I’ve been a bit quiet lately and a big part of that is that I’ve been in the midst of a move to Cork, Ireland. I’m finally starting to get settled (I’ve been here for 3 days) and process this fairly large decision. Part of this has been a great deal of panic, anxiety, and worry. I’m feeling the beginning of a serious depressive episode creeping into my mind, and I’ve been fairly vocal to friends and family about my worry that this was not a good decision for me. Many of them have responded (quite logically) with sentiments like “you’re more than your emotions”, “you don’t have to let feelings dictate how you behave”, and “feelings will pass”.
These things are all true, but they haven’t helped me to feel any less afraid and they don’t get to the heart of why I’m afraid, or even address what I believe is a very real and logical worry that is at the heart of the anxiety and distress. For most people there is a limit to the harm that emotions can do. You might feel something unpleasant for a while, and then it will pass. However I have very real evidence that my emotions are not something to be taken lightly, and that “just emotions” can make things a living hell and seriously endanger my life.
There is something very logical about being wary of anything that might disturb your emotions when you have a history of severe depression. I have had active depression for nearly five years now, and only just started to move into recovery in the last six months or so. I once spent a full semester in the midst of complete suicidal ideation, isolation, lack of pleasure in anything, and utterly overwhelming anxiety. I remember almost no moments of even contentment or neutrality: it was all overwhelming emotional pain. This may sound like an exaggeration, but I have friends who were there and know just how nasty it was. It was bad.
So while it might seem irrational to let anxiety or worry dissuade me from an amazing opportunity like this, I am risking a great deal more than most people would who try something new. I can feel myself falling into depression, and I know just how bad it can get and how long it can last. Beyond the emotional toll, there are also very physical results to my depression: while I have more skills now than I did in the past, I don’t trust myself to weather a full depressive episode without hurting myself or restricting my food and putting my body in serious danger.
When I see the potential for my mental health to fall apart, I see the risk of repeating the worst depression I’ve experienced. It is quite literally what would be termed unconscionable torture were it to be enacted on another human being. There is a great deal of logic in being deeply afraid of this possibility and in wanting to hold on to the things that have kept it at bay.
To get very dark for a minute (and let’s be honest, a lot of the things in my past have been fairly dark so I guess this is just being straightforward), when you have sat with a razor blade poised against your wrist for hours at a time, replaying the scenario of what it would be like and how hard you’d have to press over and over, and only dropping the blade when you think of the one friend who would inevitably find your body, the stakes of having some level of comfort and safety, having people you know and love around you, become much higher. This is not even an extreme possibility: this is a regular part of my history.
For some people with mental illness who have reached a stage of recovery, individual coping skills and tactics are a lifesaver. For those people, being on their own in a new place might not be as big of a deal because they know what is helpful for them and how to manage their emotions effectively. For me, the best buffer I have against the nasties is having a good support crew: friends who keep me grounded, people who challenge my ridiculous pessimism, people who know me well enough to call me out when I’m being cruel to myself, and people who I am comfortable enough to simply be around without feeling pressure or anxiety, people I can feel safe with. I do have other skills that are helpful, but so far this is the single most helpful thing that I have found: it gives me a reason to bother with caring for myself.
Removing myself from this support system gives my depression and anxiety an opening. The fear and worry and desperate desire to go home that I feel right now is not simply loneliness or the discomfort of a new place. It is at least partly the recognition that I could be in serious danger and the strong desire to go back to where I am safer. There is nothing illogical about that. That is not just an emotion, and it is something that should be taken into account when I act because it is truly important information. While I have not let this information dictate my behavior (I am still here and accomplishing all the tasks I’ll need to be able to stay), it isn’t something that I’m simply going to try to put aside. It’s something I want to remain acutely aware of, because ignoring it is putting myself in danger. Taking your emotions seriously as a force to be reckoned with is fully logical and truly important when you have a history of mental illness, and it’s a privilege to be able to set emotions aside or take actions without making certain you take them into account.
It’s been a rough week. Many of my friends, fellow bloggers, and role models are starting to show a bit of wear and tear. The whole internet has been buzzing with news about the shooting, with debates, with misogyny, with threats, with victim blaming. I’m tired. My patience is worn out. I’m getting triggered left and right by the smallest, stupidest things, and my coping skills are slowly running out.
Unfortunately, the rest of the world doesn’t stop when my spoons run out. I still have to work. My dad’s birthday will still happen this weekend and I’ll have to be social and entertain. I still have to write. I still have to clean my kitchen and cook (somehow) and deal with the sudden heat and plan for my move to Ireland next year. I just have to do it all while also feeling like I’m about to snap or break down and start bawling or just run out, stop moving, fall over and not get up.
I’m sure this is the same quandary that all those with mental illness, or those who engage with difficult topics, or those with chronic illness face: how do I remain functional and keep anything from getting worse when my reserves are almost out? I drag myself into the office, but how do I accomplish anything when my brain power is spent just trying to refocus my mind on something other than sexism and shootings and self hatred?
I’ve been trying to use a few tactics, but I would certainly appreciate any suggestions that you all have. Mostly, I’ve been trying to reorganize my priorities so that I can accomplish some things with minimal brain power. This means that my to do list has shifted away from more writing and into some easier tasks at work (as well as I can). At home, instead of trying to tackle some of the bigger project I’ve limited myself to basic, mindless things that will help me feel accomplished: putting away my clean laundry right away, making a big pot of rice and beans so I don’t have to cook for the rest of the week, paying close attention to my schedule so that I don’t miss anything. It’s hard sometimes to feel like I can do these things, but if I get one or two done each day I can head off a lot of the feelings of uselessness and keep myself from hitting a bigger breakdown later.
This also means that at work I am shying away from things that I might really screw up if I’m not all the way present. I’m doing behind the scenes work and trying to save my energy for the times I’m in meetings or have to be front facing for the company. This is the biggest challenge. Part of me is trying to accept that there are certain tasks I simply can’t do right now, but that isn’t something I like to accept and of course it makes me feel like I cannot do my job. In reality, what it means is that right now I need to focus on something slightly different, make my job something a bit different.
And when I don’t have anything that needs to get done, that means complete and utter self indulgence. It means I get to go home and take a nap, or buy myself ice cream every day if I feel like it, or go running twice, or avoid everyone if I want to, or whatever the hell at that moment sounds like it might break through the hazy fear that’s hampering me right now. I hate feeling that desperate. I hate grabbing on to any impulse that seems like it could be remotely positive, but I know that if I simply won’t get through. I hate listening to my needs. I am demanding it of myself though.
Perhaps the hardest part is being responsible for myself and my emotions. I want to fall apart over everyone, bitch people out, yell and scream and swear and cry. I want to tell everyone to piss the fuck off. I want the people who are nonchalantly commenting on blog posts about misogyny to hurt as badly as I do when I see people talk about how mental illness makes you violent. I want to puke.
But it is no one else’s fault that I feel this way. Even the people who are pushing my buttons in all the wrong ways. I still need to be responsible, and when I do lose it, I have to know to apologize and take responsibility for the ways that I can’t cope. I need to be able to set healthy boundaries: I can’t just avoid people, but I need to actively tell them I need space. It is so hard to find the emotional resources to recognize when you’re being out of line when everything feels raw. But as someone who wants to be a positive ambassador for mental illness, I need to be able to function appropriately in my relationships and with my acquaintances even when my mind is not acting appropriately.
And just for fun, I’ve been trying to take mini breaks at work during which I look at goofy GIFs on Tumblr or watch lindy hop on youtube. Little things are all that get me through. Little things are what distract me and keep my mind from spiraling. Little things are what drag me away from that nasty comment.
I will remain functional.
One of the things that has been very difficult for me in DBT is the idea of “distress tolerance”. For the most part, American society does not promote the idea that there are times that things will suck and you’ll just have to let that be and you can’t do anything to fix it. We’re a society of fixers. There’s always a solution if you try hard enough right?
Unfortunately that’s not the case. There will be times when we simply have to wait out unpleasant feelings. In general those unpleasant feelings will dissipate or be relieved with time, or after some time we will be able to change something to improve our situation. Sometimes we also just have to accept things that are shitty: certain people will not change their behavior, your health may not improve, politics might always suck. These are things that you might just have to let be. And for these things, you have to learn that your feelings may stick around and there’s not a whole lot you can do about it. This is where distress tolerance comes in.
Distress tolerance is hard. It’s not about making yourself feel better, it’s rather about making it to the end of the bad feeling without doing anything to make your situation worse. This is one of the hardest things to remember while trying to tolerate nasty feelings, and it also makes it a lot harder to be successful because it’s hard to feel like it’s working. However it’s not a bad thing to feel like crap for a while. This is hard to understand for many people. It is normal, acceptable, and in fact healthy to feel like crap sometimes.
So what is distress tolerance? There are a number of elements to it and I’m not going to touch on all of them here, but I do want to talk about how many people give tips for distress tolerance and how we can really improve on those tips. I see lots of lists floating around about what to do if you’re tempted to self-harm, or how to resist purging. These lists are GREAT. They include things like holding a piece of ice, drawing on yourself with red marker, ripping something up, all great suggestions. Unfortunately not all of these things work for everyone, and it can be extremely frustrating when you look at the list and can’t find anything that speaks to you.
It seems to me that there might be a better way to approach distress tolerance that is more individualized. Of course sharing ideas and letting others know what’s helped you is great, but not everyone likes or responds to the same things. One of the things that we’ve been discussing in DBT are larger categories that can help you: things like using your senses, imagery, taking a mini-vacation, or relaxation. Each of these categories is then open to all of your personal ideas. Let’s look at a couple of examples:
Senses. I’ve heard a lot of people give examples of this without quite realizing it: finding something soft, holding ice, listening to music. However I’ve often found the examples unhelpful until I heard the larger idea that you should think about your senses and try to pinpoint what sensory experiences really ground you. What makes you feel like you’re really in your body? I’ve heard people suggest scented candles, but those make me sneeze a lot and I don’t much like them, so I basically just discounted nice smelling things. When I heard that scent was something I could think about, I immediately thought about my dad’s spaghetti sauce. It makes me think of home, of youth. It grounds me. I got some from my parents to put in my freezer and now I can pull it out on a bad day and heat it up, letting that smell permeate my whole apartment. This personalization is far more effective for me than the generic suggestions were.
You can do this same sort of thing with any of the skills: what kinds of images calm me down? What would be a “safe place” I could picture? What has calmed me down in the past? What kinds of things do I find relaxing? What places feel “away” for me in my daily life? What’s out of the ordinary that I could use as a small vacation?
It’s a good idea to take some time when you’re NOT distressed to think about these things so that you have a small stockpile. For an explanation of each distress tolerance skill you can go here. I don’t think we spend enough time personalizing our coping skills, but it is important to think about what works for YOU.
Hello all! You might have noticed that this blog has not been quite as active lately as it has been in the past. I’ve started a new job and I’m BUSY. I won’t neglect you all though, I promise. The other reason I haven’t been posting here quite as much is because I’ve also been busy across other parts of the internet. So here’s an update of what else I’ve been up to and where else you can read my work.
I’m really excited about a post I’ve got up over at Mental Health Talk right now. It’s about the experience of being in the middle of treatment for an eating disorder. It’s pretty personal and in-depth about the ups and downs of life while fighting a disorder.
A while ago I also wrote about porn over at The Quail Pipe. Yes I watch porn. Yes I’m going to tell you about it. Why? Because I’m sick of the idea that only men are sexual beings who get sexy.
You should also probably check out what will likely be my last post at Teen Skepchick, about the relationship between feminism and atheism for me. The reason it’s my last post is because I’m moving over to plain ol’ Skepchick! I couldn’t be more excited!!!!
And last but not least, my birthday is coming up real soon. Now usually I’m the queen of asking for EVERYTHING on my birthday, but not this year. This year I want one thing: I’m asking for donations to The Emily Program Foundation. The Emily Program is the place where I receive my eating disorder treatment, and overall I’ve had a pretty stellar experience there (as stellar as it can be to have all your coping mechanisms and safety blankets challenged). I love my providers and they treat me like a for reals human being instead of a problem. The Foundation does a lot of great stuff including scholarships for treatment, education, and Recovery Night. If you’re interested in donating, I’ve set up a fundraising page over at GiveMN (which is where I work now!). Consider sending something their way if you like my writing, because I would not be capable of all this if it weren’t for them.
That’s all for now kids!
I posted last week about my lovely sweet kitty passing away, and since then I’ve been largely quiet on the subject. This is probably because my general coping strategy is to try to get rid of anything that makes me feel bad. I am amazing at distracting, at acting opposite to my emotions, at looking like I’m coping fairly well by going to work and doing everything I’m supposed to do. Interestingly enough, this strategy often gets praised: people tell me that I’m doing well, that I’m getting through things, etc. In conjunction with this, I’ve seen a lot of people lately talking about taking the negative influences out of their life. I think that one of the coping methods that our society promotes right now is to simply abandon, ignore, or run away from things that hurt you. On some level this is good: leaving a toxic relationship behind is a great idea, or getting yourself away from a horrible job. If you cannot fix a situation, it might be the best idea in the long term just to leave it.
However I think that this method of coping has gotten extended from one that applies to long term or never-ending situations (in which it’s good) to something we apply to short term situations (which are often good learning experiences or can gain you something in the end). Excising things that are negative is a good coping strategy when there is something in your life which is bad for you and will not end, and whose positive consequences don’t outweigh the negatives. It is not useful in situations that are short term and which you need to be in: for example you need to grieve a loss in order to heal from it. You might need to be able to cope with being temporarily bored because boredom will happen in your life. You should be able to tolerate an unpleasant class because it will end and you know that you need the credits. Removing ALL of the negative things from your life leaves you unprepared to process and tolerate distress. It also often requires stuffing some of the negative emotions you do feel simply by not thinking about bad things that you can’t get rid of (for example the loss of something). Those emotions have nowhere to go, and generally build. A healthy relationship with emotions requires you to be able to tolerate distress in order to process it. Avoiding all distress doesn’t let you do this.
I think that in general as a society we have lost the skills for distress tolerance because we have so many tools available to us to be able to take ourselves out of negative situations. Unfortunately, this means that we often might miss out on a big payout at the end, or leave ourselves floundering when something we can’t avoid comes along. Now I think that when we see a clear physical payout, we’re fine with putting in hard work and tolerating distress: we can work long hours or wait in line for tickets to our favorite band, but that’s because we know exactly what we’re getting out of it.
However in emotional terms we’re far worse at this. I think that in relationships people are not very good at putting up with bad times, because they assume it means things will always be bad. We may be willing to tolerate boredom (although only with our smartphones at our sides), but when we’re put into a situation that makes us feel unwanted or anxious, we bail. We haven’t learned that we can learn skills to help us calm down, to stand up for ourselves, to effectively get what we want and need, and to still validate the other person in a given situation. We haven’t learned that some bad emotions can teach us things.
The problem with this is that when we hide from things that scare us or make us feel bad, we never get around to processing that information, and our brain never gets to the point where the threat feels like it’s gone. We walk around carrying this DANGER sign in our mind indefinitely, still feeling every loss or anger or frustration or fear that we haven’t yet turned off. Our brains need to be told that a threat is gone by understanding the new shape of the world, and in order to do that we have to look at things that hurt. This can be hard. It’s uncomfortable. It feels bad. But it’s also necessary and good, and in the long run will leave us with less stress and anxiety, less anger, and less worry, more content with where we are.
There are ways to feel negativity without it getting out of control. You can give yourself a concrete amount of time to feel it, give yourself something positive to look forward to afterwards, or have other people around. Emotions don’t have to be overwhelming.
And so I suggest that we all take a minute today to be with whatever’s bothering us. Just a minute. A contained moment by ourselves to feel it, well and truly, and then to move on and let it be.
Ok, this is not going to be a well thought out or organized post, but I’ve had a lot more thoughts since the previous post about self-harm and I’d like to just throw some of them out there:
Tim brought up the interesting point of stigma being there because self harm necessarily involves harm. I think this is potentially true, however I think there are two important things to consider about this:
1.What constitutes harm?
I posed this question on twitter: would you consider a cut to be harm? Many people answered not necessarily, and that it depended on how serious it was. Let’s take a couple of examples-
a.You’re walking in the woods and you accidentally run into a tree branch. It scratches you/cuts you and you bleed a little. You shrug it off and you continue walking through the woods. You get home and everyone probably ignores it. Few people would say that you had been harmed, unless they take a definition of harm that suggests ANY pain is harmful.
b.You intentionally cut yourself and you bleed a little. You shrug it off, and go downstairs. Everyone freaks out and asks you why you would harm yourself. Are we sure it’s more harmful in this case?
I would propose a definition of harm that generally includes keeping someone from doing what they want to do, or keeping someone from functioning in their life as they so choose. Some people might include subjecting someone to any amount of pain in this definition, but I’m not sure I would go that far.
2.There are other things that we do, which we believe are good, which necessarily involve harm. Most medical care falls under this heading. Therapy. If we include pain in the definition of harm then every time you work out you’re harming yourself (my new argument to be lazy!). So while there may be a distinction between say rock climbing and self harm (it perhaps wasn’t the best example, although I do think that rock climb automatically comes with some pain), there are other examples we could look at that are praised when we do a cost/benefit analysis and decide that the necessary pain is worth it.
Beccy mentioned that there is a good deal of bias against self-harm and so it could be harmful to cut simply because of the attitudes of other people and the crap you’d get from them. Also an important consideration, I think generally subsumed under the first point I made in my other post. I personally would tend to weigh this slightly lower because I don’t really care too much about the opinions of people who are biased against those with mental illness.
So what do you think? How is self harm similar to and different from other forms of harm? What about BDSM? What constitutes “harm”? Does a small cut really count as harming if it does nothing to impinge on someone’s life?
MAJOR TRIGGER WARNING: self-harm and suicide
My dear friend Elly/Lux/awesomepants mcgee posted a really interesting question on Facebook earlier today, and I was of course compelled to answer and then blog about it. She asked “This might just be due to my fucked up brain, but am I the only one who doesn’t see non-suicidal self-harm as an entirely bad thing?”
And oh my do I have Thoughts about this one. Most people shudder and get extremely freaked out by the thought of self-harm. That’s completely understandable, as it goes against our most basic instincts: stay alive as long as possible and avoid pain. It’s confusing and sick to many people why someone would want to hurt themselves. However there are some good reasons why some people self-harm. Self-harm is a coping device. It can help you to feel in control again when the world feels out of control, it can numb pain or provide the only sensations when you are feeling numb, it can be a form of self-punishment when you’re feeling guilty and assuages those feelings, it can be a release when you’re feeling too much to handle, it can help you feel more clarity, it can relax you and relieve anxiety…there are all sorts of reasons why someone might want to hurt themselves, and the end goal of pain and injury is rarely the root cause.
So self-harm serves a purpose. It can be very helpful for people who are struggling. It can be what gets them through the day. If the injury that they cause to themselves isn’t serious, what’s the problem? We wouldn’t be getting this upset if they tripped and scraped themselves up. The person isn’t in danger, they aren’t damaging themselves, most of the time the cuts won’t result in any sort of health risk, they aren’t impacting their own quality of life (in fact they’re likely trying to improve their quality of life), so what’s the downside?
Well there are a few things to consider as the downsides of self-harm, and that would impact your health and quality of life.
1. It makes relationships hard. People who care about you don’t want to see you hurting. Generally if you’re using cutting or self-harm as a coping strategy, it means there’s something that needs to be coped with, and so the people around you become worried and anxious about how you’re doing. They want to help and solve the problem, but they’re also hurt by the fact that you’re hurting. This generally means that you get secretive about it. It can lead to lying or hiding, and you also tend to isolate when you self-harm because you think you have your problem under control and don’t want anyone to take away your coping mechanism. People can become very defensive when they think someone might take away their ability to self-harm, and they also feel judged. Overall this leads to a loss of communication, a loss of openness, and a loss of relationships.
2. There is ALWAYS the potential to do more damage than you intend. No matter how careful you are, no matter where you cut, there is always the potential that your hand slips or something happens and you land yourself in the hospital. When you self-harm, you are always putting yourself at risk in an extremely direct way. You are literally trying to get as close as possible to serious injury or death without quite moving past the line. Now many things in life involve risk, but generally we see things in a cost/benefit analysis way and weigh the risks with the benefits. It’s very possible that there are less risky ways to get the same benefits.
3. It rarely deals with the root of whatever you’re trying to cope with. It’s more of a band-aid than a fix, because it doesn’t teach you the skills to solve your problems. Whatever situation is making you feel like you need to hurt yourself will not go away because you hurt yourself. In many ways, it might exacerbate the problem because it allows you to tolerate for a longer period of time instead of changing the bad situation that you’re in. It’s a strategy that allows you to handle whatever is going on without working on whatever is going on. If you need a fix to get you through something you can’t change, then it might be very effective, but in the long run it’s not.
4. It usually escalates. Like anything else that gives you a kind of a high, you begin to get numb to it. Whatever adrenaline you might have gotten from a few scratches before dulls as your body gets used to it, and now you need to cut more or deeper in order to get the same relief. And the more you escalate, the higher your risk of serious injury or suicide is. Just like drugs or alcohol or whatever, you go further and further, and I think that for many people it does become addictive or obsessive. I know some people who can’t fathom going a day without cutting. When you can’t live without your coping mechanism, it probably is not actually helping you cope anymore. When it has lost its function, it’s simply unnecessary risk.
So there are clear benefits to self-harm. You get calm or relief from it, it helps manage emotions, and it can be a way to get through a difficult situation without breaking down. However there are also a lot of risks and downsides to it, like potential serious injury and lack of long-term effectiveness. Given these pros and cons, I think that each individual should be left to their own devices to decide if the pros outweigh the cons for them (up until the point it becomes seriously dangerous). What doesn’t make entire sense to me is the out of proportion reaction that many people have to self-harm. There are all sorts of hobbies that are risky and dangerous. Take rock climbing for example, which is also something I do and love. It’s probably at least as dangerous as self-harm, and doesn’t directly provide benefits in the same way that self-harm does (I mean it is good exercise and good stress relief, but it’s not nearly as effective as self-harm). There is no logical reason why people should see self-harm as inherently worse than other potentially dangerous hobbies and practices, but there is a huge stigma against it. Despite the fact that there are downsides to self-harm, they don’t warrant the panic that seems to appear at the mere mention of self-harm. It’s not inherently worse than any other injury or risk simply because it’s self-inflicted.