Building Self-Confidence 103

I am anxious.

A 'normal' person would feel anxious in these circumstances.

My department is being restructured. My house has toxic mould growth. My marriage is being challenged. I need to lose weight to get fertility treatments. My mental health diagnoses strongly suggest I shouldn't have children at all. My GPs keep failing to provide adequate and timely assessment of my unexplained physical health problems. I could have cancer. I could have conversion disorder.

In the last month alone, I have 5 silver hairs. I'm not yet 30. I won't finish paying my student loans until I'm 37. My brother is in the most dangerous part of Afghanistan. My father was recently made redundant. He's in his 50s. My sister is waiting for a kidney. My nephew, recently graduated from university, got his ex-girlfriend pregnant. Two of my co-workers are also pregnant.

The common themes are grief, inadequacy, and fear.

I just want to move forward. But the number and weight of the decisions I need to make paralyse me. I grow even more anxious. My reproductive cycle shuts down. My headaches get worse. And to cope, I become even more obsessed with fixing everything.

A lot of 'normal' people in my circumstances would take medication to cope. But because of my mental health difficulties, these current circumstances simply match how I always feel inside: sad, inadequate, and afraid. And since I've survived that way for years, I know I can survive that way for many more years. People experiencing depression or anxiety for the first time often panic. They wonder, "what is wrong with me?" They struggle to cope.

But, feeling sad, inadequate and afraid isn't the hard part.

Accepting those feelings.
Sharing those feelings.

That's the hard part. That's what keeps us from wellness. And that's why self-confidence is so important.

As a result of my mental health challenges, I am experiencing cognitive problems. Words are often difficult to find. I forget how to pronounce others. I lose my train of thought. And sometimes, my sentences don't make sense.

My public speaking skills are a source of pride. So, these changes have been damaging the backbone of my fragile self-esteem. When I first started making these mistakes, I panicked. It's a clear sign I'm going crazy. My mind is deteriorating. I cannot trust myself anymore. I was devastated. What were others thinking?

Three months, still no sign of improving. In fact, it's getting worse. But I've quietly accepted it. And then the next time I mixed up words in a sentence or took three tries to pronounce a word, I didn't panic. I moved on. Somehow, even though it makes me sad, my cognitive decline became a part of me. When I accepted it, what other people thought didn't matter anymore.

I treated myself with compassion.

Instead of fighting the changes or obsessively trying to control or explain them, I simply accepted them. I wish I could do the same thing for my new grey hairs or our infertility or my past. I wish I could trust other people. I wish I could share how I felt. But my feelings are still wholly unacceptable to me.


Read on the NHS Choices blog.

Building Self Confidence 102

I’ve experienced some pretty scary long-term abuse and neglect. I am not perfect. I may not even be ’enough’ for whatever you wish to measure me against. But everything I am includes those scary times. I work hard. I learn quickly. I think differently. These traits you know and love so well aren’t despite of my pain. They are because of it. And some days, I hurt too much to work hard, learn quickly, and think differently. So I work even harder, learn even more, and challenge everything. These lows give me the skills and the strength to reach higher. Lows happen. I accept them, because in accepting them, I learn to accept myself.

By denying or ignoring or covering up the experiences that continue to shape me, I deny, ignore, and cover up myself. Instead I should be celebrating. I should be painting my internal scars all over my skin so you see them as boldly as I do. I am not whole, clear, unblemished. I am formed, fragile and prismatic.

Beautiful.


Read on the NHS Choices blog.

Building Self-Confidence 101

“I'm trying.”

I haven't written. Not for weeks. I rarely do when I'm feeling poorly or I'm in transition. The last few months, I've been both.

Change comes too quickly to record. And before I can explain, I'm off again, tackling the next problem. It's been three years since I joined the system. At least you can call me patient and hard-working.

My new therapist gives me lots of homework: pages and pages of self-referential statements to agree with or dismiss. It's busy work mostly, while we work on building our therapeutic relationship, but the secondary goal is to tackle my low self-esteem.

The biggest barrier to change is my insecure attachment. I'm 'Avoidant-Fearful' which essentially means I don't trust you, no matter how many pretty smiles I give you, and the more you know me the more dangerous you become. I'm also moderately perfectionist/obsessive which essentially means I work very hard to provide you with everything you need/want from me, often at my own expense.

How did it happen?
I had no significant, stable relationships growing up, notably my parents who were emotionally unavailable and abusive.

Why does it still happen?
I can quite successfully avoid conflict by being perfectly blameless: making no mistakes, and moreover, keeping everyone at a distance.

How do I do this?
I analyse you constantly for even the faintest signs of disapproval and, depending on the risk, adjust my personas or withdraw completely from the relationship.

What is the problem?
I've been doing this so long, I have no cohesive sense of self -- quite a vulnerable place to be. Naturally, I'm quite skilled at putting up defences to protect you from discovering this. I suppose this makes me especially complex to treat: a rapid-cycling wheel of disordered personalities.

I've always refused to take medications. So when I go home from therapy and the sheets covering my emotions slip away, it is up to my body alone to weather and recover from the deep shuddering fear and shame. My choices make the difference: what I eat, how much I sleep, who I interact with, what I think.

It would be much easier to suppress every emotion, as I have done, than risk being sucked into a deep depression. But, 'sucked in' is often where I go, paralysed by insecurity, because behind all of those beautifully crafted walls stands a girl propped up on hope alone.

“Don't take this the wrong way...”

No one should start a conversation this way, most especially a therapist. It doesn't help that I already knew the evidence. I've seen the NICE guidance. I know it is your clinical responsibility to ensure people with enduring mental health problems do not reproduce. But why doesn't that responsibility extend to women who drink alcohol or smoke? What about the morbidly obese? Shouldn't every parent be required to pass an attachment interview or else be prescribed an abortion?

This is what we call inequality. If it were a physical or economical disability, the government would bend over backwards to ensure I was able to be a good enough parent. But since I have a mental health disability, they are obliged to advise me that I should not even try.

Is there a 'right way' to hear someone confirm everything you've already read in the literature? See, there I go intellectualising again. Let's try that again.

Is there a 'right way' to hear your therapist reinforce the same unrelenting beliefs you abuse yourself with?

Perhaps I did it the right way: nodding amicably, reassuring her and moving on. Funny, how the 'right way' always feels like I'm smothering myself. Would the 'right way' have been to burst into tears? Say how I know it will be very hard, but I want more than anything to be a family? That, against all odds, I feel safer, more secure, and more myself with children. That I'm not just a different person... I'm a person, with a clear sense of self. Being a mother means something to me.

Being told we can't have children naturally has been a massive loss. Being told I shouldn't have children because I won't properly attach to them is something else entirely.

“I'm trying.”

When I left my last therapist, I was terribly wounded by several things she said. I did not give her the opportunity to acknowledge my hurt. The interim/assessing therapist asked me what I was afraid of, and I couldn't answer.

Why am I so afraid to reveal how scared and hurt I am? Actions speak louder than words, but in my case they both drown out my emotions. I act like I'm fine. I say that I'm fine. And we smile together; how nice to be on the same page, isn't our relationship great? But my anger builds inwardly with each lie I give you. I give the same lies to myself.

“I'm trying.”

The key to making progress in therapy is to think and act differently. I could let it go, like I let everything go, and do my homework like a good girl (it's what she expects and wants, isn't it?). Or I could put the homework aside and tell her how I feel. What I believe. What I want. Because all three of those should matter, even if you (or the best available clinical evidence) don't agree with them. This is called Building Self-Confidence 101 (it's a practical lab).

It was the single most important thing I've ever said in therapy. If you blinked, you might have missed it, the bonafide inner Child. See me. Hear me. I want to make you proud.

“I'm trying.”

“I know you are.”

Read on the NHS Choices blog.

Pieces of Me (1)

Today I was myself. These days are so rare, now, that I decided to make decisions while I was able to trust myself.

Decision 1: Admitting I have a dissociative disorder.
Decision 2: Committing to psychotherapy to integrate myself

It gets more complicated from there. Last month has been very challenging. I meet my new therapist this week, which I have mixed feelings about. I have mixed feelings about everything.

So while I don't have the words for today, I thought I could share a few pieces of me. I've kept a journal since I was 13, but before that I wrote stories and songs. So, even though my mind works hard to forget, the paper remembers. And to integrate, I must remember. Going back is terrifying. My pulse races, my hands shake, my head aches, my eyes glaze over. I start to dissociate.

Time to do things differently.

----

February, 2000

chilling the heart that in me now lies
its tender motions i do despise
fading self-confidence silently reigns
gazing over this impassable terrain
holding the soft eyes and softer smile
all the more aching for this nameless while
even reason battles here, battles the now
crying hands typing, crying lips frown
society condemns, an impossible gap
unforgiving trees, untappable sap
no precedent, this new terrain forged
quietly approaching millennial doors

----

2002-02-14 19:17:00

"what do you do when your world collapses around you
who do you call
what do you say.


there are a hundred reasons keeping me from walking out that door right now
and a hundred more reasons begging me to

whatever the reasons I might have,
whatever the need is,
to find someone
to call home

it's not enough

I never know what to say.
Never.

I've spent my whole life sucking it up and moving on.

















there's nowhere left to go.



these entries are echoes to myself."

----


Are they ever.


Something in me wants out.


Read on the NHS Choices Blog.

Going Back to Go Forward (10)

Two weeks of therapy have passed since my last confession. I'm progressing too fast now to write each revelation and heartache. I try to be honest and write my experience of therapy, rather than just my interpretation, but my experiences of therapy lately have been wounding. And my defences have so far prevented me from writing it down. It's too dangerous. I'm too afraid.

I ache, thinking of death most days, even when cradled in my husband's arms. Even when smiling, laughing, with a colleague.

I know therapy is meant to be hard. And I am making a lot of progress. But at what cost? I don't feel safe in there. I don't trust her. She's my shattered, frosty, bleeding mirror. And thanks to her, I no longer trust myself.

I deserve better.

Read on the NHS Choices blog.

Going back to go forward (9)

I arrived at therapy eager and ready to share how much ground I covered during the weeks she was on holiday. I pulled out a map of my ANP (apparently normal part) and EPs (emotional parts) and explained how I identify more with the EP-Sad: how it’s harder to integrate EP-Happy because I’ve spent so much time hiding and protecting it. I tried to talk about the music and how it helped me access the EPs, but I faltered when it came to EP-Happy.

There was a block, I was struggling, and we both saw it. I admitted that it was too overwhelming to cover, and we moved on to EP-Sad.

I tapped into an EP-Sad memory easily enough.

“And do you remember how you felt?”

The room clouded into a dark winter, chills whistling through the ghost-like trees, and the chair became splintered wood. There were lights on the other side of the small forest, and their laughter carried. My cries didn’t.

I remember how I felt. “Angry.”

A breath. Hesitation. “Lonely.” The room yellowed; I sat on a twin bed in a dusty loft, room bare except one tape playing Wilson Phillips over and over. “Except, it’s not lonely.” Everything dissolved around me. “It’s more than lonely.” My voice was a whisper. A deep, ragged emptiness was opening inside of me.

She named it. “Despair.”

I felt like the princess in Neverending Story, finally named by Sebastian. For a brief moment. And then I felt, well, despair. I felt despair into the night and into the next day. It was horrible. That might not seem like progress to you, but for me it was life-changing. Overjoyed.

My research into adoption revealed a world of children with experiences identical to mine – and a world of people whose primary goals are to help them. I read detailed accounts of a 7 year old’s day from the eyes of their adoptive parent and I crumble in familiarity. An 'A-ha!' moment.

My therapist asks pointedly about my marriage.  I smiled, because I had been expecting this question since day 1. How can I have suffered without attachments for so long and yet have attached to him?

“I love him.”

I love him, so why can’t I trust him? Why do I hide myself from him? Resist intimacy? Control everything?

Together, my therapist and I acknowledged how I specifically seek out the role of Parent to avoid facing my own vulnerability. Even my mother-in-law seeks me out for counsel and protection. And I’m afraid, if I give up those roles, I will be rejected. Unnecessary. Unwanted. Unloved. Alone. Despair.

We left therapy with a partially unanswered directive: in lieu of any other suitable relationships (and given that I am 30 years old), how can I parent myself?

Thanks to my adoption research, I already knew how to find that answer. Self-care.

I started by taking all of the photos of my parents and stuffing them in a drawer. I stood in the hallway, fists clenched, staring across an ocean, declaring to an empty house: “I am angry at you. I don’t like you. And it’s okay to feel that way.” It was unbelieveably cathartic, because it wasn't said in anger or hate. It was said out of deep respect for myself. I don't want to see my parents right now.

It was a tumultuous weekend. I knew what I had to do, and I was afraid. We sat together in silence, he and I, for several minutes. I explained what happened in therapy that morning. I broke down in my husband’s arms. That’s a foolish phrase. I cried in my husband’s arms. I expressed my vulnerability, my grief, my fear, and my despair in my husband’s arms. I didn’t break down. I integrated.

It’s a wall that still needs a lot of smashing, but I carved a window by accepting his love and protection of me.

Suddenly, a part of me desired his approval. No. That desire was always there. Suddenly, I respected that desire. I cared for that desire. I cared for myself. I respected myself. 

I’ve been able to keep the kitchen clean ever since. 

Read on the NHS Choices blog.

Going back to go forward (8)

A common theme on adoption blogs and forums is the bewilderment that joyful times are always followed by intense lows. Why can’t a traumatised child just be happy, fin? Adoptive parents acknowledge the difficulty their new child has in regulating negative emotions, but rarely acknowledge that affect regulation goes both ways. The real on-going trauma of neglected and abused children is not poor regulation of negative emotions but in their inability to feel without every feeling digging up the earth under their feet.

Gosh, intelligent adults barely can make this connection, how is a child supposed to know that the anger, fear and shame following such a happy day is not:

1)      Due to their parents (mean and cruel!)

2)      Due to their identity (naughty boy!)

The point is, they can’t.

I am left just as bewildered, as I research more into adoption, reading personal accounts, wondering how I ended up being 30 and relating to the emotions and actions of traumatised 4 year olds.  Am I what they have to look forward to? Or were these adopted children rescued in ways I never was?

Last night was difficult. I played with (emotional) fire and (yes) got burned. Knowing how to tap into my EPs doesn’t mean I’m capable of managing those feelings. As a result, I’ve been physically ill for weeks, as well as suffering from dissociation, derealisation, and depersonalisation. Just one of the latter would be traumatising enough.

I visited an interactive art exhibit in Manchester over the holiday, staring blindly at the 113-beats-per-minute flash of my lightbulb. It looked like a tiny bird, fluttering amongst a ceiling of slow giants. Every other light bulb was half the pace of mine. What is wrong with me? I wondered. My face flushed, because I felt fine. I felt fine. But my heart knew differently. When did 113 beats per minute become fine?

More and more, I regress. As the childlike parts become dominant, I can feel whole sections of my brain going dark. The dissociation comes on more strongly at night. I panic at the sight of a strange man in my bed, my husband. And I realise now why I always think he is a family member. That part of me doesn’t know I am married. Therefore, a stranger in my bed must be my mum or my brother. Imagine waking up naked next to your mum or your brother. The disgust, shame, and confusion is overwhelming.

It only takes a moment, a single breath, to become grounded again: to cognitively realise where I am and who I am. But the feelings persist: an unearthly vacancy of self.

Last night, I experienced a key emotional memory. My EPs flashed me in one big synchronised chorus. Remember this? Remember feeling like this? This is you.

I dissociated strongly in response and then relied on distraction to get me to sleep. The visual memory remains, but could I find my way back to the feelings, when my therapist asks me? Already this morning, I find myself denying them. That’s not me. There’s nothing wrong with me. This isn’t a repression; the feelings and memories are already gone.

I’m restless, unable to work, searching for a new project to distract me. Therefore, we must be making progress. We must have hit a nerve. I’m torn between believing I can integrate this mess, undo decades of damaged attachments and emotional trauma, and the blissful ignorance of giving up. That’s called fear, and since I (the ANP) am feeling it, we must be getting somewhere.

I just wish I knew where.

Read on the NHS Choices blog.