The Looking Glass – Identity on the Borderline

The Looking Glass - By Charlotte Farhan

The Looking Glass – By Charlotte Farhan

When identity is unstable life can feel as if you are staring through a mirror wondering what the “other side” means ?

Like Alice who questions the world on the other side of the mirror’s reflection – before stepping through and entering an alternative world; our concept of self is greatly developed from infancy through our interpersonal interactions and mirrored back through society.  Suggesting that we have a tendency to understand ourselves through our understanding of how others see and judge us; this is thought to be how we develop and understand our own identity.

As a child we learn how our crying, smiling and silence elicits a response from our caregivers, this forms our first mirroring and understanding of how we are perceived and responded to. This continues throughout our interactions and learning.

“The thing that moves us to pride or shame is not the mere mechanical reflection of ourselves, but an imputed sentiment, the imagined effect of this reflection upon another’s mind.”

(Cooley 1964)

(The looking-glass self is a social psychological concept introduced by Charles Horton Cooley in 1902 (McIntyre 2006). The term “looking glass self” was coined by Cooley in his work, Human Nature and the Social Order in 1902.)

There are three main components that comprise the looking-glass self

(Yeung, et al. 2003).

  • We imagine how we must appear to others.
  • We imagine and react to what we feel their judgement of that appearance must be.
  • We develop our self through the judgements of others.

As a person who has Borderline Personality Disorder (BPD) – identity is something which has always been an issue for me and so many other sufferers. My entire life seems to have been an identity crisis and it is one of the 9 traits you have to have in order to be diagnosed with BPD.

The specific issues which concern the stability of self in BPD sufferers is exhibited in:

  • Fragmentation – Which is in no way as dominating or persistent in BPD as it is in Dissociative Identity Disorder (DID), however it still causes many issues. BPD can make it so you have adaptive personalities depending on who you are with and what scenario you are in – which to some extent most people do. BPD however causes this to be such separate fragmentations of the self that it is disturbing for us – the sufferers, to a degree it damages our personal relationships, careers, idea of self, family life and integration into society. It also affects our memories and association to people and places as our identities can separate what is dear to one “personality/self” over the other.
  • Boundary confusion – Also known as boundary dissolution is the failure to recognise the psychological distinctiveness of individuals or a confusion of their interpersonal roles. Boundaries are believed to be established in childhood within the family setting, when roles are clarified such as who is the parent and who is the child, with a flexibility to create close bonds and also have a separateness allowing you to build your “self”.

Kenji Kameguchi (1996) likens boundaries to a

“membrane” that surrounds each individual and subsystem in the family. Like the membrane around a cell, boundaries need to be firm enough to ensure the integrity of the cell and yet permeable enough to allow communication between cells. Overly rigid boundaries might constrict family relationships and limit family members’ access to one another (e.g., “children should be seen and not heard”), whereas overly permeable or blurred boundaries might lead to confusion between the generations (e.g., “who is the parent and who is the child?”

[Hiester 1995]).

  • Lack of cohesion and continuity of the self across situations and life history – Most individuals who have secure identities do so because they remember themselves as the same individual they have always been. Noticing the changes one experiences with age, experience and gained knowledge, developing their core identity through life’s stages. BPD doesn’t allow for this due to the fragmented self which has been present throughout our lives, causing perceived gaps of identity knowledge and incompatible memories. Timelines become confusing when remembering what past events mean in regards to identity.

“I don’t know who I am”

“I don’t know what I want”

“I don’t know how I should handle this situation”

These questions seem harmless to most – however when you have BPD these questions are so confusing that emotional stability is compromised and becomes dangerous if we are not supported or receiving some kind of treatment. These questions are second nature and the answers come to mind with a certain amount of ease when you do not suffer from psychological identity issues – something taken for granted by most.

When you have BPD you are seen by different people as polar opposites at different points in your life or even at the same time, such as myself; I am seen by many in my life as a self righteous, egocentric, judgemental, scary, aggressive, rude person. However I am also seen by many as an inspiration, kind, loving, empathetic, polite, selfless person. Many people without BPD may encounter this kind of reaction from certain people, contradicting what makes you, you. This doesn’t phase well adjusted stable personalities as they know who they are and realise they are probably a combination of things to different people due to differing interactions and other peoples personalities. With BPD this causes self annihilation, an instability of emotions and further fragmentation and less awareness of the self.

“who do I believe – me or me or you”

In truth – at times I feel as if my identity is a game of guess who; or that this confused dissociated state is in fact a malevolent monster controlling and interchanging me – to torture me.

Friends, family and people who have crossed my path along the way will have no idea to a certain extent that these different identities exist within me or at different times in my life. The ones who remember are those who I have split, those who got to meet the protective identity, the no empathy, unforgiving, hateful identity – who has kept me alive in times of pure distress. These people have gone from being idealised to then being devalued and thrown away. The hardest part is being aware of this, of others being more aware of this – knowing I can rip you off the pedestal in which I created for you at any time just because you reveal to me that you are in fact human and fallible.

Sometimes the mirror reflects back that no one really knows me, so in turn I can’t know myself – which then brings about the depersonalisation and not feeling as if I exist at all.

The looking glass is the perfect metaphor for how this feels – knowing one reflection is in one world and another in the next. Feeling unreal or full of identities fighting to be seen or wanting to hide. Not knowing when in front of the mirror – who will reflect back.

 


References 

Hiester, M.”Who’s the parent and who’s the child: generational boundary dissolution between mothers and their children.” paper presented at the biennial meeting of the society for research in child development, Indianapolis,1995.

Yeung, King-To, and Martin, John Levi. “The Looking Glass Self: An Empirical Test and Elaboration.” Social Forces 81, no. 3 (2003): 843–879.


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This is how it feels to be the child of a suicidal parent

There hasn’t been a day since being 11 years old that I wasn’t prepared for my Mother to die. There is no scenario in which my mind has not investigated or planned; from her funeral, what I shall say, how I will feel, who will judge me as the cause of her death. This is not due to a macabre obsession or a morbid wish, this is how it feels to be the child of a suicidal parent.

My Mother has Bipolar Disorder, she was diagnosed when I was a toddler after seeking help because she couldn’t connect with me and feared she didn’t love me. My awareness of her illness was not completely realised until attending secondary school, before this point my Mother was a workaholic and never cried, she was a passionate, opinionated, clever woman who people loved to be around, the life and soul of most parties and fancied by most men. Always doing what she wanted when she wanted and never apologised for living her life. Even when she would drop me off to friends so she could meet men on trips away or when she made fun of my weight or told me I was too sensitive or too serious – my adoration for her was impenetrable, thinking of her as the best Mother in the world and wanting to be just like her.

However my Mother had a sever break down. Suddenly this vibrant woman was in bed, unable to get up, dress herself or wash, her room was dark and filled with cigarette smoke. This made no sense to me, I did not understand why she had changed; it was like Invasion of the Body Snatchers – this wasn’t my Mother. Suddenly she was crying all the time and she didn’t want to do anything, she would watch daytime TV in bed and would be surrounded by books, paper and food wrappers.

Life hadn’t been easy up until now for many reasons for both of us, having experienced depression and loneliness at the age of seven, this new darkness took it’s toll and this was when I started self harming. After seeing a program on a TV talk show about self harmers, after hearing of how these people felt the pain go away and that they actually felt even better whilst cutting, this seemed like the ideal relief. Knowing my Mother had lots of books on psychology and psychiatry I asked her if she had anything on self harm and said it was for a school project, (which for the early 90’s would have been very progressive). My Mother found me a book on self harm and I took it to my room and started to plan my first cut.

A few weeks later I caught my Mother in the bath weeping and cutting herself with razor blades, a mess of tears and blood through the crack of the bathroom door. Shocked that she did it too, shocked that she was in pain and devastated that I had possibly caused it or was going to cause more. In hindsight this is when my Mother and I truly severed our relationship, it was the beginning of the end, even though we were almost on the same page, my need for a parent and stability and her need to be alone and have no responsibilities was like a knife slicing our family tie.

Soon after this my Mother tried to kill herself and she was admitted to a psychiatric hospital, I was left at home alone with our 18 year old lodger (who was very unwell herself) and was allowed to do what I wanted, structure and adult care went out the window. Upon turning 12 I stole some sleeping pills from our lodger and tried to kill myself, instead of dying, sleep was all that was achieved for almost two days and awaking to the realisation that the darkness still existed, there were still no adults or safety.

From this point on, again and again, my Mother tried to kill herself or self harmed to the point of needing hospital treatment. This is when preparation for the inevitable was my only solus – her death. Having lost my best friend to suicide and many other friends; suicide became such a possible outcome that I started being unable to determine when my Mother was actually in danger.  She would say “If I didn’t have you I would die” or “I want to die – there is no point”, always reminding me of how much I didn’t understand, how no one understood – when all the while I understood more than she knew.

After several hospital admissions, 17 ECT sessions and continued private therapy from her psychiatrist on Harley Street in London, it was clear my Mothers condition was getting worse, no cocktail of drugs seemed to help and the bipolarity of her disorder caused havoc on our lives. My Mother experiences mixed states with her Bipolar Disorder which cause her to be irritable, to have high energy, racing thoughts and speech, and over-activity with agitation and becomes an even higher risk of suicide.

This effected me as a child and teen and still does now as an adult. The instability of her impulsiveness, her recklessness and her allowing me freedoms that other children envied, which I did not like or want, I envied the children who sat down for dinner, who had curfew, got money for chores, did homework with their parents, had rules; whose parents wouldn’t discuss anal sex with your friends or discuss their many sexual escapades. In mixed states of mania she would become aggressive, argumentative and so unkind that this emotional abuse still causes me sever pain till this day; name calling, screaming, mental abuse and belittling me with the advantage of not remembering what she had said or done when she was feeling “better”.

There is one act which however hard I try – my mind cannot understand it. When I was raped at 15 and hospitalised as suicide is all I wanted, my Mother made my rape about her and ended up abandoning me and admitting herself to a private hospital (with room service, massages, ice cream) whilst she had stopped my private health insurance (as you do) so I had to go into a mixed boy/girl NHS adolescent unit situated on an old Victorian asylum ground. How could my Mother consider suicide when her baby had been violently raped, operated on due to the rape and then hospitalised? The doctors would ask me how I felt about her doing this, I would always protect her regardless of the fact I was so hurt and felt so unloved.

At 17 she became physical with me on the day I was moving out as I could not take living with her anymore, this truly became my only option to survive, she began to shake me, she slapped me and then she tried to push me into a single pane glass window on the fourth floor of our apartment building. In amidst of this she was shouting at me that I was a whore and that I had probably made up my rape. My boyfriend (who is now my husband) had to pull her off me and at the age of 19 had to confront her with some very stern words and managed to get me out of there.

Another aspect of her mixed states is that of mass overspending which she has done to the extent that all our family money is gone – to be fair my Father contributed to this too with his mental break down. However my Mother seemed to have plenty of money to buy Louis Vuitton bags and accessories, take long haul trips and buy expensive cars, but when money started to get tighter and tighter as the money became less and less, she became selfish and from 17 to 22 let me be homeless, go hungry and I had no access to medical care or dental care, I was very unwell at this time so needed a lot of extra support – but her need to keep up appearances and maintain some of her luxurious lifestyle came before my needs. Anyway it was my own fault after all for being a bad child.

My Mother withdrew from life, hers and mine and as a consequence her sadness took over our relationship and her own guilt for how she has treated me – chokes her just enough to say what a terrible Mother she was or is, something which makes me want to protect her, deny and tell her all is fine, I am fine and she is fine. But her withdrawal made me withdraw from her more an more emotionally, so to not get hurt when she eventually kills herself. Hugging her is painful, when she cries I want to stuff a sock in her mouth – when she complains about her life I want to be anywhere but near her.

Loving my Mother is not hard, liking her is impossible at this point and wanting to have a relationship with her is damaging. However the feeling that at any moment I shall get a call telling me she has died is always there, the preparations are always in place and the guilt consumes me. The illness, the Bipolar Disorder is not my Mother however her core personality and ability to care and love for me is a mixture of narcissism and emotional blackmail.

Who knows what will happen with our relationship, all that is evident to me at this point is for anything to be possible with regards to my Mother is a question of recovery and acceptance. Not forgiveness, we do not need to forgive abuse, however accepting it happened, and that it was not my fault is probably a better focus than my obsession that she will take her own life.


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“I am Fine” the mantra of unseen illness – By Charlotte Farhan


I am fine….

I AM FINE!

I. AM. FINE. picsart_02-16-06.14.31.jpg

However which way I say these three words they are always a lie. Not a vicious deceitful lie, but a lie which serves me well whilst simultaneously crushing me emotionally; with each utterance. This little sentence has become a habitual response to the question:

How are you?

Which is a very common occurrence, most people do not divulge their entire life story when asked how they are, it is just an extension to how we greet one another, a politeness (especially in England) to reply:

I am fine, thank you. And how are you?

However when you are really asked this question by a close member of your family, your partner, a close friend or even your therapist and you still only ever say:

I am fine. picsart_02-16-06.02.22.jpg

Well this kind of situation is what I am talking about and is what this art piece represents. This is about how self preservation means losing part of your identity, emotionally but more importantly the denial of your present state. Never allowing your armour to be compromised, focusing on other peoples problems and absorbing them, when asked about yourself you divert conversations as if they were on-coming traffic; as if your life depends on it – because it does.

The majority of the time I do not look “sick”, I have mainly unseen illnesses and my most debilitating of ailments is completely invisible to the eye. As well as this many people do not “believe” in mental illness or recognise certain neurological conditions, saying things such as:

It’s all in your head!

It’s mind over matter.

You don’t look sick. picsart_02-16-06.05.19.jpg

These statements are very unhelpful and also redundant in this context. Saying it is all in ones head is a correct statement, mental illness is in our encasement’s which we call heads, in our brains – our minds. It is not in our legs, nor our arms, it is very much a head thing. However saying it to someone as a dismissive statement is not a logical statement as it suggests that your mental illness or neurological condition should not be “in your head”. Suggesting that it maybe make believe or a lie to gain sympathy (which if you are a person who suffers from mental illness you will know this is an insult as there is no sympathy granted to the mentally ill, instead it is stigmatised). As for “you don’t look sick” this one is nothing more than an ignorant judgement, looking at someone with just ones eyes and not a full body CT scanner (which also can not see everything) there is no way to determine someones health or disability status.

Due to all this added conjecture to this particular scenario , it is not hard to understand why the “I am fine” mantra is a fail safe for so many. You get tired of explaining yourself, defending your diagnosis and dealing with people saying things like:

I don’t really believe in mental illness.

Mental illness is a conspiracy to control and label us.

Mental illness is just mental weakness.

i-am-fine-2-by-charlotte-farhan

So the simple solution is to pretend that you are fine, that you do not need help, that you are not “weak” or “dangerous”, for every mental illness denier there is another person who believes we should all be locked up and not trusted due to the stigmatisation and misinformation on both the mentally ill and those with criminal intent.

This may be the simplest of solutions but it comes at a cost to most. You see there is only a finite amount of space in ones emotional storage unit and the continuous throwing anything and everything that you wish to hide in there can mean that you reach a time you can’t shut the door anymore, let alone lock it. This can lead to you bursting and spilling out onto everything around you or it can mean you just implode – self detonate.

Truthfully for me it is a constant battle inside my head, of not wanting to alienate people or scare people with my overwhelming emotional instability and behavioural abnormalities – having to remain stoic by being the person who people come to, the provider, the rescuer. Against letting it all out, a completely “no shits given” attitude, a liberating freedom of being able to just be me, all parts of me at all levels of intensity. This of course is very black and white and a thought process due to my borderline personality disorder, the middle ground does not tend to exist in my world, it sometimes appears but rarely when experiencing high emotions. To pass off the “strong” persona I have to use the “I am fine” line a lot, which is a kind of middle ground, at least it is when one is trying to manage social boundaries and interpersonal relationships – which to me are like alien concepts that cause feelings of being an outsider.

Charlotte Farhan

There have been times in my past when “I am fine” was a defence mechanism as I was in denial about my illnesses and wished to hide the entire idea from myself, blaming my emotions and behaviours on alcohol, drugs and being a “bitch”, that crazy girl thing was easy to flip and present myself to the world as a “bad” person in my twenties – so I stuck to it. People even liked this persona, some celebrated it by telling me they loved my “fuck you attitude” and loved to see me being abusive to others or violent. If the other side, the vulnerable side – was presented (which was me during my teens, from 11 yrs to 20 yrs old) people looked at me as an emotional drain, a liability, dangerous, scary, I became an undesirable human. At these times of no control self harm, suicide attempts, eating disorders, psychosis, machiavellianism, disinhibition and an emotional sensitivity that was never-ending was my way of life. I learnt valuable lessons on survival and how to mimic other humans as a visiting entity from the planet “strange”, using manipulation to gain friends and taking on other identities which were visible to me as ideals, I could be the most popular person in the room or the most disliked, this was not up to my audience or friends, this was up to me and my chameleon like personality. The important thing is I have forgiven myself for being this way, knowing now this was and still is a neurological condition and a perfectly OK way to survive when you have only ever known trauma.

picsart_02-06-06-17-09

Now that I am in my thirties things have got to a point that my life is more introspective and having the perspective of an “adult” allows me to look at my teens and twenties more objectively and see how and why I had to survive this way when there were no adults parenting me and keeping me safe. Being an adult in this way means that when I look back I ask different questions than I did before, such as:

Where were your parents?

How long were you left on your own?

How was it looking after yourself at such a young age?

Did you have to grow up quickly?

There is a draw back to being older however, my emotions get buried deeper, I detach more and say “I am fine” even more than ever. Wanting to be liked for me, not wanting to buy friends or manipulate them to like me, not wanting to be the extreme me who needs someone to safeguard them at all times, not wanting to be the rescuer and the “strong” one all the time. Wanting people to understand my pain more, I want and need actual medical support for my disabilities but am not at a vulnerable age anymore, so am taken less seriously. Hiding in medication and being likeable and not too intense feels like a life sentence:

But still all I can say is:

I am fine!

 


i-am-fine-by-charlotte-farhan


 

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Growth – Art and Short Story – By Charlotte Farhan

Growth By Charlotte Farhan

Growth By Charlotte Farhan

 

Growth – A short story by Charlotte Farhan

 

Hope was a young woman who carried around sadness, as if it were a suitcase of old belongings she had lost the key for a long time ago. Hope wanted to be free of this baggage that weighed her down each day; wishing she could take flight as if she were a bird heading for warmer weather.

One day Hope felt a pressure in her head as if something was trying to escape, it pushed at her temples and made her ears pop. The feeling was excruciating and left hope feeling overwhelmed and scared. Suddenly something was in her mouth, it had made its way up her throat and was now sitting on her tongue as if it were a pill waiting to be swallowed. Instead she went to the mirror apprehensively and opened her mouth and stuck out her tongue, to her disbelief a perfectly intact leaf sat there, she reached into her mouth and carefully took the leaf out to examine. It was an ordinary leaf, from a tree or plant and it was a glorious green. Hope was very much perturbed by this turn of events, feeling very tired suddenly and still suffering from an intense headache, the only thing left to do was go to bed.

Upon waking the next morning after what felt like a years worth of sleep, Hope opened her eyes and could only see green; she wiped them and blinked repetitively, hoping it was just a dream. As the green came into focus she realised that she was surrounded by branches and on those branches grew leaves like the one she had found in mouth the night before. Hope was unable to move as she was in so much disbelief regarding these events before her. In an attempt to move her head in order to sit up, she felt trapped; her head was heavy and felt as if it was tied to her bead posts. Hope reached into her bedside cabinet and blindly hunted for a small hand mirror she knew was there, finally she found it and opened it up to see what was holding her down. When hope looked at her reflection she did not trust what she could see; it was surreal. Hope had somehow – overnight, grown branches out of her head, there was no blood or pain and the tree looked the healthiest she had ever seen a tree to be.

Hope was able to free herself from her bed and navigate her way to her bathroom, she washed her face and brushed her teeth, rustling around as the leaves touched. It was a struggle to get dressed as her head weight pulled her down – if she was not careful, but eventually she was ready to go outside. Hope lived in the middle of nowhere and had acres of land beyond her garden. This was a relief to Hope as the idea of seeing anyone right now filled her with dread as she didn’t know how she would explain her appearance. The aim she had in mind was to go to the woods and see if she could find a matching tree and maybe this would bring about some sort of explanation.

Hope ducked under her door frame and stepped outside into her garden, she looked around and the world seemed the same, nothing obvious had changed so she proceeded down her path to her gate. As Hope closed her gate and looked back at her little home she felt a sense of loss but couldn’t put her finger on why she felt this way. With no further thought she walked toward the woods and was determined to find answers.

The trees looked dense and there was a darkness – that you would think would fill you with fear, however it was inviting. As Hope approached the edge of the trees, she stopped and heard a noise and felt something moving about “up there” on her head, in her branches. Reaching into her pocket she pulled out the hand mirror she retrieved earlier and took a look to see what was going on. It was a beautiful bird, sat there looking at her; before she could think of what to do the bird started to sing. The most beautiful of melodies came out of this delightful creature, she felt calmer and prepared to carry on. Thinking to herself:

I shall name the bird Journey.

Hope and Journey entered the woods and manoeuvred their way through the trees, trying not to get her branches tangled with the foliage. Inspecting each tree she passed, looking at each leaf desperately trying to find answers to her predicament. All the while listening to Journey sooth her with song. Suddenly she heard a new tune and it was complementing Journey’s. Once again Hope got her hand mirror out and glanced to see what was happening. Another beautiful bird was sat up there harmonising with Journey. Now hope thought it only fair to name this bird too:

I shall name this bird Duality.

Hope, Journey and Duality continued on their path searching and singing together in perfect harmony. Suddenly a clearing appeared, it was a circular clearing with one lonely tree in the middle, it was huge and looked to be well over a hundred years old. It was so big you could build a small home in its trunk. Hope continued towards it and could see something glistening in the sunshine, it was hanging from the tree. As she approached it another beautiful bird flew down from the other tree and it too had something dangling from its mouth, it was a key. Both items were keys and before she could process what was happening the bird dropped the key into her hands and took a perch in her branches. Hope compared the two keys and they were the same except for their colour – one being blue and the other pink.

what could this mean?

Hope thought to herself.

The third bird joined in with the singing and looked at home with Journey and Duality. Hope put both keys in her pocket with her mirror and started to inspect the tree before her, the leaves were the same as hers, the branches were identical and the aroma was a perfect match. But how and why had this tree which naturally grew from the ground, also grown from Hope’s head and what were the keys purpose. This thought was so tiring and complex to understand, as nothing seemed real or based on the natural order of things, so Hope surmised that if and when she needed to know these things, they would unveil themselves to her in good time.

The third bird seemed to complete the harmony so exceptionally, the sound was enchanting, it made Hope feel less weighed down by her past and her sadness, it elevated her to a place which felt unlike any other, it was as if she had found her home. Not the kind of home she had left behind earlier, it was not that of bricks and mortar it was the sense that home existed inside her – meaning that she was always home and this feeling made Hope feel whole.

 Hope suddenly had a thought and said:

I shall call this third bird Transcendence.

This name felt fitting as this is what she felt upon meeting this bird and hearing the symphony this trio had created made her feel that she had gone beyond ordinary limitations. Hope sat beneath the tree and lay against it, with her branches touching the other tree’s, weaving herself into a comfortable position. Journey, Duality and Transcendence began to sing a slower melody, lulling Hope with a lullaby, soon she was asleep and the sun set. As Hope slept her branches curved around her creating a blanket of leaves and all three birds nuzzled into Hope and one another.

When Hope woke up the next morning she was alone and she felt different, she raised her hands to her head and all she felt was her hair and beneath it her head, simple skin and bone. It was a relief that she had returned to her normal state, however she was sad to loose her friends, Journey, Duality and Transcendence. When she stood up and turned to the tree she had laid under all night, she was shocked to find a door. In front of the door were three little parcels made out of leaves, one was filled with nuts and berries, the second was a cup shape with water and the third was a little growing bud, ready to be planted. Hope ate the berries and nuts, drank the water and carefully put the bud in her pocket, which is when she remembered she had two keys, she pulled them out and went to the door – but neither worked which perplexed Hope very much indeed. Then she had an overwhelming feeling that this door was not for her and she felt strongly that the blue key was the correct key, so she hung it on the door knob and decided to return home.

On Hope’s journey back she started to ponder what this all meant, knowing that her life had been filled with pain from her past she wondered if this was a wake up call from some kind of higher power – such as the force which aligns us and keeps the earth spinning, the sun rising and setting and the tides drawing in and out. Was it a window into the in between, with the duality of body and mind had she found the centre, the answer to – what are mental states and what are physical states? Had she experienced a mental state which took her to another world where trees growing out of heads, bird friends, keys, magical trees and little doors were the norm. Or were these things physically there, tangible and part of the order we know to exist, just undiscovered? Or possibly she had transcended, moving beyond physical needs and realities.

Before she knew it, Hope was at her gate and could see her little home which when she left yesterday she had felt such loss, today she felt excited to return home and be amongst the things she knew to be real. Once Hope had opened the gate and walked up the path she was met by a small trinket box with three beautiful feathers beautifully attached to it, as if they were a gift tag, she knew these patterns they were from her friends; Journey, Duality and Transcendence, this made Hope smile and she knelt down to open the box, inside was a tiny note which read:

Plant the bud, watch it grow – in dirt and darkness, watch it burst through to reach the light, tend to it, water it and even when nothing moves know that growth happens from within and one day you will have a tree which will nourish you with fruit and bring you shade when weary. This growth is part of you physically and mentally, it is your journey and being beyond the limits of all possible experience and knowledge you have transcended from your past and hold the key to your future.

Hope felt a tear fall from her eye and she felt such relief, she reached into her pocket and got the pink key and placed it around her neck as a reminder of her lesson, she then hurried indoors to fetch her gardening tools so she could plant the bud. When she returned outside her three friends were all splashing away in the bird bath, chirping with delight. Hope knew this was the beginning of a new adventure and that there was no turning back.


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Fragile – Illustration and Poetry By Charlotte Farhan

Fragile

My emotions are encased in glass,

self preservation enclosed them there,

in a mason jar
for safe keeping,

fear like a snake in the grass,

infectious despair
simply to scare,

in my jar
I am left weeping.

Fragility is never a choice,

does the ant get to choose it’s height?

does a butterfly design it’s wings?

I hear “stay safe”
from my little voice,

“fear not”
I reply
“this jar is airtight”,

Outside is not for me
for I see the sadness it brings.


Fragile - By Charlotte Farhan

Fragile – By Charlotte Farhan

 


 

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The importance of safe spaces and how to understand them better – Link You Life

Safe Space - By Charlotte Farhan

Safe Space – By Charlotte Farhan

A safe space is somewhere where hate speech and prejudice is not permitted. This term began to be widely understood in educational institutions and began as a space for the LGBTQ community, to be free of persecution and being silenced by heterosexual privilege. Now we have safe spaces in community groups and online – as well as on campuses and school grounds.

These safe spaces have been met with controversy that they prevent free speech and create unrealistic bubbles. This is of course not at all what they are meant to be, however privilege can make people who have not come up against stigma and prejudice in their lives, feel attacked and blamed – hence their reaction and misunderstanding of why safe spaces exist. It is in no way to silence free speech – in fact it is the very opposite, it is a place where people who are marginalised can speak out about their lives, their beliefs and not be silenced by a majority who have the platform and spotlight at all times. It encourages free speech and diversity, however it does not allow for people to bring hateful ideas into the space to force their opinions or beliefs on a minority.

There is also another kind of safe space and this is what I wish to talk about today; the online group/forum which is often used for vulnerable people. These are more like safe spaces within therapy – a place where people who have been sexually, emotionally or physically abused can come and share to help in the healing process and also shed light on the situation and raise awareness. Also this applies to groups with certain illnesses or disorders, ones such as mental or unseen illness, disabilities and so many more… As well as communities of neuro-divergent people or places people can speak anonymously.

These places can overlap – such as Link You Life, this group is not only a safe space for people to share their creativity, their lives and experiences but also it is a space with many vulnerable people in it. When you have such diverse spaces it is important to maintain structure and clear boundaries for members to follow. This way you can be as fair as possible with the group collective in mind at all times.

Trigger warnings are a method to aid in these boundaries, with the warnings in place – people can safely use the space without causing themselves adverse damage by being psychologically triggered by a post. The word triggered is overused in our language nowadays and has lost its validity and importance when in reference to trauma and serious harm, which can be caused if a person is suffering from certain illnesses, such as PTSD, CPTSD, anxiety disorders, mood disorders and personality disorders. It is not a word to be used just because you saw something you did not like or it upset you, this is just life and the reality of it.

Safe spaces are unreal, they don’t exist in our world unless created, life in fact is painful, sad and can be very dangerous for many, so if we did spend all of our time in a safe space, this would be very dysfunctional and render us unable to deal with the enormity of life and its perils. However this is not what we are asking for, we are asking for a space which we can go to and be safe to express ourselves and share our lives with others who are there for the same reasons.

So as a moderator of Link Your Life with this all in mind I take my role very seriously and I support my other LYL moderators and the members. It can mean making tough decisions and it can mean challenging ones self when dealing with others you may have never met. This is why we have a diverse range of moderators in order to maintain a non bias platform for others.

Personally due to my particular illnesses and disorders as well as my past, safe spaces are not as important to me and on this website and on my social media I do not use trigger warnings as I feel I am triggered every day – by life, so feel as an activist I must thrust my experiences as a mentally ill person and a survivor of sexual abuse and violence onto my audience and then it is up to them to un-follow me if it is too much. But this is my real life and everyday, this is outside the context of a safe space, so when I do enter the safe space – (even though my impulsive nature and black and white thinking are what shield me and allow me to be so direct), my pain and my vulnerability are given a moment to recuperate and get ready for the next battle. As well as this I see how beneficial these spaces are for others – how  space like this can give someone a voice and the opportunity to be heard, maybe for the first time in their lives and if someone has an issue with this, then they may need their own safe space to investigate, why someone being heard makes them so angry.

So the next time you hear the words “Safe Space”, be mindful of why this space exists and remember that the world is cruel and if we as individuals need to take a break, so that we can be heard or so that we can be seen – this does not stop you or anyone else doing the same.

Safe Place - by Charlotte Farhan

Safe Place – by Charlotte Farhan

 


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Inner Child – Art, Poetry and Philosophy by Charlotte Farhan

Inner Child - By Charlotte Farhan

Inner Child – By Charlotte Farhan

 

Inner Child 

by Charlotte Farhan

I abandoned you my child within,

they said you had grownup,

convincing me of my mortal sin,

forcing me to split and breakup.

You hid – undiscovered for a long time,

I forgot about you – putting childish things aside,

although I would hear you at bedtime,

telling me our stories – leaving me horrified.

For what they did to us they must be evil,

or maybe they too are hurt inside,

with all this pain and upheaval,

maybe their inner child had died.

I feel you clawing at me inside my chest cavity,

weeping and screaming – asking to be set free,

is it you or I that acts with such depravity,

would you burst from within me just to be an escapee.

I shouldn’t blame you for hating me,

for I am but another bad parent,

however trying to hide from reality,

not wanting to be called aberrant.

You inhabit my mind and body,

controlling me in order to make me see,

requiring me to embody,

all that was lost at sea.


What is our inner child?

It is the child state that exists in all of us, which never disappears – we assume as we get older this younger self vanishes, but this is illogical. Yes, we are changed over time by our experiences but do we “grow up”? Or are the ideas of childhood, adolescents and adulthood merely symbolic of societies need to compartmentalise us into accepted groups, in order to sell specific products and life style choices.

Before the 17th century childhood did not exist as a concept, in fact children were considered “incomplete adults”. However in the west, English philosopher John Locke was one of the first to describe the stage before adulthood and change the perception toward children in general. With Locke’s theory of the tabula rasa – meaning “blank slate”, he believed we as humans are born “brand new”, a mind which is a blank canvas ready to be painted on. With this he urged parents that their duty was to nurture and guide their child toward adulthood. With the rise of the middle class and puritanism within the early frameworks of capitalism – a new family ideology was formulated as an ideal for an individuals salvation and the protection of the “innocence” within children.

Jean-Jacques Rousseau once described childhood as a:

“brief period of sanctuary before people encounter the perils and hardships of adulthood”

However for the poor this separation between childhood and adulthood was not attainable. Industrialisation saw children as a viable workforce and rejected that a “childhood” was precious and that their innocence needed to be protected. With the separation between the poor and middle classes becoming more apparent in the late 18th century and with reform being discussed, the idea that all children needed to be protected became an important issue, from the 1830’s onward the campaign eventually led to the Factory Acts, which mitigated the exploitation of children at the workplace. From this point the notion of childhood saw a boom in children’s literature and toys, leading us to where we are now , where childhood is seen as a sate that not only exists, but that our development is fundamental to us being functional adults, with compulsory education and more and more done to protect children from harm, childhood is now rooted in our identities as a society.

So how does this all relate to our “inner child”?

This notion and brief history explained above, further illustrates that the concept of being a “grown up” is adaptable. Our inner child is part of us – it… is us. We never “grow up” we evolve as a human through life stages but our mind is our own and doesn’t get switched through each birthday, it adapts to circumstances and learns – but we don’t lose our child within.

In fact the most adult act we can take is to parent our own inner child. Because contrary to what Rousseau states, childhood can be full of perils and trauma and without the experience we gain from living through the stages, most children are not able to protect themselves from abuse, neglect or abandonment. Which means this trauma is taken on and carried into their adulthood – often causing an individual to become mentally ill.

This is caused not only by the acts of unfit parents and abusive adults around the child, but it is also due to societies need to separate each life stage in an individual – suggesting only children cry, have tantrums, are unreasonable or selfish and so on… When in fact these are general human behaviours with no age restrictions. Yes children test boundaries and display these behaviours – which are perfectly acceptable in order to navigate societal norms and etiquette. However when a child is abused emotionally, physically or both, they often do not get to have these learning experiences and testing of boundaries, leading the child to mimic adult behaviour in order to survive. Which is why later in life when the child is able to move away from their abusers and try and function in the world these behavioural traits often arise again and again, playing out the scenarios in which they were denied at the “appropriate age”.

This is not something I know due to my degree in philosophy and psychology – this is me, I am a pseudo-adult. As if my body were a ship, the captain of my vessel is at times a 4 year old me, an adolescent me or the me who sits and writes this to you all. It took a long time to understand that I was steered by different parts of myself, but once I understood this my self management became easier.

With no children of my own and being the product of bad parents – from abuse (sexual, emotional and physical) I am probably thought to be the last person who would know how to parent my 4 year old self and 15 year old self. This is arguably true – however the first steps are listening to the children who have been through trauma, we know a lot on what not to do.

The rest is love…

References: 

Vivian C. Fox, “Poor Children’s Rights in Early Modern England,” Journal of Psychohistory, Jan 1996, Vol. 23 Issue 3, pp 286–306

“The Life of the Industrial Worker in Nineteenth-Century England”. Laura Del Col, West Virginia University

Ariès, Philippe. Centuries of Childhood: A Social History of Family Life. New York: Alfred A. Knopf, 1962.

Brown, Marilyn R., ed. Picturing Children: Constructions of Childhood between Rousseau and Freud. Aldershot: Ashgate, 2002.


If you feel you need to explore your inner child or are already aware but need some guidance here are some helpful links:

 Working With Your Inner Child to Heal Abuse

Healing the Child Within

7 Things Your Inner Child Needs to Hear You Say


And if you are struggling with any form of mental illness please follow these link for support:

Sane 

Mind 

International Crisis Lines


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Now I lay me down to sleep – Art and Poetry by Charlotte Farhan

now-i-lay-me-down-to-sleep-1

 

Now I lay me down to sleep

Art and Poetry

by Charlotte Farhan

Now I lay me down to sleep,

eyes wide open and thoughts a plenty,

to numb to even weep,

my mind full but my soul empty.

If I should die before I wake,

please know I tried with all my might,

but could not survive the heartbreak,

I have been waiting too long for daylight.


This art and poetry portrays the ordeal of intrusive thoughts which are brought on due to mental illness, specifically complex trauma, anxiety disorders, personality disorders and psychosis.

My intrusive thoughts have been dominating my life since I can remember. As young as 5 I recall laying in my bed and reasoning with myself, internally bargaining:

“If I die in my sleep, I wont know, I will just die and then it will be over”.

Scary things had always happened at night in my world, the dark couldn’t be trusted and nor could most adults.

As I got older my intrusive thoughts took on an internal shaming ritual, whereby ripping myself to shreds about how I looked, how I had acted or how no one loved me and I would be alone forever – hence why these thoughts turned suicidal. Repeating to myself again and again:

“you are fat, you are ugly”,

as if I were counting maniacal sheep – one named fat the other ugly.

Sometimes the thoughts can turn external and onto others, fearing you may hurt someone or even kill someone – not because you want to but because you fear you will lose your mind. I used to fear that one day whilst travelling to school or college that I would push someone onto the railway tracks. Visualising it was horrifying, playing it out scene for scene , watching others scream in horror and watching myself be carted away by the “men in white coats”.

With psychosis the intrusive thoughts are there but take on a hallucinogenic  dimension. In the dark seeing evil angels looming over me or small fairy like creatures guiding me to safety, another world would open up – but what if I got trapped there? What if I wanted to stay? Reflections in mirrors can cause dysmorphic appearances, my eyes would disappear into my sockets, skin looked to be hanging off my face and seeing other people as myself.

Traumatic experiences cause flash backs which take you back to your trauma and hold you there in order to relive the ordeal again and again. Or you try and recreate the trauma and imagine a new ending – all the while punishing yourself internally, blaming yourself for what has happened to you or for what others have done to you.

Medication can help but it can be so much worse if you miss a dose or have to come off your meds for whatever reason, as well as very unpleasant side effects. There are so many drugs I have tried over the years and the ones that worked best were always the ones which left me like a zombie during the day, which is fine if you wish to be a zombie and there have been times this has suited me, to barely exist. However when you want to survive and possibly even live you can’t compromise on the “being awake” part.

The important thing to remember when dealing with intrusive thoughts or if a loved one is experiencing them, is to take this seriously – it is like any other health concern, such as finding a lump or a cough that just wont go away. Intrusive thoughts are an anxiety driven issue due to:

“THE AMYGDALA CONSTANTLY SENDING US FALSE SIGNALS THAT WE ARE IN DANGER”

Fight or flight is triggered with the obsession (the intrusive thoughts) and then the compulsion (is the bargaining – the fear) and the cycle repeats like groundhog day. Many people suffer in silence with these feelings and become trapped in their own isolation created due to living this way. So if you feel this is you or someone you know – please know first and foremost:

YOU ARE NOT ALONE!

There is support out there for you and your loved ones.

Here are some helpful links:

Sane 

Mind 

International Helplines

END THE STIGMA!


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Like moths among the whisperings – Art by Charlotte Farhan

 

like-moths-among-the-whisperings-2

 

Like moths among the whisperings 

by Charlotte Farhan

 

Anxiety can make one very small,

compressing you within,

it can keep you away like a mothball,

with depression as its conjoined twin.

The light draws us out,

but not for long,

however we stay alert – on the look out,

not sure if we belong.

We see others as butterflies,

fluttering with ease,

with their calm – we idealise,

where as we would be lost in a strong breeze.

When waking our hearts burst,

our minds race,

life pulling at us – being coerced,

forced to adorn our poker face.

We are like moths among the whisperings,

manoeuvring through the polite conversation,

like candles pulling us in – glistening,

so familiar – marking the end of our adaptation.


This painting and poem were prompted by a line in the Great Gatsby ,

There was music from my neighbor’s house through the summer nights. In his blue gardensmen and girls came and went like moths among the whisperings and the champagne and the stars.

but the line “like moths among the whisperings” made me think of how it feels to live with anxiety disorders whilst among others who don’t. It conjured up this image of anxious people as moths and non-anxious people as butterflies.

The irony is that most of the people who visited the parties in The Great Gatsby were probably butterflies. However even there I am sure a few moths anxiously found there way around , maybe with some dutch courage to aid their cause.



 

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Piers Morgan tries to erase survivors of rape by denying our suffering

Piers Morgan who is a rent a gob for the Daily Fail newspaper has taken to twitter over the weekend to comment on Lady Gaga’s rape and her suffering of PTSD. In his comments he suggests that as Lady Gaga is a celebrity that her claim of rape and mental illness is a ploy to gain fans and further her brand. Further more Piers has said that he believes it is an illness which only military veterans can experience.

You would be forgiven for thinking (if unaware of this man) that this maybe someone who suffers from PTSD or who has been raped or possibly that they have a medical degree specialising in neurology or psychiatry. However your assumption would be wrong, this man has NO authority on these matters, he is just a hypocrite who ironically has done the very thing he criticises others of doing. He uses his platform to be controversial and his articles are click bate for anyone who wishes to be angry at “the other” in society.

As you may already be aware (if you follow my blog or art) that I suffer from C-PTSD and have done so most of my life, due to sexual abuse in childhood and then being raped at 15 and then a further 2 times being sexually assaulted in a psychiatric hospital by two male patients. I was first diagnosed with PTSD when I was 15 and later with C-PTSD, with this condition you are affected to a degree that life is no longer functional. We have flash backs which rob us of the opportunity to “move on”, night terrors, hallucinations, dissociation. I have sever pain in my genitalia due to the injuries I suffered and the operations I had due to the violent rape, I developed other mental illnesses like anxiety disorders and depersonalization, as well as having sensory disorders and neurological processing problems.

Read my survivor story here: Confronting my own blood – the aftermath of sexual violence

Here are the tweets that Piers Morgan tweeted:

Pierce Morgan victim blames rape survivors

Pierce Morgan victim blames rape survivors

Pierce Morgan victim blames rape survivors

Pierce Morgan victim blames rape survivors

Pierce Morgan victim blames rape survivors

Pierce Morgan victim blames rape survivors

Pierce Morgan victim blames rape survivors

As you can read for yourself these tweets are rife with misogyny, male privilege, and able privilege as well as perpetuating rape culture, victim blaming and creating more stigma for those who speak out about rape, sexual abuse and violence – as well as those with mental illness and/or neurological disorders.

When people such as this man use their platform to spew opinion as fact and relish in controversy it is as usual the most vulnerable who suffer. These people think that “we” the “victims” are getting some kind of glory from our suffering and illnesses, that we wish to be treated as special little “snowflakes” when in fact all we are faced with is shame, blame and being disbelieved. Piers and others like him, sit in their ivory towers, with no real understanding of what marginalised /minority groups have to deal with and just vomit their privilege upon us from great heights.

As someone who is classed as disabled due to my conditions which all stem from my C-PTSD including my neurological damage, I know what it is to have less rights, visibility, opportunity, earning ability, access to healthcare, being thought of as a danger to others etc.

I have learnt that these kinds of people are just as dangerous as the rapists, the abusers, the paedophiles, the gas-lighters, this is because they open you up again, they re-rape you, abuse you, hit you, torture you, with their ignorance, the erasure they cause and the perpetuation of archaic rhetoric which stigmatises and marginalises people. They are the little helpers to these criminals, with their spreading of misinformation and opinion dressed as fact.

Here were my tweets to Piers Morgan:

Charlotte Farhan and Piers Morgan

 

Upon waking this morning after a disturbed nights sleep from anxiety and intrusive thoughts, these tweets which flashed up in my twitter feed, re-tweeted by other survivors I know, it felt like another day I had to fight through, another day I felt shamed and judged – my C-PTSD was triggered and the adrenaline started to mount in my body, gulping down the tears and anger. Then I remembered my only role now is that of my activism, in speaking out against people and ideas like this. To survive everyday is a battle, personally I am very grateful to people like Lady Gaga for speaking out, for making people like me feel heard or at least a little more visible and not the shameful secret which society would like us to remain. As a victim who has survived I know that Piers Morgans comments will have hurt Lady Gaga as they did for me, and “hurt” is an understatement – there is no word to describe how these comments contribute to the silencing of survivors and how they normalise rape culture.

So if like Piers you are confused about what PTSD and C-PTSD is, please read this information below.

Here is a copy of the PTSD Leaflet from the Royal College of Psychiatrists:

Introduction

In our everyday lives, any of us can have an experience that is overwhelming, frightening, and beyond our control. We could find ourselves in a car crash, be the victim of an assault, or see an accident. Police, fire brigade or ambulance workers are more likely to have such experiences – they often have to deal with horrifying scenes. Soldiers may be shot or blown up, and see friends killed or injured.

Most people, in time, get over experiences like this without needing help. In some people, though, traumatic experiences set off a reaction that can last for many months or years. This is called Post-traumatic Stress Disorder, or PTSD for short.

Complex PTSD

People who have repeatedly experienced:
severe neglect or abuse as an adult or as a child
severe repeated violence or abuse as an adult, such as torture or abusive imprisonment
can have a similar set of reactions. This is called ‘complex PTSD’ and is described later on in this leaflet.

How does PTSD start?

PTSD can start after any traumatic event. A traumatic event is one where you see that you are in danger, your life is threatened, or where you see other people dying or being injured. Typical traumatic events would be:
serious accidents
military combat
violent personal assault (sexual assault, physical attack, abuse, robbery, mugging)
being taken hostage
terrorist attack
being a prisoner-of-war
natural or man-made disasters
being diagnosed with a life-threatening illness.
Even hearing about the unexpected injury or violent death of a family member or close friend can start PTSD.

When does PTSD start?

The symptoms of PTSD can start immediately or after a delay of weeks or months, but usually within 6 months of the traumatic event.

What does PTSD feel like?

Many people feel grief-stricken, depressed, anxious, guilty and angry after a traumatic experience. As well as these understandable emotional reactions, there are three main types of symptoms:
1. Flashbacks & nightmares
You find yourself re-living the event, again and again. This can happen both as a ‘flashback’ in the day and as nightmares when you are asleep. These can be so realistic that it feels as though you are living through the experience all over again. You see it in your mind, but may also feel the emotions and physical sensations of what happened – fear, sweating, smells, sounds, pain.
Ordinary things can trigger off flashbacks. For instance, if you had a car crash in the rain, a rainy day might start a flashback.
2. Avoidance & numbing
It can be just too upsetting to re-live your experience over and over again. So you distract yourself. You keep your mind busy by losing yourself in a hobby, working very hard, or spending your time absorbed in crosswords or jigsaw puzzles. You avoid places and people that remind you of the trauma, and try not to talk about it.
You may deal with the pain of your feelings by trying to feel nothing at all – by becoming emotionally numb. You communicate less with other people who then find it hard to live or work with you.
3. Being ‘on guard’
You find that you stay alert all the time, as if you are looking out for danger. You can’t relax. This is called ‘hypervigilance’. You feel anxious and find it hard to sleep. Other people will notice that you are jumpy and irritable.

Other symptoms
muscle aches and pains
diarrhoea
irregular heartbeats
headaches
feelings of panic and fear
depression
drinking too much alcohol
using drugs (including painkillers).
Why are traumatic events so shocking?

They undermine our sense that life is fair, that it is reasonably safe and that we are secure. A traumatic experience makes it very clear that we can die at any time. The symptoms of PTSD are part of a normal reaction to narrowly-avoided death.

Does everyone get PTSD after a traumatic experience?

No. But nearly everyone will have the symptoms of post-traumatic stress for the first month or so. This is because they can help to keep you going, and help you to understand the experience you have been through. This is an ‘acute stress reaction’. Over a few weeks, most people slowly come to terms with what has happened, and their stress symptoms start to disappear.

Not everyone is so lucky. About 1 in 3 people will find that their symptoms just carry on and that they can’t come to terms with what has happened. It is as though the process has got stuck. The symptoms of post-traumatic stress, although normal in themselves, become a problem – or Post-traumatic Stress Disorder – when they go on for too long.

What makes PTSD worse?

The more disturbing the experience, the more likely you are to develop PTSD. The most traumatic events:
are sudden and unexpected
go on for a long time
are when you are trapped and can’t get away
are man-made
cause many deaths
cause mutilation and loss of arms or legs
involve children.
If you continue to be exposed to stress and uncertainty, this will make it difficult or impossible for your PTSD symptoms to improve.

What about ordinary ‘stress’?

Everybody feels stressed from time to time. Unfortunately, the word ‘stress’ is used to mean two rather different things:
our inner sense of worry, feeling tense or feeling burdened
or

the problems in our life that are giving us these feelings. This could be work, relationships, maybe just trying to get by without much money.
Unlike PTSD, these things are with us, day in and day out. They are part of normal, everyday life, but can produce anxiety, depression, tiredness, and headaches. They can also make some physical problems worse, such as stomach ulcers and skin problems. These are certainly troublesome, but they are not the same as PTSD.

Why does PTSD happen?

We don’t know for certain. There are a several possible explanations for why PTSD occurs.

Psychological
When we are frightened, we remember things very clearly. Although it can be distressing to remember these things, it can help us to understand what happened and, in the long run, help us to survive.
The flashbacks can be seen as replays of what happened. They force us to think about what has happened so we might be better prepared if it were to happen again.
It is tiring and distressing to remember a trauma. Avoidance and numbing keep the number of replays down to a manageable level.
Being ‘on guard’ means that we can react quickly if another crisis happens. We sometimes see this happening with survivors of an earthquake, when there may be second or third shocks. It can also give us the energy for the work that’s needed after an accident or crisis.
But we don’t want to spend the rest of our life going over it. We only want to think about it when we have to – if we find ourselves in a similar situation.

Physical
Adrenaline is a hormone our bodies produce when we are under stress. It ‘pumps up’ the body to prepare it for action. When the stress disappears, the level of adrenaline should go back to normal. In PTSD, it may be that the vivid memories of the trauma keep the levels of adrenaline high. This will make a person tense, irritable, and unable to relax or sleep well.
The hippocampus is a part of the brain that processes memories. High levels of stress hormones, like adrenaline, can stop it from working properly – like ‘blowing a fuse’. This means that flashbacks and nightmares continue because the memories of the trauma can’t be processed. If the stress goes away, and the adrenaline levels get back to normal, the brain is able to repair the damage itself, like other natural healing processes in the body. The disturbing memories can then be processed and the flashbacks and nightmares will slowly disappear.
How do I know when I’ve got over a traumatic experience?

When you can:
think about it without becoming distressed
not feel constantly under threat
not think about it at inappropriate times.
Why is PTSD often not recognised?

None of us like to talk about upsetting events and feelings.
We may not want to admit to having symptoms because we don’t want to be thought of as weak or mentally unstable.
Doctors and other professionals are human. They may feel uncomfortable if we try to talk about gruesome or horrifying events.
People with PTSD often find it easier to talk about the other problems that go along with it – headache, sleep problems, irritability, depression, tension, substance abuse, family or work-related problems.
How can I tell if I have PTSD?

Have you experienced a traumatic event of the sort described at the start of this leaflet? If you have, do you:
have vivid memories, flashbacks or nightmares?
avoid things that remind you of the event?
feel emotionally numb at times?
feel irritable and constantly on edge, but can’t see why?
eat more than usual, or use more drink or drugs than usual?
feel out of control of your mood?
find it more difficult to get on with other people?
have to keep very busy to cope?
feel depressed or exhausted?
If it is less than 6 weeks since the traumatic event and these experiences are slowly improving, they may be part of the normal process of adjustment.
If it is more than 6 weeks since the event, and these experiences don’t seem to be getting better, it is worth talking it over with your doctor.

Children and PTSD

PTSD can develop at any age. Younger children may have upsetting dreams of the actual trauma, which then change into nightmares of monsters. They often re-live the trauma in their play. For example, a child involved in a serious road traffic accident might re-enact the crash with toy cars, over and over again.

They may lose interest in things they used to enjoy. They may find it hard to believe that they will live long enough to grow up.

They often complain of stomach aches and headaches.

How can PTSD be helped?

Helping yourself
Do ………
keep life as normal as possible
get back to your usual routine
talk about what happened to someone you trust
try relaxation exercises
go back to work
eat and exercise regularly
go back to where the traumatic event happened
take time to be with family and friends
be careful when driving – your concentration may be poor
be more careful generally – accidents are more likely at this time
speak to a doctor
expect to get better.
Don’t ……..
beat yourself up about it – PTSD symptoms are not a sign of weakness. They are a normal reaction of a normal person to terrifying experiences.
bottle up your feelings. If you have developed PTSD symptoms, don’t keep it to yourself because treatment is usually very successful.
avoid talking about it
expect the memories to go away immediately; they may be with you for quite some time
expect too much of yourself. Cut yourself a bit of slack while you adjust to what has happened.
stay away from other people
drink lots of alcohol or coffee or smoke more
get overtired
miss meals
take holidays on your own.
What can interfere with getting better?

You may find that other people may:
not let you talk about it
avoid you
be angry with you
think of you as weak
blame you.
These are all ways in which other people protect themselves from thinking about gruesome or horrifying events. It won’t help you because it doesn’t give you the chance to talk over what has happened to you. And it is hard to talk about such things.

A traumatic event can put you into a trance-like state which makes the situation seem unreal or bewildering. It is harder to deal with if you can’t remember what happened, can’t put it into words, or can’t make sense of it.

Treatment

Just as there are both psychological and physical aspects to PTSD, so there are both psychological and physical treatments for it.

Psychotherapy
All the effective psychotherapies for PTSD focus on the traumatic experience – or experiences – rather than your past life. You cannot change or forget what has happened. You can learn to think differently about it, about the world, and about your life.

You need to be able to remember what happened, as fully as possible, without being overwhelmed by fear and distress. These therapies help you to put your experiences into words. By remembering the event, going over it and making sense of it, your mind can do its normal job of storing the memories away, and moving on to other things.

When you start to feel safer, and more in control of your feelings, you won’t need to avoid the memories as much. You will be able to only think about them when you want to, rather than having them burst into your mind out of the blue.

All these treatments should all be given by PTSD specialists. The sessions should be at least weekly, with the same therapist, for 8-12 weeks. Although sessions will usually last around an hour, they can sometimes last up to 90 minutes.
Cognitive Behavioural Therapy (CBT) is a talking treatment which can help us to understand how ‘habits of thinking’ can make the PTSD worse – or even cause it. CBT can help you change these ‘extreme’ ways of thinking, which can also help you to feel better and to behave differently.

EMDR (Eye Movement Desensitisation & Reprocessing):
This is a technique which uses eye movements to help the brain to process flashbacks and to make sense of the traumatic experience. It may sound odd, but it has been shown to work.

Group therapy
This involves meeting with a group of other people who have been through the same, or a similar traumatic event. It can be easier to talk about what happened if you are with other people who have been through a similar experience.

Medication
SSRI antidepressant tablets may help to reduce the strength of PTSD symptoms and relieve any depression that is also present. They will need to be prescribed by a doctor.

This type of medication should not make you sleepy, although they all have some side-effects in some people. They may also produce unpleasant symptoms if stopped too quickly, so the dose should usually be reduced gradually. If they are helpful, you should carry on taking them for around 12 months. Soon after starting an antidepressant, some people may find that they feel more:
anxious
restless
suicidal
These feeling usually pass in a few days, but you should see a doctor regularly.

If these don’t work for you, tricyclic and MAOI antidepressants may still be helpful. For further information, see our leaflet on antidepressants.

Occasionally, if someone is so distressed that they cannot sleep or think clearly, anxiety-reducing medication may be necessary. These tablets should usually not be prescribed for more than 10 days or so.

Body-focussed therapies
These don’t help PTSD directly, but can help to control your distress and hyperarousal, the feeling of being ‘on guard’ all the time. These include physiotherapy and osteopathy, but also complementary therapies such as massage, acupuncture, reflexology, yoga, meditation and tai chi. They can help you to develop ways of relaxing and managing stress.

What works best?

At present, there is evidence that EMDR, Cognitive Behavioural Therapy, behaviour therapy and antidepressants are all effective. There is not enough information for us to show that one of these treatments is better than another. There is not yet any evidence that other forms of psychotherapy or counselling are helpful for PTSD.

Which treatment first?

Guidelines from the National Institute for Health and Care Excellence (NICE) suggest that trauma-focussed psychological therapies (CBT or EMDR) should be offered before medication, wherever possible.

For friends, relatives & colleagues

Do …….
watch out for any changes in behaviour – poor performance at work, lateness, taking sick leave, minor accidents
watch for anger, irritability, depression, lack of interest, lack of concentration
take time to allow a trauma survivor to tell their story
ask general questions
let them talk, don’t interrupt the flow or come back with your own experiences.
Don’t …….

tell a survivor you know how they feel – you don’t
tell a survivor they’re lucky to be alive – it doesn’t feel like that to them
minimise their experience – “it’s not that bad, surely …”
suggest that they just need to “pull themselves together”.
Complex PTSD

This can start weeks or months after the traumatic event, but may take years to be recognised.
Trauma affects a child’s development – the earlier the trauma, the more harm it does. Some children cope by being defensive or aggressive. Others cut themselves off from what is going on around them, and grow up with a sense of shame and guilt rather than feeling confident and good about themselves.
Adults who have been abused or tortured over a period of time develop a similar sense of separation from others, and a lack of trust in the world and other people.
As well as many of the symptoms of PTSD described above, you may find that you:
feel shame and guilt
have a sense of numbness, a lack of feelings in your body
can’t enjoy anything
control your emotions by using street drugs, alcohol, or by harming yourself
cut yourself off from what is going on around you (dissociation)
have physical symptoms caused by your distress
find that you can’t put your emotions into words
want to kill yourself
take risks and do things on the ‘spur of the moment’.
It is worse if:
it happens at an early age – the earlier the age, the worse the trauma
it is caused by a parent or other care giver
the trauma is severe
the trauma goes on for a long time
you are isolated
you are still in touch with the abuser and/or threats to your safety.
Getting better

Try to start doing the normal things of life that have nothing to do with your past experiences of trauma. This could include finding friends, getting a job, doing regular exercise, learning relaxation techniques, developing a hobby or having pets. This helps you slowly to trust the world around you.
Lack of trust in other people – and the world in general – is central to complex PTSD. Treatment often needs to be longer to allow you to develop a secure relationship with a therapist – to experience that it is possible to trust someone in this world without being hurt or abused. The work will often happen in 3 stages:

Stabilisation
You:
learn how to understand and control your distress and emotional cutting-off, or ‘dissociation’. This can involve ‘grounding’ techniques to help you to stay in the present – concentrating on ordinary physical feelings to remind you that you are living in the present, not the abusive and traumatic past.
start to ‘disconnect’ your physical symptoms of fear and anxiety from the memories and emotions that produce them, making them less frightening.
start to be able to tolerate day-to-day life without experiencing anxiety or flashbacks.
This may sometimes be the only help that is needed.

Trauma-focussed Therapy
EMDR or Cognitive Behavioural Therapy can help you to remember your traumatic experiences with less distress and more control. Other psychotherapies, including psychodynamic psychotherapy, can also be helpful. Care needs to be taken in complex PTSD because these treatments can make the situation worse if not used properly.

Reintegration
You begin to develop a new life for yourself. You become able to use your skills or learn new ones, and to make satisfying relationships in the real world.
Medication can be used if you feel too distressed or unsafe, or if psychotherapy is not possible. It can include both antidepressants and antipsychotic medication – but not usually tranquillisers or sleeping tablets.

Internet rresources

UK Psychological Trauma Society (formerly UK Trauma Group): clinical network of UK Traumatic Stress Services.
PILOTS database of the National Center for PTSD (USA): published international literature on PTSD.

David Baldwin’s Trauma Pages website: up-to-date comprehensive information about trauma including leading articles.

Sane Charity – PTSD

References

Post-traumatic Stress Disorder – The Invisible Injury ( 2002). David Kinchin. Successunlimited.
Effective Treatments for PTSD: Practice Guidelines from the International Society of Traumatic Stress Studies (2nd edition) (2010). Eds. Foa E, Keane T, Friedman M & Cohen JA.
Treating Trauma: Survivors with PTSD (2002). Ed. Yehuda, R. Washington DC. American Publishing.
Adshead G and Ferris S. Treatment of victims of trauma. Advances in Psychiatric Treatment (September 2007) 13:358-368.
Bisson JI, Pharmacological treatment of post-traumatic stress disorder. Advances in Psychiatric Treatment (March 2007) 13:119-126.
Coetzee RH and Regel S, Eye movement desensitisation and reprocessing: an update. Advances in Psychiatric Treatment (March 2005) 11:347-354.
Hull, A.M., Alexander, D.A. & Klein, S. Survivors of the Piper Alpha oil platform disaster: long-term follow-up study (2002). Br. J. Psychiatry, 181: 433 – 438
NICE guidelines (update 2012): Post-traumatic stress disorder: the management of PTSD in adults and children in primary and secondary care.
Lab, D., Santos, I. & de Zulueta, F.Treating post-traumatic stress disorder in the ‘real world’: evaluation of a specialist trauma service and adaptations to standard treatment approaches (2008). Psychiatric Bulletin, 32: 8-12.
Frueh BC, Grubaugh AL, Yeager DE and Magruder KM. Delayed-onset post-traumatic stress disorder among war veterans in primary care clinics (2009). The British Journal of Psychiatry, 194, 515–520.