Book review: Shattered

Book cover: Shattered by Patricia J Grace

In Shattered: A Memoir, Patricia J Grace tells her story of the lasting impact of childhood sexual abuse.  This abuse occurred at the hands of multiple brothers, as well as others, after the death of her father.  While her mother was aware of the abuse, she did not intervene to try to stop it.  In fact, when she became infected with public lice, her mother gave her DDT to apply, adding that her brother had already been treated.

Patricia writes about the body image issues she developed as a result of the abuse.  She believed fat=ugly=safer, although of course it didn’t work out that way.  As an adult, her weight continued to rise as attempted to fake her way through her various role functions.  Her mother pressured her to have weight loss surgery, and she went ahead with this.  She later realized: “Without changing the internal messages of badness or dealing with the fear of others, I would continue to turn to food and fatness to feel safe.”  This reminds me of Roxane Gay’s book Hunger, in which she wrote about overeating to seek safety, and try to make herself less vulnerable to abuse.

Patricia eloquently describes the psychological torment that resulted from the abuse she experienced.  The abuse battered her sense of self, leaving her feeling like “a ghost of a person undeserving of the same rights, voice, or worth as others.”  She had learned to remain silent, and she felt emotionally stunted and without a centre.  She felt “trapped alive in a coffin with nails hammered down, scraping and clawing for a way out, fighting for a life with my head up and heart full.”

The difficulties Patricia faced in getting effective therapy will sound sadly familiar to many.  It was challenging to overcome the taboo and break the unwritten rules of silence instilled in her.  Heartbreakingly, like so many other childhood abuse victims there was also a great deal of guilt, “as if I were the abuser not the victim.”  One therapist commented “oh, so you were a precocious child” when Patricia disclosed her childhood sexual abuse.  Another would regularly disrupt sessions to take calls on his cell phone.

I find it so gut-wrenching to hear how even non-abusing parents can be complicit in covering up abuse and allowing it to happen.  Unlike her brothers, who were trusted to maintain silence, Patricia’s mother “needed to work diligently in shaping me”.  She explains simply that “It’s not hard to silence a child. Just threaten to abandon, not in words but in actions. Do this, you’ll be loved. Don’t and you’re not.  The message hit home over time. It took repeated lashings of, “You should be ashamed of yourself” to brand that scar into me, burned so expertly into the template of who I was to become that shame replaced wholeness like a headstone.”  Her mother even went so far as repeatedly pressing her to forgive one of his brothers, minimizing what he had done to her when she was a child.

She explained how she became split in two, with a part of her that remembered and a part of her that had repressed the memories until they became inaccessible.  She felt like Humpty Dumpty with no idea how to put herself back together.  In the end, it was Buddhist meditation that helped for to find peace and connect with herself.  She has come to accept that what happened is inescapable.  She writes that “Moments of peace, internal connectedness, and the late blooming birth of self-acceptance make aliveness worthwhile.”  She has found that she is worthy, and she is okay, and this really is an amazing story of healing.

 

You can find Patricia on her blog Grace to survive

 

Image credit: Amazon.com

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I like airplane mode

For the last 2 weeks and a bit while I’ve been travelling in Italy, I’ve had my phone on airplane mode. No phone calls, no text messages, and for large chunks of the day I have no wifi access. Part of the reason is a desire to run away from the world, and part of it is more practical – I don’t want to deal with roaming charges.

It’s not as though I’ve got all that many people communicating with me when I’m home, plus I tend to screen my calls, but I like that now it’s not even an issue. I like not being exposed to that sinking feeling of seeing an unwanted number pop up on the call display, or a notification of a voice mail that I don’t want to listen to. It makes me realize just how much dread I was having about ordinary communication.

WhatsApp has been convenient because it’s allowed me to keep in touch with my best friend. We talk usually a couple of times a day, and that’s helped to keep me grounded.

In less than a week I’ll be back home, and while I feel ready to be done with the trip, I wish I could leave my phone on airplane mood indefinitely.

Book review: Living With Vaginismus

book cover: Living with Vaginismus by Victoria Johnston

In Living with Vaginismus: Dealing with the World’s Most Painful Pleasure, Victoria Johnston provides a comprehensive overview of this pelvic pain condition.  She opens up about her own personal experience in order to try to raise awareness about an issue that most people either don’t know about and/or aren’t comfortable talking about.

Vaginismus involves the involuntary contraction of pelvic muscles (the pubococcygeus or PC muscles) making it difficult or even impossible to penetrate the vagina with even small objects like a tampon.  It refers specifically to the muscle contractions, and doesn’t encompass other sexual difficulties related to things like desire or ability to orgasm.  One physiotherapist cited in the book describes vaginismus as panic attacks of the vagina, and Victoria describes sex as feeling “like you are being ripped apart”.

Unfortunately, even many medical practitioners have a poor understanding of vaginismus, and the book includes multiple stories of negative experiences with health care providers.  The causes of vaginismus can be complex and multifactorial, and the book describes various physical and psychological factors that have been identified.  The book also includes stories about the often devastating effects the disorder can have, including strain on relationships and problems with mental health.

Victoria describes the various treatments that are available, taking a holistic view and explaining that what’s most effective can vary greatly from person to person.  Treatments include the use of dilators slowly progressing in size, physiotherapy, counselling, and medication.  There is a chapter devoted to physiotherapy exercises, complete with photos to demonstrate.  Another chapter describes Botox, a promising approach that isn’t yet commonly performed and is quite expensive.

The book includes contributions from a number of other women who live with pelvic pain.  Many felt invalidated by their health care providers, and a common theme running through their stories was how alone they felt in their experience.  The book also includes the stories of men whose partners have vaginismus.  I was surprised by how many partner stories Victoria was able to gather, and how openly these men spoke.  It really illustrated how this disorder isn’t just an individual problem; it’s an issue that couples need to face together.

Victoria calls out the many unreasonable societal expectations around sex, including the idea that is the only way of truly achieving closeness and connection, and the expectation that it’s normal for females to have pain during sex.  She advocates for more realistic, open conversations about sex, something I heartily agree with.

While vaginismus manifests itself physically, mental health is often involved, either as a contributing factor or as a consequence.  As such, it’s important to raise awareness in the realm of mental health as well as sexual health, which is why I thought it was important to review this book on my blog.  I would definitely recommend it.

 

You can find Victoria on her blog Girl with the Paw Print Tattoo.

 

Image credit: Amazon.com

The downside of being a solo female traveller

I have mostly felt pretty safe travelling alone as a female. Sadly, there have been exceptions.

One of those exceptions happened today. There was a staff guy at the hostel where I was staying who said that he “liked” me and would joke that he was “stalking” me, doing things like popping into my dorm room. It was a bit much, but it wasn’t creepy. Until today.

I was sitting in a chair outside my dorm room while my phone was charging. Dude went into my dorm room, and he stayed there. For a while. And then the moaning noises started. Not once or twice, but an extended masturbatory adventure. I wondered how the fuck is this actually happening, and what the hell am I supposed to do about it? And then a female roommate walked into the room and pretty much walked straight back out again. He then comes out after her, and I overheard her saying something like “it didn’t look like you were just sleeping”. Then buddy heads back into my dorm room.

At that point I realized there was no way I’d feel safe staying there, so I started checking other hotels online. Several were full, but I managed to find one with a room available that wasn’t too expensive.

I had told the other guy that was working what had happened, and he didn’t believe me. He was humming and hawing about giving me a refund for the next 3 nights that I’d prepaid for, and his main priority seemed to be just getting me to stop shouting. I decided fuck the refund, I wasn’t willing to put up with another minute of being brushed off as crazy. So I walked out.

So now here I am in my safe private room drinking room temperature Prosecco straight from the bottle. Seems a rather fitting ending to a fucked up day.

Going through the motions

I’ve been in Florence that last couple of days and I’m not much of a fan. There are a shit-ton of people here crammed into a small area, many of them in large obnoxious tour groups. I’ve been having quite a bit of derealization to get me through it. Yesterday I walked right over some art that some street vendors had laid out on the sidewalk because I was so disconnected from my surroundings.

My hostel closes between 11am and 2:30pm each day for cleaning. That’s hard because I run out of steam by noonish (more like 10am-ish, to be honest).

It’s becoming clearer that my hope that this trip would help put a dent in my anhedonia was just not realistic. If anything, wandering indifferently through the great Renaissance museums of Florence reminds me just how much of a presence depression is with me on this trip.

The pic above is of Michelangelo’s David. The detail of the veins on the hands and arms was pretty amazing.

Falling head over heels for Italy

Despite the happy-sounding title, I’m talking about falling in a very little sense. The combination of lithium-induced clumsiness and cobblestone streets was bound to catch up to me. It was around 6am and I was walking to the train station to catch an early train to Pompeii. I was crossing a street and completely wiped out. There were only a couple other pedestrians around, but they ignored pathetic me sprawled on the cobblestones.

I was sore, but thought there was no lasting damage. It was only later that I realized that I’d scraped up my foot and knee and sprained my ankle. Sprained ankle and walking around ruins isn’t really the best combination. The picture above is a plaster cast of a body buried in the ashes from Mt Vesuvius at Pompeii, and that’s kind of how I was feeling.

Yesterday morning I went to this tiny little cafe (maybe 6 tables), and the staff totally ignored me. I sat there for around 45 minutes and they didn’t even acknowledge my existence, much less take my order. During that time I was waiting I saw a triggering email from work. Cue public cry fest.

Anyhow, this morning I leave Rome and catch the super-fast train to Florence. Who knows, maybe when I’m there I’ll get hit by a bus, followed by falling into a canal in Venice…

Sometimes “meh” is the best I can come up with

I’m in Rome, the first stop of my Italian vacation and home of amazing art and history. And by amazing I mean more along the lines of “meh”. I’m finding the crowds hard to handle. At the Vatican museums all I could think was get me the hell outta here, and my response to the Sistine Chapel was that I didn’t see what all the fuss is about.

But at least I’m getting out and doing stuff, even though my passion for culture and history seems to have died out. Morning is my active time, and then I don’t do much in the afternoon and go to bed early.

Things are well signed, so getting around hasn’t been too hard. I feel like I’m getting negative vibes from a lot of people, but that’s probably more my depression talking than reality. Still, it makes sitting in restaurants/cafes a bit uncomfortable. They do have good coffee here, though.

20(ish) Questions

pile of question marks

I’m taking a break from doing blog awards since they can be time-consuming.  Instead, when I’m nominated for awards I’ll answer the questions posed to me in this 20(ish) questions format.  I’ll also answer questions from assorted other question tags and the like.  Feel free to join in the fun with your own answers to any or all of the questions 🙂

 

A few questions from A Guy Called Bloke and K9 Doodlepip‘s Game On series – weird life stuff

  • Why are supposedly easy to open packages always so difficult to open?   To make doofuses like me feel really stupid.
  • Time to fess up … what music from your teenage years do you turn on and still dance to?  It’s not so much from my teenage years as my childhood in the 80’s – a little New Kids on the Block, Belinda Carlisle, Roxette…  Ah, good times…
  • What was either weirdest book you ever read or the weirdest film you ever saw? [Please provide link]  When I was in university a roommate of mine was doing a paper about porn, and so she wanted all of us roomies to watch porn together.  I think we were all virgins at the time.  Anyway, we borrowed Ass-openers 8 (or whatever number it was) on VHS from one of our guy friends, and had a girls night in watching Ass-openers.  It was very educational, and no, I will not be providing a link.
  • Time to fess up again, what was the weirdest or craziest fashion craze you were in to as a kid?  Well, since acid wash jeans have made a comeback that probably doesn’t count.  Perhaps the neon spandex bike shorts.
  • What words did you make up and claim as your own as a kid?  I wasn’t much of a neologist as a kid, but my brother made up a ton of words and the rest of the family adopted many of them.
  • In what game is the word snap used?  Going back to the 80’s theme, one in which you’re wearing a snap bracelet?
  • Have you ever gotten completely and utterly lost? Explain please.  Living in neat, orderly Canada I assumed that streets everywhere had names and signs displaying those names.  And then I started travelling and discovered yeah, not so much.  I have a good sense of direction and am good at reading maps, but there were a few times I got completely lost in India because of the total lack of street signs.
  • Did you have a favourite piece of clothing as a kid or even as an adult? [For me it’s my sneakers, serioulsy old and battered but l love them!]  I am totally in love with Gap maternity leggings.  No, I’m not pregnant, but these leggings fit right over my psych-med-weight-baby and they’re the comfiest thing ever.
  • Do you have any strange family traditions?  I could say we celebrate Festivus, except I’d be lying (unfortunately).
  • Have you ever taken part in some kind of weird adventure?  When I was in university and living in residence my roommates and I had somehow managed to break our toilet tank lid in half.  One night we pulled off a switcheroo and swapped our broken toilet tank lid with one we stole from a washroom elsewhere in the building.  And we were drunk at the time, so we thought it was the funniest thing ever.
  • What is the ‘worst haircut’ you have ever had?  In grade 4 I cut my hair short and used hair gel to make it spiky.  Not a good look at all.
  • Can you remember who your worst school teacher was?  His name was Mr. Boyd.  He taught grade 9 honours math, but he was a PE teacher and hadn’t the slightest clue about math.  We’re talking 3×4=14 kind of thing.
  • We all have one, but who is yours? The crazy relative?  That would have to be me.  But I do recall a hillbilly cousin Gerald that my dad didn’t want visiting back in the day.
  • What completely safe animal are you TOTALLY afraid of??  Moths.  They’re like the ugly drunk uncle of the butterfly stumbling around and just generally being icky.

 

Come on, you know you want to answer a few – that’s what the comments section is for!

 

Image credit: qimono on Pixabay

Ways to share your story

notebook beside an old-fashioned typewriter

In my post Spreading your writing wings I listed a number of sites where you could share your story or submit a guest blog.  Personally, I find it easy to feel comfortable about sharing my writing on my own blog, but there’s some uncertainty that comes along with submitting a post to another site.  So I try to push myself every so often to venture out of my comfort zone.  Here are a few more ideas on ways to share your work:

Depression and Bipolar Support Alliance Life Unlimited feature: you can submit a request to be featured; submissions should focus on what the early indications were of your illness, what you’ve had to overcome, or what you’ve learned about yourself

GoodTherapy: personal experience, story must be 500+ words and original work

Having Time: personal essays about major life transitions, or actionable tips on improving mental wellbeing

Ideapod: this site isn’t specific to mental health, but accepts guest articles that “present bold, clear arguments about the ideas you believe should shape our future”

Mindful magazine: you can submit a mental health-related story pitch

Mind of Our Own: lets you share your mental health story in whatever form you wish; can be anonymous

Old Cove Road: particularly focused on the intersections between mental health, community, and social media

Open Minds Quarterly: share the experience of life with mental illness, in various forms including non-fiction, fiction, or poetry

Psyche: part of the Vocal media group; articles must be original content, and you can get paid based on how many reads your article gets

ResilientApp: accepts guest posts on a range of topics including mindfulness, meditation, self-care, and managing stress or anxiety

SameBoat: you can post in different topic areas including depression, suicide, anxiety. and body image

 

Of course, you can always keep an eye out on WordPress for fellow bloggers who are looking to collaborate or accepting guest posts.  If you’re reading this and you’re looking for guest bloggers on your blog, please leave your blog link in the comments below.

 

Photo by Elijah O’Donell on Unsplash

 

 

Leaving on a jet plane

Roman Colosseum lit up

Later today I’m heading off to spend 3 weeks on vacation in Italy.

This trip is what has been keeping me going through a rough stretch with my depression over the last 6 weeks or so.  Not that my depression is allowing me to actually feel excited about it, but I’m hanging on to the possibility that being in a totally different environment might help me feel a little better.  The problem is, though, you can’t really take a vacation from inside your own head.

This is only the second time I’ve gone on an international trip while feeling unwell (aside from beach vacations).   The last time was when I went to Russia in 2012 immediately following a major meltdown.  It was a really rough trip, and I remember sobbing on the phone to my parents.  I’m hoping not to have a repeat of that.

I’m travelling alone and independently (i.e. not with a tour group), so all the logistics will be up to me.  I’m quite an experienced traveller, so hopefully it will all come fairly easily, but I get overwhelmed pretty easily these days.  I also have a hard time dealing with being around people, which could be problematic.  I don’t want the attention of standing out as an obvious tourist, so instead of the no-makeup yoga pants look that is my depressed norm, I’m going to force myself to dress up and wear makeup and hope that I blend into the background.

As for the blog, I have some scheduled posts set up, but I probably won’t be online much while I’m away.  Ciao for now!

 

Image credit: Free-Photos on Pixabay

Book review: Wherever You Go There You Are

Book cover: Wherever you go there you are

I was expecting good things from Wherever You Go There You Are: Mindfulness Meditation in Everyday Life by Jon Kabat-Zinn.  He is the developer of mindfulness-based stress reduction (MBSR) therapy, and a founding director of the Center for Mindfulness at the University of Massachusetts Medical School.  This book was a best-seller, yet it managed to fall short of my expectations.

Things started off well.  I appreciated the lightheartedness of such comments as meditation “does not involve becoming some kind of zombie, vegetable, self-absorbed, narcissist, navel gazer, [or] space cadet”.  The book was laid out in a way that aimed to provide quick and easy access to the fundamentals of mindfulness meditation, with the message that anyone can meditate.  However, for me the book didn’t live up to the goal of making mindfulness meditation more accessible, and to be honest I was very tempted to give up partway through.

The book was more focused on formal meditation practice than I was expecting.  The author writes about sitting to meditate not simply as the physical act of sitting but as a sort of  profound capital-S Sitting.  I’ve heard that use of the term before and it has always somehow struck me as a tad pretentious.  Walking meditation was also covered, with a lot of attention given to a formal practice that involves walking back and forth focusing on the motions of walking.  I was disappointed by this, as one of my favourite ways to be mindful is to go out for walks and pay attention to the many small beauties of nature.  At the stress reduction clinic where the the author practices, they have clients do an introduction to lying meditation that involves a 45 minute body scan while lying down, which is fine, but I don’t think that it’s something that’s necessarily a draw for people who aren’t wanting to make a considerable commitment to formal meditation practice.

There were some very good suggestions, including trusting your own ability to reflect and grow and being generous to yourself and others.  Kabat-Zinn explains that it’s possible to find understanding and transformation in the present moment.  He wrote “You cannot escape yourself, try as you might”.  A variety of metaphors were used that seemed quite intuitive, such as you can’t stop the waves but you can learn to surf, and awareness is like a pot that is able to contain strong emotions.  Other metaphors made less sense to me, like the idea that we are dancing mountains or that parenting is like an extended meditation retreat, with the child as the Zen master.  He also likened sitting with our breathing to sitting by an open fire back in the caveman days.

At times the book tends to venture into more obscure territory, and this is where it really lost me.  The author suggests contemplating “what is my Way?” as part of meditation practice,  and adds that “as a human being, you are the central figure in the universal hero’s mythic journey.”  A quirk that irritated me slightly was his apparent love-on for Henry David Thoreau’s book Walden, which is quote frequently.  I’m not familiar with that book, and am really not sure why I’m supposed to care about it.

I think my view on the book would have been different had I been looking for something heavily focused on formal meditation.  However, that’s just not the way that I’m wanting to incorporate mindfulness into my everyday life.  I’m not someone who has any desire to go to a silent meditation retreat; that’s not how I choose to go about my inwardly and outwardly mindful journey.

I will leave you with this sentence from the afterword, which I think really captures the book as a whole: “Can we realize that wherever we go, there we are and that this ‘there’ is always ‘here’ and so requires at least acknowledgment and perhaps a degree of acceptance of what is, however it is, because it already is?”

 

Image credit: Amazon.com

Gratitude from A to Z

letters of the alphabet arranged in heart shape

Liz at My Wellbeing and Learning Journey is doing a challenge to identify something to feel grateful for starting with each letter of the alphabet (X and Z just have to contain, not necessarily start with, those letters).  I thought I would join in.

  • A-romatherapy: very pleasant and relaxing
  • B-edtime: my favourite time of the day
  • C-ondo: I’ve lived in my home for 13 years and it feels very safe, plus it’s paid off
  • D-awn: I always wake up early and get to see the pretty colours of the sky
  • E-very country I’ve had the opportunity to travel to
  • F-ood
  • G-uinea pigs: cute, cuddly, and entirely non-judgmental
  • H-elping others: I’m glad when I can make a positive difference for someone else
  • I-nsurance: makes my meds a lot more affordable.
  • J-ournalling
  • K-indness of others
  • L-ush soap: a nice little indulgence every morning
  • M-assage
  • N-ature: flowers trees, birds, and the rest of the natural world
  • O-pen-mindedness: if only there were more of it in the world
  • P-illow: I got a new pillow recently and it’s absolutely perfect
  • Q-uestioning: I’m grateful to have a curious mind that always wants to know more
  • R-eading
  • S-ocks: I have cold feet, so a cozy pair of socks is nice
  • T-ea: I love to sit and enjoy my tea when I first get up in the morning
  • U-nhealthy but yummy treats like Ben & Jerry’s
  • V-ancouver: the wonderful city where I live
  • W-ordpress: the blogging community is very important to me
  • X-enophilia: the opposite of xenophobia, and something we could use a lot more of in this world
  • Y-oga: restorative yoga is a good chance to find relaxation
  • Z-ippy: one of my guinea pigs that passed away earlier this year.

Are you up for the challenge?

 

Image credit: GDJ on Pixabay

Weekend wrap-up

wrapping paper, ribbon, and twine

Here’s what happened in my life over the past week:

  • My mood has been shit.
  • I got exempted from jury duty, which is good.  I couldn’t make a decision about what to do about the jury summons, so I did an exemption request but explained that I didn’t know if I should actually be asking for an exemption.  I guess they figured someone who’s too nutty to make a decision about a jury duty exemption is too nutty to be making a decision about someone’s guilt or innocence.
  • Although my follower numbers have gotten higher than I had ever expected and are steadily increasing, my actual visitors and views numbers have been steadily dropping.  I don’t blog for the purpose of stats, but it’s hard not to feel discouraged by that kind of mismatch in numbers.
  • I’m so not impressed with my new job.  They’re pretty sporadic when it comes to actually responding to emails, and the pay is shit, although they seem to be in denial about that.
  • I didn’t work much this week, and I’ve been having a bit of a hard time keeping myself occupied because I just don’t feel like doing anything.  I find myself wishing I could just sleep 24 hours a day.
  • My regular doctor was away so I ended up seeing a different doctor to get my meds refilled.  Without even so much as a “how are you?” she refilled my meds for 9 months.  Last week my naturopath was away so the other naturopath in the clinic did my methylfolate/B12 injection.  She also didn’t ask how I was doing.  I don’t actually have any desire to talk to health care professionals I don’t know, but I’m sensing a theme here.
  • I went to yoga twice hoping it would give me a bit of an escape from myself.  It didn’t.

 

How has your week been?

 

Image credit: Rawpixel on Pixabay

What is… gaslighting

psychology word graphic in the shape of a brain

In this series, I dig a little deeper into the meaning of psychological terms.

This week’s term: Gaslighting

Perhaps I was living under a rock, but I’m fairly certain I hadn’t heard the term gaslighting before I entered the blogging world.  Let’s start off with a definition from Wikipedia:

“Gaslighting is a form of psychological manipulation that seeks to sow seeds of doubt in a targeted individual or in members of a targeted group, making them question their own memory, perception, and sanity. Using persistent denial, misdirection, contradiction, and lying, it attempts to destabilize the victim and delegitimize the victim’s belief.”

I also wondered about the origin of the term, since I wasn’t sure what the connection was between a gas light and emotional abuse.  Gaslight was the name of a 1938 stage play that was later made into a movie, and when the lead female commented to her criminal husband about the gas lights dimming, he denied this had happened (although he himself had dimmed them) and insisted that she had imagined it.  Its a term that has been used colloquially rather than one that stems from the field of psychology.  The references cited on the Wikipedia page on gaslighting reflect this.

I found an article by Kate Abramson in the journal Philosophical Perspectives that had a lot to say about gaslighting, and she seemed to take a fairly objective view of the phenomenon.  Gaslighting undermines “the target’s basic rational competence— her ability to get facts right, to deliberate, her basic evaluative competencies and ability to react appropriately: her independent standing as deliberator and moral agent” (Abramson, 2014).  The author likened gaslighting to torture, as it aims to destroy the target’s sense of self.

Abramson writes that while there’s nothing inherently sexist about gaslighting, men are most often the perpetrators and women are most often the targets, and successful gaslighting can reinforce sexist norms.  From a psychoanalytical perspective, gaslighting is seen to be a form of projective identification, where the gaslighter projects things about himself that he is uncomfortable with onto the target, and then needs that target to identify with what has been projected.

Gaslighting typically serves multiple aims for the perpetrator.  Those who gaslight are unwilling to tolerate any possibility of challenge to the way they view things.  The gaslighting has an interpersonal aim in this sense, as the perpetrator requires the target to respond in a certain way.  The gaslighter “aims to destroy the possibility of disagreement by so radically undermining another person that she has nowhere left to stand from which to disagree, no standpoint from which her words might constitute genuine disagreement” (Abramson, 2014).

Abramson identifies several strategies used by gaslighters: love, empathy, self-doubt, authority, leveraging practical consequences of resisting, and sexism.  These may all be drawn upon to serve the primary aim of destroying any possibility of resistance.

Much of what’s out there on the internet about gaslighting is quite emotionally charged, understandably so.  It’s a devastating type of emotional abuse, but like any trend of the moment on the internet I wonder if the genuine destruction of this form of emotional abuse is being diluted by overuse of the term.  I have nothing to back that up and it may not be the case at all; it’s just something I’m curious about.

What are your thoughts?

 

Sources:

https://en.wikipedia.org/wiki/Gaslighting

Abramson, K. (2014). Turning up the Lights on Gaslighting. Philosophical Perspectives, 28(1), 1-30.

Image credit: GDJ on Pixabay

How trauma-informed practice can improve mental health care

person lying on the floor in a dark room

So, what is it to be trauma-informed?  Trauma-informed practice recognizes the intersectionality of trauma, mental health, and substance abuse, and involves an awareness that anyone may have experienced trauma, whether they have disclosed it or not.  Trauma-informed practice aims to create environments that prevent re-traumatization and promote a sense of safety.  The individual client’s safety, choice, and control is prioritized throughout services, and an approach of collaboration, learning, and building trust is used.  There should be a non-hierarchical and supportive organizational culture, and there is a focus on strengths and building resiliency, and hope that recovery is possible.

One area where being trauma-informed has the potential to make a huge difference is when it comes to seclusion and restraints.  The use of seclusion and restraints can lead to significant psychological or physical harm, and can be a major source of traumatization or re-traumatization.  The British Columbia Centre of Excellence for Women’s Health identified several strategies for a trauma-informed approach to seclusion and restraints:

  • staff training in de-escalation
  • have comfort rooms with low sensory stimulation
  • promote the development of crisis plans or advance directives to identify triggers and preferred interventions
  • assess for and address any unmet needs that may be influencing behaviour
  • debriefing following any use of seclusion or restraint to identify why it happened and what was learned.

When I was doing my masters degree one of my classmates was working in a psychiatric intensive care unit where they had instituted changes in their approach to seclusion and restraints in order to provide trauma-informed care.  My classmate had nothing but good things to say about this, and the unit had achieved very significant reductions in trauma and restraint utilization.

My most memorable occasion of being in seclusion was when I had taken myself into hospital, with the support of my community psychiatrist, and said that I was feeling suicidal and needed ECT.  They decided to commit me under the Mental Health Act and put me in seclusion, even though I had gone in voluntarily.  When I was informed I would be locked in seclusion I asked to be sedated, because I didn’t want to be trapped with nothing but my thoughts.  The nurse said there was nothing ordered.  I asked if it would make a difference if I told her that I’d throw my tiny tube of hand cream at her.  She disappeared, I heard a “code white” (aka violent patient aka me) being called over the PA system, and she returned a few minutes later with a bunch of security guards to give me the injection I’d asked for in the first place.  How very therapeutic.

Sometimes in the field of mental health care certain approaches or practices will become buzzwords, and many organizations will jump on board.  I think this has happened, at least to some extent, with trauma-informed practice, and it’s generally seen as something desirable.  Where the problem lies, though, is that there’s a difference between claiming to be trauma-informed and actually being trauma-informed.  I’m sure that the mental health and addictions program I work for would claim to be trauma-informed, just like they claim to be recovery-oriented.  But in practice, it’s just lip service, although I highly doubt the people running the place would see it that way.

I think all mental health care organizations should be trauma-informed, but it’s essential that it look trauma-informed from the client perspective, not just the staff or management’s perspective.  While individual care providers for the most part try (with varying degrees of success) to be empathetic, it’s difficult for some clinicians, and particularly for organizations, to have any real understanding of what the client perspective looks like.

Would you consider the mental health services that you’ve accessed to be trauma-informed?

 

Sources: British Columbia Centre of Excellence for Women’s Health Trauma-Informed Practice Guide and Trauma-Informed Approaches to Seclusion and Restraint Reduction

 

Photo by Hailey Kean on Unsplash

Identifying emotions

feeling names wheel

What exactly are emotions?  Well, there’s no easy answer to that; it depends on who you ask and what their theoretical perspective is.   But regardless of how we define them, how do we describe them?  That can be easier said than done.  There’s even a psychiatric term, alexithymia, for difficulty identifying and articulating emotions.  Wikipedia has an entire page dedicated to contrasting and categorization of emotions.

Several researchers have suggested that there are basic universal human emotions that remain consistent across cultures.  Psychologist Paul Ekman identified anger, disgust, fear, sadness, happiness, and surprise.  I like the emotion wheel diagram above because it takes these basic emotions and further subdivides them into more detailed descriptors.

Labelling emotions and mood tracking

bullet journal mood tracker pageWhen I’m feeling quite low, I tend to have a number of emotions going on at the same time.  When that happens, I can usually identify the basic emotions I’m experiencing, but to really get into detail it’s helpful to have a list.  I’ve never found rating my mood to be all that useful, but I do like to keep track of the mix of emotions that I’m experiencing.  I came up with this colour-coded list in my bullet journal, so each day I record a mood rating plus the coloured letters to represent the emotions I’m feeling.

I think that by glancing through the list each time I’m doing an entry, I’m identifying the more subtle emotions as well as the ones that stand out the most obviously.  Sometimes I’m able to identify where these emotions are coming from, and other times it’s harder.  I may think I’m feeling a certain emotion in relation to a certain event, but with more reflection I may realize that I’m actually reacting to something entirely different.  Journalling has helped a lot with identifying that kind of thing.

One thing that stands out to me with my emotion list is the lack of positive emotions.  I guess it’s just been so long that there hasn’t been an occasion that prompted me to add positive emotions to the list.

Emotions and bodily sensations

I typically don’t feel a strong connection between emotions and bodily sensations.  I’m not sure if this is me not being in touch with my body, or if it’s just how I tend to experience emotion.  The most notable exception to this is anxiety, which I’m more likely to feel in a physical sense (e.g. chest tightness, heart pounding) than an emotional one.  Stress can manifest itself in tension in the shoulders, back, and jaw, but I get regular massages so that’s kept from getting out of control.  I do have physical symptoms with my depression sometimes, like slowness and GI disturbance, but it seems to be more connected with the illness in general rather than reflecting specific emotions.

Facial expressions

Then there’s the matter of facial expression of emotions.  Mental illness can sometimes have a significant effect on this.  My expression (or “affect” to use the psychiatric term) gets very flat when my depression is causing a lot of physical/mental slowing.  I remember times when I’ve stared at myself in the mirror, trying to contort my face into a smile, and simply couldn’t do it.  Aside from the ultra-slow movement, this is a pretty obvious sign to those who know me that I’m not well.  By contrast, when I am well, I smile a lot.

 

Do you try to pay close attention to the emotions you’re experiencing?  Does it come easily to you, or are there certain strategies you use to help you?

 

If you’re looking for a list of emotions, here are a few options:

  • Tara Brach (author of Radical Acceptance): broken down into feelings when needs are satisfied vs unsatisfied
  • Therapist Aid
  • Hoffman Institute: this list also includes physical sensations
  • Plutchik’s wheel of emotions (see below): while this is pretty, it just doesn’t feel quite right to me

Plutchik's wheel of emotions

Image credits:

7 Cups

photo by me

Wikipedia