Tag: self-harm

Sorry for my absence this week….

Warning: this post mentions hallucinations, self-harm and suicidal thoughts, my distressing thoughts and voices and the darkness I’m feeling right now. If this may be distressing or triggering for you, please take care.

…. It has been a very bad week. I am sorry for not posting for a while. As I do not have the internet at home at the moment it’s difficult anyway. It has also been a really bad week. The hallucinations are growing / getting more frequent and it’s scary. I am so so tired and really wish I could escape and things all stop. I’m so scared and I wish someone were with me, I wish someone would hold me and tell me it would be alright although in my head it never, never is and I feel so stupid and needy and incompetent and childish and everything else for so much needing that right now. I feel so alone. It hurts but it’s numb as well. I really need to be able to talk to and see a friend but the only two people who live close by are just too busy, their lives too full and too difficult already and I know I would be everyone’s last choice to spend time with, kind as they are, and as much as they have given me. I cannot ask for more. Then the horrible monster inside me tells me that if I had a friend feeling like this and needing help I’d go to be with her straight away, why am I always alone and not allowed anyone? Then the guilt comes crashing back, how dare I be so childish and needy, greedy, ugly, disgusting, go on, get it out, cut and cut and scratch and vomit til you get it all out you sick revolting evil thing…

I want it to stop. I nearly ended it last night. There is really a limit somewhere and mine has been reached over and over again. It’s very dark right now.

I need to write and want to write and perhaps this will build some way to keep going.

Ginny xx

On panic, lemons and stitching patterns

On panic, lemons and stitching patterns

I’ve posted before about how I find that colouring intricate patterns can be very calming.

When I was an inpatient I drew and painted a few times, which I had not done for many years. I go through phases of doing a lot of cross-stitch embroidery or making greetings cards. It seems to be something that I do a lot of and then leave for a while then return to it. Sometimes I find it helpful and calming but other times, I really want to be able to do it but am not able to. If I try to push myself to, it just doesn’t work – I go wrong all the time when I try to follow a pattern, or I just can’t put together anything pretty. Then far from helping I feel dragged down lower. It’s as if when I am completely drained and lacking in emotional / mental energy, there is nothing with which to be creative. In those states I often need to sleep, or paradoxically, to do something physical like getting outside and walking.

I’ve been on two different wards as an inpatient. One of them had a variety of craft activities available and support to use them and discover and learn new ideas for projects. For example we learnt to make plaited bracelets, worked together to put together a collage display, coloured stained-glass window images, and so on. The peer support worker spent a lot of time facilitating these activities. The other ward did not really have such resources and there was nobody to support these kinds of activities. The first ward seemed much more an environment in which it was possible to focus on having hope of getting better and learning skills to cope. Of course the access to creative materials was not the only reason (I think the work of the peer support worker was very important and I will post about that separately). However I think it made considerable difference to how the days passed.

I think in working with simple materials to create something beautiful, you can empty your mind, practise mindfulness techniques, slow some of the frantic anxiety as you become absorbed in the task. The concentration it requires and the different sensations you encounter – textures of fabric and materials, sounds, colours, deciding how to combine them, perhaps repetitive and rhythmic motions, the sense of putting together something lovely from all the separate parts – all of this helps occupy your mind. In  a similar way to distraction techniques, by filling your mind with all these sensations, they can become the focus, rather than obsessional thoughts, sadness, anger and so on. It does not solve anything but can replace some of the intensity of an emotion for a time. I can find it helpful in trying to delay self-harming as well as in times of generalised anxiety or after panic attacks. My friend who suffers with an eating disorder said that in particular having something to do with her hands can calm her after eating and help her resist the urge to binge-eat and/or purge.

My clinicians explained that there is a limited number of sensations the body and mind can experience at any one time. In personality disorder, our emotions may reach a higher level more quickly and in this heightened state, we cannot think rationally or mentalise or make good decisions. We cannot see outside of the emotion. It also takes longer than it does in most people for the level of emotion to fall. One thing that can help the emotion to fall, to get to a level where we can start to mentalise, use distraction techniques or choose to do other things that help us, is to “shock” the body with another strong sensation. For example, putting your hands under very cold water, holding ice, or (this one works well for me) eating something with a sharp taste. I use pieces of lemon, or lemon juice, with a sharp and bitter taste. This can help to lead you out of extreme distress or a panic attack, to the point that you can then address how you are feeling with other techniques. Then continuing to do something that gives positive sensations can continue to calm you – for example, something self-soothing like hugging a soft pillow or wrapping up in a soft blanket, or perhaps one of the creative activities which provides a range of tactile sensations.

There is also something encouraging to me in being able to create a picture, object, etc, which is useful or attractive or perhaps can be given as a gift to someone else, even when we are really not feeling great. It’s another way to make it true that the overwhelming emotions are not all that there is and to start to hope that there could be some good somewhere in me.

Ginny

xXx

Hearing things

Hearing things

This post contains discussion of experiencing hallucinations, or sensations, which are not “really there”, as well as in very general and brief terms touching on self-destructive ideas. I put this as a warning because I am not sure whether this may be disturbing, distressing or triggering to anyone. I have discussed this very little before. Please consider not reading further if it may not be helpful to you. Thank you.

I have a question on which I would be very grateful to hear any thoughts or answers.

My understanding is that in borderline personality disorder, heightened states of emotion for a prolonged period of time can cause transient psychosis and that people who have Borderline may experience hallucinations.

A few other people I’ve met who have Borderline have shared that they experience things which I think might be termed hallucinations, for example, hearing voices, sensing presences, seeing people or things, sensations of touch, and so on. These seem to be with varying degrees of – I cannot find an adequate term – solidity? For example, ranging from the sensation of a presence with you or a sound, to clearly and specifically seeing another person in the room.

I’m frightened by hallucination experiences I have.  I know I am more likely to have them when I am in a state of high emotion. Until recently, I was more likely to have them when alone. Most commonly (I think) they are auditory – hearing someone calling my name (most commonly my mother’s voice), hearing something happening or being said again which happened a long time ago (this is closely bound to my experiencing flashbacks as part of my PTSD), hearing a voice which I am aware is in my head but which appears to come from outside of me telling me to do self-destructive things or telling me how stupid, disgusting, ridiculous, greedy etc I am, or hearing non-distinct voices but knowing that it is accompanied by a sense of pain / anger / urgency in some way. Sometimes I am aware that what I am hearing is in my head (like the voice telling me to do things to myself), but increasingly, sometimes I am certain it was in the world outside (like my mother calling me). More recently, the hallucinations are visual as well, for example, inanimate objects seeming to move or shine. I am always aware immediately afterwards that this cannot be real. Or they can be sensory – this tends to be bound up with the flashbacks again, for example, during a flashback believing that the people present when the traumatic thing happened, the people I feared, or just a non-specific sense of terror that is much more an external sensation than emotion should normally be.

These things are all intensifying. I am scared. I fear am I developing psychotic symptoms? I know my mother’s illnesses started to worsen when she was just a little older than me. Is the same thing happening to me? I would like to know, does anyone else with PTSD or personality disorder experience this kind of thing? Or even, if you are not diagnosed with a personality disorder or PTSD, have you ever experienced anything similar? How do you deal with it? At the moment I have an awareness on some level that these things I’m experiencing aren’t real. How do I make sure that I do not lose that?

I know that these are hard questions and personal questions and I understand you may not feel comfortable to answer. Anything you would like to share, I would be very very grateful for. I really do not want to distress anyone or trigger anyone in any way and if discussion of this kind of thing is not helpful for you I do not want to draw you in.

Ginny xx

With thanks for image to: http://freewallpaperdekstop008.blogspot.co.uk/

Sitting with uncertainty – Part 2

Sitting with uncertainty – Part 2

I apologise for not writing this Part 2 yesterday as hoped.  I had a weekend away for a very dear friend’s 80th birthday. It was special and lovely but I was very drained when I got home and I did not manage to write. I’m sorry.

***

I am starting to realise that it is terribly difficult for me when I realise that my thoughts or emotions are different from someone else’s about a certain situation or matter.  It could be about a particular situation or experience we are both sharing in right now, or a memory of something that happened before, or a matter of belief (religious belief, a principle, that kind of thing), or any case of sensing someone’s strong emotion. It was my therapist and someone else in a therapy group I’m part of who identified this first, then went on to identify that this difference of emotion/thought between individuals is another instance of uncertainty we must learn to sit with.

I sense other people’s emotions more strongly than my own. I find it hard to identify and name my own emotions. When I do feel them they can be very frightening and overwhelming; I may feel them so strongly that they block out anything else, becoming to me everything that there is, frightening me about what will happen and what it means about who I am. They can feel as if they physically pain me. I may feel physically utterly drained or consumingly panicked and driven, unable to sit still, pacing constantly for hours (compulsively, despite the physical pain this causes by aggravating my joint conditions). Times of overwhelming emotion are times I often self-harm.

Other times, I may feel numb and nothing at all. I may be painfully conscious that the other people I’m interacting with feel very strongly but I feel unable to reach out, to come to any connection with them. I may want to say something and know I should and know I should and want to empathise, but feel frozen and unable to respond, and know that by this I am hurting the other person still further.

Or, despite not knowing at all what I feel, I may feel the other person’s emotion (especially sadness, anxiety or anger) so strongly that beyond what I think would be described as empathy, I actually feel their emotion myself to a level that I cannot stand it. It can happen very fast and I do not make any conscious decision or any particularly strong attempt to pick up the emotion. It just happens. Sometimes, I have as little as passed people on the street, sat beside someone on the bus or had a minimal “meeting and greeting” interaction on the reception at work, and this wave or wall of emotion will hit me and stop me in my tracks. I passed someone on the street the other day and was suddenly hit by a wall of such strong anger and hurt that I stopped walking. It was like a physical presence around me and in my lower chest and I gasped and this was swiftly joined by extreme fear. The person had done nothing to me, not even noticed me nor interacted in any way.

A couple of people who share my religious faith have told me that it is a particular gift to be able to empathise to a particularly great extent – it could allow me to help someone, be there for them, pray for them, understand their needs, know if they are in danger, and so on. I think perhaps it can be a gift and could be something from which good can come. Not that I think I have any particular ability, certainly not any power, but it is a sensitivity that could lead to good.

The problem is the intensity is so great it is frightening – as frightening as my own emotions can me. It can be there to such an extent that I can no longer continue to be with the person / people, and withdraw completely in exhaustion and confusion and fear and feeling huge guilt that I cannot resolve what is happening to the person and can’t be sure – there’s the uncertainty again! – is it my fault they feel this way and how should I respond? Then I end up back in the numb place of then not knowing how to respond and not being able to give anything at all.

Whichever of these happens, I’m left unable to interact socially. I haven’t yet unpicked quite why sitting with the uncertainty of the differences and unpredictability of emotions between people is so very frightening and overwhelming to me.  However it does seem to be shared by several people I know who suffer with personality disorder.

A particular problem where thoughts, emotions, intentions and communication are involved is that you can never check enough. You can never get to be completely sure what the truth is and what is right or wrong and if you are good or bad.

In Part 1 of this post, I gave some examples of other kinds of anxieties in situations of uncertainty. All of these are around things that are more concrete, if that is the right word, where eventually you will find out some answer.  For example, to go back to the same examples I gave: tomorrow will come and I will find out what will happen, I can ask my friend which colour she prefers and be sure to choose the mug that colour, and in time I will eventually find out the interviewer’s opinion of me and whether I get the job or don’t. If I’m trying to overcome an obsessional activity or belief, for example, if I don’t wash my hands 10 times before I speak to my friend she will get sick because of me, it is possible to test out this belief in the concrete world – it will be extremely distressing to me at first and cause a huge amount of anxiety, but I can if I dare to, not wash my hands 10 times the next time I speak to my friend and see what happens. If she does not get sick, and if I dare to keep testing this out, eventually perhaps I may be able to see that I do not need to keep doing this ritual to keep my friend safe and I will be able to stop washing my hands so much. I have suffered and still do suffer to some extent with this kind of obsessional checking and in the past, CBT therapy I’ve tried has focussed on changing behaviour and seeing that the awful things I fear do not come to pass.

But where the internal world of thoughts and feelings are concerned, I find it is not possible to check or “see what happens” in the same way and I never find peace.

For example, in the above instance I can see at least to a large extent without doubt that my friend does not get sick physically. But if I am fearing that I have hurt someone emotionally, how can I be sure? If I ask them, how can I be sure they are not just saying something to reassure me? If I think that someone is having a particular thought or a particular emotion, can I be sure that I got it right? Often it’s harder to ask in these situations (and I suppose I feel that it would be socially inappropriate to do so in many situations – I don’t want to inconvenience other people with my own obsessions and fears). If I say something, can I be sure that the other person understood it the way I meant it?

Often, if I have said something that I intend as encouraging, helpful, etc, I worry afterwards that I have communicated a message that I did not intend, which is bad and that is going to be terribly hurtful and upsetting to the other person because they will get that message rather than the one I intended. Then I worry that I actually, unbeknown to myself, subconsciously intended and thought the bad interpretation, and that’s why I said what I did. This must show that I’m actually evil and nasty and need to punish and hurt myself to make sure I don’t hurt anyone else. Then I will self-punish or self-harm. For example, a friend was worried about her baby girl who could not be with her during her medical appointment, and was instead with a babysitter in the waiting room outside. I said to her something like, “It looks like she is with someone who’s looking after her very well,” intending to reassure my friend that her baby was well. Immediately I’d said it, I panicked that this sentence could have implied “she’s with someone who’s looking after her well, because you don’t” and that my friend would think I was saying that she didn’t look after her baby properly. And my mind spiralled out of control thinking that although I didn’t know it, I was really being nasty to my friend and judging her as a bad mother and my intention, although I thought that I wanted to encourage my friend, was actually to upset her because I’m such a bad person inside. I wanted to check with my friend and say, oh no no I didn’t mean this, I meant… etc, etc, but I didn’t dare to, in case that would only make it worse, because if she had not seen the bad interpretation, it would only make it even worse to mention it. I felt the desperate urge to self-harm immediately to punish myself for being so bad inside.

In these kind of instances, nothing whatever will ever reassure me as to what my intention or thoughts really were (whereas, in the earlier example about obsessional hand-washing, I could obtain the concrete proof that my friend did not get sick). There is no way to check for certain what my real intention was, that it is not unconsciously something terrible which I’m not aware of and can’t control. There is no way to check for certain what effect emotionally I’ve had on someone else, or what they have understood from something I have said.

So I don’t know what the way out is.

For some reason, self-harm does seem to be the only (maladaptive) way that I do cope with this kind of uncertainty. When I can’t check enough that I’m not actually doing bad, or intending bad, then I have to hurt myself. The one thing that does seem sure is that if I’m doing something to hurt myself, it will somehow keep other people safe, because I can make sure I’m hurting myself, not other people. I can make sure I’m punishing the evil greedy part inside me so that it doesn’t burst out.

I don’t know how to begin to deal with these kinds of uncertainty. In time I think I am going to give this a Part 3, to look at ways of trying to sit with uncertainty in communicating with people. I’ve a feeling that it’s going to be an important part of my therapy as so much of my interpersonal problems, and perhaps for others with personality disorders too, are connected to these themes.

Thank you for reading, as ever.  I would love to hear your thoughts and experiences and what you find good, or difficult, in interactions with others and in communicating about emotions.

Also, an important note: I know that in this article, I have contrasted examples of anxieties and obsessional thoughts surrounding what I have referred to as things I can check in the concrete, external world, with obsessional thoughts and fears about what is going on in one’s head / emotionally / internally. I say that it is harder for me to find the way out of the latter obsessional thoughts and fears. Please note that in no way do I wish to belittle or minimise the distress experienced by those who are struggling with OCD thoughts and actions and fears relating to the external world, for example checking doors or switches, or cleaning. I know from my own experience and from hearing loved ones’ experiences, that these struggles are deeply distressing and the thoughts just as consuming. I empathise very much with what you are going through. All I wished to do here is draw a distinction which I have come to in my own mind and to suggest that the way out of the two sides of these obsessional thoughts may perhaps be different. As I’ve said from the start, I am neither a clinician nor medically trained, and these are just my own thoughts.

Ginny xx

A shapeless piece of steel… a burn that burns much deeper – “Why do you self-harm?”

I have written this post in answer to the question I was asked of why do I self-harm and what purpose does it serve. In my opinion it definitely serves an important purpose and it is not a “cry for help” or to get attention as stereotypes hold.  It’s a coping strategy – a harmful, or “maladaptive” one, but it’s a strategy.

It’s necessary. It’s the only way to carry on. It’s a compulsion, a need, and a blessed release.

It can be almost grounding. When the voices are screaming, the guilt is exploding in me, I am crushed by anger and fear and disgust at myself and running out of breath – I know what those cuts will feel like. It’s the same every time. It’s release. I know exactly what will happen no matter what a mess everything is. I get the scissors or the razor and I know what I must do and I know what I will see as I scratch and bleed and I know what I will feel, the familiar sting, redness, throbbing. I know what that is. There it is before me and it can’t be doubted.

It’s better pain than what’s in my head and it stops the noise and hurt and racing thoughts and voices and rising anger and crushing terror and revulsion that wants to tear at my skin to get away all the bad that I know is inside me.

I can be sure that I’ve hurt myself. There it is, I can see it. It’s not good enough. I’m very weak. I need to do it more and more. But it’s something. It’s some way I can be sure I hurt myself, so I won’t hurt someone else. So I’m not such a danger to everyone else. Not so disgusting.

Sometimes it’s so that I can continue with the day.

It shuts off, for a few minutes, the frightening memory, the frightening emotion or the disgusting thoughts. Especially violent anger or the sadness that blacks everything else out and hides everything good. It literally cuts through it, a little bit, fights the way upwards.

It can end some of the dangerous dissociations where I lose time, forget things, make irrational decisions, disappear from reality into my safe escape worlds.

Perhaps sleep will come afterwards.

Perhaps numbness or quiet will come afterwards and it’s a little bit of a way to get a break.

People say it’s a cry for help. It’s not. It’s not something I threaten to do to get my own way or pressure people. It’s secret. It is the help. It is the way to keep going. If I couldn’t do it, I’d have had to die a long time ago. I’d have given in and (though it’s against every single one of my personal religious and moral beliefs when I’m in my rational mind) the darkness would have consumed everything and I’d have had to do it. I hide it from everyone, make sure I do it where they can’t see, and I very reluctantly tell my therapist about it. One of my friends says call her when I feel I’m going to do it, she’d want to know. I could never do that – I would not want to put her in the position of feeling she must stop me.

I don’t think I do it very “badly” – several people in one of my therapy groups have far worse self-harm scars than I do. It’s nothing really, it’s no danger.  But it is a way to cope.

***

“…My dreams are not the issue here, for they, the hammer holds. The hammer pounds again, but flames I do not feel, this force that drives me helplessly through flesh and wood reveals a burn that burns much deeper, it’s more than I can stand…”

(This and the title quote are from Bebo Norman’s The Hammer Holds. For some reason this song always makes me think of how I feel when I self-harm.  I know this is not anything to do with the original meaning of the song and Bebo Norman is not making this reference at all (it’s a Christian song telling the story of the Crucifixion). Yet some of the lines express how I feel when I cut.  It’s a way to bear the pain; it’s something I wish did not have to be but is absolutely needed and drives me on, it’s the only way to live at the moment. )

 

 

 

Lullaby 3 – what I can never share

Warning – this post contains some of the thoughts that I have when I am pushed to self-harming or suicidal plans. It contains mention of some of the ways in which I self-harm.  If this may be distressing for you, you may not wish to read further.

There is nowhere I fit.

The rare times I felt any safety as a child were:

  • Talking to Dad about what had happened just before Mother went into hospital, when her behaviour had become so wildly bizarre it could no longer be ignored.  At last I was heard.  My fears were heard.  This was short-lived.  As soon as she was back home, the admission of the strangeness was lost, explained away, forgotten… her world returned again, her world consumed ours.
  • When I had some academic success. Did well in a test, or an essay, or an exam. Got good marks.

Now, perhaps, it’s also “safe” if I’m “recovering” at the pace and in the way my family want.  For a while, it’s as if a bridge of some kind of expression or understanding can be built.  Sometimes they startle me with understanding and acceptance and support and encouragement and say they are there any time I want to talk.  But it’s laced with fear because as soon as I can’t keep up the progression, keep “moving forwards” – so just when I’ve started trusting, and just when I most need help (maybe I’m distressed, anxious, the voices are worse again, something has gone really wrong in my life) – they pull away, they are angry, they limit contact, I’m the problem, I just have to make more effort and try harder, I have to realise how impossible I am to be around, I’m a spoilt brat, everyone says how rude I am, on and on and on. Shift into a different gear, we don’t know anyone else who’s done as little as you, reaffirming the embarrassment and failure I am.

So the only way to cope, to avoid yet more pain of starting to trust and then yet again failing, hurting – others, and myself – is to only have contact when I can act how they want me to, present what’s acceptable and what they want to see.  That won’t be rejected.  The rest I’ll hide, and when I cannot hide, I’ll make sure I’m alone.

I do not fit in their world and I do not think I will ever be a part of it.  Constantly I am too much to cope with.  “Why isn’t it enough for you? Look what everyone has done for you! It isn’t anyone else’s responsibility to make you feel better. Look what I’ve done. It would be nice if you responded.  It would be enough for most people.  Why isn’t it enough for you?”

I hear the voices joining in the chorus and the guilt settling like a weight crushing my shoulders, fighting with the anger rising within me, mixing to a block of lead in my chest.

Why isn’t it enough for you? You didn’t say sorry! You didn’t say sorry enough!

I don’t know. I don’t know why it isn’t enough. I don’t know how to say sorry enough for the failure and rubbish and disgusting thing I am.  Some part of me wanted to show you the razor marks then, the cuts down my arm, they still weren’t enough, but that was how sorry I was – though I still couldn’t do it well enough, I was too weak.

I don’t know why it isn’t enough. But there’s this weight on my heart and on my brain, there’s a noise in my head, the voices, screaming, white noise, sucking me back into flashbacks and memories of pain and fear and disgust and hurt and desperately, desperately wanting someone to protect me and see.

I don’t know why it isn’t enough.  But I did try to tell you, and I did really want you to see my fear, back then.  But all you could see was her, and she was perfect, and I was the problem, the one that had to change, that was acting weirdly, not trying hard enough. I did try to tell you and you were there, but now you say I didn’t speak and you didn’t see.

I don’t know why it isn’t enough. But inside every part of me is breaking and crying and I’m fighting the urge to run away and not stop, hope I will freeze or collapse or die, lie down and sleep to get away, because I am so, so tired, of what the voices say to me, of being so weak I can’t do what they say, when they tell me to pour the boiling water from the kettle over my hands, to cut deeper, to take the handfuls of pills not just look at them, to actually step on the train tracks this time, it would be so so easy, you vile disgusting selfish pig, why don’t you do it? You’re ugly, you’re dirt, you can’t ever get rid of the evil thing in you, everyone will see in the end, everyone knows you’re evil. Go on, do it, cut, starve, throw up, you disgusting bitch, what right do you have to this…

I don’t know why it isn’t enough. No matter how much I wash or cut or starve, it can’t be sure to get out the evil in me, that errupts dangerously and contaminates and hurts everyone around, and I don’t ever know when it’s next going to happen, that someone gets hurt. Mother told me for long enough that I was punishing her, plotting against her, deceiving, greedy, fat, selfish, getting my own way, hurting her repeatedly, driving her to suicide, driving her away from the family, going to have them sent to prison, and nobody would ever know it was really my fault, they’d think it was hers, but really deep down I’d know it was me, and so would she. So whatever they say, I know it’s me that’s evil really.

I don’t know why it isn’t enough.

PD and ED – some thoughts about personality disorders and eating disorders

The majority of other sufferers of personality disorders that I have met with, as an inpatient and in the community service I go to now, have difficult experiences surrounding food, for example, having diagnoses of anorexia or bulimia, struggling with fluctuating weight, punishing themselves with food-related actions (starving or making themselves sick or bingeing, or deliberately eating foods they are allergic to in order to provoke a painful physical symptom) and so on.  This is just an observation from what I have encountered and there could be many factors involved – for example, issues around weight do seem to be on the up in the UK (or at least more prominent in media coverage?) and the majority of people I know with personality disorders are women, amongst whom eating disorders are also more common.  However, it did get me thinking and resonate strongly with my own experiences of food and disordered eating and of working in an eating disorder service.

I think food is tightly bound to feelings of anger at self or at one’s own uncontrollable emotions, and makes an effective – though it hurts to use that word – form of self-harm.  When you have thoughts like: I’m so disgusting I don’t deserve to eat / don’t deserve good food only rubbish, I do not deserve to care for myself so I only eat junk, I hate my body for making these demands [to eat], go on you disgusting bitch [I say to myself] look what you’ve done you greedy pig, now get rid of it, throw up til your throat bleeds….you’re foul, you’re disgusting, look how much you’ve hurt everyone, starve and make sure it hurts……. Those kind of thoughts; or even just being too low in the darkness to respond to the basic need for nourishment.

When my eating was the most disordered, I didn’t get specialist help or even much acknowledge the problem in the worst times, despite the efficacy of the function it was serving for me.  I was also blind to it.  My mother (in part because of how her thoughts were twisted by her own sickness) also prevented me from accessing the help that my GP desperately wanted me to get. Now I know that I was underweight enough to fall into the severe anorexic weight range where dire physical consequences were a risk.  My periods stopped and I suffered damage to discs in my back during this time.  (More on my own disordered eating in another post.)  This was long before I was diagnosed with personality disorder (my eating disorder first started when I was about 14) and it is only now, nearly 15 years later, that I am acknowledging it and can articulate what its functions were.

The other day I spied a leaflet for carers in the community service I’m part of, which discussed some of the signs of personality disorders.  “Eating disorders” was actually specifically listed as a “symptom”.  This struck me in particular because personality disorder often occurs jointly with other psychiatric diagnoses but these would not be classed as a “symptom” of personality disorder.  (For example, many people with forms of personality disorder also have bipolar disorder, but bipolar would not, at least to my knowledge, be classed as a symptom of personality disorder – it is a different diagnosis which someone may have at the same time.)

I would agree that struggling to feed myself well and at times, actions that would be classed as eating disordered behaviour, are tightly related to my emotional instability, lack of control over strong emotions or thoughts that are repulsive to me, and the need to punish and hurt myself.  So yes, I would say these are “symptoms” of my personality disorder.

I talked to two friends about the leaflet I had seen – both are highly experienced in the treatment of eating disorders.  One point they made was how much eating disorders are a sign of something else painful.  It’s often thought that once someone’s problems with food and weight are treated, they are “all better”.  However, that is very much not so.  The eating disorder is often masking, indeed a mechanism for coping with, something else.

It could be numbing, or controlling.  Overeating could comfort, suppress, bury, emotions.  Starvation, I think, ironically consumes; the hunger that gnaws painfully eats away other feelings and leaves a blessed numbness.  Thinking back to my own times of starvation, I have to admit that it was, at the very least in a significant part…. fantastic.*  I was wrapped in a protective, protecting numbness, for long periods.  (The times this cracked were utterly terrible, but the times it lasted froze me in a lighter, safer state, so it seemed.)  I will explore more of this in another post.

One struggle in personality disorders is that our emotions may, with less stimulus than it ordinarily takes, reach an unbearable high where we cannot cope or think, where there’s only fear, upset, panic, darkness, anger, sadness… or much more occasionally, extremes of joy (I am not sure why the extremes of positive emotions are so much more occasional.  Perhaps do they just trouble us less as these emotions seem more acceptable, and therefore we remember these extremes less?)  In these extreme states we can’t think, we don’t act rationally, our memory may be affected, and we may take extreme actions like overdoses, self-harm, suicide attempts, and so on.  Then it takes longer to come back down from that extreme state to “normal” – the level of emotion where it is possible to cope and function and think – than it ordinarily would take.

So I think one interaction of eating disorders with personality disorders could be this.  First, the eating disorder may serve the function of numbing emotions in the first place, so that those dangerous high extremes are not reached in the first place.  Second, it may serve the purpose of bringing us down from the extreme, with their numbing, consuming, controlling effect.  It’s similar to other forms of self harm.  When I am in extreme distress and I cut, for a brief time, it deals with the emotion or makes things feel safe again because I can be sure I’m hurting myself, not someone else.

These are just my thoughts and I would love to know more about research into this.  I wonder how much there is.  I have read quite widely in my work and studies about eating disorders but have not come across very much on this topic, beyond the fact that the two diagnoses can occur together.  It strikes me that the interaction between eating disorder support services and other support services like personality disorder teams or wider community mental health teams, is something that warrants much exploration if we are to support someone not only to recover physically from an eating disorder, but emotionally as well.

*When I was in the midst of the eating disorder it frequently did feel fantastic.  I am NOT advocating eating disorders and I know rationally now – thankfully – that it was anything but fantastic when I was anorexic.  I am thankful to be recovered and for the work of specialist eating disorder counsellors and services, GPs and CPNs who so dedicatedly help sufferers.  I urge anyone struggling with food and eating to get help.

At the same time, I am acknowledging that disordered eating does serve a purpose and function.  It is a way of coping.  It is harmful, as overdosing, cutting, other forms of self-harm are harmful and risky, but it is a way of coping, just as I believe other forms of self-harm are.  I think eating disorders are a way of coping with so much more than the thought processes I have outlined here.  It is different for everyone.

I believe – and I think the clinic the two friends I mentioned work in takes this seriously – that for it to be possible to survive recovery from an eating disorder and take the next steps, treatment has to respect that eating disorders are a coping mechanism, and then enable the sufferer to find alternative coping mechanisms, for example in this case, other ways to deal with the terrifying emotions and extreme lows and highs.

Though I never was specifically in treatment for my eating disorders, I am now very very fortunate that the service treating me now is helping me find these other ways of coping, and I think that as this is the start of dealing with so many aspects of my personality disorder, it will also restore my relationship with my physical body and its need for nourishment.

Ginny x