White-knuckle sobriety

I am currently reading a wonderful book on the neuroscience of attachment and trauma, The Body Keeps The Score by Bessel van der Kolk. I could (I may well) write a whole series of posts on how relevant and helpful I’ve found different ideas from it. I keep finding parts of my life on the pages; specific, eerily accurate details about the way I think, feel, and behave.

I searched my blog, and apparently I’ve never mentioned that the first psychiatrist I ever saw, when I was 16, diagnosed me with an attachment disorder. I do know this is something I’ve spoken about during talks on eating disorders, generally in the context of how my mum felt alienated and blamed by this psychiatrist. I don’t remember him being critical (I thought he seemed very friendly and had an interesting bow tie), but one way in which he definitely slipped up was not explaining his diagnosis to me. Lacking an explanation, like all sixteen year olds recently acquainted with the internet in the very early 00s, I went home and googled (or rather…Jeeved? Binged? Yahooed? I’m not sure Google was a thing I was aware of then) attachment disorders, and I was horrified by what I read. Most of what I found described much smaller children who exhibited severely disturbed or out of control behaviour, who wet the bed and grew up to be serial killers. Anxiety might have exaggerated this memory a little, but those were the basic messages I got from my research. I couldn’t see myself in those descriptions.

The descriptions in the book ARE me. They are more me than anything else I’ve ever come across. Reading this book is like encountering the Minnesota Starvation Study for the first time and being creeped out by how a group of men in the 1940s can have the exact same cognitive and emotional response to starvation as anorexic 23 year old me in 2009. My lack of joy in 2001 was mostly to do with the fact that the internet was more of a blunt instrument back then – what I found was mostly in relation to the type of attachment problems correlated with a diagnosis of psychopathy in later life. A few years later, when I could have found more relevant information, I had had The Fear Of Borderline Personality Disorder Diagnosis put into me by various mental health professionals, and so wanted nothing to do with the line of thought that insecure attachments and chronic invalidation could result in a person who behaved very much like me.

I’m quite grumpy about this. Not that I want a personality disorder diagnosis, but I feel like a lot of my behaviour over the last ten years has been geared towards making sure that no one can ever suspect me of this. As a result, I’ve not talked about how difficult I find making and keeping friends, or not reacting self destructively during arguments with loved ones. I’ve become chronically bitter about experiences in which I was invalidated or dismissed by professionals, because I was so desperate at the time to act as if I was ‘okay’ with being treated like that. I’ve hidden self harm relapses as an adult. I’ve walked around feeling empty and lost and like I have no idea who I am, but been too scared to ask for help for this, instead going to the doctor with specific problems, like my phobia of thunderstorms. I’ve lived my life feeling a weird combination of both numb and incredibly oversensitive/overwhelmed, using self harm, the eating disorder and alcohol to switch when one state or the other becomes unbearable. Part of it was down to the pervasive idea that these sorts of experiences and behaviours can’t be “fixed”; I always wanted to believe that if I just tried hard enough, I could force myself to act in a socially acceptable way, and that if I did that for long enough, maybe all the inner turmoil would just disappear. Fake it ’til you make it.

This didn’t work. This is essentially what I tried to do in recovery from anorexia. I came across the concept of “white-knuckle sobriety” the other day – the AA tenet that if a person uses nothing but willpower to stay sober, they will struggle to maintain their recovery. In The Body Keeps The Score, van der Kolk uses this phrase to explain why, similarly, trying to stay in control of your emotions by sheer force when you have no natural ability to regulate them never ends well. I very much relate to this. For a while, recovery was just as distracting and all consuming as the anorexia had been, and the rigid rules and beliefs I had about recovery gave me something concrete to focus on and cling to when I was feeling unsettled. I was incredibly inflexible and defensive when anyone even gently challenged me, because to my mind, those rules and beliefs were the only things stopping me losing any grip on sanity. And when the immediate process of gaining weight was over I started struggling a lot more. I felt empty and lost, fairly minor stressors resulted in small relapses or self harm, and I was constantly terrified that any strong emotion had the power to knock me so off balance that I’d end up in hospital. As a consequence I kept myself as numb as possible, and am now suffering from all sorts of weird side effects of that. Anxiety was the only feeling I could just about work with, because I’ve had so much fucking practice, so every emotional response I had got turned into anxiety. When I couldn’t cope with anxiety it became some sort of somatic problem: headaches, IBS, dizziness. Those I could medicate. Problem solved.

Except it all broke down last year. Situations relating to my problems with attachment kept cropping up, triggering all sorts of incredibly strong feelings that I couldn’t escape, and I’ve not been able to just swallow them or turn the other way and claim ignorance. As the depression has lifted a little I’ve become less rather than more stable: there have been more episodes of self harm in the last six months than there were in the six years previous, and problems with dissociation and panic attacks have either increased or I’m noticing them a lot more. I can’t just grit my teeth and pretend this isn’t happening any longer.

My current therapist wonders if this is coming up now because the rest of my life is more stable than it’s been in a long time (possibly ever). I have a very part time job I can just about cope with, I am in a supportive relationship, my health is okay, there are no major crises apart from the one in my head. Maybe there have been signs for years, but now is the first time it’s been safe enough to notice them. Maybe now I have the right people around me to help. Maybe.

I just wish none of this was necessary. I wish I could solve all my problems with extra cake.