On dieting culture, social media, thin privilege and trying not to be a dick

Last week was a bad week for sanity on Facebook. Several people took it upon themselves to inform us of their diet plans or shifting measurements. This was my response:

Hello everybody. This is a PSA about dieting culture and talking about it on here.

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Several people have started diet plan threads on here recently. It’s absolutely none of my business what other people choose to eat and/or do with their lives. I find the concept of trigger warnings fairly problematic – you can’t trigger warn for life, and we live in a world where dieting culture is shoved down our throats as if attempting to manipulate details of our physicality is a replacement for having actual political agency or personal autonomy (which of course to some extent it is). So I’m not suggesting it’s inherently wrong to discuss your calorie restriction plans on here in case you trigger someone (although you might like to bear it in mind if you’re planning to talk numbers). But still, if you are planning to do some kind of fad diet, I’d like to tactfully suggest you make an opt-in filter to discuss it in detail. Some of those with a current eating disorder, some whose EDs are largely in abeyance but triggerable, and some like me who turned a history of ED into an academic preoccupation and know an uncomfortable amount about dieting in culture, the physiological effects of self-starvation of short or long duration and have Opinions about the prevelance of diet talk and its functions in culture and psychology would probably all thank you. As, I would imagine, would people who don’t have a history of ED but find it all a bit depressing. I am all for people discussing and analysing aspects of dieting and food in culture – this is not a request for all mentions of food, dieting, eating to be hidden – just that if you need to log your calorie intake, food plans or weight loss you might want to make sure those reading it are of like mind. Thank you and goodnight.

fuck diet culture 1Why the rage, which I’m sure is apparent even beneath the hopefully measured tones? As suggested, we live in a world where the supposed necessity of weight loss is shoved in our faces many times on a daily basis. There used to be godawful signs outside Boots proclaiming ‘be you…only better!’ as if weight loss was some sort of universal good to which we should all be aspiring (and as if calorie restriction doesn’t have a bunch of negative side effects – check out the Minnesota Experiment.) I regard myself as basically untriggerable, although I sometimes find teenage girls and/or practising anorexics in the potentially final stages troubling, and I have this half-compassion-half-horror-half-saviour-YOU-ARE-MY-PEOPLE impulse which I expect is probably just a magnified version of how many people feel about the obviously anorexic combined with a passionate identification I really ought to keep an eye on. The prevalence of dieting culture as some sort of culturally coded universal female bonding activity is enraging and political, but it’s not triggering as such; its cultural prevalence and systematic endorsement is infuriating, but it’s infuriating on the kind of background level that everyday sexism is, the kind you need to block out to survive.

So what is it that gets me? Partly, I am largely (if not entirely, hence status) lucky enough to move in circles of politically minded, enlightened, empathetic, *thoughtful* people who rightly regard the whole thing as culturally problematic bullshit and might even (were they academic types and thus inclined) go all Foucault and Discipline and Punish on yo’ass. (Yes, I’m quite aware of the undertones there, thank you). If people talk about dieting culture and related matters on social media around me, it’s often in interrogated terms (albeit often alongside tormented, because awareness doesn’t necessarily negate impact). This week’s posts got me simply because of how…normalised it was. Like bonding over ways to fuck your body up was okay, and expected, and right. Like sharing weight loss stories and inch measurements wasn’t questionable in terms of taste or tact or triggers or functionality, but standard. Like it’s okay that those of all genders, but especially women, are expected to take the necessity of this shit for granted. Which, to be honest, in the wider world we ARE, but I tend to look to my friends and my social media circles as being somewhat more culturally aware than that.

(Don’t even get me started on the shortness of the shrift I give people who persistently attempt to bond with me over body hatred, even if framed in ‘you’re so lovely and slim, however do you do it?’ terms. You get one shot and one polite rebuff, and then it’s straight into ‘I was anorexic for a decade and cannibalised my own liver. I’ve weighed 19kg. Please don’t let’s pretend you know more about weight loss than I do,’ territory.

It infuriates me. Can you tell?

However. A lot of the time, in public or less-well-known company at least, I let this stuff slide. Not because I don’t think it’s damaging and toxic and really deserves to have a fucking spoke jammed so hard into its wheels it disintegrates all over the road made slippery with vomit and tears, but because I’m well aware that I have, well, all the thin privilege. I’m very definitely not anorexic any more, and still noticeably small. In UK sizing, I’m mostly an 8, or at least a 6 on the bottom because tiny hips and sometimes 10 on the top because I unexpectedly have tits these days. The swimming every day and walking or cycling everywhere helps, of course, and are probably the source of whatever visible musculature I have, but it’s mostly a metabolic thing. My family are all petite, with the exception of my tall thin brother; I eat probably over 2000k a day (although I don’t count anymore, so don’t hold me to it) including all sorts of sugar and fat based items, and I seem to just…stay quite small on the scale of people. I’m not particularly thin, I’m just built little. I have absolutely no objective perspective on my body, of which more later, but I say that because I’ve *been* thin, and you can’t see my ribs anymore unless I’m stretching, and I have thighs that don’t quite touch in the middle but are mostly wider than my knees. (Don’t laugh, this is significant.) I’ve gone up a size over the last few years, perhaps, as I’ve got progressively more relaxed about eating, but if I’m honest it’s mostly meant that now I have cleavage, which I’m totally down with.

And I feel terrible, because I know that I’m therefore insulated from roughly 80% of what some of the people posting about fad diets and so on are subject to. People yelling things at me on the street are usually supposedly flattering rather than insulting. Doctors tell me to gain weight rather than losing it (although I tend to raise pitying eyebrows at them when they do). Medical problems aren’t – mostly – blamed on my weight (why bother when you have a decade of eating problems to blame instead?). I can buy clothes easily; bikini-clad women in posters are within spitting distance of my shape, if somewhat less padded; I eat pretty much what I feel like; it’s easy and comfortable for me to exercise and I enjoy doing it; I’m not subject to the continuous drip-feed of fat-shaming in the media. I can go out wearing little but body paint without worrying people are going to yell insults at me on the street.

This isn’t to say that I always feel 100% happy with my body. As aforementioned, I just have no objective perspective on it whatsoever. I basically outsource my self-image these days – I know that whenever I look at myself in the mirror I am going to see a swollen, misshapen, grotesque thing, and it’s finally been drilled into me by friends and lovers and partners and strangers that that’s probably a minority viewpoint, so my emotional reaction is mostly to shrug my shoulders and get on with it. Like…I can’t be fucked to worry about looking hideous, rather than feeling I don’t look hideous. And y’know, a lot of me really isn’t perfect by anyone’s criteria – I have scholiosis and laudosis (sp??) so my spine is weirdly curved and my hips are uneven and my tummy sticks out and my shoulders are rounded down. My partners and close friends are sometimes subject to wails and flailing, but they’re lovely, and mostly used to it by now.

The point is, all this shit is internal – it happens in my head. Only very rarely – because I don’t spend a huge amount of time around ballet dancers or teenage girls or anorexic inpatients – am I significantly larger than those around me. Most of the time, I’m noticeably smaller. Which comes with its own issues, in terms of being treated with respect and as an equal, but they’re not the point here. I was once, two years ago, asked by some teenage girls in the swimming pool shower why I was so fat. It disturbed me, but not just because it was voicing my own insecurities; also because it was so unusual. What had I done that day? Was everyone suddenly seeing me how I saw myself? HAD I BEEN MAGICALLY HIDING MY TRUE SELF UP TO THAT POINT? It was…odd. How I would cope if my physical self-hatred was being continually culturally reinforced I don’t know, but the answer is probably ‘less well than I do now.’

So, who am I to condemn people who perceive themselves subject to relentless body shaming for reaching for any means of proffered redemption? I am hardly subject to the same pressures, after all, and so much of the time I keep my mouth shut.

But. I am *also* a veteran of a decade’s disordered eating, and specialise academically on its cultural construction. I am in a fairly good place to point out how traumatic and potentially damaging unthinking reiteration of the cultural messages fat is bad, weight loss is good, these are universal and unquestionable values, you are not good enough, manipulating your food intake is fine and potentially successful. (It’s not like the vast majority of all dieters regain their lost weight within 5 years or anything.) And just sometimes, the balance tips, and fighting wins out over tolerance. I don’t always get it right, but I’m not always sorry, either.

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of rage, postsecret and pastries: in which an eating disorder is not a fucking getout clause.

because of my eating disorder i am visibly underweight, but that still doesn't stop customers from asking me which pastries I recommend from the caseA friend of mine posted this image to Facebook earlier, with the admirably restrained aside ‘Well, why not? Most of us underweight people love a good pastry.’ The lady in question is naturally skinny – she always has been – and is I suspect somewhat annoyed with the repeated assumption she must be ED. My somewhat less restrained response was one of such fury that I spent an entire train journey (which should have gone on book reviews for a deadline TOMORROW, mygod) writing this.

So, what is wrong with that image/statement and the kind of thinking it represents? Let us count the ways.

1)      It is deeply shitty to make assumptions about people based on their body type. Assuming skinny people are anorexic is the equivalent of assuming fat people are lazy and slovenly.  Some people are just naturally thin. It’s extremely problematic and profoundly damaging that popular culture lionises that body type to the exclusion of more abundant ones, and this needs to be rectified, but that doesn’t mean that every thin person is thus by dysfunction, or even by conscious and determined choice. Sometimes it’s just genetics. I’m lucky, in that I have the kind of body type that means that post-recovery I’m still mostly perceived as slender, and that makes accepting eating and living and embodiment a lot easier. If I didn’t swim every day, I’d still be a UK8, assuming that the rest of my noticeably petite family are anything to go by. I’m still considerably squishier than the friend who posted the link. I’ve had bulimic friends who were close to death without acquiring the emaciation of the latter stages of anorexia. Bulimia can kill you without significant weight loss due to electrolyte malfuckery. MAKING ASSUMPTIONS IS A DICK MOVE. The people asking the speaker about the pastries they sell without assuming they’re ED are a) being polite and non-dickish, b) probably hungry and simply seeking information from the most obvious source and c) expecting the person serving them to, um, do their job.

 

2)      Having an eating disorder doesn’t absolve you of adult responsibilities, whether professional or personal. It’s a bummer, because a lot of the time eating disorders are pretty absorbing and make everything feel a bit sturm und drang and life and death, but really, everyone has their shit, and yours is no more important and special than anyone else’s, and we all have to get on with the world. The speaker works in a place where pastries are sold. It is their job to know about the things they’re selling, if not from personal experience, from talking to colleagues or other customers. Asking your server/waiter for a recommendation isn’t even necessarily personal, it’s the equivalent of saying ‘hey, person who works in this store! Tell me about the things you sell!’ ED or otherwise, the server has a responsibility to answer.the.fucking.question because it is their job.

 

3)      Every person with an eating disorder is different. People with a single diagnosis – eg., anorexia nervosa – can have vastly differing behaviours and rituals and hangups around food. Lots of anorexics do work with food. It’s a recognised thing. Sometimes people with anorexia develop a particular focus on preparing and providing food for others. Or they develop an addiction to food porn or recipe books. Such people might actively enjoy having the chance to recommend someone a pastry. As aforementioned, eating disorders do tend to make you self-absorbed, but to assume that everyone with your particular condition or broad category of symptoms must feel the same as you about everything AND THAT PEOPLE WITH WHOM YOU HAVE NEVER COMMUNICATED MUST AUTOMATICALLY SOMEHOW KNOW HOW YOU, PRECISELY, FEEL AND RESPOND ACCORDINGLY is the height of arrogance.

 

4)      The idea that having an eating disorder makes you a magic special snowflake who deserves to be treated with kid gloves – let alone whose precise habits and hangups should be immediately obvious to all and instantly recognised as special and important and serious by other people who are just trying to go through their day and be nice – is precisely the kind of self-important bollocks that gives ED sufferers a bad name. Well, admittedly we also have a bad name because of the self-destruction and because Western culture is really fucked up about eating and embodiment and so there’s this weird vindictive resentment/admiration thing going on, but bear with me here. Having an eating disorder, even visibly, doesn’t make you special. Many many people have invisible eating disorders. Probably even some of those people asking the speaker here for pastry recommendations. Contemporary culture has problematized eating and embodiment, particularly for women, to such an extent that in many circles across cultural backgrounds those without disordered eating in some sense are in the minority. (Susan Bordo and Susie Orbach have done good accessible work on this.) Having an eating disorder doesn’t make you special. Eating disorders are, when you come down to it, pretty fucking banal. Counting bites and spitting mouthfuls and crawling curled around your hunger into bed. Yes, starvation keeps you at a destabilised, flying pitch of crazy a lot of the time and everything feels deadly important, and it’s difficult not to let that leak out into egotism. But you have to bloody try, because otherwise you’re just a self-absorbed crazy twat, the same as any self-absorbed crazy twat who weighs a bit more, and in neither case do you have the right to expect everyone whom you encounter to recognise the superior gravity of your situation and treat you differently. We’re all just people, trying to get by.

5)      Along with the responsibilities you don’t get to discard just because you’re ED come the responsibilities to a) recognise the humanity of others and behave towards them with consideration and b) communicate your needs. The people asking you for advice, speaker, have inner lives just like yours, although they may be less immediately conflicted, and you have no right to demand their immediate consideration without offering yours in return. If you want people to treat you differently because of your particular crazy, you – like all of us – have the responsibility to communicate that effectively. If you’re really prepared to take the consequences – given that an inability to talk about or recommend the food you’re serving might be considered to render you unsuitable for your job, which is pretty shit but is the logical corollary of the kind of thinking you present – then you need to talk to your boss, not insinuate that people asking you to do said job are somehow being insensitive and inappropriate. You cannot blame people for failing to accommodate needs you never communicated. Without communication, you might just be a thin person who likes pastries. (Who exist, by the way.)

Having an eating disorder is a shitty, horrible, crazy experience, especially if you have to be around food all the time and it triggers you. Eating disorders trap you in your head and in your pain and in your unacceptable self and it’s horrible. But blaming other people for not psychically knowing what you need and assuming the right to be treated specially is not the way forward. Owning your shit, wrestling your demons, trying to engage with others in a meaningful way, maybe. But not this kind of bullshit. The fury, obviously, comes because I have been that person, and now I don’t get to be – but I’m better for me and better for others this way, and I don’t cut anyone slack for expecting other people to shelter them from their crazy.  We all have it. It’s how you deal that counts.

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Corpses on ice: in which I wash our dirty laundry in public

Note: I wrote this a while back, hesitated over whether to publish it, ran it past my family – all of whom, to their credit, responded reasonably and thoughtfully and gave their permission – and so I’m publishing it for the sake of completeness. But whilst I’m very interested in other people’s experiences and would love to discuss family dynamics in general, I’m very much not interested in in condemnation or criticism of the events or persons depicted herein. It was a very long time ago, and besides, the wench is dead. 

‘All happy families are alike; each unhappy family is unhappy in its own way.’

‘We always did feel the same, we just saw it from a different point of view; tangled up in blue.’

This post changed under my fingers while I was writing it. It started out as a reflection of my relationship with my brother set against my friends’ relationships with their siblings, and some sort of lament for a perceived trust and dyadism I’m not sure we ever had. And then it became about family, and the roles we take on and how they shape us, and then it became about madness and its echoes, and now…I’m not sure quite where we’ve ended up.

Where to begin?

Here, maybe. Now.

I have a little brother. He’s a few years younger than me, happily married to a lovely woman, a successful early career academic insofar as such a thing exists these days. He’s very funny, very clever, mildly eccentric, a bit goth. Film and metal geek. You’d probably like him. Most people do, me included. We’re not very close, which I (and I suspect my mother) sometimes find sad. I remember vividly the absolute incredulity and shock with which a beloved friend (who’d lost their own incredibly close sibling to cancer in their early twenties) reacted when I told them that he’d never come to visit me while I was in hospital. It hadn’t occurred to me (nor, I suspect, to him) that he might. He was at uni, as I should have been, and we don’t have that kind of relationship.

We were closer when we were younger, at least insofar as my somewhat ana-shattered and overly-narrativised memory can gather. We never had the kind of dyadic intimacy that some siblings do, but I remember us playing games together as children and hanging out as teenagers. Surviving the various playschemes and awkward all-day-stays at other children’s houses that were the lot of dual-working-parent families in the 80s. We went to different schools for the most part, so he was spared the spectacle of my various social failures and occasional triumphs. We got on well, though, mostly. He was – is – good-natured, always entertaining, very much a buffer in the complex emotional dynamics and occasional open warfare of our little family. My friends liked him. I helped him with his homework. There were silly jokes. Yes, in contradistinction to my fairly expressive and troublesome and socially involved adolescence he spent a lot of his early teens locked in his bedroom watching movies, but then I was out or self-absorbed a fair bit of the time, and his then-girlfriend was and still is a good friend of mine. For all that I grew up with cries of ‘why can’t you be more like your brother?’ ringing in my ears, I never felt entirely unwelcome or useless to him. That I can remember, at least.

Then I got ill (glandular fever, and then ME) and went mad (anorexia, plus the psychological echoes of some stuff that’ll become apparent) and stuff started changing. I was 18 when chronic illness set in, and 23 when I finally crashed into hospital with anorexia. By the time I emerged, we’d both left home for good. He was 15 or 16, and 19 or 20. I was an adult, just. He wasn’t, quite, at least to start with, although I’m pretty sure to the external eye (and very definitely to the internal familial one) the apparent maturity was assigned the other way round.

Some more background.

My mother is – or so the stories we tell each other go, which is almost the same as being true – a lot like me. She saw a lot of herself in me when I was growing up: I was ‘hypersensitive’, ‘highly strung’, ‘overemotional’, bright, articulate, perfectionist. Took things to heart. Became overly involved or intense. My father was – although he has changed now, and we don’t tell these stories so much, which in itself is telling – very rational, mistrustful of emotion or instinct, a firm believer in intelligence as meritocracy, bewildered and alienated by the easily upset, emotional, clingy daughter he had so inexplicably produced, especially since I combined those qualities with the intelligence and verbality he could understand and respect. Frequently convinced my mother was somehow to blame for my inexplicable and awkward unhappiness, for ‘indulging’ me. There were issues in their relationship about values and ways of being in the world that were – maybe – almost in abeyance until I came along and highlighted them. I became the ground on which they played out their differences, and it took me a long time and a lot of nearly-dying to stop blaming myself for being unable to resolve them.

These are truths my family tell each other: I was an unhappy, troublesome baby. I didn’t eat or sleep easily and I cried a lot. Just before I turned three, my brother was born. He was a placid, easier, happy child. Friendly and easy-going where I was demanding and insecure.

I think we can all see where this is going.

In my head, I have always been unlovable. Not so much now, but in a sense, it’s too late. Growing up, I was always the difficult one, the awkward one, the one causing trouble. Everybody, including me, blamed me for this. My father berated me well into my twenties for selfishness, self-absorption, being inconsiderate, not being more like my brother. My mum and I were very close, and she talked to me, sometimes about the really obvious relationship conflicts in which we were enmeshed. I spent a fair bit of my adolescence trying to support her unhappiness, and wishing – occasionally audibly – that she would leave.**

I don’t think anyone else remembers this, my brother included. We certainly don’t talk about it, although when I was doing my PhD I did talk a fair bit to my parents about how our family dynamics fuelled my eating disorder. I don’t know if my brother even realised it was happening at the time; I don’t know whether his adolescent withdrawal was in part a response to these same dynamics, or whether he’s even considered it. Possibly he’d say he just liked music and movies, which is fair enough. But the question comes with a side order of the unspoken assumption that when I refer to family unhappiness growing up, even tangentially, even to someone else, I am making it up, being melodramatic. Our family narrative has me as the crazy one, the awkward one, the overemotional one. Even now, writing this, I am pretty convinced the visceral reaction I expect from my family is that I making a fuss about something that I’m pretty sure nobody else sees as an issue. Yet again, I am being self-absorbed and oversensitive and melodramatic.

I could not blame him for thinking that. We both absorbed it as we grew up, and of course, it is a version of the truth.

And then, obviously, I proved such assertions correct.

I had glandular fever – or a virus like it – when I did my A-levels. I never got better, really. My brother was 15-ish when his high-flying, troublesome sister basically stayed in bed and stopped living, and (not coincidentally) stopped dealing with her emotions in a healthy or functional way. (There is another blogpost in this, but it’s not this one.) If I was a different kind of psychologist I would point to my illness as a physical manifestation of my inability to free myself from – my feeling of responsibility for – the toxic situation at home, but fortunately, I’m not. But now, I *was* trouble. I had a gap year, ill at home. I scraped through my first year of university by the skin of my teeth, supported by regular visits home where my anxious parents would provide food and concern before dropping me back. I required care and attention. By the time I came home from my first year at uni, I was also (along with my brother’s girlfriend, although they broke up not long after) severely anorexic. I was crazy, and I stayed crazy – self-absorbed, irrational, unhappy, conflicted, outspoken, suffering – for something like the next 5 or 6 years. No wonder we don’t really have a close adult relationship. We never really had the chance to build one.

I needed anorexia – and these days I miss it – because it provided a buffer between my overwhelming and difficult and ungovernable emotions and the rest of the world. But by that same token, it shut the rest of the world out. Out of hospital, I just-about maintained my pre-ana weight and finished my degree and went to Oxford to do an MSt; and there’s nothing like Oxbridge to find and nurture and swell and burst your crazy. When I left, barely functional and weighing some 35 kilos (I’m 49-ish now, give or take, and that gives me a bmi of roughly 19) I went to live with my brother and his now-wife over the summer, before I found a place to live. They were kind and welcoming and tolerant, and it breaks my heart now that I was then too broken to appreciate it, or to build something approaching a bond of equals.

But then, have we ever really been equal? In the complex mess that is my head – as opposed, obviously, to his subjective reality, about which I have no real idea – my brother has always been okay. A good person. Acceptable and lovable. I never have, and I can’t help feeling he knows this, which is why we have never been close. And while I can to some extent blame my parents – or rather acknowledge that the primary responsibility was theirs rather than mine – for the ways in which their differences and conflicts impacted upon me and my self-image and the narratives we built as a family when I was a child, I cannot really blame my brother in the same sense. He grew up from those narratives into my being variously crazy for, well, if you include the ME, ten years, ish. I was fairly shitty as a sister for a long, long time. A third of our lives. And under those circumstances, I can’t blame him for the intimacy we don’t have; rather, all I can do is appreciate the way in which he and his wife have continued to be kind and welcoming in whatever way they can.

There’s a happy ending, of sorts. My parents get on much better now than they ever did when I was young. My brother is happy and successful. I’m happy, mostly, if not successful in the same sense. And from this I have my inability to look away, or to ignore the bad things, my insistence on honesty and openness, my inability to deceive or dissemble, my directness. I wouldn’t change, really. I have built a life that works. But sometimes, when I see friends with really close families or sibling relationships, I wonder how different things could have been – or, even, where we could go from here.

 

 

 

 

** To this day, I have not and will never date people who resemble my father when I was growing up. I date sensitive, communicative, intense, emotionally and intellectually aware, often androgynous people who’ve had their own traumas and questioned themselves and come through. Ironically enough – or not – I, and my collapses, along with his mother’s death, were part of the trauma that helped my dad deal with a lot of this stuff.

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Biological clocks: in which I am bemused and curious.

I don’t seem to have a biological clock. I just don’t. No particular pull towards children or producing them; no visceral urge to reproduce; no sense of impending loss. I’m finding this paragraph difficult to write, already, because while many women I’ve discussed this with and several friends I love and respect have spoken to me seriously about their experience of broodiness and their desire for children – and I take these conversations very seriously – I actually can’t imagine what having such a thing must be like.

It’s not that I dislike children. My boyfriend has a lovely daughter, and I am happy (and indeed looking forward) to being some kind of truth-telling unconventional crazy aunty-friend type person as far as she’s concerned (although I would imagine is she lived with him full time, this might be more of an issue than it in fact is.) The same goes for any child I may know as they grow up. My friends’ babies are often cute and interesting – little unformed people! How curious! – and I’m happy to spend time with them and make a fuss of them as long as I get to give them back again. When my boyfriend’s daughter (probably to be referred to henceforth as the anti-stepdaughter) turned to me with huge eyes and said ‘are you going to be my new stepmother?’ my response was one of barely concealed horror, and the explanation that I’d like to be her friend and her dad’s girlfriend but I really wasn’t the maternal type. (She took this in her stride, bless her.) Individual kids are interesting because of their parents or their potential or their perspective, and whilst I certainly wdn’t want to spend all my time with one, I’m happy for them to be around. (Exceptions to this include any child displaying cruelty or malice, but that’s hardly exclusive to children. People are generally horrible, I can’t single out kids here.)

biological clock spiralI googled ‘biological clock’ and many of the articles I found simply assume a ‘ticking biological clock’ is a given. One actually goes so far as to describe babies as ‘sweet, lovable lady kryptonite’, but then it also makes a bunch of REALLY PROBLEMATIC gender assumptions and suggests looking at cute animal pictures on the internet constitutes a subsumed desire to reproduce, and I have several case studies (including myself) to disprove such an assertion. There’s a probably unsurprising critical mass of stuff claiming women’s ‘ticking biological clocks’ make them ‘crazy’. (This paragraph is difficult too, for rather different reasons: try googling ‘daily mail’ and ‘biological clock’ and you’ll see what I mean. But I won’t fucking link to them.) There’s a constant undertone – sometimes even in articles decrying the ‘pressure’ placed on women – that the desire for children is a) unarguable b) universal but c) ONLY WOMEN’S BUSINESS. There’s a side order of we all ought to be having children in our early twenties JUST IN CASE WE ACCIDENTALLY SLIPPED and had a career, a good time, a lot of excellent safe sex, or an exciting decade of international travel and counter-espionage instead of fulfilling our BIOLOGICAL DESTINY. Which, as a woman and a feminist but mostly as a HUMAN BEING pisses me the fuck off.

But maybe this is me? Maybe in my bemusement I am missing something. Certainly many excellent women of my acquaintance perceive themselves as subject to some sort of cumulative psychosociocultural or biological pressure. (I suspect it helps that my beloved and mostly sane parents are quite definitively and notably without any desire or expectation of grandchildren, either from me or from my happily-married brother.)  There are evidently two factors here: one, the changes in fertility as women age (and quite possibly men and others too, but I couldn’t find a useful/reliable article on this. Although there are lots out there and again Google is your friend. I would imagine genderqueer folk or those of other genders generally have to fit themselves into the ridiculous broad brushstrokes of mainstream cultural discourses on this somewhat uncomfortably anyway – if anyone could point me in the direction of some articles, that would be amazing. ) And two, an intense perceived psychological and social pressure to achieve a life structure into which you can bring children before it’s ‘too late.’ (‘Too late’ to bear one’s own biological children, one assumes – it looks like there’s no upper age limit on adoption, in the UK at least, and some support for ‘older’ parents of foster children, whose average age is 50+. But I imagine if you perceive a biological pressure, you’re probably pretty invested* in being genetically related to your kids.) And I find SPECTACULARLY difficult to detach the concept of a particular biological experience attendant on femininity – which, to reinterate, at the grand old age of 33 I have yet to perceive the faintest whisper of – independent of the contemporary cultural constructions surrounding femininity, gender, maternity, parenthood, and all the rest of that colourful mess, and yet that is implicitly what so much discourse around this is asking me to do. To assume that I have a biological deadline which somehow causes all the psychological stuff.

It might be relevant at this point to tell you that my family, whilst in some ways as monumentally fucked up as Philip Larkin could possibly wish, were unconventionally functional in some ways. My dad never discussed anything even vaguely related to my future spawning or otherwise, to my recollection at least, and my little mother** never made me feel I ought to have children; to be honest, insofar as I can remember she urged me not to, because I could get more done that way. There was probably an ‘unless you want them of course’ tacked on as an afterthought, but I can’t remember it. [There is some psychological mother-daughter mess here that I won’t go into, but if you read Luce Irigaray’s ‘And The One Doesn’t Stir Without The Other’ it’ll give you the general emotional gist.] Certainly I left childhood with no sense that motherhood was my destiny, and I remember shocking my then-lover aged 17 with the assertion that I didn’t want children. (‘But…why not?’ ‘Why would I?’ was my unanswerable and, at the time, apparently highly disturbing response.) There’s an interesting parallel here with alcohol – my family never really drank when I was growing up, it was never part of my family culture, and although I drank a bit with friends as a teenager, I sort of never really saw the point. (When I needed an emotional crutch or a means of self-destruction, in a metabolically-slender and unashamedly foody family I picked self-starvation. Go figure.) As an adult I occasionally have half a drink and fall over. Close friends sometimes find it hilarious to offer me tasty alcohol and observe this process. I am generally fine with this – I rarely finish a drink and never get hangovers.

So yeah, it’s hard for me not to see – accurately or otherwise – a parallel between growing up in an environment where parenthood was neither particularly expected nor welcomed and one where alcohol wasn’t really a thing. My contemporaries seem drawn to both, and I’ve never really understood either. (Well, I’m a bit clearer post-several-breakdowns on the anaesthetic possibilities of alcohol, but it was never my drug of choice, despite occasional attempts.) And it’s hard, from this apparently-detached, unusual perspective, not to see the bullshit peddled above about women and their ticking, crazymaking biological clocks as the misogynist imposition of a patriarchal culture – the not-even-very-sophisticated descendent of the age-old concept of the female body as dangerous, impulsive, shifting, unstable, women as possessing inferior wit and judgement and the root of their problematic and permeable inferiority lying in their reproductive organs. People in the early modern period used to believe that the womb left its space above a woman’s vagina and wondered around the body suffocating things and causing all manner of symptoms, including emotional and psychological ones – it could be treated by lighting feathers under the sufferer’s nose, which the errant uterus would dislike and return to its normal harbour. This was referred to as ‘the mother’. I’m not making this up, although I can’t work out a way of linking to the relevant chapter of my PhD here. We may have better understanding of anatomy these days, but are we really significantly less inclined to impose sociocultural constructions on the body? How is that even possible? Are we any more able to remove ourselves from our cultural context in order to see fully all the ways in which we might be influenced? I doubt it. After all, to quote the excellent Helen Malson, ‘The body is not, for all its corpo-reality, a natural, transhistorical object. It is always-already constituted in and regulated by socio-historically specific discourses.*** Which in somewhat less theoretical language means that our experience of the body is shaped by our understanding of it, and our understanding of it is culturally constructed. 

This is absolutely not to deride the very real experience of women who experience the ticking of a biological clock. Their experience is every bit as legitimate as my own. We are culturally constructed creatures, neurologically as much as anything else, and it’s entirely plausible (to my moderate knowledge) that an identity formed in hope or expectation or assumption of a particular biological future becomes physiologically and neurologically present in some sense. Bodies are amazing. I am as much a product of my problematic culture as anyone, lord knows I’ve done some stupid enough things as a complex physiologically-responsive result of internalised cultural conditioning, cf my decade-long experience of eating disorders. So yes, not a judgement.

A question, though. I am very interested in people’s thoughts here. Does this make sense to you? If you have a ‘biological clock’, how does it feel? How does it relate to your personal history/cultural background? Is this all bollocks compared to the vividly experienced reality of living in your body? I am interested. And, er, feel free to comment anonymously.

 

*That autocorrected to ‘incested’. Comment superfluous.

**pet name. My family are all ‘little’. I call the anti-stepdaughter ‘little one’. Families, eh. They get under your skin.

***Malson, Thin Woman, 49

Posted in Culture, Psychobabble, Uncategorized | 88 Comments

5 things NOT to say to people crying in the street (and a few you can).

So, some fucking idiots who deserve to burn in a hell of inane and invasive chitchat forever and ever have set up some scheme to encourage people to talk to each other in London. Their rationale is inexplicable, but at some point they mention talking to people who are upset. Now, as someone who’s been ‘upset’ in London a fair bit over the last, eep, 13 years, I can only conclude they have NO IDEA of the kind of bollocks well-meaning strangers subject people crying in the street to. (Nb. Gender is a bit relevant here – by ‘people’ I mostly mean women. Partly because due to shitty gender socialisation bollocks they are marginally more likely to be crying in the street than dudes are, partly because they are MUCH more likely to be approached/addressed by strangers.) It is a tragic truth that people often mistake the understandable human impulse ‘see if you can ease crying person’s pain’ for ‘see if you can make the person STOP CRYING, because then you win a prize, and you will obviously have solved all their problems and can go on your way with a smug self-satisfaction in your step.’ Lest you think I exaggerate, I would like to point out that all of these have been addressed to me over the last decade in London (and had the statutory number of 20s life dramas.) I AM NOT MAKING THIS SHIT UP.

5) ‘You’re too pretty to look so sad’.

Right. Even if beauty bore ANY relation to the capacity to feel emotion (which it doesn’t), in what way is it appropriate to deny an upset person their right to their feelings? (Answer: never). The implication that ‘prettiness’ comes with the requirement to adopt only self-expression appropriate to being objectified by others is at the heart of a whole bunch of fucked-up shit about gender in the Western world, and to parrot it without thought at somebody obviously in distress is unforgivable.

4) ‘Don’t cry, I don’t like to see people cry.’

Well, sorry that my grief/bereavement/breakup/sadness/exhaustion/accident happened in your immediate vicinity. Next time I get a phone call announcing a death, or am unexpectedly dumped by text, or break a bit after working 16-hour days for a fortnight, I will be sure to have NO FEELINGS until I’ve checked with all those in a half-mile radius that expressing pain is welcome in their personal philosophy. Of course your vague and irrelevant preferences should be everyone’s priority when in your presence, virtual stranger. It’s not like we all need to share the same public spaces or anything (and, therefore, are largely and sensibly inclined to do our thing and let other people do theirs).

3) ‘Plenty more fish in the sea.’

(Bonus points if this is simply addressed to a crying person with no prior contact whatsoever, so they may actually be crying about Game of Thrones or the death of their cat.)

Even if someone IS crying over a breakup, the chances are they are doing so because they are engaging in the healthy process of grieving for something lost. It is necessary to do this. Encouraging someone to stop mourning a particular person and simply go on to replicate the dysfunctional patterns their tears and the attendant introspection and memory might serve to address and reconfigure is about the least helpful thing you could do.

(Nb. If you are a FRIEND of crying person, and objectively consider their mourning for a lost partner to be excessive or dysfunctional, this is your prerogative and you are encouraged to communicate this as sensitively as you can. I still wouldn’t use the phrase ‘plenty more fish in the sea’ as an opener, though. It’s belittling both of the person and of their feelings and experiences.)

2) ‘I know what you should do….’

Let’s say the crying person you approached genuinely wanted to confide in someone, and has poured out their troubles into your willing and tissue-bearing listening ear. Let’s say you have heard in depth about the cracks in their marriage, or their crisis of religious faith, or the pregnancy they can’t bear to tell their partner about, or their fear of coming out to their dad, or the death of their beloved dog Albert. Still, unless you are genuinely a professional expert with no subjective opinions in marriage counselling, faith-based therapy, abortion counselling, youth LGBT issues, or bereavement, the best thing you can do is not to attempt to solve all their problems with a whisk of your conversational wand, but ask questions, and help them figure out what they feel/need/desire/want for themselves. It’s a psychoanalytic cliché that the patient knows all the answers anyway, they just don’t know it, but it wouldn’t’ve become a cliché unless there was a kernel of truth in it.

You just met this person. The chances are they know a lot more about their psychological and emotional background, the support networks available to them, the complications surrounding their loss, the cultural resources it’s easy for them to access, than you do. There are exceptions to this – I once directed a homeless man to the Crisis centre where I was working at Christmas, for example, because he wanted a shower – but by and large, the best thing you can do when someone is upset is listen and respond to them and what they seem to need from you. If their experiences relate to yours, then it’s much better to frame your thoughts ‘well, I think I would do x, but YMMV’ that it is to tell them what to do. They have to take responsibility for the decision, after all.

And for god’s sake, this is about THEM, not you. It’s not about you playing the good Samaritan (there are trained Samaritans for that, and their number is 08457 909090 in the UK. Or you can email them at jo@samaritans.org. Feel free to pass these details on if you feel it would be helpful.) It’s not about you going away feeling good because you managed to solve somebody’s problems. (If you feel like that, you probably didn’t.) Listen. It’s the most human, humane and helpful thing you can do.

1) ‘Cheer up love, it can’t be as bad as all that.’

Ah, my personal favourite. World literature and the entire internet do not have space to enumerate all the ways in which this is utter bollocks, but here are a few:

a) it implies crying (‘all that’) is somehow bad or shameful. It isn’t.

b) ‘can’t’? If you’ve never felt bad enough about anything to cry in the street you are lucky, chatty stranger, but you are also in the minority. You know nothing about my life. I may be bereaved, suffering from terminal illness, have a loved one suffering from terminal illness, just discovered I’m pregnant, just discovered I’m not pregnant, be depressed, be high, be coming down, be exhausted, be listening to Gorecki on my headphones. If you are (as so often is the case) an apparently able-bodied cis white male, there are scales of ‘as bad as’ you have literally no idea about. This applies to all of us. Even if you have a horrendous history of trauma, so might the other person. (I would suspect someone with a history of trauma not to be such a dick, though.) Don’t be a dick. Don’t assume.

c) The reasonableness or otherwise of my crying impulse is not your business or your problem.

d) it implies women (although males and others of my acquaintance, do yell if this happens to you too) have some duty to present themselves favourably for the gazes of (patriarchal) others at all times, regardless of their personal situations (see 5). This is bollocks.

e) I am not your love.

f) Fuck off and die in a hole.

Ah, but, I hear you cry. What of human compassion? What of people crying on the street who are desperate for the comfort of strangers? What of situations where someone is genuinely in need of help but for some reason is uncomfortable asking for it? Well, luckily for you, there are some things you CAN say without being the kind of douchenozzle enumerated above. They all hinge, though, on responding to the wishes and needs of the crying person, so once again, don’t go in wanting to be a saviour. It won’t work.

1) Crying person is crying. Check out the rest of their body language. Will they meet your eye? Are they deliberately avoiding your gaze? Are they hunched in a corner trying to keep as much distance as they can from Other People? Do they have headphones or dark glasses on? Are they trying to hide? Then THEY PROBABLY DON’T WISH TO BE TALKED TO. If someone won’t meet your eye, go on your way. People wanting or even willing to be engaged with will signal it.

2) Ask, don’t state. If whatever you wanted to say is framed as a statement, rethink it. Say something that can be answered with ‘no’, AND BE PREPARED FOR THIS TO HAPPEN. ‘Are you okay? Can I do anything?’ A lovely Facebook friend of mine suggested ‘You look unhappy. Is there anything I can do to help?’ as this opens up space for the person to refuse. They are a kind person with the right idea. You are giving the person opportunity to engage with you if they wish, NOT necessarily trying to get them to stop crying.

(If you are trying to get them to stop crying, you are a dick. This should be about what they need, not what you want. Many people find crying helpful and therapeutic.)

So there you are. Maybe, just maybe, we can engage with strangers to our mutual benefit. But we absolutely can’t when we insist on imposing our own problematic ideas and constructions upon them. End of.

Be excellent to each other.

Posted in Culture, People being dicks, Uncategorized | 7 Comments

Tales from the wreckage ii: on struggles and unexpected scars

Useful background: I slit my wrists a while back. I don’t talk about it, or even think about it, that much these days, mostly because I don’t need to. But I decided, at that point, not to self-harm again.  Partly because I seem to have a push-everything-as-far-as-it’ll-go-then-stop-and-try-something-else schtick going on that’s probably pretty healthy; partly because Other People; partly because I like the sensitivity of the scars; partly because three fairly obvious eight-inch suicide slashes is plenty to make the point (and have to hide on the rare occasions I need to pretend to be a grownup.) It seemed, and seems, the right and only decision to make at the time, and I stand by it.

Thing is, that leaves me with a bit of a problem.

I started self-harming, as this blog testifies, because it was the only language I could use to describe the pain I was in to which people would reliably listen. I’m not quite the same person as I was then, and I’m certainly not in the same kind of pain – it has been noticeable the extent to which the ongoing litany of practical disasters and insecurity constituting my present life have been mitigated by the love and support of my partner and my friends. I feel loved, which to a great extent means that emotional repercussions of my present instability fade into the foreground.

But by that same token, they’re hard to miss.

I’m tired. I’ve forgotten how to sleep. Ever since ME, I have basically been able to lie down and pass out – but suddenly, now, I am mostly awake and alert, my mind flicking fretfully through plans and possibilities – where to go, where to work, what to do. Contingency plans. Places to run to next. If I’m woken or interrupted, it takes me hours to calm down enough to get back to sleep – even if my terminally insomniac boyfriend gets up to go and have a bath so’s not to keep me awake, the chances are I’ll be staring at the phone or my ceiling for hours anyway. If I’m on my own with no warm person touching me, it’s even worse.

So I’m going slowly crazy. Everything is fragile, all of the time – I am febrile and frantic, only the thin veneer of everyday separating the outside world from the flickering whirling mess inside. Touch me, and I’ll either bleed or burst.

It’s hard in unexpected ways, the homelessness and the rootlessness. Nothing is ever quite safe. I’m never quite safe. No tenet of my selfhood is unassailable by the twin agonies of being worthless to the world and having nowhere to hide from it.

The trouble, then, is how to deal with that. And I confess, I don’t know. But it’s no less significant for being entirely unsurprising that my go-to response has consistently been to reach for self-harm or suicide. There have been whole weeks where everything is punctuated by flashing cravings– or careful considered planning – for precious oblivion, whether momentary or mortal. It’s been the last place left I could go.

I’ve been properly depressed only a few times in my life. It’s odd, while being in some senses quite emotionally positive, to be continually wrestling with the same thoughts and feelings – that I’m a burden on everyone, that I’ve already failed at everything, that I’d be better off dead – and more than anything with that dull overwhelming craving for nonexistence shot through with the constantly-resisted impulse to cut. To say, publicly, that I’m not okay any more – even though, in some senses, I am. It’s unexpectedly overwhelming, and oddly destabilising. Combine that with the endlessly shifting cities and sleepspaces and you get me, unsure quite what I am anymore, or quite how to carry on.

Posted in Uncategorized | 2 Comments

Wellcome Trust Mental Health Recovery Symposium: In which Sasha hears voices making an awful lot of sense

 Jeanette Winterson’s advice to anyone is ‘get born’. I am slightly more dubious about human existence, but could reluctantly compromise on: ‘get born; check your privilege; get therapy; fight for social justice; get on the Wellcome Trust’s mailing list’. Seriously. I would advise anyone and everyone interested in science, humanities, mental health, medical history or the human condition to get themselves on there – they do remarkable and pretty much unique work, not just in terms of exhibitions and scholarly funding but also in terms of symposia and research days and all manner of what on topics connecting scientific and medical research with other aspects of the human experience. They’re great. And yesterday’s symposium on mental health recovery was unquestionably a case in point.

Ostensibly the ‘soft launch’ of http://mentalhealthrecovery.omeka.net, the whole thing was the brainchild of PHD student and former archivist Anna Sexton, who’s looking at participatory archives and the ideologies of record-keeping (more detail here). Essentially, the archive shows the stories of four people with lived experience of mental health difficulties, and their critical dialogues with the concept of recovery. The contributors – therapist and academic Peter Bullimore, ’professionally mad’ multimedia artist Dolly Sen, writer Andrew Voyce and mountaineer and photographer Stuart Baker-Brown. Each structured and designed their own sections of the website. The day consisted of short lectures from each about their experiences and their take on the complexity of ‘recovery’ as a concept in relation to mental health, current medical treatment, and non-pathologising ways to conceptualise the lived experience of mental health issues. Peter Bullimore, therapist and educator, is probably going to get the lion’s share of this writeup, partly because he was the most technical, partly because he’s much more involved in the practical therapeutic stuff that really interests me, and also because while Dolly, for example, was funny and charming, anyone would get much more out of reading her story in her own words than they would out of me précis-ing her précis. [That sounds a bit dirty. It really shouldn’t.]

Anna Sexton’s introduction talked about how the concept of ‘recovery’ tied into a medical worldview often rejected by those with lived experience of mental health issues. She spoke of the problematic scarcity of the voices of those with such experience in written records, particularly institutional records for asylums and hospitals, and the consequently hidden, subsumed, fragmented nature of their stories. This wasn’t exactly part of the talk, but the few we can glimpse include the ‘Pam Maudsley diaries’, and the letters of Nora Quin to her sister from the York City Mental Hospital 1936-50. Believe me,  these are depressing; the last basically consist of Nora begging her sister to come and fetch her. Every week. For 16 years.

Anyway, Anna’s introduction was succeeded by Peter Bullimore’s talk on ‘The Impact of Trauma’, delivered at approximately 500 miles an hour, which was great for breadth of content, if less so for coherence of notes. To be fair, he got me onside pretty early on by going ‘so, I’ve heard voices since being abused at the age of 7, those are my experiences and I own them’, and appearing to actually do so. He also entirely denied the validity of his (or anyone’s) schizophrenia diagnosis, which I’m not really in a position to contest but can understand some might wish to – certainly I can see a diagnosis of some mental health conditions (bipolar, say, or OCD) would have some validity for those affected both in terms of understanding and accessing appropriate treatment. I just don’t know enough about schizophrenia to know if that would be the case (equally certainly, from his anecdata and my own unfortunate encounters with mental health services, I can see how it might cause more problems than it solves). He works across the disciplines that come under the banner of psychiatry, specialising in those who have been told they can’t recover. ‘A person’s lights never go out’ echoed through the talk; Bullimore stresses the importance of ‘reaching beyond diagnosis’ to the person, positing recovery as an entirely individual, experiential thing.

Trauma, he argues, is prevalent in those with lived experience of mental health difficulties. In his experience, sexual, physical or emotional abuse and neglect are often found in the narratives of those with mental health issues (and here I think he focuses specifically on voice hearers, but it wasn’t clear). The less severe the trauma, the less pronounced its effect in psychosis – but it’s non-diclosure of trauma, not trauma itself, which can be a trigger. Human beings assimilate and deal with traumatic incidents by revisiting them, narrativising them, sharing them, so they lose their power [this is me paraphrasing, I might be wrong]. ‘It’s not what happens, it’s what you do with it’ – if the brain can’t talk to anyone, it’ll talk to itself.

When people arrive in mental health treatment, to Peter the most important thing to ask is ‘how did you get here?’ To seek context and story rather than simply categorise and drug, or worse still write people off as unrecoverable. (It’s noticeable that all 4 of the MHRA contributors had been told this at one time or another.) But if you ask, you have to act if the person wishes you to – the next question is often ‘do you want me to do anything with this?’

Why do people – practitioners –  not ask clients for their stories? Many reasons – narrative doesn’t fit the medical model; practitioners may consider the client too disturbed (avoidance from practitioner) or too distressed (but a can of worms will always be a can of worms, open or otherwise); they may assume the client doesn’t want to be asked (rationalisation) or they may be afraid of ‘false memory syndrome’ (herewith a rant I didn’t write down, alas).

Why does trauma, particularly childhood trauma, manifest as voice hearing and other adult mental health difficulties? Trauma is a cognitive fog. If the subject dares not look at an event, they cannot see it. If they cannot see it, they cannot think about it from their growing perspective. The practitioner will often know a client’s thought process – or, in fact, emotional development – has halted at a particular point, but the client must be willing to go there (and thus feel able to trust the practitioner to create a place of safety from which to explore) to be able to resolve issues. Is the client’s response adult or child’s fear?

As long as we repress traumatic memories, we remain in the trauma. Frozen terror halts emotional development, so memories and attendant trauma can be triggered but not worked through. Talking about it people regress to age where trauma happened – ‘emotionally, how old do you feel?’ Often, people have multiple traumas, it’s not just one experience or incident, so if there are (say) ten boxes of hidden trauma, start with the easiest. People gain confidence from successfully overcoming the smaller ones to tackle the big ones.

‘All addictions are about avoidance’. The person they avoid is the person they most fear. Who are they angry with? Not necessarily the abuser, but the parents for missing it, or not listening or caring. 

Truth – what is really there? Adult or child?

Trust is the antidote to trauma, but must be earned and deserved.

Consent is crucial, it empowers – you can’t coerce somebody into dealing. 

BE AWARE OF YOUR OWN FEARS AND TRAUMAS. Otherwise you are a liability and undeserving of trust. Always focus on the bits of the story they don’t want to see – and ask them to explain in their own words. 

TRAUMA TRIAD. The adult must eventually be able to say to the visualised or remembered abuser that:

-          What you did was wrong

-          I am angry at you for doing it

-          I am going to stop you from doing it 

This helps unlock the frozen terror. You can use role play and visualisation – letters to and from inner child, significant figures, etc. People’s first question to their abusers is usually ‘why?’

You need to know that the person’s trauma is over and convey that without parenting or retraumatising. DO NOT PARENT – it keeps kids alive and adults insane. You need to support, not pick up. 

Case study: Anna, raped twice at age 14. She told her mother both times, and both times was ignored and told not to tell. This made it her fault. As an adult, she hears three voices: her rapist, a female voice telling her off, and her own internal voice. Why did her mother let her down? They still live together. She asks Peter ‘Will you keep me safe?’ (to confront visualised rapist). Put inner 14-year-old in safe place, invite adult Anna to confront rapist and explore the trauma triad. She recovered with gratifying speed, began resisting mother and developing adult autonomy.

 Image 

So, ask ‘how did you get here?’ (what has happened?)

If that is unanswered:

Who are you?

If that unanswered:

What’s your biggest fear?

 – when did it start? What was happening then? (remember avoidance). 

Case study: x, taken into custody, claimed to have shouting match with the Queen and have found the Holy Grail and left his coat over it. Schizophrenia diagnosis. Turns out he’s recently lost 5 close family members and his wife left him. Bereavement also loss of sense of identity, control, structure. Creating fantasy in order to cope, creating livable world. Three weeks of intense bereavement counselling and symptoms abated. 

DON’T WORK WITH DIAGNOSES, WORK WITH HUMAN BEINGS.

Work with people on their own terms. Often people are unable to speak about being unable to speak. Mental health symptoms are often imaginative rescue for sense of control.

Fear is transposed outward.

If people can’t respond in the terms you’re offering, change method – art? Role play? Writing?

Everybody wants to be asked. Everybody wants to be related to as themselves. Everyone Is people.

So, yes. That, in case it wasn’t obvious, is mostly a slightly more coherent transcript of my notes. Stuart Baker-Brown’s and Andrew Voyce’s will be shorter; I’m telling you NOW to go look at Dolly Sen’s stuff [link] because a lot of it’s art/image dependent, and she’s hilarious. (Her card runs: NONE OF YOUR BUSINESS CARD. CONTACT: NONE WITH REALITY. She set up Bonkersfest to subvert understanding of mental health issues with humour. She has the lyrics to Joy Division’s She Lost Control tattooed on her right forearm. We swapped doctor horror stories. She’s ace.) 

Stuart Baker-Brown has a diagnosis of schizophrenia; his symptoms aren’t a problem (‘psychosis is beautiful’) but how he’s been treated, particularly by the medical establishment, really was. He was told to give up any hope of working again and put on drugs with horrific side effects. Had grown up being told feelings, especially depression, are a weakness, and so never expressed any. He wanted hope and positivity from services, not denial of his ability to function. For him, recovery and indeed his condition have been about working out meanings for himself. 

Dolly Sen – just google her. 

Andrew Voyce, an asylum patient for 20 years before Mrs Thatcher closed the asylums, considered himself to have ‘written himself better’. A great believer in the power of narrative for communication and understanding, he has rebuilt relationships with his family on the basis of his writing, and contributed to several books about the lived experiences of mental health issues (eg. Grant, ed, Our Encounters with Madness). His definition of recovery coheres with that of Gordon McManus – effective therapy, a meaningful life, a new identity (I myself would perhaps take issue with this last bit). He’s unsure about the concept of curing a biological disease – much more concerned with the social dimension of mental illness. 

Jerome Carson, professor of psychology at the University of Bolton, bears a startling resemblance to one of the nurses at Addenbrookes, where I was an ED psychiatric inpatient in 2004 (I think), and I slightly regret not taking the opportunity to tackle him about that. (Given that his profile simply states that he worked in ‘the health service’ between getting his degree in the early 80s and his PhD in the mid-2000s, it’s not beyond the bounds of possibility.) He spoke about the ownership of stories about mental health, and how the concept of ‘recovery’ privileges certain narratives, and the conflict between voices of ‘professional expertise’ and lived experience. There’s been increased attention over recent years to the perspectives of those with lived experience – in Psychiatric Services journal, for example, there were 10 articles by people with lived experience for the first 50 years, 34 between 1994-2000, and 46+ since 2000.

Why is this important?

1)      Helps MH professionals learn about difficulties and experiences – enhances understanding.

2)      Gives sufferers and families sense of not being alone

3)      Addresses continual need for experiences to be shared amongst sufferers, professionals and carers.

4)      We learn by sharing stories. 

Glenn Roberts: ‘At its most arid, modern medicine lacks a metric for existential qualities such as inner hurt, despair, hope, grief and moral pain, which frequently accompany and often constitute the illnesses from which people suffer.’ Greenhalgh etc, quoted Roberts, 2000. 

Patricia Deegan, Recovery as a Journey of the Heart, 1996: ‘The goal of recovery is to become the unique awesome never-to-be-repeated human being that we are called to be.’

CHIME definition of recovery:

Connectedness

Hope and optimism about the future

Identity

Meaning in life

Empowerment.

Julian Pooley, not a speaker but an audience member, works at the Surrey Archive in Woking, which has kept mental health record s since 1700. His archive received archives from the aSylums when they shut. He collects oral histories of lived experiences on mental health – has been on R4’s All in the Mind – but expressed concern over need to have a MH professional present when essentially poking about in murky bits of people’s pasts.

(At this point I scribbled ‘look into archivist training/jobs’ in the margin. Nuff said.)

So yes. Recovery is a fraught concept, as is the ownership of stories – hopefully more will be done to redress the imbalance of practitioner and experiential accounts of mental health issues.

 

 

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