Thursday, August 15, 2013

nothing is purely good or bad, but thinking makes it so.

 “What I find most compelling about my clients with ‘borderline’ symptoms is that they are still struggling to exist despite the deep conviction that they do not deserve to do so. And they are still struggling to connect with others, despite being told again and again that they are manipulative and controlling and difficult. Far from being inauthentic, then, these individuals are reaching out into the world in the most honest, direct, vulnerable ways they possibly can, all the while bracing for the invalidation and hostility that they know is likely to follow.” —Dr. Rebecca Lester
Questions that circle around in my head...
What aspects of mental illness is a choice? Why would I choose this kind of suffering? If I am supposed to ‘sit’ with thoughts and accept my illness, but also reject cognitive distortions and avoid being defined by my diagnosis, where does that leave me? In this strange limbo state is which I am both the solution and cause of my suffering.
 Why is SI different in severity to purging/panic attacks/hysterical crying? Don’t they all hurt the same? Banning SI in a private psych ward pushes patients into a public system overrun with involuntary psychosis patients and acute care which are likely to be ineffective in the long term. Why is it unsafe for Mareike to remain on the ward and safe for me to leave it? I have clearly stated that I feel the same (if not more) suicidal since my admission and hopeless about the future; my psychiatrist has agreed that treatment has been ineffective and has admitted that perhaps CBT/talking therapies perpetuates my pain. Once again, he asked me what direction I thought my treatment should take (even though my knowledge of the health care system has previously been labeled as cocky and impeding my progress).
Why is it okay to call mental illness a medical condition when you prescribe drugs or forcibly lock people in wards, but it’s my personal choice when I can’t get out of bed or take a codeine cocktail (aka. relapse)? Why do we accept physiological symptoms of depression such as lowered energy levels or concentration problems but it is the patients fault when they self-harm or feel suicidal? I have too much energy to be depressed, I manage my anxiety too well for it to be classified as ‘interfering with daily functioning’ and I'm too confrontational/well educated to be mollycoddled and drugged. So they'll send off the paperwork and wash their hands clean of me. Back to my overwhelmed GP, cold-hearted private psychiatrist and well meaning but inadequate therapist. 
Why is positivity about our role in recovery constantly reinforced with terms such as ‘challenge’ or ‘character building’? This simultaneously places the blame/responsibility solely on the patient for their suffering and removes the responsibility of the treating practitioner. Forced optimism only emphasises the (often legitimate) negativity felt by the patient and further isolates them in a minority; stagmatising their thought processes, personality and experiences with terms such as ‘personality disorder’ or ‘treatment resistive depression’. It minimises the completely legitimate level of distress the patient experiences for completely valid distressing life factors. What if I don’t do crosswords, fall asleep in the daytime or cry at lot? What if I don’t look mentally ill and therefore have to use the last ounces of my strength to fight for some kind of recognition/treatment for my immense psychiatric pain? What if I can only take one step forward and two steps back? What then?