Here is a new project I’m working on investigating suicide in the UK. Please take a look and if you think you might like to be involved in any way please don’t hesitate to contact me at email@example.com
I was on the gloriously gale-force-winds Black Rock Sands beach in Morfa Bychan, North Wales when I took the call on my mobile. We were virtually the only people on a stretch of beach miles long, attempting to have a summer holiday whether there was a summer or not; me, my husband, his parents Betty & Neil and the kids. We’d hammered in the windbreaks which almost flew off. My husband lay on the sand in his coat and a blanket, it was absolutely hilarious. Neil was telling us a story about how his mum thought he was from the chemist’s, big and loud, VERY loud in fact, and Tom phoned and said ‘I have some very good news for you!’
It was very hard to hear what he was saying, but when it all made sense all I could say was ‘Wow! YOU’RE KIDDING.’ I didn’t have any idea that the NextGen list was coming out if I’m honest. Neither did I have any idea I’d been entered for it, so as you can imagine, the surprise was huge and I really had no idea even what it meant, could mean, should mean, and I got on with our holiday, though I knew it was the most important news of my life.
The build up to the photo/videoshoot for the PBS and Guardian was hard for me, I won’t lie. I haven’t had a single week of stability in the last two years, certainly not without diazepam, and a list of other medications, and placing huge limitations on my life, my social life, even making phone-calls and using social media. I’d been really high, the pressure building, with the fear of what would happen when I got there or if I’d know or recognise anyone, or if I could hold it together.
I live a very isolated life and don’t really spend much time with other poets or even anyone at all, socially. In the end my husband decided to travel with me because my thoughts were constantly racing, I was finding it very hard to concentrate or remember things, and we were concerned I’d become very overstimulated in London, and me, manic, with people I don’t know and a debit card, is not a recipe for a safe, enjoyable and fruitful excursion.
As it happened I recognised a few people, who were all fantastically funny, lovely, animated, compassionate and friendly and I enjoyed what little time I spent in their company; others weren’t as welcoming, but I figured they were just nervous too. The filming was fine, the poems, however, made me shake. That’s what they do, they always make me shake. These poems are all autobiographical, all for real. All for YOU.
I took the tube to the Natural History Museum, and met my husband. I queued for ten minutes all the while going out of my mind, shaking, eyes darting around, finding nothing to hold onto, my thoughts churning and churning. It was too hot, I was sweating and I felt like I might scream. I didn’t enjoy the dinosaurs.
I sank. I tried to gain some kind of composure again after a long train home which stopped in the cold and dark for nearly an hour because someone on the train took ill. I told myself I could sit back and enjoy it now, I’d done the hard work, I’d written the book for Christ’s sake. I didn’t tell anyone and I imagined my friends all enjoying the excitement with me and being happy for me. I imagined the poetry community being supportive. That brought joy to my heart. Too often all I ever have to report is that I’m ill, or I can’t cope.
On the morning of the 11th I got at text from Tom at 1am, to say it had all been announced and I should enjoy all that comes next. I fell back asleep like it was Christmas. At 4am, Steven woke me to tell me he was too excited to sleep and started checking social media; we drank tea and ate biscuits in bed and come morning there were some lovely comments which warmed my heart. Later in the morning, I posted my ‘announcement’ on Facebook.
When I got the news I felt my life had changed. I had no strange or stupid ideas about becoming part of the ‘Establishment’ or achieving ‘fame’ or rubbing shoulders with influential people or any fucking bullshit like that. I honestly felt as though, if I didn’t survive the oncoming depression I would have achieved something beyond anything I dreamt possible.
You have to understand, I have never had hopes or dreams of any award or accolade. Never. I never felt I was ‘valid’ enough to be taken that seriously. I never had the privilege of a university education and I guess I wrongly thought these honours were reserved for the more successful academics. I feel, even in this post, that I have to justify myself. Writing through the endless, endless pain of manic depression, writing not for money or recognition. Writing with no-one but my poor husband to read my poems and help edit them, for a decade.
So then it kicks off. My mood drops because I’m tired for having little sleep. I know it’s been coming for weeks. When people started to get angry I sent this text to a friend:
‘I feel incredibly lucky and grateful for this accolade, but I also know it’s only a moment and will pass as moments do, and it is only really the writing that matters. The idiots can fuck off. My friends’ support is worth more to me than any accolade and will outlast any moment of recognition.’
Some of the vitriol was so absurd I was quite frankly stunned. Some of it was so funny I laughed out loud. I felt as though I would have to step in and defend myself. I was warned that there would be many angry, jealous people. It was as though I’d done something seriously awful. It needs to be said that people I didn’t know contacted me with words of support which were profoundly felt. But it’s fair to say Facebook knocked me down a peg or two.
Steven was working last night and I sat in bed and wrote a suicide note. I couldn’t do anything because of the kids but I was very tormented. It wasn’t the day I had expected. Friends had failed to even say ‘well done’ as though they couldn’t bring themselves to do it. I felt stupid for even thinking it would all be fun and celebration. I felt like people were slamming this thing that I’d held on so tightly for weeks with such a happy heart. I WISHED no-one knew, that I could walk around at night with my dog and a lighter heart. I soon realised it mattered to me more as a personal achievement than something to tell the masses about.
I have since tried to avoid Facebook but today noticed a winding-down thread, the general gist of which was:
NextGen is bollocks anyway so we don’t need to worry about it. No-one will ever be interested in the NextGen books. Other writers with no accolades are all better and none of them will be remembered in ten years’ time. Plus: It’s all about the art! (Who knew?) It’s all about the FUCKING ART. And how could anyone on the NextGen list know that???
I feel like I’ve been punished for something nice that’s happened to me without my control that has brought much joy to my desolate world. That it has been torn apart and belittled by (some) writers I thought well of.
I don’t want any sympathetic comments AT ALL but I would like to say that people posting things online slamming those who have done nothing to deserve it, is not without consequence in the hearts and minds of those you are berating. Just because you can’t see them, they are real, they are there and they have feelings.
After all is said and done, I’m just as sensitive, average and fallible as everyone else. Thank Christ.
Things I don’t remember but try not to forget
I don’t know anything about the colour blue. I don’t know anything about Picasso. I don’t know anything about rolling heads. I don’t know anything about blowjobs. I don’t know anything about car crashes. I don’t know anything about drowning. I don’t know anything about cliff-diving. I don’t know anything about Siamese Twins. I don’t know anything about dying grandmothers. I don’t know anything about sleeping alone. I don’t know anything about Roland Barthes. I don’t know anything about sniffing glue. I don’t know anything about the National Curriculum. I don’t know anything about the drug dealers in the car park next to my house. I don’t know anything about the orange car with the blacked out windows. I don’t know anything about cannabis farms. I don’t know anything about oversized dresses. I don’t know anything about poets. I don’t know anything about the time it takes for a centimetre scar to heal. I don’t know anything about stealing from a warehouse in Manchester. I don’t know anything about vintage Lyons Raspberry Tea from 1999. I don’t know anything about love hearts made of wicker. I don’t know anything about Dennis Oppenheim. I don’t know anything about canoeing. I don’t know anything about going through the wall. I don’t know anything about Littlewoods catalogues and how my next door neighbour ran up a debt in my name. I don’t know anything about slaughtering lambs and how they smell alive in the abattoir. I don’t know anything about the stress you eat when you eat a beefburger. I don’t know anything about private messages. I don’t know anything about people who contact you and then never reply your emails. I don’t know anything about feeling sick every night and every morning as a general routine. I don’t know anything about gluten free chocolate stars. I don’t know anything about falling down the stairs. I don’t know anything about assassination. I don’t know anything about my daughter crying because my hands are always shaking. I don’t know anything about hospital food. I don’t know why I didn’t let my husband hug me today. I don’t know why I wear perfume every day whether I’m ill or not. I don’t know why I have never been able to look at birds or if it is just flashbacks. I don’t know anything about what makes me think I could be a novelist. I don’t know what to say any of the time. I don’t know why people say half the things they do. I don’t know why I have to explain myself. I don’t know why I can’t help you with your life, I’m not equipped. I don’t know why I wore a black dress to a wedding. I don’t know why I’m not a more interesting person. I don’t know anything about pain. I don’t know anything about pain. I don’t know anything about pain. I don’t know why I can’t finish reading Paradise by Toni Morrison. I don’t know why I buy my seven year old son maths books that have the answers in. I don’t know why nobody I know likes Catch 22. I don’t why I didn’t make a statement. I don’t know why a broken body. I don’t know why a broken heart. I don’t know anything about dreaming about women. I don’t know anything about dreaming about men. I don’t know why my psychiatrist wants to see me. I don’t know why I’m paying £15 per month for a fucking contraption. I don’t know why I never want a baby in my womb ever again. I don’t know why I’m getting bigger. I don’t know why paper aeroplanes. I don’t know why 2 string blues. I don’t know why he taught them to me, sat on his knee. I don’t know anything about taxidermy although they’re running classes in town and I’m sure there will be some interesting clientele. I don’t know anything about suicide, and I don’t mean the band. I don’t know anything about Death, and I don’t mean the band. I don’t know anything about the seventies men in town with side burns and dogs that look like bears with orange eyes. I don’t know anything about the man who sets off power walking every morning, and walks all day long. I don’t know why they didn’t listen the first time. I don’t know why we had to clean up our own vomit. I don’t know why I was sick once out of my nose. I don’t know why my memory chooses to retain that. I don’t worry about why my kids put the toothpaste in the beaker cap side down. I don’t worry about the things people worry about when they are worried. I don’t worry about why the curtains caught fire. I don’t worry about the germs on shopping trolley handles in Asda. I don’t worry about another cantankerous man collapsing next to me in Asda. I don’t worry about the Asda woman who is now the gym woman. I don’t worry about Indie press poetry collections being filed under fiction because there’s no poetry section in the pop-up Waterstones outlet in town. I don’t worry about casting my vote. I don’t worry about laughing when you want me to. I don’t worry about the bit in Salem’s Lot when the vampire scratches his nails down the window pane. I don’t worry about grinding my teeth all day. I don’t worry about the parts of my body that are totally fucked. I don’t worry about the 70’s swingers print fleece throw on our bed. I don’t dream about easily achieved orgasms. I don’t dream about people who make me feel screwed up. I don’t dream the same dreams you described the day before. I don’t dream about inappropriate crescendos. I don’t dream about doing it all again for a second time. I don’t dream about being loved. I don’t dream about a house so big you’d never be able to find your way out again. I don’t dream about me. I don’t dream about the wilderness inside. I don’t dream about telling you this. I don’t dream about the wilderness without. I am telling you this. I am telling you all of this. I don’t know anything about telling you all of this. I don’t dream about telling you all of this. I don’t worry about telling you all of this but I do. I am telling all of you.
Yesterday I gave an interview to a trainee clinical psychologist for her thesis on parenting and bipolar disorder. I had been very nervous about it as I didn’t know what she would ask and what it might bring up for me, but it was a positive experience and it made me do a lot of thinking.
I thought I would write a little bit about what it’s like to have bipolar I diagnosis and be a parent. I have two children, one is thirteen and one is six, nearly seven. Both my children are doing very well at school, exceeding or matching grades in all subjects. They’re described as happy, kind, outgoing, capable and talented, at school. They are generally very well behaved and thoughtful, they have empathy and they’re creative in their own ways. Obviously, I am very proud, but I’m not trying to boast. When I said these things to the psychologist, I realized that despite this enormous issue: bipolar, we have all managed to get through it, and carry on.
The psychologist asked me about any difficulties parents with bipolar may face. There are endless difficulties. I said I thought being a parent with bipolar was almost like another form of bipolar in itself, as it has a whole other dimension. I’ve been a parent since I was seventeen, that’s thirteen years, and my eldest child has been through a great deal with me. When she was born I was very ill, depression mainly, and agitation. I also had racing thoughts and I self harmed regularly and habitually. I was suicidal. Basically I was going through a severe mixed episode. I fed her, cared for her in every way I could, but inside I felt so bad there aren’t words for it. This carried on for three years, then I was hospitalized and properly medicated, though I couldn’t say I had ever ‘recovered.’ At this time, I should have already been in services but had received a letter two years previous from my care co-ordinator to say she simply had too many people on her list and would have to pass me onto someone else, though she couldn’t say when this would happen. It never happened. This was gross negligence. The way I suffered during those years is not something I could wish on anyone.
When I was in hospital, my mum had to take care of my daughter. I was in for long periods of time, and when I would see her she would often go blank, and it was painful for both of us. She resented me for leaving her. I was ill constantly for all the years up to 2010, medications not working, and having my second child. After he was born in 2006 it was a downward spiral, and I felt it had no end. In 2010 I made a decision to commit suicide. I had an elaborate plan, and it would have been devastating, but I was in so much pain I felt I was being tortured and I wasn’t rational, and I couldn’t think clearly about anything other than going through with it. My psychiatrist had been writing up a referral to a specialist bipolar unit and having tried all the medications they had to offer I felt completely defeated. I wanted to give medication one last try, for my children, and thankfully, Depixol injections worked. They completely flattened my mania, my hallucinations, my agitation. Lithium has helped me to stop self harming, very effectively, and has stabilized my mood alongside lamotrigine which I believe has helped with depressive symptoms. I tell people I’m ‘stable’ but in reality it is a daily challenge and I have had to limit myself in so many ways to stay well enough to be a good parent. This past three years has been about building on all our strengths as a family, supporting each other and for me, keeping a routine and being focused on writing as my work and therapy. My psychiatrist asked me recently, do you think you’re a good mother, doing everything you can for your children? I could categorically say YES.
When I was manic my thoughts would race, colours and senses would be more intense, I would have a pressure to talk and talk, I would want to do lots of things and have lots of energy. My thoughts would be grandiose, and I would do anything for more stimulation, which for a lot of people would involve drink, drugs, sex or spending money, but in the case of a parent who has to stay and look after children, I would ring people on the phone incessantly to talk, about anything, I would pace around the house feeling insane; I would need diazepam, and at one point, I was taking so much of it I was completely hooked .My body would be restless, I would need to move, I would shake, and not be able to lie down or sleep, and I would self harm because I couldn’t cope with the intensity of it. I would feel as though I was crazy; I remember a psychiatrist asking me what I wanted them to do and I told him I wanted them to take the top of my head off. When you’re with a toddler, or a teenager, it is the same: they are so over-stimulating, especially when you’re stuck in a house with them (and to be honest taking them anywhere in this state isn’t a good idea), it is overwhelming. My husband has had to take lots of time off work in the past to help me cope. A lot of people don’t want to be around you when you’re ill so you find a lot of your support is cut off. In hindsight, it can be understandable, because you’re irritable, you say things you wouldn’t normally say, you become enraged easily, you snap, you can’t hide your emotions.
When I was low the problems seemed endless: being so tired and sad, not having any motivation, crying, sleeping too much or too little, ruminating, self-persecutory thoughts and voices, hallucinations (when very high also), feeling a void inside nothing will ever fill. Pure despair. You have to cook, clean, get them to school/nursery, sort finances, sort shopping, go to parent’s evenings, after school events, wash them, clothe them, play with them, give them affection; and you think of nothing else all day but your own death and how you might accomplish it, how everyone would just be better off without you, how your husband will meet someone nicer who will make a nicer mother for your children (yes, this is how irrational you’ve become), but you’re too lost and exhausted to try. Either high or low, agitation and psychosis is something that would cripple me, and often, my husband would have to medicate me on chlorpromazine, which is a very old anti-psychotic but the only thing that ever worked, and lorazepam or diazepam, and put me in bed. When I’d wake it would begin again, the tension mounting, the anxiety, the agitation, the breaking down.
These episodes don’t last days, and even when I was ultra rapid cycling and very ill (mood-swings lasting hours and changing very erratically) it would go on for months. You’re probably wondering how the children coped. I tried hard to be there for them, talk to them, be open with them, and not let them down. But I have an acute sense of failure and every time I so much as had to go to bed to lie down, I woke up feeling like I had failed them and I couldn’t stand it and it fed into my bad feelings about myself. I believe very firmly that children are entitled to know what’s going on and should be allowed to be upset as it is a normal human reaction, to a parent going into hospital, or mummy getting upset, or being drowsy, or not being able to play, or being irritable. I found that others tried to pretend everything was alright, and gloss over things or sugar-coat them, to protect them. This, I have always thought, is damaging. Of course, you don’t want to devastate your children or upset them, but their natural emotions and reactions are an important part of their wellbeing, and shouldn’t be stifled. There are ways to comfort children, and be open and honest at the same time.
I believe that there needs to be centres for parents with severe enduring mental health problems, where they can take their children, receive treatment, and be around others in the same position. We need this provision, it is sadly lacking, adult mental health services have a huge chasm because they don’t make provisions for families. They make provisions for families whose children are suffering from mental health problems, as they did for me when I was a child, but not families in general, families who may feel very isolated and alone. I think that every family who goes through a parent suffering from mental illness should be offered family therapy as a matter of course. I also think that specialist personal assistants should be used in mental health services, especially for families. Practical support given for people who maybe haven’t got the support they need and need help doing practical things, while they are unwell. I think this could be even more beneficial that therapy in the long run, keeping families together and parents at home. It could save a lot of money on lengthy hospital stays, children having to go into care temporarily. Not once can I think of an instance when being a parent with bipolar was catered for or treated as an important thing, for me. Even simple things like providing books and toys for waiting rooms in mental health clinics would make a difference, to people having to bring their children in with them. Otherwise, these places are blank, clinical and unfriendly. It’s almost as though professionals pretend your kids aren’t part of the picture, until they feel a need to involve child social services, which often isn’t necessary.
I recently took part in a computer-based bipolar support package, where I was filmed answering questions about parenting which would be made into a film which could be accessed online, to help other parents going through the same thing. I think this is marvellous, based at the Spectrum centre at Lancaster university. If anyone wants to know more they are on facebook. There are people out there trying to listen and make a difference, but as we all know, it all comes down to funding essentially, and I think we all know the situation there.
The psychologist asked me if there were any positives in being a parent with bipolar. Children are the best distraction the world has to offer. If I am agitated and I go walking with my son, who will talk to me about Spiderman and maths and Harry Potter, I feel ok, I get rid of some energy. We play scrabble, and although it is hard to stay focused, it keeps me focusing on something. We cook, we bake, we read books, we draw, we listen to music, we just get along. I have to stress that when it is severe none of these things are possible, but on a daily basis the children keep me in a good place with these distractions. My daughter and I have great conversations, about everything. I get so much joy from them, from seeing them happy, it is the biggest motivation I could ever have in my life. I write because I love them and want to do well at something in my life, and I stay reasonably stable, not just because of the medication, though it has helped enormously, but because I have them in my life and they are my purpose. The psychologist said she’s finding that a lot of people like me, as parents, are telling her similar things, that their children are flourishing, being labelled, ‘gifted and talented’ and are sensitive, kind and mature for their ages. I feel like I must have been doing something right, though obviously, these children have not been without their fair share of heartache over this. But I believe that children need experiences, and the emotional support and backing of their parent (s) or carers so that when they get older and things happen in their lives, they are prepared in part, and will learn quickly how to adapt and cope.
My daughter went to school one day and told the students and teacher in her Personal, Social and Health Education class that her mum has a mental illness. Later on, one girl sneered, oooh, your mum’s mentally ill! To which my daughter replied, ‘some people are. And?’
I’m listening to Radiohead in the car on the way to Liverpool…has the light gone out for you/ because the light’s gone out for me…I think of people I knew when I was ill and shaking and broken. I think they wouldn’t recognise me. I think of things I said or did five, ten, fifteen years ago and I cringe. I think of the work that I’m doing and how, if I edited it properly I would be left with 10 per cent of mediocre mumblings. I think of how often I have thought this. I think of how I wasn’t so anxious off anti-psychotics. I think of telling my husband who will tell me, again, that this started when our son was born, not because of pills and injections. I think of how he might be wrong. I think of how our son looked like he was turning blue even though he was really fine and just fast asleep. I think of all the women who made me feel inadequate because I couldn’t breastfeed anymore because they put me on the pills. I think of how my breasts are much smaller now, how they are redundant. I think of all the really real sad dreams I have about my brother-in-law and how even though I know he is very happy they trouble me all morning. I wonder who these dreams are really about. I think of my facebook friends and how I’d like to meet some of them in real life and how awkward it would be, for them. I think of how I’m too shy to post much on facebook because I have a neurotic fear of being exposed. I think this couldn’t be any more of a contradiction. I think of Shane because Radiohead is playing and the synchronicity of each of their album releases was insane. I think of the spectrum of emotions and experiences I had as a twenty-something and how different things feel now, how I’m insular and steeped in conscious and unconscious foreboding. I think of how I get on with people less and less, and how I smile more. I think about Carol at the clinic and how she saved my life and how I didn’t want her to, and how I’m grateful now. I think of songs I most associate with suicide. I think of Fresh Tendrils in my head and how that is my favourite song. I think of how Hell for me would be a closed room full to capacity of patterns and textures. I think of how this fear makes me visualize decay. I think of how the house might burn down because I’m not there to witness it. I think of things I’ll never be able to talk about. I think of how my husband knows these things exist. I think of our lad going around the house this morning with a pair of tweezers and a magnifying glass looking for stray bugs. I think of how Elizabeth worries I will get ill and have to go away again. I think of how I couldn’t promise her that will never happen. I think of how I know some truly beautiful people and how I am in awe of them. I think of how I never say the things I most want to in person. I think of the man who collapsed in Asda while I was singing The Perfect Needle to myself, how his teeth were all rotten and how we’re all going to die. I think of all the ways I might die. I think of executions. I wonder how my brain got so fucked. I think of Anne who is dying and the closest thing to a grandmother I have ever had and how I haven’t seen her in years for reasons that don’t really matter or make sense. I think of how she is sick and how I’ve missed her, and how I’m sorry. I think of how the dreams I have about my brother-in-law are really about me. I think of how this is the happiest and most stable I’ve ever been in my life. I think of how I’m glad the agitation is reasonable this morning. I think of how I’m nervous about the way I look today. I think of how I feel hideous most days and how this is pathetic in a world where disfigured people walk around regardless and get on with their lives. I think of how I feel disfigured inside, somehow. I think of how I don’t want to come across as self-indulgent. I think of how venomous a thought that is inside others. I think about how strange it is to go to Malaysia, blindfolded, and visually experience none of it, take lots of pictures and come home to see what you’ve missed, like the artist Pak Sheung Chuen did in 2008. I think of how a friend told me they’d rather lose an eye or a limb than have a mental illness. I think of how I’m sat in a French cafe with my husband. I think of how feelings of inadequacy permeate my day. I think of my too-small filter coffee and how good it tastes and how I’m drowsy and still wearing my coat and scarf. I think of Simryn Gill’s photographs of interiors and how I looked and looked for traces of anything warm or human, an empty cot for instance held my interest but how I as a viewer, felt abandoned, and how they seemed like a completely fathomless and cold apocalypse. I think of how I’ve lost the ability to play full albums in my head like I did on long journeys when I was fifteen. I think of how I’m sure all the pills have contributed to this decline in mental capability. I think of how ashamed I’ll feel if any of the parents from school read this, how there’s no reason I should, how I feel like a victim of societal repression, stigma, and my own self-consciousness. I think of how alienated I feel. I think of plunging my naked body into the sea, of freezing alive. I think of how remembering my dreams feels like clutching at vapour. I think of how unreal and unrealistic it is to accept advances in technology other people have created with themselves in mind, with money in mind, without knowing how they work or where their components came from. I think of all the people who don’t miss me. I think of all the people who are more valid than me. I think of all the people who are not more valid than me. I think about how my concept of validation is only reasonable in my head for a few minutes at a time and involves the occasional looks of people who don’t love me. I think of how my husband never wants to listen to what I want to listen to in the car. I think of the song Heaven by The Walkmen and how it makes him think of me, and how that makes me smile. I think about the plagiarist, Christian Ward and how I’d like to sit in a cold room with him for an hour and I don’t know why. I think of how I don’t feel sorry for him but how his audacity fascinates me. I think of how I’m amazed I’m thinking about it because I don’t really care. I think about my husband falling through the clouds. I think about him with perfectly formed, white wings. I think of myself as a harpy in the forests of the outskirts of my hometown. I think of how codeine helps. I think of how my brain feels like melting ice that freezes over without warning. I think of how that’s not very original. I think of how there’s not more to life than poems. I think of what a cold-hearted bitch I must be not to have cried for three years. I think about men on Death Row in Texas getting a glimpse of the sky on their way the their execution. I think of how maybe it is a primer for the afterlife, of Heaven and Redemption. I think of how insane this is. I think of how my husband and my daughter are committed in their atheism and how our six year old son believes in Heaven and how I don’t want him to be afraid. I think of how I used to dance in clubs and how I have a whole other body and sense of rhythm now. I think of how diazepam helps. I think of how I barely talk to anyone so it doesn’t matter what I think or what I need to say. I think of how The Pixies song I Bleed used to make me want to cut myself. I think of how before I took lithium lots of things made me think of self-mutilation. I think of how lithium dulls everything, reinforces apathy and inertia, dampens all the feelings that make you you. I think of how I wouldn’t dare not take it again. I think of how being overweight and having bad skin and no emotions is better than being dead or permanently in the agony of despair. I think of how many people have told me they don’t take medication because of the side effects, and I think of what it’s like to have a choice. I think about when I took that photograph that lit up the room and nobody wanted me to take it and I felt like an insult thrown back. I think about the swimming pool and the very hairy man who is always striding up and down and occasionally diving in and showing off all his hairy male-ness and how he must be giving someone a rash. I think about my boy tumbling in that time. I think about falling in sideways, a hundred times, hitting and hitting the pale blue surface of the water fully clothed, my mouth open. I hear the other mothers applauding. I think about how I’m empty inside and so nothing that anyone says to me can penetrate and I slump down in the deck chair and I feel my heart slow down. I feel my heart slow, slow. I think of how anyone reading this far must want more than I’ve got to give and will possibly see me in a worse light than ever. I think of how my father and I used to dream we were painting all the town’s houses primary colours in the night, how we both had the same dreams. I think of how my husband sometimes kisses me, like someone he hasn’t seen for a long while. I think of how he won’t understand why I’m writing this. I think I’m not sure either. I think of the girl stabbed and set alight in Blackpool. I think of all the screaming ones. I think of all the sad ones. I think of myself in wide, midnight dreams of nothing.
I’d just like to share a few thoughts about this letter from Dr Skogstad, who is the consultant psychiatrist at the Cassel Hospital. (NB. He wasn’t the man in charge when I was there all those years ago; I have never met Dr Skogstad.)
One of my feelings when I read and then re-read this letter was: this isn’t really a proper response to what I have written. Another feeling was: the tone is ostensibly polite but actually rather patronizing.
The most troubling aspect of it is: there is no acknowledgement that what I experienced at home was abuse. This is where I get the impression that the Cassel (and by extension, a lot of psychoanalytical psychotherapy) is actually lagging behind societal attitudes. I haven’t shown this letter to anyone except Melissa and the readers of this blog but my hunch would be, most people nowadays would recognize what I describe as abusive.
Linked up with this is the doctor’s failure to recognize that health professionals themselves can contribute to someone’s difficulties. By labelling very distressed teenagers in his care as having “personality disorder” while not giving that description to the parents who have abused them, he is basically saying that responses to abuse such as depression, anxiety, low self-esteem are pathological (i.e. abnormal) but that abuse itself is not pathological or abnormal. He is still operating a hospital where parents of teenagers are given a forum, as they were in my day, a forum that the more disturbed parents used in order to justify themselves and to manipulate the hospital staff. In short, the focus is still on Keeping the Family Together. (A family where the teenagers are this distressed, have attempted suicide often more than once, etc. is a family that has already fallen apart. If it was ever, in any real sense, “together”.)
His suggestion that the term “personality disorder” is not denigratory or pejorative in any way also marks this man and his hospital as out of touch. He should speak to a few more GPs if he thinks it’s seen as just another diagnostic term, and while he’s at it he should check what social workers, probation officers, the police think when they hear the term. The way the term is generally used it is taken to mean “untreatable” and, in many cases, “not to be trusted” and also “violent.” I don’t care for the insinuation in this part of the letter that I have somehow got this wrong: I have known plenty of people who are burdened with this often very unhelpful label. (And why is it unhelpful? Crucially, because it locates someone’s difficulties within them, as if that person is somehow fatally flawed; it pays no heed to the external factors involved. And abuse is a very important external factor.)
Freud famously decided that all the accounts of abuse he was hearing couldn’t possibly be true, that they were fantasies. It seems that some of his heirs are still swayed by him.
I have decided not to respond to the doctor’s letter personally.
23rd January 2013
Dear Ms Hamilton,
Thank you for your letter to my secretary and my sincere apologies again for responding only so late and only after your prompting. It seems that the Cassel has made a lasting impression on you, as you are thinking about it and making contact with us after such a long time. I hope that your time here helped you and gave you capacities and strengths that you could use in your life since. I also hope the reason you are thinking so much of the Cassel again now is a good one rather than another particularly difficult period in your life.
Since the early 1980s, when you were here, there have been numerous changes to the Cassel to respond to our research and to adapt to changes in the NHS and its increasingly harsher financial realities. However, the hospital is still there to help people with severe emotional difficulties and has retained many of its old principles. We are now much smaller than when you were here, but we do still treat adolescents, as long as they are over 16, together with (mostly young) adults. Structures have also changed and so we don’t have the particular meeting anymore that you describe, but we do regular family work with adolescents or young adults as part of their treatment and sometimes offer forums for parents or carers.
Like you describe about yourself, all our patients had a troubled and often very traumatic upbringing, which has formed them and has often made it difficult for them to get on with themselves and their own lives. When we call what our patients suffer from “personality disorder”, we are not using this in any denigrating way, as it is sometimes perceived and you seem to hear it. For me and my colleagues, it is a way of describing as a short hand deep rooted emotional difficulties that need understanding and appropriate treatment, usually through psychotherapy and other support. In fact, the term has in recent years also helped to instigate developments in different parts of the country to establish services for such people.
Thank you for your good wishes to the Cassel.
With best wishes,
Dr. W. Skogstad