Month: October 2015

Lullaby for a Stormy Night – 2

I thought that the title of this series required some explanation – why Lullaby? “Lullaby for a Stormy Night” is a song by Vienna Teng, to which I have posted a link below.  I was very moved when I first heard it, the gentle piano music and the words promising the child acceptance, empathy, love and never to be left, seeming to answer a fundamental need for this safety that I think we all have – and showing a love that I hope I would be able to give to any child I should ever care for.

Here is a link to “Lullaby”, with thanks [please note this video is not mine, I am simply gratefully sharing]:

I very much like several of Vienna Teng’s songs and identify with the lyrics – if you like the above I think it’s worth listening to “Anna Rose” and “Harbor”, in particular.

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Lullaby for a Stormy Night – 1

In therapy yesterday, we talked about having a “safe place”.  Someone asked me what mine was.  This thought has prompted me to write a series of reflections on this theme.  I think there will be 5 or 6 in total but this may change.  This introductory post to the series is poorly written, for which I apologise.  It’s hard to form these thoughts into words.

The short answer is I don’t think I have a “safe place”, certainly not an actual physical place as I’ve heard other people with personality disorder speak of, and I don’t think I really did, bar one period of my early life which I’ll talk about in one of the subsequent reflections.

Over the past couple of years, with varying degrees of strength, I have felt a longing for a home, a stable home, although I didn’t necessarily term it “safety” in my mind.  I’m not sure if I have ever actually felt safety.  That sounds ridiculous.  Yet if things were not physically dangerous there was a terrifying uncertainty and need to prevent disaster through the years of living with mother’s illness and behaviour, then – still now – the need to prevent everything I fear in myself getting out to other people.  I was in danger, and I was the danger.

I did want a home.  I felt that more and more raw longing.  I felt it when my childhood family home was sold in my parents’ divorce, even though I had not lived there for many years and it had by no means ever been safe, it was still a wrenching goodbye and a loss of something. I don’t know what. Perhaps it wasn’t a loss if it had never been there in the first place, but an absence. Absence of home.  Longing for it I tried to stay with my dad and stepmum, and what happened in that time hurt beyond belief and still feels as though it greatly damaged this family further.

***

Now I am trying to create a home and a safe place in my flat.  I am incredibly grateful to have a place that is my own, to have had support through the council to get to this stage, where I can make a flat my own rather than renting a room as a lodger in someone else’s house or in a shared property.  I never thought this would come.  It is actually remarkably hard to make this flat a real home.  Partly because I am getting used to the responsibilities of having a home – a greater number of bills, repairing things, upkeep and so on, which is all new to me although it is very late in my life for this to be new! Partly because I am so unused to knowing how to create something of my own.

***

As a child, whilst I did not have a feeling of safety, I created places in an internal world and escaped.  Now this world comes unbidden and stronger than I expect.  I have been told in therapy that it’s unusual that there are so many relationships in my internal world, rather than it just providing an escape to numbness.  I don’t know how yet, but it is connected to feelings of having different personalities and of detaching from what is happening around me.

A counsellor I saw at school towards the end of my time there understood my escapes, I think.  She realised how little, until I went to school, the outside world existed to our family and how little it crossed with mine (or rather, mother’s).  The counsellor saw clearly how she taught me at home to keep me there for her, in her world, because she couldn’t cope with going outside it, magnifying school to be a terrible threat because she couldn’t cope with me going.  And the counsellor said to me that to be able to live as I did, I must have found some way to escape and rebel.  I was surprised at the question and could not answer it, though I could begin to see what she was touching on.  I’ve returned to it at various times and now I think that perhaps my alternative worlds were how I escaped.  (Also, so perhaps was schoolwork and so was my eating disorder.)

It feels sad to realise the absence of such a place now, and it is sad to realise the efficacy and strength of the alternative worlds then, and of my dissociations now.

***

Would I even know how to live if it were safe? How do I even begin to cope with the risks involved in becoming closer to those I most care about? When so much in me is, in so far as I can really believe, dangerous, repulsive, unacceptable, a disappointment, something people close to me really cannot cope with in the end and have to limit contact with?

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