Frustrations of “positive thinking”

A million books (and quotes, and viral photos, and little inspiring trinkets) can educate you on how to “think positively” to make the most out of any given situation.  You can take deep breaths, you can chew each mouthful 32 times, you can feel the current of the air against your skin, you can embrace the moment, you can repeat, silently or out loud, any number of positive mantras.  And yet there remains a glaringly obvious hole in the theory.

“Thinking positively” will not actually get you out of a bad situation.  Sure, if missing the bus makes you feel like the world has ended, some breathing techniques and mantras and thought tricks might provide a temporary fix.  It will not help you to understand why a seemingly mundane event has caused such a drastic reaction, nor will it mysteriously re-mould time so that the bus was never missed in the first time.  But a plaster is better than nothing, at least until you can get the splinter out.

Which leads me to the point.  “Thinking positively” cannot bring a bus back to the stop you are now waiting at.  Taking deep breaths will not prevent you from experiencing excruciating pain.  Chewing 32 times will not cure you of depression. Feeling the air’s current is pleasant, but it won’t change your relationships with other human beings.  Repeating any number of mantras, silently or out loud, will not change your dead-end, minimum-wage, soul-sucking, alienating job and offer you the life experiences of your wildest dreams.  Life does not work like that.

If we are talking mental health symptoms and situations, “positive thinking” may temporarily (and yes, helpfully) remove you for minutes or hours from the feelings and thoughts you are experiencing.  Unfortunately, no amount of “positive thinking” and cognitive magic tricks are going to provide a permanent solution, nor will they actually address the problem beneath the problems.  Furthermore, mid-crisis, you most probably don’t need the added stress of thinking that you can’t even think right!  If you already know that your thoughts are not rational, you can’t fight them with rational thought, because you have already second-guessed what your “positive” side is going to say before s/he has had the chance to chant it.  It doesn’t make sense to think about your thinking when it’s the thinking about thinking that you think is causing you grief.

If we are talking other life situations (relationships, for example) then this “positive thinking” stuff can also be outright dangerous.  Take a person in an abusive relationship.  The advice should not be “concentrate on the image of the sea”, but “get the hell out of there, as quickly and as safely as you possibly can.”  No amount of thinking will save you from what is, quite correctly, perceived as a terrible situation.  Can you think your way out of poverty?

The “positive thinking” club puts the emphasis on the person experiencing the distress, taking away the onus from the contributing factors.  If you have had horrible experiences, and are told to simply “avoid triggers” or “count to ten” or “think about why this affects you so much” then you may feel as though you are being blamed for your own problems, which you did not actually create, having not actually chosen for yourself the horrible things you experienced.  You should not be focusing only on “thinking positively” but on processing and understanding what happened and experiencing the range of related emotions, which may or may not include an element of putting a positive spin on the process, but which certainly does not hold you responsible for your own pain.  Yes, the power to heal may be yours.  But if you are not able to wield it, it is not your fault, nor a sign of weakness or faulty thinking, that you have not yet healed.

Positive thinking, minus the scare quotes, can be an incredibly powerful tool.  This is particularly true when evaluating a thought that is influenced, not only by your mind/ thinking habits/ perceptions, but by your environment.  It can be very positive to learn to accept your body in a culture that continually tells you (most especially if you are female) that your body is somehow not up to scratch.  It can be positive to remember that worth is not measured by productivity, and productivity not always measured in physical output, in a capitalist society.  It can even be positive, despite my earlier sarcasm, to learn to focus on the small and the quiet things, to remember that in any given moment, nothing is usually especially wrong.  But you need to balance this with honest evaluation of what your actual situation is, and how you can make actual, real-world, literal, not Snap-chattable, changes if you need to.

 

Misconceptions

Recently, someone I know to be an otherwise compassionate and intelligent person made a comment that seemed to be minimising the seriousness of Bipolar II. The comment itself is not really important, and it’s possible that I read the tone wrong (although I did not mishear the content). The way it was made reminded me of a friend I once had who dismissed bipolar as a “casual illness.”  It wasn’t that the comment was made in an unkind way; it struck me as uninformed.  This surprised me, because it was not said by someone I would expect to be uninformed, and not said by someone I have known to be dismissive; yet the comment was both.

Essentially, the person suggested that Bipolar II is not a “serious” illness and doesn’t cause “severe vulnerability”, as compared with other illnesses which are much harder to “recover” from (my thoughts on “recovery” are available here and I believe, and have seen, that people can and do experience recovery from and within all sorts of illnesses, even those deemed most severe).  I hear this kind of thing a lot: “just” depression, “just” [insert any number of illnesses].  But in my experience, “just” depression, “just” Bipolar II, are things that can actually kill.  As in, quite literally, cause death.

What I wanted to say/ should have said/ didn’t say to this person, is that I don’t have the luxury of taking bipolar lightly. On more than one occasion, I have almost lost my life because of it.  On more than one occasion I have lost friends, jobs, opportunities, because of it.  I will probably be taking medication for the rest of my life.  I will always be sensitive to the changes in my mood, the way a sailor learns to be sensitive to the wind.  I cannot afford to take any period of wellness for granted, and  I can’t afford to be flippant about it.  If you can, then count yourself lucky, and educate yourself on the topic before you say something.  (The person, by the way, did acknowledge that there were things that s/he didn’t know about bipolar/ depression.  Which is absolutely fine, most people are not walking medical encyclopedias.  But if you don’t know something, it is probably better to do a superficial google browse before dismissing as casual the illness of a person you know has that illness, in front of that person).

I know where I’m fortunate, by the way.  I know that (especially at the moment, not being consumed by any particular mood) I am lucky, and I have zero interest in playing a game of comparisons.  I am also aware that some people are impacted much more severely by bipolar (I or II) than I am (currently).  My point isn’t that my particular mental state, at this particular time, is better or worse than that of anyone else.  My point is that it isn’t the name of the illness that should shape your perception of it.  “Personality disorder” or “bipolar” or “schizophrenia” or “PTSD” are all different conditions.  The severity of each varies from person to person- not necessarily from diagnosis to diagnosis.  No two people, with the same diagnosis, will be impacted in the same way by it.  People can and do have periods- even long periods- of stability within the trajectory of their illnesses of any kind.  Some illnesses have higher “recovery rates” than others, some have lower “relapse rates”, the likelihood of recurrence varies.  But you should never put the word “just” before anything.  It disrespects the experiences of the person with the problem.  It makes you look like you don’t really care.

Where Stigma Lies

When I was perceived by psych services to have EUPD (BPD)- and I say perceived because this was never a formal diagnosis; rather, it was the perception of some nurses based solely on their experience of my self-harm- the way I was treated was disgusting.  I was occasionally refused treatment, being told that “hospitals are for really ill people.”  I was told that “if you were really suicidal, you wouldn’t have told us/ you would have done it by now/ we couldn’t stop you.”  I was called an attention-seeker, to my face, by a nurse at A&E.  Add to this the pervasive and deep-rooted opinion that being “just” an “attention-seeker” meant that all attention should be withdrawn from me, and we had a real problem on our hands.  To me, that problem was the brick wall I faced trying to make myself heard.  To them, that problem was me.  To them, self-harm was the only tick-box they needed to fill, to slap on me a diagnosis of which I actually had almost none of the other symptoms.  And to them, having ticked that box meant that they could rest easy in the knowledge that They Had Done All They Could Do for someone for whom (they assumed) nothing much could be done.

I heard a “joke” once, one of the very unfunny variety.  “How do you treat a person with BPD?”  “Refer her.”  This is offensive in so many ways but it does capture the sense of walking in and out of a revolving door that I experienced, and that I know is experienced on a daily basis by people with a diagnosis of PD.  I see this played out on my Twitter feed, on my WordPress reader, and in conversations with people in my day-to-day life.

Someone tweeted recently that the names of personality disorders basically just list things we don’t like (emotional instability, narcissism, antisocial-ness) and create diagnoses from them.  I read once, I don’t remember where, a psychiatrist admitting that “diagnosing a person with personality disorder often means there’s something about them that you don’t like, but you can’t put your finger on it.”  This is part of why there is such a negative perception of people with diagnosed personality disorders among professionals.  It is also why I think it is important to pay attention to the language used when talking about mental health service users.  The stigma is in the language.

It’s also not OK to (randomly) decide that a person needs to meet 5 criteria to fit a diagnosis, but then base their diagnosis on just one of those (in my case, this was self-harm, I know others have different experiences).

And please note that I in no way mean to minimise the experiences of people who have a diagnosis of PD, with which they actually agree.  I’m not saying that PD isn’t a “real” diagnosis.  I only mean that we need to seriously think about how and why PD is diagnosed, and what it means for the individual in reality.  If PD is used as an excuse to withdraw help, rather than referring to specialists for help, then it is not a helpful diagnosis.  If people with PD continue to be stigmatised because PD is seen as something we (a) can’t change, (b) don’t like and (c) would rather not pay attention to, then we have a serious problem on our hands.

We have a serious problem on our hands.

 

 

From the Inside Out 

​Today, not for the first time in my life, I walked through the doors of a new CMHT.  This time it felt different.  Over the last year, through work, I have experienced these places in a new way, from the perspective of supporter rather than supported.  I have marched into meetings where I have felt comfortable to sort through information about the lives of others. I have learned to feel confident about advocating, discussing.  It took a while to recognise emotionally that I was not the one under scrutiny  (at least not in the same way) but once I did, I found myself able to enjoy working in this new capacity.
Today I found myself back in my old position, in an attemptedly happy waiting room with an assessment looming over my head.  I envisioned my colleagues watching this scene unfold and was overcome by the oddness of it.  I was led by a kind, bright person into a small room where I was asked for what felt like (and may have been) the fiftieth time, to go through the details of my life, starting at birth. 

I noticed as I spoke how easy it is for stories to vary over time.  Stories about yourself are never objective.  They change according to your thoughts and feelings at the moment of telling.  I felt suddenly terrified that I would get it wrong- how can you get your own story wrong?- that I would somehow forget something crucial or remember something vital but hitherto unmentioned.  It went fine.  The decision was made that, as I generally function fine, I require no intervention bar perhaps a medication review.  I should receive an appointment in the post sometime next week. I was congratulated on riding out my crisis, on my long-ish stint of stability, my ability to see past myself.  I told the kind, bright person that I liked her necklace.  I left.

The whole experience was like walking through a mirror or going to a country where people drive on the other side of the road but nobody thought to tell you.  Quietly unsettling.  For a year I have walked in different shoes.  Today I put my old ones back on and remembered what it is to be on display in a glass case- no- to be a glass case yourself and have someone look through you, shine a light, open you up. 

It felt incredibly strange. 

It felt like a new injection of empathy.

People

A few years ago, I got chatting to somebody on a mental health forum online.  We exchanged poems and kind words and, in an online-only kind of way, we became almost close.  I didn’t hear from her for a long time.

Yesterday I chanced upon the site where we met whilst looking for old poems.  I posted a message on her last thread to ask how she was.  I received a message from a moderator to let me know that she had passed away at the start of this year.  From the messages posted, I can more or less conclude that she died from suicide.

I feel so sad.  Although I never got in touch for such a long time, I did think infrequently about her and wonder where she went.  It seems I only just missed speaking to her again, though this year is already halfway in.  All I can do is hope the best for her loved ones.

*

Recently, I made over 700 followers on this blog.  It feels amazing to have reached so many people.  Twitter, too, is proving fruitful in terms of furthering the small online mental health community I have around me.  Because that’s what it is, what we are: a community.  We look out for each other.  Drop messages.  Tweet across the Atlantic.  Pop cyber-hugs on the end of blog posts when we don’t know what else to say.  It is something I feel privileged to be a part of in my small way, something I am proud of.

Today’s sad news makes me all the more aware of how real the people are behind their words.  How concerned we should be, how we should look out for each other.  That’s why the mean comments about attention seeking upset me so much before- you never know how much sadness is really lurking behind another person’s seemingly throwaway words.

So this is a sad post, and a happy one.  I am happy to have known that person.  I am happy to be in touch with all the people I have come into contact with through WordPress, through Twitter, through whatever other sites.  And I am grateful.  But I am also very sad.

 

Triggers and Strengths

I have been more sensitive recently.  More easily hurt, as though I were covered in small wounds and other people were salt.

As a consequence of this, I have found more things triggering.  I can’t shy away from those things that trigger me because it is my job to deal with them.  So I have struggled at work, struggled to listen to the high emotional frequency in the air, struggled to listen to the ache behind other peoples’ words.  Struggled, in truth, even to get up in the morning/ afternoon (shift-dependent).

Things happen at work that inevitably trigger me because I have shared experiences with others.  Because others are not always as empathetic as I try to be in dealing with the problems faced by residents.  That hurts me because I think of how they would perceive my own struggles and I know, overwhelmingly, that their perceptions would be negative.  I become angry, I fight not to become jaded.  It’s hard.  every.  Single.  Day.

A GP prescribed an antidepressant to which my mind and body reacted very badly (I looked/ felt too stoned to go in to work), so I am waiting for a referral to the psych services of North West London.  They said it will take about a month.

Along with this have come negative thoughts and feelings, inwardly directed.  I struggle with this becomes I am no good at this.  I am triggered becomes I must act on this.  Sometimes my thoughts are loud enough to wake me in the night.  Sometimes I drink to blot them out, only to find they become more insistent.

I am coping but I am not coping well.  My coping strategies are not healthy ones.  My thoughts are not always reasonable ones.  My attempts to thwart the thoughts are often thwarted.

I drink to drown the dreams that died of drink, is a thought that cropped up in my head one day on the Tube.

And so, I have been trying to come up with something positive.  This is what I have come up with:

I am strong.  I may not feel it (I often don’t feel it) but I am.  I have an unwavering drive to survive, despite not wanting to at times.  I make efforts to stay safe, even when staying safe seems the least viable option.  I struggle… but to struggle is better than to give up.  I think of all the times I “failed” to die and try to see them not as failures but as successes: I am alive.  That is beautiful and I cannot dispute that.  I think of the relationship I am in, of how wonderful it is, how I have fought to maintain it. I block out the memories of past disasters, to be dealt with a later time.

So for all that I feel weak by being triggered, and by hearing the thoughts that call me useless and pathetic, I have to remember that to mainly resist the triggers takes a strength I do not always realise I have.

I need to try to hold onto that.

More Attention Seeking 

Yesterday, my colleagues,  myself and some people from other services went on Self-harm and Suicide training. It was both easier and more difficult than I thought it would be. Easier,  because I wasn’t triggered and at no point did I feel I needed to leave the room.  Harder,  because the opinions expressed hit the nerves I knew they would.
“It’s attention seeking,” they said, referring to superficial wounds and people  calling ambulances, “pure attention seeking.  But you can’t say that to them, of course.”

Later on, I made the point that negativity is often associated with self-harm because of these very opinions.  It was a bold move and one that could have left me exposed.  But I felt it was the right move.  Almost exactly fifteen minutes later? “Attention seeking,” a colleague repeated. “That’s all it is.”  I sighed, though not audibly.  Sighed because my opinion meant nothing.  Sighed because, despite the trainer’s best efforts, this simple point was not sinking in.

The trainer herself made one grave error that made me shut off for a while.  “It’s common for people to say that people who really want to kill themselves don’t talk about it.   And that’s true…”  I was amazed.  This smart, empathetic woman cited the samaritans frequently- and yet ignored one of their major bustings of a harmful myth.  My colleagues looked pleased with themselves.   See?  I could hear them thinking.  Attention seeking.

I could have raised my hand and called her on it but I didn’t.

Sitting in that room with me, I know, we’re some sensitive and empathetic people, as well as several that had lost a loved one to suicide.  I wondered how they felt about these opinions.  Wondered if they were offended, or if they had quietly grown used to the myths and unpleasantness bandied about by others.  I have never lost a friend or relative to suicide and I cannot imagine how they must have been feeling in that moment.

What I do know is how I myself, having been a self-harmer and attempted/ planned/ seriously considered suicide,  felt.  Hopeless and angry and saddened.  Their thinking was beyond my understanding.  I didn’t want to scream or shout as I have at other times and this itself concerned me.  Have I resigned myself to the fact that to communicate the reality of self-harm to these people is futile?  Have I become inured to their way of thinking?  In becoming so, have I absorbed some of it to the point where some of my own empathy may ebb away?  I hope not.  I have built my image of myself on empathy, and to have it challenged was all but infuriating.

If I rolled up my sleeves and expressed these feelings, how would they react? “Oh we didn’t mean you,” they might say, through teeth gritted with disgust or embarrassment.   “You’re not an attention seeker.  It’s them.”  Us and them, us and them.  Again and again.

So I kept quiet and I believe my decision was wise.  But in this blog and among my friends and even to strangers, I will continue to fight for a greater understanding.  I need to believe that these negative perceptions can be overturned.  I am not sure that the greatest problem facing mental health service users is stigma (there are budget cuts, for example).  But it is a big problem,  a problem which in itself leads to violence,  inadequate care and shame.  I do not exaggerate. So yes, in my life,  I continue to fight and as I reach out to my audience I will battle against the stigma I faced today.