Motherhood, mental illness and beyond

Posts tagged ‘self-harm’

The fat and the furious

Trigger warning: self-harm

If you’re a regular reader of this blog you’ll know that I’ve had problems with food since childhood.  26 years of bingeing, self-loathing & dieting have led me to the point where I am the heaviest I have ever been and so ashamed of my body that even the school run is a self-conscious gauntlet that I dread. I know that there’s more to life than just physical appearance and that my self-consciousness is probably vastly disproportionate. But what is undeniably true is that my body, already damaged thanks to degenerative disc disease, cannot withstand many more years of abuse.

I’m furious with myself for letting things get this far. For losing control so badly, for ignoring the damage I was doing and for setting such a poor example to my children. They don’t see my bingeing, nor hear my sobs afterwards as I emerge from the fog and realise that I’ve lost control yet again. But I can’t hide this from them forever – I need to stop before they’re old enough to realise what’s going on.

In a way, I’ve been here before. I used to self-harm; I used to cut myself as a way of coping with life. When my daughter was born I decided that I needed to stop because I didn’t want her to ever think that it was normal or ok. It took almost 2 years but I managed it, and haven’t cut myself since March 2011. I’m proud of that. But now I seem to have come full circle and once again I need to fight against my urge to harm myself, although this time it’s with food rather than a blade. I firmly believe that my bingeing is another means of abusing my body in order to retain control, although it’s not a conscious desire the way cutting was.

A little over a year ago a psychiatrist told me that I have binge-eating disorder (he described it as being like bulimia but without the purging, and that’s definitely how it feels to me) but he didn’t consider it a big enough problem to necessitate referring me to anyone. Since my crisis a couple of months ago I’ve been seeking help for my eating problems but without success. My GP said she couldn’t do anything but to ask the psychiatrist I was seeing after admitting to suicidal thoughts. I spoke to the psychiatrist and she said she couldn’t help but to talk to my GP. I reached out to an eating disorders charity but they too told me to speak to my GP, who is still regretfully adamant that there isn’t anything she can do (it seems there are no appropriate services in my area). So I’m on my own.

Well, not completely alone. I have a very supportive husband, family and several friends whom I can be totally honest with. But at the end of the day, this is a battle that I have to fight myself. Against myself. And just as before I have to do it slowly, one day at a time. One hour, one minute at a time if need be. Having got through one day, I tell myself that I can get through the next. And the next. And the next. And I desperately hope that this is a fight that I can win because losing is no longer an option.

I am, therefore I eat

Fat. Greedy. Obese. Disgusting. Pathetic. Ugly. Stupid. Weak. These harsh, hurtful words are all hurled at me on a daily basis. Not by family, friends or even strangers in the street but by me. My self-loathing spilleth over. Two of these words are incontrovertible – I am fat and I am obese. There is no proof for the accuracy of the others but I know that they’re true. Well… I have always been convinced that they’re true but lately chinks have begun to appear in the armour of my certainty.

I wrote here about the discovery that I apparently have an eating disorder, specifically binge-eating disorder or BED. At the time I was reluctant to apply the label of having an eating disorder to myself but I was able to admit that my eating is definitely disordered. I think about food all the time, from the moment I wake to the moment I go to sleep. I eat 2-3 meals a day and I graze in between whether I am hungry or not. Sometimes I will invent an excuse to go to the shops just so that I can buy chocolate or biscuits, either to eat in the car before I get home or to hide away and eat in secret where no-one can see. If there isn’t anything sugary or fatty for me to graze on I begin to panic and until I find something acceptable to eat I am unable to focus on anything else. If there is food around I’ll be picking at it.

So why haven’t I admitted that I have an eating disorder? Because I honestly believe that I am just greedy. I’m deeply ashamed of myself for this and for my lack of self-control but to label it an eating disorder seems an overreaction. Even considering the possibility makes me feel like a fraud, as though by comparing myself to people who really do have eating disorders I’m belittling their struggles. It feels like attention-seeking.

And yet… Friends who are far more knowledgeable and experienced in this area than I am are adamant that I have an eating disorder. A psychiatrist said that it was BED. The NHS website has a section on binge-eating which says:

In diagnosing binge eating, your GP will ask you about your eating habits and look for three or more of the following signs:
1) you eat much faster than normal during a binge
2) you eat until you feel uncomfortably full
3) you eat a large amount of food when you are not hungry
4) you eat alone or secretly due to being embarrassed about the amount of food you are consuming
5) you have feelings of guilt, shame or disgust after binge eating

Three or more? Well I tick all five boxes. So why am I still so reluctant to acknowledge this?

I’d like to say that it’s due to a lifetime of internalising society’s disdain for the supposed weakness and greed of the overweight and obese. I’d like to say that years of seeing people mocked and targeted purely because of their size and presumed inability to eat healthily has had a profound effect on me and left me able to only blame myself for my problems with food. And there may be some truth in that. But in reality I had issues with food long before I became aware of these things.

I wasn’t an overweight child but I was convinced that I was. I remember crying in the playground because I didn’t want to be fat any more. I remember binging from the age of 7 or so and guiltily hiding the evidence. I remember almost flooding a childminder’s bathroom once when I panicked and tried to flush a handful of chocolate bar wrappers down the toilet. I remember my first year at secondary school, when I would barely eat Monday to Thursday but on Friday spend my entire week’s lunch money on a mountain of food. After one of the staff told my mum about that I began taking packed lunches and supplementing them with food from the canteen when I wanted to binge – a much more subtle approach, I felt.

I have no idea what caused my problems with food (I had a happy childhood, I was well-fed, looked after and loved) but I doubt that the emergence of these issues at around the same time that I began to self-harm is a coincidence. Whatever the reason, I have been doing this for about 25 years and it is time to face up to this, to allow myself to admit that this problem may be greater than I have believed for the last quarter of a century. I need to be kinder to myself and recognise that perhaps I am not as weak as I think, that maybe the root of my obsession with food is related to my mental health rather than a character flaw.

My name is Sam and I have an eating disorder.

Food glorious food…?

This post follows on from My big fat problem.

I have had issues with food for almost as long as I can remember. When I was a young child my mum kept a large tupperware box of chocolate biscuits (Club, Viscount, that kind of thing) on top of one of the kitchen cupboards. I used to wait until I was the only person downstairs then drag a chair into the kitchen, clamber up and get down the box. I would rummage through to find my favourites; sometimes one or two, sometimes half a dozen. It was a fairly big box so I knew I was unlikely to be discovered. At the first opportunity I would sneak my pilfered biscuits upstairs and hide them under my bed. Then after bedtime, when I should have been sleeping, I would sneak them out again and scoff them; I can vividly recall the glee, delight and guilty pleasure I felt. Then I would hide the wrappers in my shoes, and bury them at the bottom of the kitchen bin at the first opportunity.

I don’t know how old I was when I began doing this. I suspect it began around the same time as my self-harming so I would have been about 7. It makes sense to me that these behaviours probably began together as I have long suspected that my binge-eating is merely another manifestation of my urge to self-harm. Certainly the urge to binge and the urge to cut are both triggered by strongly negative emotions such as anger, despair, grief, unhappiness, frustration etc. Since I finally managed to stop cutting in early 2011 my binging has become more and more of a problem.

I’ve mentioned before that the psychiatrist I saw a while ago told me I was a compulsive binge-eater. After talking with some very kind and knowledgeable Twitter friends recently I found myself googling binge-eating today and was directed to this page on the NHS Choices website. It’s extremely informative and eerily familiar – every aspect of binge-eating that it describes applies to me. Eating excessively quickly, eating large amounts when not hungry, eating alone or secretly, feeling out of control, experiencing feelings of shame, guilt and disgust after a binge… This is what I do. This is me.

Despite having been given a good (and kind and helpful) talking-to by my knowledgeable friends on Twitter (you know who you are!) I still don’t feel that I have an eating disorder. Eating disorders are serious illnesses, while I just have no willpower. No self-control. I am greedy. I don’t have an eating disorder. Except… These experienced, knowledgeable, lovely people say that I do. The NHS website says that I do. The psychiatrist said that I do.

So. I may not be ready to admit that I have an eating disorder but I know that my eating is disordered. The difference just be semantics but for now that’s as much as I’m comfortable with. I’m waiting for a referral to a Cognitive Behavioural Therapist for my anxiety and I will definitely be mentioning my problems with food.

In the meantime I am not going to follow any faddy diets, no Atkins or Slimming World or 5:2 or anything like that. Partly because I can’t afford to but mostly because I know that they will not help me stop binging. I need to focus on my binging, not my diet as a whole. I need to arrest the impulse to binge before I act on it and I need to get into the habit of examining why I want to binge each time.

I’m not going to set myself any big scary weight-loss targets, even though that is a major part of why I need to get my eating under control – I am 5 stone overweight and that’s affecting my health as well as my happiness. For now though my only goal involving scales is to weigh less each week than I did before, even if it’s just a few ounces less.

I expect I shall blog about this again in the future but for now this is it. I know what I need to do. I know why I need to do it. I think I know how to begin doing it. So here I go…

A school facilitated a pupil’s self-harm; why part of me wishes mine had done the same.

It was reported by various media outlets today that a pupil at a school in Surrey was permitted to self-harm under the supervision of staff. The child’s gender varies depending which account you read and his/her age has not been made public. The school in question provides specialist education for young people up to the age of 19 who have Asperger’s, higher functioning autism or an associated diagnosis.

This story resonated with me. I began self-harming very young, at the age of 7. I started by scraping a My Little Pony or Barbie hairbrush across the skin of my forearms until it bled. By the age of 10 or so I was using one of my dad’s disposable razors; by the time I started university I was using kitchen knives. I went to great lengths to hide what I was doing – I felt ashamed of it and didn’t want anyone else to know. At the same time I was desperate for someone to notice so that I could come clean, own up and get help.

The first time I ever told anyone about my self-harming was when I was seeing a bereavement counsellor at the age of 19. After a few sessions I hesitatingly confessed the shameful secret that I had hidden for so long. His response wasn’t what I expected – almost jovially he said “Oh don’t worry, if it helps it’s a good thing”. I was stunned and horrified by his response, and never went back.

Looking at it now from a more mature perspective I can see what he was trying to tell me. Self-harm is a coping mechanism. It’s a pretty rubbish one admittedly, and definitely not healthy, but it helps the individual to cope with or process feelings and situations that would otherwise be utterly overwhelming. Many self-harmers find that when their families discover their secret they remove anything with a sharp edge in an attempt to stop the harm. However well-intentioned this is it often does more harm than good; the self-harmer has no outlet for their feelings and may turn to far worse coping mechanisms in order to regain control.

Because at its most basic level self-harm is usually about control. When you are feeling overwhelmed, panicky, as though you are suffocating, self-harm is a way to focus and regain self-control. Having this coping mechanism taken away can be devastating and can sometimes cause a downward spiral leading to suicidal thoughts.

I suspect that this is what was uppermost in the minds of the headteacher and principal of Unsted Park school when they implemented their support scheme for the pupil in question. Apparently staff were told to give the pupil (who may be a boarder) access to sterile razor blades and accompany them to the bathroom, checking they were ok every couple of minutes. The wounds would then be cleaned and dressed.

Obviously this isn’t an ideal solution and teaching staff should not have to bear that sort of responsibility. But as far as I can see once the school became aware of what the pupil was doing they only really had 2 options; to try to put a stop to it and risk the pupil spiralling downwards or to make sure it was done as safely as possible while finding a better way to support and help the pupil.

By the time this policy had been in place a few days several staff had complained. The school, its headteacher and principal are now under investigation. There has been no mention of whether the pupil is getting more appropriate support, or indeed any support at all. I hope they are.

When I was young the thought of someone finding out about my self-harming both terrified and tantalised me. The thought of being escorted to the bathroom by a teacher so that I could cut myself would have been horrifying and humiliating, I didn’t want anyone to find out what I did. And yet if someone had told me that they knew I would probably have clung to them, sobbing with relief and begging them to help me stop.

There are no villains here, no wicked teachers encouraging children to mutilate themselves. There are only staff who, I believe, were doing their best to cope with an extremely difficult situation and fulfil their duty of care towards a pupil. Whether the policy in question was the best course of action is debatable. But a young person was supported and cared for and that’s the most important thing.

I wonder. If my school had been this aware and responsive would I still be a self-harmer 25 years after I first began?

Mental illness doesn’t just leave scars on the mind

This post is about self-harm. Some may find it triggering.

Self-harming is often misunderstood by people on the outside. It is seen as attention-seeking or the sign of an extremely disturbed mind – after all, why else would someone deliberately set out to hurt themselves? Equally there are some Western subcultures that have veen accused of seeing self-harm as a badge of belonging or a rite of passage, and it is treated as nothing serious.

To me, self-harming is serious. And idiotic. I know that it is an unhealthy way to deal with emotions and stresses and yet I continue to do it. It is a compulsion. When I was 19 I hesitantly confessed this to a grief counsellor that I was seeing, only for him to reply that if it helped me to cope then it was ok, it wasn’t harmful. I was horrified – I wanted someone to tell me to stop, that I shouldn’t do it, that it was wrong. That was the last time I saw the counsellor and the last time I spoke about self-harming to anyone in the healthcare system.

I began self-harming at about 7 years old, while being bullied by my school teacher. My mother recalls finding bitemarks all over my arms and realising that I had done it myself. I soon moved onto breaking the skin – I would get a small plastic hairbrush from one of my Barbie toys or similar and scrape it along the skin of my forearm until it bled. By the age of 10 I had discovered my father’s disposable razors in the bathroom. By the time I started university I was using kitchen knives, or my fingernails if I got the urge while I was out.

This may be horrifying reading for someone who has never felt the urge to self-harm. But it helps, counter-intuitive as that may seem. I self-harm when I am in a state of heightened stress or emotion, when my thoughts are frenzied and I feel trapped. Pain helps me to focus – not only does the knife cut through my skin but it also cuts through the fog in my mind. It’s a way of regaining control. It’s almost equivalent to slapping someone who is hysterical – it shocks me out of the mental frenzy. By the time I have staunched the bleeding I am calm, rational and focused again.

Of course, there are many different ways of self-harming. Cutting is perhaps the most obvious, along with burning. Some people take up sports and push their bodies to the limit. Some people drink to excess or take illegal drugs. However I have recently come to realise that my compulsive overeating is also a way of self-harming and one that I seem unable to control. I haven’t cut myself in almost 2 years despite battling the urge almost every day; I don’t want my children to grow up thinking that it is normal, that it’s ok and a legitimate way of dealing with stress. However I comfort eat like you wouldn’t believe. At the first sign of stress my thoughts turn to food, usually sugary. I am unable to focus until I have eaten and once I start eating I struggle to stop.

This post has turned into somewhat of a confessional for me – I have never been this honest with anyone but DH. And now I am about to fire it into the ether for anyone to read. :-S But in a way I think it is just as important to be honest about self-harming as it is to be open about mental illness. (I have no doubt that for me the two are related). If this post makes one person feel less abnormal and less alone, or if it makes one person more compassionate towards self-harmers then it will have been worth it. So I am going to take a deep breath and press publish. Here goes.

Tag Cloud