When I was fifteen I went for a psychiatric evaluation at the local hospital’s out-patient facility. I don’t remember how I got the referral, I suspect my Mum got one through our local GP. There were all kinds of people in the waiting room; some were clearly very distressed or catatonic, some had severe intellectual handicaps, and all of them sitting in various states of agitation. Welcoming was not a word I would use to describe this space. After the evaluation, I remember Mum telling me how alarmed she felt to bring me there and how I just didn’t seem to fit among that group of people. If only all mental illnesses were so equally obvious, talk about starting at a disadvantage.
The reason I found myself in the there was that I had been self-harming. I don’t remember the catalyst for it. I do remember obtaining a razor blade from an art classroom at school and then sitting in bed late at night wondering where would be the best place to cut so that nobody would see it.
I also remember thinking that other people would view it as “attention seeking” behaviour. If I cut somewhere visible I was sure to be judged by the other kids at school who apparently thought that self-harming was just something that people did to be cool. There’s a good chance I felt an extra pang of judgement about it because I was (and still am) an alternative dresser. I have always worn black – I do this goth/cyber/skater/weird thing – and when I was at school in the 90s it was still considered a bit of a strange choice. All the parents of other goth kids I knew at school probably thought the same thing as mine did, that it was just a phase I’d grow out of, some kind of rebellion. Of course, we know better now, or at least I like to think we do. My predilection for the macabre really has no bearing on my insides, although there is probably some truth in the fact that people dress how they feel. There are plenty of death-metal loving, night-time graveyard frequenters that really are very well adjusted. Some of them are good friends of mine. It’s really just a matter of taste.
There’s a very interesting intersection of stereotypes and judgement that exist between self-harming, attention seeking and alternative dressing. I have on many occasions been accused of dressing the way I do because I want people to look at me. I’ve also been told it’s because I’m creating a facade to hide myself behind. This toxic notion that all goth-y types are morbid and depressed and self-harm for attention was and still is extremely powerful. Moreover, this assumption also appears to lead to the strange conclusion that if an alternative dresser is actually depressed, that it isn’t real and shouldn’t be taken seriously.
The point here is, there was an unbelievable amount of stigma about self-harm at the time, and I remember it distinctly. So I hid it. My boyfriend at the time was also self-harming and this came to light one weekend when he got particularly upset at my house. He had been having some trouble at home and was generally pretty unhappy. My Mum asked me if I was self-harming too and was upset to find put that was the case.
By this point I was feeling really unstable in my relationship with my boyfriend. I have a notion that my feelings of rejection, my general disbelief that I wasn’t going to end up marrying this guy, probably, was a big part of the problem. I was pretty desperately unhappy about the situation and it was probably the first symptoms of love addiction or at the very least an extremely broken attitude towards love and relationships. But who even knew that was a thing, right?
So I walked into the office of the psychiatric evaluator. She had long, black curly hair, which was worn down and unkempt. She seemed really quite annoyed that I was sitting in her office. She rattled off the questions on her piece of paper at a near super-human speed, and in many instances pretty much answered the questions for me. “How often do you feel sad? Not that often probably? Yes? And you said your boyfriend self-harms too? Hmmm. So really you’re just doing it because he is? Yes?” There’s a good chance she would have completed the form without me ever having to open my mouth. I got the distinct feeling that she really just wanted me out of there as quickly as possible; that I was just some stupid kid. She seemed convinced that my self-harming was me copying my boyfriend for attention. Because that’s obviously a normal thing that people do. She had me rumbled as soon as I walked through the door – what a faker.
The “diagnosis” came quick. Based on my knowledge of psychiatric screening tests, I likely didn’t make a score that placed me into any sort of category that required help. A low score totaled up by a woman who fudged the numbers. My Mum and I left the hospital safe in the knowledge that it was just a phase, teenage angst, that there really was nothing to worry about. My internal adult self screams with rage when I think about this. What teenager that self-harms is just going through a fucking phase? What kind of mental health worker, somebody paid to be a point of safety and understanding for people experiencing sometimes exceptional trauma in their lives, sends a fifteen year old person out of their office to just work out the self-harming thing on their own? It was the medical equivalent of being told to pull your socks up and stop making such a fuss.
The next 10 years were spent regularly reeling in and out of anxiety and depression, never telling anyone, thinking it was all my head (!) and most importantly believing that nobody would ever take me seriously. I had zero coping skills and virtually no self-esteem after a string of really poor relationship choices during that same period. I completely silenced myself – obviously I didn’t do this consciously, nobody does, it’s just something that you learn over time.
From the giddy heights of hindsight this all makes perfect sense and explains so much of my behaviour during my late teens and early 20s. I was fucking angry and deeply unhappy, despite an intentionally happy outer disposition. The crippling fear of the constant troughs in my mood made it extremely difficult to enjoy feeling good when I did.
This “diagnosis” along with its learned silence still affects me today. During a group therapy session a couple of weeks ago, I was talking about how I felt physically unable to reach out for help when I am in panic. In moments where I need love and support the most and the only thing standing between me and it are a few words or a text message, it gets stuck in me. A lump in my throat, my hands freezing as I endlessly pick up and then put down my phone. Like something in me takes over, “They won’t get it, you’re just going to be a burden, you can’t call home it’s 2am, if someone comes over it will be really awkward, nothing anybody says or does is going to help you, don’t be so silly, they will think you’re a huge idiot, you’re on your own.” Sound familiar?
As I was describing this thought process to my group and my therapist for the very first time, I realised how much shame I felt. How utterly vulnerable it made me feel to ask for help. As such, I was so convinced that my experience would be rejected in its totality, it had rendered me physically incapable of speaking it or even writing it as it was happening. The image of a drowning person, hands tied behind their back as they sink into the abyss, seems to fit here. As my therapist bounced back to me the things that she was subjectively hearing underneath my words, I immediately began to think of this experience at the out-patient clinic. It seems so strange that these events that perhaps at the time were out of the ordinary, but didn’t feel traumatic, could have such far-reaching effects into the future. That they could dictate more than a decade of warped thinking. Everything tumbled into place, it was quite a revelation for me.
For people who have suffered with panic attacks and anxiety, I suspect the inability to speak is a common experience. I wonder how many people have in some way experienced shame around their mental illness that has led to their silence. This is one of the fundamental messages of mental health awareness and indeed so many other things that we package up in neat little boxes and hide away on a shelf. Shame and stigmatism are silencing and dangerous. Even as I write this, I’m thinking this piece has the potential to upset someone close to me or that I’ll be told that I’m making it sound much more serious that it really was. The reduction of a person’s experience is such a powerful thing to do to them. An inability or refusal to take someone’s experiences seriously, to really hear them in a compassionate and understanding way, simply leads them into a world where they believe that their words, thoughts and feelings don’t matter and aren’t real. It’s like some sort of societal gas lighting, and it’s killing people. Thousands upon thousands of them every year.
So as I consider all these things that have happened to me, that have led me to this moment, I feel angry. I was let down by a professional who should have helped me. Her decision that day, had it been less indifferent, could have meant a very different set of choices and feelings in my formative years. Being given the coping skills, understanding and information that I so very much needed at that time would have be life changing for me. Although I do not regret my life or where I am now, I feel I suffered more than I really should have.
It’s no secret that children’s mental health care is severely lacking. It seems so strange that we are so careful about the physical health of a person when they are born. We even protect fetal tissue before it even begins to take on a human form. Yet when an impressionable and helpless child becomes mentally unwell, there is apparently no safety net, unless the illness is very severe. We teach children to wash their hands to prevent the spread of germs, but nobody teaches them how to deal with difficult emotions or how to change harmful thinking behaviours. Having said all this, the same applies to adults. Broken your leg? Here’s statutory sick pay, you’re clearly incapable of working. Struggling with crippling depression? You’re fired and you’re not entitled to disability benefits. Perhaps if we put some effort into enabling children and young people to recognise emotional distress, we might not only have a much healthier adult population, but also one that was able to see through mental illness’ invisible cloak.