Saturday, 11 October 2014

Day of the damned

Every other month seems to be 'National Toadstool Height Preservation Month', 'International Rat Fancier's Heart Health Month', or 'World Month For Outie Bellybutton Support'. We have weeks and days too - 'Ticking Clock Annoyance Awareness Day', 'Adult Lego Rights Week', and 'There's No Shame In Using An Electric Toothbrush For That Week'. 

I'm always shocked when I find out the event I've been helping to organise is in aid of one of these elected time periods - mainly because I never remember when they are, nor do I understand what they do. Wouldn't just walking through the streets shouting "Mental illness!" Have the same effect? Well, perhaps that depends on where you live. I simply go ahead and shout about things I believe need to be heard, whenever the hell I feel like it. It works for me, and it makes it a lot easier when it comes to diaries.

I've been actively trying to defeat stigma for what seems like forever. Back in the late nineties during an ill-advised pseudo-rebellion, I walked through the high street of my village in rural Somerset with my scars on show - it was summer, I wasn't about to stay covered up to pander to anyone else's squeamishness. Of course I hadn't quite prepared myself for the inevitable staring and loud enquiries of young children, who thought I'd obviously had an accident involving a lawnmower, or that I had a particularly feisty feline friend. I felt shamed that I'd exposed innocent young minds to something I didn't even understand myself yet. 

It's odd when you think that I'd spent the first six months of my serious cutting hiding it for all I was worth. Tubigrip was my friend, and I could blame it on the tendonitis I'd got from too much violin playing. But a couple of times I'd slipped up, and being that my mother was alarmingly astute despite her inherent skill in appearing distant and disinterested, she busted me. I think by that point I'd started to almost want someone to find me out. 

Once the cat was out of the bag (please excuse me, I can never resist a play on words) I lost all of my ability to care about other people seeing my cuts. On many occasions I turned up to the pub where my underage companions and I drank on a daily basis with open wounds I hadn't bothered to even dress. My GP made me visit the nurse at my local surgery weekly to at least try and avoid infection, and I'm sure they thought I was a lost cause, such was the look of pity I got at each visit. 

During this time I met another cutter, who acknowledged me but we never discussed it. She never let anyone see her arms, but we all knew. I remember thinking "But this isn't a thing, is it?" Because I genuinely didn't know anybody else did it. I was hooked on the high, the release, the sense of strength it gave me. I disliked her at first, because she unintentionally made me feel inferior by having more than me. A prime example of just how messed up it all was.

I only recently found out (well, just now actually) that there is a 'self injury awareness week', and this led me to thinking what that might consist of. Is it a day when the self-injurious throw away the bandages and run naked through neighbourhoods the world over? Should we wear our scars like the badges of honour and bravery they sometimes feel like? Are parents suddenly less likely to wrench their toddlers out of our paths in Tesco? I'd imagine not. It's never going to be an acceptable way to express emotions that can be so hard to define in any 'normal' way, like crying or shouting, stomping or sobbing, wringing hands and gnashing teeth etc. just as a skunk is cute and fluffy until it propels a stinking cloud from beneath its tail (I got that information from cartoons).

It's obviously good that most of society don't accept physically harming oneself to be a 'normal' thing - but treating those of us who do it like lepers isn't 'normal' either. The idea that I ever chose to scar myself for life whilst realising I'd be scarred for life is frankly ridiculous. I wasn't thinking. I was acting on an impulse - and one that had provided a way for me to open a valve and release the pent up pressure. I was in the moment each and every time. I was saving my own life.

I used to take photos before things got more serious, I thought it'd help me not to do it again (or perhaps deep down I thought I had achieved something I wanted to record). There were other far more triggering things I did to feed this sense of pride, but I still haven't decided if I should go as far as to describe them here. I desperately want to just go all out, but the last thing I want is to give someone else my twisted ideas. That's the problem with honesty really - I would willingly tell you all about it because I'm not ashamed, but I also have a conscience. Sometimes a trigger warning isn't enough if someone is actively looking for triggers. I did that, and at certain times I felt I was somehow in competition with others who also did it, and talked about it. I cannot stress enough that however I felt in those moments when I was medicating myself with physical pain, it was nothing in comparison to the shame and guilt I feel now every time a stranger asks me why my skin is completely messed up. It's still visible even under my tattoos. 

During my pregnancy, many midwives saw the scars on my belly and my legs; most probably confused them with stretch marks, but when the health visitor came for the first time after my son was born she had notes saying I had a history of mental illness - I'm pretty sure someone had clocked what they were during a scan and made a note to ask me if I had 'a low mood'. I know how to lie frighteningly well simply to deal with those unwanted questions from strangers, so after the second visit they left, never to return. It's pretty shocking to think that one question was the only time anybody made the slightest attempt to gauge if I had post-natal depression. I went on to reach breaking point just after starting back at work. Why on earth would I ever volunteer the information that I was convinced would be enough for them to take my child? Had it been the doctor I see now, he would've sussed me straight away. Scarily though no drugs would've helped. 

I struggle with motherhood. I'm not afraid to admit that. But I'm never EVER neglectful either physical or emotionally and I love my child so much it hurts. I would rather die than find out he'd harmed himself. And that's why I want to talk about it. 

Wednesday, 8 October 2014


The most pleasant dream you've ever had. The one where you can jump from the top of the stairs and fly. The one where you have no need to walk, or run, or think, or perceive. The one where you find yourself in a dream, inside a dream, inside a dream, inside a dream.

You are perfectly formed and perfectly minded. A hand, a foot, an eye, a thought, a belief; they are all rolled together into an understanding you can't explain and could never have imagined. Words and feelings are your fingers and toes, and memories are folded together like downy feathers under your wings. You are the leader and the follower and the hope and the desire.

You don't feel cold or burn in the sun; you can smell the warmth and the light as if it filled and saturated every sense. Nature, brimming with colours and tastes, as light falls on your face wherever you turn. The sea and the rivers lift you to mountain tops where snow is the stars, the forest is your hair, and the moon is your oyster.

Where all those you love are gathered together, in a time when the clocks froze in the past, the present  and the future. In a place you've been but never been. Past animosity or petty disagreements never happened; the newspapers are blank pages because language is just a soft blanket. There are no circumstances, no time, no other places than here. No painful moments, no debts or disasters of any kind you can remember. The animals you buried in gardens over the years are all there - you wonder why you thought they were gone, because nothing is gone. Nothing is done. This moment and every other moment is right. It is all here, it is all overwhelmingly now.

The world is as big as an infinite expanding universe, so you can survey it all in the knowledge that none of this matters. All your beauty and every single drop of your being is captured here. This is where you were before you were born. You were flying.

This is the dream that happens when you die, X. 

We continue on, in a world where this dream gets forgotten. We feel we have lost a limb, a ventricle, a life-giving artery. Normality has altered and nothing will ever be the same. The mothers and fathers ache for you. We feel the loss of those first days with the life you created, and ultimately sacrificed yourself to bring to us. We fall into the void you leave, only to emerge, bruised and exhausted somewhere we never imagined. Somewhere in the blackening dust of reality. We feel your loss whilst you are dreaming. We burn with the injustice of what shouldn't have been your story. The ending was all wrong. All wrong. 

There are no words that can deliver you back to our world, nothing to comfort, nothing to believe. But comfort comes with time and belief is in the eyes of the boy with the full head of hair - he is our connection between our dream and yours. In our world, there are no wings. 

You're in your dream now, dear X. You're jumping off the top step. 

Thursday, 25 September 2014

Generation 'why'

Sometimes I wonder whether the entirety of my creative life has come from misery, and without that, I'd just be another one of evolution's normal boring life forms (because 'talent' is all I have?), pleasant enough and of course as valuable as anyone else, but minus that little 'je ne sais pas', that... spark. That spark is what I've come to rely on in order to pretend to contribute to society. 

My generation, the early adopters of Walkmans, dial-up internet, chatrooms and Second Life, were told we were all special. Probably not such a great plan, although well meaning. Yes, of course I know that being creative doesn't give me the right to judge those who aren't, but I reserve the right to be honest about it.

Recently I met with my new therapist, with whom I'm about to commence an 18 week journey of hell/dialectical behavioural therapy (DBT) which was designed especially for the awkward ones like me. The ones for whom DBT's better looking sibling - CBT - just doesn't cut it. In the same way I don't 'get' dubstep (I tried Skrillex again today, but still nothing), I also don't 'get' most therapies. If you read my previous post you'll know that for the most part the drugs definitely don't work, unless you're really really REALLY depressed. BPD isn't just a brain chemistry malfunction - it's more a full system failure. Like trying to stick a floppy disc into a CD drive, or something equally as dated and obsolete.

I'm dubious about the outcome, and here's why: I'm quite used to living life under this blanket of dullness, occasionally disturbed by a period of hell-for-leather emotions. When you fly by the seat of your pants in life, the idea of just coasting along on a calm sea doesn't seem particularly appealing. I'm an emotional surfer, I long for the biggest waves to ride - no matter how dangerous they might be. I've already decided which bits I want to keep and which I'm prepared to let go of, but I'm pretty sure that defeats the object.

I imagine that most people who don't have a mental health condition must think that anyone who does have one wants to not have it. Not so for me. Mine has steered me into depths I never imagined, and made me swim in dark and dangerous waters, alone, in a cave, with a limited supply of oxygen and no idea where I'm going to end up. I could feel my way along the rocky roof and into a new cave, as yet undiscovered. I could be eaten by a predator, the like of which has never been seen before. I could run out of air and expire, sinking lifeless in a rubber suit to the bottom, never to be seen again. But during those times is when I've been struck by inspiration that just doesn't happen when I'm well. I can hear entire orchestral arrangements in my head during these flashes of inspiration. I barely ever remember how a piece got written from start to finish - it's just something instinctive and primordial that allows me to release built up frustration at not being able to express emotion appropriately. 

Inspiration is a slippery fish. It seems to require the things I'm currently particularly short of - time, and space. I no longer have full evenings sitting at the computer, hammering away at the midi keyboard with a triple vodka by my side. My midi keyboard now shares a desk with my work laptop, and I'm so physically exhausted I often go to bed before 9pm. Parenthood has scuppered my rock 'n' roll lifestyle, that's for sure. 

My therapist explained that eventually I'd stop associating inspiration with trauma and consequential black mood; she assured me that I wouldn't lose this spark, just that I'd learn to access it in a different way. I'm finding that pretty hard to accept.

Friday, 12 September 2014

Feeling lucky?

I consider myself one of the lucky ones, yet to many of my friends I'm 'the girl with the bad luck' - I've lurched from one chaotic disaster to the next for the entirety of my adult, as well as my adolescent life (not that I ever made it into adulthood emotionally). You may have already read about some of the things that verge on the ridiculous. The first thing the last psychiatrist I saw said about my diagnosis was this: "I could've diagnosed you as soon as you told me about your teenage years". Apparently, chaos is a given with BPD. I'm not sure how my mental health could possibly have influenced most of the events I've experienced, unless you actually believe that one can project one's emotions on a very physical level via some sort of telekinesis. What I do know is that by a simple comparison with mostly everyone I know, something major is going wrong for me.

Often, I feel like a fraud. I have very few physical problems when compared with the people I work to help in the disability sphere. I'll give you two specific examples: the first is someone who was blown up by terrorists in a club in Bali. After the blast, he found himself alive, but surrounded by the remnants of others who weren't, including 5 of his friends, and a man desperately trying to hold his own intestines in. I asked him how it had made him feel, which to my surprise he confirmed that nobody had done before. I guess fear and tact is the reason most steer clear of being so direct, but I have neither of those when it comes to difficult subjects - I'm straight in there with the questions, because I'm genuinely interested in the answers. The second is someone who lost 3 limbs to an IED (improvised explosive device) whilst serving in Afghanistan, aged 19. I've also met Simon Weston, who was the most injured soldier in the Falklands conflict and has since managed to rebuild his life very successfully. I'm willing to assume, from the way they talk about it, that unlike Simon, neither of these two friends have come to terms with those events yet, which is unsurprising and also upsetting when you care about them and wish you could heal them. I often try to imagine myself in that situation, just after an explosion has ripped my body and the bodies of others around me apart as if we were made of inconsequential material. I feel angry and yet determined on their behalf. My mental scars are like paper cuts compared to theirs and yet here I am, twenty years later, so moulded by the past that I am childlike in my emotional responses to normal life.

Naturally I will say out loud that I understand how everything is relative. Of course I'll frame it the way everyone else does - but inside I still kick myself daily for falling to pieces when I have all my limbs in tact. I'm someone who chooses to ignore my mental health, because to acknowledge it would be like admitting I left my mind back in 1996 (I did). But it's like trying to compare apples to oranges - we each have a unique experience of life, and what one person breezes through effortlessly, another finds an impossible mountain of emotional turmoil. Maybe with the more widespread access to FMRI scans that can reveal which parts of a brain are used during a specific action, we'll be able to understand what the hell is going on. 

From time to time I wonder whether there'd be any physical manifestations of the inner turmoil - the brain is plastic after all, and over time one can alter one's physiology just by thinking. It seems a little odd to me that BPD is so damn stubborn; it's generally caused by trauma during childhood, but it doesn't respond well to any form of medication for the most part - only 5% of those diagnosed get any relief with drugs. Having been a human guinea pig for a psychiatrist in a rural area with no experience of diagnosing or treating my condition, I can say with a pretty large degree of certainty that I don't respond to medication AT ALL. If only he'd known enough to not have put me through what was essentially a pointless battery of psychotropic/psychoactive/serotonin re-uptake inhibitors and benzodiazepines, perhaps I'd have managed to stay awake for long enough to pass my A Levels. As it was, I went from being a straight A* student, to barely scraping a pass mark. 

I've already talked about the many unfortunate things that happened during my school years, but I was expected to do well at sixth form college, the bullies weren't there anymore and I had 11 GCSE's under my belt, only two of which were below an A grade. I thought, and I'm sure my mum thought, that I'd sail through college in the same way. I hadn't counted on flunking every subject, including music, which I lived and breathed and spent every spare second doing (FYI I only got a C because my performance was A standard, whilst my exam was terrible - I remember writing my name on the paper but nothing else). 

It seems perverse that the 'treatment' I pushed for at the time ended up rendering me useless and costing me my education. And I did have to push - I finally annoyed my psychiatrist enough for him to do some research and then ended up at The Priory, where I was offered 4 months as an inpatient by a doctor who specialised in his own version of borderline personality disorder. By the time the NHS agreed funding to cover the £60K it would cost for this programme, I'd lost interest and decided I wanted to get on with my life. It was only very recently that I realised I needed to prevent my son going through any of this, and therefore mummy had to sort her shit out. You might be thinking that it was my own fault for not taking the opportunity, but that's sort of the thing with mental health - it influences how you think about everything

I actually think it was a good thing. Now that I can look back and reflect, I would've ended up as another out of work session player had I gone to music college, not that I'm in any way implying that it's not a worthwhile career, but one needs a good head to make it work. I'm the one who dealt with the tumultuous years that led me here, and I'm also the one who ended up with a job and private medical insurance to cover a treatment programme I probably should've had at the beginning.

I'm forever turning on the TV to see friends I studied with performing on enormous stages in stadiums across the globe, and wondering why I didn't work harder. I suppose the point here is that I am truly one of the lucky ones, because now I know I can actually make a real difference to others in sharing my mistakes. Creativity is a dangerous beast - it sparks at the first signs of danger, yet switches allegiance as soon as the chaos calms. Maybe I will write a new album, maybe I won't. But for now I'll channel my leftover mind into as many distractions as possible. Recovery is still a long way away, but at least now I'm on the stretcher being pulled into a rescue helicopter.

Monday, 1 September 2014

Part two.

The mind can often hide behind a clever face, but once you take what's hidden and carve it into your flesh, well then people don't react quite so well. Please don't read on if you think reading about cutting might be a trigger for you. 

I should begin by saying that this particular method of self-harm is not something I still engage in - and I'm going to tell you why.

I was extremely squeamish in my teens, as many of my schoolmates will confirm. I passed out watching a video of kidney dialysis in a science lesson once, much to my embarrassment. I would actively avoid any sort of experience that might involve needles or blood, and that caused all manner of issues when it came to vaccinations - especially ones that were to happen at school. They used to lay out the crash mats from PE for wetties like me who couldn't bear even the sight of a needle. Despite this phobic reaction, after the incense stick experience, I must've retained that feeling of relief somewhere in the back of my mind until the day I tried to smash a pint glass against a wall. If you haven't already, you can find a whole post about this on my blog, 'Inside the actor's' studio'. 

So, why did I stop? Somewhere during the mess of time that was university, my favourite method of self-harm was transformed from a way to relieve my pain, into a way of inflicting pain on me. One of the hallmarks of borderline personality disorder is a tendency to be in abusive relationships, and I certainly lived up to that expectation. I'm sure that whilst you read this, whether this is the first post you've read or one of a few, you'll have felt a sense of chaos and a distinct lack of chronology. That experience you're having right now is nothing more than a reflection of the chaos of my life over twenty years of lurching from one disaster to the next. University was three years long. Just three years. Yet I managed to amass an impressive amount of chaos in that time. 

It was during my second year that I answered the ad that would kick off events even I couldn't have imagined could happen in a soap opera, let alone in my painfully real life. 

It's hard to know where to start explaining this, so I'll just give it to you straight - I met a 'man' with what I can only describe as 'the gift of the gab'. He wormed his way into my life and into my home, my friendships, my career, my whole world. He conned me, and many others around me. He stole an enormous amount of money that had been left to me by dead relatives. He physically (and sexually) abused me, sometimes in public, yet nobody ever intervened. He was very clever about it all - that was the most terrifying part. If I tried to get out, he would smash things. He forced me to cut myself, saying he was a real life vampire - and yes, of course I'm aware of how crazy that sounds - but I wasn't given a choice because if I refused, my room and I would be smashed to bits. He hacked into my emails and sent abusive messages to my entire contact list alledging that I was some kind of sexual deviant. He pretended to be someone else to lure me into communication. He broke into my car. He threw a brick through my bedroom window. He showed up on the doorstep of my student house, and convinced my housemate to let him in by fabricating a story of his mum being run over, before proceeding to cut his wrists and wipe blood on the walls. If I tell you that this particular incident came after I returned from my mother's funeral, I hope you can imagine the pain that caused me - and was intended to cause. 

On four occasions, he gained access to my student house and swallowed enough paracetamol to constitute an overdose. I duly delivered him to A&E, expecting that he'd be taken off my hands and sectioned. Instead, I was forced to stay and deal with bowls of vomit and urine, alone, because despite what he'd done to me I cannot leave another human being to die. He received no medical treatment, they did not administer any antidote, and no psychiatrist was called. I wanted to get on my knees and beg them to section him so I didn't have to suffer the abuse anymore. I've given you the potted version of this story because it's too awful even for this blog. Suffice it to say that I lost the last weeks of my mothers life to this utter coward and it still affects me every single day. I still don't know why nobody helped me - perhaps they were all completely fooled too, but one would have expected at the very least for someone to see him hit me in a bar and do something to stop it.

I don't know how I got through that time and even now it feels like I imagined it all. I remember going to the police after he posted a suicide note through my door, but after giving a statement that took a full 6 hours to write, it was decided that if he wouldn't accept an 'invitation to interview' then the CPS wouldn't take it any further. It was my word against his, and back then email evidence wasn't deemed relevant if it was over 30 days old. I find it really hard to admit what he did to me, and only recently have I allowed the words to come out of my mouth, during my most recent psychiatrist appointment, when I knew if I didn't get it out my son would suffer for it.

You can read between the lines, right? You know what I'm getting at. I can't bring myself to type it. I remain convinced that he wasn't 'clinically insane', he was 'criminally insane'. There was far too much forward planning and engineering for it to just be a case of being mentally ill. 

I wasn't able to grieve for my mother because of what he did. Yet I feel guilty for not trying harder to get him locked up. Others have gone on to suffer because of that, and I can't forgive myself for that. And that was why I stopped cutting myself. I couldn't allow him to hold that over me ever again. In 2006 a dear friend tattooed over the scars on my arms and finally I didn't have to deal with the stares of strangers, or the abuse dished out to me by strangers with no shame. 

Tuesday, 26 August 2014

Incense, alcohol, and the birth of escapism

I said I'd write more about self-harm, so here we go. Don't ever say I didn't warn you - my honesty is sometimes a gift, but often a blunt instrument. 

The term 'self-harm' is a bit of a misnomer actually. For me at least, it was a way to avoid harm - it was more self-care. I imagine around 70% of people reading this will have absolutely no idea what I'm talking about (or they think they don't) and the remaining 30% will completely identify with this nugget of truth. So, I'll start at the beginning and I'll make an attempt to explain how such a dichotomy exists. 

At 14 I had my first run in with it; at 34 I can still see the tiny round scar on my left wrist. I was in my bedroom, it was 1994 and I'd spent an entire night meticulously plastering the walls with every single picture of Kurt Cobain I could lay my hands on. I'd even bought somebody else's bad photos from a gig I never went to - you could do that by post then, by responding to adverts in music magazines. I remember vaguely that I was angry about something, which was a fairly common occurrence for me given that I was a teenager. Days of bullying sometimes got too much and when I came home to a level of expectation I felt I couldn't satisfy, I had a tendency to feel trapped in a life I couldn't control. This particular evening was not in any way different, but it just so happened that as I was holding a smoking joss stick (one of those incense sticks you light and then blow out), I wondered what it would feel like to put it on my skin, so without really thinking about it longer than that one moment, I pressed the glowing tip into my wrist. As I did, I felt a stinging pain as you might imagine, and then smelt that unpleasant burning flesh smell. Needless to say it wasn't a very positive experience, but somehow I felt calmer afterwards. This was the first of many very similar moments.

I didn't do anything like that again for a few years. What I did do, however, was watch someone very close to me do it, day in, day out, whilst I stood by feeling helpless and completely ineffectual. Perhaps that makes what happened later on worse - because I knew how much it hurt to see someone you love destroying themselves in reaction to something that wasn't their fault at all. But self-harm takes many guises, and even though deliberate physical injury on the outside didn't start happening until later, I found other ways to quash those painful moments. 

It was around this time that I first experienced what I now know was a panic attack. I'd developed a fear of going to bed at night, which in hindsight may have been as a direct result of bullying - going to bed meant that getting up and going to school was the next thing that I had to do, and so I developed nausea every time I lay down in my bed. I spent many nights sleeping on the bathroom floor after retching violently for several hours, and eventually my mum dragged me to see the family doctor, who prescribed what I now know was an anti-psychotic. I was living life in a fantasy world where I was a tiny person living inside a human-sized vehicle, looking out through eye holes and driving my body around from inside the control room in my brain. That way, I was invincible. I had vivid dreams that people at school reacted to me in exactly the way I wanted them to - including boys. I often daydreamed during lessons, and in my last year there I became fixated on one particular boy who I'd seen at the choir I went to in the school holidays. He attended the sixth form college attached to my school and I often saw him playing pool through the window of the portakabin that housed the student common room whilst I was in art lessons. I was besotted, but he was 16 so I knew I didn't have a chance of even speaking to him. As a feminist looking back can't help but wince at the level of importance I'd placed on this boy. I have an amazing imagination though, so the world I'd fabricated inside my mind felt more real than my actual life, and it was there I sheltered myself.

I began stealing alcohol from my parents' booze cabinet in my last year at school. My house was right opposite my secondary school, which was both a convenience and a nightmare. Once we were in year 11 and allowed to leave school during breaks, my circle of friends and I would go back to my house to smoke cannabis and mess around. I never quite knew if I'd even have a friendship group if I hadn't've had a house to offer as a refuge. I never felt like part of that group, as desperate as I was to be accepted. I'd pour spirits in a glass and add squash neat to take the taste away, before necking it. I don't recall any of the others doing that. 

By the time I was 16 I started going to the pub a few doors down from my house and drinking every night, despite being under age. Rural Somerset wasn't somewhere that checked identification, and I still don't know if my parents knew. For them, the final straw was when they left me in charge of my younger step-siblings one evening, and I drank a bottle of whiskey whilst waiting for my friends to arrive. After they'd stopped me dancing in the garden in pyjamas, they had to put me to bed before my parents arrived home, and I'd given myself alcohol poisoning. I spent the following day (a Saturday, when I attended a morning music club) puking my guts up in front of younger children. My mum dragged me back to the GP and I was subsequently forced to attend alcohol counselling with a wrinkly prune of a woman, who had tar-stained skin and a croaky smoker's voice. She would smoke, I would smoke, and I don't remember much else, other than drinking a pint of Ouzo the weekend after the whiskey babysitting debacle.
Around this time I'd also started smoking tobacco. The first cigarette I ever smoked was a disgusting herbal variety meant as a healthy alternative to normal cigarettes, which was a harsh and nauseating experience, but one I had convinced myself I needed to have. I would hide around the side of the house with my step sister in my dressing gown after my mum had left for work (but before we had to be at schoo) smoking these horrific herbal fags and coughing and wheezing. 

It didn't take long to graduate on to tobacco and from there on to cannabis. Of course I'm not for one minute suggesting that this is a logical and expected progression. The irony was that a few years earlier I'd chastised my mum after catching her smoking in the school staff room. I'd been convinced that both parents would get cancer and die, yet here I was forcing myself to learn to smoke. It's there the self-harm instinct becomes more obvious. This is how it all began.

Sunday, 24 August 2014

The potter's wheel

I am truly a product of stigma. I'm made of the misshapen clay that is spat out by a culture of silence. 

Perhaps you are mildly irked by the melodrama of those two sentences, and probably rightly so. I could list the friends that will read that opener, and think of any of the thousands of times I've behaved like a hormonal teenager, only without the excuse of puberty.

Yesterday I went to a psychiatrist for the first time in ten years. He came with high recommendation from a couple of colleagues and friends, both with their own struggles. I always like a road tested doctor, so I had high expectations - of what I had no idea - but I felt positive about it just the same. Keep in mind that I also recently saw someone I had been led to believe was a consultant psychiatrist through the NHS, but who subsequently turned out to be a trainee GP with very little experience in diagnosing mental health conditions. It's at this point I want it noted on the record that I have absolutely no issue with people dedicating their careers to working in the NHS, least of all on the frontline of mental health. I've done it myself (let's ignore the irony for now, shall we?). But given my long and jumbled history, I would've thought I'd be the least suitable candidate to be foisted upon some poor sod still learning the ropes. He was angling to either diagnose bipolar, or not, and I'm definitely not bipolar. I even told him so. I mentioned possibly a touch of cyclothymia, but I felt that it didn't fit either. I hinted at my previous diagnosis as a clue, but he still managed to come away with an inaccurate account of my life, and a diagnosis of mild alcoholism, not before calling my long-suffering other half and frightening him silly by asking probing questions about how fit I was to care for my son. 

When I hadn't heard a peep over a month later, I called the centre, who informed me that he was only a trainee, and he had now left. They had no access to my records. Then I got a voicemail from him (he'd called during working hours, so of course I'd not picked up) asking me to call back - only when I did, a very befuddled chap on the other end of the phone told me that despite this being the number of 'integrated psychological services', I was definitely not through to the right place. After several similar exchanges and further bafflement, I gave up. I imagine that due to the pitiful lack of funding for NHS mental health services, many less bull-headed than me would've thought this was indicative of the treatment they may (or may not, as it's questionable whether persistence would've resulted in any sort of suitable care plan) consequently get, and fallen deeper into whatever mental ailment they were experiencing. 

To give you a bit of a flavour of just how wrong that appointment had gone, here's a summary of the 'facts' he'd managed to make up: 'Her father was violent' - he wasn't, never has been, and. I sure as hell didn't say he was. 'They had little contact after the divorce' - nope, I saw him regularly. 'Helen has no contact with her step-siblings' - not true at all. 'She was on a heroin detox programme in 2007' - categorically, I have never taken heroin, and never will. As I explained very carefully and in great detail, I was put into a detox because I struggled with the physical side effects of coming off over the counter codeine, and rather than help me with a weaning plan, my GP somehow thought that sending me to a heroin clinic for hardened users of illicit street drugs would be the best course of action. There I was given Subutex (a synthetic opioid that is usually given to aid withdrawal and for very short amounts of time) for over A YEAR completely unnecessarily, and I've been since told by a doctor that this was abuse. I agree. I spent a month unable to eat, drink or sleep and lost a third of my body weight in the process. They refused to give me anything to help with this. That black hole in my life also lost me a relationship, although that would have inevitably happened anyway.

Let me clarify here that I don't judge addictions based on what the drug of choice is - what I do do, however, is judge someone who works in a heroin clinic based on their ability to decide how to treat what is essentially a very minor physical dependence caused by a lack of accurate diagnosis or adequate pain management. If you read yesterday's post, you'll know what I'm referring to here. It stands to reason that you don't treat someone who takes a measly 8 non-prescription codeine tablets a day (I.e. The recommended dose) with the same blunt instrument approach as you do a person who takes £100 worth of heroin a day, and then leave them with a new addiction to a drug with such a long half life, it takes them a month to detox in cold turkey, alone, with no medical supervision of any kind. I've never come as close to suicide as I did at that time.

I haven't yet decided what to do with the letter containing all these wrongs - it's also gone to my GP - and I may send a copy to my GP myself, highlighting these inaccuracies in my horribly pedantic fashion and suggesting they do their own investigation into what's going on at the centre. God help anyone who gets referred there in crisis, that's all I can say before I get so angry I bang out a load of expletives...

So, on to yesterday's private psychiatrist - there couldn't be a more stark contrast frankly. This guy sauntered in to the oddly decorated waiting area to collect me about 30 minutes after my appointment time, and led me to an upstairs room with one of those giant desks old school doctors have. I noticed that one side of it was wonky. I wanted to be annoyed by his tardiness, but as soon as he started speaking I forgot to hold that grudge. 

I had a hunch he might ask me the popular ice breaker: "What do you want to get from this?", and he didn't disappoint on that score. This is my least favourite part of any appointment. I don't know what I 'want', I've never experienced it before. I've experienced plenty of things I didn't want though. That's exactly the sort of question that trips me up in job interviews too. He asked me if my referral letter was accurate, so we went through my chequered medical history, and he asked me about each entry in detail. We corrected all the fabricated parts, and then he began to delve, enquiring into my life chronologically as well as asking very specific questions that would've normally made me very uneasy. Something told me to just give it up though, and I told him all the gory details, knowing that this time it might actually help.

He knew the last doctor I'd seen, the one who'd diagnosed 'multi-impulsive personality disorder' before I'd turned down my chance of treatment in favour of pretending for a few more years. I wasn't ready to move into a clinic for a year where you had to eat alone and shit in a commode for the first fortnight, and then ask to use the toilet after that. I was residing alone at the time, doing my own thing, indulging in my self-harm however the heck I wanted and I wasn't about to give that up; besides that, I asked if I could bring my rat with me - the answer was "No" - so of course I didn't go. I didn't care that the NHS had stumped up £60K, and yes I'm aware how stupid that sounds. But I had, and still have the emotional intelligence of a teenager and I'd already decided to go back to study in the time it had taken to get this one appointment (and that was about 2 years, FYI). I know now that it wouldn't have been the right treatment programme anyway - it was an eating disorders unit, and I didn't have an eating disorder - at least that wasn't all I had.

Back to the new psychiatrist. He asked me what treatments I'd already had. He asked me if I felt I had an 'empty void I was trying to fill'. Basically, he got it. At the end he just looked at me with raised eyebrows and a knowing look, and said "Borderline personality disorder". I laughed nervously. I'm not sure why, because I already knew that he'd say that. Reactions are one of the parts of social interaction I struggle to make sense of. Then I asked how severe I was in comparison to his other patients with the same diagnosis; "I knew you'd ask me that" he replied, "You're at the most severe end of the scale, but you've got some balance at the moment". He went on to use an analogy of a lump of clay on a potter's wheel - the hands shaping the clay in one's formative (note the 'form' part of that word) years, are the hands that make what should be a nice symmetrical smooth vase. They might be family, teachers, peers etc. Only sometimes they poke holes in, or press into it too much instead. BPD is a vase with one side much shorter than the other. The taller side is cognitive development (I'm not lacking in intelligence at all) and the shortened side is emotional development, which is stunted. When I say I'm still 16 in my head I'm not joking. I never left secondary school.

My disorder is most symptomatic during periods of stress in my life, and those of you who know me will also know that I'm one of those unfortunate souls that people describe as 'unlucky'. The new psychiatrist described BPD sufferers as living a 'life of chaos'. We attract crazy. I'll gladly let you into some of those events later on - but for now rest assured that you couldn't make it up.

After that, he enquired as to whether any family members had mental health problems; and this is the point here - 'I am truly a product of stigma. I'm made of the misshapen clay that is spat out by a culture of silence'. The generation before me suffered in silence, enduring chaotic childhoods, teenage years rife with bullying, and less than happy adult lives; this led to many an ugly vase. There's nothing I can do about that, but what I can do is help my generation to break the cycle.