and seeing why a person who is suicidal may be talking about it, but may still be completely serious about it…

But what if they weren’t serious about it…? What if they were talking of it, but weren’t seriously considering ending their own life? Clearly things still aren’t good for that person if they are talking about being suicidal. Clearly they still need support if they are seeking it. Whatever is wrong that is making them talk of being suicidal is very real and valid and deserving of help.

Often people are dismissed as not serious about it, because if they were serious, they wouldn’t be talking of it. Yes this is a myth… but can we ever take that chance? Can we ever know for sure what is in their head? Can we ever really dismiss someone’s talk of suicide as being not serious? Unfortunately it happens. Too often.

But… we need to remember that saving the person’s life is not our only aim. We want to decrease their pain. We want to provide them with caring, empathetic, support. Through doing that, regardless of whether they were ever likely to attempt to take their own life, we can make a remarkable difference to the life of another human being.

That - our response as caregivers – is as important as any other aspect of suicide prevention.

Another common reason that people may not be taken seriously when talking of suicide is that they are labelled as attention seeking or perhaps manipulative. Because what is often being focused on is people’s actions, rather than what lies behind those actions, the distress and pain they are experiencing.

A gentleman on a training course I was delivering recently spoke up and said ‘I find it disgraceful that there is a diagnosis that appears to automatically come with the label of ‘manipulative’. That condition was Borderline Personality Disorder (BPD) which he stated that his wife lives with, and that on many occasions she has been labelled as ‘manipulative’ or ‘attention seeking’ because of her actions, but also largely because of the association her condition has with those terms.

I’m very aware of the link with those terms and BPD. I have BPD, and I’m probably lucky in that I have not, knowingly at least, been called attention seeking or manipulative. But… I can think back to times where I have acted in ways that an outside person could definitely label as attention seeking, and perhaps manipulative. If they were focusing on my actions, not what lay behind them. Because for me, when I think of those times, I don’t think mainly of how I acted. What I can primarily see is the distress I was feeling, the emotional pain that was so very strong – and I know that at the time, I was so desperate to reach out and find a way to ease that distress. My actions may not make sense to others at those times, and I’m not sure they even make sense to me. But in those moments I wasn’t even able to see beyond the emotional pain to even think rationally. It’s the reasons behind the actions we need to try to understand, not just the actions themselves.

So you think a person is acting out / being manipulative / being attention seeking? Maybe they are, maybe they’re not. But regardless – what’s going on in their mind must be pretty extreme for them to be acting that way. The clue is in the term ‘attention seeking’. They’re seeking attention. There must be a reason why they are seeking attention. Let’s try to help with that.

And if we want to save lives – if we want to prevent suicide – let’s ensure not to add to people’s distress. Let’s not just dismiss their pain. Let’s see beyond the actions, try to understand reasons, and provide an empathetic non-judgemental, caring response.

I’m proud to work in the mental health sector in Scotland. Over the past 18 months, I have played a cruicial role in mental health training in Scotland. I have trained over 1000 in various mental health and suicide prevention training courses. I have witnessed great partnership working in Scotland. I have met some really amazing, passionate, life-saving people.

In the past 10 years we have reduced the numbers of people dying by suicide by 20%. Great work has taken place – and continues to – in Scotland and I’m pleased to be a part of it.

But… while there’s a lot that’s wonderful, we can’t ever ignore the not so great. We can’t ever let the not so great slide by. And we can’t ever let it be acceptable.

What I find so saddening is that recently, in three separate parts of Scotland, participants spoke of cases where a person had reported to professional services (in at least two of these, hospitals), distressed and suicidal. My training participants reported that the person had been sent away, but went on to take their own life the same day. My participants being concerned that they are being trained to do work, provide the right responses and approach, but what happens beyond that…? What if they provide the right response, but the services they signpost to, don’t…?

One of these was K, who in March 2014, was sent away from hospital twice, labelled, ‘manipulative’ but took her own life that day. I was already very aware of K’s story, but to have training participants who I’d never met before, bring this up as an example in training, in my mind was further testament to quite how badly K was let down.

We have done amazing work in Scotland reducing the suicide rates. But I’m left wondering quite how many of those who did die by suicide were sent away from services, dismissed despite being suicidal, and went on to take their own lives?

Given that in three separate parts of Scotland people have stated to me on training that they know someone who this happened to, one can only wonder…

This is never acceptable. But even if those individuals didn’t go on to take their own life, they were clearly in a lot of emotional pain – clearly more support was needed, clearly dismissing that pain wasn’t the right course of action.

I should state that I am very aware that there are two sides to every story.

I’m also very aware that I, myself, also left psychiatric hospital in 2011, intending to take my own life that night, being very serious about it, being very open about it to a nurse, but being dismissed. I was 100% serious in what I was stating, but it was pure luck and circumstance, and later the support and understanding of a very good caregiver the next day, that meant I didn’t go on to take my own life.

There are two sides to every story. But if I had taken my own life that night, would anyone have ever known that I was open to psychiatric services about my intentions?

There are two sides to every story. Both sides need to be heard, so we can learn from them. But the unfortunate thing is that in many cases only one side can ever be heard, because the other is no longer with us.

I’ve perhaps gotten a little side-tracked from my original point – that suicide prevention work needs to be about more than just preventing deaths by suicide. But my original point is still there in all that I’m saying… let’s ensure that everyone focuses as much on helping with the pain and distress that a person is feeling; let’s focus on providing an appropriate response so that we can play our part in easing that distress.

There’s another important point that I wanted to make. One that is somewhat different.

One for all of the genuinely amazing people who do provide appropriate, caring, empathetic responses to people who are suicidal.

The reality is that we cannot completely prevent suicide. Some people will go on to take their own life. If you’ve provided the right type of support to a person, and they went on to take their own life, no matter how much training you’ve undergone, or no matter how much experience you have, that must be very difficult, and potentially heart-breaking.

You may thing ‘I wasn’t able to help’. Because they went on to take their own life.

But… the work you do isn’t just about saving lives. If, when you helped the person, you eased their distress, if you provided comfort, care, reassurance… if you eased their sufferering in any way in that moment of time, you did help. And that is something wonderful.

The work we do in suicide prevention isn’t just focused on saving lives. It is our aim – but there’s much more to it than that.

If you eased someone’s distress, even if they went on to take their own life, be proud and know that you did good.

 

 

Posted in attention seeking, borderline personality disorder, mental health awareness, Mental health in Scotland, suicide, suicide prevention, World Suicide Prevention Day 2014 | 5 Comments

Wondering about therapy – thoughts welcomed from others

I can’t believe I’m writing / typing this. I’m in an extremely vulnerable mindframe, and it feels like a huge part of me is saying ‘Stop typing. Stop talking. Stop communicating. Stop exposing yourself and how shit you are.’.

I’m wondering about therapy.

I’m scared of therapy.

Appointment six today perhaps, and barely even finished assessment. ‘Formulation’ stage. Almost 9pm. Appointment was 11am. And it feels like everything is hurting inside. Like a deep physical ache that hurts but that which is ultimately an emotional ache.

Like I’ve picked at some emotional scab and it feels really raw and painful, and I need it to stop hurting, but I don’t know how right now.

And I’m not even thinking of anything in particular. There’s nothing I’m really thinking of that I could maybe try not to think of. Just this deep ache that feels so unbearable.

It hurts more than I could describe or could have imagined given what we did, what I technically don’t consider to be that big of a deal. It hurts so much.

And I tell myself that that is ok. That that is good even.

That therapy is meant to be difficult. Meant to be painful. I don’t know… perhaps that I know I’m connecting with it, and that’s partly why it’s so painful.

But then there’s the thoughts of ‘how am I meant to endure this?’

Will it always be like this? I can’t put myself through dealing with stuff if the result is just to feel this painful.

Yet a part of me thinks that this is the stuff that has been underlying for so long that is coming to the surface.

I don’t know.

But when I’m feeling like this it stuns me quite how painful it can be.

And I guess a part of me would be grateful to hear from others who’ve undergone therapy. Particularly for very painful traumatic experiences. I don’t know.

I don’t know what I want to know. Just perhaps maybe, does it get easier? Is it worth it? I don’t even know what I want to know.

Just it hurts so fucking much, and even though I know maybe that’s the whole point, I hate how much it hurts.

And I can’t believe I’m putting this out there.

I don’t know what I’m typing, and I don’t know what I’m asking, and I don’t know if any of it makes sense, but here we go anyhow…

Posted in therapy | 12 Comments

Accepting my own survival

After the last therapy session I wrote about the difficulty of accepting the horrendousness of my own past. This is something I hope will come with time. Something which I don’t particularly want to do, but which rationally and emotionally I believe will be necessary.

It’s hard. Very hard.

When I mentioned to my therapist at this week’s session about her validating my story as ‘horrendous’ (or what she’d heard of it) was unsettling, she reminded me of something important.

That it may have been horrendous. But that it’s much, much more than that.

We know about the two different sides of me.

Yes, there’s the vulnerable, emotionally unstable, ‘unwell’ me. The side that doesn’t cope very well at all. Who can’t cope with her emotions. Who is self-destructive. Who believes much bad things about herself. The needy, reliant one. Who feels worthless. Who has little self-esteem. Who hates herself. Who is creeping in now and needs to stop me saying all this stupid stuff. But basically the one who, on the face of it, was most affected by the ‘horrendousness’.

But then there’s the other side of me. The really competent one. The confident one. The one who definitely does cope, and does so very well. The independent one. The ambitious one. The high-achieving one. The functioning one. The one who runs support groups and delivers training courses. The same one who doesn’t really do the emotional side at all – that maybe being one of her saving graces.

But… the therapist pointed out that it’s not just a story of horrendousness. The competent, capable side – I may not have developed that side if I had not experienced the things I’d experienced. And that side is the one which has kept me alive and kept me safe.

That made a lot of sense to me.

Yet, like most people, I don’t really see that as a big deal. So, despite the stuff, I’ve achieved a lot, and will likely achieve a lot in the future, and on paper I have a lot going for me, but it’s no big deal really – it’s really genuinely not – and don’t many people achieve great things.

But then I think of the girl that I was and all that she experienced – all of it – and I see it as slightly more of a big deal. Slightly.

That competent, capable side of me isn’t necessarily the healthiest in itself. But it’s long since been my survival mechanism. Not just a coping mechanism, but an actual survival mechanism.

I remember being very young – too young to be thinking this way — and thinking ‘I’ll focus on my studies, that’s how I’ll get through it. I’ll study hard, work hard, make myself a better life’. And as time went on that same approach but in more detail. ‘I’ll go to university, get a degree, a good job, my own house etc.’.

It was very straightforward in my head. I thought that was the answer. I thought that would make me fine. But the horrendousness and its impact was still there. And I definitely wasn’t fine.

But that approach – it enabled me to survive. And as more things happened, and as I got very unwell, it was that side of me that looked after me, that ultimately kept me alive.

There’s more to my survival than just that ‘approach’. There’s things I did. There’s the impact on my mind. There’s many survival mechanisms that ultimately weren’t good. But still – they enabled me to survive.

It shouldn’t have been like that. I shouldn’t have had to survive.

But I did.

So it’s not just a story of horrendousness. It’s also a story of survival.

But still while rationally I can say that, emotionally I still think ‘it’s really not a big deal’.

And just like I maybe need to, with time, accept the horrendousness in order to begin to heal from it – maybe at the same time what I need to do is accept and honour my own survival. The things I did to survive. The ‘me’ I developed in order to survive.

And the fact that am the one who got me through it.

To accept that horrendousness is painful. I’m not sure that it’s something I can yet do. But until then I can’t really connect with it as being ‘me’.

Yet it’s scary to accept it, and one of the ultimate things stopping me likely is the feeling that it will be totally overpowering and all-consuming.

But… if while accepting the horrendousness – when the time is right – I can focus on accepting my own strength, my own power and my own survival, then the hope in that will play a part in helping me accept and heal from it.

One big issue for me this year is that on a number of occasions the emotional pain that I have felt – for various reasons – has been so overpowering that I believed that I couldn’t bear it. And on some occasions believing really strongly that I needed to take my own life in order to ensure that I would never have to feel that pain again.

Only on one occasion did that belief move beyond thoughts of suicide onto making plans to end my own life, but I would like to not feel this way. It’s not good.

I would like to feel that level of emotional pain and believe that I can endure it.

Actually, fuck that, I’d like to not actually feel that emotional pain at all, but one step at a time…

Rationally, in this moment, I believe that I can tolerate that level of distress and endure it. But emotionally when I’m in that distress it’s very different.

But… there is no level of emotional distress I have not felt before. No level of emotional distress I have not survived before.

To believe, acknowledge and accept my own survival and the fact that there is nothing that I cannot get myself through – that will be necessary for my own future survival.

Who knows if this makes any sense, but it makes sense in my head – what ultimately matters.

Despite bad – I survived… and I will continue to do so. I need to believe this.

Posted in beauty from pain, borderline personality disorder, dealing with emotional pain, hope, psychologist, survival, therapy, trauma | Leave a comment

So you want to binge…? (A letter to myself)

Currently I’m doing lots of different things to help me try to manage my emotions. To help combat bad thoughts, painful emotions, and to help reduce destructive behaviour.

Most of these things are things that I’m doing of my own initiative. Mostly things I’m figuring out myself. I’m taking the approach that I know myself best and using that knowledge to try to figure out what will work best for me.

I’m starting therapy, yes, and it means I’ll have some support to work through stuff – but I know that in itself will bring up a lot of difficult stuff. So I feel like alongside therapy I need to do some work in managing the stuff that it brings up.

Something that I’ve been struggling with more and more lately is binge eating. It’s always been a mild problem at best, but it’s been more and more noticeable lately, and it’s something that I want to change. But I’m aware that it’s about emotions more than it’s about food, and that what needs to primarily change is the bad emotions that lie behind binge eating.

Which is just one of the things that I hope therapy will help with.

Because I’m building up lots of different tools that may help in different situations, I wanted something that might help when I want to binge. So I decided to write a letter to myself. A letter that hopefully I will read when I want to binge. A letter that will hopefully help.

I printed it out, put it in my toolbox, but then figured it might be worth sharing here in case it might help someone.

But firstly, a note… this is not me giving advice to anyone else. I am not an expert in this by any means, and I am only just trying to tackle this myself.

It’s primarily nothing more than a letter to myself. It’s not intended to be advice to any other person. 

Only time will tell if it is any help to me. And I’ve no idea if anything in it would be of help to anyone else. But might be worth sharing in any case…

================================================================

Dear Amanda

So you want to binge again to make yourself feel better…? I know this has become quite a regular habit lately, but I want you to know that you can take control of this.

And it is only you that can take control.

You can swing it either way. You can let binging control you, or you can control it.

Part of the problem is that you do it without thinking – just do it almost instinctively.

You know it’s bad, but in that moment, you don’t really care. Because you just want to feel better.

But it’s become quite a big problem – literally ::) You’ve put on over half a stone in just a few weeks. So physically quite a problem – but emotionally it causes a lot of problems too.

One thing that I need to remember is that when you binge ‘to make yourself feel better – that’s exactly what you don’t do. You don’t make yourself feel better. You think you do… but ultimately you make yourself feel a lot, lot worse.

Actually, let’s make that clearer, as maybe in a moment of haste you might just skim this letter.

When you binge ‘to make yourself feel better’ you don’t make yourself feel better. You make yourself feel a lot worse, but emotionally and physically.

This has to be the basis of you taking control. If food really did ultimately make you feel better then this wouldn’t be a problem, you could binge all you want. But it’s a destructive behaviour which is making you feel bad in a lot of ways, and this is why it needs to change.

So how does it make you feel bad?

  • Weight: Weight wise, yes, it is negative. Earlier this year you had an obese BMI, then you got down to ‘overweight’. I want you to get down to the upper end of a healthy BMI range, or even just slightly overweight. Why? Because of the health risks associated with being quite overweight, but as much as that, about how it makes you feel mentally. The bigger you get, the worse you feel about yourself. When you were taking control of your weight, you were feeling better about yourself – but the past several weeks when you’ve been overeating and binging constantly, as a result you’re been feeling the extreme opposite of feeling better about yourself. Weight for you isn’t about a number. It’s about how you feel about yourself. The bigger you get, the worse you feel. When you can’t fit into your clothes you feel disgusting. It affects your self-esteem and so much more.
  • Mentally: Even the weight aspect was mostly about emotional impacts rather than physical impacts… but the weight impact is slightly more long-term. When you actually overeat / binge, what is the impact mentally? You give yourself a hard time about it afterwards. If you binge now, do you need yet another reason to give yourself a hard time?  You feel weak, disgusting, guilty and ashamed. And probably more. You started out wanting to binge because you felt bad feelings… all you are doing is giving yourself even more bad feelings on top, and probably without even acknowledging them, and they build up and build up to more bad feelings, and then you need to pig out again. It’s a vicious circle without you even realising it. Stop letting food have that power over your emotions. Take control. You can do this.

But you know it’s not as simple as just reading this letter to yourself and then not binging. It’s not that simple. This letter is designed to ground you.

But if it grounds you, the bad feelings that make you want to binge are still there. That’s the problem. So you don’t just read this letter and say ‘ok, fine, I won’t do it.’ Because the bad feelings are still there.

You’ll need to take care of those bad feelings. As well as possibly finding physical ways to manage those cravings and wanting to overeat.

I’ve some ideas for you, but they’re just that… ideas.

Ideas based on what I know of you. But also ideas on research I’ve done on what lies behind binge eating and what might help. I’m not an expert on this, but I’m the best expert on you, so this is worth a try, right?

Some of these ideas might work. Some not. Some on some occasions and not others. Only you can figure that out over time.

But firstly, I want you to know that while I want you to develop a healthy relationship with food, I don’t want you to become obsessive about it. I don’t believe that you will. For a few months at the start of this year, you did great. It came naturally. That’s what I want for you.

But… what you need to remember most of all – this isn’t about food, it’s about emotions.

So the primary focus isn’t on food, it’s about your emotions and dealing with them.

So you want to binge right now?

  • You can say no. Only you can take control. But right now, you can take control. Say out loud if you need to. ‘No. I refuse to binge right now. I refuse to deal with my negative emotions by binging. I deserve better than that. I deserve to treat myself better. I am saying no and I am taking control.Say that out loud right now. Several times if you need to.
  • Just not today: Note, you said that you refuse to binge ‘right now’. The nature of wanting to binge is that it needs to be done right now, but remember that with trying to manage all destructive behaviours / desires, something that you’ve long found helpful is the ‘just not today’ tactic. ‘I’m not saying I won’t ever do it, just not today’. It works for you, so try it now.
  • Is it actual hunger? You’re taking control and saying no, but remember you’re not saying no to food, you’re saying no to binging. Food is healthy and necessary. I want you to have a healthy relationship with food. But think – is it that you are actually physically hungry, and it’s showing as wanting to binge. When was the last time you ate? I think you struggle to tell the difference between emotional and physical hunger, so there’s a really good document I found online at the end of this pack. Refer to it if needed. And if you’ve gotten things mixed up, and it is actually physical hunger, then go and eat something. Something at home. Something safe.
  • Can you trick your mind a little bit? Yes, this is about emotions, not food. But can you trick your mind a little. Presuming at this point you’ve established this is emotional hunger not physical hunger… can you have something small anyhow… like a piece of fruit or a yoghurt. In the past I think that this has sometimes work. Your mind feels a little satisfied and a little comforted. Maybe try it and see if it works.
  • The feelings: I’ve no idea in reality if any of what I’ve suggested so far is going to help, but I hope that it will ground you a little, and may even make you feel better in itself. But it’s not going to be enough. Bad feelings were present to make you want to binge. Most of those bad feelings are still there, so know that those feelings need to be taken care of. How are you going to do that?
  • Acknowledge the feelings: Would it be helpful to write down the feelings? Write down what is happening to make you want to binge? I don’t know. Only you in this moment when you are feeling whatever you are feeling can know that. But my thinking is that by binging you are ignoring the negative emotions… but they will still be there. So maybe do the opposite of that. Try writing about them if in this moment you think that will help. Or maybe ring someone – maybe a helpline like the Samaritans. Don’t know what to say? Ring them and say these words ‘I want to binge, and I know there’s bad feelings behind it, so I wanted to talk to someone about that, as a way of managing those feelings’.
  • Could it be boredom? Thinking about all of this, I know that almost always it’s likely bad feelings lying behind a proper binge. But could it be boredom? Could it be habit? Could it be just what you’re used to doing? If it’s boredom / habit, what can you do? I think maybe something that really focuses your attention. Reading, housework, puzzles, jigsaw, a dance DVD, anything… I’m thinking though that going out for a walk might be risky, as it’s too easy to then go into the shops for the junk food, although simple solution… if going out for a walk is what you do, then maybe don’t bring money with you. No money with you = inability to buy the food in the first place.
  • Replace bad feelings with good feelings: Back to the bad feelings. Acknowledging them, by writing or talking about them might help. But what else? Well, I’m figuring that in order to challenge the bad feelings, it might be helpful to do things that bring good feelings. So, what makes you feel good? At the back of this pack, there’s some pages which ask you to list out things that might make you feel good. Write some out, then try them. Here’s some ideas.
  • A bit of pampering – a shower / bath (very dependent on reasons behind bad feelings), body lotion, paint nails etc
  • A comedy dvd for some laughs
  • some happy dancy music (and maybe even dance around the room)
  • write down things that you do like about yourself / that are good about you
  • put fresh sheets on the bed
  • spray room and linen spray
  • cuddle a teddy (again very dependent on reasons behind bad feelings)
  • light some scented candles.
  • Is there anything in your toolbox that will help?

They’re just some ideas. I’m sure you can think of loads more. What is most likely to work is what feels most right for you in this moment.

So, what now? I don’t know.

Can’t you tell that I’m making all this shit up as I go along? :)

Nah, in reality, I am yet I’m not. I’m saying this based on what I know about you. And given that this is a letter to yourself, and I know myself best, I hope that you found something in it that works.

You can pull up so many pieces of advice from the internet, books etc, or advice from other people… but this is advice to yourself cos you know yourself best.

I hope that as therapy progresses, as you learn and understand more and start to heal, as the bad feelings decrease, as the distress decreases generally, this will be less of an issue.

But in the meantime, I hope that there might have been something in this letter that helps.

I know you also have the ‘dealing with distress’ booklet, and you’re planning to work though that, so hope that you will get new ideas and tactics from that – not just on dealing with the want to binge, but ideas in general on coping.

I have written this letter with the best of intentions. If it works, it works. If it doesn’t it doesn’t. But… if you read it when you have that desire to binge, and you realise something in it that really doesn’t help, or realise something that would work better if it was changed… then change it… You have the electronic copy, change it and re-print it… make it what works for you.

Oh and here’s another idea, time permitting… if you wanted to binge, have read this letter, and found something helpful in it, and managed not to binge:

  • Highlight what it was that helped you. It’ll make it easier to spot next time.
  • Again, time permitting, write about how you feel now that you have not binged. Do you still feel bad? Do you feel better? I’m hoping that you will feel a little better for resisting, and that whatever you write about how you feel now will be something that could help ground you in future.

Finally… find a reward for yourself tomorrow. A non-food reward.

Ideally this is a reward for resisting binging. But either way, if you read this, if you engaged in some of the stuff you thought might help – even if you did binge in the end, you still tried not to, and you did your best… so you deserve a reward.

Not food, and doesn’t have to be something that costs money. Even just taking some time to do something nice for yourself. Believe that you are worth it.

You’re doing great!

Love, Amanda

Posted in binge eating, binging, dealing with emotional pain, food, letter to myself, managing disstress, self-help tools | 5 Comments