This feels very personal to write, but here goes...
There are some days that slowing down enough to attend appointments leaves me feeling more alone (even if nothing negative happens) than if I just keep distracted with being busy. It would be easier to just keep in the flow of being “busy,” never coming to shore to catch my breath - maybe I’m fine after all? Some days I’m not sure if I’ve made everything up… Nearly two decades of mental illness simply imagined.
I think it’s because sometimes I feel more connected and supported, and other times I don’t. Right now, because I feel so raw - so vulnerable to trust being broken, being misunderstood or pathologized, or being let down once again, I depend so much on such fleeting exchanges. There’s no way for the other person (professional) to know how much I hang on words they probably don’t understand the gravity of… And I don’t want to do that to others - I so wish I didn’t put that on people - even unintentionally, but knowing this doesn’t change the underlying need/reason why this occurs.
It’s hard needing anything or anyone right now - especially formal supports/treatment after the trust that has been broken in the last few months. But I’m also conscious that needing others (despite the risk) is still something I need to keep myself open to, otherwise the only stable or reliable relationship I turn to (in terms of deeper comforts), is the eating disorder (and that doesn’t align with where I want to go in life.)
I don’t function well within the current public mental healthcare system, but I don’t know how to heal or find support without it (some amount of finances would better grant that, but despite what enormous privilege I do possess, it’s not in the cards right now.)
While I certainly don’t want to box myself in to only seeing one way forward (I don’t believe that’s the case) it is however, a complicated reality and I find myself feeling activated by anything resembling the “just do it” method, whilst simultaneously feeling hurt by any indication that my capacity is not believed in. At the base of all this activation (I am making a point of choosing this term over “reactivity”), is the fear of loss, letdown, and further injury.
I do not believe this is a fault within my personality, rather, I see it as a direct result of previous attachment injury, inborn temperament and early life experiences that have made me more sensitive to threat, and trauma. It is not a pathological reaction, but rather a learned response that makes sense within those contexts.
Right now, I am finding myself very tired of feeling like what I hope for from the mental healthcare system (and my own treatment interactions) is too “radical,” or that I’m just too angry when I should be grateful. I am both, and both are reasonable responses. Asking where the system can be flexible to my care needs (whilst holding myself to the same expectation to be flexible to the limitations of larger systems) shouldn’t be seen as seeking or mis-perceiving conflict.
It is beyond emotionally draining to constantly re-explain how “intention” isn’t the same as “impact” to programs and providers. This is not to apply blame, it is simply a reflection point that this argument (“it’s meant to help you, so you should see it as such”) is something people who have experienced trauma and/or unhealthy power dynamics will find activating. By describing the impact of the system’s limitations on my own care or needs (as I see them), I am not meaning to say the intention is malicious - just a reminder that great harms have been carried out through valuing intention over impact.
I realize the concepts I value in my own care journey are not easily embodied in practice settings that are severely depleted in resources, bound by certain policies and procedures, and deeply entrenched in a Western medicine/psychiatry framework. Of course these concepts will seem “radical” in that context.
But should they be considered all that radical?
“Radical” is an arbitrary label that depends on where we situate “normal” on a spectrum of care approaches. Are harm reduction principles radical? Are the principles behind abolitionist and anti-carceral care radical? Is valuing lived/living experience in a way that is felt by these individuals radical? Is asking for an attempt at safe (culturally competent, gender-affirming, non-judgmental, trauma informed) care radical? Is basic dignity and respect between human beings regardless of what role they occupy - patient or professional - radical?
Of course we won’t agree on everything. Of course the whole system cannot be changed within individual care interactions - I am not asking for that. But what are we saying if we aren’t trying to honour the values we claim to espouse?
It is painful to walk into care interactions, or engage with treatment, knowing that I must give up some pieces of myself - of my own values, simply to access care… Of course, all relationships are built on compromise but please understand where giving away pieces of myself has led me in the past (into unsafe situations.) I know I must be flexible to fit into current treatment environments, what I am asking for is simply to not be broken out of shape once more, with no one to put me back together when I yet again “fail” treatment. Because if you turn that phrase on its head ("perhaps reframe it" as is so often suggested to those with lived/living experience), maybe treatment is also "failing" me and so many others.
If we are going to talk about the power of “and,” grey areas, and flexibility - why should I trust any setting or professional that struggles to do those very things themselves? Why should I compromise without seeing some degree of mutual effort to ensure we fit what I need - and you can potentially offer - together?
Perhaps I am just my illness talking, perhaps I have no grip on reality… or perhaps these truly aren’t that “radical” to ask and advocate for, after all…
Food for thought.
- S.
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