Wednesday, 20 March 2019

A Heap of "S" Words and an Aitch: Stigma, Suicide, Self-Harm - and Hope

By Martin Baker and Aimee Wilson

My good friend and fellow mental health blogger Aimee Wilson recently enrolled on an online course at Future Learn, titled Understanding Suicide and Suicide Prevention Strategies in a Global Context. It took me about thirty seconds to decide to join her! This is from the course description:

On this course, you will gain a broader understanding of suicide as a worldwide issue. You will analyse global suicide rates and patterns and explore common risk factors. You will explore the social and cultural factors that can influence suicidal behaviour. You will also look at suicide prevention strategies and learn how these can be enforced in communities.

Having a study buddy is great because — as Fran and I have found many times — you have someone to share ideas and perspectives with, and to talk through any issues that come up. This is especially valuable with something as complex and important as suicidality.

As with other Future Learn courses there is an online forum where students can connect, answer or ask questions, and post comments. One of the modules, Introducing Stigma, invited us to “share examples from mental health settings that help clarify the meaning of the terms [stigma, stereotypes, and discrimination].” I posted the following to the discussion area, drawing on conversations Fran and I have had over the years:

My best friend who lives with bipolar disorder has lived with suicidal ideation for most of her adult life. [....] In her case, the perceived stigma surrounding suicide (how she would be viewed by her community after any attempt at taking her life, whatever the outcome might be) is one of the factors which in her case is protective. The stigma helps to turn her away from that edge. This is something I don’t think I have seen reported elsewhere. Not exactly a good aspect of stigma, but worth noting.

I mentioned this to Aimee on Twitter, where we have been tweeting our progress on the course. She hadn’t heard that particular point being made before either. It made sense to her, although her personal experience with stigma was different:

For me, the stigma means I find it hard to ask for help when I am feeling that way.

I replied that the impact of stigma wasn’t simple for Fran either.

Yes, and that [aspect] is also present for Fran. So it’s all very mixed up and confused/overlapping. (We go into this in our book HTLT in some detail). I guess the different aspects affect people in different ways, and not always “logically”.

Here is the key passage, from chapter 7 of High Tide, Low Tide, “The ‘S’ Word: Being There When Your Friend Is Suicidal”.

The stigma surrounding mental illness is unhelpful and dangerous to the extent it makes people less likely to seek help, or speak to someone about what they are going through. Yet paradoxically, it can be protective to some degree. As Fran sees it, the taint of suicide would follow her even in death. She would be remembered not for her successes — her career, her books, her caring relationships, or the courage she has displayed through decades of illness — but as a failure. Whether or not she survived, she would always be “Fran Houston, that woman who tried to kill herself.” As much as she despises it, the shame of suicide helps to keep her away from the edge.

Aimee and I had chance to discuss this further in person. The idea that stigma could have a protective effect gave her a perspective she’d not had before. I asked if she would share what it meant to her:

Having experienced recovery from Borderline Personality Disorder (BPD), I’ve learnt that it isn’t linear. Recovery is still a rollercoaster; it’s just that you tend to actually stay on the track a lot more! So, it feels like my recovery is constantly being tested by challenges in life and it means that I’m always looking for new inspiration and new reasons to stay on that track. Hearing Fran’s thought process around suicide was really enlightening and I have definitely added it to my arsenal of inspirations I can call on when things get difficult.

And that’s why it is so important to keep the dialogue open about such “difficult” topics as stigma, suicide, suicidal thinking (also known as suicidal ideation), and self-harm. (That’s a heap of “S” words, right there!) All too often these are hidden away or talked about only in terms of statistics and strategies (another two!). Exploring trends, causes, and effects on a societal level is important, but behind every statistic is an individual with his or her personal story, experiences, insights, and potential. That can too easily be lost. As Fran’s experience of stigma shows, things are not always as simple or clear-cut as they might appear.

No one is saying stigma is a good thing. It is overwhelmingly unhelpful, unhealthy, and damaging to both individuals and society at large. But the fact that it may, under some circumstances at least, help someone step back from the edge of self-harm or suicide deserves to be acknowledged and considered alongside other factors.

When it comes to something as complex as suicidality and self-harm, the best approach is to start from the individual person’s perspective, experiences and needs. And if we cannot guess what those are — and we cannot — we need to be prepared to ask the questions.

What are you going through right now?
What helps?
What doesn’t help?
What do you need?

Sharing our stories in a spirit of openness allows us to learn from others, expand our understanding, and can bring hope. What more valuable work can there be?

How do you feel about the topics discussed in this article? Please feel free to share in the comment section below.

Further Information

If you would like to know more about courses offered by Future Learn you can find all the information on their website. There is no enrolment charge and most courses are free to access throughout the duration of the course and for 14 days afterwards. You can upgrade for unlimited access plus a Certificate of Achievement or Statement of Participation. For the course Aimee and I are taking the upgrade cost is £52 (GBP).

Aimee Wilson is a 28-year-old mental health blogger who has used her personal experiences to develop a popular online profile. Her blog I’m NOT Disordered has close to half a million readers. Aimee’s first book, When All Is Said & Typed, is available at Amazon.co.uk, Amazon.com, and in other regions.

 

Sunday, 17 March 2019

When She

By Aimee Wilson

 

When she fought, he won

When she stole, he caught her

When she looked, he hid

When she bent, he broke her

When she hurt, he caused it

When she ran, he gave chase

When she saw, he missed it

When she heard, he ignored

 

But when she died, they revived her
When she cut, they mended
When she swallowed, they treat
When she cried, they soothed
When she ran, they caught
When she lost hope, they showed her the way

 

She won back what he’d taken

She mended what he had broke

She stabilized what he had moved

She finished what he had started

She lived

 

 


About the Author

Aimee Wilson is a 28-year-old mental health blogger who has used her personal experiences to develop a popular online profile. Aimee was diagnosed with Borderline Personality Disorder in 2009, and after over 60 attempts on her life was admitted to a long-term, specialist psychiatric hospital almost 200 miles from home. It was during her two-and-a-half-year stay in hospital that Aimee began her blog: I’m NOT Disordered.

Originally it was meant as an outlet for pent-up frustrations from inpatient life, and a means to document her journey through the trauma therapy that eventually led her into recovery in 2014. The blog has developed into a platform for others to tell their stories and to give their own message to the world — whatever it may be.

Aimee’s blog now has close to half a million readers. Its popularity has resulted in three newspaper (in print) appearances, two online newspapers, BBC1 national news, ITV local news, interviews on BBC Radio 5 Live and Metro Radio; as well as a TV appearance on MADE. Aimee has had the opportunity to work with such organisations as North Tyneside and Wear NHS Foundation Trust, Northumbria Police, Time to Change, Cygnet Healthcare; and with individuals who range from friends, family and colleagues, to well-known people in the mental health industry.

Her first book, When All Is Said & Typed, is available at Amazon.co.uk, Amazon.com, and in other regions. You can follow Aimee’s blog and read more about her at www.imnotdisordered.co.uk.

 

Wednesday, 13 March 2019

Open Hands. Open Arms. Open Heart.

This important principle reminds us not to hold too tightly to people, relationships, and situations. Healthy things grow, and to grow is to change.

In the time we have known each other Fran has moved from mania to depression and out again. She has grown in self-awareness, and developed tools for looking after herself. I have learned a great deal about what it is like for someone living with illness, and how to respond to Fran’s needs and the needs of others. At times Fran needs me close beside her, at other times she needs space to grow independently.

“Open hands” recognises that change is natural, healthy, and necessary. It gives us permission to grow without feeling guilty or restricted. Imagine holding a small bird in the palm of your hand. It feels safe, protected, and cared for, but it is free to move, to grow, and even to fly away.

“Open arms” reminds us that, no matter what happens, we will always welcome each other back as friends.

“Open heart” connects our friendship to our wider network of relationships with other friends, family, and the people we encounter in our lives.”

 

Excerpted from chapter 1, “The Caring Friendship: Key Skills and Attitudes,” of our book High Tide, Low Tide: The Caring Friend’s Guide to Bipolar Disorder. Available at: Amazon.ca | Amazon.com | Amazon.co.jp | Amazon.co.uk | Amazon.de | Amazon.es | Amazon.fr | Amazon.it | Barnes & Noble

 

Sunday, 10 March 2019

My Mental Health Talk for International Women’s Day

Last week I was proud to speak at an event organised for International Women’s Day by the Women in Digital network where I work.

I’d been invited to take part by my friend and colleague Lisa Overall. We agreed on a topic for my talk — how to support a friend who lives with mental illness — based on an article I wrote originally for No Stigmas, “a global non-profit movement utilizing peer-to-peer connections to promote mental wellness and prevent suicide.” The article was subsequently published at The Mighty.

I had given the talk once before, at a Talking FreELY event in 2017, but it is a topic which resonates with many (at The Mighty my article has been “liked” more than 1,200 times) and I was confident it would work for this new audience. The room was filling nicely by the time I arrived. I’d estimate there were close to sixty people there as the event got underway. (It is possible the promise of cake had something to do with the turnout!)

After introductions, things got off to a great start with a presentation on women and mental health by Lois White who leads the mental health awareness team at BPDTS. Like me, Lois is a Mental Health First Aider, and equally passionate about the work we are doing within the company.

After her talk Lois introduced me and took charge of the projector, anticipating almost all of my “next slide, please” moments. (Thank you!) I’ve done a number of public readings and talks in the past few years, but I still get nervous. Fortunately, once I am up there I find myself calming down and easing into things.

I had the script for my talk on my Kindle to keep me on track and on schedule, but I found myself ad-libbing freely. It’s hard to know when you are in front of an audience but it seemed to go well. There were even a few laughs in appropriate places. Lisa told me later I’d had the room in the palm of my hand, so I guess I did okay!

I received some very positive feedback afterwards, which is testament to the relevance of the key message I wanted to get across: that no one is too far away to be cared for or to care; and that with some basic tech and a little imagination we can be there for our friends and loved ones, whether they live on the other side of town or an ocean away.

In the interval I got chatting with a few of the other attendees including Andy Heath who was photographing the event. I couldn’t attend all the sessions but I’m glad I stayed for the next two speakers, who shared what has influenced and motivated their life and career journeys. The message to follow what interests you most and where your passion lies rather than “chasing grades” resonated strongly for me, as did their commitment to remaining open to new challenges and opportunities.

In case anyone is wondering, I didn’t have Fran with me on live video link (maybe next time!) but she messaged me before and after my talk and was very much with me as I shared our story. I even sneaked in a mention or two (or was it three?) of our book. I still feel self-conscious doing that, but a friend told me something this week that really struck home:

You were wondering where you are in the mental health community ... you are a writer, and an adamant and steadfast supporter.

She’s right (thanks, Jen!) As I wrote recently, I have been struggling a lot with my self-confidence of late, unsure in particular of my role and place within the mental health community. My talk, the positive responses to it, and the other speakers at the event helped me reconnect with the idea that I have a voice and a message worth sharing.

For that, and much else, I am grateful for the opportunity to take part. Thank you.

Photo credit: Andy Heath, with permission.

 

Saturday, 2 March 2019

Or Maybe You Were an Asshole

Don’t push someone away and then expect them to still be there when you have a change of mind.” (Anon)

That quotation made its way into my social media stream the other day. Maybe you’ve seen it, or something similar. Maybe you agree with the sentiment.

After all, it doesn’t feel good to be pushed away by someone you care about. It’s easy to sit back and feel self-righteously aggrieved. But things are not always what they seem.

Someone might push you away for all sorts of reasons. Maybe they have major trust issues, and very good reasons for them. Maybe they have a lot of other shit going on right now and can’t keep all their plates spinning at the same time. Maybe they need to believe someone will be there to welcome them back. Maybe it isn’t about you at all.

Or maybe you were an asshole and they needed to push you away for their safety and well-being.

 

Wednesday, 27 February 2019

One Step at a Time: Walking for Wellness, Walking for Me

When I’m happy, I walk.
When I’m sad, or lonely or lost.
When I’m hurting, or numb.
When there’s too much to think about
Or nothing on my mind.
I walk.

Walking has played an important role in my life for as long as I can remember. So much so that it was one of the first things I included in the wellness tools section of my Wellness Recovery Action Plan (WRAP). It’s also made its way into my writing more often than I’d realised until I began writing this article. (The idea for this piece came to me whilst, wait for it, walking into work one morning a few weeks ago.)

My family never owned a car, so when I was growing up in Liverpool if I wanted to go somewhere it was catch the bus or walk. From the age of eleven I walked thirty or forty minutes each way to and from school, lost in my thoughts about whatever was going on for me at the time. In my late teens I remember going for Sunday evening walks to West Derby village and back, a round trip of maybe an hour and a half at my ambling, contemplative pace.

About that time I started going on the Ramblers’ Association (now The Ramblers) public walks every couple of months with my aunt and her friend. I loved the exercise and the sense of freedom, being out on the hills. The people were lovely but I mostly kept my own counsel and walked separately the rest. There was one exception, a lady whose name escapes me some forty years on. Her spirit is captured, however, in one of my poems from that time.

Song to the high hills

Take my hand offered
across streams
we jump
that trickle your laughter
down the savage fen.
Share with me one day’s
journey
in this weird land,
where even the spring shuns
the mark of our
trespass
and unnamed birds cast down
forsaken echoes
from the high hills above us.
Do you not see
the whole earth bleeding …
distant mountains burn
a venous red
and at our feet
the bare rocks haemorrhage,
oozing lichen up from unseen wounds.
Believe me,
cares that clothe us
city-bound
will fall
today
like autumn leaves
       that colour in your hair
come winter’s purge.
And yet, in all of this,
a little rain might mark my sadness
sevenfold
to court you but a day
—surely inhibition falters
as we share the innocence
of exploration together.

Innocence tempting revelation.

From: Collected Poems: 1977–1984.

I joined the hiking club at university but didn’t keep it up. I do recall one hike with friends across Ilkley Moor during a thunderstorm that painted the sky in all manner of crazy hues. Instead, I took to taking urban walks on my own, mostly early in the morning. A favourite route took me out of town to a park where I would sit a while by the lake before making my way back for lectures. One day I went further than I intended and got myself a bit lost. I remember taking my shoes off and walking part of the way back barefoot across a golf course in the rain. A different early walk, along a derelict railway to the local park, was captured in another of my poems.

The Bunch of Wild Flowers

this morning
as you slept in his arms
I wandered,
picked you flowers white as sonnets
early in the morning
where the lonely go
and lovers wonder)

stirring in your arms he
tasted autumn in your hair
ascent of flowers,
brushed away the cobwebs or a dream
and (plucked one throbbing rose as red as
kisses
early in the garden
where the lovers grow
within each other’s arms

And bore you welcomes wild
of flowers truer than all orchids
my love
this morning as you slept
in his arms I wandered
gathering poems deep as daisies
early in the morning
where the lovers
go,

From: Collected Poems: 1977–1984.

Urban or rural, walking for me has always been about space: space in which to think or not think, depending on what I most need at the time. It is my instinctive response to uncertainty, challenge, and loss. When I got the news that PJ, a dear friend from university days, had died my instinctive reaction was to get out of the house and walk. It didn’t matter where, I just needed to be moving. (Years later, that one evening of loss is imprinted on these local streets, although I’ve added many overlying layers of other days, people and memories in the intervening years.) A week or so later I took the day off work and went to the coast for a solitary hike, long enough to try and process the fact that my friend was no longer here. After my mother died I walked by Crosby Marina the evening of her funeral. The words that came to me are, perhaps, a poem. If so, it is the first I’ve written in many years.

Wandering
Wondering

How do I feel
What do I feel

Release
Relief

Re birth

Stillness
Silence

Un known
Un homed

Un tethered

Still
Calm

Centred (thank you

— Liverpool, March 26, 2018

I mostly prefer to walk alone but there have been times when I’ve taken a trusted friend along. One of my dearest memories of PJ is of walking her home in the snow one dark winter night. Years later I recall another walk in the snow with a different friend, when we got seriously lost on Wimbledon Common. The walk Fran and I took around Beaulieu in 2013 when we met in person for the first time was, quite simply, precious.

We walked, and talked, and took photos of the Abbey and gardens, and went on the monorail and the old open-top bus, and walked some more, and sat, and talked some more. It was amazing—and the most natural thing in the world. If we were a little shy it didn’t show. We were just two friends out together enjoying the day.

From: High Tide, Low Tide, The Caring Friend’s Guide to Bipolar Disorder.

Walks by the sea are special. I spent six months in Norwich on placement from university. One Sunday I drove to the coast with one of the other students for an hour or so walking on the shore.

(In the Depths of) Singing

Down the western reaches of the sea i
findme walking with a friend,
wind and seasalt wildly in the sky, you on
my mind. Late november: pebbles in a
wilderness of oceans and a fulling moon.

Something like the flesh of friends too
raw for touching walkwe. Two
investigating puddles. Our togetherness apart
we wander down our dreams while all the
waves one water can involve strike
sparks about our feet. From flints we
gather in the night.
We gather. In the

(o i love the waves that break upon
me like you)

nightly

From: Collected Poems: 1977–1984.

That memory sparks another. One morning long ago when I ought to have been at work but instead spent the day on the beach walking with a friend who understood that sometimes shared solitude is just what is needed.

A few years ago I paddled in the sea along Long Sands Beach at Whitley Bay here in the north-east. At first it was cold. Then my feet went numb. I probably should have come out at that point but I kept going to the point when my feet were hurting with cold. I got out of the water, dried my feet, and put my thick socks and boots on, expecting my feet to warm through within a few minutes. They took so long to thaw out I was beginning to think I had caused some serious damage. I have paddled in the sea several times since then, but not in quite such extreme conditions.

Over time, regular walking routes become saturated with memories. The best example of that is the walk I take each evening when on holiday at the Cumbrian cottage my family have rented for the past twenty years or so. So rich are the echoes of the people and situations I’ve brought with me in mind and heart over the years that I’ve named it Memory Lane. Fran has accompanied me on that walk many times via the magic of Skype. A few other friends have done the same.

I have done a few sponsored walks. When I was at school I organised a twenty mile walk for friends in aid of the World Wildlife Fund. I think only two of us completed the task but we did raise some money. More recently I have done the Alzheimer’s Society Memory Walk a couple of times, and taken part in the NAMI Maine Walk, accompanying Fran from 3,000 miles away. Last December I took part in the Jingle Bell Walk to raise money for children’s cancer charity The Chris Lucas Trust.

Returning to my solo walks and their place in my wellbeing, the best example is the walk I took almost every evening during the summer of 2013 when Fran was traveling in Europe. Those walks were part of my wellness plan for that period, which was the most challenging we’d faced as friends and one of the most traumatic Fran had ever experienced.

That wellness plan developed into the Wellness Recovery Action Plan I mentioned at the start of this article. It is a living document and will grow with me as my needs change, but I cannot imagine walking not being in there as one of my key wellness tools.

Well, this article has turned out to be rather long and rambling, much like many of my walks!

I will close with another passage from our book, because short or long every walk starts out as a single step, then another, then another. And where steps are concerned, size and speed are not always the most important things. The important thing is to keep moving.

As we like to say, baby steps are steps too.

This is one of our favourite [sayings]. It reminds us to stay focused in the present moment, to take life one step at a time, and to acknowledge that even the smallest advance counts as progress. Fran is very goal-oriented, and becomes frustrated if she seems to be straying off course or failing to make fast enough progress. In depression, this can reach a point where she despairs of ever achieving her targets or even progressing further towards them. At such times, “Baby steps are steps too” reminds her that she rarely stays stuck for long. She will try new ideas, or re-visit old ones, until something happens to move her forward.

From: High Tide, Low Tide, The Caring Friend’s Guide to Bipolar Disorder.