9 months on from the #seeme14 Parliamentary Reception

9 months ago this evening I attended the Parliamentary Reception to mark the re-founding of See Me Scotland, Scotland’s national anti-stigma programme.

I have a tendency to work a lot, and being self-employed, I can’t just get cover when needed, so often am unable to attend these type of events. But this one being in the evening, it was manageable.

I spent the day quite looking forward to it. Because I was excited by it, and what it might mean for the future of mental health stigma in Scotland. I was enthusiastic and optimistic about what it could achieve, hopeful that this would be something which could make a very positive difference in people’s lives.

Thinking back to the event, four things stick out in mind for me:

  • That it was positive that most of the event speakers acknowledged that there can be as much stigma in the health and care sector as anywhere else;
  • That there seemed to me, from meeting people and from viewing the attendance list – a noticeable absence of NHS staff representatives… which confused me given that they are the National Health Service, and this related to mental health stigma
  • What also stuck with me was a conversation I had with a head of a Scottish mental health charity. On introducing myself to them, they responded with ‘Oh yes, Amanda, I follow your tweets on twitter, you’re very entertaining’. Obviously slightly alarmed at this, given what random drivel my tweets often are, they then clarified for me ‘No, what I mean is that you’re enlightening and inspiring, you have a good way of getting your voice heard. In my position I usually can’t do that in the same way. Keep it up.’
  • That there were so many amazing people at that event, whose heart truly was in the right place, who had the power to make a difference, and are a wonderful asset to mental health in Scotland. I walked away with a feeling of being proud to be involved in what is the mental health sector in Scotland, and I still retain that feeling, since there is a lot that is good about it.

I left the See Me Scotland Parliamentary Reception as enthusiastic and hopeful as I went in. 9 months to the day later, I am left wishing so much that I could say the same.

Instead, I’m left very disappointed by so much of what I’ve witnessed in the months since.

But, it’s not just me that’s left disappointed….

I am very involved in mental health in Scotland in many ways. I run a mental health training business and am one of the busiest mental health trainers in Scotland. I run mental health support groups. But, more than that, I have very regular contact with many people throughout Scotland who live with mental illness. Many who themselves experience stigma. Those best able to judge the See Me Scotland programme. And what I have been hearing from so many isn’t good…

‘Stigma’ itself is a very broad term. I often find it remarkable quite how many different ways it can be viewed – and how one thing which is non-stigmatising to one person can be viewed as completely stigmatising to another who is coming at it from a different perspective.

What I find so saddening is that nine months to the day after the Parliamentary Reception people seem to be asking the question ‘What will it take for out anti-stigma programme to take stigma seriously enough that they themselves stop stigmatising?’

For me personally it didn’t take nine months to start asking this question. Little by little concerns started to form in my mind. But I still took the stance of ‘give things a chance… give them time.. especially with a new team formed… find their feet… give them time to listen to people, etc…’

But nine months is a long time in my eyes, and if people don’t say it like it is for them, will we ever really change stigma…?

This piece is also very much based on the conversations I have with many others – several who approached me to chat about it, concerned… people are alarmed, and something surely must change…

Here’s just two quotes I had from two people who approached me to speak of it last night.

“See me are meant to fight for us mentals and what they are doing is just like… making us look mental’.

“I just wish that there could be an organisation run by people with the right intentions, no bias, real understanding.

There’s more quotes I could provide. My hope is that people will be comfortable enough to speak out publicly themselves, but in some cases there is a clear conflict and a wariness of the impact it may have on them of speaking out in an honest but critical way.

Wanting an organisation run by people with the right intentions – I can’t speak for anyone’s intentions. Only they themselves can do that. But the more time goes on the more many seem to conclude that the intentions of See Me seem to be about looking good, rather than doing good. It’s possible to do both, but should doing good be compromised for the sake of looking good…?

No bias – See Me Scotland receive funding from the Scottish government. They are managed by the Scottish Association of Mental Health and the Mental Health Foundation. Which I’m sure has many advantages. Yet brings a clear conflict of interest.

What about stigma from the Scottish Government – are See Me going to speak out against their funders? One person who spoke to me described how they experienced stigma from one of the organisations who manage See Me, and was left wondering why we can’t have an independent body who are working to bring about change and combat mental health stigma.

Real understanding – I don’t know the background of all See Me Scotland staff members. But I don’t need to. It’s likely that some have a real understanding of mental health – and some less so. But how can they really get the best understanding of mental health? But listening to those who live with mental illness. It’s clear that they’re seeming to ‘involve’ people with lived experience at many stages, but are they really listening to them? Not often enough from what it seems…

Prior to last night here’s just a few examples of some things that I’ve witnessed.

An implication from See Me that if someone has lived experience of mental illness that this means they will be on benefits: At a See Me focus group a few months ago I raised the question of why are positions in See Me which specifically look for people with lived experience of mental illness unpaid positions? Especially given that that’s pretty much the most valuable experience that a person can bring to an anti-stigma organisation.

Their automatic response: ‘We’re debating that, but the problem is that it’ll likely affect their benefits’. Now maybe I’m being pedantic about wording, but this is quite different from ‘the problem is that it may affect their benefits if they are on them’.

I’m not naïve enough to think that everyone who lives with mental illness will be in work and not on benefits. Particularly if you’re looking for a broad range of lived experience. But I’m also not naïve enough to think that just because someone lives with mental illness doesn’t mean they are on benefits, and frankly it’s quite stigmatising to suggest otherwise…

The See Me Scotland Advisory Group – See Me have developed an Advisory Group, 50% of whom have lived experience of mental ill-health, and were specifically recruited for this reason (unpaid of course). I happened to speak to a couple of members of the lived experience advisory group not too long ago, and in their cases they weren’t completely happy with how they were being treated.

Obviously somewhat wary of saying too much to protect the parties involved, but certainly the impression that had been coming across when I had spoken to them was that their involvement was tokenistic, and at that point they were not being meaningfully involved. That the first meeting had the funders present, and was a bigwig-type meeting, without any involvement of the people on the ground. This was certainly disappointing to hear, given that it’s the people on the ground who know mental illness – and mental ill-health and stigma are ultimately about what those people have to say, and not just about the graphs, slideshows and figures… I haven’t caught up with either of these individuals on this subject recently, but here’s hoping that things have improved on that end…

These are just two of the things I’m aware of, there’s much more I could add…. But wary of the length of this piece.

I had mentioned that things escalated somewhat last night.

Today, nine months to the day after the Parliamentary Reception to mark their re-founding See Me re-launch their programme. In preparation for that, yesterday evening they launched their new website.

The website – This included a section on various mental health conditions and the ways in which people are stigmatised. Soon afterwards I spoke to three people who were very alarmed by it – one of whom I contacted, the other two contacted me.

People were alarmed by how misleading and stigmatising the information on these sections were. Throughout the evening via twitter others raised concerns also – to the extent that it seemed there wasn’t one of the conditions webpages that at least one person hadn’t highlighted as alarming and stigmatising…

It was the eating disorders section and the dissociative identity disorder (DID) section people I was in contact with seemed to be raising the most serious concerns about regarding stigmatising content.

But… what is most disappointing is that I have witnessed a person in Scotland who lives with DID offer to help See Me write a section on the condition – and witnessed them be fobbed off. Only then, it seems, to give the task to someone who appears to have little knowledge of the condition, and who wrote a highly misleading section on the subject.

I myself will admit that I have limited knowledge on DID, but on reading this webpage on DID and stigma, it seemed so remarkably at odds with the little that I did know.

So, it seems that in this case:

  • See Me Scotland had a clear offer from someone who lives with a very misunderstood mental health condition to write information on their website relating to that condition;
  • They then appeared to fob that person off…;
  • Passed the task to a person who appears to have little hands-on knowledge of the condition;
  • Approved and published the piece, despite it being highly misleading, accurate and stigmatising.

Is this the best we can expect from our anti-stigma programme? Is this the best that people who live with that condition deserve?

It was far from just being the DID section that caused concerns from people. Most of the sections on conditions did… And it’s interesting to see that those sections have now been removed from the website, at least for the time being…

I know the person who wrote these sections. They were commissioned freelance by See Me to write them. But… this is nothing against this person. This is about See Me and See Me only. It is See Me’s website, it is See Me who approves and publishes the content, and it is See Me’s responsibility alone to ensure that they don’t cause further stigma.

What struck me was a feeling of ‘is this how seriously See Me take their own website and the information on it? Is this how seriously they take stigma?’

Looking back, this blog post seems full of opinions and hearsay and quotes from anonymous people. But it is what it is. An accurate account of what I’ve seen, heard and witnessed over those past nine months, and a partial account of why I’ve lost the optimism I had for See Me on 28th January.

This isn’t an anti See Me piece. Far from it.

I’m not anti See Me. I’m quite for them, because I’m anti-stigma, and I want Scotland to do all it can to challenge stigma. In the right way, and as affectively as we can.

Which must mean listening to what people have being seeing, hearing and witnessing. Really listening. And acting on it.

We’ve over two years left of the re-founded anti stigma programme I heard about in Parliament that day. So much good can still be done. Things can change for the better. Hear those voices which need to be heard – and don’t just take it as criticism to be rejected. Please take what people say as their truth –a truth which is valid and needs to be heard.

Posted in mental health awareness | Leave a comment

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

Accepting the horrendousness

A lot of people struggle to accept their mental illness, but it’s not something that I ever really remember me having much difficult with. Once I recognised its existence that is.

I had read about borderline personality disorder (BPD) about 18 months before I was diagnosed with it. I knew ‘that’s me’, but didn’t think too much about it for quite a while. Until I got quite unwell. I always knew it was more than depression, so when I was diagnosed it just felt like a relief that others could see what I saw.

As for depression – which I don’t think I do have anymore – in hindsight I could see several past episodes of depression, but at the time it was just a case of ‘that’s just how things are’, it was my norm, and I didn’t recognise it as anything more. But once I did recognise it, things made sense, and for that reason, there really wasn’t much difficulty in accepting that I was mentally ill.

But there’s something else that is incredibly difficult to find acceptance of – accepting my past (my childhood) for what it was. 

In our last appointment, my therapist noticed some change of expression on my face. She said that I looked sad. I replied: ‘But, it was sad, isn’t it?’ Her reply: ‘No, Amanda, it was horrendous’. 

In that moment, caught up in the distress that I was feeling, I did recognise it as horrendous. Overwhelmingly horrendous. That being despite the fact that I didn’t even feel like I’d told her anything really bad.

But later – after the appointment – I realised that this, someone else describing it as ‘horrendous’, had really unsettled me. Rationally I knew that it was someone validating my past (or at least what they’d heard of it) exactly as it was. But it still unsettled me.

I’m trying to understand it, yet I don’t know if I can quite explain it.

Yet, just as I wrote (typed) that, I think it clicked with me. (Which perhaps shows quite how powerful typing in this space can be.)

I know on some level that it’s probably very natural for a person to struggle to accept their own childhood as horrendous, to realise the horror of it. After all, it’s their norm, it was just ‘how it was’, and they never really knew any better.

I know all that. That makes sense to me.

Although what else just occurred to me was that part of it may be related to that whole ‘stiff upper lip’ thing (is that even the right term?) The ‘not talking’ about bad things. The ‘just getting on with it’ without actually saying that what we need to do is ‘just get on with it’, without even acknowledging that unwritten rule. The ignoring of the bad things. The just getting on with it, cos things don’t affect us if we don’t acknowledge them. The smiling and getting on with it. The requirement to pretend you’re fine when you’re really not. The pretending this to yourself, not just to other people. The ‘just don’t think about the past, and it won’t affect you’. And all that other shite…

It has only occured to me in writing this blog post that given that that’s what I grew up with, and everything else on top, is it really any surprise that it’s so hard to accept that childhood as horrendous.

Even just the fact that I can imagine one person in particular reading this now and thinking (based on what they’ve told me before), that I should just not be thinking about the past), that people will think that I ‘just need to move on’ etc.

They’ve told me that when I actually wasn’t even thinking about the past, but now I am, and I’m choosing to, I need to, it needs to be thought about, it needs to be focused on, it needs to be healed from.

That’s why it can’t matter to me what other people think, and it can’t matter if any single person thinks that I just need to be superhuman and ‘just move on’.

Because I have more facts about me than anyone else will ever have. I know me. And I’m the one connecting things, joining the dots…

I used to say that ‘yes, I’m mentally ill, and my childhood – and issues experienced in adulthood to some degree – may have played a part in that, but then again, I may have gotten mentally ill anyway. We might never really know. What ultimately matters is managing it.’.

But now I can see things much more clearly for what they are. That – like anyone else really – my past experiences contributed to the person that I am today. And quite simply way too much fucked-up shit happened that left me in somewhat of a mess mentally. Not just a few years of it, but way beyond that. And those extremely negative – horrendous – experiences left their mark. They quite definitely contributed to my illness. They quite certainly played a part.

Yes, I’m mentally ill, but I don’t so much see it about that anymore. I see it as much about healing from the harm that was done to me. Reclaiming me. Undoing the damage. That was going to need done, whether I’d ever been mentally ill or not.

There’s also other reasons why it’s hard yet to accept the past as horrendous.

Not wanting to feel like a ‘oh, poor me’, when realistically I need a little more of that in order to start healing.

There’s also the fact that ‘didn’t we all have it hard? Doesn’t everyone?’ (Yes, in our own ways, some more so than others, some more so than me… but it’s never a competition, and what did or didn’t happen to anyone else doesn’t change what happened to me – and my head is about me and nobody else.)

But also – it’s painful. Last Saturday was a very hard day. I was riddled all day with bad memories popping up. Everything was a trigger. Everything reminding me of something. And in many cases reminding me of things I’d forgotten / not remembered.

I took an external view of much of it, and was shocked. But only in a way that I would be if someone else had told me it. I was sad too.

But I’ve been reading up on healing from trauma, on connecting with my inner child and other such stuff. That in itself is progress, since it’s not that long ago that I couldn’t even go there. Couldn’t even say those words, couldn’t even read up on it, couldn’t even acknowledge ‘her’.

But… while on the surface I acknowledge that past as horrendous, deep down accepting it as such is much more difficult. Because that might be the start of truly feeling the pain associated with it, feeling the emotions of it. I don’t think I’ve really begun connecting with that part of me, and I just don’t think I’m ready.

It’s beyond painful to accept it for what it was. To accept the horror of it, how badly I was let down, how much was wrong. It’s even more painful to emotionally connect with it, and to feel and see the impact it had on my mind.

But I do feel that that acceptance needs to be one of the first steps in the healing process. The acceptance of things for what they were. The acceptance of those many experiences as horrendous.

I don’t know what it will take to enable me to start doing that, but the rational me says that I need to take my time with it, to go at my own pace, to do what feels right, and to trust that between my therapist and I we can figure it out together.

This is all weird and new and I think back to whatever I’ve just written and I’m not sure that it really makes any sense to me..

 

Posted in acceptance, borderline personality disorder, BPD, depression, mental illness, pain, psychologist, self-acceptance, therapy, trauma | 10 Comments

7th of July, the fourth

Anniversaries seem to be important to me. Well, some more than others.

Good anniversaries at least. I like to celebrate milestones, mark things.

7th July is an important day for me. I suspect it always will be.

7th July 2011 was the day that I turned a huge corner, realised that I didn’t want to die. I so badly wanted the pain to stop, but I didn’t want to be dead. That’s different.

I’m not going to go into all of that again. There’s plenty of it written in past posts:

I’ve thought about the milestone today. I thought about a lot of things today. Not all of them good.

The reality is that I want to mark this milestone as it’s another year alive, another year survived since I made that decision.

So I want to write something tonight.

But the reality also is that I feel incredibly shit tonight. For so many reasons, many of which I don’t even know or understand.

On the day I made that decision, 7th July 2011, I wrote ‘No matter how hard it gets, no matter how much it hurts, I’m going to stick it out’, and the reality is that it shocks me sometimes quite how fucking hard that actually is. To ‘stick it out’. And it shocks me quite how much everything hurts. Quite how unbearable things feel in my head. Quite how much of an effort everything is.

Right now, I’m writing this despite being in a ‘fuck everything and everyone’ type of mood. Marking a milestone is great, but sometimes it’s hard to mark a milestone which relates to staying alive when everything in your mind hurts too much.

When, no matter how much you know it’ll pass it makes no difference, cos it’s still there feeling like that in this moment.

And when you realise that no matter how much you do externally that is good, inside your head still feels like shit.

When you have the will inside you to try to make things better, but you’re still not sure if you have it inside you to endure how painful it might be.

No idea why I am writing any of this, but it is my place, and it is my day.

And I like to note my milestones as some part of me knows how hard I’ve tried, how much I’ve achieved simply by ‘surviving’. So I’m doing this for me, as I’ll be glad of it at some point.

I don’t have it in me tonight to say anything much good. It’s just a bit scary how much my head feels like it did then.

Yet I’m different. Things are so different.

With so much of the same head.

Confusing. Yet not.

Familiar.

Crazy.

Fucked-up.

Fuck everything.

Surviving is too hard sometimes.

Tomorrow is a new day.

 

Posted in borderline personality disorder, BPD, child abuse, emotional fuck-up, fuck-up, mental illness, pain, personal, suicide, trauma | Leave a comment