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?

 

 

 

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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.

What does abuse do to you?

This is a very difficult post for me, even anonymously, to share publicly. The word ‘abuse’ is a big and scary one and I wouldn’t classify anything I’ve been through as that, though I know others would disagree. 

In light of my recent post ‘recovery’, I’d like to be able to follow it up with a second post that looks more honestly at the shadows behind that word. In many ways, I think DBT (dialectical behavioural therapy) has actually been unhelpful to me. I feel almost as though the past year has taught me how not to cry, how not to react to terror and torment and so reinforced many of the lessons I learned as a child. My therapist, possibly not to her fault, actively discouraged me talking of anything vaguely traumatic and helped gloss over everything that is my life. This has helped me in some ways, it’s arguable reduced some of the ‘BPD’ symptoms (though, I am not sure if I have just made allowances for this elsewhere). The thing it really hasn’t helped me with, and if anything has pushed me further into the hands of denial with, is my PTSD. 

Post traumatic stress disorder. What a phrase. 

I’ve suffered this arguably since I was a child, though obviously I wouldn’t have seen it that way then and I still don’t really now. I have nightmares every night, sure. I have night terrors still, like a child and wake myself up screaming and fighting. And then there’s the day times. Every half step, something seems to trigger my memory and I find myself wincing or bracing to fight my way out. It’s exhausting. It sounds like something out of a movie, but it’s not. It’s really not. This is my life. 

I feel like I am trapped in my childhood, and that wasn’t a good place to be. 

So these are some of the symptoms DBT has not helped me deal with. These are the manifestations of a constant overflow of traumatic memories, one after the other flooding my brain and frying it’s circuits. 
What is it like to have PTSD? It’s exhausting. 

And what of the original trauma? 

Now that I have finished DBT, I am allegedly ‘robust’ enough to start dealing with it. I am not gloating in anyway, but I have ‘survived’ a childhood of abuse, neglect, homelessness but now after a year of DBT you think I might be robust enough – thanks. 

Anyway, so this means onward referal, which I am entirely grateful for. The downside being I must now try and share my story again. 

If admitting to having PTSD is hard, admitting to having been thtough any trauma is impossible. I just can’t do it. So I start scraping around the top of the barrel for some lesser, more acceptable memories. I need to portray to this team I am struggling, but my inner autos kick in and I simultaneously need to portray that I have never been abused in any way shape or form. 

So what does trauma do to you? This. 

It terrifies you to talk and terrorises you to not. 

Even the memories I class as lesser, the one offs, even they terrify me. And it’s only just dawned on me how freaking scary this all is. 

This is all I can share for now. Thanks anyone who reads. 

Recovery

I’ve not blogged for a while, and as such this all feels largely stretched apart. Day one of therapy to day 365 with only a few insights in between. That is certainly not how it has been.

Every session has changed my brain in one way or another, forced me to question something I had never even considered before. I still remember first joining a Dialectal Behavioral Therapy (DBT) group. I remember thinking it absolutely wasn’t for me. I remember reading everywhere that it was the ‘gold standard’ for borderline personality disorder and exactly what I needed, but it didn’t feel right to me. In the end, I was dragged along reluctantly by the NHS and my therapist.

Initially, I thought it was rubbish to be truthful. Mindfulness was the core and most difficult concept to grasp, and I suspect anyone reading this who hasn’t studied it for a prolonged period (or even may have) might agree that at first, it seems like utter sh8t. For me, I think the core of it is just being more present and for now, that is helpful. I do few specific mindfulness ‘skills’ but instead try and make my whole life a more ‘mindful’ experience, meaning I am more consciously partaking in my own life. See, I told you it’s a strange concept.

So anyway, this is titled recovery. Do you ever ‘recover’ from borderline personality disorder? I’m not sure that you do. In fact, I’d go as far as to say that for me, trying just to ‘recover’ from it, may conversely aggravate it. I think it will always be there, always be a part of me. Over the course of the year, I have been forced to accept that I have borderline personality disorder, BPD. I’ve been forced to accept its ways. And in an odd way, it’s been forced to accept me. The core dialect in DBT is the balance between acceptance and change. Me and BPD have had to fight head on for this. For every time I’ve had to accept that BPD ‘makes’ me lash out in rage (for example), BPD has had to accept that I don’t want to do this anymore. That I want to change. For every time BPD has had to accept that I feel happiness, BPD has had to accept that this might be okay (again for example). We’ve had to accept change. I’m never really sure if BPD has helped or hindered, supported or sabotaged. Whose side is it on? I suppose it has always been there for (or against) me.

Now I am on strange and unknown territory. I used to describe having BPD as walking a tight rope. Either side of me, was an abyss. If I moved to far in either direction, I would fall. And often, the abyss meant suicidal thoughts, plans or actions. You can imagine the fear. I fell from side to side into each abyss regularly, never really knowing how I got back out. Now, I do still see an abyss to the left. But to my right, is recovery. I stand facing it, my toes clutching at the surface. I know if I try to move to quickly forward now, I will offset my newly found balance and fall back into the abyss. But I know if I don’t move at all, I will never leave my tight rope. So I am trying to find my feet, I suppose. At least I am aware I have them now.

I no longer fear my BPD, nor it me. In the early fights, my BPD would ram into me with incessant force and pain and batter me while I whimpered helplessly. The first time I fought back, it seemed stunned. It fought me harder and I fought back harder until we both came to a form of impasse. Was my BPD trying to knock me down, or was it trying to teach me I was strong?

Now we just stand like two equals, looking at one another unsure what to do next. I have never not been scared of my BPD, and maybe it not me. I have never stood up straight before. I feel like I’ve had a transplant of so many organs during my year in DBT. My chest breathes freely and my heart ticks away casually. My stomach feels calm and knot free.  I feel free. My head is so quiet – how strange! There is a part of me that wants to reject my new organs for they are not as I recognize and do not seem my own but I think maybe I will take some time to get used to them and see how I go.

There is hope, and to anyone in the early stages of treatment or still fighting head on with their BPD, please do know this. I’m sure you know it already, otherwise you wouldn’t be here. Don’t just take my word for it, find your own ‘recovery’. Take whatever journey is needed. I hope your pain eases soon, you are strong. You might not believe me now, or believe that you’re capable of ‘recovery’ because believe me, 12 months ago I didn’t either. But you definitely, definitely are.

Take care.

“I think the saddest people always try their hardest to make people happy because they know what it’s like to feel absolutely worthless and they don’t want anyone else to feel like that.” – Robin Williams

The common cold: A mental health analogy

Trying to get people to understand what it’s like to have a mental health problem who haven’t been there themselves is often a frustrating ‘banging your head against a brick wall’ experience. Understandably, people find it a very difficult concept to get there head around and stigma and invalidating, ill-informed senseless comments still linger around mental health such as ‘just get over it’ and ‘stop being so selfish’ etc.

Imagine yourself having a cough/cold. Or the flu,what you percieve to be the flu. Fluctuating between being bunged up and that endless stream of tears and (to be frank) snot (where does it all come from?!). How tiresome life becomes. How hard simple tasks can be. To you, you feel awful. You don’t want to do anything but get better. That is your body’s insticts kicking in. Rest, please rest. I will fight this illness if you rest. 

Now try and imagine how other people view you. Have you ever heard people say it’s ‘just a cold’ or ‘get over it’?

Imagine how you perceive other people with a cold? A bit of you may feel sorry for them, but is there some part of you that thinks ‘We all get colds, can’t you just get on with it?’.

My point is, what you see from the outside, is rarely what it feels like from in the inside for someone else. A cold is obviously different, in that every one has had a cold. Hence the ‘common’ cold. So empathy is a little easier.

Trying to empathize with something you have never felt is near impossible. It works with physical illness too. I am fortunate enough to have never suffered from cancer, or a heart attack or a stroke etc. etc. I don’t know what it feels like to experience these, I can’t even imagine. BUT what I can do is listen. Not judge, I’ve not been there. Try and let go of my preconceptions. The closest you can get to understanding something you haven’t experienced is to listen to the words of someone who has.

Listen. Take it for what it is, not what you think it is.

‘Light at the end of the tunnel’

After ten years in and out of various therapies, I had two months of freedom. Two whole months. I had two months where the wicked monsters and demons of borderline personality disorder weren’t wittering in my ear, judging everything I did. It sounds silly, but I felt like I was part of the world. Like I was ‘in it’. I felt the ground beneath my feet, I felt the warmth, the cold. I didn’t react to it, I just felt it. I had an eerie sense of calm and quiet that allowed me to get on with my life for once.

It sounds great and I suppose it was. But two months in ten years feels a bit harsh. I couldn’t tell you what got me there. I keep thinking, if I could just remember the route I took I might find ‘it’ again. I might find wellness and I might stay there for a little while longer but it seems to have gone. And I just feel frustrated that I lost that path so quickly after finding it.

As a positive, one thing this experience has enabled me to see is there is ‘light at the end of the tunnel’. Sometimes the tunnel is so long and so dark we can’t see the light, but it is there. And that, I suppose, is hope. And I will hold onto that hope now whilst I navigate the twists and turns of this dark tunnel.

“‘I have to go back, haven’t I?’ said Harry. ‘It’s up to you’ replied Dumbledore. ‘I have a choice?’ ‘Oh, yes!'” – J K Rowling (Harry Potter and the Deathly Hallows)

The monsters inside your head

 

I stumbled across a post on a blog the other day that featured an artists interpretation of various mental health diagnoses as images or ‘monsters’ to be more specific. The drawings were wonderful and the idea inspirational.

I started thinking about monsters, an idea I probably haven’t considered in the physical sense in many years. When someone mentions the word monsters I often think of dark shadows and thoughts and feelings rather than a physical monster itself.

I had an image in my head of a few child- like monsters, I started to draw them out in all different colors. They all looked fairly non-threatening and bubbly albeit slightly ‘strange’ and ‘weird’. I initially had the image of a pile up of monsters and someone fighting there way out of them, but my imagination ran thin pretty quick and I was fair few monsters short of a pile up. So I gave them a rock, or an island, and left them all there instead. I captioned the image ‘friend or foe?’ unsure of how I felt about the presence of these monsters.

I then began to think about monsters inside someones mind, pulling at cables and wrecking circuits and pulling the person all out of sorts. This seemed fairly accurate to me and an image I’d like to have tried to draw. But those bubbly monsters just weren’t going to cut it here.

So, that is when this figure started coming into play. Originally I saw a man type figure with long hair holding dozens of reins in his left hand, all linking to parts of my brain and a whip in his other hand (as is in this picture). I then saw the man on a 6 legged creature similar to the one in the image holding reins over that, instead. I’m not sure how the man or creature are controlling the mind now, since they’re not actually attached, but I imagine they still are somehow.

I suppose the thing I like about this, is now the man can be removed along with his creature from the brain, where before he was attached.

The man remains faceless for one because I couldn’t decide what emotion to put on his face. But also because as I drew and rub out various versions of his face I started to see a blurred image of all occurring and I kind of liked that. It made me feel as though the monster was more universal and could be inside anyone’s head.

Black and white thinking

Today got me thinking about black and white thinking a lot. As one of the criteria for BPD, you’d think I’d have given it some consideration before given I carry that diagnosis. But I wiped it aside, presuming I didn’t do that or feel that as I do with most things. But then I was talking to my DBT therapist today about continuum’s and where people may stand in them. Specifically, she described one end of a continuum as people who trust completely and approach everyone with open doors. Then she spoke of the other side, where people become isolated and untrusting of everyone. I thought, yes, that makes sense. Then she added a bit, about the middle and said ‘it was probably the best place to be’. Where you trust people who earn your trust, and don’t the others. I guess you learn how to scale it for yourself and judge it. She said just because you’re in the middle, it doesn’t mean you can’t be betrayed. But even if you are, the affect of having trustworthy people around you may buffer the betrayal. This all kind of made sense to me.

I realised how rarely I thought of this middle ground. Hell, I’m not even sure I remembered it existed. I either love my job and it’s my world, or I hate it. I spend whole days participating in hobbies, or none. I exercise religiously and ‘excessively’ or I barely move. I do or I don’t. I can or I can’t. I’ve known I’ve acted this for a while, but I’ve never considered just how black and white it is. It’s never occurred to me that having a bad day at work doesn’t mean I should quit, up and go travelling or do something reckless and damaging. Things aren’t as black and white as that. Things aren’t just good and bad, there is a middle ground. I can see it now. It is possible to trust someone without trusting them with your life. To be a friend without being a best. This is strange territory for me, but I think it might be helpful that I have seen it.

‘I want you to listen to me very carefully, Harry. You’re not a bad person.[…] Besides, the world isn’t split into good people and death eaters. We’ve all got both light and dark inside us.’ J. K. Rowling.

Where to start..

‘That’s quite common with.. borderline personality disorder’ The words fall of my therapists tongue slowly and awkwardly. She watches me closely to see how I react to her words. I nod, knowingly.

Two years ago, a young doctor diagnosed me with borderline personality disorder (BPD).  He sat but a yard from me in his pristine shirt and tie, tucked neatly into his lined trousers with one leg bent at a right angle, balanced almost arrogantly on the other. I suppose trying to appear relaxed in this rigid setting. His face was sincere and agreeing.

I could tell as I spoke and answered his questions his mind was whirring at a million miles per minute, putting things together. Figuring me out. He was an intelligent man and when at the end of the hour he came to his conclusion, I actually felt a little relieved. He explained the disorder to me, he explained the feelings associated and referenced some of the things I had mentioned to him. The diagnosis fit where no other had before and actually made some sense to me. I nodded, solemnly, trying to hide the chaos from my face. I’d heard of the disorder before and I wasn’t sure if this felt like a conviction or an explanation at the time. He escorted me out of the room in silence, him pleased to have found a diagnosis and me weighted by it.

Now, two years later as my new therapist uses the word’s so uncomfortably, I realize just how alive the stigma still is. How reluctant even mental health professionals are to use the words, afraid of it’s implications.

I slip in and out of denial and acceptance so readily with this disorder. I know it is me, it fits like a glove. But the stigma drives me away from it from time to time. That frightens me. The disorder doesn’t, I am not actually ashamed by the disorder but society forces me into retreat and secrecy over my diagnosis.

‘Fear of a name increases fear of the thing itself.’ J. K. Rowling.