Infertility gave me the chance to question my abilities and accept being child free

(Please be aware that this essay is my opinion and represents my life. In no way am I judging anyone for their life choices with this piece) 

Being child-free was not my first choice; like most people the indoctrination of the projected ideal of “family”, being specifically to procreate in a hetro-normative way, had been passed down to me through relatives, religion, culture and societal norms – there was never a need to challenge this or think of a life otherwise inclined. Everything reflected this narrative, in literature, film, TV, cartoons and advertising – all showing you the eventuality of having children and it being the “right” thing to do.

My first ever fears of not being able to achieve this pre-prescribed life was at the age of 7. My fear arose upon realising that I liked boys and girls romantically, already having fancied and kissed both, my mind was now confused; to what this made me? Could I have a “normal” life, because no one else seemed to be like me? Running to my Mother in tears I tried to convey all of these fears and express the isolation that I had already perceived as my future. My Mother simply said to me:

“This is a phase and everyone experiences it, you will grow out of this and get married and have babies”

Looking back on this moment it is strange as my Mother was considered a “progressive”, she stood for equality and claimed to be a feminist (a very privileged second-wave white feminist who echoed Germaine Greer) but still in comparison to my racist and homophobic Father and grandparents on both sides, my Mother always seemed like a beacon of light in a murky prejudice swamp of people.

My Mother challenged marriage and did not think it was anything other than a legal agreement which protected you financially, often saying that she didn’t even want or need a man, just a child (me) and the two of us facing the world. However my Mother seemed convinced I was a “mother earth” type – stating I (even when very young) had always displayed maternal qualities – qualities she would say she did not possess.

At the age of 18 my boyfriend (now husband) and I got pregnant. We were living together in rented accommodation that we could not afford and could barely feed ourselves. At this point my mental health had taken another nose dive, my agoraphobia started at this point and was still having regular psychotic episodes, being very unsafe and destructive with myself due to my borderline personality disorder. Stability was no where to be found, except in one another. To make things more complicated my boyfriend is Muslim and we did not want the family to hate me and know we had sex outside of marriage (in hindsight this would not have happened as the family are beautiful people – but we were kids ourselves and scared). We decided to get an abortion.

As a survivor of CSA, rape and sexual assault the termination procedure was very triggering for me. Vaginal examinations cause me to have sever flashbacks, which causes me to experience chronic pain in my vagina and anus, this is due to complex post traumatic stress disorder. As I was at the latest stage of being able to have a termination I had to be put under general anaesthetic – reminding me of the internal surgery I had after I was violently raped at 15.

When I phoned my Mother to tell her, she at first misheard me and thought I said “I am not having an abortion”, well thank goodness this was not the case, she started screaming down the phone telling me:

“you stupid girl, you will ruin your life, you have to have an abortion”

AT 26 years old my boyfriend (now husband) and I started to try for a baby, we were more mature and intended on getting married in the near future, so we joyfully prepared for our “real” lives to begin as parents. After 3 months I got pregnant and we couldn’t have been happier, all our plans and dreams were going to be put into practice and realised. However after our first visual scan – after seeing our little life we had created; in the early hours I miscarried. It was an ordeal like no other, experiencing the loss physically and emotionally, the pain mocking you and the world reminding you that you have failed and that it is most probably your own fault.

Friends and family were either unable to comfort me due to awkwardness or the projection of their own fears, together repeating the mantra:

“this one wasn’t meant to be.”

My husband and I still grieve to this day for this loss.

Soon after the miscarriage I was diagnosed with polycystic ovary syndrome (PCOS) , this diagnosis was a shock and scared me so much that for another 4 years I did not address my PCOS and ignored all the symptoms and hid my head in the sand – not wanting to face it. The doctors told me that it was likely that my anorexia and bulimia had given me a metabolic disorder which had lead to PCOS. Then just before I turned 30, after almost 2 years of feeling at deaths door and putting on lots of weight even though I wasn’t eating much, I was diagnosed with Type 2 diabetes which I developed from having PCOS.

The girl with the eating disorder inside me saw this as the biggest failure possible. These illnesses were considered by society as “fat people sickness” deemed to be the responsibility of the overweight and lazy, the burdens on the NHS and society. For the first time since I was 11 I felt I couldn’t take back control of my body, as I always had during periods of extreme stress and emotional unrest. No longer able to starve myself like I had , especially if I wanted to have a baby.

The anger toward myself was violent, wanting to rip my flesh and fat off my body, often obsessively imagining cutting fat with scissors, wanting to stab myself in the ovaries and remove the cysts.

After the diagnosis and being at the doctors and hospital appointments weekly, the eventual conversation began about whether I wanted to have children or not and what fertility treatments were available to me. Even being referred to a diabetic midwife to get the best advice possible due to my PCOS and diabetes. At this point feeling confident we would be able to conceive. People kept telling me that the fact I had been pregnant twice before meant that it was just a matter of time and patience. So my husband and I persevered and continued to do all we were told.

We had been trying for over 2 years and we had no luck, the next step was for me to go to the doctors and ask what our options were for fertility treatments. Due to my disabilities, visiting the GP surgery  is an ordeal in itself, unable to go unassisted my husband came with me, however I went into the appointment alone as knowing there would be a lot of fat shaming, which would embarrass me in front of my husband.

Walking in, this unwanted feeling of loss surged through me – feeling emotional and anxious, adrenaline pumping through me, shaking, I sat down. The doctor asked what they could do for me. Explaining as clearly as possible my situation whilst gasping for air through shear panic. After the usual chit chat about my medication, diabetes checks and general well being – I took the plunge and asked:

“What are my fertility options?”

The doctor tilted their head in that manner which suggests pity. The following information was about to hit my ears and puncture my heart:

“Unfortunately your BMI is too high for us to give you any fertility treatment, if you can loose the extra weight before you are 35 then we can give you IVF treatment, ideally you would start fertility treatment now due to your age.”

My heart stopped for what seemed like a lifetime, the tears swelled in my eyes and throat and the rage inside me was switched on. Indignant to the ridiculous hoops, that metaphorically were too small for my fat sickly body to jump through. The doctor knew that due to my circumstances that this achievement was highly unlikely, having PCOS and Diabetes made it very hard to loose weight, not impossible but certainly challenging, especially when unable to leave your house freely and in a time constrained manner. Having lost so much weight since my diagnosis, logically my thoughts were that fertility treatment would be a woman’s right and that I had shown my commitment to being healthy. Not, however, arbitrary bureaucracy dictating that my weight fit into the predetermined “one size fits all” paradigm, due to the outdated system that is BMI testing. As a tall, big framed person – my BMI has been high even when visibly skinny.

My voice was irate, my tears chocked me and my anger made me shake – the “hysterical” mentally ill person was about to blow, you could see my doctor visibly lean back – ready for impact. Crying through my words I said:

“But how is this fair? How can you treat women this way? These rules are ridiculous and penalise people who are over weight, even if they are as healthy as they can be. Fat people get pregnant all the time, I see them!”

My doctor explained to me it was due to the area I lived in, in other areas of the country women have until they are 40 and the weight requirement is not an issue. This injustice made me feel detached and empty. They didn’t care that I was severely mentally ill, that leaving the house on my own was impossible, making regular exercise difficult. Even reverting back to my anorexic or bulimic ways was not an option, not eating now made my  pancreas produce less insulin, my liver produce more glucose, which makes my body store fat. These requirements gave me (a now 31 year old) 3 years to loose weight and then 1 year in which to conceive with IVF. To some this may seem achievable, for me I knew that the impact this would have on my physical and mental health was dangerous. That already the obsessive thoughts had begun:

“I wont eat. I will exercise excessively at home. If I am stressed I will have to start to self harm again, to keep the pain controlled and away from others. I will have to only focus on this until I get pregnant – nothing else will matter, If I don’t succeed I shall have to kill myself.”

These thoughts took over and were at the back of my mind when I told my husband what the doctor had said, pretending that to a certain extent I was OK, that I could handle this. Although there was this little voice inside me, whispering repeatedly:

“Is this what a safe Mother would do? Is this the parent I want to be – half dead by the time a baby arrives? Will I be able to regain mental stability once pregnant or once the child is born? What if we miscarry again? What if this recreates a dangerous environment for my child, such as the one I grew up in?”

In hindsight the realisation had already hit me, that was the end, the end of that dream. That the answer to all my thoughts and questions were right there in front of me. Not realising it at that point, but a valuable lesson, a pause in the rat race for the nuclear family, an opportunity not granted to most – a chance to question all of this!

Over the next 2 years keeping most of this to myself, especially because when you do tell people, they can not help themselves but say:

“This will happen for you, I will keep the faith”

Not realising how damaging these words are, making you feel like less of a woman or human – for the fact you had lost “faith” or that this will not happen for you at all. This made me feel very alone and meant my grief was shoved down and buried. More opinions from people were:

“Why not adopt?”

The answer was simple – in this country (the UK) I am considered as a severely mentally ill person, who cannot adopt. This at first seems like an injustice. Yet if you think about the fact that severe mental illness is an umbrella of disorders some of which mean you can be a danger to yourself and others, you can deduce that this is for the protection of vulnerable children and not to discriminate the mentally ill. This does not mean that there shouldn’t be further investigation, to look at how to give those who may have chronic mental illness and wish to have children more support.

You see mental illness is almost viewed in groups. It starts off with situational and circumstantial reactions to the stressful eventualities and life events we face, such as grief, stress and low self esteem which can cause bouts of depression and anxiety – normally affecting an individual for less than a year. Then you have people who have mood, personality and anxiety disorders for more than 1 year or chronically, such as: bi-polar disorder, addiction and impulse control, clinical depression, personality disorders, OCD, generalised anxiety disorder, eating disorders etc. Then there are disorders considered severe which are psychotic disorders such as schizophrenia, psychotic depression and postpartum Psychosis, as well as trauma related disorders such as post traumatic stress disorder, either complex or non-complex. 

Most people who suffer mental illness in their life time, do so for short periods or their illness does not affect their ability to lead a functional life. However some of us have severe mental illness which impacts everything in our day to day lives, our abilities to function and take care of ourselves are impaired and the likelihood of impulsive unsafe behaviour is higher. So the point I am trying to illustrate is that – there is a point to this rule – to be properly assessed makes sense. Furthermore only the individual can really know if they can or cannot take care of a child, asking themselves:

“Am I too ill to have a child and take care of that child, to not impact them in a negative way with my illnesses and disabilities?”

The realisation was clear and logical, the answer for me, personally, YES!

Asking myself continuously why the need to have children and each time it was apparent to me that all my motivations were selfish. Wanting a child so that I could experience a “happy family”, to “break the cycle” of abuse and neglect I had faced, to witness my husband be a Father so that I could experience a healthy Father and child relationship, so that if my husband died I would have a part of him still here. None of these reasons seemed good enough, seeming empty and damaging to a child.

Thinking of myself when young and the pain endured from my parents, who really should have questioned everything before bringing me into the world. Possibly concluding it was just to fuck me up and narcissistically abandon me or hold me emotionally hostage. Or maybe it was to love and be loved and things changed, as life does. Whatever the reason – the reasons were never challenged, the status quo needed to be maintained, as would have been if I was never afforded the opportunity to question my abilities as a parent. It is never a bad thing to ask yourself:

“Can I truly (to the best of my knowledge) say that upon having a child that I shall be able to look after them, emotionally, physically, fiscally and that I shall not put my child in danger due to selfish needs and ego”

Genuinely most people will think they can do this (I did too), however the statistics of child abuse, neglect and sexual abuse paint a different picture. Furthermore the extremes are not the only damage that can be done, the importance of functional safe upbringings is fundamental to bettering the physical and mental health of children collectively. Too often the selfish needs of adults cause children the most harm. Having children or caring for children is a privilege, it is not to be taken lightly and your rights to “have them” does not override their right to exist in a safe environment.

Even though grieving for what could have been, for dreams that were never realised is still a process I am very much in, the reality that having a child would be unsafe for both me and said child; makes me feel better about my decision to not pursue something that has already been taken off the table. My focus is now on imagining and realising a new life  more suitable for me.

Yes, being child free was not my first choice – in spite of this my choices now as a child-free person are limitless.

 


If you have any feedback on this essay please fill in the form below:


Essay by Charlotte Farhan

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.

Outsider Art – Unlocked by Charlotte Farhan

Unlocked - By Charlotte Farhan
Unlocked – By Charlotte Farhan

Unlocked – By Charlotte Farhan

A pressure builds inside my head like a boiling liquid,
spilling out of me, the security lock has been breached.
The fear that anything could escape – this is unscripted,
witnessing my life – my credibility is impeached.


This illustration is of my inner turmoil spilling from my mind, when experiencing a locked in state from flash backs and psychosis as a result of having complex post traumatic stress disorder and psychotic depression.

As I get older the locked safe where my darkest thoughts and memories have been kept, since being very young; has started to erode with time. Rusty and old, the hinges are no longer able to hold it all in.

Since starting reliving therapy in 2014 there have been many disturbances to my treatment, such as the NHS only being able to offer 6 weeks and then leaving me worse than before, opened up and dumped.

Then last year I found a therapist which was able to offer a reduced fee (as we are on such a low income) all was going well, even though it was soul-destroying and painful and made me cry in those 6 sessions more than I ever had. Still it was a process and felt as if maybe I would be able to deal with the trauma of my rape and sexual abuse as well as all the other issues which had developed as a consequence. However this was not to be the case, due to my borderline personality disorder I ended up splitting my therapist in my mind and however much I tried, this could not be changed. From thinking “she is my saviour” to “she is trying to kill me”, which then led me to become dangerously suicidal. So having no real choice, the therapeutic relationship had to be terminated.

So I am left unlocked and wide open…


 

If you have any questions on my work, if you wish for me to exhibit in your gallery or would like to purchase a piece , please contact me via the form below, thank you.

Why is Severe Mental Illness left untreated in the NHS Mental Health Services

Art By Charlotte Farhan
Art By Charlotte Farhan

The mental health system in the UK which is provided by the NHS is failing people like me everyday; so lets see why?

Here is what the NHS have to say about accessing mental health services in the UK:

Mental health, emotional wellbeing and resilience is all about how we cope with what life throws at us. It concerns the way we feel about ourselves, conduct relationships, handle stress or deal with loss.

Good mental health and resilience are fundamental to good physical health, relationships, education and work, as well as being key to achieving our potential.

This is just an opening statement on the NHS website and already there are many issues:

  • The first sentence implies that mental illness is only from environmental factors around us such as “what life throws at us” and completely negates to say that mental illness can also be a neurological condition which is visible to us on MRI scans. So for people like myself who have C-PTSD, BPD and suffer from periods of psychosis or someone who has schizophrenia, bipolar-disorder, dissociative disorders and many more are left already feeling like this does not include us.
I Am Still Bleeding - By Charlotte Farhan
I Am Still Bleeding – By Charlotte Farhan
  • It goes on to say, that in order to maintain a good life: mental health, emotional wellbeing and resilience are paramount. When someone like me sees this, the complete lack of effort to include severe mental illness appears as if the NHS caters to an exclusive group which myself and others are not welcome in. Some mental illness is not “fixable” in that there is no cure and the assumption and misinformation is irresponsible and suggests that those with mental illness can be healed with a one size fits all solution.

 

 

  • For us with severe mental illness the world is very different , we do not have the privilege of those who suffer from situational depression and anxiety solely. The world expects and allows us as people to feel depressed after death, or anxious after a car crash and what ever else “life throws at you”.  This was not always the way, society has come leaps and bounds in the last 30 years to accept depression and anxiety in a mainstream way. This help is now widely available to the general public and society is more and more open to those who suffer from depression and anxiety as most people have had it or know someone who has. With celebrity faces, depictions in modern film, TV and literature as well as many charities and campaigns continuously running to educate the world about depression and anxiety, the world is still silent about those like myself still viewed as “crazy” or “psychotic”. Due to complex sever mental illness which are still only referenced in horror films, crime dramas, documentaries about “the criminally insane” murderers, news reports where “someone with a personality disorder has killed someone” or referenced as the go to insults for people displaying “weird” behaviours.
Art By Charlotte Farhan
Art By Charlotte Farhan

The NHS go on to say:

Less common conditions, such as psychosis, can make you experience changes in thinking and perception severe enough to significantly alter your experience of reality. These conditions include schizophrenia and affective psychosis, such as bipolar disorder, and can have the same lifelong impact as any long-term physical condition.

 

 

The issue here is that even within the severe mental illnesses there are some which will be focused on above so many others. With an over emphasis on  Bipolar disorder, schizophrenia and a general reference to psychosis. There is no mention of the most common of these disorders; C-PTSD or PTSD, there is no mention of personality disorders, dissociative disorders or to the disorders which have psychosis as a symptom. It is as if the world is not prepared to let go of the label “crazy” and still needs some of us to be under this stigmatising label so that we can be scapegoated as the deranged creatures of nightmares so that fingers can be pointed and there is a face to the monster.

This next paragraph from the NHS is misleading:

Mental illness is treatable and, with appropriate support and treatment, people do recover. Many move on with their lives and are able to care for their family, contribute to the local community, and get back into employment or training.

Vulnerability - By Charlotte Farhan
Vulnerability – By Charlotte Farhan

The sweeping statement that “mental illness is treatable” is an insult to many, it should instead read ” some mental illness can be treatable and severe mental illness is manageable with continued support and treatment”. This goes back to the generalised view that depression and anxiety are the only illnesses affecting the masses and that people can only have mental illness which is subject to your own psychological resilience.

Also some with severe mental illness like myself have symptoms from our illnesses which are depression and anxiety, so you will be offered in the NHS to have these treated rather than the severe illness which caused the symptoms of depression and anxiety. for example, I have C-PTSD, BPD and psychotic depression and due to these severe illnesses I have other illnesses which are symptoms of these, such as: GAD, agoraphobia, OCD, Adult ADHD and BDD.

And then lastly the NHS tell you what is needed but only provide one option in reality:

But this may not always be a straightforward journey. Many people only need a short course of psychological therapy or six months of medication, while others will need much more support and intensive treatment, be it medication or extended therapy.

The issue with this paragraph is again how the less complex and severe your illness is the more you are taken care of. Most people will only need a short course of medication and some focused counselling like 6 weeks of CBT if they suffer from anxiety and depression if caused by general life’s ups and downs, they may then need this again and it will be available to them throughout their lives.

Neurosis and Psychosis - By Charlotte Farhan
Neurosis and Psychosis – By Charlotte Farhan

However when it brushes us “the complex cases” under the carpet with the statement “while others will need much more support and treatment” this makes me very angry. As they imply they “the NHS” will provide this for us, but in fact this is NOT the case as all. You will be offered drug treatment of archaic psychotropic drugs, you will be offered short term therapy (6 weeks) and then once you have had this treatment you can not re-apply for treatment until after 6 months. So if you are not “cured” after 6 weeks, tough luck! Which as you have read is impossible for complex and severe mental illnesses.

There is no after care, the emergency lines (crisis support) they allow you to have whilst in treatment are then closed to you, (not that they answered when you were allowed to call them). Finally the pièce de résistance is that you will be told (like I have been told 3 times over the last 21 years) with no uncertain terms that “there is nothing we (the NHS) can do for you now, sorry”.

Agoraphobia - By Charlotte Farhan
Agoraphobia – By Charlotte Farhan

The devastation that is felt by people like me, who are unable to be part of society due to our mental illnesses due the stigma attached to us, is so overwhelming that in most cases it leads to a relapse and more often than not self-injury, suicide attempts or death. When this last happened to me last year, I suffered a further breakdown and relapse, this meant I did not take care of myself for over 6 months resulting in more ill health. If I did not have a husband who takes care of me when ill, I would have died. So what about all of those alone? What about my husband who has to deal with this on his own?

Now I ask you, is the mental health system working effectively?

Source: http://www.nhs.uk/NHSEngland/AboutNHSservices/mental-health-services-explained/Pages/accessing%20services.aspx#

Next time I shall be sharing my timeline of treatment within the NHS from age eleven to now. So follow my blog to keep up to date on my future posts.

 

My colleague from ART SAVES LIVES INTERNATIONAL and dear friend Jade Bryant is also exploring the NHS and its failings within the Mental Health System, please follow this link to read more and get involved by sharing your stories.

Attitudes Of The Mental Health System – By Jade Bryant 

 

Find more art from Jade; HERE

This is the beginning stages of a campaign which ASLI (our non -profit) will be running in the near future. We hope to elevate our voices and others and then we hope to take this to the government; to bring about change as well as running workshops and programs which will aim to engage better understanding within communities, so that people like myself and Jade and so many others can be included properly in society which will inturn help us with our mental health.

Thank you for your time.

Pain and Detachment - By Charlotte Farhan
Pain and Detachment – By Charlotte Farhan

If you have anything to say on this subject, or your own story please get in touch via this contact form: