Ramblings on terminology, recovery, and believing in what we don't yet know...

I was thinking a lot today about the way we use terminology, often without much thought, and the impact this can have. This then led me to think more broadly about how often we can find that with time find ourselves in places of progress and acceptance that once never felt possible. I saw a question today about recovery, and these three things inspired me to write again...

Clinicians, and especially academic clinicians often use terms like 'abuse', 'neglect', and various diagnostic labels rather readily in their formulations (both of psychological distress at a broader level, and at an individual level) without perhaps fully appreciating that whilst a common and relatively accepted language in many clinical/academic forums, when characterising an individual's experiences these terms can take on quite powerful and personal meanings (even if you also happen to be an academic or clinician). The first time the terms 'abuse' and 'neglect' were thrown my way in the context of my personal experiences I fell of the depression cliff in a major way. I had never conceptualised my experiences in that way and was not equipped or supported to deal with that. Neither my clinical or academic understanding helped - in fact they made it worse. People that I loved became alien, experiences and memories that were treasured became 'contaminated' and those I'd suppressed and forgotten bounced back at me like a hail storm. I could not make sense of my conflicting emotions - either 'abuse' and 'neglect' meant that people that I deeply love deem(ed) me unloveable or not worthy of their care, or they meant that these people were people I was somehow wrong for loving and so my problems were my fault because I pursued these 'bad' things. This took me to some terribly dark places that hung around like glue for far too long.... For a long time I believed that I had been depressed my whole life, would never get better, and was destined to die young. I could not conceive of happiness, and I could not think of a resolution to these conflicts in my relationships.

Well, I was ill and that was depression thinking, depression talking, but when you're in it, it's very hard to know anything else, it messes with your thinking so powerfully at it's extremes. But as a consequence of those experiences I think that I seize and treasure in ways that perhaps I otherwise wouldn't those moments in my life when my boyfriend spontaneously kisses me on a Tor and I forget everything but that moment, or when I watch the sun set over the sea in his arms and feel total peace and contentment in body and in mind. That is not to say that peace, contentment, invigoration, or mindful engagement come easy, but they DO happen, and pretty regularly. I would not say that I'm depressed these days and I'm certainly not in that black hole anymore.

With the terminology and my relationships, well I've come to accept that there is a world of difference between professionals using 'abuse' etc. to predict vulnerability to psychopathology, and what it means as a lived experience. In my case, my experiences no longer mean to me either that there is something wrong with me, or with the people who have been labelled with these things... I think now in terms of the most positive and constructive way of approaching these relationships - not what any of our pasts or limitations 'mean' about our worth. This works, mostly pretty well. We are close, but mostly they will neither share my highest highs nor my lowest lows, because they cannot tolerate my experiences of psychological distress in a way that is helpful to me and so they are not a safe place for vulnerability. But others can, and there are other places for me to connect in those ways.

So what does this make me think about recovery? Well the ED stats are depressing. But so are the chronic depression ones. Statistically I'm screwed. But I look back and my life has changed SO MUCH for the better - and in ways that I would never have believed possible. I could list all that, but that's what journals are for and why I keep one. To me the critical thing is that now there are highs and lows - bad stuff (and annoyingly incomprehensible sad moods) still happen, but so do joy, laughter, connections, and self-acceptance. Neither all the time, but that seems like a fair deal to me. I have accepted and moved forward with a pain that was so deep that it drove me to attempt to take my life, and also forgiven myself for having done so. If I can achieve all that with my depression, why should anorexia be so special? Who's to say that the things that I can't yet quite see with that won't one day be my every day experience?

With depression, I took things one day at a time, one quest for happiness at a time. I think that the same is true with anorexia. There have been times when I've been better, and times when it's slipped again... But I KNOW that I can shut that voice up, it will probably always whisper from time to time, but it's a whisper that I can shut down, like the whisper of depression on the mornings when I'm inexplicably sad - it doesn't have to get elaborated and I just need to be slightly more proactive about doing the good stuff to ensure that it doesn't become amplified. Personally, I think that one can't (and in my case I'm not sure that I'd choose to) erase one's history and experiences, but whilst the vulnerabilities may remain, they don't necessarily have to have so much impact. I kind of believe that a part of this puzzle (although not the whole) is that our emotions DO respond to our behaviour: if we behave as though we are better, with time, parts of our emotional experiences will catch up and change. It takes a great deal of persistence, determination, and distress tolerance, but I believe that it's achievable. And without a doubt, it's not worth giving up on. After all life is more fun when you let yourself laugh, and chocolate's more fun when you don't count the squares :-)

On the power of a room filled with flowers :-)

I've been thinking a lot recently about the 'whys' of anorexia - I've become involved in consulting on a new trial of an intervention for eating disorders (which I received myself as an inpatient nearly two years ago) and this has meant that my professional and personal worlds have blurred (even more than the boundary battlefields of living with a boyfriend who researches the same area and at the same University!). I have also been thinking a great deal about shame, fear, and the need for acceptance (I'm reading Brene Brown - who has some wonderfully insightful things to say). My experience (both personally and in my interactions with others who have struggled with anorexia) is that the fear of losing control/letting go/being vulnerable is not limited to negative experiences. There's a fear of positive emotions too. A general fear of being 'seen' whether in association with the good or the bad. When I passed my PhD exam, people got me flowers, there was a champagne moment, cards, compliments, lovely things... The whole lot terrified me; I didn't feel worthy; I knew my thesis was not that good, I knew every flaw, every bit of mess and imperfection in my PhD and I was terrified that accepting these lovely gestures, enjoying these moments set me up for the shame of someone else seeing them too and taking it all back or belittling me. But without these kinds of positive experiences, and more importantly without living them, being in them, accepting them - hell enjoying them, how can one possibly foster better self-esteem, challenge shame, develop resilience to the battering that anorexia can deliver?

This weekend turned out to be somewhat challenging - something stupid unexpectedly set off that evil anorexic self-hatred. I stuck by my food regimes and so on, I didn't give in in that sense. But on my beloved weekly coastal trip I sat crying behind my sunglasses while my boyfriend swam in the sea, I could not allow myself to enjoy it, to let go - I wanted to, I knew I should, I knew I could... What stopped me? Anorexia. Nothing about the cognitive effects of starvation etc can account for this - my body is not starved any more. With all mental health problems, if you have ever been trapped in the depths of despair that they can bring, there will always be a fear of that coming back - and that instills a fight mentality, to ward off the terrible warning symptoms that could spiral into a repeat of previous personal hells. But what of the positives? Of letting go, living life and actually actively pursuing fun? Seeking the good stuff, acting as if you deserve it? Not just the food, but the happiness part? Surely without that recovery is unattainable...

A few years ago I was deeply deeply depressed. My route out was ultimately not via sitting of NHS waiting lists (quelle surprise!) but by behaving as though I believed in happiness even though I didn't - buying myself flowers, going to the coast (hence the now weekly routine), lighting candles, taking the time for a warm bath or a good book. It was bloody hard work - especially at the beginning, and it's no replacement for the psychotherapy that eventually followed, but it took me away from a place of hopeless suicidality. Perhaps it will also be the key to finally kicking anorexia's butt once and for all... After all if you're never seen by others, you trap yourself in isolation and disconnection. If you never allow yourself pleasure, you deprive yourself of the incentives to fight for life, and in doing so fuel anorexia's flames.

In that spirit I have planted (or rather my very tolerant boyfriend did!) myself some beautiful roses - hopefully my happiness (and their health - which I'm already worrying about!) will blossom over the coming months...

A poem... not very good

Empty Light

Heavy tears bring the relief of light
Heavy blood the numbing loss
Heavy in me
Heavy without
Heaviness of a relentless mind
When will this heavy 
Become light
That my heart might lift
My feet skip
My soul sing for life
Will this illness of light
Leave me, heavy
This illness of heavy
Show me light
Within not without
Beauty in mind, body blind
Worth a right
Not earned by light
Heavy the price
For the lightness of life.