Posts Tagged 'Suicidal ideation'

Once upon a time…

Note: This post was going to be submitted for the Carnival Against Child Abuse, but it became more about trying to peel off another layer of scar material that was caused by the marriage.  It could be triggering, please read with care.

There was once a little girl who got hurt by the people who should have taken care of her.  This experience taught her about keeping secrets, packing the bad things into containers inside her head and to forget about most of the bad things altogether.  She became good at playing the parts and emotions that were acceptable to those around her.  Compartmentalisation and dissociation became her way of life.

As this girl grew, the dissociative walls became higher and more entrenched.  Her core beliefs were that she was a nuisance, stupid and ugly.  But she wasn’t a victim.  Oh no, she knew that bad stuff had happened, but she believed that it happened to every little girl, and no one else seemed to be complaining.  So when the girl became a woman and met a nice man, she didn’t tell him about the bad stuff; instead she listened to his stories of being abused by his sister when he was a boy.  She didn’t understand how that could have happened to this seemingly big, strong man.  It made him cry and she comforted him.

So began, what would become 8 years of physical, psychological and sexual abuse for that woman – us.

In many ways, the man came into the relationship more honest and open than we did.  He said he’d been abused, we didn’t. We got so caught up in his past that we didn’t say anything about ours – we didn’t really consider it that bad or worthy of talking about anyway.  Abuse was what we had come to expect.  So when he raped us for the first time, we dissociated it away and considered it normal.  Besides, he was good to us – he gave us flowers, cooked for us and treated us with a form of delicate care (when in front of other people) we’d never experienced before.

A pattern developed over time, he would have a crisis of some sort and we would save him.  He needed us to be strong, so we were.  We were hardly innocent within this scenario.  The woman at work used to feel sorry for him as we appeared to pick on him and order him around.  I can understand why they would get this impression – he needed to be saved and we needed to be a saviour.  The weaker he became within his work and mental health, the stronger we had to be, and the more he would abuse us when no one was looking.  The strength we showed to the world was one of us organising our world to gain some control.  When we got behind closed doors there would be a dissociative switch to one who enjoyed the pain that he inflicted sexually and physically.  He became good at triggering our switches, so we built the walls inside our internal house higher and stronger.

About four years into the relationship, we were in a side impact car accident.  We sustained a mild concussion.  In that one instant, our lives changed forever. Our coping mechanisms fell apart.  Suddenly we were weak.  Suddenly he had to be strong, but he wasn’t able.

He had been intermittently seeing different therapists over the years, but had never seen one for more than three sessions.  They were always useless or changing their fees or playing games…   We realised we were in trouble and started counselling again.  He began to self-injure, often in front of us or because of us.  He was fired from his job for assaulting a supervisor.  We tried to be strong, but were slowly falling apart.

He got a job as a security officer – a job where he could “get some respect”.  We also changed jobs.  But nothing fixed the things that were happening in each of our heads or in that house.  We were two people who had serious mental health issues crashing into each other.  We became suicidal and were regularly assessed for danger, always to be released back into the care of the strong man who was now our husband.

On the 9th of February 2008, we attempted suicide.  It wasn’t our most serious attempt, but it landed us in A&E and then the secure psychiatric ward.  On the 10th of February 2008, the strong man took us home.  What followed is blurry, but I know M made a smart arse remark to him about how he needed to grow up.  He then showed us how strong he was by trying to kill us.  His level of violence scared him and he called our mother, screaming that he’d done it this time and it was all over.  The mother thought he’d killed us.  When she talked to us, she asked if we wanted someone to come up to be with us.  Sophie said “yes”.  With our family there, he couldn’t cope with what had happened, so left the house on the 14th of February 2008.

Looking back, I can see how our different issues collided to cause what happened.  If he’d married someone who wasn’t dissociative, this probably wouldn’t have happened.  We were so conditioned for abuse, if it hadn’t been him, it would’ve been someone very similar.  Could we have ever made it work?  I doubt it.  He was not interested in healing.  He paid lip-service to therapy, but wasn’t prepared to invest the time and energy.  I was too defensive and in deep denial.  I wasn’t prepared to heal myself, instead I was so caught up in his problems that he was all I could see.  My life became about fixing him.  He has refused to attend the court ordered counselling as part of the Protection Order, so I don’t think he’ll ever heal.  I hope he does and proves me wrong…

The following clip is one we did a year ago to try to work through the events surrounding the marriage.  It may trigger.

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Now playing: Powderfinger – Sunsets (acoustic)
via FoxyTunes

Looking out through crying eyes

Looking out through crying eyes

Looking out through crying eyes

Losing myself… over and over

The last few months have been interesting ones to reflect on.  I can spot within the blog entries the points at which I’ve been suicidal, trying to reach out and at what point I shut down and went back to the “everything is fine” mindset.  This is the one of the big advantages of blogging – the ability to reflect back on your thinking.

So I sit here, listening to Missy Higgins and wonder how I can keep going and in which direction to go.  I know that I am losing myself again.  I know I do this regularly.  I get lost, confused and overwhelmed.  I then seem to find some sort of plateau that seems safe for awhile – almost like finding a clearing in the forest.  I’m deep in the forest now and I’ve got no idea which direction to turn.

Having the mother here is difficult.  I have issues about the sound of people eating or breathing – yeah, I know it’s weird.  I can’t stand the sound of either, it seems to get amplified in my head and drives me crazy.  Unfortunately the mother does both fairly loudly.  I wish I could say that I love her and this is the only problem, but in all honesty I don’t love her.  I know some of us feel happy when she is around, but there are no tears when she leaves.  We don’t mind her being here for a short time, but we’d prefer it if she was only here for a very short time.  I know this sounds ungrateful, disrespectful and as if it’s breaking some law of nature.  But I don’t feel anything much towards her.  I also don’t feel hatred, I know that much.

Part of the reason is that I have never felt like a person around her.  If I was noticed, it was as a medical condition, an A+ grade at school, thin, fat, loud, silent, the mistake…  I was never “Michelle”.  This de-humanisation has been present throughout my life.  At the wedding, it became more about what the sister-in-law wanted rather than anything to do with me or the now ex-husband.  This feeling of being an object is what I tried to capture in one of the very first Polyvore sets I did…

I was a silhouette that had no soul, no place and no voice.  I can hear some in the background telling me not to be so melodramatic :)  I apologise, I’m in a rather odd mood.

Yesterday while out mowing the lawns, we decided to give Liz another try.  It was interesting reading through the comments to our entry about our journey with therapists (a BIG thank you to those who contributed).  Our reaction to the comments summed up our history – if it was possible to read into any of them that the whole issue was our fault, we would; if it was possible to read into it that it was the fault of the therapist; we would internally defend them.  It was a replica of our attitude towards our abusers…

Anyway, we’ve decided to give seeing Liz another go.  We don’t have any strong objections to her methodologies (although the religion issue is a big red flag).  Many of our issues with her are about her habits, for example turning her cell phone to vibrate mode.  I’m a little stunned that none of her other clients have found this an issue.  One of the major issues is that we are unable to communicate an issue as it occurs.  Because of this, we couldn’t say “Liz, we find it uncomfortable that you look at your cell phone while we are having a session”.  We sent an email to her to explain some of the issues and to see if she thought therapy was what we needed right now.  She responded that maybe the relationship issues with therapists is something that needs to be part of my healing (or words to that effect).  I agree with this, but also know that I’ve let bad therapeutic relationships go on for too long when they’ve hurt and been destructive.  I don’t trust my own judgement on what to do at a very basic level.  I, as the object doesn’t have a direction…

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Now playing: Missy Higgins – Stuff and nonsense
via FoxyTunes

Broken heap on the floor

On Thursday we got a call from ACC.  After three months deliberation on our case, they made one minor change.  M asked how our corrections to the report had been factored into this decision.  ACC response – what corrections?  They had never received them, or lost them.  To put this into context, we started this process in February of last year, it’s gone through about five different variations on the report and now gone to mediation.  It took us two weeks and a lot of strength to write those corrections which involved correcting the details of our abuse and more devastatingly, writing anywhere for the first time that the father sexually abused us.  So this was highly confidential, soul destroying information… and they LOST it!  It could have ended up anywhere, anyone could have been reading it – it had our name, address and everything on it.

When I’ve told people this, their immediate response is “Oh no, do you have a copy on your computer?”  Yes, of course we do.  I know that’s the reasonable response you give to an adult.  But SO holds the secrets on that bit of paper and she is 7.  All she sees is that we should never have told the secrets cos it’s bad and lots of people read it and it’s bad and we’s get into trouble and we’s bad and evil and it all our fault.  It becomes a mantra that we’re bad and evil for telling.  W and SO are closely linked within the system.  SO gets upset and W will react.  This action meant a call to the mental health crisis line on Thursday night to stop the suicide.  In typical form with our interactions with this team, the connection was bad and they were going to call back.  They did eventually – on Saturday.  We had the usual conversation:

Crisis Line: You’re suicidal, lets bring you in for an assessment.
Us: No thanks, your only option is hospital and that isn’t an option for me.
Crisis Line: No, we also have community placements or agree to regular contact for a week to see how you’re going.  We can also get you in to see one of our community psychiatrists.

Sounds reasonable, doesn’t it?  Almost like they will be able to help.

Us: In my experience that has never happened.  I’ve been promised community placement, only to end up in the psychiatric ward.  I’ve had phone calls daily from your team and they’re more triggering than helpful.
Crisis Line: Well I’m sorry that has been your experience, let us know if we can help.

I know that those of you who haven’t experienced their services will say I’m being stupid for rejecting this assistance.  I know that they have saved many lives.  But our issues with authority and psychiatric hospitals mean that they are more likely to kill than save us.  We call them for the distraction, nothing more.

One of us called them again on Saturday night and we ended up being hauled in for an assessment.  It was hell.  We need peaceful surroundings and control when we’re suicidal.  But last night it was raining and there was international rugby on TV.  Those two factors meant that a great deal of the homeless had decided to be suicidal that night in order to watch the rugby, have a shower, get a meal and warm bed.  The shelters would’ve been overwhelmed, and they know that if you say you’re suicidal, they have to admit you.

We managed to get out of the hospital and get to the relative safety of home.  But we’re a mess.  The oddest things are triggering.  We know that people need to talk about how they cope with sex as a survivor.  But today, it’s too much.  It’s become about others not being safe – cos all sex hurts.

We’re in trouble and I don’t know how to fix it.

Scarlet

One of the first YouTube clips Sophie created was Little girl lost… which used the song Scarlet by Brooke Fraser.  This song represents our suicidal struggles.  It isn’t one of her more popular songs and as far as I know she never made a video to go with it.  Here is a simple fans version…

Middle of nowhere
Finally you can breathe
Nobody knows your name
It’s easier

Shut your eyes tightly
Clench your fists ’til they almost bleed
Cautiously, lightly
Gently expose what’s underneath

And all you feel now
Is the scarlet in the day
Even if it’s real
You can’t stay…

So there you go
You’re gone for good
There you go
You’re gone for good

Your mind is swollen
From months of thought without release
They’ve taken their toll on you
And this very moment
Of timid and fragile honesty
Is precious and rare and fleeting

And all you feel now
Is the scarlet in the day
And even if it’s real
You can’t stay…

So there you go
You’re gone for good
There you go
You’re gone for good

Oohhhh…

There you go
You’re gone for good
There you go
You’re gone for good

Hospitals – the psychiatric type

In the town where we grew up, there was a psychiatric hospital.  It was spoken about in hushed whispers as a scary place where crazy people were fenced in and tortured.  In reality, the hospital catered predominantly for those who were institutionalised during a time in our history when those with even minor problems were often hidden away.  We were told as part of our abuse, that if we told the secrets we would be sent to prison or this hospital forever.  So our early contact with psychiatric hospitals was negative.

If you place these experiences within the context of our rather traumatic experiences with the medical profession, you get a picture of someone who has deep seeded issues and fears about all things medical.  The young ones especially react with terror even when driving by a hospital.  We avoid dentists, doctors and nurses where at all possible.  In many ways this fear enabled us to appear high functioning for many years – if there was a threat of having to ask for help through therapy or medication, well that just wasn’t acceptable.  Time to stamp it all back down into The Basement and carry on being invisible.

Then arrives the dissociative train wreck we experienced when about 34.  Our coping mechanisms fell apart.  Then there was the final straw – we were teaching a group of 40 students when something about the interactive whiteboard markers caused Angel to come forward.  So there you have a 5 year old drawing pictures of flowers on the whiteboard while a group of adult students look on.  M comes back to find half the board covered…

So back to therapy we went.  We were in the throes of an abusive marriage and suddenly facing a childhood that wasn’t as perfect as we’d convinced ourselves it was.  These factors led to constant suicidal ideation and intent, which in turn resulted in us needing to find some support to keep safe.

In New Zealand there are a few support lines for suicide help – Lifeline, Samaritans, Youthline, the emergency number or the local mental health hotline.  Lifeline, Samaritans and Youthline are confidential – unless they feel you are in danger, in which case they will try to get your details and send around the Police.  Emergency services transfer you through to the mental health hotline, unless you are already need emergency care.  Once you’re in the mental health system, you are told to call the mental health hotline.  Usually you wait for 5-10 minutes on hold before the phone is answered – ever been suicidal during the Christmas season and had to listen to Christmas carols for 20 minutes while waiting to see if someone can help you stop killing yourself?  You can at least double the waiting time if you call after midnight, as that’s when they go down to one or two operators.

If you do manage to get through to a human, you’re asked for your details – name, phone, address, caseworker and then why you’ve called.  If they consider you to be at risk, they will send around the local mental health workers to assess you.  If they consider that you aren’t at risk, they will discuss grounding skills you can use before sending you on your way.  The problem with this is that at any one time we can have up to 5 suicide plans – apparently that means we don’t really mean to die as we’re not focused on one plan (we consider it covering our bases in case one doesn’t work).  We can also begin the phone call with one who wants to reach out for help; but by the time we get to actually talk to someone, we’ve switched to one who either won’t talk or says that everything is fine.  So in many ways the service doesn’t suit us (and a majority of the population).

If you are considered at risk, you get the joyful experience of being escorted up to the psychiatric ward of the local hospital.  Where you begin the wait for some poor registrar who has been working for at least 10 hours and is surviving on a combination of adrenaline, coffee and sugar.  This person then has to assess your level of danger.  Most registrars haven’t dealt with anyone with a dissociative disorder, let alone tried to understand if there really is a risk.  They have a thankless job of walking a tightrope – is the patient telling the truth?  To make this job more complicated, during our experiences with registrars they’ve encountered –

  • Aimee (9 yrs old and carefree) who smilingly told the nice young registrar that she was too young to drink.  Quite forgetting that the body she shares is in it’s mid 30’s and sitting cross-legged on a hospital bed while drips are hanging from each arm to pump us full of drugs to counter the drugs we’d OD’d on.
  • Sophie (16 yrs old) who is our safest bet for these assessments – no one would section Sophie.  The main problem is getting close enough to hear her as she talks very quietly when scared or worried.
  • M who is the other safe bet.  She’s confident and knows how to work the mental health system to ensure that we are released.  Release is always her goal as the young ones she protects are violently triggered by hospitals.
  • Ellie who won’t be sectioned as long as she can keep her swearing and scorn for the medical profession under control.
  • Frank who is the worst one to front for an assessment.  He doesn’t get suicidal, but doesn’t understand what constitutes aggressive behaviour as seen in the eyes of a psychiatrist.  He doesn’t actually get aggressive, but his anger at being in a hospital is seen as aggression.

It’s at this point where we’ve usually been sent home.  But on two occasions we’ve been admitted or sectioned under the Mental Health Act.

Event 1:  Sectioning with two nights in hospital.

  1. Night of admission, put into art therapy room with triggering artwork around the walls.
  2. Given a single room across from an alcoholic man in his 40’s (the father is an alcoholic).
  3. As punishment for being admitted W used all of her strength to try and break the arms by bashing them against the storage unit in the room.
  4. A miracle was there in the form of a part-time night nurse.  She realised we wouldn’t sleep so asked if we wanted art supplies and then she sat and talked to us.  She didn’t care who she talked to, she just sat on the floor and let us talk and draw.  She got us Arnica cream for the bruised, swollen mess that was now our arms without a fuss.
  5. Then there was the daytime registrar.  We had asked to be released as the hospital was too triggering.  He went through the whole assessment again.  He asked why our symptoms made us special.  We tried to explain that we weren’t special, just sometimes experienced dissociation.  He dismissed the dissociation saying it wasn’t important.  Then when returning after talking to the consultant, said that the dissociation made us too unpredictable to release.  Yes, the one symptom that he totally dismissed, became the thing he used to keep us in.
  6. That night the same part-time nurse told us how to get out – say the words “I have no intent”.
  7. The following day a different registrar got the consultant to come in and talk to us.  He was going to let us out for the day, but M came forward and dazzled him with a veil of sanity.  We were outta there.

Event 2:  Admitted to the secure unit with one night stay.

  1. Saturday afternoon attempted suicide through an overdose and was taken to ER by the husband.
  2. Put on a drip and was overwhelmed by the dissociation.
  3. Overheard the nurses say that we hadn’t really overdosed, but were just attention seeking – our bed was right beside the nurses station and strangely enough the curtains aren’t sound proof.
  4. As soon as we were coherant, we asked to leave.
  5. After a 5 hour wait, we were assessed by the same psychiatrist who once picked up the phone while we were in the room and told the DBT specialist that “the borderline actually turned up, do you want to come meet her?”
  6. Because of all the triggers, Ellie and Frank weren’t able to control the anger very well.  We were escorted to the secure unit by the Police.  We didn’t threaten anyone or even raise our voice, but we were considered to be irrational and dangerous because of the barely contained rage.
  7. We were released the next morning.

If we are ever sectioned again, we’ll request to go to the secure unit.  It was comparatively peaceful and safe.  If any of the half a dozen patients even raise their voice, they are immediately surrounded by about four staff and taken away to be calmed down.  The only downside was that the cups of tea were lukewarm – hot water being a dangerous weapon.

This is a very light hearted look at our experiences.  In reality, during the sectioning Sophie was nearly destroyed when her twin came from The Basement to tell her why they were created.  The day after we were released from the secure unit, the ex-husband tried to kill us.  Other incidents have occurred while we’ve been waiting to be assessed, including one I’d like to forget where a patient masturbated while looking through the window at us.

We sit in wonder when people say that they voluntarily go to hospital.  It’s a concept that we don’t understand – why would you volunteer for torture, ridicule and scorn?  We know our perception is warped and that hospitals help people every day.  But it’s not something we identify with.  It was once recommended that we go to Ashburn Hospital for a minimum of six months to try and break our cycle of destructive thinking.  Just the thought of that was terrifying.  I wonder if part of the reason is that in New Zealand the focus within the psychiatric ward seems to be on holding you in a safe place until the suicidal intent goes, rather than helping you in a long term way.  It’s reactive rather than proactive.

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Now playing: Dixie Chicks – Wide open spaces
via FoxyTunes

The big stampeding elephant in the room – otherwise known as self injury

In our post on Saturday, we mentioned that we were self-injuring daily.  To us this was no big deal, and we listed it as number 4 in the reasons why last week was bad.  Yet, this is what almost everyone picked up on within the comments.  This surprised us – we couldn’t see what the issue was.  Self-injury in some form, has been part of our life for as long as I can remember.  In some ways it has become a normal part of life.

A definition of self-injury or self-harm is interesting to arrive at.  I’m going to break one of M’s rules and use Wikipedia for the definition – not because it’s particularly good, but rather like all things Wikipedia, it’s a good starting point.  So according to Wikipedia:

Self-injury (SI), also referred to as self-harm (SH), self-inflicted violence (SIV) or self-injurious behaviour (SIB), refers to a spectrum of behaviours where demonstrable injury is self-inflicted. The term self-mutilation is also sometimes used, although this phrase evokes connotations that some find worrisome, inaccurate, or offensive.

(Wikipedia: Self-injury, 2009)

So how do you determine what a demonstrable injury is?  Some of my self-injury is psychological in basis, which is notoriously difficult to identify as having a demonstrable injury.  Does the injury have to be immediate?  I consider eating disorders to be a form of self-injury, but the effects are not always noticeable immediately.  So in short, self-injury is like defining the length of a piece of string.  To me, what defines self-injury is the intent of the action or non-action.  Why did you pick that sore?  Why didn’t you eat that piece of cake?  It’s definitely not about how much you bleed or how big the bruise is, it’s about why it happened and how it made you feel afterwards.

In many ways I feel like a fraud talking about self-injury.  I mean I’m “high-functioning” and “we” don’t self-injure.  Then I look at the scars on my skin, the signs of malnutrition evident in my toenails, the sores that never heal because they’re picked at, the bruises on my leg etc.  None of these are an attempt to get attention – the scars etc are on parts of the body where they won’t be easily found or recognised as self-injury.  They’re also not an attempt at suicide – the plans around suicide are very separate from our self-injury.  But the over-riding feeling for considering myself a fraud when talking about self-injury is the shame.  It is considered by society as a weakness, a character flaw, disgusting, self-centred…  My opinion of self-injury is affected by this societal view.  If someone I don’t know says that they attempted suicide or self-injured, I tend to dismiss them as attention seeking – I buy into the societal whitewash.  But I also know many people who self-injure on a personal level and at no time do I consider them to be attention seeking.  The big difference between these scenarios is that those who really suffer with self-injury rarely talk about it and I know the pain of my friends.  I know they’re not faking.  I know that they sometimes struggle to get out of bed and even pretend to keep going.  Their pain is real to me.  But I also feel that sense of helplessness that comes from not being able to “fix it” for them.

I think this is a huge reason why society view self-injury as it does – there is a sense of helplessness about what to do.  Will sympathy make the person feel worse?  If we talk about it will it give them ideas?  But it’s mainly I DON’T UNDERSTAND…  Often the lack of understanding comes from all sides – the self-injurer often doesn’t know why they need to injure, family and friends don’t understand where they went wrong, and the doctors treat you as another “one of those patients” where you don’t want to get too close because it’s a long journey out of self-injury.  Yes, it often becomes about the people around the self-injurer rather than the injurer themselves.  It is rare to find a person who will sit with you during that pain in an unconditional way.  But when you do, it’s incredible.  I’m not sure I would have the strength to do it, I’ve talked to one person who needed that unconditional support and I’m not sure how effective I was.

Sorry, this is very rambling.  But my thoughts about self-injury are so confused.  I know I do it.  I know I shouldn’t, but every day it happens.  I’m worried what will happen if I accept this as my reality – will it mean that I’ll also be accepting the self-injury and not want to stop?  Or, will it mean that I can look at the stampeding elephant coming towards me and make it change it course?  In the words of Frank – fucked if I know.

I hope that the more we talk about it, the less of a grip it will have over me and others who suffer.  Not looking at the elephant in the room doesn’t make it disappear, it just makes the shame more intense.

References
Wikipedia: Self-injury. (2009, July 9).  Retrieved 13 July, 2009 from http://en.wikipedia.org/wiki/Self-injury

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Now playing: Sia – Breathe Me
via FoxyTunes


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