All that I am, all that I ever was…

I am more than my mental health. I am more than my homelessness. I am more than any one aspect of me. I am Addy. And this is…


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Relapse: Identifying your early warning signs

Although I have been lost to the demons of depression and mental chaos over the last few months, I’ve been doing my utmost to heave my way out of the maelstrom. One of the most enjoyable activities I undertook came at me via the Mi Recovery group I partook in during May/June of this year.

The exercise was part of a week that saw us take a look at relapse (which was kind of ironic considering it was around then when I began to lose control!) and revolves around identifying warning signs of an impending mental apocalypse.

At present, only a few people have seen this (and only one of those in any degree of detail) but considering my elongated absence from this blog, I’ve decided to share it as a way to ‘make up’ for my disappearing act. For even if you don’t find any value or substance in the activity, you may enjoy having a wee giggle at my attempt at “art”!

Creating your timeline…

First of all, choose a metaphor that suits your view of the world (such as an ovulating road or a winding river) to use as a basis for your timeline and then sketch this on a big sheet of paper. Once this has been drawn, mark onto this picture all of the most significant experiences/events/incidents that have shaped you into the magnificent human being you are today.

After all of your major experiences have been documented, make a list along your timeline of all of the resources (people, places, distractions etc.) that you used to get through the difficult times and that energized you through the good times. You may also wish to mark onto this timeline any strengths and/or values you have procured along the way.

Once this has been completed, whether you realize it or not, patterns will have emerged throughout your timeline. Before any period of mental ill-health there will be an array of thoughts, feelings and behaviours that repeat throughout your timeline. These thoughts, feelings and behaviours – more often than not – will be early warning signs of an impending relapse or episode.

You will find that knowing your warning signs is a major weapon in your battle with mental illness. Now that you know what to look out for, you will know when you need to seek help in the future.

My timeline…

Notes
(i) The larger text in various colours are strengths, values and resources that I’ve procured along my journey.
(ii) Yes, there is a glaringly annoying mistake on ‘Page 5’. I was extremely tired when I coloured this page.
(iii) The two blurred words on ‘Page 5’ are names I did not want to revealed publicly.
(iii) The timeline was based on my post ‘Your Life as You Remember It‘, so should you fancy more detailed information about the various stages of my life, you’re welcome to pop over there for a quick read! :)


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Mi Recovery: Biopsychosocial Personal Treatment Plan (aka Self-Love!)

“The Biopsychosocial Personal Treatment Plan (aka Self-Love!)”

ME_468_AcceptingSelfLove

“A trigger is a recognisable risk that can produce or stir-up symptoms. Triggers can be preventable,”

In week one of the Mi Recovery series we built a biopsychosocial model of the causes, symptoms and treatments of our mental illness(es). Now, in week three, we look at how we can use this model to identify techniques and strategies in which we can combat our triggers.

Since my breakdown in 2007 I’ve done a lot of work in understanding, analysing and identifying my triggers. The manner in which I’ve been living (homeless, socially isolated, no support structure) has forced me to educate myself on what needs to be avoided in order to prevent catastrophic collapses of my mental health. Personally, I think it’s vital that anyone dealing with mental health issues spends some time identifying their triggers; for doing so gives you knowledge – and knowledge is power!

There is no easy way to identify a trigger; sometimes they are obvious, sometimes they sneak up on you, but with time, committment and support (I can’t express how important this latter factor is when it comes to dealing with triggers!) it is possible to produce a list of things that trigger you.

For example, the smell, taste and presence of Gin and Tonic sends me right back to the night I was assaulted in Adelaide ’07, whereas articles on emotional abuse, rape or victim blame mentality have the potential to dredge up a cavalcade of unwanted memories and emotions. There are also a plethora of songs I cannot go anywhere near, as well as people, places and movies that can send my spiralling out of control.

Whenever I am confronted with a trigger my gut reaction is to avoid at all cost! But, as I recently wrote about, triggers can be preventable. Approaching triggers from the biopsychosocial approach is one such way to identify potential new strategies and wrestle back the control that triggers have on our lives.

My Biopsychosocial Personal Treatment Plan (aka Self-Love!)

“Enjoyable and healthy activities that I do for myself, that decrease stress and symptoms, help my moods and help me manage the things that trigger my symptoms.

Personal Treatment can affect all aspects of the person – the physical/biological, the psychological and the social. Personal treatment is a holistic approach. Research says that people who have included Personal Treatment activities in their lifestyle are more likely to recover than those who rely on medication,”
~ Pat Deegan ~

The first step in applying the biopsychosocial model to our triggers is to work out which categories they each fit into; are they biological, psychological or social in origin?

For example, if your trigger is a place, food or medicine – then they are biological triggers. Whereas (in my opinion) loneliness, anniversaries and television series are psychological triggers and people, boarding houses and clothing are social triggers. However, how you categorise your own triggers is entirely up to you. There are no right or wrong answers, only those that are pertinent to your lived experiences.

This – utilising ‘The A-Z of My Emotional Triggers‘ and input from Meadhbh and Audrey – is what I ended up with:

__week3__Biopsychosocial Personal Treatment Plan-vert

Once you have identified biopsychosocial nature of your triggers, you can then use the same approach to brainstorm potential new strategies and lifestyle changes that could be implemented to help you manage them.

Again, there are no right or wrong answers as to how you approach this. In creating my list I decided to take a two-pronged approach, firstly by looking at things I could implement to help fight my triggers in general:

General Strategies

And secondly, by creating ideas specific to the more difficult triggers in my life.

Given my current situation, the most obvious trigger to tackle first was the person who has been – through no fault of their own – triggering me of late:

cats After this, I decided to take a look at the issues of songs, sleep (lack of) and the isolation/loneliness that plagues me so:cats2

And, as a final experiment, I decided to brainstorm strategies I could implement next Tuesday (being the 7th May and one of my “bad days“):

Specific Strategies 2

A few notes on the above tables:

  • All text in black is specific to me.
  • All text in purple is specific to Meadhbh.
  • All text in orange is specific to Audrey.
  • Some of the ideas in the ‘Strategies & Lifestyle Changes’ table may seem extreme to others (e.g. is self-harm really a viable treatment option? is leaving Wodonga really something that would help deal with my triggers? is it really possible for me to give myself comfort?) but, like I said, they are pertinent to me.
  • Some of the ideas overlap as I believe they fit into multiple categories (e.g. ‘tell her about the person she reminds me of’ or ‘face head-on’)

How the Biopsychosocial Personal Treatment Plan could help…

In all honesty, given my current mood, I’m still processing this approach to dealing with triggers – hence why I haven’t explained it all that clearly (sorry!) – so if you have any questions about this activity or how I’ve applied my triggers and strategies, don’t be afraid to ask.

However, I do believe it is a worthwhile activity to undertake. In creating the above lists I have identified hitherto unseen strategies that could help in my ongoing battle with triggers. The exercise has also helped me realise my current coping mechanisms (flee, run away, avoid) have done little to help but a lot to hinder my recovery.

In creating this list I have acquired knowledge over my triggers. Thus – once I’ve implemented some (or all) of these strategies – I will have power over them to.

Like I said, knowledge is power.

And power…is strength.


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Mi Recovery: A picture of me, in a strong fame

“The importance of maintaining a sense of self,”

whatareyouworth

“Our stories and relationships change when we learn to value our whole self,”

As many who suffer from mental illnesses may attest, mental health problems do not exactly lend themselves to an over-flow of self-esteem. When a person becomes unwell with mental illness, they exert a lot of time and energy finding ways to treat their symptoms and manage their illness. So much so that it’s common for the individual – as well as family, friends and medical professionals – to focus entirely on the illness, forgetting that there is an actual, unique and whole human being beneath it.

This renders the person with a mental illness almost unable to see themselves as someone worthy of love or attention. In fact, in some extreme circumstances (and I speak from personal experience) the focus solely on the illness(es) can lead to someone completely losing their sense of self, their worth as an individual and their necessity as a member of the human race. They can see none of the skills, talents or values they possess as their illness (and/or trauma) causes them to focus solely on the negative aspects of their personality; aspects which are often unfavourably exaggerated out of all proportion.

A good example of this was a post I wrote yesterday in which I questioned whether or not I actually had any positive skills or values. A statement that immediately returned the comment:

You are a very caring person and very aware of other people’s needs. You have very good computer skills, you are a good artist, you are a talented photographer (if you had a camera that is), You have great taste in music with a wide variety of styles, You are also a very skilled writer when your illness allows you to be.

You seem to have got yourself in a rut of running yourself down and not seeing what is good about yourself, I know this is due to your past experiences but somehow you must break through this and see yourself for how good you are, not how useless you are.

This rut is something many who suffer from mental illness fall into, especially those who have had their sense-of-self destroyed by an abusive relationship.

Stephanie, for example, was a talented artist and photographer, someone who could work in a myriad of styles and produce work that was both multi-layered and truly inspiring. Whenever I would tell her this, however I would tell her this, she would instantly disregard my comments as a “complete lie” or that I was just saying that because I “had to” as her friend. The years of abuse she’d suffered (in combination with her mental illness) had made it impossible for her to see what everyone else could.

My thinking follows the same pattern of negative reinforcement that the exercise we undertook in the Mi Recovery group seeks to change.

A picture of me, in a strong frame

“I respect my limitations. I know my strengths. I compare myself with myself,
not with others who have different challenges and attributes to mine,”

The premise behind this exercise is to build a picture of who we are; the things we value, the things we like to do, our strengths and skills, how someone who knows us well would describe our abilities and successes, what aspects of our illness fit into the picture and what knowledge, resources and strategies strengthen this picture.

Once this picture has been formed, we then need to ask ourselves what internal and external resources we need to draw on to maintain this picture. For example, support groups, counselling, asking for help (external) or resilience, determination, insight (internal). This I could do easily…it was the actual strengths that I struggled with.

However – partly because I had to, partly because I needed to – I did (finally) create a portrait of myself:

A Picture of Me in a Strong Frame (2)

~ Key ~
BROWN TEXT (HAT) are three things I value in a relationship
RED TEXT (HEAD) are things I value in life
ORANGE TEXT (ARMS) are aspects of my illness I believe fit into the picture of me
PURPLE TEXT (BODY I) are things I am skillful in
BLUE TEXT (BODY II) are some of my strengths
GREEN TEXT (RIGHT LEG) are external resources I need to maintain the picture
PALE GREEN TEXT (LEFT LEG) are internal resources I need to maintain the picture
YELLOW TEXT (GROUND) is something I really (really) need to learn how to do to maintain this picture!
GREY TEXT (ANNOTATIONS) are things I like about my body (I chose to add these due to my body image issues)

Given the negative view I hold of myself it’s safe to say I do not yet believe everything I’ve included in the picture of myself. Some of them are things other people have recognised in me (e.g. Samantha saw my kinkiness as a strength, my family see my compassion as a strength and many people have noted my intense survival instinct and determination) whilst others are things only I believe (Zelda games are a skill? Really?)

But I believe it’s important to include these things in my picture, purely because they are all things I need to start believing rather than dismissing about myself.

It may be a long time before I do believe in this portrait, but for now I shall just celebrate the fact I’ve created one!

Why not make one of your own…you may be surprised by what you come up with! :)

 


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What are your beliefs about mental illness?

Part of the Mi Recovery group I began last Tuesday is homework. Why I’m so excited about this I have no idea, as when I was but a pimply faced schoolboy I’d much rather have been exploring the nooks-and-crannies of Hyrule than analyzing the ins-and-outs of Illyria.

But today, given I have nothing better to do besides fantasizing about the possible punishments that may befall should I refuse to do my homework, I’m actually looking forward to my weekly homework assignments (and/or creating ludicrous excuses as to why I didn’t do it; such as…the mouse stole it to power their cheese making machine!)

believe

HWQ1: What are some of your beliefs about mental illness?

In all honesty I actually have no idea how to answer this question. But as I’m unsure whether the group coordinator is legally allowed to issue lines, detention, something worse (or something better, depending on your proclivities) I figured I’d have to write something.

When I was a teenager, I believed mental illness was something to be scared of. That if you admitted your mental illness you’d be taken from those you love and locked in a dark, foreboding psychiatric institution for the rest of your days. I believed mental illness should be kept secret, that it was something to be ashamed of, that it made you weak, worthless, useless and a lesser human being.

So I valiantly kept my issues hidden whilst I embarked on a quest to prove to the world I was “normal”. For a while, this actually worked, but it wasn’t long before one of my fundamental beliefs about mental illness was proved correct: that it is not something that can be magically “pretended” away.

So by the time I was a late twenty-something, broken, beaten and bloodied from the ravages of breakdowns, discrimination and, well, beatings, my mental health beliefs had changed. I believed mental illness was a punishment; a reckoning for whatever crimes you had committed in this, or past lives. I believed that because of my mental illness I deserved to live an isolated life; a life devoid of love, nurture, happiness and human interaction. I believed that if I had friends, my illness would drag them into the quagmire of my soul and ruin them as it had ruined me.

But then, courtesy of a dream involving drum playing penguins, a tap-dancing bunyip and a cigarette smoking hot woman in a multi-coloured rainbow bikini, I was forced to challenge everything I believed. Why does someone with a mental illness deserve to be punished? Why does someone with a mental illness deserve a life devoid of hugs, kisses and cunnilingus? Why does a mental illness have to define someone’s personality? It didn’t – and never had – defined mine.

It was, like diabetes, bronchitis, toe fungus and cancer, just an illness.

So, as I entered my thirty-somethings, my beliefs changed and have remained stubbornly in place ever since. I believe mental illness is just that, an illness, brought on via a combination of our life experiences. It doesn’t control our actions. It doesn’t dictate how we live. And it certainly doesn’t define who we are.

A mental illness can be overcome. It can never be cured, I firmly believe that, but someone can stabilize their illness and learn ways to cope with the demons, darkness and deities that it unleashes.

I believe that no-one should be too ashamed to talk about their mental illness. Nor should they be labeled courageous or heroic if they do. I believe that discussing mental illness should be akin to talking about a cold, a sprained ankle or – heaven forbid – “man flu”; only, in the case of the latter, with less whining from the men and less eye rolling from the women.

I believe someone with a mental illness is a human being; nothing more, nothing less.

HWQ2: How did you learn those beliefs?

A combination of:

MEDIA REPORTAGE | IGNORANT JOURNALISTS | and SOCIAL STIGMA

There was also:

FAMILY | FAMILY | and YOU GUESSED IT, FAMILY!

And, just as obviously:

ABANDONMENT FROM FRIENDS | ACCEPTANCE FROM OTHERS | and THOSE WHO WERE INDIFFERENT

As well as:

BOOKS | ENLIGHTENED JOURNALISTS | and THE ARMY OF MH BLOGGERS I ADMIRE SO MUCH!

But, most importantly:

ME | my desire to EDUCATE MYSELF| and my stubborn REFUSAL TO GIVE UP!

HWQ3: Discuss what you have learned this week with your support person…

Given that I don’t actually have a support person (i.e. friend/partner/family member) that I can discus my Mi Recovery group with, I shall have to share them here:

  • The Biopsychosocial Model and how it could play an important role in the ongoing management and development of coping strategies unique to my journey.
  • If “Recovery is not a solitary process, [but] a social process,” (Jacobson & Greenly, 2001) does this mean I stand bugger all chance of recovery? I believe so.
  • For me, the most important factors that assist recovery are: empowerment, education, (personal) responsibility, advocacy, sense of self, passion, courage, hope and Serena Ryder. The latter of whom has frequently assisted me with both courage and hope.
  • Not having a support person throughout the Mi Recovery group is going to make the next nine weeks exceedingly difficult. If anyone wishes to apply, please send your resumes to all those stray thoughts @ gmail dot com. I won’t be able to pay for airfares, but I will treat you to a weekly pot of peppermint tea (and, if you’re lucky, a pastry of your choosing! :p)

 


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Mi Recovery: The Biopsychosocial Model

At the culmination of the first week of Mi Recovery we played the warm-down ball game I have become so familiar with courtesy of the Hearing Voices Support Group. The moment Meadhbh suspected this was about to happen she squealed in girlish glee and prepared to intercept the rolled up Velcro (apparently the budget wouldn’t stretch to an actual ball) whilst I sighed in apprehension about having to say something worthy and meaningful about what I’d taken from the group; which was plentiful!

In approaching this series, I have decided to focus my weekly review around whatever I say during this warm-down game. Yesterday – and this is a direct quote – it was…

“…the biopsychosocial model.”

__Biopsychosocial Model

For those unfamiliar with the biopsychosocial model (BPS), it is a model that was created by psychiatrist George L. Engel in 1977 that posited a combination of biological, psychological and social factors play a significant role in human development. Which is in contrast to the traditional model of medicine that suggests every disease can be explained in terms of an underlying deviation from normal function; such as a pathogen, developmental abnormality or injury.

It was this model that we used to examine the theory of mental illness, and the causes, symptoms and treatments we (as individuals) have experienced on our life’s journeys.

As everyone’s experiences of mental illness are unique, our diagnoses (whether that is a Mood or Anxiety Disorder, a Psychotic Illness, a disorder resulting from alcohol/drug use or a combination of all four) are largely irrelevant. It is our life experiences that determine the course of our mental illness and the symptoms/treatments thereof.

The biopsychosocial model allows us to look at our lives from three perspectives in order to determine what events have been most relevant and, in turn, how we can use this knowledge to take control of our lives and find new paths on our road to recovery.

My Biopsychosocial Model

The core component of the biopsychosocial model is how it allows us to see how experiences through our lives our linked. As such, the model is approached from three viewpoints:

1. Causes

These are all the elements that can be/have been attributed to be the cause of our illness. For example, some people believe mental illness is genetic (which would be a biological cause) whereas others believe some of the root causes of mental illness are isolation (which would be social) and trauma (which could be considered psychological).

The following is my own personal BPS model of the causes of my mental illnesses. Yours, should you wish to write one, may look very different:

__Biopsychosocial Model (CAUSES)

Notes on my model:

  • Some may argue with my overlapping of homelessness as being biological, psychological and social. But having spent a large period of my life homeless, it was the only place that fit for me.
  • I have placed sexual minority in the overlap of psychological/biological because it has both a biological (I was born with it!) and psychological (if you have the password, I’ve explained this here) component.
  • The most contentious placement would probably be “abuse” which many at the group believed should be placed solely in psychological; I however believe it has a HUGE social component, hence my placement of it in the overlap.
  • If you have any questions regarding the items and their placements, don’t be afraid to ask! :)

2. Symptoms

The second viewpoint is ‘symptoms’, which are all of the symptoms we experience as a result of our mental illnesses. For example, the butterflies in the stomach or sweaty palms of anxiety (which would be biological), an increase in destructive voices (which would be psychological) or isolating behavior (which could be seen as a social symptom).

As with both the causes and treatment of our illness(es), these symptoms are unique to the individual. This is what I came up with when approaching my symptoms via the BPS model:

__Biopsychosocial Model (SYMPTOMS)

Notes on my model:

  • I have placed victim-blaming in the social/psychological overlap as I believe it has both of these components. The victim blaming we receive from others (social) and the blaming abuse victims place on themselves (psychological).
  • Over-indulgence relates to me as: excess alcohol consumption and over/comfort spending.
  • Personally, I believe self-harm begins as a psychological symptom that becomes a biological one, hence the overlap between these two factors.
  • The most contentious placement (and one which I mulled over for nearly two hours) was hypersexuality. Although many may see this as predominantly a social or psychological symptom, based on my own experiences of this state, it can become a biological one.
  • If you have any questions regarding the items and their placements, don’t be afraid to ask! :)

3. Treatments

One of my biggest (and longest standing) issues with the mental health and psychiatric industries is the “one-size fits all” approach to mental illness treatment. Everyone’s experiences of mental illness is unique, so why do people persist in believing that a singular course of action (be it medication, talking therapy etc.) will have the same effect on everyone?

Perhaps this is because I have (obvious) issues and grievances over how I’ve been treated by mental health services, perhaps not. Either way, treatments that may find their way onto your BPS are medication (being biological), talking therapies (being psychological) or support from family/friends (social).

In my personal opinion, one of the most important treatments (and one that is noticeably lacking from my own BPS) is nurture; the physical love we receive from those around us can have a significant impact on our ability to deal with the stressors and pain of mental illness.

I hope one day to be able to add it to my own biopsychosocial model:

__Biopsychosocial Model (TREATMENTS)

Notes on my model:

  • Given the MASSIVE overloading of psychological treatments, is it any wonder I am teetering on the verge of a massive psychological breakdown?!?
  • I believe distraction comes primarily from the distraction we can find on our own (psychological) and the distraction our friends/family can offer (social); hence the overlap.
  • HVSG stands for the Hearing Voices Support Group I attend (I was being lazy!)
  • I have included Meadhbh (and occasionally Audrey) as psychological treatments because when they’re behaving themselves, they can be a source of great comfort, support and love.
  • Mindmapping is a self-help therapy designed to interrupt and sooth triggers. I’ve been working with it for a couple of months now.
  • I’ve long believed endorphins can have a massively beneficial effect on managing mental illness.
  • The all-overlapping kimnyk is something I have discussed in my password protected pages and relates to a part of my sexual-personality that I’m not comfortable sharing in detail with the world due to the abusive, ignorant and damaging comments I’ve regularly received about it in the past.
  • Once again, if you have any questions regarding the items and their placements, don’t be afraid to ask! :)

Once you have written your own biopsychosocial model, how can you use it to assist in managing your condition and working toward recovery? By comparing the three viewpoints and identifying the wheres, whats and wherefores of your life, you can begin to see links between the symptoms, causes or treatments you may wish to explore further.

Personally, I have already realized the immediate need to begin balancing  how I treat my illnesses as the overload of psychological treatments is already becoming a cause – and, if a breakdown occurs – a symptom.

I’ve also noted (as I have in the past) the enormous detrimental effect my tendency to isolate myself during periods of distress has had on my mental wellbeing and recovery. I need to allow myself to believe that asking for help is not only acceptable but doesn’t mean I’m weak, worthless or not trying hard enough. This was hammered home yesterday afternoon, following the worst reaction to a trigger I’ve experienced in months!

As I continue with the Mi Recovery group and learn more about myself and my illnesses, I fully expect to refer back to my biopsychosocial model on a regular basis. Not only to add any new items but to use the connections I’ve highlighted to assist in my journey toward recovery, forgiveness and acceptance.

Perhaps you should try writing one of your own (in a supportive environment, of course) as you may be surprised by the things you discover.


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Mi Recovery: Introduction

mi recovery

Following Acting Up, another group I have begun this year is called “Mi Recovery”. Of all the groups I have begun this term, this is the one I am most looking forward to undertaking.

Mi Recovery is a peer education program for people living with mental illness, offering a peer based approach to the complex issues faced by people with mental illness by combining challenges faced through the lived experience with up to date best practice research. The program adopts a holistic approach where a person can acknowledge their whole self rather than living ‘as their illness(es).’

As with some of my other groups, I have decided to share my experiences of the group on this blog, not merely to chronicle my progress but to share any information or strategies I learn in the hope that others may find them useful in their own journeys.

Given confidentiality is paramount, these posts will focus only on my personal experiences and journey, as discussing the health and wellbeing of others without their permission can have a devastating effect on recovery, trust and health.

Over the following ten weeks I am hoping that Mi Recovery will assist in the creation of new coping strategies, further refine existing coping skills and help remind me who I am and my place in the world.

Only time will tell whether I’m successful in these goals but, as always, I will be giving it my best! :)

“Recovery does not mean that one is ‘cured’ nor does it mean that one is simply stabilized or maintained in the community. Recovery often involves a transformation of the self, wherein one both accepts one’s limitations and discovers a new world of possibility.”
~ Patricia Deegan~

Week 01: Theory on mental illness and factors that enable recovery.
Week 02: Reframing my Whole Self and Understanding Stigma.
Week 03: Treating myself.
Week 04: Planning for Recovery.
Week 05: Working with Relapse.
Week 06: Communication Skills and Strategies.
Week 07: Stigma, Discrimination, Rights and Advocacy.
Week 08: Making the most of the National Disability Insurance Scheme.
Week 09: Motivating purposeful activity.
Week 10: Review of recovery aspirations and program conclusion.