Body Image: Hating Myself

My only respite at the moment is sleep. For those few precious hours each night I don’t have to be intensely uncomfortable in my own skin. I can be in my dream away from the itching, bubbling sensations I get in my body. I’m really struggling with body image at the moment to the point where I constantly envision myself tearing my skin off my body. Peeling off my thick thighs and flabby belly. I’m at war with myself.

Getting dressed each day is horrible, trying to find clothes that don’t cling to my skin. I pull clothes that have no shape on to hide my body but nothing quite hides me enough to give me any ounce of confidence to face the day. Worse than getting dressed is showering or bathing…having to completely take my clothes off is nauseating, not to mention the mirror opposite the shower. I have my shower scolding hot so that I can get the relief of a steamed up mirror and then on my way out I can do my best to pretend my body doesn’t exist.

When I sit down my thighs distract me, every reflective surface, every mirror, every shop window stops me in my tracks and brings in thoughts of disgust and utter hatred for the vessel my soul resides in. I want to hide under a blanket constantly, that way I can cover up my repulsive self. I fell out of love with me a long time ago.

I want to go back to ballet but I’m afraid there will be an actual elephant in the room and that elephant will be me. I’m not sure I could handle seeing myself in a leotard and pretty pink tights, I feel far too ugly for that. I want to see family and friends. I miss them an awful lot but I don’t want them to see me. I’m terrified they’ll see what I see, I don’t want anyone to see that. What if they comment on my appearance? I’m not sure I could cope with that. I wish I had an invisibility cloak, then I could go out and about without any worries.

I feel trapped… Trapped in my skin, trapped inside buildings, trapped inside myself and trapped in a body I absolutely despise and then comes the urges to attack myself. I declare war on myself. I self-harm and create scars as ugly as I feel, I go to sleep wishing I don’t wake up so that I never have to see my reflection again or feel how my body makes me feel.

Eating Disorders Awareness Week 2016

This week has been eating disorders awareness week and today is Sock It To Eating Disorders Day. I’ve been unable to blog during my 5 month (and continuing) stay on the psychiatric ward but I just wanted to bring your attention to this week with some blasts from the past.

My Fixers film ‘Sectioned’ focused on my experience of being sectioned for my eating disorder. I wanted to tell people about the reality of these illnesses and the difficulties that come along with recovery.

I think it’s important that people are careful when posting about eating disorder awareness on social media as sometimes people post their low weight pictures which leads to competition, triggering others but also reinforcing stereotypes. I wrote an article on this for The Huffington Post. You can read this HERE

You can also check out 101 things that no one tells you about anorexia HERE

Get your silly socks out, have fun raising awareness and if you can, donate to b-eat the eating disorder charity HERE

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?

Health Check Wales: Eating Disorders

I recently wrote a piece about eating disorders for Health Check Wales. Here is the article:

My battle with mental illness began at such a young age that I don’t really know what it’s like not to have one. But I can understand how it must be difficult for someone to understand it if their lives have not yet been touched by it. I’ve seen the stares, heard the comments and read the hate I’ve been sent over the internet. Being unwell is hard enough on its own without the added ignorance and stigma. I became fearful and anxious around food when I was five years old. After seeing a family member become unwell I thought that I would become poorly if I ate food too. As I grew older food became more of an issue. First it was about fear, then it was about perfectionism and control. I was seven years old and banging my head against the school toilet walls for getting a question wrong. By the end of primary school not eating had become my identity. Other children in my class were good at PE or art or maths. I was known for eating “like a bird” and I finally felt like I had a something that I could do. Secondary school complicated life even more. I was bullied, I didn’t feel welcome in any of the friendship groups that I tried to hang around with. I felt geeky, ugly and hated myself. I saw the bigger girls wearing gym knickers in PE and I was scared that I’d get big and be laughed at in my gym knickers too. I began to walk for hours before school, I’d barely eat anything and anything that was eaten would be thrown up. I was self-harming several times a day and overdosing at the back of class – and yet my school didn’t get me help. At this point I didn’t even know that I had a mental illness. Once I left school life became more difficult because with each sad event that happened in my life anorexia and depression seemed to grip their hands tighter and tighter around my neck. I became withdrawn and isolated myself from everyone. It’s scary how mental illness can blend seven whole years into one big blur of hospital admissions, detentions under the Mental Health Act, numbers, scales and suicide attempts. Growing up I wanted to be a nurse or a dancer, battling severe mental illness was not a part of the plan. Often eating disorders are on a spectrum and it is recognised that symptoms change. Someone who meets the criteria for anorexia may months or years down the line meet the criteria for bulimia, or binge-eating disorder. I have certainly experienced many different symptoms with my eating disorder. My primary diagnosis is anorexia. Many months of my life have been spent surviving – or dying – on very little food. I would eat so little food that my body couldn’t keep itself warm. I’d spend my day in the bath or leaning against a radiator. The cold that an eating disorder brings is different from the cold of a winter’s day. It is unbearable, painful and numbing. I’d see the number on the scale drop and the outfit options in the wardrobe became minimal as nothing would stay on my tiny frame, and yet the reflection in the mirror never changed. The girl I saw in front of me didn’t seem to be shrinking, and therefore any weight I lost did not feel like enough. I’m not sure it would ever have been enough. I was slipping towards death, not happiness, perfection or body satisfaction. Then comes the bingeing and purging. The uncontrollable binges that extreme hunger brings. I’d sit on the kitchen floor and eat and eat and eat. I’d work my way around the room, from the fridge to the cupboards, and sometimes, once the food had all gone, I’d eat icing and drink vinegar. I’d try to make myself sick but nothing took away the feelings of guilt and self-disgust, anger and fear that would be left behind for the coming weeks. I hate bingeing and purging and I hate the way I feel I have no control over it. I’ve tried to stop it by attempting to end my life in the past – that’s how desperate and horrific it has made me feel. I also struggled with abusing laxatives and diet pills. I would take far more than the recommended amount but the more I took, the more I felt I needed. I knew exactly the time to take my laxatives so that it would have an effect at night when my family were asleep. Every night spent in agony in the bathroom, sweating and biting onto a towel with pain. It was horrible. One night I took 20 times the recommended dose and I genuinely thought I was going to die. I was in so much pain that it made me sick. My body was weak and I was lying on the bathroom floor, convinced it was the end. I was admitted to hospital the next day and laxatives have not been a part of my life since. I’m still in treatment now and I still really struggle with my mental health. I’m on medication for depression and the other symptoms that affect me and I’m in Dialectical Behaviour Therapy for my eating disorder, which has helped me cope with the distress that an eating disorder can bring, as well as recognising when decisions are fuelled by emotions. Eating is still a challenge. Regular eating is not something I’ve ever really done and I struggle to eat regularly every day but I’m better than I was. Depression and mental illness still take over my life and there are days when the suicidal thoughts are a whisper in my head, but there are still days where the suicidal thoughts are loud and repetitive and I struggle to find a reason to carry on with my life. My hospital admissions are getting shorter and the length between them is getting longer and I see that as a positive sign. I recognise I’ve got a long way to come but I am already on the journey and I never thought that I would be where I am now. While I would never wish mental illness on myself or anyone else I am grateful for the lessons it has taught me. I’ve learnt that everything happens for a reason and the best days of my life have happened as a direct result of the worst days of my life. I spent a night in a police cell when there were no hospital beds available. I was law-abiding, not violent and very shy. That night was terrifying and traumatising and made me feel a lot of shame, but without that night I would never have appeared on national radio and news, live TV and newspapers like I have. I would never have started my blog or found my love for writing again. Without anorexia I would never have met my best friend in treatment, my recovery buddy, who I have shared many happy memories with at the beach, or at a restaurant winning against our eating disorders. I would never have been to London to speak at conferences and meetings. The help and treatment I receive from South East Wales Eating Disorder Service has been life-changing, and without their help I wouldn’t have achieved these things either.

Sectioned: A Spoken Word Piece

Last August I was sectioned under the Mental Health Act and spend two months in hospital. When I was discharged I decided that I wanted to do something with my life and turn a negative into a positive and so I began working with Fixers. Around the same time I noticed a lot of pro-ana and pro-mental illness posts appearing all over social networking and one comment that really stuck out to me was someone saying that they wanted to be sectioned so that they could have a hug whenever their sad. I was also shocked by the amount of comments about mental illness being fashionable and people likening the psychiatric ward to a big sleepover but that is not the reality.

I wrote a spoken word piece and used my photography along with Fixer’s filming and editing to create a piece to explain what being sectioned is like from a patient’s perspective whilst also targeting the groups in social media that aspire to be unwell. Being sectioned often feels like something I should keep secret and be ashamed of  so that’s exactly why I decided to shout about it publicly. There should be no stigma.

Feel free to share this video and spread it’s message.

STOP

STOP

My psychologist handed me a few of these cards yesterday because I need them. There are times when I don’t think, I just react and then I end up making the situation worse whether that be because I’ve shouted back in an argument or because I’ve hurt myself or spent money I don’t have.

I’ve stuck these in a few places where I am likely to see them at a time when I need them. They are in my self-soothe box and next to my computer and I’m going to save the image onto my phone too.

I think STOP skills can help everyone but I feel it is important to put this on my blog because I think both people with mental health conditions and those caring for people with mental health conditions could benefit from this. Don’t just read it, write it down and put it where you will see it. If you struggle with binge eating stick it on the fridge, if you struggle with spending then put it in your purse. Put it somewhere that suits you.

I Love My Body Because…

I love my body because it is mine. I am the only person to know what it’s like to be in my skin and to know each and every perfect imperfection and I think it’s pretty special to have something that no one else has got.

I love my body because it is my vessel and I travel around in it like we travel in cars. Sometimes it’s like one of those old bangers that keep breaking down but you still love it anyway because it’s got character and other times it feels like the latest model of luxury car and nobody can bring me down.

I love my body because without I couldn’t ice skate or dance, or be anywhere for that matter. I need my body as much as I need my heart and it should be given the same amount of respect. If my heart felt funny I wouldn’t ignore it so I will not shame my body for anything that it is or is not.

I love my hair because it gave me those memories of sitting on the floor whilst my mum plaited it and those hilarious photographs I look back on from when I decided to dye my hair outrageous colours. I love my hair because it is a part of the genetic mix up that I received as a gift from my parents.

I love my eyes because they allow me to see the beautiful world. Without them I would never have seen a rainbow or a waterfall. I didn’t need mascara on my lashes to see them because my eyes were enough.

I love my nose because without it I wouldn’t be able to smell freshly baked bread and neither would I be able to long for the nose piercing I’ve always been to scared to get.

I love my mouth and my wonky teeth because they enable me to smile, laugh and talk so that I can share my life with others. I love them because they allow me to eat watermelon and share pic n mix with my family at the cinema.

I love my arms and hands because they have given so many hugs and held my closest ones’ hands when they have needed it. My arms and hands are in constant use and they deserve some credit for that. I am using my hands to type this now, without my hands my passion for writing would dissolve.

I love my stomach because it protects my organs and keeps them cosy. My soft skin always feels warm on my stomach and my core gives me balance when I am dancing or skating.

I love my bum because it allows me to sit in my friend’s car and laugh until our stomach muscles ache. I love my bum because it sits on the grass whilst I make daisy chains.

I love my legs regardless of whether my thighs touch or not because they allow me to walk, run, jump and dance. They are my own personal mode of transport.

I love my feet because those five tiny toes grew into pointe shoes and danced and then they grew into walking boots and climbed mountains.

I love my body exactly the way it was made.

DBT: What Is It And How Has It Helped Me?

Recently I have had many people asking me on Twitter about DBT and it is really hard to describe it in 140 characters. My DBT folder is a good few inches thick and I’m not even half way through the treatment, there is a lot of information and so I decided to write a blog post about what it is and how it has helped me and could potentially help others.

DBT stands for dialectical behaviour therapy. I started DBT last December and my treatment involves attending a skills group every Monday for two and a half hours and then an individual session each week with my psychologist. I remember when I started DBT I just thought that it would be another treatment that would fail or that I would become too unwell and have to leave the treatment which has often been the case with me. I thought it was nonsense and it wouldn’t help me. Recently I have noticed that DBT is actually changing my life. I am still poorly and I still struggle but life is very different to how it used to be and I finally feel hopeful about the future. Everything has clicked into place, DBT has clicked into place and I’ve gone from thinking it was a waste of time to wishing that everybody had the chance to learn the skills that I am learning because they aren’t just life saving, they are life changing.

There are three modules in DBT, these are distress tolerance, emotion regulation and interpersonal effectiveness. There is also a strong focus on mindfulness with it being the foundation for all three modules.

What Is A Skills Group?

A DBT skills group is different to group therapy because behaviours should only be mentioned if it is to say that skills were used. The focus is on the positives, the times where skills were used and the skills there are to learn rather than focusing on the illness and behaviours. Many DBT groups are for those with personality disorders but I am extremely lucky that my Tier 3 eating disorder service offer a DBT group specifically for those with eating disorders.

At the beginning of every session we have skills feedback where each member of the group is given up to 5 minutes to talk about their effective skills use over the course of the previous week. For example coping with a stressful situation such as going out for a meal. We are supposed to have folders but being stubborn and hopeless I didn’t have one up until this weekend when I realised that actually DBT is doing something and the information I am being given is important.

The goals of skills training are to decrease relationship difficulties, intense and unstable emotions, acting on impulse and confusion about self and troubling thoughts whilst increasing interpersonal effectiveness, emotion regulation and distress tolerance as well as using mindfulness.

This is my DBT folder:

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Mindfulness

Mindfulness is all about being in the present moment. It’s about being aware of what is happening and what you are doing as well as observing what is going on internally and externally.

Mindfulness is not about your mind never wandering, mindfulness is about recoginsing that it is.

Mindfulness includes two sets of core skills. These are the ‘what’ and ‘how’ skills. ‘What’ skills are all about observing, describing and participating. ‘How’ skills are all about doing things effectively, non-judgementally and doing one thing at a time.

You can do almost anything mindfully including driving, eating, brushing your teeth, colouring and cleaning.

States Of Mind

The three states of mind that DBT focuses on are emotional mind, reasonable mind and wise mind.

Emotional mind is probably where most of us spend our time. In emotional mind our thoughts and behaviours are controlled by our emotions and therefore we can get thoughts that are unhelpful and distressing. It can be difficult to think logically and rationally when in emotional mind and facts are often distorted to fit with the current distress. In Harry Potter terms emotional mind would be Ron Weasley.

Reasonable mind is intellectual and scientific as it includes logical and rational thinking. Thoughts are based on facts and evidence and the person is able to plan how to respond. In Harry Potter terms reasonable mind would be Hermione Granger.

Wise mind combines both emotional and reasonable mind, it is the calm which follows the storm. Wise mind grasps the bigger picture rather than just parts. It ensures emotional mind is soothed whilst knowing that reasonable mind is correct. In Harry Potter terms wise mind would be Harry Potter.

The aims of DBT are to recognise emotional and reasonable mind and find wise mind to then appropriately address problems. Finding wise mind is not an easy thing to do and can take a long time to achieve. It is possible though. 100%.

Distress Tolerance

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Distress tolerance was the first module I did. It is all about getting through a difficult moment when you cannot make it better but without making it worse. For example if I am feeling upset about a situation in my life then I might restrict my intake in order to cope but that doesn’t get rid of the problem. In fact if we look at the bigger picture it has made the situation worse because not only am I upset about that situation but I now have to deal with the impact anorexia has on my life. Distress tolerance skills are crisis survival skills aiming to reduce suffering, not to get rid of the pain.

Wise mind ACCEPTS was the first skill we were taught. It’s all about distraction which is excellent but should only be used in the short-term. Wise mind ACCEPTS can be helpful to divert your attention from distressing thoughts. Choose things that grab your attention and keep you absorbed.

Activities: Such as baking, writing, journaling, nail painting, making an amazon wishlist, dancing, playing a game, collaging, colouring, reading etc.

Contibuting: For example blogging, tweeting, volunteering, making something for someone, look after a pet, smiling at someone etc

Comparisons: Be careful with this one, don’t make unhelpful comparisons. Perhaps compare yourself to a worse time and look at how far you have come.

Emotions (opposite): Create a different emotion by watching a comedy or fails on YouTube. Look at cute animals or baby photos. Find positive quotes.

Pushing away: Leave the situation behind for a while. Put it in a box and decide not to think about it.

Thoughts (changing): Change your thoughts by playing word games, doing a puzzle book, counting in 3s backwards, speaking another language or learning song lyrics.

Sensations: Focus on the five senses (taste, smell, touch, sound and sight) by using a stress ball, having a bath, using hand cream, listening to loud music etc.

Distress tolerance has a huge focus on pros and cons. What are the pros and cons of tolerating the distress? What are the pros and cons of not tolerating the distress? So basically what is good and what is bad about using skills compared to using behaviours?

Other distress tolerance skills include radical acceptance which is accepting what is happening at the time without making it worse or doing anything. There is also turning the mind which is all about turning your mind towards acceptance and willingness rather than willfulness.

I think for me the key parts I got from distress tolerance were self-soothing and distraction when distressed rather than getting angry or upset with people or harming myself.

Emotion Regulation

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Emotion regulation helped me to understand and name my emotions. Emotion regulation also decreases unwanted emotions and emotional vulnerability. These skills are important because they quieten the body, quieten behaviour, help to find wise mind and improve self-respect.

Emotion regulation takes a healthy perspective on emotions. We need to accept that we are emotional beings and that emotions are neither good or bad. It isn’t helpful to judge your emotions. Whilst it is okay to have an emotion, there is a difference between having an emotion and acting on an emotion. For example, it is okay to feel angry with your partner for lying to you but it is not okay to punch your partner in the face repeatedly because of it. Emotions are pretty good at convincing us they are permanent but they are not. Emotions come and go and get replaced by another emotion regularly. Emotions may feel like the truth but feelings are not facts.

Emotion regulation taught us to describe emotions. It gave us words that related to the emotion for example other words for anger are fury, rage, wrath and frustration. It also gave us prompting events for the emotion, for example seeing blood may make you feel disgust. It also focused on the biological changes relating to the emotion as well as expressions and actions and the after affect of the emotion.

Emotion regulation focuses on changing the emotion. Firstly it is important to check the facts. To notice and observe the emotion you are feeling and want to change, what event prompted the emotion, what your interpretations, thoughts and assumptions are. You should also ask yourself whether you are assuming a threat and/or a catastrophe and then think about whether your emotion fits the facts. If it doesn’t or if acting on the emotion is not effective then opposite action can be helpful.

Opposite action is acting opposite to your action urge. For example, the other day I had my sunglasses on because I wanted to hide from the world but realised this was coming from a place of emotional mind so then I took the sunglasses off. If the urge is to avoid then don’t avoid. If the urge is to attack then avoid or be nice.

Certain things in life can make us more vulnerable to emotional mind but there are ways to reduce vulnerability. The acronym ABC PLEASE can be used to remember these skills.

Accumalate positive emotions: In the short-term do pleasant activities that are possible in the moment. In the long-term make changes to your life so that positive events will happen in the future. Build a life worth living.

Build mastery: Do things that make you feel competent and effective to combat any helplessness or hopelessness you may be feeling.

Cope ahead of time with emotional situations: Rehearse a plan and prepare to cope skillfully with emotional situations.

PLEASE: Treat PhysicaL illness. Balance Eating. Avoid mood-Altering substances. Balance Sleep. Get Exercise.

Interpersonal Effectiveness

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I am only beginning the interpersonal effectiveness module now so I don’t have a huge amount of information on it. The aims of interpersonal effectiveness are to be skillful in getting what you want and need from others, for example getting others to take your opinions seriously or being able to say no to unwanted requests. Interpersonal effectiveness also aims to build relationships that are healthy, strengthen current relationships whilst also ending any destructive ones.

The three parts of interpersonal effectiveness are objective effectiveness which is about being effective in asserting your rights and wishes, relationship effectiveness which is about acting in a way that you maintain positive relationships and finally self-respect effectiveness which is about acting in a way that keeps your self-respect.

Myths can get in the way of interpersonal effectiveness, for example feeling like I don’t deserve to get what I want or need might make me not bother asking but interpersonal effectiveness gives challenges to these such as, ‘we are all equal and we all have the right to ask for what we want and need’. It is okay to ask for what you want and need and it is also okay for that person to say no but the person saying no doesn’t mean that you shouldn’t have asked in the first place.

Diary Sheets

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Everyday I have to fill in several diary sheets. I started off just filling in the standard DBT diary sheet which gets you to rate emotions, urges and behaviours from 0-5. However this has now been tailored to me so as well as filling in that sheet I fill in a mood and food diary and write down how much time I spend on myself in that day and what I have been avoiding that day. It is a lot to do every day and I spend the majority of my time thinking about it or recording things but that is a good thing because DBT is not one of those therapies where you only have to do it in the session, it can be applied to everything and should be used every day.

I understand that DBT may not work for everyone, the same as any other therapy or medication but I can honestly say with my hand on my heart that after a very lengthy battle with no signs of recovery or improvement I am on the road to recovery. DBT is changing my life.

Recovery: The Definition

I think recovery means different things to different people but something I felt compelled to write about was the idealistic view of recovery. I’m not sure where it came from but there tends to be this idea of recovery floating around that is unrealistic. I find that especially in the eating disorder world recovery is viewed as the sufferer returning to who they were before the eating disorder. As though the sufferer would wake up one morning and none of it would’ve ever happened.

Recovery from a mental health problem is similar to recovery from a physical health problem. If someone breaks their leg then that fracture will have always happened, the patient may get pain in that leg and perhaps in later life arthritis will develop. The patient has worn the cast and gone through treatment but that bone will always have broken. If someone has cancer and they go through chemotherapy and have the tumor removed and thankfully get given the all clear then they are in remission. They still had cancer, they still had to go through the physical and emotional hell that they went through and the patient will probably always have the fear in the back of their mind that the cancer could come back. They are not the same person. This is the same with mental health problems. A patient with bipolar may be stable but they probably have the fear in the back of their mind that they could have another manic episode. I’ve heard the questions and comments such as, “Are you back to normal then?” as though recovery blanks out everything that happened during times of illness.

My illness will have always happened to me. I am better in some ways but I am still really unwell. My illness has changed me because being sectioned for two months, spending a night in a cell and battling anorexia and bulimia for a very long time does change a person. I am not actively suicidal at the moment but I still have to look away when I see a train approaching the platform because I don’t trust myself not to jump in front of it. Whenever I hear a police officer’s beeping walkie-talkie it reminds me of being in a mental health crisis. These memories will always be a part of my life.

I don’t think recovery is about having a perfect, idealistic life where you smile and laugh and the sun shines and mental illness doesn’t exist. I think recovery is about stability and managing symptoms. It’s about living and feeling joy and excitement but also feeling sadness and sorrow when bad things happen because life is always going to throw sad things at us simply because nothing is permanent. Recovery is about living life the way YOU want to rather than your illness dictating to you constantly. Recovery is about looking after yourself and managing distress rather than hurting yourself. Recovery is about managing and not about having a perfect life.