Punishment

Two people (real people, but I can’t give details) were talking about the mental health system.  One mentioned that hospital had felt like a punishment, and the other took that literally.  “Oh,” she said, turning to me.  “I get it.  So hospital is like a punishment for the ones who don’t get it.”  I explained that hospital is for people who need more support than can be given in the community.  After several explanations she “got” it and I felt relieved.

And then I remembered.

I remembered how much, at the time, hospitalisation felt like a punishment to me.  That purgatorial state.  The way the nurses and doctors could be unkind, dismissive.  The way that I often felt I was there because “nothing else could be done” with me, that I was there because there was no chance of me getting better.  The loneliness, the restrictions on when I could see the people I loved, the constant pumping of medication I didn’t want (and didn’t think I needed) into a system undernourished by depression.  I could see why she thought it was a place for the hopeless ones, the last-ditch-attempt ones, the ones who were effectively being punished for being unwell.  Because at the time, that was exactly how I felt.

I saw through my own arguments, how weak they seemed in the face of the facts.  Even though hospital is a place for “getting better”, it definitely doesn’t always feel like that.  I understand why she took that comment literally, and I wish I didn’t, and I wish she didn’t have to.

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Predestination

In an alcohol support group once, I heard a woman say that her daughter seemed like she would be “one of us” when she got older.  Her daughter was six.  She had, said the woman, “all the tell-tale signs.”  None of these included interest in alcohol, or any signs of addiction to anything else, from video games to jam sandwiches.  No; it was obstinate behaviour, wanting to have her own way a lot, being selfish and thoughtless.  Things I would have thought fairly normal in a six year old, and better dealt with by telling her off/ encouraging better behaviour, than by labelling her a premature alcoholic.  Yet this woman genuinely believed that her daughter held the seed of addiction within her, and would grow up to be like her mother.

I’m well-versed in the fact that addiction can repeat through generations (whether through biological leanings or learned-behaviour) so I’m not saying that it was wrong or stupid for this woman to have concerns about her daughter’s future well-being.  I am saying that, in structuring the idea of The Alcoholic as this person with specific and immutable characteristics (which could actually be possessed by anyone, and to varying degrees), she was attributing to her daughter a serious problem that the girl could have no way of knowing whether or not she had.  All because she was stubborn about the kinds of toys she wanted to play with. I can’t help but wonder if, by reinforcing (explicitly or implicitly) this kind of negative perception of her daughter, the woman might end up producing self-doubt in the girl before any signs of a problem are present.  Prevention is better than cure, sure, but there are better ways to prevent than to scare-monger and to stereotype.

This was not a solitary concern- others nodded, agreed, and shared similar thoughts.

This is one of the reasons I stopped going to such groups.

Echoes

I’m going to talk about something.  Something I haven’t spoken about on this blog (or in many other spaces), and something I won’t go into detail about, for many reasons.

In my past, I have suffered trauma.

This is the case for many people who experience mental illness, and for many people who self-harm, and for most people who are female.  Between the lines on this blog it probably won’t have been a stretch to imagine.  I haven’t spoken about it for the same reasons I haven’t spoken about my recent bout of mental ill-health much: the desire for privacy; the worry about who might read it; and yes, the (undeserved) sense of shame.

One reason I have so rarely (if ever) spoken about it with mental health professionals, is that I am scared.  I have noted again and again the stigma and unhelpful treatment that comes with certain diagnoses and the fact is, the diagnosis I am talking about (BPD/ EUPD) is very often associated with trauma.  Like the self-harm, it feels like another box to be ticked to label me with something I genuinely don’t think I have.  It is sad and unfortunate that this fear would render me silent, but it is a fact.  Like everyone, I don’t want to be misunderstood, and the sad truth is that asking for someone to understand would be likely to trigger the opposite reaction.

Another reason is that in the past, trying to discuss it has flooded me with long-lasting distress, destroying my ability to cope and to keep myself safe.  At the moment I am actually working through it, and I am trying to do so slowly to avoid such a back-slide.  I wrote a little about the feeling of doing so:

Breath catches in throat
over sharp bones
of baby birds, no,
the sharp bones of the words
I don’t flesh out.

Supposing they grew into fledglings.
What then?
Little fledglings of stories.
I’d be choked on the fluttering wings
of the things I don’t say.

These little fledglings of stories, though, are what I need- one day- to let fly.  At least, this is the narrative we are told. That talking helps.  That it’s Time to Talk.  So this is what I am doing now- talking, trying to be brave.  (By the way I don’t think talking always= bravery.  There are reasons for speaking or not speaking that have nothing to do with courage.  There is often bravery in silence, too.  But this is my attempt).

I feel exposed now, having written this, and I can’t be sure of the wisdom of posting it, or whether I will leave it up.  But like my other recent post- about feeling unwell there is something in me that wants others to know that they are not alone.

We are taught to minimise pain, because things are always worse for someone else.  We are taught to feel weak when we express it.  We are told that we can move past it, get on with it, forget it, sometimes even by those who have been through it.  But we are not selfish, we are strong, we are not wrong if we can’t bulldoze our way from past into future paying no regard to the events that shape them.

I tell myself this and will keep doing so until I feel it.

 

Progress

I used to keywork a guy- a young guy- who became increasingly chaotic and difficult to manage in terms of behaviour.  Eventually he was moved away from where I was working and into a different service.  Yesterday, I bumped into someone who works at that service.  She said he is doing really well, and that he started college on Tuesday.  It made me really happy to know that things are good for him, at least to the point where he can do something like that.  People progress, we should never forget that.

Truth-telling Time


I promised to be honest on this blog, a long time ago.  So here’s the truth.  I’ve been going through a hard time lately.  Various mental health symptoms have shaken every part of me, to the point where I’m not sure where my outline is.  Though I hate to admit it, I need the medication I refused to continue taking back in January.  I’m “welcoming” back the sleeping pills, the medication, the visit to A&E, the interventions I’ve been avoiding like an actual plague (bubonic/ zombie-creating/ whatever).  I’m torn (again) between these two things: (1) the medication may make me less like myself but (2) I can’t be myself if I’m not really surviving.  If I actually, literally, don’t survive.

I haven’t blogged because I feel like a hypocrite, who gives out advice about how to cope with mental distress, but actually refuses medication and becomes really, really unwell.  And although I’ve spoken again and again about how mental unwellness is “nothing to be ashamed of” I have been deeply, deeply ashamed of having fallen back into the trap it has laid me.  I feel like a total mess.  I have some great support around me, and without that support, the place I’m in would be a million times darker, even though that feels impossible.  I’m exhausted but I’m fighting.  I don’t have some inspirational sentences to draw from that, because I’m not inspirational.  I’m just medicated and moody.  Needy.  It’s an embarrassment I can only overcome enough to write this because even though it’s rubbish, I’m hopeful someone, somewhere, will feel slightly less alone because they feel like this too.  Even that seems unlikely right now.

 

Peace & love.

Basic Respect

Recently, I had to go to the GP for some mental-health related stuff.  I went with my partner, for moral support.  We both introduced ourselves and we both explained who we were.  Soon after she realised what the appointment was for, however, the doctor began addressing my partner instead of me.  I drew her questions back to me, but it annoyed me that she clearly thought I wouldn’t be able (or willing?) to speak for myself.  Of course, I understand that when you bring another person into an appointment, it may well be because you aren’t comfortable/ confident to speak… but it shouldn’t be assumed that you just can’t.  Even when I had made it clear(er) that I had things to say, she continued to check basic details and actual details of symptoms with my partner, without actually asking me first.

In addition, the doctor asked the same questions over and over again- perhaps she was uncomfortable, or perhaps it was her way of getting to the bottom of it, or perhaps she had had a long morning but the experience was extremely frustrating, particularly given that not all of the questions were pertinent to the situation at hand.

Eventually some progress was made and I have to stress that without support, I would have left that office without a single plan in place.  I also have to note that the GP for her job, asking a colleague for support and realising (eventually) that something needed to be done.  

I just wish sometimes that people understood that mental health doesn’t prohibit a person from describing, explaining, or advocating something for themselves.

Identify?

Once when I was in hospital, a doctor (or nurse, or someone, I don’t recall exactly, I was ill) asked whether I “identify” with my bipolar diagnosis.  Later that week someone else said “I can see your diagnosis is something you  really identify with.”

I have really mixed feelings about what it means to “identify” with a diagnosis.  I know that psychiatry is not an exact science, so there is guess-work and a subjective sense of what fits where, and how.  So yes, in a sense, I do identify with the diagnosis of bipolar.  I recognise in myself the highs and lows, the behaviours, thoughts and attitudes that come with them.  Textbook.  And the acknowledgement of this, of my recognition, brings some positive results with it: more helpful prescriptions, a framework for treatment, and (the usefulness of this is underestimated) a logic within which others can read me.

On another hand, even if psychiatry is aiming at a pinata in the dark and hoping for a lucky strike, I’m not sure a diagnosis should be something you “identify” or “don’t identify” with.  Certainly, I can say when something doesn’t feel right to me.  If someone diagnoses me with an illness whose symptoms I cannot recognise in myself, I can definitely make the case for this not being my diagnosis.  This will hopefully lead to the results I mentioned above, re: treatment.

But some people don’t “identify” with their diagnosis- nor do they necessarily identify with any.  The pressure to hammer square symptoms into the round holes of diagnoses can lead to counterproductive outcomes.  For example: over-diagnosis of some conditions because some of the symptoms fit for many people and there’s nowhere else to put them; diagnosing people with an illness of which they have only one or two symptoms; abandoning hope for some people, assuming that their lack of place within the rigid structures available means that they have no illness at all (and that because of this, the symptoms of the now-non-illness need not be taken seriously anymore).  Not everyone “identifies” with a diagnosis, but that doesn’t mean nothing is wrong.

In addition, while I understand that psychiatry is inexact and sometimes a blunt tool for a fine operation, I think if you are going to use something as medical-sounding as “diagnoses”, you can’t afford to put that much emphasis on “identification.”  Nobody “identifies” as having a physical health condition.  And no, physical and mental health conditions are not the same- despite what people say, they are often not even similar- but if you are using the same language, giving the same weight to the same words, you need to have something behind those words.  Something that doesn’t just depend on whether someone “feels” like you might be right.

I know I have written before about how I “have” rather than “am” bipolar.  It might not seem like an important distinction, but the point I was making at that time was that recognising the signs and symptoms of an illness within yourself, doesn’t mean that these define you.  They may be important and have a big effect on shaping who you are, but this doesn’t mean that they are all you are.  The diagnosis, the illness, isn’t necessarily intrinsic.  But something not being an identity in and of itself, doesn’t mean that it isn’t tangible in real terms.  For example, I don’t think of myself as “identifying” as a lesbian.  I just am one.  It’s not something I picked and chose to call mine, like being a goth or an emo or a banana or whatever.  It’s something I consider intrinsic and ingrained, which would exist regardless of my own understanding of it (whether cultural or personal).  In the same way, I don’t think bipolar is something I “identify” with.  It’s something I think explains a lot of my symptoms, and for me it is a useful framework to work within.  However, this exactly the reason that I don’t think of it as something I identify with.  I have it, or I don’t.  The diagnosis is useful to me, or it isn’t.  The language of identification doesn’t belong in medicine of any kind.  Not from the same people who, when you “identify” as mentally healthy, take this to be a symptom of your illness.  No.  You can’t identify your way in or out of a problem.