I’ve begun…a club.  A one-man club.  You can join if you’d like.  Really it’s just a blogging diary about your take, your real take, on identity, madness, illnesses, sex, love, men, women, family.  I believe so much in the power of writing in that it reveals to us who the fuck we really are.  Anyway I’m tired of sugar-blogging, I got real shit to say that most people may not want to hear or care about, but I need an outlet.  I can’t stand sitting and actually writing in my fifteen hundred leather journals because I lose focus and smell the leather.  You know.  Now with a blog diary you can add the music you’re in the mood for, tweet your angry ones, add media, all strictly for YOUR ENJOYMENT, not anyone else’s.

In Sylvia Plath’s poem “Fever 103″ (which I swear if you bipolar it reads like honey, massages your brain) she wrote my most favorite line in all of poetry:

       ”…my selves dissolving…(old whore petticoats)…”

 

Maybe this will be practice for my poetry and stories, too?  But it will strictly, from now on, be a diary.  A simple diary that abides by my moods.  If you are interested (though I’m not promoting this blog), we could figure out how to share shit and get into subjects and issues and just bitch and laugh together.  I’d like to set up specific days where I HAVE TO WRITE, though I can write any day, but I promise I will NOT write about useless shit, I only pay attention to alarming or curious things.  In other words I don’t give a fuck if you walked your dog today.  I do, however, give a shit if you’re having a rough day or a great day, if you feel your selves dissolving, and especially if you suffer or know someone suffering from complex trauma/PTSD, Bipolar, ADHD, Dissociation, and/or BPD.

So my first Petticoat Diary entry falls flat.  Shyness, insecurities.  I’m assuming I’ll adapt. So if you’d like to join in you’re most welcome, or just stick my logo on your blog, link to me (and

I’ll do the same) and just write on your own.  Thanks for reading.

Amy Jo

Nurse Jo always followed with a heated blanket, Seroquel, and fact sheets.  As I laid there sucking in air and crying like I imagine I must’ve when I was a little girl, feeling blindfolds on me and blood on my cheeks, hot and sticky and too real, Nurse Jo would shut off the lights and tell me to squeeze the blanket as she calmly, almost like a drifting story, read aloud the facts of trauma and sexual abuse and post-traumatic-stress disorder.  I liked facts.  They neatly fit into my head, massaging my brain.  Then I’d listen for the snow out my double-paned window, picturing it falling across the parking lot lights. 

My first time at the hospital I showed up like a child in a woman’s heels, banging on the heavy security door and saying into their intercom “help me please help me”.  I was seeing things by then, my brain had a fever, I was hearing voices at night and having moments of total loss of reality.  Nurse Jo didn’t like me then, she made that obvious when I told her I had been abusing speed.  She’d taken her time answering my calls, didn’t check on me, and was curt.  I guess she didn’t particularly like anyone–she was a typical business-type nurse.  Which I found comforting.  I knew I didn’t want a woman’s tone telling me I’d be just fine.  Having someone not like me there was a good distraction from my sick brain.

It was, I believe, my third time back, when Nurse Jo seemed to have assigned herself to me, after Doctor Lean asked me over breakfast, face in his notes, “have you ever been sexually abused, Amy?”

“Yes.”  What.

“More than once?” Oh, Christ, he’s serious.

“Uh, yeah.”

“And your ages during the abuse?  Okay, okay…”  It was like watching him do alga-rhythms, hunched over his favorite notebook, discovering.

“And physically abused?”

“Yeah,” I could feel my throat failing me.

“Okay, thanks.  Eat your breakfast and I’ll have the nurses give you a nicotine patch.”

Every day, there was Jo, watching me, waiting for signs, slipping me information and videos on PTSD.  When she was on duty no one switched with her.  I could cry like a child and she was there in her plain scrubs (all the other nurses decked out for the holidays) and simple jewelry, spilling the facts.  She never left me until I fell asleep.  Night, however, allotted no peaceful sleep.  I was up every hour, certain my breath would quit me, too. How does it all stay contained within your skin?  I wondered and waited for it all to come seeping through me–a black, choking hound of poison.  I’d called the desk many times, believing that that was it–it was over.

I’d try to close my eyes and pretend I was home, safe.  But then I’d hear the voices, the red eyes when I’d close my eyes, the terrifying way shadows fell from lamps across the floors.  I’d think about one of my last nights home-what I had been doing.  How had I not picked up on the obviously strange things I had been doing?  That was the night I had been painting my library black–the walls, the ceiling, the lampshades, the desk, the bookshelves, as I listened to Radiohead’s “Wolf at Your Back Door” over and over, child and fiancé somewhere asleep in our house.

As I said, there are points when everything is quite clear.  Points when your mind takes you beyond yourself and out into the vacuum, and the fear never subsides but becomes the fuel you run on; your self has truly left you behind with all your faulty manufacturing, and you look again, into the deadpan mirror above the sink.  Your eyes are black holes in your gray, swollen face.  You eye the scratch marks on your cheeks.  The halogen blinks and buzzes.

So it comes to this, I’d say to myself when I was grounded and not delusional, it is this: this plane of being that is stripped of all emotion, all comfort, all basic needs, and no one, no one is going to reach you or get you out.  Alone in the end, what is this faithlessness.  Where is God, my God, your God, gods, angels, spirits, the godhead, Atman, Ali.  In the stripped down version of life we are amoebic entities swayed by chemicals and disruption.  Love is a construct.  I am no one.  I am so empty I’m not even scared anymore.  Gone.

You can try to build a world around you and manically fill it with what your hands can try to take, coming up tired and empty each time; coming up short another death, and dying every day–watching who you are slip between your fingers–changes you.  There are people and there are circumstances that, if they strike when you are most defenseless, can devastate you beyond repair.  Some parts of your self cannot and will not heal. So?  Your possibilities change.  Your choices enhance in an unknown direction.  You’re a different person right down to your mutated amygdala.

Sometimes I know, during my kaleidoscope of mood and identity shifts, that I will discover and explore this world I’m in just as I would’ve explored the other one, and I’ll find a way to make it what I can accept.  There is no time for grief or pity, madness teaches you that.  And sometimes I think, as I look at the reflection of my black pupils: you really are just fucked.  And then the thought occurred to me as I prepared for another shockwave of hyper vigilance, hyper arousal, panic, flashbacks and dissociation–I thought: imagine then, imagine what it would look like–what it would take–what it could mean–if a person still lifted themselves up and faithlessly put their hearts and heads in the hands of no one but a chasm of unknowns.  Or God.  Or a nothingness that allows for a different sense of security. Or a power that was great enough to find you here.  We do not break.  We open up, and then we are given the chance not many have–to look into our guts to see what we’re really made of.  I no longer wait for that false light to descend upon me and give me grace and awareness.  And there is love in this world, but only if you’re well enough for it.  My sense of security had lain on such fragile things, fragile as a body.  Even now, I still have dreams where I am displaced–put out into the dark space among the stars with no line to pull me back in, no gravity, no air, no signs.  Not a soul but me and my quiet, spinning brain.

I had to find all these pictures of myself and love the girl that was in them.  I had to be my mother.  It wasn’t easy but it was worthwhile and I learned a lot of great self-talk from it, I can more easily calm myself down or cheer myself up, and it’s become a habit to say “take it easy on her, she’s lovable.”  I guess I’m going back to this because I need to check in on myself once in awhile to see how I’m doing.  I have to do that because I get quite careless, forgetful, and when I’m not paying attention, I stop loving me.  Her.  Much easier if it’s a “her”.  I tend to hurt myself (…a lot, and it doesn’t bother me…til later…and it drives my sister mad).  I’m struggling with some issues, but I’m also moving forward in big ways.  Am I trying to reassure myself that I’m doing everything “right”?  There is no right way, there is just your way.  Stop judging yourself.  It’s so easy to not judge others, but I’m crude on my own turf.  I’m debating on making this blog vague or really intense (which would be quite long) but a lot of intense things are going on.  And a lot of peaceful things.  Maybe I shouldn’t blog at all.  Maybe this is just life and I should enjoy all it’s many moods and ambiguities at once.  I know, I’ll make a list.

1.  I moved back into my apartment I lived in and loved when Emma was just one and two, before I got engaged and sick and well, disengaged and lost my mind.  This apartment is MY HOME, it always was.  I hated leaving it, even for that big nice house my fiancé bought us.  Because I get lost when I find love, turns out.  I forget who I am.  That’s one of many reasons why we’re not together anymore (that and the fact that he left me, gave me the boot, when I was severely ill with complex ptsd and psychosis) eh-hem but anyway that’s another number.  So this home that I’m back in wreaks of me!!  I’ve got all my art and photography up, (I used to interior decorate as a side job so I’m pretty handy on my own, I love decorating).  My apartment (upstairs of a 89 year old woman, it’s a big, huge old house with lots of charm) has eleven windows, art, my photography, a claw-foot bathtub, old iron (iron?) registers at the windows, tall white, old kitchen cabinets, hard wood floors that I refinished myself the last time I was here, my antiques and shabby-chic furniture, my stuff I painted and refinished, my millions of books and book shelves, small warm lamps and lighting everywhere—I’m just filling you in on my little dream home here cuz I love it so damn much.  I ‘m finally out of the low-income housing where all my and my daughter’s shit got stolen, landlord coming into my house when I’m not there, nosey neighbors, three windows, sooooo small—it was a year of hiding and depression there.  And I’m FREEEEEEE

 And now he’s finding that person, and I love him, but it’s time for us to see if we’re just not meant for each other.  We bring out the best and worst in each other.  And what was I then but an empty shell on the verge of breaking?  He used to hold me and make me tea when I had flashbacks.  He looked calm but like he wasn’t there.  Did it scare him?  When I was in the bin he and my sisters came to see me and when I confessed to them everything—how my soul was gone, how I was dead and there was nothing and all that horrible horrible shit, he disappeared.  Did he slip out of the room?  He’s not one to ever, ever talk about his feelings (but he explodes occasionally with them and I spend more goddamn time talking and explaining then anything else).  Anyway, we were like zombies together.  And now, now we have this fever.  And we’re each afraid but willing to accept that one of us is gonna meet someone they may fall in love with.  What happens when the fever ends?  Do you know, reader?  Because I’d like advanced warning for prevention here.  I don’t want to get burned again.  But my very nature allows me to do so, deep down I prefer to get burned again.  Huh, who knew?  See that’s why I write, I learn little things about me.That’s him and our daughter.  She’s everything to us.  Obviously.  I think every parent says that.  But she is something else.  My sweet little mama.  My Tootie. He’s one hell of a dad.  Best I’ve ever seen.  His gentle, shy, quiet side—that selfless side—reminds me of my real dad, John, who ended up drinking himself to death.  But when he was my daddy for a few short years, man he loved me and my sisters.  He was so delicate and insecure and sweet.  I remember…yeah, I remember, lots of things, that’s for another time.  Anyway, back to this man.He’s cute isn’t he?  We’ve always always been turned on by each other’s frustrations, and then afterwards we talked.  Or go do something.  Man I need to make sure I’m not thinking with my #%$&  Am I just desperately trying to keep him and believe he’s still in love with me?  I can tell you honestly the answer to that is NO.  I don’t ever trick myself so foolishly; I’m very careful with myself and of being aware and on top of the truth and the reality of what I’m doing, maybe because I’m terrified of getting hurt,or terrified I’ll hurt someone else which is so much worse,  and when I do, I twist it or shut it off AT FIRST, but I do come around and knead it out in my hands, make it make sense and make sure it feels right in my gut.  So how come this dirty lovely **** affair doesn’t feel wrong?  At all?  A little stupid and somewhat dangerous, but the fever is it’s own thing, you know what I mean?  Isn’t that pretty good though?  Ten years and we make each other crazier and crazier the older we get (crazier as in desire, lust, what-have-you).   It is what it is what it is.  So, okay, he’s coming home from a job working on oil riggs (gone months at a time) and I think we’re so turned on by each other because we’re being so damn honest with each other.  No “oh but I love you!” but instead it’s more like “yeah here’s the raw truth, take it or leave it, I’ll do what is best for me this time”, there’s none of that false we-owe-each-other-our-souls-do you love me but you’re not in love with me BULLSHIT, we’re just honest.  And that’s pretty damn sexy to see him honest and know what he wants.  So now he’s that way, and he’s that way around me, which is a bonus.  I never expected to love him.  I do, I love him.  In the beginning he was that nice guy that I couldn’t turn down because I felt obligated because he was so polite and kind and generous.  And deep down that’s him—generous and kind-hearted.  I never expected for a second I’d love him.  I wanted a poet, a passionate somewhat angry person who liked the music and words that I did, who understood what the fuck I was talking about half the time.  Not this guy who read my poetry and essays and didn’t even know what expression to wear on his face, what some of the words were, (don’t get me wrong he’s a math genius) nor did he even care “oh that’s nice”.  Like with my publications and making the Dean’s List while I was working and had our daughter, I wanted to be doted on, so I thought.  If someone today doted on me I’d chuck.  But I do want/need someone to believe in me.  Say they’re proud of me or pretend they’re slightly impressed to help my screwed up ego.  Anyways, he wasn’t my “type” and what do you know—those “types” that you think aren’t for you actually are perfect for you.  Well no one’s perfect for each other, but the way we get along when we don’t have the pressure of a relationship on us—it’s something to see.  I guess I’ll take that.  That’ll be enough.  And it’s a good thing.  May not come with a ring but I was never the marrying type anyway.3.  I’m finally off of Seroquel and Abilify and I feel alive and awake and I am pursuing disability finally.  There’s a fire under my ass.  Unfortunately this includes insomnia sometimes.

4.  I’ve decided to continue/go back to therapy.  Ugh.  It’s so draining.  I wish I could go to “the city” here and see a specialist.  Why don’t I try?  The Mental Health system in this small town is caddy, it’s sick.  It ain’t right.

5. My mother.  My surface mother.  I’d say she’s close to being my best friend, we laugh so hard we cry all the time, we have fun, we tell each other almost everything, we tell each other our fears and talk about our mental illnesses and what it’s like, we even talk openly about her betraying me and leaving me to that abuse and we’re finally ok and loving about it.  What’s NOT cool is like this debris left from it—she still tends to treat me like I’m the middle child who has no voice and causes all these problems, who’ll bend over and take it cuz her wrath still terrifies me when she’s mad.  She thinks her life was as equally as hard as mine, and she goes on and on about it.  She talks to me and at me, she doesn’t know me.  How can this be? How, I’m wondering, do you only want to get to know the surface of your child?  Why hasn’t she ever been curious about my heart? Proud of me for all I’ve made it through instead of treating me like I put myself in that position.  She had a picture perfect childhood.  I was left and ignored by one dad, beaten and molested by the next by the age of four, and my mother ditched me.  How can she say she knows what the fuck my life is like?  She couldn’t possibly imagine!!  She’ll never know what it feels like to have no self, no identity, confusing personalities, psychosis…ok ok I’m going to save this for a different post.  I’m getting pissy.

**picture of my real dad, John, my sister  Nikki on the left and me, the freaked out one, on the right.  He didn’t care for me that much and he left me to always help my sister (he didn’t believe I was his at first or something) so my mom and Aunt C say, but my other Aunt J says how much he loved us, even if it was for a short while, he loved us.  And that fills quite a gap in my chest.  His love from what…two years…is enough to help me get over the “unlove” from the next father figure.  Doesn’t make up for all that I lost and gained, nor the fact that there is some irreparable damage done to me, but hey, I’m not asking for too much.  He loved me then.  He loved me. Aunt J told me last week on the anniversary of his death that I have my dad’s beautiful, dark eyes and long lashes.  No one’s ever told me I had anything of his.  I cried because I was so happy.  I have his eyes. Despite the comb-over and goggle glasses, he actually was a handsome guy.  This one time, after not talking for years (decades) I found him in a bar, and I  sat and had a beer with him, I had a beer with my daddy, and he took out the pictures of my sisters and I in his old wallet, and he knew somehow where we were living and what our jobs were.  He was like an excited child that I was sitting with him.  There was no past or future there, we were just blood relatives having a beer, wishing for so much from each other and not knowing what that was.

So what I’m wondering is is it a mistake to do what I’m about to do with someone you love? We both admit we love each other, we’re just terrible and not who we want to be when we feel committed to each other.  It goes both ways.  Hmmm

Back to the picture of me up there in the flowers making that stupid face (I’m never kind to myself, it’s humorous in my head), is she alright?  Is she gonna be alright?  Maybe that’s not a fair question to ask, because anything could happen in life.  PTSD and psychosis trains you to expect the worst I swear to God.  But as for right now, she’s doing alright.  I can see her blooming a little bit, waking up to the sun, to coffee coming down a bright warm hallway, her little girl chatting away and asking what they’ll do for the day.  She is no longer empty but whole somehow, and excited for that wholeness to grow someday into grace.  She sees she has a future for herself—for the first time in a long, long, long time.  It was just two years ago when she wanted to die, she was struggling to survive the next hour, and now, me?  Yeah I’m okay.

“…my selves dissolving…

(old whore petticoats)”  

                                          –Sylvia Plath, Fever 103

So it’s time I started a journal, a real one that I won’t be too embarrassed about.  I guess I’m

doing an experiment–consecutively writing, making myself write about what’s really going on, and to better my situation and health/illness.  That line from Sylvia Plath is my absolute favorite, so I named the blog after it/her. What’s really killing me?  I can’t write my story.  Can’t even begin.  Maybe brutal honesty will help–I’m only honest to myself when I write; so this should be interesting.

This isn’t much of a home page  but I’ll add more as time goes on.

Later for now.

Me

  In those seven somewhat healthy years, I went to college, I began to write and write (which turned into a pitched fever as a spelled out the past and I began to decline, in my late twenties), I made the Dean’s List, worked full-time, and had a baby girl, and all the while I had no idea who I was or what I had been (or what I was going to become).  Maybe God or the godhead or the powers of the universe blessed me with a few years of peace (and ignorance, I knew it would all come to a head) because the future was an awaiting nightmare, and the past was a numb journey through alcohol and drugs, music, men, and me giving myself away to anyone who’d take me. 

Now before those seven “ignorant, peaceful” years, I was a subtle train wreck, running and running away from myself, and I had become so numb in my early twenties that I had nearly vanished.  I felt that there was one small piece of me, though, that hung on, always hung on, even when I was a little girl, and this tiny piece of myself was enough to help me survive.  And surviving was all I wanted.  It feels strange to recognize that truth, how ambiguous we are, because at the same time I was clinging to a shard for survival, I was also finding myself standing on top of downtown buildings in a bigger city, high on Ecstasy or Coke, feeling less numb, less afraid of death, less afraid of everything–except for my life.  I was terrified of me.  Of what I had become.  Was it reversible?  Reparable?  Each night I’d sit up in bed in the dark room, burning with “what have I done what have I done to myself.” 

It’s kind of easy to, when you’ve been abused and abandoned most of your life, to think you’ve actually done it all to yourself–all the chaos, all the emptiness, the loneliness you’re too proud and fake to admit, the terror in the night when panic attacks make their first marks on you.  It’s so easy to look at your pathetic self in the mirror, someone whom you thought was pathetic before you tried to ruin your life, and feel the guilt and shame wash over you, drown you–only you don’t gulp for air, you don’t fear the drowning, you expect it, you don’t believe your little life is worthy enough to seek air, so you sink.  And when I was sinking, I knew I’d pay for it some day, because I believe you must take care to every instinct you have about yourself.  If you ignore what you can’t hear but see that it’s there, you’re not a fool because you weren’t wired to care about yourself, and in this sinking time you don’t realize that you were rewired by someone other than yourself.  It’s not about blame and forgiveness and all that stupid worthless bullshit, it’s about believing and knowing that you did not do this to you.  It’s about believing in the deepest part of you that there is something beautiful in all of this, you just have to find it, and that journey is cruel and relentless and so tiring, but I believe with everything in me that there is something beautiful about it all–the madness, the emptying and filling, the love and hate, the underlying of current of love from loved ones. 

I’d try to vaguely remember the young girl I once was, if she ever was young; I have to go back to the sprite I was before the age of five, before I was molested and beat and then abandoned by those around me that could have saved me.  My mother, she left me there, wanting to believe so bad that she had found true love with a “real man” unlike my alcoholic father.  And to make it worse, she loved me in a different way, different even from my sisters, different from anyone else, because she loved someone she allowed to get hurt and damaged and broken.  She watched him throw my little body around the room and into the sides of a truck and off a dock when I couldn’t swim and boots and belt and humiliation.  It is not so much the physical that gets you, it’s the power-raving lunatic who terrifies you with his presence and threats, his child pornography and secrets.  It’s still hard not to be so overwhelmed and furious with my mother (furious is such a small word) when I look, now, at what I’ve become.  Granted, the emptiness is gone and there is a kind of peace in me I’ve never ever known, but my life aside from that is, well, sad.  Very sad.  How can I not think sometimes (especially we she shows no respect for the work I’ve done to get this far) that if she were given the chance, if the same opportunity should arise in a different disguise, she would again, leave me in the back where it’s dark and the sick prey on you.

 The only person that can save me from this very present is, quite clearly, myself.  Most of us with Complex PTSD I believe already know self-reliance, how to fight your way through anything, how not to give up, and know the quiet resiliency of getting back up, again and again, no matter how many times you have fallen after they’ve quit kicking you down.  Rewiring.  You’re falling on your own.  You seek out any means of obliterating your potential.  You begin to master what they (they being whoever your perpetrator/abuser(s) are) set out to to do.  And yet still, buried beneath all that self-hatred and self-abuse and loathing, you’re still hanging on, like you did as a little girl, because your instincts told you, even then, that your body was your temple, and anyone intruding was vile and ill and they knew of no things like faith or love or God.  There was, in that early moment of intrusion, self-awareness.  And you knew that self was worth protecting–extremely worth protecting.  She was sacred.  To you. You loved her.  You treasured her.  So you stowed her away inside because you were too little and too…human…to face the unbearable. 

What got me thinking about these things is oddly much more universal that what I’m saying here, yet I can only write about my experience, not that of others.  But I was imagining all the pain in the world humans endure, all the sweet little children that have it so much worse than I did, and then those that seem to go through life unaffected.  First, I imagine this pressure on the globe, and for the first time I understand why Jesus wept for us, why the Hindu’s and Buddhists seek nothingness and that that is everything–we have to learn to rise above our pain, and that, now that is a beautiful thing to see.  Pain and love are one in the same.  There is no good and bad, no black and white.  So I imagine pain teaches you the makings of your guts–your will–and love, love compliments it by filling you, filling you up so that when pain comes around again, love hasn’t dressed your wounds but is your wounds, your scars.  We fill with love and then are tested through pain to see what we’re made of, what others have made of us, and what we will make of ourselves.  I imagine with each great pain we can a peek at the love inside that has grown and is growing, and we can bear more, because we are so full, and they both bring us to tears.

I am disappointed in my mental reaction to being off most, maybe all, my meds.  The abilify was just about out of my system when I momentarily “cracked”, the Latuda I quit for three days to stop the nausea, and the Seroquel was well out of my system.  My, I guess, “reaction” or “state” was extreme anxiety ( I was certain I was going to lose it again and be back in the bin), I thought flashbacks were coming liking a train and I was this amebic blog that was pissed that I hadn’t managed to develop my own, personal defenses and strategies strongly enough; I was sort of in that floating stage where nothing seems quite real, where you’re on the ledge of a very big drop and vacancy into outer space, that godless place.  I called all my favorite numbers and was, thankfully, able to reach my psychiatrist who was on call and he prescribed me some benzos (not my favorite things but they helped).  I actually called the hotline, bawling like an idiot, and said I needed a shot of Abilify in the ass before it was too late.  Yes I said that.  “Too late?  For what?  Are you going to hurt yourself?  Are you in danger?”  Ummmmmmmm…trying to figure that out when you’re off your rocker is a tough one.  What if you feel like there’s this count down happening in your system and at zero you’re going to lose total control and you may hurt yourself or worse, someone around you.  Yet you always get like that when it’s bad, and you never hit zero.  Ever.  Must just be a fear.  But how can you not be scared when you hear crying and you run for the door, thinking it’s your child or a neighbor girl in serious trouble, in pain and sorrow, only to find nothing there.  And why did a med for schizophrenia work SO WELL for me, aside from the nausea?  I felt better on that (before I got sick) than I’ve ever, ever felt in my life.  Now there, I suppose I’m fearing labels.  And that’s ridiculous. 

I was driving the other day, waiting at a stop sign, when something wretched occurred to me: What if I’m not the best thing for my daughter?  What if I’m not the best thing for her?  My head tells me I’m not good for her, look at the bipolar (tho it’s mild and I still think it’s mistaken for borderline personality disorder), adhd, complex ptsd, psychotic features (though they don’t effect her, are not even seen by her, and mainly occur during PMS), unable to work (i’ve tried so many times and I’m going to again dammit), can’t finish my chapbooks or even start the memoir–what kind of example am I setting?  Then my heart kicks in and it’s like this–the way I love her is my example to her.  I love her good and I know I do.  Our relationship–our connection–is beautiful.  I realize I wouldn’t want a child to grow up in a “normal” “perfect”, conforming environment, but I want her to know she is so lovable and is loved, and to believe in herself, to have faith in her body and mind, but to eventually teach her that that body and mind can trick you, and then you have to rely on a strong heart and a faith based on your instincts and secret moments.  I want her to have faith in every step she takes, accepting mistakes and learning her lessons.  She’s got such a huge heart, always looking out for the feelings of others, and I want to be sure she doesn’t forget herself.  Like her mother.  I guess I feel like she doesn’t have a sick mother, she has a mama that learned a lot through some wretched experiences that I will never let her go through (unless she has chemical, biological mental illnesses), and I’m still learning.  I see, I see more and more about this life and who I am and how I want to not live it but just be for now (it’s all I can handle), and how my family taught me about love when I was mad and lost and given up in the hospital or in the prison of my rooms, faithless and empty and scared.  But they loved me in all kinds of ways that kept my sick head afloat, like they held out a rope to me and said to the shell of what I was “we promise, we promise, just keep swimming.”  And eventually, when I came out of it, they were there, in tears, waiting and believing and knowing I’d come out somehow.  It shocks the hell out of me when someone proves that they believe in me,.  It shocks the hell out of me that I was worth drudging through all the shit with, that I was worth anything at all.  I still find that hard to believe.  “Just stick to your mother role” my T always told me.  I miss her, after ten years, yet she just wasn’t letting me be me.  Or of course it could be me and not the educated psychotherapist–I just couldn’t, in the end, breathe with her, I wasn’t me shining, I was becoming this paper girl who acted as directed.  Paper Girl.  I’ve always felt like a paper girl, but when I’m with my girl or my sisters or cousins, it disappears.  In small ways I’m becoming whole, fractions are filling in, and I just have to keep taking the shit in stride.

On an end note I was extremely happy with myself a few weeks ago–I started disociating and instead of panicking like usual, I faced it, I accepted my depersonalized body and no mind, and actually was able to shut off my mind (no mind!) and let it just happen.  And the fear vanished and suddenly I was in control of losing control, it was amazing, so the fear never came and it ended sooner than usual.  Sweet, eh?  More later, Amy Jo. 

Radiohead and Cat Stevens and Awolnation–my music choices of the month.

I haven’t been blogging because I’ve been going through a lot of medicine changes. Off the Seroquel and abilify (yes!) and on Latuda, which kicks ass except it makes me sicker than a dog. I’ve also been…proliferating. I like that word. I was, one night, starting to dissociate, panic, and have a flashback and for the first time in my life I let go of something, I dropped my fear, and I let it come, I welcomed it. And you know, it didn’t turn out so bad! Yes I was very impressed with myself. I’ve also been getting extremely close to my emotions and picking at them to happily see that they are fitting in compliance with the goings on that cause such emotions. I’m trusting my feelings again. I’m slowly validating them. Some of them.

I’ve been rolling this poem over and over in my mind but it has no shape yet, but it’s about my sister, my best friend, Nikki. From the time I began writing essays and poetry and stories, even when I really sucked, she looked at me as if I were truly amazing, which is something else to feel for a girl who believes herself to be nothing. Feeling worthless is my undercurrent I can’t seem to shake. Even after the worst, and getting slowly better and better, I still find it surprising and hard as hell to believe that anyone would truly give a shit as to what I was going through (why should they bother themselves?) let alone love me and tell me I have potential. I still can’t hear those words but my my sister’s repitition over the years may actually pay off, because a part of me, however small, is starting to believe them, and not by choice.

Nikki has read every book on PTSD/complex PTSD/trauma that she can get her hands on. For some crazy, selfless reason, she wants to understand as completely as possible, what it’s like. She’s been my soul on the sidelines when my own light went out (and for a long time). She tries to put herself in my shoes and actually experience it and she comes out crying and compassionate, telling me how brave I am. What on God’s earth did I ever do to deserve this? It’s so strange to have someone love you so much, so completely and without question. They see something in you you may never see, but BECAUSE they see it, we gain an ounce of faith in ourselves, even if it partially is through someone else’s eyes. I can imagine what she sees when she looks at me because she’s amazing enough to tell me, knowing I need it explained. I can then see me, through her, and I feel an inch of hope, and a little respect. Yet when it comes to how I truly see myself, there’s this stain in my eye. I’ll never see her. I have pieces and fractures of her and the as-we-speak-developing “spirit” or persona that was quite annihilated for a few years. I’m no longer sad that I’ll never be the girl I was, because that girl was sick and lost and empty and young forever. But what it means to me that even when I was her, my sister loved me so completely, and she knew it was coming. I had always played the strong tough role, but as my mental health deteriorated and I began slipping and then I REALLY lost at my own game, Nikki was there with silent tears, knowing I had to do it my own way, on my terms, and knowing that I’d be the one to get myself up, not anyone else. She respected that side of me, and I forever love her for it, among a million other reasons.

There was, however, a time when I openly (and for the first time) admitted that I had lost. I had lost who I was, I had lost my soul, I lost my future, I was gone. My sisters visited me at the bin and all I remember telling them as I finally cracked in front of my family was “she’s gone she’s gone she’s gone”and I broke in front of them, everything came out, I had NOTHING anymore, I believed it was too late for me (I was having lots of psychotic episodes along with flashbacks) I’ll never be able to explain what it feels like to be gutted of your soul and everything you’ve ever known as safe, love, concern, forward motion, growth, purpose, faith, belief. It was all shot in the gutter. I didn’t have to tell my sisters my desperation, somehow they knew it and they saw it that day. It was like the chapter in my life we’d all known would come, because a person doesn’t just go through that unscathed, tough, sarcastic, and wild. I think of how many times I’ve hurt my sisters, yes I’m that sibling, the ass. Well I was. Not always, but everything was a joke and everyone worried too much. Bipolar and ADHD didn’t exactly improve my life either, flying by the seat of my pants, frivolous spending, careless…everything. Hard-core everything else, because I was running, desperately. I hid it so well until I became permanently numb, hating myself worse than ever before. Ugh that was a bad time in my life.

Anyway, Nikki. If I didn’t have her, I honestly don’t believe I would’ve made it. I trust NO ONE in this life, I’ve never reached out to anyone because I never felt worth it, or lovable. I still don’t really. But Nikki, she waited for me for when I was ready and she knew somehow I’d open when only I was ready to. She never pushed for it or spoke for me (though she’s stood up for me plenty), she knew my secret that not many people understand—if I’m gonna break, I’m gonna fight till the death of me, and then I’ll fight for the life of me, once the terror passes. Don’t tell me what my life is, because I know perfectly well when I fuck things up and when I ‘m living smoothly. I really do know, more than I can possibly explain, that if it hadn’t been for her compassion, her hunger to understand what I was going through, and her lifelong encouragement and believing in me, I would not be here. I was so close, so close, to that edge, that “abyss” I wanted to disappear in, but she never let me experience those horrible nasty experiences I went through by myself, she held my hand, as if she were back up, and let me make my choices. She did the ultimate sacrifice for someone with PTSD—she experienced my terror with me as best as she could, so I wasn’t alone. I love you, Nikki, with all my mending heart. You are the bravest and most selfless person I will ever know. Thanks for never, ever leaving me alone in that dark. I love you.

Amy Jo

It is a sunny afternoon, the light

coming in yellow through her curtains

that cut through the smoke.

Cat Stevens feels like water inside my soul

and then she switches it to Bread

and hands me a dust rag.

I dance across the green and brown

carpet squares; I wipe the hazy walls, the stiff

yellow furniture with the green and gold flowers;

speakers as tall as I am:

it is 1984 and I am my mama’s bumble bee; I shine everything

everything is for her.

She is young and beautiful and lauging;

this is the age I wanted to be her–chain-smoking Dorals

and sipping black coffee, no men for us, no fathers, no drunks

She tells me to get dirty but stay in the yard as she

folds freshly washed laundry from the Good Will.

I see her always moving, and I was a part of that motion,

that current,

that music like water.

I used to find my gravity in her eyes, her crayon-brown eyes, soft and mischievious…

Not this woman

with

this dead stare,

this woman

who wrings

her hands

and tells me

“Amy if there was a gun, I’d do it”

empty tears for all the shadows of men

that hurt as that she loved–her loss–

Mother–too proud, too too tired, too weak

to play now at this life.

Across the table in my secret desperation

I hear the invasion of The Guess Who singing,

my favorite, She’s Come Undone;

my mother doesn’t hear it anymore

she stares blankly into the white walls

she never sees me

not even as I serenade her

because there are tears in my eyes,

because for a moment I missed being a part of her

because I am the woman undone

in a song

about her

and I wonder, as the notes float up

to her bleached ceiling,

why it was so much easier

to lose fathers than a mother

she sighs “men, men, men”

and I abandon her need for me and stare

blankly into the table, aching

for a mother solid and holding, who she

once was briefly, thirty years ago

and I realize there are two types of people in this world:

those who live by the instruments of their own soul

and those

who live by that of others, never filling

but constantly emptying.

copyright2011amyjosprague

Time for Two for Tuesday, sharing two favorite poems/poets I’ve recently found.  Each week I’ll have new poets I’ve never heard of before or have been interested in reading.  The first one is by one of my favorite contemporary poets, Christian Wiman with his poem “Interior” fromThe Cortland Review, Issue 32 (link shared at end):

Today I found these fabulous ones: “Regret” by John Casteen and Mark Bibbin’s “When It Was Always Dark”

Regret

This life, it is like conducting
the symphony of a warring country;
the cellist has been shot through the wrist it’s all in,
the horn player has buried his child
and sworn off music.

The conductor will never hear his piece as he hears it.
Sometimes I wake between three and four, these winter nights,
clenching tightly the what-is-not-there,
and I can’t negotiate with that kind of failure.
Outside the wind is roaring at the house.

I had to throw away someone I loved.
The thing that I said at first, about the conductor?
Such a man has no cause to expect redemption.
Fine. So I’ll never understand anything.
So this life, it’s never going to explain anything.

When It Was Always Dark (Mark Bibbins, The Cortland Review)

Even porch lights that made gold of the grass
are lost,
and those birds that stitched across the moon—
not birds, something
else.

No, do not think angels.

Fireflies,
hands over flashlights—who wants them now?
And what could shine its
way again,
so easily, through these fingers?

Fog
assembling in a cool, low place;
birches nodding against one
another
though there was no breeze.

However long we waited, it was
not
only to fill hours with waiting.
All we took with us on
our way,
all we have wept
at being unable to
forget.

Something pressed into a hand,
no beloved thing,
but sweet—
small, and hard as luck is to arrange.
Full with love—what
else could fit in its place?
Someone once said
dark.
And nothing. That
too.

A hand on the curtain—whose—and who saw?
There is no
one to tell
of our dark animals—of how we made
from the sky
whatever light allows.

ISTSS (International Society for Traumatic Stress Studies)

Ingo Schäfer, MD, MPH,

Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf,

Hamburg, Germany

Helen L. Fisher, PhD, MRC,

Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King’s College London,

London, United Kingdom

Posttraumatic Stress Disorder (PTSD)

Consistent with their increased exposure to childhood trauma, high rates of PTSD have been reported for patients with psychotic disorders. In clinical populations of patients with schizophrenia, the prevalence of the disorder is 17-46% (e.g. Gearon et al., 2003; Fan et al., 2008). Psychotic patients with a history of childhood trauma tend to present with a variety of additional problems, similar to that of other populations with childhood trauma. They suffer from impulsivity and suicidal ideation (e.g. Conus et al., 2010), vulnerability to revictimization, more current or lifetime substance abuse (e.g. Garno et al., 2005), as well as higher levels of current depression and anxiety, and more dissociative symptoms (e.g. Schäfer et al., 2008) than patients without these experiences. Mueser et al. (2002) proposed that both the effects of specific PTSD symptoms and of these common correlates of childhood trauma contribute to the more severe clinical course and the worse overall outcome that is observed in psychotic patients with childhood trauma and/or PTSD (Garno et al., 2005, Conus et al., 2010).

Assessment

It is recommended to routinely assess trauma and PTSD among patients with psychosis. In current practice, however, patients are rarely asked about traumatic life events and only about 2% of patients with psychosis receive a documented diagnosis of PTSD (Brady et al., 2003). Barriers to better assessment seem to be a lack of confidence and belief in utility of intervention and some uncertainty amongst clinicia

ns whether patients’ reports can be trusted (Salyers et al., 2004). With regard to assessment, research suggests that instruments of childhood trauma and PTSD developed for the general population are also appropriate for use among people with psychosis (Fisher et al., 2011, Schäfer et al., in press).

Childhood trauma and its consequences has long been a neglected issue in patients with schizophrenia and other psychotic disorders. During the past decade, the interest in this topic has markedly increased. This article provides an overview of the prevalence of childhood trauma and PTSD in patients with psychotic disorders, clinical challenges, and emerging treatments.

Prevalence of childhood trauma

The existing studies suggest a high prevalence of early trauma in patients with psychosis. In a recent review of 20 studies focusing on patients with schizophrenia, Morgan and Fisher (2007) reported a weighted average of 42% child sexual abuse (CSA) in female patients and 28% in males. The weighted averages for child physical abuse (CPA) were 35% and 38% respectively. At least one form of abuse (CSA or CPA) was found in 50% of the patients, irrespective of gender.

Findings on the link between childhood trauma and psychosis

Studies on the link between early traumatic experiences and psychosis are suggestive of such a relationship. Recent research has utilised larger samples that are representative of the population being examined and several longitudinal studies have been undertaken in the past few years (Cutajar et al., 2010, Arseneault et al., 2011). The mechanisms underlying the association between childhood trauma and psychosis remain unclear. Cross-sectional studies have demonstrated that negative perceptions of the self, anxiety and depression partially mediated associations between trauma and psychotic symptoms (Gracie et al., 2007). Moreover, biological mechanisms such as dysregulated cortisol following exposure to childhood trauma (Faravelli et al., 2010), potentially increasing sensitivity to later stress, have recently been investigated.

Childhood Trauma and PTSD

continued on page

Treatment

Initial studies suggest that trauma-specific treatments are as beneficial for patients with psychosis as for other diagnostic groups. Psychotic patients with early and complex trauma can benefit from present-focused treatments with an emphasis on psycho-education, stabilisation, and the development of safe coping skills. Trappler and Newville (2007), for instance, treated 24 patients with chronic schizophrenia and complex PTSD using the first phase of STAIR (Cloitre et al., 2006). A control group of patients received supportive psychotherapy sessions. After 12 weeks of treatment, the patients in the STAIR-group showed significant reductions in Impact of Events Scale scores and positive psychotic symptoms, while no improvement in these was observed in the control group.

Several case studies and open trials reported that exposure-based interventions can also be used safely and effectively in patients with psychosis. Frueh et al. (2009) treated 20 patients with PTSD and either schizophrenia or schizoaffective disorder via an 11-week CBT intervention that consisted of 14 sessions of psycho-education, anxiety management, and social skills training, as well as eight sessions of exposure therapy, provided at community mental health centers. Treatment completers showed significant PTSD symptom improvement, maintained at three-month follow-up. Moreover, significant improvements existed with regard to other targeted domains (e.g., anger, general mental health).

A further approach to treat PTSD in patients with psychosis was developed by Mueser et al. (2008). The 12- to 16-session program combines psycho-education and breathing retraining with cognitive restructuring to address thoughts and beliefs related to trauma experiences and their consequences. In a recent randomised controlled trial the program was compared to treatment as usual in 108 patients with severe mental illness (39% bipolar disorder, schizophrenia or schizoaffective disorder). At six-month follow-up, CBT clients had improved significantly more in PTSD symptoms, perceived

health, negative trauma-related beliefs, and case manager working alliance.

Clearly, more research is needed to further develop and evaluate appropriate treatments for psychotic patients with PTSD. Nevertheless, the existing trials suggest that patients with psychotic disorders can benefit from both present-focused and trauma-focused treatments, despite severe symptoms, suicidal thinking, and vulnerability to hospitalizations (Mueser et al., 2008).

Conclusion

Childhood trauma and PTSD are frequent in patients with psychosis and severely affect course and outcome. Initial results on the effects of trauma-specific interventions in patients with psychosis are promising. Given the high prevalence of childhood trauma and PTSD in this group, it is important to further develop and evaluate treatment approaches appropriate for patients with psychosis and implement them into routine practice.

References

Arseneault, L., Cannon, M., Fisher, H.L., Polanczyk, G., Moffitt, T.E., & Caspi, A. (2011). Childhood trauma and children’s emerging psychotic symptoms: A genetically sensitive longitudinal cohort study.

American Journal of Psychiatry, 168, 65-72.

Brady, S., Rierdan, J., Penk, W., Losardo, M., & Meschede, T. (2003). Post-Traumatic Stress Disorder in Adults with Serious Mental Illness and Substance Abuse.

Journal of Trauma and Dissociation, 4, 77-90.

Cloitre, M., Cohen, L.R., & Koenen, K.C. (2006).

Treating Survivors of Childhood Abuse. London, Guilford Press.

Conus, P., Cotton, S., Schimmelmann, B.G., McGorry, P.D., & Lambert, M. (2010). Pretreatment and outcome correlates of sexual and physical trauma in an epidemiological cohort of first-episode psychosis patients.

Schizophrenia Bulletin, 36, 1105-1114.

Cutajar, M.C., Mullen, P.E., Ogloff, J.R., Thomas, S.D., Wells, D.L., & Spataro, J. (2010). Psychopathology in a large cohort of sexually abused children followed up to 43 years.

Child Abuse & Neglect, 34, 813-822.

Fan, X., Henderson, D.C., Nguyen, D.D., Cather, C., Freudenreich, O., Evins, A.E., et al. (2008) Posttraumatic stress disorder, cognitive function and quality of life in patients with schizophrenia.

State of the Art: What is the relationship between traumatic

experiences and other DSM-IV diagnoses?

There is ample evidence that many traumatized individuals

have a wide range of symptoms and meet criteria for a range

of psychiatric disorders, particularly when traumatization

was interpersonal, began early in childhood, involved threat

to life and limb, and was severe and prolonged. For example,

trauma-related disorders have very high rates of comorbidity

with major depression (e.g., Brady, Killeen, Brewerton, & Lucerini

, 2000; Perry, 1985; Sar et al., 2000); anxiety disorders (Allen,

Coyne, & Huntoon, 1998; Brady, 1997; Lipschitz et al.,

1999; Stein et al., 1996); substance abuse disorders (e.g.,

Brady, 1997; McClellan, Adams, Douglas, McCurry, & Storck

, 1995; McDowell, Levon, & Nunes, 1999), and eating

disorders (Brady e

via ISSTD Trauma FAQs.