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…
- 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.
- 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.)
- 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.
- 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).
- 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.
- 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.
- 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.