“Urge-surfing” *Trigger Warning – Self Harm*

After a period out of work after I completed my degree, I have recently returned to the stresses of working life. During my time off, I felt relatively well for the first time in many years and didn’t struggle to badly with my thoughts and feelings, even though I was receiving very little professional support.

Having been back at work for a few months now, the daily grind seems to be chipping away at my resilience, leaving me raw once more. With this, familiar (but unwelcome) thoughts and feelings have returned, along with the urge to act upon them. I have been trying to surf these out alone, I’ve managed this previously and figured I could again but the urge hasn’t decreased in it’s strength. I told my partner more explicitly how I felt as I feel my resistance dwindling, and I’m also fed up of the urge not passing.

She already knew I was struggling with these thoughts but as I struggle so much to express them whilst in their grasp, it was helpful to be able to tell her more honestly. Having similar experiences herself, she provided me some practical ideas to try to reduce the urge. She suggested I paint my skin with nail varnish or something similar in the areas I would have liked to have self-harmed.  This seemed like a good idea to me and I said that I would try it.

Health professionals in the past have suggested to me that I am much more of a practical person than an emotional person and so doing something like this seemed much more appealing and easy than trying to discuss in any depth what was going on inside my head at the time.

Interestingly, as I painted on my skin I felt more in touch with the emotional side of things though; the things I didn’t feel I could access or express. At first I felt disappointed that the painting didn’t offer any pain, and in fact conversely was potentially soothing. I began to concentrate though on shaping the nail varnish realistically, and this grabbed my attention more.

As I carried on I fluctuated between feeling some of the feelings I used to get when I self-harmed – anger/aggression – and wanted to do more. I also noticed the familiar lack of perfection feeling, where each mark led to another to try and harm ‘evenly’; I suppose I was concerned with the appearance of the marks.

In between these feelings and whilst I was particularly focused on painting evenly, I began to think about why I wanted to self-harm, where this urge was rooted.

I recalled a few weeks ago seeing an old friend, who I knew used to self-harm. She had scars of varying ages and I couldn’t help feel almost jealous. I haven’t been able to self harm in a long time and even when I had, I never did so anywhere visible and especially not on my arms, because I am required to work with these showing. I felt jealous that hers were on her arms and visible and she didn’t hide them.

I thought further about this. Returning to work has meant that, once again, I see other people’s pain. Lots of peoples pain. Frequently. A proportion of my workload involves helping people with mental health conditions, people who self harm etc. and various other things. I see their pain all the time, I feel their pain all the time. I try to help them and sometimes this is painful for me, too. Helplessness.

But nobody sees mine. It is very rare I will show my pain. I have always been a rock for my family and many other people, and this can be very difficult. This is how I feel at work too, especially as I’m often in a position of seniority. People look at me for guidance, for help. People expect me to be able to manage everything and anything. People expect me to be okay all the time.

People expect an awful lot of me and it’s a fault of my own that I often don’t expect very much back.

My pain seeps out through the cracks, tearful moments or angry outbursts. But I still find it very hard to talk about what’s going on inside my head and this is very alien to me. I find it much easier to help others, but I feel I need to try and find some ways to help myself now.

Has the urge passed? I don’t know. Did this help? I think so. Exploration feels better. 20161227_231012.jpg

 

 

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Is “recovery” a choice?

It seems fair to me, to say that having a mental illness is not a choice. If it were, would anyone take it? I think that no matter the source of mental illness, its anything but a decision. But what of recovery, is that a choice?

Firstly, I don’t mean for this post to sound in anyway invalidating, my experience has taught me just how incredibly difficult recovery is, how painful it can be to go against the grain of what some part of your mind is telling you to do and build new tracks, try new behaviors and ultimately fight against “yourself” – does this mean you’re wounding “yourself?”. I’ve lived the horrendous “2 steps forward 3 back” as the scales tip between my being in control, and my illness being in control. The frightening mismatch between how I feel and how I act, between what “I” want to do, and what I am doing. It seems a complicated tangle, trying to unravel yourself from your mental illness, to find where your connected and where you’re not, to distinguish self from not self. The age old “who am I?” identity crisis. The identity mental illness gives  you, the mental illness within that identity. You get the picture – it’s confusing.

I can identify now a number of “choices” I had to make along the way, the choice to try something, anything, other than what my mental illness was telling me to do. To not just exchange one “bad” behavior for another. Others I’ve spoken to speak of “turning points” or times where something just “clicked”. What is this click? Is it something internal, or external? They now speak of their mental illness as though its something distant and separate (which I find myself doing now, too, but used to find odd when in the midst of being “ill”). Remember that constant, voice in your head that guided your life? Maybe you still have it, it becomes a whisper. Now and again, it shouts out like a stubborn child when circumstances wake it, but now, you’re able to kindly say “no”. That is a choice. Whilst I completely appreciate just how important it is to listen to this “inner child” or what have you, to find out what he or she wants, what guides THEM and what motivates THEM. But, similarly, we can’t give in to every tantrum they, or mental illness throws, otherwise we’re never going to recover. We have to set boundaries, just like we might with a child. It doesn’t mean it’s easy though, having a child kicking and screaming inside your head that you “can’t” listen to.

Does this make any sense to anyone else, or am I just crazy? Is recovery a choice?

I recognize the need for support etc. and the right external environment. I’m not saying its an easy choice by any means, but is it a choice?

 

 

 

The PTSD chain

The chain tightens around my neck once more. Sometimes, it sits so loose and I am so used to its weight I almost forget that it’s there, until it clasps back around my throat and I am gasping for breath. It can be the smallest things that wrench upon the end, capturing me in my noose, an act of violence on the television, an unusual smell, a taste, and suddenly I am overwhelmed. I might not even realise it’s tightened sometimes as I stare blankly, sweltering my own feelings trying not to let them show whilst my heart hammers against my rib cage “They can hear it, surely they can hear it!”.

On my own, I can fight against the chain. I prise my fingers between the cold and my skin, but the more I wriggle and fight, the tighter the chain gets. 

 I long to put this chain down so much. 

At breaking point with services

Today marks my last day of DBT. It has been a roller coaster of good and bad, mostly good though. Yet today, I feel upset. I feel angry and frustrated  and dropped. I will try not to make this a rant about the NHS, as that’s not what I want to do, god knows I understand the struggles – I work for the NHS too!

So how have I been dropped?

Within the first couple of months of DBT, my one to one therapist went on maternity leave, understandable and acceptable and though sad, I got on with it. The DBT group didn’t feel this void for MONTHS. I had signed contracts saying I would attend all sessions, I would try and help myself blah blah blah and my therapist signed contracts too. But it would seem this was the first one way street I was to drive around as though I would be picked up on my end of the contract if I slipped with self harm, for example, seemingly there was no need for them to upkeep their end of the deal and find a new therapist for me.

So months later, the void was finally filled with another therapist, and though I had quietly sat tight for the time without, I was grateful and a little relieved. She was a good therapist, perhaps not always entirely in tune with me but far better than nothing, she was kind and caring. I saw her for longer than my first therapist and the only real hang up was she had a number of taboo subjects which we couldn’t visit, which seemed counterproductive to me.

So a few months later, she leaves, very near to the end of my years DBT. Again, this isn’t picked up for a while and then when it is? I temporarily see someone twice, someone who I actually liked and could connect with and let me talk about ‘taboo’ subjects, she advocates within her knowledge that we can continue to see each other and work through these things to the end of DBT and beyond. Shortly after this, the system picks this back up and says I can’t see her. She is based at one centre, and due to my address I should receive treatment at a more local centre.

So, I have travelled for a year to the further away centre to receive therapy, both group and one to one, and now that its not convenient to them, I’m not allowed to do this anymore. My second, beautifully paved one way street.

I cannot see my new therapist anymore and I am alone. Rather than handing my care nicely over to my local team, from hand to hand, I am temporarily dropped once more. Someone at my local centre will, at some point, pick me back up out of the darkness, dust me off for another 7/8 weeks and then, probably, drop me again.

So right now I am feeling pretty helpless, hopeless and powerless, common themes throughout my life. Once again I have no choice over where I go from now, I just have to sit tight and wait. I truly feel like disengaging and giving up with services at this time and just keep running until I fall for good, it is just not worth it anymore. It’s too hard and inconsistent and though I appreciate it is not the therapists fault, I truly feel that nobody cares.

Eating disorders: control and shame

I think for me, ‘disordered’ eating has always been to some extent about control; a fairly common theme, I know.

It makes kind of logical sense in some ways. I dread the stereotypical ‘wanting to be in control of your body because of times when you haven’t’, though I do accept this theory. For me, I’ve been thinking more and more about exactly what it is I want to control: is it my weight, my appearance, my eating desires? Is it about wanting to see how far I can push myself, how much discipline and control I have over myself? 

These were all things I used to think I wanted to be in control of. From a young age I learnt to control myself in so many ways and ‘controlling’ food helped me to continue this; which is something I felt I should do. 

Suddenly though, I realise it is not just about these things. It is about controlling me. It’s about holding me back. Keeping the little battered me inside. 

I feel so utterly branded by shame on the inside that I must hide myself; I must not have desires or be who I want to be. 

It feels as though every part of my soul has been seared and scarred by shame and I darent share it with anyone for fear of repulsion. My eating disorder has cut over scar after scar of shame and kept me quiet, kept me hidden. 

Do you remember the wounds?

It makes physical sense that a scar won’t look the same as the wound, nor the skin before. The tissue, damaged then inflamed seeks to heal and creates a substitute tissue to stand in the originals place. Thick and non-functioning, it fills a void. Do you remember the wounds before them? Remember the wounds your scars replaced, what they stand for? Do you remember the pain of them, how they came about? Do you even remember the story they tell?

Many scars tell a good story, but many more tell a horrible one. 

And what of the emotional scars, the ‘psychological’ ones? Do we remember what stood before them? Do we remember ourselves before that trauma? Our emotions, our thoughts, thick and hardened through the hands of abuse not dissimilar to the scars on our skin. The bodies inate, desperate mechanisms to heal and heal quickly. To survive. 

Can we change them? Can we soften the scar tissue in anyway? Can it be treated? Can we remember what was there before, can we remember the wounds? Would it help to?

What is it like to be covered in scars you don’t remember receiving, wounds that have healed behind your back without your knowing? Perhaps that is unanswerable.