Listen to the Pain

Listen to the Pain

I hurt myself today. I hurt myself most days. Before you judge me, think off all the times you hurt yourself.

Being a seventeen-year-old most people do not understand me anyway. That doesn’t stop them trying to work me out or telling me what to do. I have given up on wondering why they do not just ask me. Maybe asking me a question would result in listening to me and that is something that they are not prepared to do.

My latest incident of self-harm had resulted in me being in hospital overnight. Even though the bleeding had stopped, and the cut was not dangerous, the hospital staff could not send me home without permission from somebody from a mental health crisis team, so I stayed in a small hospital room. That might be misleading because that might cause you to believe that there was a bed in the room. I should say that I stayed in a room in a hospital. It was a small room, with something that looked like a cross between a sofa and a bench in there, along with one chair that looked like the ones my old high school used to use. Looking around the room I was not sure if I was going in there to be cared for by a nurse or interrogated by a police officer. Instead, I had my mum for company. She didn’t know what to say to me, being brutally honest I don’t think she has known what to say to me for years. That meant that she ended up asking if I was okay about four or five times an hour. Other conversation starts that she tried were asking about how some of my friends were doing, how college work was going and if I had made any new friends at college.

Eventually around eight thirty in the morning one of these crisis workers arrived to see me. They had a series of questions that they asked me, clearly the same questions they would ask whoever was in front of them in a room in a hospital. Yes I have self-harmed before. No I haven’t had any support for my mental health. Yes it was with the intention to die when I hurt myself last night. No I do not have any plans to end my life right now. Yes I do feel safe at home. Yes I would prefer to be at home rather than a hospital room, even one that had a bed.

Apparently, I passed the test, because I was allowed to go home. I think that means I passed. I was eligible for home treatment. Whether that was a reflection of their perception of my mental state or my safe home environment, I’m not sure. What it resulted in was a few different adults coming to see me over the next few weeks.

They came to our house, one at a time on different days. Each wearing a lanyard as if I am likely to ask them to show me some ID at any moment. I think the idea is that they all have their own specialities and their different ways of working. Maybe it is my blurry mind, but I am struggling to spot the difference. Three of them mean I must tell the same story three different times. I think about changing some of my answers to see if they challenge me on it, but I do not have the mental energy required to be so creative. It all leaves me feeling assessed rather than helped.

A couple of them come round a few more times, but from the beginning it feels like they are wanting to be able to say they no longer need to work with me. The whole time I feel that their main goal is to work out how likely it is that I will attempt to kill myself. That leads me to feeling that I only deserve help if I am on the brink of death. I have been wanting help for years, but it has only arrived after I cut myself deep with the intention to die. It feels like I was on the front of the Titanic, pointing out the iceberg but no one was listening or believing it was a problem. Then I hit the iceberg and a bunch of rescue boats have been quickly sent my way. Now the people driving those rescue boats sound like they want to dump me back in the Ocean for someone else to pick me up.

My feeling that I need to be on the brink of death is backed up by the fact that whenever I say that I am not feeling like I am going to act on any thoughts of suicide then whichever worker I am talking to starts talking about exit plans. That means either passing me on to somebody else or me using the techniques they have told me about to look after myself from now on. I can see why some people attempt suicide on purpose just to try to get some help. For now, something is stopping me from doing that. That would be called attention seeking, or a cry for help. I am not sure when those phrases started to have a negative connotation attached to them. Yes, I am seeking attention, I would say I was actually needing some. A cry for help? Yeah. Can someone help me then? Their professional approach though leaves me cold, I am not too sorry to see their rescue boats starting to turn and sail away.

They seem liked they have asked the same questions and had the same conversations thousands of times before, and are fed up of having them. I would have thought the art of their job was to make it sound like the first time they had ever been in this situation, remembering that it is the first time for me. Sometimes they look so drained by their job that I almost start feeling sorry for them. There are moments when they forget who they are talking to and they use some phrases that I have to think they are not supposed to use in front of me. Risk incidents, is one of those phrases, summing up what I have told them by checking for clarification that there have been no risk incidents since they last spoke to me. What counts as a risk incident? In the real world that could be anything from somebody nearly slipping on a wet floor to a building being burned down. In their world I think it means that I have not attempted to take my own life. It is because of these lack of risk incidents that after a couple of weeks they decide I am no longer a serious enough case to be deserving of their attention, so they refer me on to the local team. They obviously word it much more pleasantly, but that is what I hear.

I have to wait three months to be seen by someone from the local team. Apparently, I should be grateful that they bumped me up the list and saw me so quickly. The woman I see there has a similar vibe to the crisis team people, including the lanyard. She makes me feel like I am being assessed again, with her clipboard and her forms. Knowing that she has used those same forms with every young person she has ever worked with makes me feel like a number rather than a person. She seems nice enough and I can talk to her, without talking about the things I probably most need to talk about. Just when I think that she might be interested in helping me now that the assessment is complete, she mentions something about how long her waiting list is, implying that she won’t work with me for too long. I know the waiting lists are a problem, but making me feel like I am getting in the way is not helping me at all. It turns out she never really gets away from assessment mode either, in our three sessions she is simply trying to work out if I am a serious enough case to justify keeping her from seeing the next person on the waiting list. It appears I am not serious enough, as she ends our sessions after the third one, rather than working with me for the eight that was on offer to begin with. By that stage I am not sure whether it is a bad thing or not to be not getting the help I have so far been offered. Is bad help better than no help?

A couple of months later the optimism in me comes back just enough to refer myself to a local young person’s listening service. I had never heard of them before, so had no idea if they would be any good, but figured they were worth a try. From the start it was definitely different. Her name was Ashley, she was youngish, I guessed around thirty and it turned out she was thirty-one, and she didn’t wear a lanyard. A big difference was that she started the first session by asking what I liked, and anything good that was happening for me at the time. It felt difficult to tell a stranger what I liked, I realised later that was down to my fear of being judged. At least though someone was taking an interest in me as a person, which felt like a new experience for me. I did not tell her everything that I liked right from the start. With a little encouragement from Ashley, I did tell her about a few TV programmes that I liked. That meant that a big chunk of our first session was spent talking about Stranger Things and Umbrella Academy. Both of which she seemed as passionate about as I am. It was not what I was expecting, but once I relaxed into it, I genuinely enjoyed the session. Will it help me stop self-harming, probably not, but it was good to have someone who looks like they will talk to me rather than at me. More importantly she made me feel heard.

I am able to go to college now, wouldn’t go a as far as saying that I was comfortable there, but I could bare being there most days. Whenever I start to feel like my mind is wandering or my anxiety is getting too high in class, I find myself looking forward to my next session with Ashley. Part of my curse at the moment is that I always want to be somewhere else. If I am at college I want to be home, if I am at home I want to be at college. Neither place is appealing, which leads me to wanting to escape. At least now with Ashley I feel like there is somewhere that I am happy to go towards, rather than escape from.

I make sure that I am there in plenty of time for my second session with Ashley, she catches me off guard with her first question.

‘Hey Gina, how has your week been, anything good happen?’

First of all, she remembered that I preferred to be called Gina, rather than my full name Georgina. That matters to me. Then asking about something good? I had been so used to talking to adults about how difficult my life is, I had almost forgotten what it is like to talk to adults about something good. I know we had that chat in the first session, but I had figured that was just an ice-breaking, rapport building type of thing. After a few moments of me being literally speechless, I was thinking it was purely because I was not used to being asked such a question, but then Ashley said something that made me realise another reason for my reluctance to be forthcoming with an answer.

‘You can have something good happen and still deserve help you know.’

I had become so conditioned to being assessed rather than helped that I had stopped wanting to tell anybody anything good about my life for fear it would send me crashing down a waiting list or out of a service altogether. After smiling and nodding at Ashley I managed to remember something.

‘I got a good grade in a piece of history coursework,’ I said and realised that it was the first time I had told anybody about that, which seemed odd. History was not Ashley’s area of expertise, but she was still able to ask plenty of questions about it to get me talking about it for around twenty minutes or so. She was enthused by my enthusiasm for subject. By the time I had finished talking about it she had made me feel like a history teacher inspiring a passion for the subject in a student.

After a little more Stranger Things chat, Ashley did get around to asking about what was not so good about my life right now, what I would like to change if I could. Whilst I was still a long way from being ready from full disclosure, she did manage to get me to tell her about being bullied throughout high school, feeling like I’ve been on the brink of an eating disorder for at least the last five years, hardly ever seeing my Dad and feeling like my Mum is emotionally unavailable. In a little over twenty minutes I told her more about what is troubling me than I have ever told anyone else.

‘So in summary it’s shit,’ Ashley said and got a laugh out of me. ‘But I definitely feel like that is all stuff we can work on and whilst we won’t be able to magic it all away, we might be able to come up with a few things that can help you manage it all a little better.’

Even the repeated use of the word we in that sentence was something that I felt separated her from the other professionals had been assigned to help me in the past.

In our third session Ashley had a chess board out on the table in the room.

‘Don’t suppose you play chess?’ She asked after we had our usual catch up at the start of the session.

‘I actually do.’

‘Queen’s Gambit?’

‘Totally,’ I said and laughed.

‘Knew it.’

‘It was so good.’

‘It really was.’

So we had another Netflix show to talk about and a game to play.

Ashley could obviously play a pretty good standard of chess, but she was able to keep the questions coming in a relaxed manner as we played, keeping me off guard with whether the questions would be about something good, something bad or something completely trivial.

In between sessions was still a struggle. Like I was drowning in life and once a week Ashley would provide me with a life raft. Why is my default setting to hurt myself? Am I angry with myself? Do I think I deserve punishment? Or is it simply that I believe it is the only sure fire way to distract myself from the other pain? I know that not many people self-harm in the widely accepted definition sense, but how many times have you had some food that you knew was bad for you? Or drank too much alcohol when you knew you would regret it? Or have a late night when you were already tired and would feel horrendous the next morning? We harm ourselves in so many ways.

In our next session just as I am deciding between moving a knight or a pawn, Ashley comes straight out and asks.

‘What causes you to self-harm?’

She managed to ask it in such a way that I did not feel like it was and accusation, or that self- harm is anything that I should be ashamed of.

‘That’s a big question,’ I said after sighing.

‘Answer it however you want.’

‘It’s more than just one thing,’ I said, leaning back in my chair, away from the chess board.

‘It often is.’

‘Sometimes I just want to feel something, almost to remind myself that I am alive. To check that I can still feel something. Other times I am feeling so much pain that I need to distract myself from that and the only way that I can think of to get that done is by causing physical pain,’ I lean forward and push a pawn forward a couple of spaces.

‘I get both of those, there is logic to them,’ Ashley says as she brings out one of her bishops.

‘And to be honest there are times when I feel like I am screaming out to the world how much pain I am in, but no one hears me, so instead of telling them I have to show them.’

‘Ah some good old attention seeking,’ Ashley said with a hint of a smile. Her being able to say something like that, and me knowing that she was being ironic was a great example of the connection I already had with her. If any of the others I had seen had mentioned attention seeking, then I probably would have walked out. None of them would even get close to using humour either. ‘Do you regret it afterwards?’

‘Yeah, not always instantly, sometimes instantly, but it usually takes a little while for the thoughts of ‘what on earth are you doing’ hit me.’

‘Then how do you feel?’

‘Stupid, guilty, ashamed, all of which often leads to anger.’

‘Sound like the beginning of a cycle.’

‘Definitely,’ I nodded.

‘You’re not stupid, you’re in pain. I know me saying that won’t magically make you stop feeling that, but I think you deserve to hear it. What are you guilty about?’

‘For making people worry about me, for making people around me more miserable themselves.’

‘That’s nice of you to think about the impact on others, but it’s not helping anyone.’

‘I know, if anything it’s just making it worse, so they are going to worry more and feel more sad.’

‘So much better when you say it yourself.’

‘How do I stop?’

‘How do you stop?’

‘What?’

‘Are there times when you have the urge to self-harm, but don’t?’

‘Yeah, so many times.’

‘Then how do you stop yourself?’

‘Distract, distract, distract.’

‘Maybe all life is a distraction,’ Ashley said as if she was about to switch into a philosophical debate. ‘But what distractions work for you?’

‘Depends where I am.’

‘Of course.’

‘Going for a walk can be good. Especially at night. Oh my God, walking around a graveyard can be amazing. I know that sounds weird and please don’t report me or anything, but yeah I love walking around graveyards at night.’

‘It is a little weird,’ Ashley said with a smile. ‘But like I say, weird just means different. And to be honest I love it too, something so peaceful and spiritual about it, and gets me thinking.’

‘Oh my God yes, I start thinking of all the people who are buried there, the lives they had, the people they knew, the things they did.’

‘Good place to get prompts for stories to write I would imagine.’

‘Totally, yeah. Love the sense of history of it all.’

‘Okay that sounds like an excellent distraction for you. What else can work?’

‘Doodling sometimes, even though I am rubbish at drawing. Binge watching, usually something I have seen already, I know some people find it boring when I tell them I watch the same things over and over.’

‘Actually there have been some studies done that show that re-watching things we like can be good for our mental health, because of the comfort it brings, we know what is going to happen and we know we are going to like whatever we are watching.’

‘Definitely eases my anxiety, usually at least.’

‘Okay, anything else ever work?’

‘Youtube videos can work, they can be a bit hit and miss though, depends on what videos I’m watching and whether they remind me of the pain or help me escape from it.’

‘Yeah I guess with all these things it is important to notice the impact they are having on your mood, if they are making you feel better then carry on, if they are making you feel worse then look for something else to do.’

‘It’s difficult to notice things like that though, especially when I am feeling crappy.’

‘Hey look, none of this stuff is easy, if it was easy there would be one book of around fifty pages out there that we would all read and then life would be a breeze. We are not doing these things because they are easy, we are doing them because they are worth it.’

‘True, true,’ I conceded with a nod.

We drifted off into a chat about a couple of new Netflix shows and then a bit more about college life and how it hadn’t changed too much since Ashley had been at college herself.

Working with Ashley was making me feel better, but it was still leaving me with an uneasy feeling. Being all better was appealing, but getting better seemed difficult and complex. Plus I still felt like I was trying to ignore things until they went away.

‘So how have you been? What’s been happening for you?’ Ashley said to start our latest session as soon as we sat down on separate sofas.

‘I am self-harm free for eight days now.’

‘Firstly congratulations,’ she managed to say that without sounding patronising. ‘How has that left you feeling?’

‘Good, good.’

‘No, really,’ clearly my answer hadn’t been as convincing as I thought it was.

‘Scary.’

‘There it is. Why scary?’

‘Partly because the longer it goes, the more pressure I am feeling to keep the streak going.’

‘That totally makes sense. I would say to look at the big picture though. So let’s say someone went thirty days without self-harming, then self-harmed the next day. The temptation would be to think of that as ruining the whole thing and making those previous thirty days pointless. I would say to instead look at it as only having self-harmed once in thirty days, then to focus on how long you can make the next streak lasts. If it lasts fifteen days, then you have only self-harmed twice in forty-five days.’

‘That makes sense.’

‘And focus on the wins. It is so easy to think of the one moment it takes to self-harm as a failure, but what about all those many moments when you didn’t self-harm? So even if the streak does come to an end then take time to reflect on how well you did to go so long without doing it.’

‘I can do that, at least I should be able to.’

‘Not easy, but worth it remember. Anything else scary about it?’

‘This is going to sound totally weird.’

‘You know I love that.’

I could not help but smile before I continued to talk. ‘I feel like I sort of miss it, and am not ready to completely let it go.’

‘That’s not that weird,’ Ashley replied.

‘You almost sound disappointed,’ I said with a smile.

‘Maybe a little,’ she smiled back. ‘No seriously, that is relatable for a lot of people. I think most, if not all, of us are searching for an identity and when we have one, it’s difficult to let go of it, even if we know it is a negative one. Are you left thinking that if you’re not the girl who self-harms, then who are you?’

‘Yeah, I think that’s it.’

‘Maybe we need to boost your identity another way then, so you can replace it with something rather than getting rid of it and leaving you feeling like you don’t have one at all.’

‘That makes sense.’

The next couple of sessions after that we did some work on creating a new identity for me. Ashley suggested having as many parts to my identity as I could think of, that I was comfortable with, rather than only identifying as one thing. The aim being to get me to think of myself as well rounded person with many things that make up my identity. She explained the danger of only identifying with one aspect being that it puts too much pressure on that one thing, for example if I only identify as an A-level student, then any disappointing assessment grade could result in a big negative impact on my mental health. Between us we came up with a few things that I could say made up my identity, including being a daughter, a student, a creative person, someone who cares about other people and the planet, a dreamer, an animal lover and someone who wants to travel the world.

The identity stuff made sense, all of the stuff that I did with Ashley made sense, ultimately though it still was not going to make me feel any better in the long term. That was not Ashley’s fault it was mine. I was expecting her to fix something, but I had not even told her the main problem. After fretting about it for hours I did not even go to my next session with her. She left a voicemail message on my phone, she was perfectly lovely as always but I could tell she was disappointed that I had not turned up. The next week she gave me a ring to check if I would be coming to the following days session. I answered the phone this time, apologising for not coming and lying about a hectic week of deadlines at college being the reason I did not go to the session.

‘No need to apologise at all,’ Ashley said. ‘Just want to make sure you want a session tomorrow.’

‘Yeah,’ I said with barely disguised hesitation.

‘We could do something different if you like? I was thinking we could go for a walk.’

‘Oh erm, yeah okay, yeah,’ for some reason that appealed to me more than a regular session. I arranged to meet her at the end of my road at our usual six o’clock time.

I arrived at the meeting point a minute or two early, Ashley was already there.

‘Hey, good to see you,’ Ashley said.

‘You to.’

‘Shall we head this way?’

‘Yeah okay.’

The darkness meant that meeting up for a walk felt a little strange, but I felt safe with Ashley, I also had a feeling she was heading somewhere in particular. She gave off a vibe of walking purposefully and made a few direction decisions without checking with me. We chatted away as we walked, only about trivial stuff, mostly about college. After ten minutes or so I had a feeling that I knew where Ashley was heading to, feeling that proved to be accurate a few minutes later when we arrived at a graveyard.

‘This the one you walk around?’ Ashley asked as we got there.

‘Most of the time yeah.’

‘I thought you might appreciate it. That it might make you more comfortable, comfortable enough to be the real you.’

‘The real me?’ I asked.

‘Yeah, I know you’ve been holding back on me.’

‘Well, erm..’

‘And that’s totally okay, you can hold back anything you want. But I would not be doing my job well if I did not at least try to provide you with the environment to allow you the best chance to feel like you could tell your full story,’ Ashley said then sat down on a bench on the edge of the graveyard.

‘My full story,’ I said as I sat down next to her.

‘Only if you want to tell it.’

I stared out across the graveyard. ‘He’s not actually in here, but I do think about him whenever I come here.’

‘Who?’ Ashley asked slightly tentatively.

‘My Uncle.’

‘Oh I’m sorry, when did he die?’

‘A couple of years ago.’

‘And..’

‘Suicide.’

‘Oh that’s awful. I think that’s the worst way to lose a loved one.’

‘Mum was devastated.’

‘It was her brother?’

‘Yeah.’

‘Were you close to him? Did he live locally?’

‘Just round the corner. Depends what you mean by close.’

‘Some people are really close to their Aunties and Uncles, others hardly ever see them.’

‘I saw him a lot.’

‘So it hit you hard when he died?’

‘In a way yeah,’ I looked around the graveyard, Ashley sat with the silence, waiting for me to carry on speaking. ‘Does it count as being close with your Uncle when you are in a sexual relationship with him?’

‘Oh Gina,’ I could feel the look of sympathy coming from Ashley, even though I was still looking away from her.

‘When I say sexual relationship I mean that he had been raping and sexually assaulting me for a couple of years before he died.’

‘And no one knows about this?’

‘Just you. How do you tell your Mum that her brother is raping you? Then when he kills himself and everyone is so shocked and talking about how good a person he was, how do you say oh by the way he raped me several times.’

‘Do you think that’s why he killed himself?’

‘The guilt? I’m not sure. As he was capable of doing what he did to me, he was obviously capable of just about anything, so I have no idea what else he had been doing, what he was thinking when he did it. Not long before he died, I did imply that I was finally ready to tell someone.’

‘You don’t feel guilty about his death?’

‘No way. If that was why he did it, then it wasn’t guilt, it was shame. He wouldn’t have been sorry for what he did, he was sorry for getting caught.’

‘I get that. Must be so hard not only having something like that happen to you, but then to not be able to talk about it,’ out of the corner of my eye I could see Ashley shaking her head slowly as she talked.

‘Impossible to describe. That’s one of the reasons I’ve never told you.’

‘I don’t think there are any words to describe something like that.’

‘Plus I didn’t want you telling anyone else.’

‘I don’t need to tell anyone else if you don’t want me to.’

‘Really?’

‘Really, because you are not in danger from someone now.’

‘Oh, okay,’ I said and let out a long breath.

‘I can tell someone if you want? Or help you tell someone.’

‘No, no it’s okay.’

‘This why you self harm?’

‘I think so, the biggest reason at least.’

‘Trying to escape from something you can’t escape from.’

‘Yeah I guess. Can’t fix it, because it’s in the past. Can’t talk about it, at least can’t tell the people I live with and spend most time with. When they ask what’s wrong, I can’t give them an honest answer.’

‘No wonder you use the word trapped.’

‘Exactly. I know all the advice will tell me that I need other people to help me through this, but everybody leaves.’

‘How do you mean?’

‘Both the grandparents that I was really close to have died. People who I thought were friends have drifted away. Even him, before he started doing that, he was my favourite family member and one I would be most likely to talk to about anything I was struggling. I lost him in that way as soon as he started using and abusing me. It’s also like I have lost my Mum and Dad, because I can’t talk to them about the one thing I need to talk about most.’

‘It is so tough when people leave our lives.’

‘Now there’s you.’

‘What do you mean?’

‘You won’t work with me forever, I know our sessions have to finish soon.’

‘I can do more sessions with you. But yes I can’t work with you forever. People do leave our lives. Unfortunately, family members die. We can’t stay friends with absolutely everybody we become friendly with. The way I think of it is the impact these people have when they are in our lives is the most important thing. Of course that’s not always positive, your Uncle being a disgusting, horrible example of that. But all those good people we meet, they can leave us with a positive impact. They might not be in our life anymore for whatever reason, but their impact can last for our whole life. The happy memories, then things we learned from them, the love they showed us and how they made us feel. With me, don’t think of me as a major character in the book of your life, but think about me as a character who only appears in an early chapter, but when you look back at the end of the book you realise that was a turning point in your life and things got better from there.’

‘Bigging yourself up there a little,’ I said as I turned to look at Ashley, staring blankly at her for a couple of seconds before allowing myself a small smile.

Ashley let out a little laugh. ‘I have to massage my own ego occasional.’

‘You deserve to have it massaged.’

‘Aw thank you. I know you are drowning right now. I don’t want to just be a life raft for you, because then when we do stop working together, you will be right back to drowning. I promise I will do all I can to teach you how to swim.’

‘I think we might have been working together too long already, because that analogy made sense straight away in my head.’

‘I do like wearing people down to being on my wavelength eventually.’

‘I do want to swim I promise. But can I spend some time on the raft first?’

‘Of course you can.’

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