It is sometimes an appropriate response to reality to go insane.
― Philip K. Dick, VALIS
I was a consumer of mental health services off and on for nine years. Diagnosed with depression, schizophrenia, borderline personality disorder and many more labels. I experienced involuntary hospitalisation, massive doses of medication, and electro-convulsive therapy. I was told I would always have this ‘brain disease’. I was told that I would probably never recover or work again. During this time my identity went from being a successful, creative, attractive, strong woman, to a hopeless, fat, unemployed mad woman with no future.
Today I am a general manager at a major mental health organisation, a board director, an adjunct research fellow, a public speaker and the writer of this blog. These are all things that I was never supposed to be able to do, and this blog was certainly never supposed to be written. Seems that prognosis was wrong… but it could easily have been right.
‘Don’t ask, don’t tell.’ Why trauma has a leading role on this mental health website.
During hundreds, perhaps thousands, of contact hours with mental health professionals, not one single doctor, nurse, therapist or community worker ever once asked me about past trauma.
No-one knew about my childhood experiences of violence at home, bullying at school, a terrifying two-week long abduction and rape at the age of thirteen, or how they might be linked to my madness.
I certainly wasn’t going to bring it up. I didn’t know how, and even if I did, I felt far too ashamed and confused. I was told that I had a chemical imbalance in my brain, and I gave over to being medicated, hospitalised, given shock treatment and put on the pension.
A socially acceptable recovery.
After about five years, and with support of some amazing professionals, I able to make a partial recovery: what I call a social recovery. I got back to work, back to life, off medication and stayed out of hospital.
From the outside I appeared ‘recovered’. I thought I was ‘recovered’. Even though, on the inside, I still thought I was evil. I still heard my voice, I still, occasionally and secretly, self-harmed. I still struggled to keep it together. But I had, at least, reasons to fight, reasons to keep it together, and the skills and support to do it. What I had done was learn to live with my madness in a socially acceptable way. I had achieved a life that was worth living.
Courage gifted by peers and a new, deeper recovery.
Nine years after I first entered the psychiatric system, I was lucky enough to be managing a peer support program, called Voices Vic. I began to hear public talks and attend training from international consumer leaders associated with the hearing voices approach.
These were people who had been where I had been. But these leaders, people like Ron Coleman, Jacqui Dillon, Eleanor Longden, Rufus May, Peter Bullimore, had richer stories than me. Whereas I was living a life that felt ‘worth living’, and that ‘I could cope with’, they were living lives that they ‘deeply cherished’. I had only found out how to get by. They were on a whole different level. I wanted what they had. And as I listened to their stories, over and over, I began to see that it was possible.
What seemed to have made the biggest difference for these people was in making sense of their madness, particularly in terms of past trauma. Each of them was able to explain how painful experiences in their past were directly linked to their madness. This knowledge enabled them to fundamentally change the experience of madness, and led to healing.
Confronting my own past trauma, making sense of my madness.
And so, with indescribable trepidation, but inspired by my peers, I began to explore ‘that thing that had happened when I was thirteen’. I talked to a therapist, but then I went completely mad again. This, of course, is exactly why many people say we shouldn’t talk about trauma. But they’re wrong.
I did end up psychotic, suicidal, back in hospital, back on medication, and being told by a psychiatrist that I had come too far to risk it all now. My trauma was in the past and it would only keep me sick to talk about it. I must get back on medication and forget the past. I fought and fought. I knew that I was right.
And then I remembered how the system really works, so I lied. I told the doctors they were right. I drew up a ‘sensible’ recovery plan for myself, and got discharged. Then I went straight to CASA (Centre against Sexual Assault) and got myself an amazing counsellor called Marion. And while it was painful, I began to find a way to really heal. I discovered ‘that thing that happened when I was thirteen’ was called ‘abduction and rape’. The words felt strange, and scary. I discovered that so much of what I felt was shame, not meaningless madness. I discovered that much of what I felt and thought and experienced was really common amongst people like me. I learned about grooming, and Stockholm syndrome, and how our bodies respond to sexual assault. This was extraordinary. Why had no-one ever told me this before? I wasn’t mad or evil after all – but what had happened to me certainly was both.
I was privileged to be able to work closely with many amazing consumer leaders and peer workers, from whom I drew courage and hope and creative ways to direct my journey. I learned to find compassion for my voice and myself. I was able to identify layers of shame – about 15 of them – which were why this inner voice had so persistently told me I was evil for so many years. I put myself through a mock trial and found myself innocent of all charges. I began to stop ‘coping’ with ‘symptoms’ – and instead engaged with them, listened to them, understood them and was able to transform my experience of them. I am now completely off psychiatric medication. I can now say that I, too, cherish my life.
Life for me is still, often, deeply painful. I still live with some unusual experiences. If my values feel challenged I will hear my voice – but this reminds me to bring myself back to my value-base. That voice is unpleasant, but it is a part of me and it serves a purpose. I still feel urges to self-harm – sometimes hundreds of times a day. But I don’t do it, I wouldn’t do it, because now I understand what it’s about. I cannot undo all the harm that was done to me through trauma, but now that I understand how it has affected me, I know that I was a victim and I am now a survivor. And I know how to survive and draw strength from that. My remnants of madness drive me in my life and in my work.
The deafening silence about trauma and mental health
Trauma is the most prevalent experience amongst people who end up in our mental health hospitals and systems. One major study in the US (Goodman, et al, 2001) found that 87% of public mental health patients had experiences of severe trauma, and similar findings have been replicated over and over. Child abuse, bullying, sexual assault, family violence: the list is long and it is heartbreaking.
Although the evidence for the links between mental health and trauma are now indisputable, our health and community service systems almost never even ask people about trauma, let alone offer any kind of trauma-informed care or services.
I do not understand how it is that we can have a multi-billion dollar mental health industry that is almost universally silent about trauma. Especially when so many of us are already silenced by fear and shame from our experiences. We not only fail to receive the help we need, but our fear and shame is often compounded by the silence of the people who are paid to support us.
Why I’m writing this blog.
Yes, I worked hard on my recovery. But I was also lucky to be able to access such extraordinary workers and peers. Most people are not so lucky.
I want recovery and healing to be a matter of standard practice, not of luck. And so, despite all the horrors of my past, I wouldn’t change it. Because I now have the opportunity to use what I have learned out of my pain to make a difference. To be, I hope, a part of building a better mental health system that is based on the truth of people’s lives.
This blog is one of the ways that I can make a difference. It is a space for breaking the silence about trauma and madness, and for honouring the myriad of creative and adaptive ways that human beings respond to distress … and can bring about healing.
Luckily, these days, I’m an optimistic kind of person. Well, mostly. I believe in change. People can heal, and so can organisations and systems. One day mental health systems will stop reducing mental and emotional distress and difference into simplistic biochemical labels treated with pills, and will stop telling people that they should learn to ‘accept their illness’.
Instead we will understand that madness makes sense in an insane world, and that with the right support people can actually heal, rather than just get by. I hope you join me.
Goodman, L.A., Salyers, M.P., Mueser, K.T., Rosenberg, S.D., Swartz, M., Essock, S.M., Osher, F.C., Butterfield, M.I., and Swanson, J. (2001). Recent victimization in women and men with severe mental illness: prevalence and correlates. Journal of traumatic stress, 14:4, 615:632. Retrieved from: http://link.springer.com/article/10.1023/A:1013026318450#page-1
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