Life has many gifts. I’m not so far gone as to deny that. Long, tight hugs from someone you love. Sunrise on a frosty but perfectly clear winter solstice. A child laughing in delight when you explain something to their satisfaction. Some people receive more of these gifts than others. Perhaps some people earn more of these gifts than others.
But life has many terrors too. Pain. Loneliness. Fear. Again, some people receive more of these terrors than others. And perhaps some people deserve more of these terrors than others.
So many different paths through so many gifts and terrors. What’s a gift? What’s a terror? In the end, we are all the same.
When your body is breaking down but the pain just keeps increasing then life has one last gift for you. When your mind is breaking down but the pain just keeps increasing then life has one last gift for you too. The pain will always end; you don’t have to be afraid; no one can take that from you. Death will always come: life’s last gift.
I have so many bastard lists on the go at the moment as I try to get organised. My memory is hopeless just now so I am using lists for even the most basic things. Here’s a list from ten days ago that I am referring to frequently, for comfort, reassurance and to torture myself (impressive résumé for a list):
I feel guilty for the terrible things I have done which I can never fix or undo
I hate and despise myself; I am a terrible person
I have never achieved anything and I am intensely ashamed of that
I am a burden and I drag down my family and friends; I know for a fact that they will be better off when I am dead
I will never have someone to hug and hug me
I will never have someone to love and love me
I will never have someone to cuddle in bed with
I have feelings of intense loneliness which are very painful
I will never have someone I feel safe enough to have sex with
I am putting all the weight back on and everyone is laughing and looking down at me
I am ashamed that I can’t manage my eating
I hate my body and want to rip it apart and set it on fire
I am ashamed and horrified that I didn’t apply for the ordinary degree that I had credits for and so ruined even that faint hope for a future
It really hurts and I feel intensely ashamed every time I see someone talking about managing to be a doctor or medical student with a mental illness
I am a waste of the Earth’s resources; one less human is better for climate change
I am a waste of NHS resources
I am a waste of taxpayers’ resources
I am ashamed that I can’t manage my mental illness
I am ashamed that I so desperately want people to like me
I want to be free (though I don’t deserve that)
I want to be at peace (though I don’t deserve that)
I want to be finished and gone and in the past so that the harm I did can heal
It was hard to write but I felt better for it as my head felt clearer and emptied out. It is like cutting into raw, burnt skin when I expose this intense, overwhelming shame. If it wasn’t for the fact that I will be dead in a few days I wouldn’t be able to. I don’t know why I am publishing this. It eases something and makes these last days less painful, I think. I have no right to ask or hope for that of course. Also, it’s a kind of proof to myself. I would never, never, never talk about these things if I thought anyone I knew could even remotely possibly find out. There is always a possibility that you can be outed from an anonymous blog. But it doesn’t matter if you’re dead.
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.
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.
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.
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. https://t.co/Q1lTdtI1or— 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.
In the latest episode of the Therapy for Black Girls podcast, 120. Helping Children Regulate Their Emotions, there is a very interesting discussion starting at 35:50 about the difference between discipline and punishment. As you can guess from the podcast title, the discussion is specifically about parenting children.
According to the guest psychologist, Dr Ann-Louise Lockhart, punishment is about making the parent feel better by discharging their anger and annoyance at the child. The child feels the parent’s negative emotions and that makes them not want to repeat the behaviour. Discipline, on the other hand, is about teaching the child something specific that the child can apply to their own life later and so not repeat the behaviour again.
My experience as a child was of being punished not disciplined, using these definitions. I think that was pretty typical of the time I was a child. I wasn’t punished often because I was, mostly, a ‘good girl’. I am pretty severely mentally ill and don’t cope well with it but I don’t know if there is any link with those childhood experiences and my present mental state. Don’t know, not really interested as nothing I can do about it now.
What does strike me now is that even as a child and teenager, while I wasn’t being punished often by my parents, I was definitely punishing myself a lot. A fuck of a lot. For all kinds of minor things that I blew out of proportion and thought were horrendous. For example, I have three thick hypertrophic scars over my sternum between my breasts from not being able to answer a question in my maths Higher prelim. I was so intensely frustrated sitting there not being able to answer the question that I was overwhelmed and the only way I could keep myself intact, keep my composure and pretend I was normal, was to promise myself that that night before bed I would punish myself by cutting as deep as I could over that bone. I visualised the cutting and imaged the pain and felt so much better. I felt calm and clear headed. And so I finished my exam. Can’t even remember if I ever did attempt an answer for that question. Can’t remember my result for that prelim. But I know that I kept my promise that evening and cut as deep as I could over that bone.
I have kept punishing myself out of my teens and throughout my adulthood. I’ve never really questioned it. It’s self-evidently necessary that I need to be punished and obviously I need to take responsibility and do so to at least attempt to try to make myself a better person. I weaponise my rage and frustration and aim it at myself. Then I listened to this podcast and thought about this psychologist’s definitions of punishment and discipline. I am telling myself that I am discipling myself and shaping myself into a better person. But I’m not; this is about beating myself down to make myself feel better. Does that sentence even make sense outside of my head? Lots of things die when they come out of my head into the world. That’s usually a good thing. Try again: I punish myself to make myself feel better; so I can tell myself I am doing a good thing. I know that’s true because I can remember feeling satisfied if I’d really managed to hurt myself. I felt safer, I think. I feel like I’m doing right, like the world is going right.
I have reduced hugely the amount I am punishing myself with food and restriction. Haven’t self-harmed in a very long time. Don’t drink. Don’t take drugs. Cut down the over-exercise a lot. Still isolate myself and don’t get enough social contact. Still sabotage important things in my life. Still fuck with my prescription medication (it’s going really well as I’m sure you can tell from my recent posts). Over the years my need to punish myself has morphed and adapted. I’ve tried so many things. I am so very tired. I am tired of punishing myself and getting worse. I’m tired of hating myself and just seeing that I am an endless pit of hate. I’m not a better person for it. I am just… less. Broken down.
I could try to disarm the punishment but I don’t feel very hopeful that I could make much difference. But then I took up running which is just the most laughable thing for me to think I could ever do. Made an attempt at intuitive eating though don’t know how well it’s going (obviously the scales are the only arbiter of progress). Started mindfulness and found my own way to help the depersonalisation. <off to google “how to stop self-punishment”>
Oh, I’m sorry. Were you expecting an inspirational concluding paragraph. Wrong blog.
I left home at 18 years old to move to a city and go to medical school. I loved it then fucked it all up.
I did the first two years fine, even got distinctions in both the first and second year end of year exams, but then had a psychotic depression that completely derailed me. Dropped out of third year part way through and repeated and completed it. Completed fourth year though had some classes to make up. Started final year three times and couldn’t complete it and dropped out.
It was so long ago (I am in my forties now) but goddamn, it’s still so painful to think about. I never tell new people I meet about it and never bring the subject up with people who already know. Is it really fucking relevant to anything?! I suppose if it’s still so painful then it’s relevant to something.
I have a new friend who has a somewhat similar experience, except he actually made it and graduated and worked as a doctor for a while before his mental illness made him quit, and he keeps talking about it. Oh my fucking god, it kills me. He was talking about what happened to him and he casually said he had to leave medicine because he didn’t get enough support. It wasn’t some pained justification just said matter of factly like it was self-evident. He then implied that that was what had happened to me. I was absolutely astounded.
It had literally never occured to me that there was any other possible reason for me dropping out other than I just wasn’t good enough. Obviously I was pathetic and useless. I was given all these chances and I fucked them all up. Self-evident. That may well actually all be true (I bet it is) but there is a small part of my brain saying maybe there is more to it than that and I hear that and I am astounded again. This conversation happened a few days ago and I am still a bit dazed.
I always thought everyone agreed with me that it was self-evident that my failure was because I wasn’t good enough. Why would they question that? And my new friend just waltzes in and goes nope nope nope and my brain just stops. I realized later that night that my other friends don’t act like they agree with me (they are probably hiding their real beliefs in order to be kind to me though) which actually explains a few weird things I’ve noticed over the years. That small part of my brain then says what if they really, genuinely don’t agree with me and don’t think that and now I can’t stop crying. Hope is heady stuff but heads are seldom involved, to paraphrase Terry Pratchett. What if new people I meet don’t all assume that? God, what if my unquestioned assumption has been wrong for fifteen years. I actually don’t think I can withstand this line of thinking.
It doesn’t matter anyway as maybe I am not a terrible person for this but I am a terrible person for other reasons and I know for a fucking fact that I am right there. Absolutely right. I am irredeemably ruined and there is no hope for me. Heady hope meets hard, cold reality.