Scattered pieces

Please note that this post will discuss self-injury and disordered eating.

Control is a tough subject for many survivors of abuse… I desperately search for control, as it feels as if my life has been so out of my control for most of my life. As I grew up, I thought that if I could just get control of things and make everything perfect, then the abuse would stop. In my world, control and safety became intertwined… if I had control, then I would be safe… but, I could never gain the level of control needed…

I’ve often thought that my disordered eating has been about control… this is supported by the inner dialogue that accompanies it – an inner dialogue that has mentioned traits such as strength and cleanliness. But, the events of the last week have shown me how little control I have regarding my eating…

It started last Thursday, and was triggered by a number of stressors… extra workload; a minor conflict with a co-worker; November 18 is my ex-husband’s birthday; and a psychiatric assessment with the Community Mental Health Services (CMHS) on November 20… All of this left me feeling overwhelmed, and as if there was no way to escape. It also coincided with the idea that my weight was now “ok”, that I didn’t really need to lose any more, and that I needed to start stabilising. This last thought about my weight was seen as “weak” and a threat against the drive to control things through the weight loss, and towards the “end number” that comes from the disordered eating thinking… So, in what I now consider to be an addictive, self-injurous move; I started to binge.

I became obsessed with food. Periods between binges were consumed with planning the next episode… I binged at work… I binged with the curtains pulled… It felt so shameful and disgusting; but, this is what I thought I deserved… what I needed…

Looking back, it all seems so surreal. I can see some of the actions as making sense – as a response to the stress… but, so much of it was senseless.

I mention that there was a self-injurous aspect to it, and this was evident in the foods chosen… all of them were ones that were previously seen as “treats”. It was this “treat” aspect of the bingeing that gave me a clue as to the motivations behind it… As part of my early experiences of abuse, I was often given a treat afterwards for being a “good girl”. These treats were usually food. The treats were given to one in the system who was/is unaware of the abuse, so they were always accepted with a smile… Meanwhile the ones who had just experienced the abuse were there, watching the treats being gladly received…

This negative aspect of being given treats and presents is one that I’ve mentioned in therapy before… But, I only talked about it in a detached way, and only from the perspective of how “awful” it was to be given treats after the abuse… What I failed to talk about, or even acknowledge; was that in order for the treat to be given, something horrific happened before it. I failed to connect those dots in a meaningful way. I’m still not sure that I really have connected the dots… but, I’m more aware of them. I’m more aware of the ones within the system who hold the abuse…

I don’t think it’s any co-incidence that the final act of bingeing happened with potato chips and raspberry fizzy drink… It was like a final assault, and it worked…

On Tuesday things began to shift… I stooped to what I considered a new low, when I binged at work. Then, by Wednesday there was starting to be more internal communication about the bingeing. Since the previous Thursday I hadn’t been out walking, but decided to make an internal agreement… if I finished the walk by 11pm then another episode of binging was going to be allowed; but, if it was after 11pm, then I would draw.

The walk was “interesting”… internal chaos, at times walking faster to try to beat the 11pm deadline, at times walking slowly to make sure that the deadline passed…

I arrived home right on 11pm. It was agreed that this meant that 11pm on the dot had passed, and therefore drawing was the agreed upon plan of coping…

It’s been so long since I’ve drawn anything! I always think of it as being too messy, and pass judgements about my ability… I forget about how connecting and emotional it is…

On Thursday there was still a desire to binge, but instead I went out and took photos… meaningful, healing photos…

Ones representing direction…

Others representing the system…

It was emotional, positive, and what I needed to try to ground myself in the present. I’d become so immersed in flashbacks, that I’d lost all track of time, place, and location… These seemingly simple acts of creative expression eased that feeling… It was hard work, but worth it.

It’s now three days since I last binged. The desire is still there, but it’s manageable… The problem, is that the weight gained by the bingeing has ramped up the need for my weight to keep dropping… In the space of a week, I’ve gone from thinking that I might be able to ease the weight loss to a maintenance level, to having weight loss goals again. I know that this was going to be a possible reaction, but I still feel at a loss as to what to do…

So yes, the illusion that I had control over my eating, has been destroyed…

—————-
Now playing: Brooke Fraser – Scarlet

The other night, I was locked up in the Police holding cells.  I wasn’t under arrest… I was being assessed under the Mental Health Act. I’m still struggling to see how this is an appropriate way to respond to someone with mental health issues.

The events leading up to my detainment are fairly complex, but the event which triggered the Police involvement was when I abruptly ended a call to the crisis team.  I know that wasn’t the wisest thing to do, and even though I said “goodbye”, the end of the call was abrupt.  This hasn’t been an issue in the past, but for some reason, this time they contacted the Police.

A unit was sent to my house to “assess me”.  As I had stamped everything back down after talking to the crisis team, I felt sure that this would be nothing more than a formality… I was wrong.  The two Police who turned up, said that I didn’t appear happy; so they suggested that they take me back to the station for an assessment by one of the local crisis team.  As I knew that this “suggestion” was not really a suggestion, I went along with them.

This is when things started to get really weird… I was sitting in the back of the police car with the female officer, and she read me my rights – my criminal rights… you know those ones they recite to people in handcuffs in television programs… the ones where I have the right to remain silent, and everything that you say or do can, and will, be taken down and used in a court of law… those rights.

I sat there rather stunned, but agreed that I understood my rights.  She assured me that I wasn’t under arrest, but that assurance came too late… my mind raced to when my father used to take me to the police station with him for the raffle draws, and specifically the time when the policeman put me in the cells to show me what happened to “bad girls”.

When we got to the Police station, things became surreal… I was processed – my property inventoried; my jacket taken (because it had ties); my shoes and earrings removed.  I asked to keep my phone because of my anxieties, but that request was denied.

I was then taken from the intake area to the desk, where I stood within the red square on the floor, and was questioned about my criminal past (or lack thereof).  Thankfully I was wearing jeans which are about two sizes too big, so I could drag the excess material down and stand on that, rather than the cold concrete floor.

Then one of the worst things I have ever experienced… I was taken to a holding cell.  The sound that the door made as they locked me in was incredible.

I sat on the stainless steel bench, shivering uncontrollably, trying to keep it together.  I tried to focus on a spot on the floor of the cell and stay present.  The internal noise was incredible… screaming… yelling that this is what you get for telling the secrets… voices saying to shut up… urges to self-injure… everything came in a rush.

When the crisis team came to assess me, he joined me in the cell.  A man I didn’t know sitting between me and the door, in a small, locked cell.

He asked all of the usual questions, and I reassured him in all the usual ways.  All I wanted to do was go home… that became my goal.  Anything to leave that cell.

He agreed that I could go home.

I know that the crisis team, and the police need to be aware of the safety of their staff… but how is this an appropriate way to handle someone with mental health issues?  At no point was I violent.  I never raised my voice.  I never even looked any of them in they eye.  I was compliant and answered all of their questions.  So why was I put in a locked cell which is usually used for criminal suspects?  I don’t understand.

I remember asking if I was under arrest when they were processing my property.  The policewoman said that I wasn’t… but yet, I was being treated like a criminal.

All I did wrong, was ask for help.  Don’t worry, I won’t be doing that again.

—————-
Now playing: Audioslave – Doesn’t Remind Me
via FoxyTunes

It’s always interesting looking at other countries politics from the outside… you have the distance and impartiality to look on it with a mix of humour and confusion that comes from not really understanding the issues, or their impact.  I obtain all of my political knowledge about America from the mainstream online media, so it was rather amusing to see the coverage of The Rally to Restore Sanity and/or Fear.  It appears as if most of the mainstream media was attempting to spin this rally as a political maneuver, and it could be argued that it was.  But for me, the big message was directed towards the media and the agitators to stop the divisiveness and encourage reasoned presentation of the issues.

Looking at some of the signs that were carried at the rally, they speak volumes… “If you keep shouting like that, you’ll get big muscles all over your face” … “And take it off CAPS LOCK” … “Even my sign chooses not to yell” …

It can be easy to yell the loudest and longest, but where does that get us?
It can be easy not to say anything, but where does that get us?

As a survivor, I struggle finding the middle ground between these two – that sweet spot of “sanity” that Jon Stewart is advocating for.  I delay speaking up, because I don’t want to bother anyone, or there’s too many negative messages about asking for help.  This silence causes things to build-up, and I explode in a rush of dysfunctional behaviour.

I’ve yet to find that reasoned, assertive voice that advocates for my own well-being.  Until I find this voice, I’m going to struggle in a system that requires you to fight for your basic rights.

Today, I saw the crisis team psychiatrist… it didn’t go well.

He showed me to the interview room, with this pleasant, eager young woman following in his wake.  I was a little puzzled about her presence, but had a sneaking suspicion that she was a training psychiatrist come to sit in on the interview.  Having had this before, I knew that they always asked if it was acceptable for the trainee to sit in, at which point I was ready to politely decline her being there.

We entered the room, and he sat down briefly, flipped through my file, noticing that there weren’t any blank pages, so left to get some.  Saying over his shoulder to the eager young woman (who had scooted her chair up to the desk), to introduce herself.  She was incredibly polite, saying that she was a trainee nurse.  When the psychiatrist returned, I asked if she was studying at the same institution where I worked – she nodded eagerly.  I asked that she not be present as I worked there and didn’t want to discuss the issues I was facing in front of a student from the same institution.  His immediate reaction… “But, she’s here for my safety”.

Apparently I look like someone who would either physically attack this old man, or scream sexual harassment.

What was interesting, was that at no point did he consider my safety.

His compromise, was to sit the student in the corridor just outside of the office with the door wide open.  It was a busy corridor.  At one point a woman stood at the doorway for over a minute trying to close an adjoining door – while loudly talking about her inability to do so.

Then there was the interview…

“So you didn’t show up for an appointment last week with Dr X”
“No, I’ve shown up for every appointment that has been made for me”
“Accusation number 2″
“No, I took care of myself”
“Accusation number 3″
“No, that didn’t happen”

So it went on… “What’s your mood level?” “How are you sleeping?” “What drugs are you taking?” “How much and how many have you got left?” “What do you want?” “Why are you here?”

Then it got worse. “I’ll prescribe X drug”. I asked what that was… he went into a long description about how benzos are addictive and their effect diminishes over time. He didn’t actually tell me what the new drug was, just how bad my current medication is. When I asked what the new drug would do, he said it would calm me down. I asked about another drug that I’d been recommended, and he scoffed. Saying that’s an anti-psychotic and that I’m depressed; and they only give that drug as injections up at the hospital anyway.

As I’d checked about the use of the drug before going into the appointment, I knew that it was also used for PTSD symptoms – my main problem at the moment; so I knew he was wrong about it’s use.  But I didn’t correct him… he was not a person to be corrected.

We’d started the interview pretty low, but this crushed us.  We crumpled.  I asked if it was ok to leave, he said yes; so we got up, thanked him for his time and left.  As we were doing so, he flipped my file shut with a sigh and leaned back on his chair.

I know I didn’t handle the situation well… I know I should’ve taken the drugs he was offering… but I couldn’t cope.

When I got back to work, I put my things down and told my cynical friend that I thought I was going to cry… we went into a spare meeting room and it all came out.  How I dissociate, how unsafe I am, everything…  She contacted the work place therapist who sat with me for an hour talking about things.  When I described the appointment to him, his comment was… “Yes, the psychiatrist had done his job.  He’d mentioned all the right things in all the right ways; but he didn’t care what happened beyond his vision of what you were and needed”.

It was this therapist who gave me the two creative expressions that I put up here today.  I decided to remove one, as although parts of it were powerful, the potential for triggering someone outweighed those benefits.

I’m still at a loss as to what I can do.  The birthday has now past, and that seems to have eased things internally.  I’m back at work, and that has forced a level of functioning.  I also have my cat back home… that always makes life good.

—————-
Now playing: Sarah McLachlan – I Will Remember You [Live]
via FoxyTunes

So, long time no posting…  I wish I could report some wondrous reason for my absence, but unfortunately not.  The only reason is pure dysfunction.  The reason for the dysfunction are my lessons for the week…

Lesson 1: Remember, listen and pay attention

I’m often reminded of the ripple effect any incident can have in a dissociative system.  Something that doesn’t even register as a ripple to you, can be tidal wave to another part of the system.  So when I briefly posted an entry on this blog that contained the words “good girl”, I had no idea what the consequences would be.  I didn’t sense any real warnings about the meditation when I read the original entry.  But then, I don’t think I was really listening and paying attention to what was happening internally.  I was thinking of sharing what I thought was a valuable resource with others – librarian mode in full flight.

The first hint that things weren’t right, was a message from S:
“I’m no ones good little girl”

Once I saw this message, I edited the entry to something I thought was safer. Ellie tried to reassure S -
Ellie: “it’s been changed”
S: “too late… pay the consequences”
Ellie: “it’s been removed, no need for consequences”

The thing is, I should have known not to use that phrase – it was listed in one of the original trigger inventories that I did early in my healing journey.  But I was arrogant, careless and disrespectful.  I was thinking of sharing a resource, more than I was thinking of the ones who carry the wounds.  There were consequences to using that phrase, and it’s impossible to blame her.  I trampled all over S and her triggers, so why should I expect niceties in return?

Yes, it would have been great if S could have dealt with the situation differently.  But, it also would have been great if I’d thought about what I was doing.

Did I really pay attention inside? No.
Did I think about the phrases I was reading and using? No.
Was I being a self-important pompous twit by finding something that others might find useful? Yes.

I was thinking of myself more than the system.  No wonder they don’t trust me.

Lesson 2: Be responsible for your own safety

Yes, the consequences of my actions meant that S lashed out.  The flashbacks were horrific and all consuming. This allowed the ones who are dangerous to come forward and, for want of a better word, play with the body.  But before we reached this point, I had the opportunity to ask for help from Allison and the crisis team.  That would have been the sensible thing to do, but what did I do instead?  Basically, I set Allison up for failure.  I was unable to say the words “I need help”.  Instead I buried the message in emails from M and the young ones tried to tell how scary it was within therapy.  It wasn’t surprising that Allison couldn’t work out how bad things were.  But her inability to read all the messages that seemed obvious to us, meant that she had failed.  So after therapy on Monday there was a dangerous incident that meant we ended up in respite care for two nights.

The truly sad thing, is that even after the incident, I wasn’t able to communicate to the crisis team that I was still in danger.  Both Sophie and M were telling the team that we were in danger, but also didn’t want to cause a fuss, so were going along with their plans to send us home.  When it became obvious that this was going to happen, a very restrained Frank came forward and indicated how unstable we were.  At least some part of me was willing to step up and protect us.

So this is what I’ve indicated to Allison that we need to work on immediately, my inability to communicate the level of danger I’m in.  I need to know how to read the signs within the system and communicate it clearly.  I know I’m hampered from this free communication because so many of the young ones are triggered by hospitals, and our fear is that if we are honest about how bad things are, we’ll end up there.

If I’d been honest today, I probably shouldn’t have been released from respite.  But respite was different this time.  I was in the same place, but the carer in charge for the week was different, as were the mix of the clients.  This threw the dynamics off to the point where it didn’t feel safe.  It felt like my house growing up; rather than the healthy, vibrant place that the other carer made it.

I know I’m not out of danger yet.  I’m seeing the crisis psychiatrist today, so I’ll get another chance at trying to be honest about my level of danger and establishing what options are available to me.  I’m almost resigned to a hospital stay… some think this would be a good idea, especially in the secure ward where we can release some of the pent up emotion in a safe environment.

So at the moment I feel like a complete and utter failure.  I put the system under more stress at an already stressful time, and I didn’t take adequate steps to protect us once the damage had been done…  Yup, a failure.

Note: Please be aware that I am getting support, I’m not putting this out there and expecting readers to save me… although donations gratefully accepted (especially therapy vouchers) – you know, just saying :)

It’s often been said that small acts of kindness mean so much. I don’t know where the quote comes from, but it’s truth is re-enforced daily.

Today I saw Liz for the last time, the “rupture” during therapy on Monday couldn’t be worked through to a point where we felt we could continue seeing her. I’m seeing the Mental Health Crisis Team psychiatrist on Friday to see what can be done to help me through the public health system.  Because of all of this, I was feeling pretty low.  As a distraction, M thought she’d check our work emails. Right at the top, was one from a lecturer we had done some information literacy teaching for last week.  We were expecting it to be some criticism, as it felt like such a bad session… this is what he wrote…

Hi

Thanks a lot for teaching my class the other day. I was very impressed by the amount of care that had gone into your presentation

Matthew

This on a day when we were at our lowest in a long time…

Small acts of kindness mean so much…  What may seem to be an insignificant gesture, can touch the person who receives it in ways you’ll never imagine.

I thank those who have commented and sent words/thoughts/wishes of support while I’ve been blogging about my healing journey…  At different times they’ve given me hope, laughter and pause for thought… Thank you.

—————-
Now playing: Green Day – Time Of Your Life [Good Riddance]
via FoxyTunes

I’m writing this from a respite care house :) Respite care is a very odd experience. I’m in a normal house on a normal street with a “normal family”. I’ve just had the most surreal evening meal with this family… They blessed the food (mild trigger, but nothing too bad), ate, talked and joked. There were no undercurrents, no tension, no unspoken hostility… It was very, very odd. I haven’t experienced that in my adult life ever. I’ve never witnessed a family who loved and joked without malice. I still don’t know what to make of it all.

My room is simple and comforting. I’m the only “client” here, and they have a capacity of three clients at any one time. There are no locks on any of the internal doors – including the bathroom, which is a little triggering, but it still feels safe! I’ve felt welcomed into the home without reservation. They don’t care about my diagnosis or what has led me here. There is just warm comforting acceptance. They’re not the Crisis Team trying to therapise me, they’re just a normal family who accept strangers into their house with basic guidelines in place.

There was a visitor for dinner who has mental health issues and is going through the DBT program, she convinced me that the program, as delivered here, wouldn’t suit me. It was interesting to talk to her though. It sounds like her world fell apart and she is now struggling on an invalids benefit. I can see how that could so easily have been me. But instead my current level of dissociation keeps me on a different level of functioning.

So I am safe! I’m writing this from my iPhone as my computer access is non-existent (as is access to a spell checker *sigh*). I’m trying not to worry about the silly things, like my crops in FarmVille and Farm Town dying while I’m here. But the little things will get to me every now and again. I’ve been told that I can stay as long as I need to get myself back to ground; as I’m somewhere out Pluto way at the moment, that could take awhile.

On a random note… Our door has a painting of Tigger on it, which pleases Aimee immensely :)

M is not particularly good at communicating, while she may have a solid reason for any decision, this is often no communicated well to the rest of us.  So when she was reluctant to call the crisis team, I thought she was blocking our attempts to achieve safety, or possibly protecting the young ones in her care from the trigger of going to hospital.  I was wrong.  Her greatest fear was realised, the crisis team can’t do anything to help us stay safe.  She wasn’t worried about the respite care or the hospital, she’d prepared her young ones for that; she was worried about them not being able to do anything.  In some respects, what happened was worse – we had several phone conversations with a very nice and understanding crisis nurse who explained about coping mechanisms and grounding techniques, but informed us that there were no respite beds available.  After referring to our notes and talking to us for over half an hour, she assured us that the nearly full local psychiatric ward wasn’t the right place for us.  Instead she encouraged us to continue with our coping mechanisms and taking it a day at a time.

It was the worst case scenario, the crisis team were trying their best, but don’t have the resources to help us.  The were polite, friendly and called back twice to check on us, and to try reassure us that we can do this.  It was devastating.  This was M’s biggest fear… we need safety and we can’t get it.  We’ve now officially tried all of our options.  There is nowhere else to turn.  Sometimes when we’ve called the crisis team, the service has been so bad that it’s kicked us into a release of anger that has driven us through the suicidal ideation and out the other side.  It’s acted like a release on the pressure valve.  We couldn’t even get that today… the nurse was so polite and trying to suggest ways to get appropriate boundaries in place with the mother etc.

In many ways our suicide attempts have appeared impulsive… there’s been a final trigger that has pushed us over the edge.  But the plans are well thought out, just waiting for that final trigger.  This is what we fear may happen again.  In many ways we’re calm and functional – when we told the mother we were calling the crisis team she asked when things had got bad again, we explained that they’d never been good.  I know this could be an indication that the mother has no clue as to our true level of functioning, rather than any indication of how we appear to be coping, but it gives a hint as to how we appear to the world.  The crisis nurse could see through the veneer, she said we sounded in trouble, she just couldn’t do anything about it.

When the crisis nurse confirmed that there would be no assessment and there were no places, we were in tears.  We were crying because we gave up on getting help.  We know that no one can do this work for us, but we’d really like some help to get us through the rough patches…

I said in my last post that I’m treading water in an ocean rip… well the current just got bumped up a notch or three…

I had my last session for the year with Liz on Tuesday.  I’ve totally forgotten everything that was said except for one thing… I told her that I wasn’t angry and she laughed, saying that she didn’t believe me as she could cut the pain and anger that was in the air with a knife.  I’m honestly not aware of the pain and anger.  Sometimes I can get a glimpse of annoyance with something, but not pain and anger.  But they must be there, I’ve disclosed two more abusive events over the last two weeks, that must generate some emotion… surely.

As a result of the session, I had a really bad night trying to work through the different messages and fantasies that were coming through.  It was a blur of switching, talking to a friend and negative behaviours.  By morning the previous day was a gone from my memory and I had a made a firm commitment to taking further steps toward respite care.  I still hadn’t heard back from my psychiatrist, so I went to see my GP yesterday afternoon.  The appointment was very surreal…  I explained why I needed respite care and she was so unprepared for organising it that she didn’t have the right referral forms with her and was unsure if they would accept me because I have suicidal ideation.  I can understand them not wanting to accept someone with suicidal intent, and I’m not sure how far along the scale I am between ideation and intent, so I’m possibly not a safe bet for respite.  But I have to try.

When I got home, after assurances that the doctor will fill in the forms the next day and send them off, I found an email from my psychiatrist.  I’d also asked him about respite, but basically he passed the buck to the crisis team.  To put this into context, I haven’t physically seen the man in over six months.  He’s changed and increased prescriptions via email based on my reporting of issues.  So this latest passing of the buck is a bit of a blow.  Whenever I’ve asked the crisis team about respite care in the past, they’ve always said that they are full.  The only option is the psychiatric ward.  The psychiatrist said that he will warn them that I might need respite care… well that’s pretty meaningless in the scheme of things…

So… I have no therapist for the next month; a GP who has said that I might not get into respite because of suicidal ideation; if I do get into respite, it could take weeks to get a spot; and a psychiatrist who is fairly casual in their level of response.  I wasn’t expecting anyone to come and save me… but at least someone to offer some realistic hope would’ve been good.  I’m now at work and can feel the heaviness of the depression and hopelessness closing in.

In the good news stakes, the mother has suggested that she doesn’t come up for Christmas.  I can’t yet bring myself to confirming that I don’t want her here, but I know I have to.