Cower brief mortal


I’ve never been brave. Never really stood up against authority. Never really fought for anything. Never really created anything. My funeral is going to be really boring and probably embarrassing for my family.

A skeletal figure, wearing dark purple robes, with a scabbard at his waist and holding a scythe. At his feet a skeletal rat, also hooded in a purple robe. From Wikipedia.

There is too much pain in my head taking up all the room for me to change. I am in too much pain to ask for help. Two friends today have sent me messages with soft invitations to talk. I can’t. I can’t bear to. I am too unbearably and overwhelming lonely to be able to manage being around people. I have turned down two invitations for today despite not seeing or speaking to anyone for days. I can’t cope with it. My thoughts and feelings will tear me apart. I can’t have anyone see that.

I can’t undo the terrible things I’ve done and I can’t make them better. I can’t even say sorry, not that that would make it better. The only way for those things to heal is for me not to exist in the world anymore. I need to be in the past and forgotten.

I can see that I need to do something or I will die. The hotel is booked for tomorrow. I can’t die today as it is my friend’s birthday. I have a multi-layered plan with backup options if there are fuck ups. I have learnt from my past experiences and other people’s. I think it will work. I will keep trying until it does. I have a list printed out of all my financial and household accounts with phone numbers and websites and a list of people for my family to contact. My house is not completely organised but what’s left won’t take long. I could be free. I could be at peace. Finished and gone.

There’s still a little part shouting that there’s a chance left to rebuild my life and this time maybe make a life where I feel happy sometimes. I remember the last time I felt happy: it was about four or five months ago and I was playing with my sister’s children. We were dancing round the kitchen laughing and shouting and I felt this creaking, old thing open up in my chest and head and suddenly realised I felt happy. Pretty much as soon as I named it, it disappeared. Then it fluttered back to life about ten minutes later for a few seconds. I recognised it as happiness but maybe it was joy. I don’t know the difference. I remember nearly crying and feeling embarrassed. I also remember thinking that I couldn’t remember the last time I felt that. Very long way to say that I don’t know how to feel happy. I don’t know how to create a life with happiness in it. I don’t even know where to start.

When I consider my life and weigh up the times I’ve felt happy and the very little good I’ve done against all the pain I’ve felt and terrible things I’ve done there is no contest. The average manic depressive lives to their early sixties which means I’ve probably got another twenty years of this. No. I won’t do it. (And you can’t make me.) I have had enough. I have to die.

Self-destructive behaviours

[brief descriptions of self-harming behaviours]

I have a whole menu of self-destructive behaviours to call from when times are bad. I rarely do them nowadays and I think to the outside it looks like they are in my past and done with but they feel very much available to me whenever I need them. I find that a comfort and it makes me feel safe.

The Art of Self Destruction at NCH Collection, website currently bugged so can’t find out the artist.

I self-harmed a lot as a teenager. I drank problematically and took recreational drugs too much in my early twenties. I binge ate for two periods in my late twenties and late thirties though a large part of that was down to the physiological effects of dieting. I have comfort eaten/emotionally eaten (eating when not hungry but instead to relieve emotions; not binging) my whole life. Neglected my sleep despite knowing it was key to managing my mood. Not exercising at all for most of my adult life then over-exercising to the extent of injuries in my late thirties. Deliberately and accidentally socially isolating myself despite being the type of person that really needs social contact. Deliberately being horrible to people to push them away because I don’t deserve people being nice to me (it feels wrong). Fucking with my prescription medication (it’s going great). Deliberately not doing things I enjoy to punish myself. Oh, the list just keeps going on.

How I haven’t ended up with a borderline personality disorder diagnosis is a miracle and I think basically is because I am naturally a very personable person and was brought up middle class. I did four years of medical school and am pretty well read and get called “articulate” (I smile and try not to tell them to fuck off) so know the pitfalls of what healthcare professionals find difficult. I get on well with them and make an effort to do so. I wonder if that sounds manipulative. I bet it could be interpreted as manipulative. I see it as self-defence. They can literally decide where I sleep that night and whether I am dragged out in a cage of nurses unable to move properly. I think they are less likely to do that if they think I am an ‘easy’ patient. I never tell them if I have suicidal thoughts and answer only vaguely when directly asked which they don’t do very often. Healthcare professionals are a potential threat even when they are being nice to me. I would rather keep away from them, or at least keep them at arm’s length, and be safe even if I am alone. Does that could as a self-destructive behaviour? Not really engaging with psychiatric services? Or only engaging superficially. I don’t think they could do anything anyway. All I see is disappointment from my real life and online friends. Obviously this strategy is working out tremendously as you can see from how well my life is going.

In the post linked above, I was bragging that I hadn’t self-harmed in a very long time. Whoosh, gone. Have self-harmed several times in the last week. I don’t know if self-harm is generally seen as a kind of addiction anymore but to me it feels addictive. I feel like I want to do more and I have to exert effort to stop myself. My mood is fucking horrendous just now (bet you can’t tell from how articulate I am) and the self-harm was the most beautiful relief from the agitation. Better than any medication or ‘healthy coping strategy’. There’s the secret: it’s so addictive because it just goddamn works. But but but… It always escalates and always spirals out of control eventually. It isolates me from real people as it’s a barrier that they can’t understand and I can’t overcome. And it damages my poor, abused body that has really had enough. I can see that it is innocent and doesn’t deserve this. I do but it doesn’t.

Your body is not an object, not a sculpture based on some universal and enduring Platonic ideal of beauty — it is a living creature, an animal in your care that needs care and compassion, that suffers and dies if neglected.— Michelle Allison (@fatnutritionist) December 20, 2017

So going to have to knock this self-harm on the head again. I read this thoroughly compassionate article about self-destructive behaviours in Psychology Today. Cried but the soft tears when you feel like an awful, tight pain is unclenching and releasing. Then I read the follow up article by the same writer about how unhelpful shame is when trying to deal with self-destructive behaviours. And I sobbed for a while because I can’t deal with my shame. It’s too huge and overwhelming. I’ve self-harmed pretty severely (until it doesn’t hurt anymore; you either know what that means or you don’t and I’m not going to spell it out because I worry more about triggering the people who do understand than I worry about educating you) and shame hurts order of magnitude more than any physical pain I’ve experienced. The second article made so much sense to me. This is the key quote: “[D]o not shame yourself as an attempt to make yourself overcome the behavior. At best it will leave you feeling worse about yourself. At worst it will increase your dysregulated behavior.” I’ve heard that so many times before but the writer actually laid out her thinking here. It was like she levered some space in my head.

Of course, I feel like I very much deserve my shame and deserve to be punished. Still have that strong push to punish myself and like that would be doing the right thing. But it’s nice to get that little unclenching and space for a while at least.

Stockholm syndrome

As I’ve written here before, I am using the Headspace app to do guided meditations. There is a course called Appreciation which aims to help you “[d]iscover a renewed sense of gratefulness for life”.

Cropped screenshot of the Headspace app showing a description of the Appreciation course.

I was in my twenties before I discovered that there were genuinely people who were grateful for and enjoyed life. I’m not talking about making the best of things or finding moments of joy or moments of peace that pass and then you remember them fondly. I know those things exist as I’ve experienced them myself. But these people’s overall assessment of life was that it was something to be thoroughly appreciated. Appreciated as something precious, even.

Blame it on my rural Scottish Calvinist upbringing that teaches and rigidly enforces the idea that seeking pleasure is wrong, a sin. Definitely letting the side down anyway. Or blame it on my decades of mental illness. Not the fluffy, milder variants that are suitable for awareness campaigns but the version that means I’m sitting here typing this with a black eye and two broken ribs. (So there won’t be any jokes for a while because it’s going to hurt to laugh for the next month.)

Screenshot of The Void in Minecraft from Minecraft Wiki

Life is not something to be grateful for. Life is something to endure, a trial, an ordeal, something to suffer before you return back to the darkness and the silence. Maybe there’s a point to it. I don’t know but I think there isn’t. Thinking you should be grateful for this is just fucking Stockholm syndrome.

The truce

[self-harm, mention of sexual assault, suicidal thoughts]

I don’t really know why but I grew up hating my body. I hated how it looked and I hated how other people treated me because of how they thought it looked. I read somewhere when I was a young teenager that your body is just there to carry your mind around and that framing stayed with me. I never considered how it felt.

Black Truce by James Gleeson

I started self-harming when I was 14 years old. I mostly cut my abdomen with a razor blade. I also cut the tops of my thighs, my inner thighs, my hips, my left shoulder, my chest and my breasts; anywhere that was covered by my PE kit. I think I self-harmed because I didn’t know the words how to express my pain, frustration and anxiety from my untreated depression. I had also been extensively bullied at school for years. I had a lot of suicidal thoughts and plans too.

After eighteen months or so of self-harming, I finally went to my GP, was honest about my symptoms and I was given fluoxetine (Prozac) and weekly counselling (changed days to what people get today) which helped a lot. My GP was very matter of fact about my self-harm and focused on what I now know is called harm minimisation. I never felt even a flicker of shaming. I had been self-harming every day: every night in the bathroom before I had a shower. I always had wounds in various stages of healing. This is actually kind of horrifying me now to look at these memories from my current relationship with my body but it was so normal then. It felt like a logical and sensible response to my life. It fucking was a logical and sensible response to my life. But the self-harm just melted away as the depression melted away. I don’t remember any kind of fight to stop. It just naturally camed to an end. From the time I was 17 years old to now in my early forties, I have self-harmed less than a dozen times. When my mood is bad, thoughts of self-harm do come into my head but they feel miles away. It’s only in the worst of situations that I actually do go past thoughts and act on my body.

Can you only self-harm if you hate your body first? I don’t think that’s true. Sometimes things are just very desperate. There are no good choices available in some situations. But I did hate my body; almost as much as I hated myself. Those hatreds and despairs felt separate from very early on and remained separate until this year. Note that I’m not saying the hatred and despair has melted away but it feels like a frayed, stretched apart cloth between me and my body rather than a solid, impenetrable wall.

When I look down at my hands, there is still a tiny pause while I recognise them as mine. They don’t feel like mine but intellectually I know they must be. There is a much bigger pause when I look at body parts that I dislike more like my abdomen or my breasts (it still feels weird typing “my” there; my habit is to say “the abdomen” or “the breasts”).

That pause and the detachment were put there deliberately to protect my body from me. I can’t remember exactly what I read or what I heard that made me decide to pursue this detachment but I remember pushing it in my mind until feeling like I was quite separate from my body was a very natural state. It tied in well with my depersonalisation.

The next stage was a calling of a sort of truce between my body and myself. I think this happened in my early twenties. I had been sexually assaulted a few times by then though had convinced myself that it wasn’t affecting me. I was dealing with a lot of psychiatric medication side-effects. I was fat and finding that unacceptable to myself. My body didn’t feel like mine and I still hated it. I was reading about fat acceptance and I longed for the peace that the people I was reading about had found. It wasn’t this but I read something like this tweet from Michelle Allison (the Fat Nutritionist):

Your body is not an object, not a sculpture based on some universal and enduring Platonic ideal of beauty — it is a living creature, an animal in your care that needs care and compassion, that suffers and dies if neglected.— Michelle Allison (@fatnutritionist) December 20, 2017

It lead to a sort of ‘truce’ or ‘deal’ in my head: I won’t hurt you anymore and you will leave me alone. That was the basis of my relationship with my body for the great majority of my adult life. I did the basics to look after it, to some extent anyway, and the rest of the time I was free to ignore it. The best that can be said for this ‘truce’ or ‘deal’ is that it eased my relentless drive to kill myself which had been powered by my hatred of my body. The thoughts were still there but there was a distance too. I self-harmed very rarely. I gave up drinking alcohol entirely and I didn’t take drugs (I was very lucky in that I hadn’t developed addictions to either). I didn’t exercise and didn’t eat very nutritiously but I don’t think I had any disordered eating behaviours either. But it was a miserable, joyless way to live, I see now. Not taking any pleasure in my body, whether that was eating or sex or physical activity, etc, meant missing out on a lot of the experiences that make life worth living and make a human, human.

What changed was I read two books this year that profoundly challenged my thinking. The first was Come As You Are by Emily Nagoski about female sexuality which explained a lot of my past experiences to me, not just about sex but also about emotions and the stress responses. The second was Intuitive Eating by Evelyn Tribole and Elyse Resch which explained a lot about eating, hunger and fullness. Both of these books talked matter of factly about taking pleasure in your body and of being connected to your body. It probably sounds ridiculous but I’d never considered that was possible. I kind of knew that some people had strong, solid relationships with their bodies but I didn’t think that applied to any of the people in my life and certainly not to me. But these books were arguing that yes, it was possible for me too.

So I stepped inside my body. Quite terrifying at times and very unsettling. These books made my thoughts safe enough and the meditation released my depersonalisation enough to make it possible. My medication and all the endless self-care I do controls my mood enough, at the moment at least. I still feel some detachment but I think that is fading as my new thoughts bed in. In some ways, I am convinced being connected to my body is a much better way to run things rather than my old detachment and ‘truce’ but in other ways, it feels riskier and more unstable.

I’m still afraid of my body and I still don’t like parts of it but the old hatred and despair has faded away mostly to nothing. I’ve seen it flare up a bit at times but not for long. Is this a new truce? Not really. This is very soppy but I feel like my body and me might be on the same side now. There is something very peaceful and lovely with that.

Sometimes they are the storm

This will make no sense because I am currently high. Best of luck.

Some people you like to have in your life because you feel like you are walking down the same path through the world, through life. It’s companionship and warmth and while it might not give happiness all the time, it does give comfort. People underestimate comfort.

Some people you like to have in your life because you can stand in their lee. The world or life rains down against them and you stand in the shelter, for a while. Time to breathe, maybe some solace too when times are tough.

Some people you like to have in your life because the path is boring and even the storm above you is not enough and you want to be engulfed and let yourself be the very rage and despair. They are the storm itself.

Self-esteem meditation

I started meditating in June using the Headspace app on my phone. I signed up and did the free meditations for the first few (four? ten?) days and then bought a subscription.

Meditating has made an astonishing difference to my depersonalization. It is literally the only technique that has made a significant difference though, to be fair, I have felt so hopeless about finding anything that helped that I don’t think I made a serious and sustained attempt at any technique. This wee app made a difference right from the early days. Never in a way that was too much of a shocking, painful change (snapping into hyper-reality from being very dissociated is profoundly fucking terrifying) but a feeling of control like if I push that particular part of my mind that the app targets and calls mindfulness, that particular part of my awareness, then the depersonalization recedes back. If I lift off that particular part of my mind then the depersonalization will drift back in. It might sound mind-boggling for it to be important to me that I can get the depersonalization back if I want it but it is important as it has helped me get through things that I don’t think I could have survived another way. Well, maybe. Maybe not. It’s mine though and I want to be able to send it away and call it back as I chose. That might not be possible and might require far too high a price but it’s what I want just now. The depersonalization is not my master these days, well, not all the time, and I am grateful to the meditation for that.

The Headspace app has has a huge library of meditations on topics from grief to sleep to productivity. There is a thirty episode course on self-esteem. Here is the introduction to episode 4 of the first ‘Learn’ ten episodes:

Now after a lifetime of thinking that we are not good enough: maybe we don’t like the way we look or the way we are or the way we feel or the way we think. Maybe we don’t like the way we think other people think we are. Low self-esteem can affect us in so many different ways. But it’s always looking for more fuel because all of these internal storylines that we have, it doesn’t matter if it’s low self-esteem or something else, they all require fuel and that fuel is thinking. So it’s quite normal when we come to an exercise, to learning something new, that we fuel it with whatever is most common in the mind. So for someone who gets very anxious when they’re learning a new exercise like this they might be very anxious about the exercise. Someone with low self-esteem learning a new exercise will probably think that they’re no good at it or that they wish that they could do it better or they wish that things were changing faster. And that’s just the nature of that storyline playing out. Again we don’t need to give it more attention and more credence than it deserves. It’s simply recognising that’s the habitual pattern of thought that has built up over time. It’s not who we are. The less we identify with it the less important, believable almost, it becomes in our life. So just something to bear in mind as you’re doing this each day. Coming to the exercise completely fresh, leaving behind any preconceived ideas as to whether you are good at it or bad at it, whether it’s going to work quickly or not. Simply watching the process. Being present with it as it unfolds.

Introduction to a Headspace self-esteem meditation episode 4

I think that is a fascinating way to think about self-esteem. I was expecting some nonsense about self-compassion (which isn’t nonsense; I just can’t get it to work for me) being the better way to consider or judge the self. But this idea of thinking just being fuel in an unwanted fire undercuts this and made me pause and really look at my assumptions. I don’t fully understand it yet but I will keep thinking about it and finish the course. Things that I thought were self-evident, obvious, solid premises might actually not be true or even just actually not that useful. It’s so lovely to come across something new that gives me some hope that things might be different. Of course, I am a psychiatric patient of twenty-five years standing so I know that hope is heady stuff except heads aren’t often involved (to paraphrase Terry Pratchett) and I’m not going to call myself cured quite just yet. Put a button in front of me and say “press this and you’ll never have existed” and the only delay to me pressing it is my formerly middle class upbringing that will make me pause to say “thank you”. I’m almost entirely convinced that I don’t deserve good self-esteem. That things are bad because that is they way they should be. I really don’t know what makes me keep trying things like meditation. It’s certainly not logical. Well, that tangent went a bit dark. Aren’t you glad you are wasting your life reading this blog?

‘Self Esteem’ by Betsy Cook

It’s just so fluffy… meditation, mindfulness. How can you take such simple concepts seriously? Dissociation is so huge and complex. Abnormal mood is so huge and complex. How can something as beyond basic as focusing on your breath help such severe, profound, overwhelming symptoms? A huge and complex problem needs a huge and complex solution, right? Turns out that that assumption has done me a lot of harm over the years. Here’s an analogy: you spend six hours making a hugely complex and fantastic meal. It should have a rich interplay of exquisite tastes and textures. But it’s just bland and flat and sits in the mouth like stale bread. Less interesting than stale bread, even. You’re fucked, right? Nothing simple is going to save this meal, all this work, you’re going to have to start again. Wrong. Turns out the very simple addition of half a teaspoon of salt brings these flavours to life. Sometimes something simple is all that is needed. I’ll add to that though: sometimes a series of simple things is all that is needed.

The other reason I resisted mindfulness and meditation is that is so goddamn fashionable and pushed on us psychiatric patients. Another simple concept: what works for one person’s problem might or might not work for another person’s apparently similar problem. Don’t we get to chose where to spend our (very limited) energies? I came to meditation of my own volition. I kind of fell into it naturally, first through a real life friend and then by enjoying how well written the app was and then by being astonished by the results. It has just happened. Just happened because of lots of little choices that I made. So it feels like it is mine. I told my current psychiatrist recently that I had started meditating and he said “good on you” but didn’t push. I felt pleased. Going by twitter, a lot of people have bad experiences of psychiatric services almost insisting that they spend chunks of their time and using up chunks of their energy on techniques that were, at best, useless and, at worst, actively harmful. So that put me off too.

This feeling of being able to make choices and make good things happen in my life is valuable and precious to me. Not quite as much as the relief in my symptoms but it has been an unexpected bonus. That’s unexpectedly boosted my self-esteem as well. I can do something! I’m not 100% hopeless! (Just 95% replies my brain.) Did the people who wrote the app mean for that to happen? Who knows, but it’s good anyway.

Massage and the need to be touched

I remember as a child, maybe late primary school and early secondary school ages, having this desperate wanting to be hugged. Like something was physically missing from my body. It never even occurred to me to ask anyone in my life to hug me. My parents weren’t physically demonstrative and neither was anyone else so I just wasn’t touched for years until I started having romantic relationships.

I’ve had “low maternal warmth” written on my psychology notes now (see how they blame the mothers; not the fathers) and I’ve learnt how most (almost all?) people need a certain amount of physical touch and physical affection in their lives. The two times I’ve had long term romantic partners have been the times that I’ve had consistent touch and probably the main reason why I (mostly) remember those times fondly. I’ve not had a partner for a long time and that’s what I miss the most by far. But even just briefly imagining it there, I get strong thoughts that I don’t deserve it and that that will never happen again for me. Probably fair to say that I am too fucked up psychologically to be inflicted on another person. Anyway, the touch I am describing here is very different from sexual touch. I think it’s possible to meet all my needs for physical touch without any kind of sex.

I am a child of the MDMA (ecstasy) days, before ‘legal highs’/novel psychoactive substances, and one of the effects of that drug is that my friends and I got into the habit of hugging a lot. I remember that time fondly too. I still hug my friends to say goodbye and most of my family too. But these are quick hugs that don’t soothe my brain the way a long hug does. When my relatives’ children were small, I would hug them a lot. Partly because of my absolute fucking horror at the thought of them feeling like I did when I was a child and partly because it made me happy. I’ve had two long hugs in recent months. One from one of my oldest university friends and one from my sister and both because I was upset. They helped, and I am grateful for them, but they weren’t enough. I feel like I am this empty, insatiable pit of need when it comes to wanting to be touched.

So if you read the self-help articles and books then you are advised to try ‘therapeutic touch’ when you feel you don’t have enough touch in your life. I was given a voucher for a massage as a birthday present and I’ve had two and going to have a third today. They are very expensive. It feels intensely relaxing physically and my muscles feel liquid and released. But it’s for the psychological benefits that I am doing it. When my massage therapist moves round the couch to a different area she keeps a hand on my back or my shoulder. I am sure there is some what I’d disparagingly call hippy or spiritual (because it’s outside of my knowledge and experience) reason for this but what actually happens in my brain is that it suddenly starts thinking “I am normal” because she hasn’t taken her hands off me the second that she could. My brain starts thinking I might be okay and not entirely repulsive and repellent. Just a normal human body. A bit of detangling of my thoughts.

I grates with me that I have to pay someone to touch me and can’t find it naturally in my life. But, as previously mentioned, I am not in a position to have a romantic relationship and that seems to be the way that my society is organised to meet people’s needs for touch. I am lucky that I have this massage therapist that I feel safe with, and can occasionally afford to pay, and that I have my friends and family to hug. Maybe one day I will have more, and I would like that, but it’s okay just now.