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.
[suicide, no mention of methods because I am not that fucking irresponsible]
If you have been unfortunate enough to have read the recent nonsense on this blog then you’ll know that I am planning to end my life. Sorry, that was a bit abrupt. Should have paid more attention to those Breaking Bad News workshops. Actually, they did come in handy when telling all my Mum’s friends that she had died. I didn’t cry once. I don’t know if I should be proud or ashamed. Anyway. My thoughts are bad these days and it’s hard to create a chain of thought. My thoughts are like trying to grip water in my hands: I can see they’re there but I can’t hold them.
Blah, blah, blah, tl:dr; had enough.
I set another date as last weekend fell through (yes, that phrase is doing a lot of heavy lifting) and have started lining the practicalities up, eg finishing food, distancing myself from people, “tidying up loose ends” as the nurses put it. I adapted my plan (have a series of plans to try to account for my inevitable fuck ups) and was waiting for something to come through the post which was due the middle of next week. It arrived today. I’ve had a lot of psychotherapy in my life so I now quite often find myself observing myself as my life happens to me. (Psychotherapy never has any disadvantages or harmful effects.) I watched myself go from “oh fuck, I don’t know what I think about this” to the sudden delighted excitement of “I could be free today!” to despairing “I bet I fuck this up again”. It was lovely and awful and overwhelming. Is it odd to say I felt some hope fluttering about in my head?
I calmed down and opened up my post. Only half the order with the rest due the middle of next week as originally planned. I definitely felt some relief. I feel bad for admitting that. Does it mean I’m not committed to my plan? Am I going to fuck up again? Am I going to pull out? I don’t think so. I feel quite steady and settled in my decision to die. It will most likely be horrible but there’s nothing I can do about that; will just have to thole it. It will pass. If I don’t kill myself now then I will have years of this pain to get through. My friends and family will have years of pain of having to deal with me. I think it is natural to have a little bit of trepidation or regret about big decisions (I think I learnt that in psychotherapy) but you have to be resolute too. I’ve been certain that I was going to succeed only to fail in the past. I just have to keep trying.
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.
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”.
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.)
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.
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.
I am saying the most crazy things. My thoughts are relentless and flying. I keep not being able to tell what should stay in my head and what is okay to say. What have I done. I think I have irredeemably ruined everything. I can’t undo what I’ve done. I can’t believe I’m going to have to live with this for the rest of my life. I can’t even begin to approach trying to understand what I have done to other people. What will they think if/when they find out. I think I would be so hurt. What have I done. I don’t know how to be honest. I don’t understand the truth. I genuinely can’t believe I am doing these things. And why. For what. There isn’t even any benefit. Not to me and not to anyone else. It is just so destructive. I have this profound, overwhelming urge to beat myself down and punish myself and make everything right. I can make everything right again. I can stop polluting the air by breathing it out and I can stop contaminating the ground by walking on it. It won’t redeem me but it will make things better. I can’t do right like a proper person but I can make this tiny attempt at it and that’s better than nothing, surely. I have to stay away from people as I am just hurting them. That is such a simple and obvious solution. Try harder and do better controlling my thoughts. Not get lost in them and let myself be swept away and end up saying pure craziness. I don’t have muscle and bone and blood under my skin; I just have guilt. There is a guilt monster under my skin animating me. I have to feed it. Sometimes it wants me to do ‘right’ and ‘good’ and lets me feel a bit better. Sometimes it wants ‘bad’ as it thrashes about under my skin making sure I am punished. What have I done. I will regret this for the rest of my life. This will dog me for the rest of my life. Will add it to the list.
[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.
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. https://t.co/Q1lTdtI1or— 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.