When you hold space for someone with mental illness

(Trigger warning: suicide)

The first time it happened, I was five months pregnant with our first baby.

It started with panic attacks. My then-husband was starting a new job with greater responsibility and, coupled with the expectancy of fatherhood, he was feeling overwhelmed and anxious and started missing work. We tried to get him help – I took him to a psychologist and checked him into an overnight mental health facility when the panic attacks got really bad. I thought things were shifting, but I was wrong.

One morning, after a couple of weeks of stress leave, he got ready for work in the morning, kissed me good-bye, and headed to the office. I was relieved. Maybe this rough spot was finally over. I left for work, assuming we were shifting back into “life as normal”.

A couple of hours later, I phoned his office to check how he was doing. “He didn’t come in today,” his boss told me. “He phoned earlier and said he couldn’t do it.”

I panicked. Where was he? Why had he told me he was going to work when he wasn’t? What was he hiding?

The rest of that long day was a blur of phone calls and tears and hand-wringing that included a car ride out to his favourite fishing hole with my mom to see if he was there. He wasn’t.

Some time that evening, I got a phone call that he was at the hospital. After multiple suicide attempts (that involved a knife and bottles of pills), he’d woken up in his car, realized that, if all of that effort hadn’t killed him, perhaps he was meant to live after all, and drove himself to the hospital. He was rushed into surgery to patch up the damage he’d done and to make sure that none of his internal injuries would be fatal.

The second time it happened, I was “pregnant” with a different kind of baby – I was just about to quit my job to start my own business. Fifteen years had passed (years which included the births of our four children and the loss of one of them), he’d gone back to school to get a university degree, and was finally in a job that looked like it would be permanent enough to support our family while I launched a business.

Once again, a new job with new responsibilities caused the panic attacks to start happening. Once again, we tried to get help. And once again, I got the phone call that he’d taken a lot of pills and needed to be taken to the hospital. (This time, there was no knife involved.)

This time, instead of recuperation time for his physical injuries, there was a very difficult week’s stay in a psychiatric ward. And this time, I had to juggle the needs of three children, trying to keep their lives as close to normal as possible, while driving back and forth to the hospital to support him.

At this point, if you’ve been reading my work long enough, you might be thinking that I’ll be offering “tips on holding space for someone with mental illness”, but that’s not what this post is about. Instead, this post is about me, the former caregiver and advocate of that person with mental illness. And it’s about all of those who, like me, have had to hold space for people with mental illness.

Because when/if we hold space for people with mental illness, we have to practice radically holding space for ourselves too.

It’s taken me a long time to process the impact that those two suicide attempts (as well as the many times when I was worried it might happen again) have had on me. It wasn’t, in fact, until the marriage ended five years after the second attempt, that I finally acknowledged the toll it had taken on me.

Last week, when social media blew up over the suicides of Kate Spade and Anthony Bourdain, I, like many others, was triggered by the stories. They brought back a flood of memories, accompanied by grief, fear, self-doubt, anger, and all of those other big emotions that are part of what a caregiver/advocate has to carry. It’s probably a good thing I didn’t have time to write a blog post last week, because it would have been a more triggered version of what I want to say. This one comes with a little more reflection.

Both of the times my former husband attempted suicide, my adrenalin kicked in and I went into warrior/mama-bear mode. I protected, I nurtured, I fought flawed health-care systems, I ran the household, I negotiated with psychiatrists, and I made endless calls trying to get the right kind of support.

While most of us are familiar with the fight, flight, or freeze responses associated with stress/trauma, there’s another reaction that has recently been added to the literature, and that’s what I was experiencing (though I didn’t know it at the time). It’s the “tend and befriend” response that is found more frequently in females than males. “…compared to males, females’ physical aggression and fear-related behaviors are less intense and more ‘cerebral’–they are displayed in response to specific circumstances and are less tied to physiological arousal. So while both sexes share the capacity for fight or flight, females seem to use it less.”

Researchers found that, during tough times, stressed females spend significantly more time tending to vulnerable offspring than males.“They reasoned that the adaptive value of fighting or fleeing may be lower for females, who often have dependent young and so risk more in terms of reproductive success if injured or dislocated. And females of many species form tight, stable alliances, possibly reflecting an adaptive tendency to seek out friends for support in times of stress.” (Both quotes are from this article. And here’s a link to a research paper about it.)

There’s a tricky thing about trauma, though, that I didn’t understand back then. If the trauma isn’t adequately released at the time, it roots itself in the body and, from then on, whenever a stimulus brings up a body memory of the trauma event, the body responds exactly as it did during the trauma. In other words, though there were only two suicide attempts in our twenty-two year marriage, there were a LOT of stimuli that triggered my “tend and befriend” response (as well as my less prominent fight/flight/freeze). The mental illness of my partner didn’t simply disappear in the in-between times, so any time there were hints of it showing up, although I didn’t consciously think “he’s going to attempt suicide again”, my body responded as though that were true.

Though “tend and befriend” might seem like a more gentle, healthy response to stress than fight, flight, or freeze, I can tell you that it often is not, especially when it’s a triggered response and is unnecessary in that moment. When it showed up, for example, when I was exhausted and yet still had to go into warrior/mama-bear mode on behalf of my children, it drove me to burnout. And when it showed up at the expense of my own well-being (ie. protecting my then-husband rather than looking out for my own interests), it nearly killed me and left me vulnerable to abusive behaviour and manipulation.

It was so present, in fact, that it took several years longer than it should have for me to end the failing marriage. I was so afraid that the marriage breakdown would cause him to attempt suicide again and that my children would have to bear the grief of that, that I held the marriage together much longer than I should have. I was so used to assuming that I was responsible for his emotions and the way they impacted my children, that I couldn’t imagine the world functioning any other way. It took a lot of work for me to release myself of that responsibility. Even three years later, I can be unreasonably triggered by a simple text message from him.

Several years ago (before the marriage ended and after my mom died), I was diagnosed with adrenal fatigue. I was exhausted. My heightened state of alertness and responsibility meant that my adrenal glands had been overproducing for so long that I could barely function anymore. I started taking supplements and tried to change my diet and sleep patterns, but it wasn’t until my marriage ended and the stimulus was largely removed from my day-to-day existence that I finally started to feel like sleep was replenishing me and I wasn’t among the walking dead anymore.

It’s not gone, though. There are still stimuli that trigger the same response in me. When, for example, my children’s emotional meltdowns or panic attacks are similar to their dad’s, I get triggered into the same anxiety and the same tend and befriend response. I rush too quickly to fix things and I don’t always wait for those involved to take responsibility for doing their own emotional work. I’m getting better at recognizing it and finding ways to self-sooth so that it’s not destructive to me or my children, but I’m not foolish enough to think the problem is fixed. I’m still actively working to heal it and release it from my body.

How then, do we as caregivers and advocates stay in the work for people we love without burning ourselves out or resorting to destructive patterns? How do we hold space for ourselves when we find ourselves holding space for those with mental illness?

Here are some thoughts on that…

  1. Recognize the trauma/stress that you are carrying. Unfortunately, it can often be our own strength, and our internal narratives of how we “can handle anything” that contribute to our downfall. If we don’t recognize the impact on our bodies of the trauma that’s being caused by a loved one’s mental illness, it roots itself in our bodies and can become an unhealthy, subconscious response to even the slightest stimuli. This denial can cause burnout, addiction, and destructive behaviour if not addressed.
  2. Care for your body. This is important, because your body is the container that holds the trauma. Go for whatever body treatments help you to release what you’re holding – massage, reiki, craniosacral, EMDR, acupuncture, etc. And take care of yourself with healthy food and movement. Pay attention to the signals your body sends you, because your body may be letting you know that you’re carrying too much. (Take it from someone who’s wrestling with how my weight may be a signal my body’s been sending me about the trauma.)
  3. Resist the urge to take on responsibility for anyone else’s emotional or mental health. You can not fix them. You can not make them happy. You can not even ensure that a person will not attempt to take their own life. You can support them and hold space for them (if you are not becoming too damaged in the process), but the outcome is not on you. Even if, in your desperation, you said what you’re pretty sure was the WRONG thing just before the suicide or attempt (which I did), the outcome wasn’t your fault. Let that go.
  4. Get help. Don’t be ashamed to reach out to friends, family, professionals, etc. You can’t do this alone and you shouldn’t. Sometimes it’s as simple as having a friend who will let you cry in their presence so that you can release what’s bottled up inside. Or asking a family member to step in to care for the person with mental illness. And don’t hesitate to hire a trauma professional to get to the deeper place of healing (or look for social services support, if you don’t have the financial resources).
  5. Know when to walk away. For those of us with a strong tend-and-befriend reflex, it’s really, really hard to walk away from someone who’s hurting, even when we’re being destroyed in the process. But consider the possibility that the person you’re supporting may actually be better off on their own, learning to walk in the world without the crutch you’ve offered them. Consider that your triggered tend-and-befriend response, though it’s comfortable and familiar to them, might actually be to their detriment as well as your own. And also… consider that they may be manipulating you (knowingly or unknowingly) to get you to stay.
  6. Create and hold the boundaries you need in order to stay healthy.Again, this is especially hard for anyone caught in the tend-and-befriend patterns. We want to make sure everyone else is cared for before we care for ourselves, because that’s what we believe will serve our overactive nervous system. But an un-boundaried life will destroy you. Practice saying no to the small things so that you can work up the courage to say no to the big things.
  7. Pay attention to how seemingly healthy responses may actually be unhealthy ones. Whenever I kicked into tend-and-befriend response, I always thought I was doing the right thing, tending to and protecting those I was responsible for, and sacrificing my own interests for theirs. But those responses were masking what was going on underneath and they were setting patterns into play that have taken years to release.

There is nothing easy about this, and if you find yourself in a place where you must hold space for someone with mental illness, know this… I see you. I witness how hard you are working. I know the tears you cry into your pillow at the end of the day. I get it and I hope that you will find the support you need so that you will not be destroyed by this.

Please, take care of yourself. The world needs you.

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Note: If this post resonated with you, check out the work that I do in helping people learn how to hold space for each other and for themselves. 

Trauma and Trump

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I first noticed it while watching the first presidential debate. When Trump spent the whole time interrupting Hillary Clinton, belittling her, and standing behind her in an intimidating way while she spoke, I was so shaken up that I could barely stand it. This wasn’t just the usual political jostling for space – it was something more. My daughters were surprised when I kept yelling at the TV and by the end of it, I had to go for a long walk to release my outrage rather than take it out on the people I loved.

It was worse when the infamous bus video came out and we heard him unapologetically talking about grabbing women by the pussy. That one took me more than just a long walk to release.

I noticed it again last week during his press conference, when he was gas-lighting reporters by refusing to take their questions, calling their news outlets “fake news”, and treating them like they were stupid for listening to any of the leaked information about Russian interference. This time, though, I knew it was coming so I could witness my reaction more objectively, almost like a scientist watching a subject respond to stimuli.

It took me a while to figure out what was going on. I am, after all, a Canadian who won’t have to live under this administration. Why did I have such strong emotional AND physical reactions to him? Why couldn’t I simply ignore him or dismiss him as full of hot air but not my problem?

I realized that I was being triggered. Like so many other women who have shared similar responses, Trump’s misogyny, gas-lighting, bragging about sexual conduct, intimidation, etc. was triggering my past trauma.

Like every woman, I have been interrupted time and time again by men who think their voice is somehow endued with more wisdom. I have been raped by a man who climbed through my bedroom window and let his lack of control over his own sexual desire shatter my youthful innocence. I have been the victim of gas-lighting by more than one person who couldn’t bear to listen to my concerns and dismissed them as irrelevant, convincing me that I must simply be overreacting. I have been repeatedly grabbed by the pussy by a man who thought he had the right to do so and who ignored my effort to explain why it didn’t feel good.

I have worked hard to find healing for all of these things, but trauma doesn’t go away easily. It hovers under the surface, pretending it’s healed, pretending it’s a thing of the past. But then when it’s triggered by a stimulus that brings back the body memory of the trauma, it erupts in fear and rage and physical pain and all manner of complex emotional and physical reactions. It’s not rational – it just is.

Trauma responses are primal responses – meant to protect us from whatever threatens our safety. They are also deeply rooted in our bodies and cannot be regulated with only a brain response. I couldn’t think my way through my reaction to Trump – I had to seek to understand it on a much deeper level. That’s why some of the “just think positive thoughts” self-help mantras can be so damaging – because they attempt to gloss over the way that trauma, grief, fear, etc., gets rooted in our bodies and has to be healed by a much more holistic approach than simply positive thoughts.

In recent months, especially since Trump won the election, I have been hearing similar responses from many, many people not only in the U.S., but all over the world. It feels like his election has unleashed an epidemic of trauma. We’re vibrating in fear and rage that is deeply rooted in us and we don’t know how to respond. Many dismiss us as over-reacting (because surely our trauma isn’t as bad as people who’ve lived in war zones, for example, so it’s not legitimate), but that feels like a whole other layer of gas-lighting that diminishes our experience and heightens our response.

I’m also hearing another voice – the voice of People of Colour and other marginalized groups saying to white women like me “What took you so long to wake up? We’ve been saying for years that the system is rigged against us. Why did it take Trump getting elected for you to see what’s going on? And why are you being so fragile when we’ve seen much worse?”

The answer to that is complex and multi-layered, and some of it has to do with our privilege and access to power. Some of it also has to do with the fact that it took us longer to be triggered. While People of Colour have been seeing things in the media for a long, long time (probably all of their lives) that has triggered their trauma, we’ve been able to ignore it longer because it didn’t apply to us.

It’s like an abusive family where some are suffering the abuse more than others. The child who’s not getting hit can say “It’s not happening to me, so that means it’s not happening.” She says it out of self-preservation – because the only way she knows how to survive is to live in denial. But then one day she gets whacked across the head by the abuser and suddenly she has to rewrite the narrative of her family. Suddenly she too is unsafe.

The problem is that it’s difficult to forgive someone who ignores your pain until she feels the pain herself. And it’s difficult to feel empathy for the tears and rage of someone who spent much of her life in denial and dismissal of yours. And it’s also difficult to trust and be in relationship with people with trauma when you too have been traumatized. So we end up with situations like the Women’s March on Washington, where they’ve had to work through various levels of conflict trying to find a common voice that gives space for all of the marginalized groups that want to be heard. And this is only scratching the surface – these groups will need to do some deep healing work to learn to speak of their trauma and betrayal and fragility and find ways to heal it and learn to trust each other to hold space for it all in order to move forward with a united voice. 

There are other complicating factors as well. Some of our trauma didn’t start with us. Some of it was passed down through the generations, and when we are being triggered by a stimulus we don’t understand, it might actually be related to a trauma experienced by a grandmother or great-grandfather. There is scientific research that has found evidence that we can pass trauma down through our DNA. They’ve found descendants of holocaust survivors who have the genetics of trauma, even though they haven’t personally experienced the trauma themselves. There is also research that says it can be passed through our lineage in ways that aren’t related to DNA.

So, in trying to work together toward a common voice, we also witness the effects of generational trauma. People of Colour who are the descendants of slaves and Indigenous people whose ancestors were the victims of genocide, for example, are carrying centuries of trauma with them. Their ancestors are crying out to be heard through their descendants.

I am the descendants of settlers and colonizers who have not (as far as I know) been subjected to slavery, but I am also aware that my Mennonite ancestors were tortured for their faith and run out of more than one country because of their stance on non-resistance. I suspect some of that trauma was passed down through my DNA and then got all mixed up with my settler guilt to create a stew of complex personal narratives and healing work.

And then there are the witch burnings. Women are carrying this in our DNA as well. At one time, any woman who would have dared to speak about the Feminine Divine or even who was courageous enough to own her own business was called a witch and burned at the stake. We carry with us that body memory as well, and when we consider marching or raising our voices or making a scene in any way, we might be triggered by the ancient voices in us, passed down through the generations, that say “it’s not safe. We were burned for this.”

The other complicating factor is that “hurt people hurt people”. Those who’ve suffered trauma and have not addressed or healed it in themselves are more likely to inflict it on others. Gabor Maté, a world-renowned expert on trauma, surmises, in fact, that Donald Trump’s behaviour is evidence that he was a victim of trauma. “What we perceive as the adult personality often reflects compensations a helpless child unwittingly adopted in order to survive. Such adaptations can become wired into the brain, persisting into adulthood. Underneath all psychiatric categories Trump manifests childhood trauma.”

Maté also says “The flaws of our leaders perfectly mirror the emotional underdevelopment of the society that elevates them to power.” That suggests that we have a whole lot of people walking around with unhealed trauma and those people are capable of causing a great deal of harm as a result. That’s a frightening thought.

Today, Trump is being inaugurated, and I fear that we have only begun to see the wide-ranging effects of the trauma being triggered by his actions and by those he’s placing in positions of leadership. I fear that trauma specialists will be overwhelmed with the people coming to them for support. I also suspect that physical health will suffer – that emergency rooms will see more and more mysterious illnesses that people haven’t connected to their trauma. And we may see an increase in violence, with traumatized people not knowing how to manage their unexpected response to stimuli. I hope that I’m wrong on all counts.

What do we do about it? A trauma therapist would tell us to remove the stimulus from our lives first so that we can heal, but we can’t hide from it when the person triggering us is possibly the most influential leader in the world. So we must do our best to heal ourselves, to equip ourselves with coping skills, and to become trauma-informed so that we can support each other through this.

If you want to become more trauma-informed, here are some resources that I have found useful:

  1. Trauma: The Injury Where the Blood Doesn’t Flow. In this podcast (that is part of an entire series of podcasts on trauma) is an interview with Eduardo Duran who works with Native and Indigenous cultures in the healing of trauma. He shares how Indigenous spirituality is woven into the generational healing work that he does. I found it to be really eye-opening about how spirituality needs to be a part of the conversation.
  2. TRE – Tension and Trauma Releasing Exercises. Based in the belief that trauma becomes rooted in our bodies, Dr. David Berceli developed a series of exercises that assist the body in releasing deep muscular patterns of stress, tension and trauma. My friends Petra and Leckey are specialists in TRE if you’re looking for someone to help you.
  3. When the Body Says No: Exploring the Stress-Disease Connection, by Dr. Gabor Mate. Dr. Mate has done extensive research in the mind-body connection where stress and trauma are concerned. He links many forms of physical illness (ie. arthritis, cancer, diabetes, heart disease, irritable bowel syndrome, multiple sclerosis) to the ways in which our bodies have been trying to protect us from emotional harm.
  4. It Didn’t Start With You: How Inherited Family Trauma Shapes Who We Are and How to End the Cycle, by Mark Wolynn. This is a fascinating and eye-opening book about the ways that we inherit trauma. One of the stories that stuck with me most was about a young man who had been a successful student and athlete and suddenly he couldn’t sleep at night and was suffering from terrifying cold in the middle of the night. After some work with Wolynn, he discovered that an uncle he hadn’t even known had frozen to death in a hunting camp at the exact age this young man was at the time when the cold and sleeplessness started.
  5. In an Unspoken Voice: How the Body Releases Trauma and Restores Goodness, by Peter A. Levine. Like Gabor Mate, Levine is a leading voice in the field of trauma. He draws on his research and observation of the naturalistic animal world to explain the nature and transformation of trauma in the body, brain, and psyche.
  6. The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma, by Bessel Van Der Kolk. This is the third book on a similar subject (ie. the body and trauma) in this list, so it might seem redundant, but I find that each of these offers something slightly different that adds to body of wisdom. Van Der Kolk uses recent scientific advances to show how trauma literally reshapes both body and brain, compromising sufferers’ capacities for pleasure, engagement, self-control, and trust.
  7. Beyond Inclusion, Beyond Empowerment: A Developmental Strategy to Liberate Everyone, by Leticia Nieto with Margo F. Boyer. This isn’t specifically about trauma, but it’s a useful resource about working with marginalized populations.
  8. Man’s Search for Meaning, by Viktor Frankl. While I don’t recall Frankl actually using the language of trauma, this profound book about his experience in surviving concentration camp talks about how our quest for meaning creates resilience. I believe it will be an important book to return to in the next four years.
  9. The Shadow King: The Invisible Force That Holds Women Back, by Sidra Stone. Again, not specifically about trauma, but a really useful read about how the Inner Patriarch (which, I believe, is rooted in trauma) has held women back and how we can reclaim our power.
  10. The Burning Times: A documentary about the witch hunts in Europe. The film questions whether the widespread violence against women and the neglect of our environment today can be traced back to those times.

Note: I realize that my resource list is rather limited and includes mostly the voices of men (especially for those resources directly related to trauma). I would like to expand this list with more voices of women and marginalized people working in the field of trauma. If you know of any, please offer them in the comments.

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