The De-escalation Room

The de-escalation room has become a room I have spent many hours being restrained in. It’s a small room with a few soft chairs and that’s it. I just wanted to share what it feels like to be in that room.

It’s scary, suffocating, closed in. Utter panic runs through my veins and frustration bubbles, boils and overflows as the actions anorexia wants me to take are stopped forcibly. I want to cry and scream and shout and kick and sometimes I do. Overwhelming. Terrifying. Darker than dark. That’s what it feels like to be in there. Locked in.

But I understand it, I understand why I am there. It’s for my own safety and wellbeing I know but that doesn’t make it any easier especially when anorexia has taken over.

I’m in a scary place right now and de-escalation has become the place where I spend most my time. Sad really to think that life has come to this.

Doing Pirouettes From The Corner

Last night when I had my final feed for the day the nurse who was with me helped me to use imagery to get through it. We both did ballet and both love ballet so she got me to close my eyes and imagine I was in ballet class. In my mind I walked to the corner, watched the four dancers before me then did my preparation and off I went with my arms in second position spinning and spotting, spinning and spotting until I reached the end of the room. Then I watched the three other dancers that were after me before walking to the corner and repeating. I repeated this over and over again in my mind until my feed was finished and that’s how I got through it. Total imagery taking me away from a reality that feels unbearable.

If I Were To Get Well…

This week my psychologist and I spoke about if I were to get well and what it would look like and my fears around it and to be totally honest I can’t remember what it’s like to be well. It has been over a decade of illness and nearly two years since I came into hospital after a handful of shorter admissions.

If I really try to imagine it I imagine a ‘well’ life to be quite good. I wouldn’t be in hospital and I’d be at home again with my family and my dog. I’d bake and cook meals and snacks for myself, I have hoards of recipes saved for when I get better and I can’t wait to try them out. I would enjoy eating, an idea that seems incredibly alien to me right now. I would go to ballet and help out with the younger classes. I would go to the beach with my friends and laugh the night away at karaoke. I’d watch telly with my family and go to the cinema with my dad. I’d play on the 2p machines at Barry Island with my mum. I would have my freedom back and I could go on walks alone, just my iPad and me. I’d experience new things, new foods, new places. I would live instead of exist. I would be able to be an adult although that absolutely terrifies me.

Everything about getting well is full of uncertainty and it completely overwhelms me. I’m scared to eat again, it’s been nearly a year since food passed my lips and it terrifies me to think of the day I have to put it in my mouth again. I don’t even know how my stomach would physically handle solid food after so long. I’m scared of the taste and texture and ‘greasy’ feeling food gives me. I’m scared to gain weight, to be fatter than I am now. I’m scared that none of my clothes would fit me. I’m scared that being bigger would make me hate myself even more than I already do. I’m scared of the responsibilities that come with life, I’ve got a lot to learn, and I’m scared of the day another of my loved ones dies, it feels unbearable to think about my mother and father dying. I don’t even think I could handle my dog dying. I need to reintegrate back into society and that scares me, even the thought of standing in a supermarket aisle terrifies me at the moment because I am so used to these four walls. I also worry that I wouldn’t have anything to blog about. My whole social media outlet is centered by mental illness and if I were to get well then where would that leave me? I’m not sure that I know who I am without all of this and the thought of being an adult terrifies me. I might be in my twenties but I don’t feel ready for that yet. What would I do for a career, I mean I don’t even have A levels, would I have to go back and study? A recovered future is full of questions. If I were to get well then I wouldn’t have a mental health team around me, these people I have known for years will not be in my life anymore and that really scares me.

I want a normal life, a recovered life but I’m not sure that it’s possible and that makes me feel a bit torn when it comes to recovery. Part of me wants to really give it a shot but the other part wants to give up and die and I can’t say which side is winning at the moment although it is probably the latter.

Radical Acceptance: Making The Best Out of The Situation I am In

Radical acceptance is a DBT skill and it’s all about accepting the situation you are in and making the best of it. It’s a skill to use when the situation can’t be changed, for example after someone binge eats they cannot change that they have binged and the best thing to do is to radically accept you have binged and to use skills to cope with the binge rather than using more negative behaviours to cope such as purging or self harm.

Right now I am in a situation I do not like. I am frustrated that my choices have been taken away from me now that I am sectioned and it gets to me that I can’t do what I want to do like going for a walk or going to bed when I want to instead of having to wait for the medication round to get to me. It’s frustrating that I don’t have freedom and I find it suffocating that I have two staff members within arms reach of me at all times. I long to have five minutes alone, to use the toilet in peace, for some privacy when visitors arrive. It gets a bit much sometimes but I can’t change this. This is the situation I am in and I will be in until I go to a specialist unit in May. I have to radically accept that this is my life right now and make the best of the situation that I can. None of this is going to go away. I wish I had choices, freedom, privacy and alone time but I don’t so I’m radically accepting that this is how it is. When my visitors come we can still have a nice time without privacy. When they feed me I have to accept that this is how it is and I have no choice in it. Whilst this situation feels suffocating I have two people next to me that I can talk to about anything and everything and I should embrace that and use them. Things aren’t great right now, I hate the situation I am in but right now I cannot change it, I just have to make the most of it.

Panic Attacks

Panic attacks are a frightening experience and involve feeling faint, heart palpitations, nausea and breathlessness. These symptoms can become so strong that a person feels like they are going to lose control or even that they are having a heart attack and are going to die.

Panic attacks can be triggered by stressful situations, such as taking an exam or a packed tube train but they can happen for no apparent reason at all.

Talking about them can help, there are breathing exercises that can help calm a person down or using distractions like ‘I Spy’ on a busy commute or listening to music. Talking therapies and medication can also be very effective in managing panic attacks.

Music And Recovery

As cliche as this sounds, I can honestly say that I would not be alive if it weren’t for music. Music has got me through the good times, the bad times and everything in between. I will never forget getting up in my hotel room and listening to ‘I’m on top of the world’ by imagine dragons whilst getting dressed before my appearance on BBC Breakfast. I will never forget listening to Meatloaf in the car on the way to the airport before we flew to Rome. That’s the funny thing about songs they hold memories and that can be a double edged sword. Whenever I hear ‘moves like Jagger’ I am plunged head first into the memory of sitting in the lounge in a psychiatric hospital whilst a patient dances around the room. Hearing ‘cake by the ocean’ will always remind me of the cold,hard days spent in utter boredom in the secure unit. There are Ed Sheeran songs that remind me of ex partners and no matter how much I like Ed Sheeran, I cannot hear these songs without feeling like complete rubbish. Music can be therapy but there is also a danger of music being harmful to the mind so be careful.

So, music and recovery. I use music at the moment to get me through my feeds as I’m currently being treated for anorexia nervosa and am being fed through an NG tube. I have a specific playlist named ‘Feed’ which consists of:

  • I’m yours-Alyssa Bernal
  • Boom clap-Charli XCX
  • Recover-Chvches
  • Learn to live-Darius Rucker
  • Starman-David Bowie
  • Survivor-Destiny’s Child
  • On top of the world-Imagine Dragons
  • Cold in Ohio-Jamie Lawson
  • Living in the moment-Jason Mraz
  • Breathe in, breathe out, move on-Jimmy Buffet
  • Little me-Little Mix
  • Scare away the dark-Passenger
  • Superheroes-The Script
  • Let it go-Demi Lovato
  • Heroes-David Bowie
  • Chocolate-The 1975
  • Love my life-Robbie Williams

All of these songs I either find relaxing, recovery focused, feel good or they hold positive memories. I find feeds really distressing and I know a lot of recovery can be distressing, that’s why in DBT there’s a whole module called ‘distress tolerance’. For me, music is my distress tolerance. ‘Cold in Ohio’ always relaxes me whilst ‘living in the moment’ reminds me of mindfulness. ‘On top of the world’ is a proper feel good song and also reminds me of the positive memory when I went on BBC Breakfast. ‘Little me’ gives me the reminder that I want to make 4 year old me proud. Maybe I won’t be able to listen to these songs again once all of this is over but for now they are getting me through and that’s what recovery is about, getting through.

I Need You to Know That I Have a Personality Disorder

I need you to know that I have a personality disorder, it is the diagnosis that I don’t speak about publicly and rarely talk about to anybody because I’m scared that telling you what I have will make you think I am a bad person. I desperately need you to understand what life with a personality disorder is like. It isn’t an excuse for the way I behave, it’s an explanation.

My personality disorder makes any kind of relationship difficult. No one seems to stay long in my life and I often find that I am ‘too much’ for people as I am vulnerable and dependent. I feel inadequate a lot of the time. I struggle to fit in and often my efforts lead to me embarrassing myself. I have powerful relationships and a lot of love to give but they are full of terror and fear. I fear abandonment and rejection so much that it normally leads to the relationship breaking down. Being close to me is a challenge and I find myself constantly asking for reassurance in relationships but in the end the mistrust and need for reassurance pushes the other person away. The slightest change in a relationship feels unbearable. I find it hard to believe peoples’ excuses for not seeing me and I take it as rejection. I often end up attacking those who are close to me ensuring the very abandonment I fear. I can’t control myself. I’m like a tornado destroying everything in my path. Personality disorders are destructive. Never think that I don’t care about others, my struggles with relationships make me think I should be alone forever and stay away from everybody. Self-hatred is always with me and the hurt I’ve caused plays on repeat. I’ve lost so many people because of my personality disorder and it’s agonising.

I struggle with my identity, I don’t really know who I am, and neither do I understand myself. Things can change dramatically one moment to the next. In two minutes I can go from being full of hope to completely hopeless. I can be motivated to change the world one minute and the next not have the motivation to wash myself. I am impulsive which leads to me spending money I don’t have and getting into a financial situation that I need help to get out of. I struggle with bursts of anger that take over me and often lead to me self-harming. I struggle with suicidal tendencies but no wonder death is appealing, my world is very confusing and painful. The mood swings, paranoia and delusions on top of the confusion and anxiety in relationships is exhausting. I’m terrified of the future, what if I’m always like this? Will I ever be able to have normal relationships and get married and have a family? Will that ever be a reality for me?

I can explain my personality disorder to you but I can’t make you understand it. I just hope that somehow this piece of writing helps you to understand how complicated life with a personality can be and I hope that the people in my life that read this can give me their time and patience to remain in my life.

Section 3

I’m sitting on the end of my bed in hospital. Numb but in pain. I don’t understand anymore. Utter confusion. Dreaming of a future like a child, imagining I’ll be a vet or a teacher but seeing reality like an adult…I am just a psychiatric ward patient….I probably don’t even deserve the word ‘just’ in front of that. I’m a nothing, a no one. Three months locked away has completely detached me from the world around me. I belong nowhere and with no one. The world outside the window doesn’t feel like mine. It’s like I don’t remember what the rolling hills look like, nor the supermarket aisles or petrol stations. My ballet shoes disintegrated when my life turned into compost. Maybe new flowers will grow out of the soil but I doubt it. It feels like I’ll never feel the sun on my skin again and that my heart will never vibrate with the bass of loud music. Will I always be gone? Will I ever find me again?

States of Mind: Emotional, Reasonable and Wise Mind

In DBT we looked at states of mind and I found it quite an interesting and helpful concept. The states of mind are emotional mind, reasonable mind and wise mind (Linehan 1993).

Emotional Mind

Often we are in emotional mind when we are perhaps very excited or very angry. Maybe it’s a special event or celebration or you’ve had an argument with someone. When we are in emotional mind our thoughts and behaviour are controlled by our emotions, our thoughts can be unhelpful and often distressing. It can be quite difficult to think logically and rationally. Emotions drive opinions and strong emotions can drive strong behaviours such as drinking, self harming, binging or exercising which may help in the short term but in the long term these behaviours may actually become the problem. Sometimes the facts can become distorted in order to fit in with the current distress. Emotional mind often leads us to do what we want to do.

Reasonable Mind

When we are in reasonable mind our thinking is often logical and rational. Reasonable mind is based on factual thinking with evidence. When in reasonable mind we are able to plan how to respond to a problem, however it is possible when in reasonable mind that we may come across ‘cool’ or ‘cold’ when approaching problems. We may be in reasonable mind when we are at work. Reasonable mind often leads us to do what we should do.

Wise Mind

Wise mind integrates both emotional and reasonable mind and is often the best way to approach a problem because it both recognises the emotional distress but also knows the facts. It often means viewing the bigger picture rather than just seeing little parts. Wise mind ensures that both emotional and reasonable minds are met, reasonable mind is right but emotional mind needs to be soothed. An example of when a lot of people use wise mind is when they are helping a friend, or dealing with someone else’s problems but it is important we address our own problems with wise mind too. Wise mind looks at what is appropriate and effective for the situation.