Putting the pieces back together: Working through being pathologised and silenced

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I was a busy, full-time working mother in my late twenties when I experienced a life crisis.  I went to my GP, supported by my family, who convinced me that a wee tablet would help me sleep. The GP medications did not help my mental and emotional distress. Several days later, I needed mental health intervention, and I had no power or control over the medicalisation of my distress. In time, I recognised the parts of myself that needed attention. I began integrating them, supported by my husband and family. I also moved as much as possible and practised occupational therapy on myself. I walked, cycled, climbed, painted walls, and connected to people. I gradually and slowly deprescribed from medication under the supervision of a psychiatrist, and thankfully, I did not experience any adverse withdrawal effects or major relapse following this.

I am an occupational therapist (OT), a mainstream healthcare professional whose foundation is in holism. My education gave me a broader understanding of human needs and their ability to adapt to their environments. Since qualifying, I have worked in physical rehabilitation at a local hospital. But, as a student, I trained in psychiatric hospitals and always wanted to work in community mental health. Family members had positive experiences in OT while inpatients in mental health services. I believed in therapeutic methods and was confident that I could recover at home, medication-free. The diagnostic quick fix did not help me as it pathologised and silenced parts of me that needed to be heard. The term “nervous breakdown ” is a more accurate description, and in my view, I didn’t fit into any diagnostic box. I over-focused at school and achieved an academic career even though my parents were told when I was 11 that I was not that type of a student.  Due to learning difficulties at school, some of me couldn’t believe I was worthy of being on the OT course, and another highly valued profession strived to be a “competent OT.”

Silenced

The only way I can accurately describe the experience is a dissociation from my usual self, where childhood parts wanted to be heard, followed by a shattering of self and an unfamiliar mental and physical weakness. Initially, I processed the experience with a creative and expressive personality where the parts spoke their truths, unfiltered by a cognitive, spiritual part of my mind where everything was connected. Every second of life had meaning and purpose, and extended family-related programmes were expressed.  Over the years, my close family and I eventually recognised these acute dissociative parts of me that needed support in processing events that replicated patterns of unhealed developmental trauma and possibly intergenerational issues. This type of stress always precipitates the dissociative experience. 

My faith in God and a positive mindset was present despite my family’s controlling behaviour and judgements of my busy, changed personality. A core belief that the world is a meaningful place was very active. Nobody ever sought to listen or understand me or asked what it felt like and what I needed them to do to support me. Initially, they were scared and had no time for any “bullshit” as they just wanted the old me back and immediately sought to retrieve it with medical intervention and coercion. I was never grandiose, but I remember thinking about grandiosity and how people sometimes think they are Jesus. I could understand this feeling, especially in my case, if you see the world more open and connected and are being unfairly judged, persecuted, and pathologised by people who love you. Professionals treated me in the context of my family’s fears (stigma-based) and distress, and they never asked me what I was thinking or feeling. The story of my behaviour from my family seemed to take precedence over me and my wishes not to be medicalised were ignored. This dynamic only embedded the developmental trauma I experienced around my identity and worthiness.

The medication path was not for me, and this decision was strongly formed from family experiences and my related life experiences. Due to the negative bias, I had a strong will, believing I had a right to choose differently. My curiosity and questioning personality exacerbated the part of me that rejected the medicalisation of my distress. The medication slowed my body, slurred my speech, and created an intense appetite, even on very low doses. I disliked the controlling effect medication had on my ability to think creatively and clearly. I disliked the brain fog and habitual daily drive to eat and sleep. I had very valid reasons not to take medication before and after the crisis, and my parts needed to be heard, understood, integrated, and given time and space.

Learning to heal

I was never hospitalised, so I could engage in domestic activities at home while processing information. Domestic activity helped me regulate and keep my family home somewhat functional.  This habit of doing meaningful and purposeful activity, thus fulfilling my occupational roles as a mother and wife, was enhanced by OT training. I  also have an intellectual part, which gave me an inner awareness of what was happening. As a result, I had names for the experiences, such as loosening of association, flight of ideas, and tangentiality of speech. I could control my fast thoughts mindfully. Cognitive Behavioural Training CBT helped me, as I used it unconventionally to process the information that initially was overstimulating me, like my family environment. I wanted the multi-sensory input as I was learning to integrate my environment and creative thinking experiences.  My brain was open and healing during this time; my body wanted to move and listen to rhythmic music as I remembered more and connected the dots, which was a good feeling. 

I wasn’t emotionally elated but was busy thinking and doing with a positive attitude.  I smiled and sometimes laughed inappropriately out of social context when I remembered a “connection.”  The ripple effect of memories created a momentum that I learned to manage. This prolonged remembering was so important; there were 1000s of memories that would flow, and this one stayed with me. I remembered the books a good friend and a close family member gave me growing up. The teachings in those three books made sense and were like stepping stones to my recovery – The Power of Positive Thinking – The Artist’s Way – Anam Cara. Little did I know at 17, when I read my first self-help book, stressed and overfocused on the exams, that this book on positive thinking would be essential to me passing my exams, becoming an OT, and recovering my health and well-being of myself and others. Bibliotherapy,  the art of reading self-help books, is recognised as an essential part of learning in the fields of self-development, mental health and well-being.  

Absolutely everything was a memory “losing of association.” It didn’t matter where I looked at home, a coat pocket, a hotpress, or a handbag. Everything was relevant to what was happening, and I learned to “connect-well” with my environment. I realised that the objects were creating a memory, and I learned how to control them. When shopping, many things had increased meaning to me. I eventually realised that a younger part of me was remembering. Instead of impulse buying, I took photos of what I connected to while shopping. I used mindfulness, and occasionally, if I could find two or three reasons to buy ( a gift for my children), I would buy it as it also comforted that part of me.  

I remembered our course director in OT, who was both judged and loved for this trait of randomly smiling. She had a wealth of experience in Mental Health OT, and her unique personality inspired me. I remembered another OT lecturer researching sensory integration, which helped me unconventionally during my experiences as a part of me thought about the concept of sensory integration during periods of severe mental over-sensitivity—remembering patterns.  Over time, there were patterns to the experiences and the broader context of my environment, which affected the behaviour of everyone around me.

Familial metaphors

Disconnection is present in all families to different degrees sometimes due to misunderstandings and unnecessary defensiveness. Some are locked and hidden away without any remembrance. Due to all the memories, which I can’t even connect to now, I realised the theme was misunderstandings, possibly fuelled by people’s different realities. I understood the power these misunderstandings can have on a persons life and sometimes its only at the end of their life that they are able to come to the surface.  

During my memory experiences, I concluded that people could easily read into things depending on their realities, perceptions and words get twisted, people get locked in hurt and loss.  Over the years I have pieced together that there was an ancestral familial connection, which takes time to unravel. During my acute remembering communication fluctuated. I could be more coherent than normal or very challenged to speak and sometimes reverted to metaphors. Sometimes, familial metaphors surface when remembering a connection to the past. This familial metaphor act among family members could appear odd outside the family context, and I realised the importance of home and broader family context as family communication was just as important in understanding and supporting everyones behaviour changes.  

I learned that people’s behaviour patterns could not be forced to change, and I couldn’t make my family see what I could see as my experience was not theirs. They had to have experienced it themselves in their own way. I realised everyone, including family, was also experiencing a pattern of the thought picture I was connecting to as I was sensitive to behaviour changes in people I met during these times. I understood that family had so much importance in supporting one another, as they have family memories, inherited behaviour patterns, and ancestral wisdom that sometimes comes to the surface. This remembering is a natural process that happens a long way over time, but  I realised during my experiences I had a fast remembering, and I am learning to integrate this remembering part of me when it comes knocking.

Different experiences

I could understand how people going through similar experiences could misinterpret information, and it was the only time I was conscious of the need to to practise skills from the field of mindfulness or CBT. I had to learn to sensory integrate highly stimulating modern communication and sometimes living environments. Modern communication can be overwhelming and unsafe when people don’t know how to respond. The part of me that was able to be a witness to my experiences was present from the first onset experience, during which I remember hearing a playback radio conversation. I knew the radio was not talking to me. Still, I could understand how these coincidences and media experiences, in general, could be interpreted as delusional communications, where everything in the media seemed so natural and meaningful. I did not experience auditory or visual parts. But one time, I remember experiencing sequential flashbacks (connection to all the jigsaw pieces) of my life, and it felt good and a bit like a spiritual experience (i.e., these experiences and memories were an essential part of my journey in life). I experienced more creative ideas and learned to process and integrate my environment better every time I experienced dissociation and an over-sensitivity to life.  

A creative part of my personality complimented my understanding part. Art in school immensely helped me process and express my emotions during exam years. I later used my artistic experience to manipulate paint and multimedia expressively during the recovery process. However, I still need help with time management, and finding the head space to focus on details and creative techniques is still challenging. Walking (repetitive movement)  and activities of daily living in the home are a greater need and a more accessible option daily. At the same time, I have completed art therapy and drama therapy workshops over the years, where the structured timeout gives me more permission to focus on this creative part. Similarly, I found yoga beneficial. However, I remain very cognitive, and it’s still my autopilot integrated with creative doing. In time, I hope to focus more on deeper somatic integration work on my being.

I was an overthinker from a very young age, and the conflict between my birth parents encouraged an over-mentalisation. Growing up, I thought a lot and dissociated from my body and emotions, my adaptation to life events.  A monotropic thinking style and reduced interoceptive awareness fuelled an over-focus and dissociation that was easy to pathologise. Ironically, these cognitive parts created by adversity have also immensely helped me. I needed to piece my life back together from my earliest memories as a young child and create a coherent narrative. Positive experiences and memories related to listening, compassion, acceptance, and validation eventually occurred over time in a community without a power dynamic. Eventually, much of my past and adaptations (parts) made sense to me as an adult. I always had a hopeful part, and I still hoped to consult with a psychiatrist in Ireland to validate my decision not to take medication long-term.  I’m still searching, and I have been fortunate to have met excellent GPs who have validated this decision. Becoming a parent requires some support. Fortunately, I had a local parenting mentor who did individual and group teachings nearby. She was trained in a method of parenting developed by Tony Humphreys, which deeply resonated with me; they made sense, were non-pathologising, promoted unconditional love for the child, separated behaviours, and promoted boundaries. Despite his other ways of thinking & controversial beliefs, these parts of his work deeply resonated. I struggled with boundaries and realised that, as per teaching, I first needed to parent myself, allowing me to take time outside the home and attend self-development events. 

Supported by nature

My personality did not encourage social interaction, and there was minimal opportunity for connection outside family members and OT roles. I knew I had to create connections inside and outside myself, finding purpose in my life as I embarked on the road to better health.   An OT friend became a great gift. She was non-judgmental and a great listener, and she worked in the field of mental health OT and wellness. She validated my decision only to take meds when needed, i.e., when sleeping was challenging and helped me develop insight into my family’s fear and reactions. She also supported and helped me locally establish a structure for starting community connections.

During these dissociative experiences, a part of me needed to speak to people or connect in some way.  Telephone and social media connections were available when I was regulated enough to use them, while handwriting and email were a slower, more controlled way of communicating. Communication has sped up over the years for people in mental health distress, and modern communication methods make these experiences all the more instant and sometimes challenging to manage. But as long as I could move, write, read, and relate, i.e., make sense of the experience, I could process what was happening. If information pathways need to be restricted, communication could still happen by choosing and adapting to a slower method.  People who do not get an opportunity to process their experiences due to both long-term and acute forms of tranquillisation are possibly set back in their health and recovery.  

I have been very fortunate to have had the experience of “social farming” for most of my life, finding freedom in the outdoors. Daily access to nature was foundational to my recovery, as walking and running supported the parts that needed adventure. I no longer need to run but enjoy walking and cycling, which helps me process and integrate somatically and cognitively when required. I found swimming and dancing more complicated, but I recognise the importance of this rhythmic movement as a regulating activity helping to integrate the brain and body. 

I climbed many mountains and eventually climbed the highest freestanding mountain in the world, Kilimanjaro, with a close friend. This empowering challenge symbolised overcoming some of my childhood fears of climbing the mountains where I lived or walking to the other end of the road where I grew up. Due to an attachment fear, I missed out on relating to family. However, the road less travelled metaphorically became well-travelled during my therapeutic journey, where I met many people and eventually received validation for my vision of holistic, integrative mental healthcare.

Piecing things together 

The bigger jigsaw of mental health in Ireland needs to be pieced together in the individual experience and family-community contexts. Through my mental health training, intergenerational history, and family members’ reactions, I pieced together how other family members and I may have been pathologised during our experiences. A part of me wishes I could turn back time, given the people and the parts of myself I have connected to, as I have a better understanding of helping myself and others. I see the individual journey of life as being like a jigsaw. We can help each other connect the missing pieces of our lives, helping to understand things a little better in the context of each other’s individual experiences and the broader family/community experience.  The mental health crisis I experienced was the catalyst for starting this journey. And if it were seen as an opportunity for growth and transformation, there would be less fear and stigma associated with it.

Parts get buried when life is overwhelming and unsafe, especially when fear is communicated. We need the support of others to find safety in connecting the missing pieces in the context of surrendering to fear. Sometimes, this happens volitionally among loved ones, and life feels like a dance rather than an organised, linear, controlled plan.

Increased opportunities for reunions and regular connections will help improve our health, our families, and the broader community as we can all learn from each other’s experiences. As a collective, we have even more power to understand our mental health – life journey and make positive health changes. The OT training embedded and strengthened a “creative doing part,”  In time, I will balance this part of me with a coming home to myself and eventually being content with “being.”  We all have an innate need to heal from things that happen in life,  and it’s part of our life journey, which is interconnected with family and friends. It’s a complex process of remembering when life allows us to reflect on them more fully, supported in the safety of others. This pain or increased creative expression needs to be listened to. I have compassion and understanding for the journey I and others have made so far, and I can’t force my healing process or that of family & friends. With increased connection and understanding, we are reducing the burden of stress one piece and one generation at a time. Trusting in our reality and realising people see things through their own experiences, we will all come to a balanced reality, where there is less conflict in the realities we all experience.

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