Editor’s note: After a short break, we start the second year of monthly mental health guest posts. For November I have secured a moving description of living with Post Traumatic Stress Disorder by Nettie Edwards, a hugely talented digital artist who creates work with her iPhone and iPad. Her images illustrate this piece and I urge you to take a trip to her blog – http://lumilyon.blogspot.com/ – to see more of her work.
One of those sparkling early mornings that sometimes follow a night of heavy rain: birdsong rings brightly through air not yet choked with traffic fumes; the sun, low in slate-blue sky, glazes all with a golden wash. Inky shadows collect in the creases of the pavement. I usually miss all this: I’m rubbish at doing mornings.
You’re getting hard on yourself again! Move on, bring your focus back to the present. What am I feeling right now? Absolutely nothing, I’m numb, there’s no physical sensation, as if my life is happening in front of me on a cinema screen. This is heart-breaking, I used to love the rain. Then one day, the floods came and washed all the feeling away, leaving nothing but this feeling of not feeling.
But at least I managed to get out of bed this morning, managed to leave the house.
My mind wanders back a year…
I’m with my doctor, wrung out and desperate, telling her that I can’t bear being inside my body any more: I’m a bag of nerves: physical tension, mood swings, irritability, anxiety, panic attacks, hyper-vigilance, lack of concentration, memory and motivation. Exhausted from hardly sleeping, but having nightmares when I do, I’m afraid to step out of my house, most of all: of being with other people.
Then: words that I never wanted to hear myself saying: “Do you think anti-depressants might be a good idea?” My doctor shakes her head “no, you’re not presenting as a depressed person. To be honest, I don’t know what’s wrong with you or how I can help you…”
“Splish, splash, splosh! I like jumping in muddy puddles!” a child rushes past me on her way to school. Shock reverberates through my body: I’m dizzy, shaking and feel punched, convinced that I’m going to die. Post Traumatic Stress Disorder: you’ll have heard it associated with war veterans, victims of violent crime or natural disasters. I have experienced none of these terrible things and yet here I am: my body so saturated with the chemicals of trauma that the unexpected appearance of a joyful child feels like an attack on my life. The wait for an assessment and diagnosis of this mental illness lasted many months, during which time, my health deteriorated even further. Finally, due to the specific circumstances and complex nature of my trauma, I was asked: “what kind of person would you like your therapist to be?” My response was “a warm, creative, free-thinker who enjoys a good argument.” And so it was that Lucia came into my life…
Our room in the day centre that was once a Victorian-Gothic hospital, is dim and sparsely furnished. I wonder out loud, how it is possible for anyone’s mind to heal here. Lucia apologises: resources are tight and the Mental Health services are moving out of the building soon. She’s tried to cheer things up a bit with a few small posters. One features some Chinese calligraphy: Lucia explains that it reads “Mindfulness” which is what I’m here to learn. The currently prescribed treatment for PTSD is Cognitive Behavioral Therapy (CBT), but Lucia has decided that Mindfulness will be a gentler path for me: “unlike many of my colleagues, I don’t believe that I can transform you into some “perfect” being, I just want to help you learn to be kind to yourself, accept yourself and what has happened to you. We’re not going to talk about what brought you here because each time we do that, we allow those who have harmed you to harm you some more: let’s not give them that power. She slides a sheet of paper across the table and says gently “I’d like you do do some homework” There’s a chart with questions: How do I describe myself? What are my core values? I’m flung into panic and begin to shake and weep, winding a tear-sodden and shredded paper tissue around and around my fingers: I don’t know WHO I am. No! The truth is…I’m petrified to think or talk about who I am. Talking about me is part of how I got into this mess in the first place…
I’m in another room: this one’s much more attractively decorated and comfortable, as seductive as the voice that coaxingly asks: “How are you feeling today? It’s ok, you’re safe here, all feelings are welcome…” as I remember these words, the memories and rage tumble out, as they have done, over and over again…for how long? I don’t know anymore, these memories have become my past, my present, my future. They’ve become part of my skin and bones.
Michele Rosenthal, a PTSD survivor who runs the support group healmyptsd.com has written “The bottom line is this: After a trauma occurs, survivors get lost in the gap between Before and After, Now and Then, Today and Yesterday, who they were pre-trauma and who they become as a result of experience. Nothing and no one is safe, stable, familiar, recognisable, known or dependable. Suddenly, the entire world has changed and how survivors perceived and knew themselves and their identities has shattered.”
If you have no sense of who you are, even the most simple of decisions becomes traumatic and can feel impossible to make: what shall I wear today? What do I want to eat? What shall I do? In my case, this led to complete shut-down, depression and self-loathing. I’m an artist and designer, I spent over 30 years of my life learning to trust my instincts to guide my creativity. PTSD robbed me of those instincts: It also robbed me of any vision of the future.
Mindfulness: a principal of Buddhist teaching, is the art of BEING in the present, of focusing thoughts on the HERE and NOW. Mastering Mindfulness takes great commitment and daily practice, but it doesn’t matter if you do it for 30 seconds or 30 minutes, getting into the habit is what’s important. There are many approaches, but the one that works best for me is Mindful Listening: wherever you are, close your eyes, and focus on the sounds around you. Make a mental note of each sound you hear. If you can, allow your yourself to focus on them for a few minutes. You may find that your mind begins to calm down, your body to relax. The opportunity arises for you to gently nudge your thoughts from an anxious place to somewhere more calm and comfortable.
At the beginning of our work together, Lucia warned me that I would find it hard to let go of my pain and anxiety. She suggested I read Russ Ballard’s book The Confidence Gap. I’d like to suggest that you read it too. Ballard is a practitioner of Acceptance and Commitment Therapy (ACT) He writes: “The goal of ACT is to create a rich and meaningful life, while accepting the pain that inevitably goes with it”
“WHAT? You want me to ACCEPT what happened to me? You want me to FORGIVE?” Now I’m angry, and I’m angry with myself for feeling angry….
Lucia pleads: “NETTIE, NETTIE, show yourself some compassion, be kind to yourself”
Slowly, the penny drops: I can’t change what has happened to me but I can decide what’s going to happen next…
Part of what happened next was that I learned to be less hard on myself for being ill. Self-compassion, in the form of accepting my limitations didn’t mean giving into them, it just made the baggage a little lighter for the journey. Lucia talked a lot about journeys: “in your life, you are like a pioneer. It doesn’t matter how many mountains you have to climb over, or rivers you have to swim across, you keep going west: because you HAVE TO!” she likened our work together as “digging for the diamond inside that is “Nettie”
Anyone who has suffered with similar health issues will recognise the massive amounts of strength and courage it takes to recover. To begin with, it feels impossible: “look at the mess my life is in, how will I ever clear it all up?” Our negative thoughts and feelings have become so enmeshed with our identities, how is it possible to change them? Lucia and Russ suggest we don’t even try but rather, get on first-name terms. Now, whenever I begin to worry, I’ll say to myself: “here we go, it’s The Disaster Movie: I’ve seen this one before! BORING!” So I’m immediately distancing myself from from anxious thoughts and can begin to think more EFFECTIVELY: “ok, I’m worried about the ferry to France sinking, that’s not so daft, after all, there’s a possibility that it might, but if I get myself so worked up before the trip that I’m rendered incapable of coping in an emergency, I’ll be far less likely to survive”. In giving myself permission to have negative thoughts and feelings, some of their power diminishes. Furthermore, By placing them outside of myself, I’m able to see them for what they are: not an integral part of me, but separate and modifiable. Once I began to see my Mind’s healing as a creative endeavour, I began to feel curious, and just a little excited…
Unless I choose to end it (and I have no intention of doing so) my life is going to carry on and I must continue trekking west through the uncharted landscape of recovery. It’s up to me to choose the paths I’ll follow and I must take responsibility for these choices. It’s been almost a year now since Lucia and I first met. She had to work hard to earn my trust and it was a painful journey but by the end of our allotted time together, I was feeling much more in control of my depression and anxiety. Now I’m able able to see glints of the “diamond inside” that Lucia wanted me to uncover and polish. However, the loss of a loved-one was at the heart of my original trauma and as the PTSD symptoms diminish, what has began to surface is the raw grief that was suppressed by them. My head may be clearer, but my heart will take longer to heal: For the last six months, I’ve been on the waiting list for NHS bereavement counselling.
Here and Now…
I’m sitting in my garden. It’s a beautiful Autumn day: the sky is deep blue with fluffy clouds gathering; the sun feels hot on my cheeks despite a cool breeze. What can I hear? The last leaves rustle on the elder tree, wind chimes tinkle; some way off: cars, an airplane, a dog barking. A tiny shiver runs down my spine and I notice that I’m smiling: it feels good to be alive. The tag on my teabags reads “you are, you have been, you will be, what you do” and this makes me notice all of the things that need doing in my garden: the things I’ve neglected because if my illness. Well, I’m not sure how much I’ll get done today: I might get tired, I might not get myself mentally organised enough to complete one single task…but that’s ok, I’m not going to beat myself up about it. I’m taking each moment as it comes and I’ll welcome my difficult thoughts when they walk through the door, but I’m not going to invite them to sit down and have a cup of tea with me: after all, I now have other visitors to attend to. Today I’ll throw a party for my small achievements, one of which is that slowly, but surely, I’m learning to love the rain again.
Useful article by Dr Russ Harris, About ACT Qcan be found here http://www.actmindfully.com.au/upimages/Dr_Russ_Harris_-_A_Non-technical_Overview_of_ACT.pdf