Tuesday 5 July 2016

You have to be happy to discover you are depressed.



Years of preparation and dreams were invested in winning a place in the class of a renowned baroque bassoon professor in The Netherlands. I had arrived. I was so happy. Everything could not have been better. So, I guess at this stage I had nothing to explain the frightening anxiety, stress and depression I was suffering. Previously, I had many environmental explanations for being unhappy. With those factors whittled away, the mental ill health lay as exposed as a reef at low tide.

For years, I had understood I was ‘being silly’, ‘overreacting’, ‘attention seeking’, 'showing off'. Since the age of one I was known to react outrageously. As a toddler I would smash drinking glasses with my teeth or storm around on all fours imitating a Sherman tank. At primary school I was the ring leader of the playtime games one day and hiding in the library the next suffering social anxiety. I so longed to be someone else. I longed to be a boy.

From the age of eighteen I escaped this pain with alcohol and drugs. So many fun nights were fuelled on self-medication. Breaking into the Sydney Botanic Gardens to play with the nocturnal animals and hug the life sized muscly statues. Jumping the fences of the Municipal Swimming pools in Paris for midnight skinny dips. All night partying in roof top spas in Reykavik's midnight sun. Not to forget the aforementioned Bicycle Thieves of a debauched Amsterdam night. I also tried escaping geographically. Out to dinner one night on Oxford St Darlinghurt, living in London three weeks later. My friend likes to hold himself responsible for this fast relocation with guilt, but I know deep down he is proud to have made such an awesome suggestion. A former Viennese resident, he exclaimed his excitement at how easy it would be for me living in Europe now that my newly issued British passport had arrived. I was gone!

Well, 'gone' didn't go quite as fast as a I had intended. I heard from Nick, 'Come on Kate, there's a cheap flight leaving in two days, come with me.' Well despite sleeping at Sydney airport to assure a front spot in the queue, we didn't get on the flight. Nor did I the following week, the third week I did. Three weeks of farewell parties at our famed Stanley St abode made a festive exit.

I've diverged from the depression. So, furnished with a valid medical complaint I felt justified in seeking medical assistance. My symptoms were taken very seriously. I was happily surprised not to be fobbed off as being ‘being silly’, ‘overreacting’, ‘attention seeking’ or 'showing off'. I was assigned a team of three mental health clinicians who observed me weekly over a period of six months. During this six month period I was forbidden to drink alcohol, smoke cannabis or avoid exercise; I was to run (not walk, run can you believe it?) for a half hour period every second day. 

Being taken seriously had a profound effect on me. Amazingly I had absolutely no difficulty abiding to these terms. I thought it was the cure and that that was all I had to do to be freed of my terrifying mental distress. I reported weekly like a diligent parolee. In place of drugs and alcohol, I took up tea and biscuits. I purchased myself a china teapot, a selection of loose leaf teas and bone china cups. I invented my own form of tea ceremony. With the motivation of being cured, I was finding the task not a challenge at all. Those who knew me well were astonished at my abstinence and diligence.

With the six month period elapsed, I felt cheated. I had played my part of the bargain, why was that black dog still hanging around like he'd just rolled in excreta? It was because, drum roll, I had a condition called Borderline Personality Disorder. Personality disorder????? 'Excuse me?', I thought, 'well you have a dress sense disorder!', I wanted to say to the doctor. There was no medication for this condition and it could not be cured, but with psychotherapy the symptoms could be eased. 

Funnily, except for the bad name, I was sort of happy to have a diagnosis. There was a reason I was in so much pain, a reason why it felt like no one liked me, a reason I hadn't been successful, a reason I wanted to kill myself. This of course meant I wasn't being silly’, ‘overreacting’ or ‘attention seeking’. What a fantastic relief. I wanted to tell everyone, 'hey I'm not useless, I'm ill!' It was terrific validation.

Why was it Borderline Personality Disorder? Borderline of what? I did my research as one does, and 'we' lived on the borderline of psychosis and neurosis. Well, that made a lot of sense to me, in fact it was a very good description of how I felt. Disorder with your personality? So I understood that to mean I was born (could've been some nurture in there too, wasn't sure) with a personality that doesn't work in your favour. This also make buckets of sense, as when I was in distress I would instinctively want to do something totally destructive, like put your hand in a blender and turn it on, cut all your hair off, break your good reeds before and audition. There were occasions I couldn't stop myself sabotaging or hurting myself. I'd watch myself doing it, unable to arrest the movements of my body whilst observing incredulously.

And so began the psychotherapy. I was already 31 years old and the healing had only just begun.

Monday 20 June 2016

Spiegel im Spiegel

Wednesday is the final group therapy meeting of my Dialectic Behavioural Therapy (DBT). It has been a 52 week course of intensive introspection and skill building. Others may arrive bearing wrapped gifts or cupcakes, I want to bring something much more reflective of my experience.

It is by chance that just a few days ago I heard a radio performance of Spiegel im Spiegel by Arvo Pärt. On this very first hearing I was taken aback by how similar this piece made me feel to how I felt whilst practising DBT mindfulness skills. It was immediately clear that I should perform this piece for my therapists and fellow group therapy members.

Spiegel im Spiegel is so named because of the infinite repetitions occurring when one places a mirror in a mirror, or Spiegel im Spiegel. These repetitions can be heard in the arpeggios performed by the piano over which the cello line plays repeated F major scales, the scales create long beautiful soothing melodies. Naturally, these melodies are essentially scales in contrary motion, a musical term meaning ‘mirrored’. As the piece continues they lengthen and lengthen. I understand this to symbolise the ever increasing images of the mirrors’ reflections. Pärt has cleverly created tension and release by choosing to commence or end the scales on notes other than the traditional tonic or 'do'. The cello melody commences on the supertonic ('re'), the second note of the scale,  this gives me the impression that the piece had started before the musicians had even arrived. Perhaps the composer wants to remind us that we exist in a tiny moment within an infinity?

This is precisely what I have done for the last twelve months. I have looked at myself in the mirror, again and again. I have become aware, through repetitive mindfulness activities, of every thought, physical sensation, emotion or urge. When the reflection within the reflection is examined and understood, the cause behind these thoughts, physical sensations, emotions and urges becomes clear, it's cathartic. With complete acceptance and/or willingness to change, I have been able to calm and validate myself. I have been able to see how normal it has been of me to do what I did in those challenging circumstances. Alas, my experience has been of much repetition. In these reflections I found beautiful soothing. One of the distress tolerance skills is to self soothe through the five senses. I use my ears to be soothed by music, my eyes to see the beautiful patterns the music makes on the page, I can smell the old aged wood of my cello and the rosin or tree sap on my bow. I feel the wood on my skin as the instrument vibrates with the resonance of sound. The dissonance and harmony comprise two opposing forces which can be simultaneously true, this is the dialectic. It's what suffering Borderline Personality Disorder is. It's wanting to live and die in the same moment; it's hating something because you love it so much; it's many strange things which I have learnt to radically accept.

F major is a beautiful choice of key. Before the common practise of equally tempering tuning in the late eighteenth century, key signatures would arouse desired emotions in the souls of audiences. So for the lessor musical scholars in my audience, what I am saying is that the note a composer chooses as his 'home' note can affect the emotion one feels in the music; depending of course how the musician chooses to tune his instrument. Temperament (are you seeing the emotional connection?) is a frightfully complicated mathematical phenomenon. Go and chat to Pythagorus, he can explain it so much better than I. F major is a key which evokes a pastoral setting, it places me in a forrest or upon a rolling hill. Mother nature is my God, it is the glory of natural instinct which tells a flower when to bloom or an animal to migrate. This for me is evidence enough of God's existence. My earlier religious experiences taught me to despise the word 'God', so mother nature she is for me. I guess this is all a long winded way to explain how F major places me in the midst of my higher power, in her greatest cathedral.

Learning to play Spiegel im Spiegel has required much skill in emotional regulation, the third of the quartet of skill groups one learns in DBT. Yet another dialectic, to remain detached from the emotion of the music in which I wish to swim. Maintenance of my rational brain, is a requisite of expert cello execution. In DBT language 'wise mind' is a place where the perfect balance of emotion and rational mind exist. This is where I must remain to affect the emotions of the listeners, yet maintain a high level of technical prowess.

I greatly hope this performance of Spiegel im Spiegel will bring great comfort, encourage further soul searching and celebrate the end of a truly remarkable year of therapy. Thank you Marsha Linehan, creator of Dialectical Behaviour Therapy.


Thursday 9 June 2016

My names's Kate but I can't say the next bit.

Do you have any idea how hard it is to discover you are an alcoholic? It's hard.
Do you have any idea how hard it is to say, "I'm an alcoholic"? Even harder.

It transpires that saying it is actually the easy part, believing it takes months.
Everyone else was doing it but I couldn't do it. So at my first meeting that's what I said, "My name's Kate, but I can't say the next bit". No one judged, they just listened. What a beautiful group of people.

I only went to AA meetings to prove that I wasn't an alcoholic. But after ninety meetings in as many days, I learnt that alcoholism is a disease of denial and I was indeed an alcoholic.

I'm grateful to my friend who first suggested I go. She was very clever and discreet in her method. I had admitted myself to Christmas Island Hospital because I was so afraid of committing suicide, I felt safe at the hospital. She came to visit me and brought me some reading material. The book had a blank cover, very odd. When I opened it I saw it was a book from Alcoholics Anonymous. I was furious. I didn't want to divulge my fury to her as it would expose my denial. So I took the book and read it, showing that I wasn't afraid to meet my demons (believing I didn't have any). It was a fascinating read. I was horrified when I read that an alcoholic was someone who craved another drink after the first. I too craved more alcohol after I started drinking.

But no! I'm not an alcoholic. I wear pearls and drink champagne from flutes. Alcoholics were those who drank more than you, alcoholics were those who drank from brown paper bags and drank alone, or in the morning. Well, as I slowly became educated I learnt so many things about alcoholism. It was a disease that didn't discriminate, it chose poor people, educated people, famous people, my friend's mums. I saw all kinds of people at meetings. Some had lost jobs, families, dignity, pride, houses, there were so many different types of alcoholics and so many stories, but all craved another drink after the first and drank to get drunk. All were running away from pain.

At meetings I felt as though I belonged, I had something in common with those in the fellowship. After many many meetings I had finally completed the first of the twelve steps, I had admitted I was an alcoholic and that my life had become unmanageable.

The next eleven steps followed. It was just amazing what I did. It involved regularly questioning myself, holding myself to account for my behaviour. Once over the shame, one begins to carve out a self with which one becomes happy, content, even proud. Another relieving step was to apologise to all I had hurt. A monumental task, I'm sad to say. Firstly, I had to recall all the people I had hurt. This was not so easy. The people to whom I had caused grief, were fortunately not so numerous, but they continued to pop up, and for this I choose to continually make amends. It was rather unexpected the incredible love and forgiveness offered me. Perhaps they were shocked into it?

The final step was to help others overcome their alcoholism. This was a great honour. I was fortunate enough to have been one of dozens of women worldwide who went to the five metropolises in India to share our stories of recovery hoping to inspire women in India to do the same. This was like the jewel in the crown of sobriety. I shared my story with university students, doctors, rehabilitation patients and alcoholics. I was greeted with vast thanks, warmth, humility, dahl and chai. I found the people of India to be so spiritual, happy and generous. I was expecting to see poverty, but I found wealth; wealth of colour, wealth of flavour, wealth of community and wealth of acceptance. Meeting recovering alcoholics and their families in the slums of Mumbai I viewed, joy, gratitude, love and support. It was almost as though their detachment from materialism was their key to happiness.