Why does physical illness always go hand in hand with a mental health crash?

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Look, I apologise in advance for this. It’s basically an, ‘I’m really poorly, am feeling sorry for myself, and I really miss my therapist’ ramble written from under the duvet, on a Friday night, whilst my wife is out at a gig that I am too ill to go to.

My immune system is beyond crap. My blood levels have never fully recovered despite it being nearly two years since I completed my last round of chemo. As a result of depleted lymphocytes, my infection fighting capacity is pretty non-existent. The doctors had hoped that things would’ve improved by now, but unfortunately my body is stubborn and has decided it would rather pick up and fight every bug that is going! I’ve been ill for almost two weeks now with the exhausting cold, cough, chest infection, no voice thing that’s doing the rounds. I’m so so bored of it. I just don’t have capacity in my life to be ill and still.

I thought I was getting better at the start of the week, hence the fact that I managed to drag myself to therapy on Monday albeit sounding pretty husky. By Tuesday, though, the dry, croupy sounding cough headed south and turned one of my lungs into some kind of gurgling swamp and I suddenly felt like I’d had all my energy burgled from my body during the night.

I finally made it to the doctors on Wednesday. By which time both my lungs sounded like crackling Autumn leaves being trodden on every time I tried to breathe. I’d spent the whole night trying to sleep propped on the sofa in between coughing fits but it was all a disaster. I know that I need to get better at seeking help before I am completely on my knees but I always worry about people thinking I’m some kind of malingerer or hypochondriac….which is I guess a hangover from all the doctor visits when I was misdiagnosed with my cancer where I was repeatedly sent away (fobbed off!).

I didn’t see my GP (apparently she’s retired) instead I saw a stony-faced misery guts with GP qualifications. I was really only there about the chest infection so it didn’t really matter that she had the bedside manner of a cadaver. The annoying thing is, though, that I could’ve been there about anything: my mental health, or illness, depending on which way you look at it has been pretty bad for the last six months or so.

Realistically after the huge anxiety attack I had a few weeks ago, coupled with the negative feelings I’ve been having about my body and the urge to self-harm it would have been good to air some of those concerns and discuss the possibility of medication for the times when things get out of control. Of course I didn’t say anything, I just took my prescription for antibiotics and went home. I didn’t feel comfortable telling her anything about my emotional state. I wonder how many people feel like this about their doctors?

By the time it got to yesterday I couldn’t even get out of bed. I was absolutely knackered and felt like my body was made of lead. My wife had to take the day off work to look after our son as I just couldn’t move or function in any meaningful way.

I’m not really here to moan about how ill I feel, what I wanted to talk about is how I’ve noticed that when I am poorly my ability to function effectively in a mental/emotional sense is seriously compromised. I wondered if any else has noticed this in themselves?

I’ve said before that I struggle to maintain the connection with my therapist between sessions and that I hate midweek especially. It’s so tough. It’s essentially when the little parts of me are most active and start to overwhelm me. It’s the time when I most feel like I need to check in with Em, to ask whether she’s still there, that things are still ok, and that something hasn’t happened that has changed the relationship.

It’s a really tricky position to be in because that tiny, screaming, terrified bit of me that is totally uncontained is desperate to reach out to her and seek reassurance but the thing is, when I do that, she doesn’t respond and so that desperate little girl feels completely abandoned and then can’t trust her when we go to therapy.

So this week has been hideous. Because I have been so poorly it’s felt as though my adult has jumped ship or died. I haven’t had the physical or emotional strength to hold it all together and my little ones have had free run of my mind. I’ve felt like I am completely emotionally unanchored. I feel like I need grounding and holding tightly. I have been so ill that I’ve stayed in bed and hugged pillows to try and settle and soothe those little parts, but it hasn’t helped and I just feel lost. This small inner child is desperate to be held close and I don’t know how to do that for myself so it’s become overwhelming. I really could use a transitional object – not that I’ve said this before!

I always miss my therapist between sessions but this week it all feels unmanageable, like a life and death situation. I feel like my filter is down and I desperately want to tell her how I feel and how much I miss her. I want to tell her how scared and vulnerable I feel. I basically want some kind of reassurance from her that things are safe still. Rationally I know that everything is fine and that we can work through some of this stuff on Monday but the child parts don’t get any of it. They just want to be cuddled…by her…NOW!

It’s tragic really and I know it’s basically my wonderful friend ‘maternal transference’ doing the rounds. I know that this desire to be taken care of and nurtured back to health comes from my childhood where I was never cared for or fussed over when I was sick. More often than not I was packed off to school because my parents were busy, or sent down to a relative because, ha, my parents were busy. Always too busy.

When I was a bit older and my parents had split up I was left at home in bed when I felt unwell. My day would be spent drinking Lucozade, making toast, and watching Supermarket Sweep and the lunchtime episode of Neighbours….and then watching the repeat again at 5:40pm. There was no one there to take my temperature, hold me close, bring me treats etc. There was never anyone there.

I think so much of how I feel when I am ill (or well for that matter) stems from this feeling of my not being important or worthy of care and affection. I always felt like an inconvenience, something to be managed (when ill) and so now, it’s little wonder that when I feel like there is someone who maybe does demonstrate some care and compassion (Em) I want to latch onto it and hold it greedily against my chest, or place it inside myself. I want that person to be there when I am sick.

I feel like a whiny kid writing this, but actually that’s exactly what it is, I currently have a bunch of whiny kids loose inside that want to be held and contained and my adult who is really just a crap babysitter isn’t even available to try and do the job.

I hope I am well enough to go to session next on Monday – pray to the antiobiotic gods! – as I don’t think I can cope with a missed session right now. As the title of my blog suggests, I’m ‘holding it together with rubber bands and chewing gum’ – it’s fairly precarious.

The one positive from being this poorly is that I haven’t got the energy to think about physical self-harm and I am not eating much because I feel rough and so that in itself is enough to take care of the anorexic voice for now. It’s a sad day when you feel lucky that you’re only dealing with illness and attachment issues!

I literally just want to be held. I know it can’t happen. I want to cry.

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I wrote this poem over the Easter break and gave it to my therapist (must’ve been having a brave day!).  It still feels really relevant today:

Not here

I am not in your presence

but, oh

how painfully aware of your absence I have become.

 

Time and distance

stretch

out

endlessly

between us…

 

You are so far away.

 

The holding place in my mind

struggles hard to keep you whole

 

Are you merely a figment of my imagination?

A hologram, perhaps?

 

*

 

Even when within my reach

you always feel so very far away

 

I can see you,

feel you, but

I cannot touch you.

 

That small space

opens up like a vast ocean

I stand on one shore

you on the other

 

You beckon for me to join you

promise to be my guide

and to witness the lessons of the Self

that only I can teach

myself.

 

For the longest time I have waited

warily watching

assessing the dangers that might lurk hidden

in the deep.

 

I believe I will reach you –

eventually

(is it misplaced confidence or simply wishful thinking?)

and so I begin the swim.

 

My muscles relax into a familiar rhythm.

The hardest, aching parts of me begin to soften

as the distance between us lessens.

 

It’s farther than I thought, though, and

sometimes cold

sometimes silent

sometimes strange –

The horizon keeps shifting.

 

I tread water a while

rest and catch my breath.

I look up and discover that

I can no longer see you.

 

Panic.

 

a sudden shiver

a lightning bolt

 

Both sea and sky shift rapidly

calm blues now rage-filled greys

Angry, turbulent clouds roll heavily in

raining hot tears down like shiny silvery bullets.

My fear rises alongside the storm-whipped waves

 

I am exposed

I am scared

 

Is there still safety on your shore?

I can’t be sure.

But it’s swim or drown

and so I keep moving.

 

There’s no going back.

I must have faith in what I feel

And trust in what cannot be seen.

 

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Recovery from self-injurious behaviours (self-harm and anorexia): Can it ever really happen?

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I apologise if this is difficult to read or triggering for anyone. Just to be clear, I am going to be talking about eating disorders and physical self-harm here. If you think that this might upset you or compromise your recovery, please don’t read it.

From personal experience, I know that if I am feeling on shaky ground with regard to looking after myself often reading someone else’s story can get right inside my head. Rather than encouraging me to keep eating or avoid harming because I see the damage it causes for others it somehow does the exact opposite. When I am in a good place, however, I am not impacted in that way. I’m trusting that you’ll make the right decision for you. (Hmmm, looks like my teacher persona wrote that last bit doesn’t it?!)

I have been wondering about something a lot this week in amongst all the other crap that takes up space in my brain and that is: is it possible to make a full recovery from an eating disorder and to stop wanting to use physical self-harm to cope long-term? Do the attacking thoughts and drives to harm oneself ever truly disappear or is the best you can hope for the strength to be able to ignore the voice that tries to persuade you to starve yourself or harm yourself? Can you really silence the Inner Critic for good?

I haven’t really got my thoughts together on it so this is really just thinking out loud.

To be honest, I am not in a great place emotionally/mentally at the moment and so I guess this is why this question has been circling in my head this week especially. The last few months have been hard for me. I have been opening up more and more in my therapy sessions and getting closer and closer to the core wound. Sometimes I have been staring it right in the face and it is total agony. At the same time, it has felt, week on week, as though I have been gradually edging my way closer and closer to a precipice.

This week I feel like I’ve finally reached the drop off and am peering down into the deep, dark, watery abyss where my old companions anorexia and physical self-harm reside. I’ve banished the pair of them to this place many times over the years at those times when I’ve managed to free myself from their shackle-like grips. There have been so many occasions over the years when I have found the inner strength to run screaming as far away from that place as my legs and mind will carry me. I’ve sought solace in activity, distraction, and the thought of ‘please let me make a proper recovery this time. I am going to change’ and managed a period of time where I function almost normally… BUT there is always something that draws me back to them and to this place. No matter how resolved I am to move away from this hellish spot I always seem to find my way here, as though on autopilot.

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As I said, this week it’s felt as though I’ve been metaphorically standing on the edge of the precipice and have seriously been contemplating diving down into the darkness again to join my terrible friends because frankly, what I am running from in my head feels too painful, too hard, too devastating. I need to escape from it all. I can’t cope with how bad things feel. I can’t just ‘sit with it’ and wait for these feelings to pass because it is all-consuming and it’s been going on for months and months now. My sense of inner strength and desire to keep fighting has been totally eroded. I just can’t do it anymore.

I am stuck, frozen, between two terrible choices – which damaging, crap friends do I hang out with now? Ahead lie Anorexia and Self-Harm. They’re more than ready to welcome me into their shitty mind games. Behind me lies Attachment Trauma. The question now, is which option hurts less? Attachment trauma is steadily destroying me. Right now I feel like I have been left. I feel so sad and little and lost. I am screaming out for holding and containment and yet no matter how loudly I yell or how many different ways I say it there is no one coming. No one cares about that little girl. There is no one who cares enough to scoop her up and tell her that it’s all going to be ok, that she is safe and loved and that it’s all over now, that she doesn’t have to hurt herself anymore.

I have tried to do that for myself time and time again over the years, but my adult is so overwhelmed by the intensity of these feelings that are coming up again that l am scared stiff and not sure I can keep going down this path, facing that demon, and essentially feeling increasingly anxious and traumatised. I just cannot continue feeling like this and so what lives in the depths of that black void is familiar and, in some sick way, comforting. Given the choice right now, I’d rather spend time sitting with anorexia or self-harm than be caught in the grips of abandonment trauma.

I developed an eating disorder when I was 16 and began physically self-harming (cutting and burning myself) at 17 and so, tragically, it appears that I have spent more than half my life (on and off) attacking my body in one way or another. I’ve never got my BMI up over 17 apart from when I was pregnant and feel very uncomfortable weighing any more than 46kg. In my head the magic sustainable in control place is 45kg and a BMI of 16.1. Yep. Fucking insane. But it’s the borderline weight where I feel ok and yet still able to conceal how unwell I really am. I don’t draw too much unwanted attention or concern as I can hide at this weight – or at least that’s what I have convinced myself. I’m not sure it’s really the case.

The one thing I know and hate about eating disorders is how skewed your mind gets. I hate the secretive, weird place I inhabit when I start focusing on my body in an extreme way. Everyone who ever tries to demonstrate care or concern becomes the enemy and I resent them commenting on my body or what I am or am not eating. I think it’s probably because so few people truly understand that it’s not really about food – eating cake won’t fix things. The eating disorder is a really shit coping strategy. For me it always starts off as trying to control something at a time where I feel like I have no control/am out of control.

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And yes, in some ways for me it is about my body image too. I am critical of my body and when I am really unwell I just cannot see how skeletal I get – how grey, tired, and just poorly I really am. The thing is, when I am caught up in full-blown starvation mode it’s a focus, a distraction from other terrible painful issues.

I know that starving myself or cutting/burning my skin doesn’t take away what is tormenting me and that’s why I know that jumping off the edge and into anorexia or self-harm isn’t a good option (really, I do know that!) because whatever I choose to do attachment trauma will only jump in after me.

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This, then, is not a good proposition because then the three of them will gang up on me and I will end up drowning again. I know I am literally only a few steps away from a complete breakdown and I need to try hard to back away from all this. I need to find a better way to cope. I just don’t know what that is. Therapy doesn’t seem to be helping much right now, in fact it’s just created the melting pot for all this stuff to truly emerge.

Recently, I threw out the scales in a bid to stop that part of me that gets obsessed with numbers. It was just starting to get bonkers inside my head. So, I have no idea what I weigh right now but I think it must be about 47kg because I feel fat and people tell me I ‘look healthy’ … yeah, that one! It’s insane that being told you look well is a frigging trigger isn’t it? Ugh.IMG_1474

I should be pleased with myself really as I have actually been working hard to pull myself back into a better place lately – this is largely through eating large tubs of Hagen Dazs each night and sharing bags of Galaxy Counters. Which, I suppose isn’t especially normal! But it has resulted in a stable body weight for a good few months. It’s not binge eating. It is systematic feeding of high calorie foods whilst being distracted by TV. I hate it.

My brain has the most brilliant inbuilt mental calorie counter. Several of my newish friends (those that have no idea of my history) are doing weight loss programmes at the moment and when they talk about it to me and I am able to launch into some detailed conversation about the nutritional value of something or the calorific content I think they must think I am strange. I often get the ‘you’re so lucky to have that kind of body that doesn’t put on weight. I only have to look at a cake and put on a stone. You eat whatever you like and you’re so slim’. Little do they know that I am fighting my own body battle, telling myself ‘I must eat the cake, the ice-cream, the fattening stuff so that I don’t fall into the place where I eat pretty much nothing and spiral downwards’.

Another reason that I have had to try and maintain a reasonably sensible weight is because (and here’s where I should be writing that I value my health, care about myself enough to look after myself, and that I am not plagued by negative voices) part of my follow up cancer care is that I see the consultant every three months and part of that check is getting weighed (rapid weight loss is a marker of active Lymphoma).

Last October I went in for my check and there was a flurry of concerned questions from the nurses as I stood on the scales because I had lost 6kg in the three months between appointments. I knew that the weight loss wasn’t down cancer but I also couldn’t tell them what mess I had got myself into with not eating and over-exercising. So since then I have tried to get myself off their radar and creep back to a more acceptable, if still too low, weight.

Over the years I have crawled back up out of the abyss more times than I can remember. I’ve sort of joined the rest of the world masquerading as someone who is ‘fine’ and has it all together. But I won’t lie, even when I am ‘well’ or as well as I ever get, the voice inside my head that tells me I am not good enough, that my body is disgusting, and that the only way to feel better about myself is to not eat and self-harm myself is always there. The only thing that changes is my response to that voice. Sometimes I have the strength of mind to say, ‘fuck you! Leave me alone. I am not listening to your shit anymore’ but then other times it just doesn’t happen and that’s where I am at today.

I have to be especially careful with exercise when I am in this head space. For me exercise is a double-edged sword. I have always been fit and active, sporty, and competitive. I really like to get out and run or cycle. It gives me an escape from being my head. I zone out. It feels good. When I am ‘well’ exercise is fine but it can quickly turn into something negative and self-destructive, like it did in the summer: I got back into my running in the Spring having not really done any since finishing my cancer treatment. I was determined that I was going to get my fitness back (despite the consultant telling me that I would struggle because of the radiation to my chest and weakness in my lungs).

My exercise plan started off as a healthy twice weekly thing: a quick 5km run. But it wasn’t long before I threw in a 40km bike ride, then upped my running distance to 15km each time. By the middle of the summer I was up to running 15km on alternate days of the week, cycling 40km on the other days, and walking my dogs 8km most days. Oh, and let’s not forget to mention the 30 day arms, abs, and plank challenge app that I would do in the evening. It’s literally all or nothing with me.

I liked getting out. I liked feeling super fit again. I enjoyed knowing that my speed and stamina were improving and that my friends, who have always been healthy and active, were posting significantly slower times than me. It’s so addictive watching your times on the Strava app…but then it soon became something to beat myself with, always needing to go faster. The only positive at this point, was that despite the ridiculous amount of exertion I was sensible enough to keep eating properly. I was attacking myself with exercise but I wasn’t attacking my body by not eating which is what I would have done in the past.

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Then one day it changed, just as it always does. Big sigh. I had started skipping meals again. I rarely have breakfast anyway, but on this day I hadn’t eaten at all. I decided to go on my 15km hill run. It was a hot, humid evening – 23 degrees according to the car thermometer – and I pushed myself hard. It had been a stressful day and I need to run away. I posted my quickest time by miles. I felt pleased with myself. The voice inside my head that berates me incessantly was silenced briefly. But by the time I got home and walked in the door I was dizzy and sick. I blacked out in the hallway. I had a bath and the room began spinning in the way it used to after drinking too much alcohol at Uni. I was so unwell that I had to ask my wife to help me up the stairs and put me to bed. I felt awful.

I really scared myself and since that day in May I have only done one short 8km run. Part of me wants to go out and run hard and fast and push myself but there is another protective part that is telling me ‘NOOOOOOOOOO’. I feel stir crazy and lethargic not moving and I have too much time to think but it’s the only way I can think of to keep myself relatively safe and right now that’s the best I can do.

So that’s the anorexia covered, what about self-harm, then? At Easter things were feeling particularly precarious with regard to wanting to self-harm again. I had self-harmed straight after the Christmas therapy break having not done so in several months. The break had stirred up a lot stuff: it’s when I started to become more aware of the different parts of me and how much the little ones were impacted by the separation from my therapist. I didn’t feel able to tell her about any of it at that point and so took to hurting myself instead.

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As the Easter break approached I could feel myself getting stressed and anxious about not seeing my therapist and I that’s when I decided that I would make a commitment to myself that I wouldn’t cut or burn myself again no matter how bad things felt. Tall order, I know! I decided to book in for some tattoos on my wrist, forearm, and ribs – the places I would generally hurt myself. I was going to get something symbolic in place of scars. There was three month wait for the artist I wanted and so in this time I knew I couldn’t damage my skin because it would affect the tattoo and tbh I didn’t want the artist seeing new cuts or scars either.

So for three months I didn’t hurt myself at all (even though I wanted to at times) and since having the tattoos I haven’t cut or burned myself either. Instead I have meaningful reminders that I can survive and that this is not the end: Lotus flowers, unalome, semi colon, root chakra etc. So, these tattoos have worked as a symbolic protector. I haven’t self-harmed but it hasn’t meant I haven’t wanted to. And that’s what I am pondering in the title of this post; will that desire, need, whatever it is, to harm ever disappear fully? Will there be a time where I feel anxious or depressed and my brain won’t take me to this place? It won’t cross my mind to cope in a negative way? I don’t know. I hope so.

So for now, today, at least, I am digging my heels in as much as I can and leaning away from the edge.

At the start of this I wondered if it was possible to ever really recover from an eating disorder and the desire to self-harm?

Perhaps the real question is: will I ever feel good enough? – because I guess underneath it all, that’s what it’s all about.

I guess maybe it’s time to bring this to therapy…again.

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Alanis Morrisette’s, ‘That I would be good’ has been stuck on an almost constant loop in my head since Wednesday. It’s another of those songs that I haven’t heard in years but I guess is a reminder of having been in this place before, in my teens, and so it’s come up again now.