Closure

Closure. If you're like me, when you read that word, what immediately jumps to mind is the phrase 'closure is a myth'. But upon further rumination, I have to disagree. I think if we look instead at what the word is really intended to mean, we will find that we are simply misinterpreting the concept of 'closure'.

According to society, closure is supposed to be an end. It's supposed to be the light at the end of the tunnel that is grief, suffering, or trauma. All too often, people struggling through difficult times find themselves frustrated when that 'end' comes, and we don't suddenly feel better. But closure is not erasure, not forgetting, not 'coming around' to see things differently. Closure changes, not erases, the pain that preceded it. We don't like, we don't forget, we only begrudgingly accept our pain - but somewhere along the line, it gets a little less cumbersome to carry around with us. That's what closure really is - a slow, gradual process of learning to live with things we'd rather not.

Our society seems to think that closure comes from some action, either on the part of the sufferer or by some legal, moral or ethical system. Once we put the bad guys behind bars, the victims will have closure. Once we find out what happened to the missing person, their family will have closure. Once we lay our loved ones to rest, we can find closure. That notion, that performing some human action somehow triggers this magical peace called "closure" to fall upon us, is one of the most damaging approaches to the grief process.

Loss doesn't end when 'answers' are found. Pain doesn't stop hurting when justice is done. Grief isn't over when the funeral service is. In fact, these are often the most difficult times for sufferers and mourners. When everything is sorted out, put away, packed into neat little boxes, when everyone else goes back to their lives, and a hurting person must try to go back to their life, the way it was before tragedy struck... that's the hardest part of grief.

You go to work or school the next day. Everyone is talking and laughing and there are posters for upcoming activities or achievements, you are expected to go back to being productive, to getting things done, as if the trauma you experienced didn't just happen... that's when you want to scream. Everybody seems to think you'll be 'okay' now, and you're just not.

Several years ago I lost my best friend Angie to bone cancer. She fought it for over five years, lost a leg, a lung, her hair over and over, and then God called her home. The whole time, Angie had this attitude, this way about her that just made all of us forget, just for a moment, the monster in the room (the dreaded C word) - and just have fun being together. Angie was the best person I've ever known. The day before she died, I sat by her bed and held her hand and promised her that we would be okay, that it would take time but we would get there.

The day she passed, hospice came and cleared out all the medical equipment. The funeral home came and took her after a couple hours. The pastor from the church came and talked to us. We all started planning services and tributes and all the arrangements that come with losing someone you love. We set to work for days, put together a visitation and a funeral service, came together to remember our lost loved one... we cried, we laughed, we experienced it together, and if you weren't okay - well, that was okay too.

Then the funeral service was over. We had dinner together and then everyone went home. The next day was a weekday and I had to work. My coworkers were sympathetic, but no one could have stopped that first day back from being one of the hardest things I ever had to do. I remember getting up in the morning, getting dressed, thinking I was okay... driving to work, logging onto my computer, greeting my coworkers, and then... I was just walking back to my office from the bathroom when it hit me out of nowhere. My best friend was gone and I was never going to see her again.

I almost fainted in the hallway. I still remember the dizzying way the tiles on the floor seemed to spin as I tried to catch my breath, a crippling panic attack overtaking me. I remember rushing back to the relative privacy of the bathroom before slumping to the floor and sobbing. I remember looking at myself in the mirror, willing myself to 'get it together', but the panic wouldn't abate. Eventually I knew I had to come out of the bathroom, but as soon as I walked into the office I shared with the rest of the injury prevention team, I ran into my boss and I couldn't hide the sheer torment on my face. She asked me if I was okay and I broke. Ugly sobbing in the middle of my office. She gave me the rest of the day off. I think that day was the worst day of my grief - trying to go back to normal, to all the people who, for some reason, didn't seem to have noticed that the world had stopped spinning. I just wanted to scream at them, "Don't you realize that everything is WRONG now??" But my grief was not theirs.

The following day I tried the 'go to work' thing again, and this time I did a little better. I had panic attacks all day, but I managed to contain them. Worse, I worked with a population of at-risk kids for four hours each day at that time, and they didn't even know anything had gone awry in my life. They didn't need any more troubles. Still, I wanted to scream all day, at all the people who couldn't see that the planet had just shifted off its axis, but I didn't. I did cry the second I got into my car to go home. I did call my mom at lunch and wonder aloud if it would ever get better.

After that every day got a little better. Not a lot. I had to be on medication for the crippling panic attacks I was experiencing regularly. Visions of those last days still haunted me every time I closed my eyes. I was somehow unable to remember over 8 years of happy times but blinded by a few days of tragedy. People told me that would start to change... with time. And I wanted to rage against this 'time' thing, this thing that was the only cure for the misery I was in, but that which eluded me. I won't lie. That was a dark time in my life. Little things would remind me of my friend, and still stuck in the grips of mourning, all I could think about were the worst of times. I don't even know how long it took before the good memories started to outweigh the bad, but I know it felt like far too long, and in the eyes of nearly everyone else, it was 'over' and I was supposed to be 'okay' now.

All I wanted to do was scream that I was not okay. That the funeral, the visitation, the things we'd done in memory of my best friend, had not given me this elusive 'closure' thing that was supposed to mark the end. At that time in my life, I did firmly believe that closure was a myth - but I, and the rest of society, simply failed to understand what closure actually meant. It wasn't something that came from a funeral service or from finally having answers, it wasn't a switch that flipped... it was this slow, gradual ascent from the depths of grief until finally, one day, you looked around and realized that you didn't look back and cry so often anymore - that you could finally look back and smile.

Today I feel closure. That doesn't mean I forget Angie, or that I miss her any less, but now the good memories outnumber the bad. Now I see her everywhere - the rainbow on a day when I just can't seem to dry my tears... the whisper in God's ear that she promised to make - to look after my dear borrowed kids... the sight of one of her favorite things in my daily life. And I thank God for having the priviledge to know her.

My Scarlet Letter

Most people are familiar with Nathaniel Hawthorne's The Scarlet Letter. A great deal of people have studied how Hitler's Germany branded Jews and other "undesirable races" with a patch or armband. The concept of 'marking' people who were considered undesirable is nothing new, in fact, most people think it's a quite antiquated concept. But it's not. It's alive and well in America, in YOUR city, today.

I wear a scarlet letter. Actually it's more of a purple smock type garment with three arm holes that neither fits nor flatters anyone. But it's my scarlet letter. Upon admission to the hospital, patients with psychiatric issues are not given the standard blue and green gown that ties in back and shows most of your backside if you're not careful. Patients with psychiatric issues are given The Purple Smock. It's bright purple. I mean, you can't miss it. It's one-size only, it hangs off just about anyone's shoulders, and it's nearly impossible to keep everything covered while wearing it. It's just a really rather unpleasant thing to have to wear.

But what's worse is that it brands you. Right now I'm in a mixed ward - patients with physical issues, but some of whom also have psychological issues. Because of the 'episode' I described in my previous post, I have been relegated to the group with psychological issues and branded with The Purple Smock.

When you're wearing The Purple Smock, people stare. Some people, family members or other patients don't really know what it means, but many do, and all the medical personnel do. Just like with Hawthorne's Scarlet Letter, it immediately tells anyone who sees you that you are different - and not a good different. You are defective. You have done something or said something that earned you that detestable garment, You are the book, and you are very much being judged by your cover.

So, knowing upon sight that you are 'crazy' or 'SI' as they like to refer to us, people treat you differently. Again, you'd like to think that hospital employees are a little more professional than that, but they're not. They're human like everybody else and they know what The Purple Smock means. Suddenly every word out of your mouth is called into question, every action scrutinized. You have to try to decode if people are really taking you seriously, or if they're just nodding and smiling, all the while knowing you're crazy, and applying the stigma that is so often attached to that. This is hard enough for most people to do, but people with psychological illness struggle enough to decipher what is going on in most social situations. Psychological illness SUCKS. I'll flat out say it, it SUCKS. Being labeled and stigmatized, on top of psychological illness? That's just like kicking a person when they're down - and if you think it doesn't affect the treatment they receive, you are deluding yourselves. The Scarlet Letter, still exists - it's just a purple smock now... and I don't know about you, but I'm ready to take it off.

#SHATTER STIGMA

Episode

Yesterday, I had an episode. That’s what I call them, but I guess it doesn’t give you very much information on what I’m actually referring to. As most, if not all of you know, I have Borderline Personality Disorder. After participation in an outpatient treatment program a couple years ago, I am managing my illness much better and the good days certainly outnumber the bad, but every once in a while, one of those days pops up that just seems determined to break you. On those days, I’m not proud to say that I still don’t cope well. Those are the days I have ‘episodes’.

An episode means suicidal. It means I’ve lost control of myself, my environment and whatever situation I’m in has gotten past all my defenses and taken over control of my body, my mind, everything. In a way, I cease to be ‘me’. Friends and family have told me they don’t recognize the person they see during one of my episodes. I want to try to explain why. I’m going to use an incident that happened yesterday to illustrate, by making this post my open letter of apology to everyone my behavior affected.

To whom it may concern:

Before anything else I would like to apologize for my behavior yesterday. I would like to explain to you exactly what I personally perceived which generated such an extreme response, but in no way do I intend these explanations to serve as excuses for the way I acted. I understand that each person’s actions are their own to claim, regardless of state of mind.

Something most of you probably know is that I suffer from Borderline Personality Disorder. A big part of this disorder for me is that I am very sensitive to social interactions. I often perceive people as being hostile toward me when they are not, or suspect people are lying to me when no one else seems to think so. Those are just a couple of examples. Often,  a family member or trusted friend helps me interpret the world around me so that these misperceptions do not interfere with my ability to function to too great a degree. Other times, however, when no one is there who knows and understands how the disorder manifests in me particularly, I tend to base irrational actions on those flawed thoughts.

This is essentially what happened yesterday. Yes, the initial reason I was upset was because I couldn’t understand why small changes to my care couldn’t be made. I should have been able to realize that (a) I didn’t get to make the rules and (b) the rules weren’t intended to do ill toward me, but because I do not perceive things normally, I couldn’t see those things – all I saw was judgment. I felt that by refusing to consider those changes to my care, the staff was judging me, labeling me in some way and, as I’m very sensitive to judgment, I did what of course is the hallmark of BPD – I *way* overreacted.

Today, with some perspective, I can see that it’s unlikely that the staff was actually thinking that way when I suspected it, but that my own actions lent credence to the theory I so strenuously objected to. It was that sense of being judged or not listened to, rather than the actual approval or denial of my request, that caused me to lose control and act out the way I did. Sometimes this is hard for me to explain to people who don’t have the disorder because from the outside it looks so much like it’s just a temper tantrum because I didn’t get what I wanted, but there is much more going on underneath. The situation escalated as I felt like more and more people were judging me, dismissing me, not understanding me, etc. Eventually I get to a point where this is so dominant in my mind that I start thinking my whole life will be full of judgment and that’s not a life worth living – thus the suicidal ideation and sometimes action. 

From the outside I can see how it looks like, when, after not getting what I want, I simply throw a tantrum over it, but on the inside, it’s no longer about whatever the original argument was anymore (which is why the original argument is often so trivial and people wonder why I react so strongly). What is happening is that I am losing control of whatever little part of me is restraining the other, bigger part shouting at me that people are judging me and that my life will always be that way and therefore I should just kill myself.

When I calm down, usually after some sort of pharmaceutical intervention as that’s all we’ve found to work thus far, that lying part of my brain recedes and I’m left wondering who that person was that acted so out of control, so irrationally. So not like me. At that point I recognize that my actions were destructive, that my perception was seriously mistaken at the time, and that I am ashamed of the way I acted. I usually see the other side of the initial ‘argument’ as well – and wonder why I couldn’t have just accepted it instead of freaking out. But then I guess that’s the disease. Later I’m sorry. Like today, I’m sorry. I’m sorry for the way I acted, I’m sorry for anyone I hurt either physically or emotionally, I’m sorry for the resources I forced others to expend trying to keep me safe from myself. If I had it to go back and do again, there’s no doubt in my mind that things would have played out much differently.

In any case, this is a somewhat simple explanation of one of the aspects of my disorder, but the one that is most relevant at the moment. I hope that in reading this and seeing my apology you can forgive me – and whatever loony-tunes bug got into my head – for the way I acted. I really am trying every day – and will continue to try – to moderate the symptoms of this disorder to allow me to live a more normal and hopefully much less dramatic life.

Thank you for your time in reading this. I know it is not an excuse, and I don’t intend it as one – I need to learn how to interpret the world around me accurately on my own, and that is something I will work on. My hope is that explaining my behavior from my perspective will help us all understand each other a little better. I know we can make strides in this area!

Regards,

Kate