“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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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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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.

Halloween and the stigmatisation of mental illness

It is that time of year again – All Hallows’ Eve.

Halloween is upon us and has been all weekend, it is a celebration, a ritual and a chance to party with friends, adorning costumes and different personas for one night. With the nights drawing in and winter fast approaching it reminds us of the dark and in turn the dead.

However Halloween has become a mass capitalised practice, with shops and establishments enticing you with their decorations and latest gimmicks from the beginning of October. Making plans for this one night affair becomes about popularity and with the addition of social media – a costume contest is held with hashtags and a one-upmanship mentality.

Although this is not the scariest thing about Halloween, in fact the most frighting of attitudes and beliefs come out to play during this festivity and that is the representation of mental illness and the mentally ill. With depictions in horror films, on TV and in literature – as well as costumes depicting “psychiatric patients” or the idea of insanity being cool or glamorised.

As some one who has sever psychiatric conditions and who has had these since being a child, my thoughts on this subject are something I wish to be heard on, hoping that listening to someone who is actually mentally ill, who has been hospitalised in genuine Victorian asylum buildings in the UK, as an inpatient on a psychiatric ward, that in hearing me you will understand that my suffering, trauma, illnesses and identity is not something you get to “have fun with”. You don’t get to put it on for the night and then take it off without hearing me tell you that this is causing me and people like me to be demonised, you continue our persecution and discrimination. Whimsically you step into a piece of clothing which represents people who have been killed for their disabilities, locked away and forgotten about due to their illnesses, and tortured or experimented on because they behave and think differently to the perceived average person.

Having been stigmatised and labelled as dangerous to others, as a person who is violent or unstable – a person to be feared, a monster. I myself, have believed these things to be true, having allowed myself to be shamed into submission, thinking that in fact I am a scary, crazy villain. So I hid from it, allowed myself to be silenced, accepted family and friends stigmatising me with their fancy dress and in their language when watching horror films. Listening to people discuss my situation as frightening, something which scares them so much they can’t watch.

In the depictions of mental illness within horror films and on TV sometimes I catch a glimpse of myself, in a girl who is screaming manically and bashing her head against walls, or rocking herself in a corner or strapped down sedated in a hospital bead. I have lived these experiences, I still do sometimes. The rocking myself is a self soothing, allowing me to keep myself safe.

Yes I have done this in the dark, on a psychiatric ward – yes it was scary.

But not for you! For me!

When experiencing psychotic episodes I have smashed my head repeatedly against walls, on tables anywhere I could. As I rarely remember my psychosis or at least only fragments of it, I can not tell you exactly what I was thinking – but I can guess with almost complete certainty that it was to stop the intrusive images, the voices, the flashbacks, the pain… It was not because I was possessed or dangerous to others it was because of my neurological damage due to early childhood trauma. Which again is not scary in the spooky horror sense when explained, it is in fact a medical condition and symptoms.

Being in a psychiatric hospital is not a horror fest or a sensationalised attraction to experience. It is like any other medical facility, it is there to treat people with illnesses in a focused in-patient manner. Yes the Victorian buildings were scary and yes me and my in-patient friends would tell ghost stories and scare ourselves whilst walking through the abandoned buildings and grounds – but we didn’t think we were the monsters, we knew we were thought of this way by the outside world.

(West Park Hospital in Epsom is where I was an in-patient for 6 months in 1999)

However we had seen real horror, most of us having survived childhood molestation, violence, and emotional abuse. We knew we were only really a danger to ourselves, hacking away at our own flesh daily, burning ourselves with lighters, putting ourselves in danger as vulnerable people, not eating, taking substances to excess and attempting to kill ourselves often. We were the scariest thing around – to ourselves, but are we really people to be feared? No – we are people who have been vilified in order to hide the realities of true horror, which happens everyday in plain sight, by people you know, people you forgive and people who you look up to. Our ideas disturb the status quo and our sadness gets in the way of the idealistic idea of living a happy life. We make you uncomfortable – because deep down you know we are not different, that you could become ill or have a breakdown. Your neurology is not bullet-proof. We are not made of weaker stuff.

So I ask you to think about the depiction of mentally ill people at Halloween, I ask you to challenge your thoughts on what we look like, act like, or are capable of. Think of the backstory of a character and realise just how un-scary someones emotional distress, neurological condition or neuro-divergent ideas are in context. Think how you may make someone you know feel – who has mental illness, when you dress up as a deranged “psychopath”. Don’t contribute to this stereotype and the discrimination it allows to continue.

(These images are of graffiti myself and other in patients did in abandoned rooms during our stay at Woodside adolescent unit at West Park Hospital in Epsom, England in the summer of 1999 – during art therapy sessions. These photographs have been taken by people who site these as disturbing images of “crazy”impatient scribbling. I see them and remember letting out our pain, me and my best friend Jenny (who took her own life years later), of us together – expressing ourselves through art, this is NOT a horror movie scene or anything sinister.)

Do you reinforce the idea of the Rape Myth?

Living in this world as a victim who survived sexual violence, assault and child molestation I have had to learn from an early age that the systems of power and society are against me due to my gender and mental illness. People speak of you with either a perception of doubt and contempt, a whispered shamefulness – or deem you as a broken shell of a human, with no use; it makes people uncomfortable. These people are the ones that if they read or see a depiction on film/TV similar to your situation, will dissect and find a way to blame the victim, even when it is a child, they do this in front of you – holding on tightly to the idea of the “Rape Myth“.

That night, that house, that girl, that room, that boy, that blood - By Charlotte Farhan

That night, that house, that girl, that room, that boy, that blood –
By Charlotte Farhan

Perceptions of rape and any form of sexual assault or abuse are somewhat still judged by our prehistoric natures, along with murder – this need to defile and desecrate another human is sadly a behaviour which seems to be harder to evolve past. However even though there are sociobiological theories of rape which have been heavily criticised for assuming that only young attractive women are raped or that rape is motivated by desires and sexual needs only; is why this research needs to be considered but not seen as a completed study. We can not argue that rape has been used as a tool by our species. With high status and powerful males enslaving women as their playthings throughout history, with rape being used as a weapon of war to ethnically cleanse or to humiliate the opposing combatants. However the question which seems too complex to answer is whether this is something our species has innately, or is a behavioural component, which due to our long history of patriarchal power has never been challenged – until very recently, as more and more women are emancipated from their male family members.

So why is the “rape myth” still so prevalent today?

This month has been very triggering for most survivors, with Donald Trump admitting he has sexually assaulted women, with Brock Turner being released from his pitifully short sentence and with Ched Evans being acquitted after his family paid £50,000 for information from past lovers of the victim and then brought forward two ex partners and using the victims previous sexual behaviour against her in the case. These three high profile examples of how our world is determined to reinforce rape culture, show that power, privilege and using a woman’s sexuality to discredit her, are all achievable ways that men and boys who have never challenged these archaic ideas can “get away with it”. That they can be given the impression, it is their right, that their future is more important than a girl or woman’s or that women can’t be trusted especially if sexually active. Rape myth

When I was raped at 15 by a boy in my school, many things were used against me – this was back in 1999 in England and even though I had a lot of evidence against him, still it was much more “prove she is not credible” rather than “prove he is guilty”. The fact I had fancied the boy was a big thing used against me, which as a child myself became confusing – when people repeated this to me again and again;

“but you fancied him, you wanted him to fancy you”?

These things were true but did not cancel out the fact he violently raped me. It was 1999 and it was as if people had not ever challenged the idea that:

1) rape has nothing to do with being attracted to someone

or

2) you can’t be raped by someone you fancy, which as an adult, now – I have no problem understanding. I blamed myself for years, thinking

“it was my fault, I fancied him, so he had the right”.

14222250_1247889421920118_1434256253494472869_nHowever the most disturbing of “victim blaming” I experienced was that of my mental illness and disability being used against me – to discredit me by suggesting my ability to understand what happened to me was impaired or that I had done this to myself. Having been severally sexually traumatised vaginally and anally which meant I had to have internal and external surgery on my genital areas, it was clear to the physicians and police examiners that this was from forced aggressive penetration. However this was not what my rapists Mother said – who spread the false information that I had in fact self harmed my genitals to frame and blame him. This spread like wild fire amongst the students at my school, teachers and parents and due to my unstable mental health displayed in school previously – many just assumed this must be true about “that crazy girl”.

There are still people from my school year who are addiment I lied and that I did it out of some sort of “crazy” spite or something to that effect. But one thing has always bothered me about these people, they seem to accept that he was convicted for grievous bodily harm – that he beat me and cut me open with his force and violence, however this to them is not rape or sexual assault, this is fine, because I was asking for it.

Confronting my own Blood – By Charlotte Farhan

Confronting my own Blood – By Charlotte Farhan

My rapist was not convicted of rape, the police told me that this was due to his age – as he was also 15 and the fact that they could not determine and prove a lack of consent (like with so many cases). So he was convicted of GBH and Unlawful Sex – he was put on the sex offenders register and was on a tag for 12 months, but this was still not enough regardless of the outcome for some. It did not matter that I was bruised, bleeding and emotionally broken ready to take my own life, to them I was a whore and an opportunist.

It took so long for me to accept my rape as rape – this was due to our culture, my upbringing and my age. Once able to detach the 15 year old girl from being the primary source of all my information on what happened to me, I was able to look at it with adult eyes, eyes which have now survived and lived.

It was only 2 years ago – having turned 30 and reaching the point that I had lived 15 years on from my assault, whilst doing intense reliving therapy for my CPTSD, that revisiting my memories voluntarily was possible – apposed to flash backs and intrusive thoughts. Through this new lens of awareness I saw 15 year old me held down (face down) crying into the sheets as the boy raped me or of myself choking from forced oral penetration, it was then and only then that all the other details fell away – what I was wearing, that I fancied him, that I had gone into the room voluntarily and that straight after it had happened I had told my friends we had just had sex, to fit in, as I did not understand what had happened to me. These details were not what happened to me, these details were from society’s ideas of girls and women – from a rhetoric that found me (the victim) more guilty than the perpetrator.

You Know You Want It - By Charlotte Farha

You Know You Want It – By Charlotte Farhan

The facts are – I did not give consent and could not stop what happened to me due to fear and force. That until you are in a situation like this, a rape – that did not happen in a dark alley by a scary man, but one that happened by someone you knew, liked or loved, it is then you realise how we do ourselves as a species an injustice. We do not prepare girls and boys for the real dangers – we are not taught about consent and of how important this is. Instead as a girl you are taught you must prevent yourself from being raped or targeted by men, that you are the only one in control of this. Or that you must defend yourself by carrying a weapon or whistle, your told “scream out”, or you are told “cover up” don’t give men ideas or an invitation. Boys are then treated as if they are less responsible when it comes to sexual behaviour, that promiscuity is acceptable and even encouraged in an environment of toxic masculinity, with the idea a girl or woman needs to be “ruined” or “broken in”, a sense of entitlement is continued and facilitated. All the while placing all people who identify as male in one patriarchal predatory box , a box – which if male and you are the victim of rape, then this is not taken seriously,  and is ridiculed or deemed to be a weakness, clamming “real men can’t be raped”.

Despite considerable research and publications in professional and popular journals concerning rape, such myths continue to persist in the minds of the masses. r-drunk-driver-safety-advice-large570

We need to stop:
  • assuming that women and girls are more likely to lie about being raped than being raped. Of course false rape allegations exist, I have even witnessed one myself – however our culture reflects a problematic discourse when addressing this issue. Whichever stance is taken the girl or woman is either a liar, a slut or crazy. Here is a great article on this: He Said, She Said: The Mythical History of the False Rape Allegation
  • thinking women are “ASKING FOR IT”! This idea is ridiculously flawed and contradictory. If in fact “we” are asking for it, then this would mean we were asking for consensual sex or we invited a person to comment on how we look or behave. There is no clothing, age, background, ethnicity, disability or behaviour which lends to the idea “we” are “ASKING FOR IT”.
  • allowing predators to suggest that by having none consensual sex with an individual is doing them a favour as they are deemed not aesthetically conventional in their appearance or are disabled. Beauty and rape have no ties and cause this false idea that you can be too ugly to be raped. I was told this once by a horrible misogynist, who suggested I was too fat and ugly for rape victim. Disabled people are more likely to be taken advantage of as again I know too well. The same can be said about claiming that “you brought them into adulthood”, which is often used as a defence when women rape minors, especially if adolescent. Reinforced by a culture that will pat the boy on the back, for being taken advantage of by an older woman – but one that would react very differently to a girl who is under age, with an older man.
  • Thinking rape is about sex and sex alone. Rape is taking control of someone’s body and autonomy by force. It is not simply a person gets so overwhelmed by desire and can’t control themselves, it is so much more complicated and is never simply explained.
  • Promoting the “scorned woman” narrative, that women and girls get so enraged about being rejected by a man that their little minds overheat and conjure up allegations of rape and abuse for shits and giggles. This is a stereotype of women which has been depicted through history in all manner of literature and now film and TV. The fact that it is so widely believed is proof when you hear women accusing one another of such things. When research shows men are more likely to commit a violent crime after rejection in an intimate relationship. Please read this article: These 14 Women Were Brutally Attacked for Rejecting Men — Why Aren’t We Talking About It?

We need to look at rape as… well just that – RAPE!

People need to understand the fundamental differences between rape and sex and the need for children to be taught about consent couldn’t be more evident, along with the rest of sex education needing to be taught younger and more liberally. But how can you make a difference, simple check your attitudes and beliefs about what you have read and ask yourself:

Have you ever reinforced the rape myth?

 

false-allegations-perception-and-reality-rgb

If you are a victim who survived sexual violence, rape assault or abuse and wish to get more advice or support here are some helpful links:

RAINN : https://www.rainn.org/

Rape Crisis : http://rapecrisis.org.uk/

Pixel Project : http://www.thepixelproject.net/

Sane : http://www.sane.org.uk/


 

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The darkness creeps in – Art and Poetry By Charlotte Farhan

The darkness creeps in - art and poetry by charlotte farhan

The Darkness Creeps in – By Charlotte Farhan

Hearing everyone else cry
but no one asks
tears fall easier for them
my cheeks still dry
every day adjusting masks
staring at the sun
happy to comply
the darkness creeps in.

Mother loves with conditions
distance is key
with my confused contrition
more sadness dies
ignite the family tree
save ammunition
guilt injected lies
the darkness creep in.

Privilege protects them all
the abusers
predators blame accusers
before nightfall
enablers allow for this
take it on the chin
bury it within
the darkness creeps in.

Reality is fleeting
inside nothing
never staying in focus
with eyes bleeding
letting in all the nothings
hopeless neurosis
crushing psychosis
the darkness creeps in.


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Clouding of Consciousness – Art and Poetry by Charlotte Farhan

Clouding of Consciousness by Charlotte Farhan

Clouding of Consciousness by Charlotte Farhan

Clouding of consciousness,
adaptive defence kicks in,
my mind is filled with fogginess,
thoughts start to fade into rottenness,
no longer within my own skin.

I left me so I could survive,
muted and distorted,
reality and make-believe collide,
identities become contorted,
memories remain unsorted,
personalities I must contrive.

The world becomes bottomless,
no up or down,
just godlessness,
walking through a ghost town,
life is now preparing to shutdown,
parts of me are now autonomous.

There is no sense to be made of this,
autopilot is safer than being discarded,
why would it be better to reminisce,
instead let me be transported,
away from that place still haunted,
throw me into the abyss.

Dissociation has to exist,
without it we would not have been revived,
our pain and abuse dismissed,
leading so many to suicide,
washed away with the tide,
so some of us remain inside.


 

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Everyone is Watching – Art and Poetry By Charlotte Farhan

Everyone is Watching - By Charlotte Farhan

Everyone is Watching – By Charlotte Farhan

With this unseen malady,
the world is set to a different frequency,
faces move past with only apathy,
when they can’t fit you into a box,
intelligent, irrational, focused, erratic…
you seem a paradox.

Knowing people question me,
life feels scrutinised,
under the microscope,
wishing to be disguised,
not made to walk this tightrope.

Being able to be free,
not continuously analysed,
a participant, not an absentee,
hearing my voice,
without having to be patronised,
without having to prove my disabilities,
they love to give you the third degree,
have I not proved my invincibility?

We the stigmatised,
are not your problem to fix,
not here to be tamed and civilised,
neither will I be cured by your crucifix ,
“God only gives us what we can handle”
is this a joke – a chance to poke,
superstition and dogma we must dismantle,
instead with these ideas they provoke.

Everyone is watching me,
no longer left alone to recover,
my life is not something you can disagree,
they want to rip it away – uncover,
these things you can’t see,
no one would want this,
so with this plea,
stop watching me.


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Make it Stop – Art and Poetry by Charlotte Farhan

Make it Stop - Art and Poetry by Charlotte Farhan

Make it Stop – Art and Poetry by Charlotte Farhan

Waking up,
whipping eyelids open in panic,
heartbeats pound at my chest,
a frame of mind completely manic,
inside is emptiness,
depressed,
with nausea rising as if volcanic,
anxieties flood and infest,
unwanted thoughts,
borderline satanic,
the compulsions arise,
obsessed,
a lump in my throat,
gigantic,
memories pushed down,
repressed.


 

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Deflower – Poetry and Art by Charlotte Farhan

Deflower by Charlotte Farhan

Deflower by Charlotte Farhan

The room lost light in the darkening hour,
faced with the rawness of masculinity,
sheer force of primal desire,
the need to overpower.
Purity is artificial,
confused with naivety,
acts of aggression begin,
no words spoken just acts of taking,
in a flash of violence I cower,
this is my fault – my femininity.
Parts of me were devoured,
like a wolf ripping open its prey,
no culpability,
laying on my back praying to the holy trinity.
This did happen to the wallflower,
washing my skin imagining holy water,
searching for divinity,
this was more than purification,
sobbing in this shower.
Having not lost my virginity,
it was not misplaced,
it was taken,
it is not romanticism,
they cut off heads,
they deflower,
they dis-empower.
Art and Poetry by Charlotte Farhan

 


 

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