“You cannot punish the pain out of people”

A friend sent me this quotation recently and I have been pondering it. Wisdom. Wisdom that calls for compassion. Compassion for people when you are uncomfortable with how they survive. Especially when you want their behavior to change, to go away.

Tomorrow I have the opportunity to spend three hours with mental health professionals on the topic of trauma and self-directed violence (SDV). It is a privilege to have people give me their time and attention, whether in person or online. It has been a challenge to teach online. I am fortunate in that many of the people who take my courses say they find them useful. That said, there has been one comment that keeps coming around often and I will improve my teaching tomorrow to address it up front.

The comment is that clinicians want specific actions to take to facilitate stopping SDV. We discuss the traumatic origins of the suffering that leads some people to find relief, even if temporary, in SDV. I teach that the principles of trauma-informed care, connection and empowerment, are the answers to the question. People turn to SDV for multiple reasons. For some, SDV is an all-purpose tool to manage the intense repercussions of trauma. One cannot simply force oneself, nor another person, to not need SDV. Interventions that are based on coercion, i.e. tying people down, might temporarily stop the behaviors of SDV, but not the need. Adding more trauma in never a successful answer.

So tomorrow I will offer a simple and very powerful answer: “You cannot punish the pain out of people.” And then the conversation moves on to how we help people understand and release their pain, and create environments that best support doing so…

My Body, My Choice

That phrase, chanted for decades, has now increased in popularity. Heard for decades during protest marches for reproductive freedom, it is now being chanted by people demanding freedom from mask requirements during the coronavirus pandemic.

“My body, my choice!” “My body, my choice!” “My body, my choice!”

Where have we not heard this? In a march for freedom for those who live with self-directed violence. Hm… It is to the point, isn’t it? Appropriate. It is what I have been arguing and advocating for, for decades.

Why have we not marched, chanting and waving our scarred arms? I can think of two answers. We are at great risk if we expose ourselves as scarred people. One, if we are identified by our scars we might be subjected to a psychiatric label. Or as simply “gross” or “crazy.” That can have some brutal outcomes. There is a reason most people keep their lives with self-directed violence secret.

If we are labeled because of doing what we do to our own bodies we run the greater risk, more than being judged. We find ourselves vulnerable to losing a vast amount of choice. If a person working in the biopsychiatric industry wants to, they can choose to commit someone “for their own good.” Commitment is the use of force in an attempt to control someone. Living with self-directed violence leaves us vulnerable to losing our freedom and potentially our jobs and more if we are labeled “a threat of harm to self.” Right? For years I published the words and artwork of the harm done by the institutionalization of people who are doing their best to tend to their own needs. That is the purpose of self-directed violence – it is a way of solving a problem in the moment. Are their more destructive ways people cope? Yes. They are not typically reacted to in the same way. The greatest harm I experienced from my life with self-directed violence wasn’t the damage I did to my body. It was the losses and brutality I experienced in the psychiatric system. Where there was very little choice.

My body. My choice. What do you say?

Welcome 2021!

I know that this is, rather simply, another day in our lives. But on our calendar it signals a new beginning. I have never heard more people eagerly celebrate the end of a year more than the end of 2020. Does the virus care? No. Do I care? You bet.

As I am sure is true for you, 2020 was filled with sorrow, challenges, deep concerns, and a serving or two of outrage. My commitment to keeping this blog active lasted a while, then faded as I gave my energies to the challenges of the times. I felt rather guilty about that. That means I made myself miserable, more so than needed. 2020 was a wild ride. I have horses, so I know about wild rides!

I have been very fortunate. 2020 ended, for me, with solutions to my personal challenges, improving health and now, a renewed focus on the work I cherish. I’ve come back home, to here.

That said, I truly am tired of my multiple stops and starts. So I have done the unthinkable, or what used to be unthinkable. I have asked for help. That is an “OMG” sort of challenge for me. I have received help. I am delighted, grinning from ear to ear, to say that I now have a crew of people to help with this site. Today I want to introduce you to one of them. Without her there would be no site as she is the one who initially designed it and is now on board with taking me through the development of this web site and keeping me on track. When I get overwhelmed, which happens often, instead of shutting down the computer and getting a bowl of ice cream I will now get in touch with Kristen.

Kristen and I name each other “sister,” we were born to different parents but that is irrelevant. She knows brutal grief and loss, she has wisdom and a deep heart. And she has computer talents!

Here is a picture from the best of my world, people and critters that bring me joy and comfort. Thank you Kristen, the team of Ruta and Cloudd celebrate and thank you. I let him do the smooching…

I wish everyone a Happy New Year,

Ruta

Is this healing?

I have no idea who is reading these words, yet I am presuming that you have had some challenges lately.  A global pandemic, cultural transformation, economic challenges, many of us are living in stressful times.  I’ve been away from this site in part because of them and in part because of personal, individual challenges.  I’ve had some intense days, ya know?  I think you do.  I have been busy with decisions, actions and emotions.  Taking my beautiful dog through his last days.  Needing to move two of my horses rather urgently and creatively and courageously asking for help, taking out a loan, and partnering to build them a new and peaceful home (and learning some carpentry).  Being a witness to overwhelming fears of one friend, and the inconsolable grief of another.  Preparing to attend the memorial of a young man who was greatly loved and died suddenly before witnessing the birth of his first child. Intense times.

I have been frightened, joyful, outraged, grateful, despairing, joyful, grieving so deeply I sit and rock myself.  I have asked for help, gone silent, had some sleepless nights and some shaking fears and shaking courageous choices as well.  I have turned to comfort foods and watched videos in the middle of the night.  I’ve felt unable to focus on work and overworked on other days.  My home is a mess and my pants are too tight.  And I’ve had some of my unfinished past rise up and present itself for healing.  I took on some of that work and postponed the rest.  But the chunk I’ve worked on has freed me.

Sounds like life, right?  Mine, perhaps yours in these nonboring times?  One thing I have not done is cut, burn or beat myself.  If it were not for getting back to writing here I might not even have recognized that.  Someone recently asked me to define what a “self-injurer in recovery” looks like.  I replied that I don’t make those definitions for others.  I can only speak for myself.  That was not the reply they were expecting, nor desiring.  I knew I was supposed to say that I had stopped the personal “destruction.”  Yet that is not how I see this.

I have not needed to turn to Self-Directed Violence (SDV) to cope lately.  That is all.  Am I recovered?  I don’t know.  I don’t care.  I used the tools I had, and the ones I needed, to get through moments of hell, times that felt insurvivable except that I found ways to survive.  For decades that included SDV.  And now for decades it has not.  Does that make me recovered?  Not to me.  It makes me less likely to be shunned or psychiatrically incarcerated I suppose.  I am now more broke, chunkier, sore than I was 6 months ago.  I am also stronger and wiser and more compassionate and hopeful.  Life stuff.

My stronger, wiser, more compassionate and hopeful self.  If I had to use some sort of definition to describe healing (I don’t care for the word “recovery”) I would use the previous sentence.  And it wouldn’t matter to me if I was still cutting.  Just because my ways of coping are now more typical and societally acceptable they are what they are.  And my previous ways of coping are… what they are.  Perhaps the most powerful recent lesson for me is that judging how we cope can keep us muddled down.  As long as we are not dead yet we can heal.  We can decide to define the term for ourselves.  There is great power in that.  Or so I’ve realized in these weeks that I’ve been away.  We are stronger than we think we are.  We can pursue peace, freedom, justice, health, joy… how do you define healing?  Or if you like the word “recovery” how do you define that?  Is it useful to you to judge your emotions, your actions?  Why are you still here?  What matters to you?  Does living with SDV hold you back, keep you going, both?

These are transformational times, globally and locally.  Are they personally?  I’ve been in the thick of challenges lately.  They have been well met.  And that is not because I haven’t “lived with SDV.”  Who knows, someday I may decide I need the knife again to get by for some reason.  That would not be a failure.  To me.  What do you say, about you???

Isolated, hidden, we need not suffer alone…

I’ve sat here staring at this screen for quite a long time.  Uncertain about what might be helpful in this “novel” time.  I am fortunate – I am in my home, with some of my animal companions, have enough food and warmth, and my greatest possession – the gift of friends.  I worry deeply about those of us who are not in such fortunate situations.  The people in the psychiatric hospitals, the prisons, nursing homes, group homes – all places that people who live with self-injury are housed, how are you?  You who may not feel understood.  Who may not be understood.

I have also been bearing witness to the stories of those in the health care facilities, from nurses and respiratory therapists, doctors and janitorial workers, doing their best to serve others while worried about their own futures.  And I realized that all these people, in all of these places… there is a common ground between some of them.

The general perception about people who live with Self-Directed Violence (SDV) is that we are severely psychiatrically ill, incompetent, potentially dangerous or, using mainstream language “cray cray.”  In the nearly two decades that I published the newsletter The Cutting Edge: A Newsletter for People Living With Self-Inflicted Violence, I had the profound privilege to listen to people from around the world.  They told us, the readers, their stories and their pain.  We found in each other a safe place to be heard, to be understood.  Perhaps that is the most powerful ground of healing, being understood, learning we are not alone.  It has been for me.

Over the years some of the people shared more about who they are.  I learned so much more about people than I could have imagined.  I learned that the common denominator for people living with SDV is trauma.  Not gender, nor income or profession, not ability, race, or age.  The people who had survived their challenging moments with SDV were both prison inmates and correctional officers, people living behind the walls of psych hospitals as patients and the therapists who work there.  I met people who live on death row, on the back wards, and on the street.  I met firefighters and veterinarians and accountants and artists and athletes and teachers and doctors and nurses.  This group of ours is as diverse as any.  Our common ground is one of the ways, SDV, that we find useful to survive as we, hopefully, heal.

And I remembered a poem that I published years ago.  Today I thought a long while about the author, Amy.

Excellent and effective

An excellent worker –

The day flows by

smiling and productive

with co-workers –

The night falls

and with it the facade –

Terror, lost time, flashbacks –

Burning off the filth –

Cutting away the painful memories –

Beating the offending parts –

Whatever it takes

to find a moment of

Relief –

Until tomorrow comes –

And I begin again –

Amy

Amy is a nurse, an excellent one.  And I wonder how she is, in the midst of this unprecedented health care challenge.  I wonder if she knows that she is understood, that no matter whatever form of self-injury she needs, she is not crazy, nor broken.  I presume she is a compassionate healer.  I hope she has deep compassion for herself.  I hope that you have deep compassion for yourselves.  As for me?  I’m even finding some for me, too.  May we all be kind, to ourselves and each other.

 

 

A victory to share…

I presume many of us are challenged by the changes in our lives in the midst of the coronavirus pandemic.  I hope you are being kind to yourselves, and each other.  I thought this would be a brilliant time to share good news.  After years of effort by many people, the FDA finally ruled to ban “electrical stimulation devices” that targeted people who live with self-injury.  The “stimulation” referred to is the literal electric shocking of people, electrodes attached to their bodies that can deliver an electric jolt any time a staff member decided to use the “device.”  If someone began to self-injure, or possibly looked like they might be considered it, they could be jolted as a solution to a behavior that was deemed only pathological.  Obviously, calling this traumatic is an understatement.

This ruling was made in early March, last month.  Some facilities have been granted a 180 day period of “gradual transition” so this form of psychiatrically acceptable torture will still occur for another 4 or 5 months.  But it sounds as if the shocking will finally end.

The primary facility defending their right to use the devices is the Judge Rotenberg Center in Canton, MA.  For years I and many others addressed the brutality happening there and it seemed that nothing would ever be done to stop this medicalized torture.  A long journey, many determined and tired activists later, however, and the FDA has come around.  May we remember this result in the days ahead when we are all challenged to work to deny abuse and oppression or cruelty.  There is no shortage of those but I believe that there is more compassion and energy and this win feels good.  No fancy words, but good.  Changes like these do not come about without great efforts by many people and I cannot celebrate you enough, those of you who made this happen.  May you rest a bit and then on to the next challenge?  Well done.

“Harm Reduction”

It has been an electronic adventure here since the last time I wrote.  I am now two laptops further in my life and finding my way.  Hint: cheap is sometimes too cheap and not useful.

In the meantime life has changed for all of us as a virus demands our attention and change ripples throughout the world.  Many of us are mandated to stay home as much as feasible, at least those of us who have homes.  Some of us in institutions, whether psychiatric facilities or prisons or group homes, are feeling more trapped and unsafe than ever.  Many have lost their jobs, their incomes; others are working in conditions that are exposing them to illness yet they need the income from their work.  Stress abounds.  For those with histories of some form of trauma this is a very challenging time as connection to others has been altered and there is a smell of helplessness in the wind much of the time.

What do we do?  We do whatever we do, often going back to ways of being that helped us survive.  As a society we are asked to reduce the potential harm, the loss of life as a result of an overwhelmed medical system, by reducing the impact of the corona virus as it makes its way through our communities.  We are doing this by staying apart from each other, sometimes at a very high cost. We are practicing “harm reduction” as I see it.

I learned the phrase “harm reduction” initially in the substance abuse community when compassion dictated that we provide people who were injecting themselves with drugs clean needles so that they would not become ill and possibly die.  Needle exchange programs were created to save lives.  We encouraged people who are addicted to alcohol and not able to abstain from the drug to reduce harm by not driving under the influence.  Thus the designated driver and free ride programs were created.  Now we hope that the Narcan we distribute will bode survival for the person addicted to opiates.  Harm reduction is based in a wise and compassionate understanding of human suffering.

How does this pertain to living with Self-Directed Violence (SDV)?  It’s the same principle: if you need to self-injure, are you interesting in reducing the harm?  That might mean learning anatomy for some so that wounds are not more harmful than intended, or resulting in permanent damage beyond a scar or two.  For others it might mean analyzing who is safe to speak with about SDV and who is not given how the responses of others affect our lives.  Want to get admitted to a hospital?  Tell a mental health clinician that you are cutting or burning yourself and the odds are increased that you will be admitted.  Don’t want to end up in a hospital?  Be cautious about whom you trust.  Not sure?  Write to us here, you will find a safe place to express yourself.  I have learned over the years that having a place to feel free to speak my mind is a lifeline.  If you are someone who is determined to never self-injure again and are afraid that you will, we can listen.  If you are someone who is determined to choose what it is that you do to your body and will cut until you don’t choose to anymore?  We can listen.  Stress levels are high almost everywhere now.  One thing I know?  Living with overflowing challenges is not a new experience for those who live with SDV.  We survive.  We cope.  How lovingly can we do this is my question…

If we say that those who self-injure will kill themselves…

Last night I saw a Facebook post announcing a therapist’s upcoming class on “Teen Self-Injury: Working Toward Healthy Coping Skills.”  No, not something I’m going to link you to here.  I looked through the teaser information about this course and sighed.  We have work to do if we want to support deep healing for people who live with Self-Directed Violence (SDV).

The information began with typical fear-mongering about how horrifying it is for people to discover that others, in this case young people, live with self-injury. Is it troubling that many people need self-injury as a way of coping?  Of course.  Yet making this about the “drama” of self-harm, rather than understanding the prevalence of trauma and how people cope, IS harmful. Was trauma mentioned?  No.  Were psychiatric diagnoses mentioned?  Yes.  This particular person opted to link self-harm with depression.  Not as a means of understanding a person’s life but as a way of connecting psych labels.  And people who live with SDV tend to get a collection of those…

If we only focus on a person’s behavior, and especially if judge it, how can we truly promote understanding and create an environment that supports healing?  This clinician, as a representative of the majority, focused only on promoting a training that will teach people how to make people change, he said from “unhealthy” to “healthy.”  Sounds good superficially right?  But this is the most common destructive response to people who live with SDV.  Whether by blatant actions such as restraining people (tying them down and/or forcing powerful numbing drugs on them) or subtle ones (such as shaming, demeaning, or leveraging people) the use of coercion is never helpful.  Never.  Ever.

The experience of trauma results in disempowerment and disconnection.  Much more on this to come.  But please consider what creates a healing environment… empowerment and connection. Not easy, but yes, that simple.  Attempts to control a person’s behavior… disempower and alienate people.  Doesn’t matter if you think it is “for someone’s own good” or have various initials behind your name.

The most disturbing sentence of the promotional piece?  That was easy to find: “Self-injury is an unhealthy coping mechanism that can lead to an increased risk of suicide.”  Wrong.  No citations.  Dramatic.  Terrifying those who care about someone who lives with SDV, right?   That is the sentence that sets up the justification of coercion. The “OMG, we need to stop the cutting because it will lead to death!” And then we can therefore begin to justify doing just about anything to a person to force them to change.  And what does that do?  Adds huge piles of additional trauma to a person’s life, compounding the challenges that are already there. And then… as you add disempowerment and increase the experience of disconnection?  Then I am afraid for you.  Not because you cut or burn or punch yourself.  But because you are isolated, judged, shamed and alienated.  Then living gets that much harder…  That is why we are here.

And the link between SDV and suicide? Having a coping mechanism that, while not necessarily bringing healing, allows you to survive your challenges in the moment, reduces the possibility of suicide.  More on that later.  Please think about this.  And please think very critically of what is written about this topic.  What might sound helpful… may not be.

Healing is always an option…

I have reread Tanya’s words from last week’s post- they have inspired much reflection and a wave of gratitude for my wise friend and colleague.  This past week has given me the opportunity to do some thinking as I’ve been flattened by a flu bug.  Not much reading, no writing, lots of reflecting…  I am a very fortunate person.  My life’s most brutal challenges were early on, healing from them over the past decades has brought me more joy than I could have imagined.  There were hard times along the way, there is still much work to be done, but I have gone far enough down this path of healing to trust it.

I want to share with you one piece of writing that has inspired me repeatedly over the years.  Whenever I begin to feel uncertain about taking on the challenges in front of me I consider Darlene’s words.  Can there be more challenging circumstances in which to keep the flame of healing alive?  We can heal.  Anywhere.  As long as we have breath, we can heal.

I am a 40 year-old woman recovering from SIV.  Since coming here (to prison) with a life sentence in 1997 I’ve grown beyond the need to self-injure, though the impulse still arises in highly stressful or painful circumstances. The healing I’ve found was self-motivated, not due to being treated while property of the Department of Corrections.  Their method of dealing with inmates who self-harm is not much different than some outside ones.  Inmates who hurt themselves are punished for it be being stripped and confined for up to 3 weeks in a small bare cell.  Of course this is done under the guise of protecting that inmate from themselves.  As far as actual counseling, the mental health staff are understaffed and are responsible for so many inmates on each of their caseloads that appointments are only monthly and often cut short after 15-30 minutes.  Furthermore, the turnover rate for those counselors is high, therefore once any form of communication lines are opened between an inmate and counselor, that counselor moves on and is replaced by another, leaving the inmate to start all over again with a complete stranger.  It’s a vicious cycle with no solution other than the ones we find ourselves.

I found strength by forming my own support group consisting of people who were doing positive things for themselves. Some of those had self-harmed in the past and found other ways to deal with life.  As I grew I began reaching out to people who were actively harming themselves, passing on what I had learned.  I also took steps to begin healing from my past trauma, sexual abuse issues.  I believe my healing there, the self-forgiveness I found, were the biggest achievements in no longer having the need to harm myself.

                                                                                                         Darlene Dixon

 

Thank you Darlene.  Again and again.

The Definition of Healing

I have been thinking a lot about healing lately.  I have a tremendous gift in that I get to work with a dear friend this year on an emerging project out of New York. As we travel together, we talk about our own ever changing, constantly painful and often enlightening pathways to healing.  I am always reminded that the journey is not linear;  that healing is work and that that work is often as exhausting and lonely as it is necessary.  The definition of healing is to become sound or healthy; to alleviate a person’s distress or anguish; to correct or put right.  The assumption in this is that there was a wound or injury to be corrected.  That healing comes only after hurt.

When a physical injury happens, the body forms scar tissue while healing.  Our magnificent biosystem knows that the injury cannot happen again and over compensates by reinforcing the area against further harm.  If our skin is cut, we have a scar.  If a bone is broken, extra bone grows back.  Our bodies know that the area must be protected.  This is not in question; there is no discussion or thought it just happens.

What then happens to our mind when the hurt is not as obvious?  How will our brain respond and protect us from ever being hurt again?  It will reinforce just as our body does.  Our brain will protect us from the pain that needs to be corrected.  But is that healing?  And what happens when we need to remove the scar because the protective shield we have put in place is actually preventing more than just further injury?

As people who have survived incomprehensible pain, we have reinforced and protected even the most intimate parts of ourselves.  We have corrected the wrongs by creating barriers to ensure that we are not hurt again.  We are brilliant in our abilities to self-care in ways that are misunderstood and diagnosed and treated but they also keep us safe and make us whole.  Until they don’t.

I cut my leg on a piece of glass as a child.  My body formed a large scar on my left thigh as a result of the wound to ensure that I could not be hurt there again.  But as I grew and my body changed, that scar has moved and changed and now is it is an ever-tightening piece of skin that causes me discomfort from time-to-time.  The scar, which was formed to correct an injury is now causing me a different pain.

My healing is not linear.  As I grow and change, some of the scars I have formed to protect my emotional pain are starting to cause me discomfort.  They have protected me and prevented re-injury and for that I am grateful and humbled by the masterful way my mind and body took care of me even when I didn’t know it was happening.  But now, I must look at some of these and do the hard work of peeling away these barriers.  I must do the exhausting work of finding new healing.  I don’t know where the process will take me and I can’t ensure that I don’t get new wounds.  But I know I must allow myself the gift of vulnerability.  And I am grateful for all of you for the support needed to try.

written by my beloved friend and brilliant colleague, Tanya Stevens, whom I hope we will hear from often..