Connections

Next week will be my last two days of work.  I work at 2 services, as a mental health worker; in one, I have already had my final day, last Thursday.  In the second- the one that I started at in 2015- the 25th will be my last day.

2 services.  16 people in each.  32 people.  32 people I will, most probably, never see again.

In 2 years, seeing people nearly every day, you get to know them.  Despite all kinds of ideas about detachment and boundaries and so on, they get to know you pretty well too.  Maybe not about the ins-and-outs of your life, maybe not about your family, maybe not about your favourite pub.  What they do see is probably something that cuts through all those things, straight to the chase: your style of being.  What I mean by that is that every individual has a series of styles: a style of talking; a style of moving; a style of expressing; a style of interacting and connecting.  If you are a fairly transparent person, then the style of being people (at work) see is most probably the style closest to the one you use when you are out-of-context, in the world, in your life.  When I said that I was leaving, people I have been supporting told me things about myself that I hadn’t noticed, about the way that I interact and the way I behave.  I was surprised, but I shouldn’t have been.  Why should insight be only one way?

It’s strange to be leaving.  This time last month, working in those two services had worn me down to the point where even the one month’s notice I had to give seemed like too much to work through.  And yet, on Thursday, I found myself in tears.  16 down, 16 to go.  Excluding coincidence, like I said, that totals 32 people I may never see again.  32 people whose names I will try to run through in my head so I don’t forget them.  Some whose names I might anyway, one day, forget.  Who will also forget mine.

I wrote each person a personalised goodbye message.  Some were easier than others, some more thoughtful than others.  One person told me she will stick hers to her noticeboard.

One week from today, I will be out of both services, for good.  Something I have been wanting for a long time… something I have been vaguely dreading for a while.  Off into the unknown- but everything’s unknown until you know it.

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.

Ways to Higher Ground

I haven’t posted to this blog for ages.  In fact, I haven’t written at all for months.  Truthfully—because I aim always to tell the truth here—I have been stuck in the realm of negativity.  It sounds odd (or melodramatic) but even the weight of a biro between my fingers has felt like too much of a responsibility to bear.  And so, at least in terms of the written word, I have stayed silent.  Or is it better to say, invisible?  For a long time, as a kid, if you’d asked me to choose a superpower I would have asked for invisibility.  But in the real world, outside fantasy, for me, that isn’t possible.  Whether or not I feel seen, my actions have consequences and impacts that ensure I am perceived.  It is up to me, like it is up to everyone else, to try through those actions to shape positive impacts, worthy consequences.  One thing I do that I know has some small impact is this blog so, in the spirit of growing visible again, I want (for the first time in months) to write.  To write honestly.

In the realm of negativity, I felt I encountered a split path.  “Two roads diverged in a yellow wood/ And sorry I could not travel both/ And be one traveller, long I stood” (Robert Frost).  I have stood here a long time.  Except, unlike Frost, I saw many splits in the path and for all I squinted through the yellow wood, I couldn’t see past the trees.  I still can’t.  I recognise (and thank) the fact that I have so many choices in my life.  But choice can also be overwhelming.  I feel overwhelmed.

I’ve always been a “big picture” person.  Take the mundane example of housework: I often feel like things are done when other people can (apparently) clearly see that they are not.  I notice the general gleam.  Others notice the smudge on the skirting, the dust in the corners.  It has its benefits and its drawbacks, this big picture view.  The thing with being a “big picture” person, is that you learn to see the picture even when there is none.  It’s a bit like doing a jigsaw puzzle.  Even though large chunks may be missing and the image may be fragmented, you know that this is temporary and so you hold in your mind a vision of the image that should be there and disregard the pieces that aren’t.  This is uplifting in some ways.  It lends hope because you know that no matter what, all these pieces (even the missing ones) are part of something greater.  On the other hand, though, it is impossible to go through life simply not noticing that there are vital things missing from the picture.  When you step closer, you notice the flaws and they can floor you.  That’s how I’ve been feeling.  Floored by flaws, unsettled.  A person without a plan.

I’ve been here before, in this wood with the diverging paths.  I’ve been here so often you’d think I’d have built a treehouse by now.  But I haven’t, so is it a wonder I feel exposed?  Is it a wonder I have the sense of having failed?

That’s it, though.  The old clichés, the crappy Facebook memes, are true: if I haven’t given up, I haven’t failed.  I almost gave up.  In almost doing so, I could almost have lost everything and yet… here I am.  Standing on shaky legs, sure, but standing nonetheless.  It’s bleak sometimes, it’s dark sometimes, it’s hard always, but I’m here.

I wasn’t going to write.  I was going to stay invisible.  And then, last night, I was giving another person subtle advice and as always when giving another person advice, it felt easy.  There’s time to figure things out, I said.  It’s not over, I said.  Nothing is ever perfect, I said, but that doesn’t mean things can’t be good.  It doesn’t even mean they can’t be great. I looked at someone else’s tangle of paths and I saw a multitude of futures in them.  It would be hypocritical, then, to look at my own and see none.  Really, I still can’t see my own clearly.  I am exactly as lost as I was before.  But there are ways out (compasses, maps, guidance).  Ways to higher ground from which, I hope, I will be able to see the bigger picture once again.

Hopeful

Looking at my WordPress stats over the last year, I can see that one of my most popular posts is the one in which I give the number on which you can text the Samaritans.  The Samaritans are a telephone listening service in the UK, often associated with suicide prevention.

Every single time I get a view on that post, I feel hopeful.  Hopeful that it has helped someone to reach out.  Hopeful that someone, somewhere, has been able to contact the Samaritans in a way that they feel comfortable with.

I know there are pros and cons to calling or otherwise contacting a listening service.  I know it sometimes helps and sometimes doesn’t.  I’ve both worked for one, and called some.  But sometimes the very act of reaching out can let you feel less alone.

I know some people who read my post will never pick up that phone… but some will.  I hope that they find what they need.

Addiction

Often, we are taught that addiction is something intrinsic to a person’s personality, to their nature and identity.  This is why the Twelve Step programmes refer to the stock character of The Alcoholic or The Addict, having defining characteristics that can be recognised by all people undergoing similar struggles.  In other words, a lot of the time addiction becomes not a behaviour, but an identity.  As an identity, it is harder to shake.  If you are, for example, an alcoholic, your behaviour will always be informed by this identity.  You will, as the literature states, never be able to drink “like a gentleman.”  Your character itself prevents this from being a possibility because it is a trait of your character that you will lose control after the first drink.  At least, if you’re a “true alcoholic.”

I am going to make a controversial statement here.

I was an alcoholic.

For many years, I drank to excess on an almost daily basis.  So often that I can actually count instances in which I didn’t drink (the time I had labyrinthitis, for example).  My behaviours were certainly those associated with alcoholism: I lied about my actions; I drank to excess; I lost control.

But I got better.

How I did this remains a mystery to me.  It’s as if one day I was tee-total through complete fear of the consequences of my drinking and the next… I wasn’t.  It wasn’t easy.  I had several “benders” when I went back to drinking at first.  I put this down partly to the addiction model itself: as I had been told I would lose control, and believed I would lose control, I did.  A self-fulfilling prophecy.  I also put it down to the fact that I wasn’t fully well yet.  In time, though, my behaviour changed.  I am able to drink in moderation- and I say this in all honesty, not lying to you, not lying to myself.

I know how much the disease model of addiction helps people.  I am not even denying that it is real. I only know that for me, it proved to be untrue: there was a way back.  This may be rare, but it is true.  Perhaps I was never a “true” alcoholic- but I fit all the criteria for one.  What I see now, is that it was behavioural.  An entrenched behaviour, sure, and an almost impossible one to modify.  But it wasn’t impossible.

I understand why some people never drink again.  I see that as a success story.  But for me, learning moderation was a major success too.

 

 

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.