Freudian Script: How Common Are Mental Health Problems?

common-mental-disorders-marbles If you’ve visited this blog before, you’ll know I like to bang on about the accurate and sensitive portrayal of common mental health problems. You may have noticed that I don’t find many good portrayals – in fact, I sometimes find it hard to find any examples at all.

Mental health has a visibility problem. Is that because it’s not all that common to have a mental illness? Or is it because we like to hide from things that scare us and that we find hard to understand?

Of course, some mental health problems are overrepresented. If you watch enough crime drama, you might be forgiven for thinking that one-quarter of the population of New York City is a psychopath – and the other three-quarters victims.

To clear things up, here are a list of mental health statistics, comparing common mental health problems that you might see in fiction to reality in the UK. I’ve included nods to other health problems, to give an idea of scale.

(NB: for most stats, I’m using prevalence, which is the number of people with a condition during a given time – as opposed to incidence, which is the number of folk diagnosed with a problem during a time period)

One in four adults will experience a mental health problem in any one year
That’s 25%. For comparison, 21% of adults have a university degree.

8-12% of the population experience depression in a year
Asthma has a similar prevalence at 9.6%.

Postnatal depression affects 8-15% of women
This is similar to the lifetime risk for breast cancer at 12.5%.

Social anxiety is the third most common mental health problem worldwide, with a prevalence of about 5%
In England, diabetes has a prevalence of 6%.

2-3% of the population will experience obsessive-compulsive disorder in their lifetime
2% of the population are vegetarian.

1 in 200 people will experience a probable psychotic episode in any year
1 in 200 people will be diagnosed with cancer in a year.

Schizophrenia is the most common psychotic disorder, affecting 1.2-2.4% of people at any one time
Epilepsy has a prevalence of just under 1%.

Over a lifetime, 0.9-2.1% people will have a diagnosis of bipolar affective disorder
The risk of developing leukaemia is 1.7%.

0.6% of the population have significant psychopathic traits
0.4% of the population are doctors.

Each year, around 5,000 people die by suicide
About 1,700 people die in road traffic accidents and 550 are murdered. Suicide is the leading cause of death in young men under 35.

With thanks to Mental Health UK’s excellent Fundamental Facts

Not Accepted Anywhere? Authenticity and Diversity in Writing

woman-question-diversityFrom #WeNeedDiverseBooks to the recent #dontselfneglect, Twitter campaigns to encourage diverse voices in writing are gloriously active right now. This is awesome! I am delighted that there is a push to recognise the value of diverse voices in fiction and the benefits this has for wider tolerance and acceptance of all folks, just being who they are.

But I struggle with this recognition in my own writing and, from browsing the #dontselfneglect hashtag, I’m not alone.

So, I’m going to tell you a little bit about me – more self-disclosure than I’m usually comfortable with – and I’m going to try to explain why participating in conversations about authenticity and diversity in writing is so difficult for me.

Who am I?
If I had to describe my identity, I would say I’m a bisexual, Christian, mixed-race, cis woman. However, I would shy away from describing myself as a woman of colour or LGBTQ, even though I am both of those things. Why is that?

Woman of colour?y
My father is from Sri Lanka and my mother is from Norfolk. I grew up in Devon. There is not a lot of diversity in Devon. At primary school, I was one of three “coloured” children in my class – which is a fairly high percentage, actually. (I use the word “coloured” here not because I currently embrace it or endorse it, but it was the only word I had at the time. I only started correcting my mother on her use of it about two years ago.)

I didn’t have much exposure to other people of colour. My main cultural experience was visiting my father’s family in London. Southall was a revelation to me – for once, I was not the minority on the street. I loved to wear South Asian clothes and I would bring them home for my friends to dress up in, like fancy dress costumes. We had a tradition we called “Indian Christmas”, where we would all wear my clothes and my dad would cook curry for us, before we watched a Tamil movie (with subtitles, of course) and play Carrom. I tried to learn Tamil once or twice, but didn’t get very far, and it is a source of shame to me.

When I tried to interact with South Asian culture, it didn’t always end well for me. I went into a boutique looking for a nose stud and I was stared at for my short hair, my Western clothes, my ignorance. Before my cousin’s wedding, I was criticised by a complete stranger for not waxing the hair on my arms. I often felt rejected by that side of my culture.

I didn’t struggle with much racial harrassment as a child. I was called “muddy face” when I was about 6 and I was called Paki once or twice in senior school. I get a lot of people asked where I’m from, or about my heritage. I have been asked about my religious beliefs, or what kind of wedding I had. I carry a fear of harrassment. My husband (who is white) doesn’t understand why I don’t want to go to a football match, or to certain pubs in town. I fear prejudice, even though it has not formed a large part of my experience.

LGBTQ?
My sexuality is a different kettle of fish. I didn’t know any LGBTQ people when I was growing up, not in person. I did, however, have a broadband internet connection and total immersed myself in fandom. While I have talked before about the problems of gay stereotypes in fanfiction, it exposed me a lot of diverse people, attitudes and opinions. The internet was my education, and stopped me making a tit of myself when I finally met gay men at university.

But I’m also religious, moreso as a teenager than I am now, though I still believe in God and Christianity. When I started to recognise my attraction to women, I panicked. I didn’t know what to do. I sought out the support of a minister I knew, who helped me work out some of my fears via email in a very supportive and validating way. I’m so grateful to him for that outlet.

Yet I have never had a relationship with a woman. In total, I have had one relationship, with the man who is now my husband. If you’re looking for diversity in my dating life, you will not find it. I have never been harrassed because of my sexuality, but then I have only disclosed it to people I trust. I didn’t tell my mother until last year.

Authenticity
When I participate in conversations with other people of colour or members of the LGBTQ community, I feel like a fraud. I don’t have significant battle scars, I don’t feel regularly marginalised or excluded, and I am extremely privileged in terms of my nationality, education and financial situation. When I hear people talking about encouraging diverse voices, I don’t think of me.

I find it easier to talk about my identity in terms of achievements and choices, things that I’ve done rather than things that were given to me. I am a doctor. I am a writer. I am a wife.

I find it far easier to write about Cardiff, a city I lived in for five years, than about the Anglo-Asian experience, what I’ve been since I was born. “Other people know more about this than you”, I think. “Shut up and write about mental health or Wales or murder. If you write it, you’ll only get it wrong.”

I want to tell you that this is all nonsense, because of course it is, but it’s very difficult to shake. Despite all evidence to the contrary, I don’t feel like a person of colour or LGBTQ. And therefore I don’t feel like I have a “POC voice” or an “LGBTQ voice”. BUT I do feel pressure to include people of colour and LGBTQ characters in my work, because I should be out there, doing something about this – and I want to! I want so badly to write them, but I also want to do them justice.

If you write it, you’ll only get it wrong.

It’s an ugly feeling. I don’t have any answers, by the way – if you’re reading this and feel like me, I’m afraid I have no idea what the solution is. Because my voice is important and I want to be heard, and I want to tell other people’s stories, the ones that aren’t heard.

But, if you do feel like me, I want you to know that you’re not alone. You’re not a fraud. Your voice is your voice, and you need to use it and not try to be anything else. For me, that’s not trying to be “more Asian” or “more queer”, because I am who I fucking am.

I’m going to try to be more “me”. I would encourage you all to do the same.

Goodbye 2014, Hello 2015

Every year, I write a post about my writing and personal progress over the past twelve months and look forward to next year’s goals and challenges.

For this New Year’s Day, I’m going to look at some awesome things that happened in 2014 and pair them up with where I’m taking them in 2015.

In 2014, I became a published author


I can’t shout about this enough, because it fills me with a giddy joy that I’ve longed for since I was a child. It’s been a very steep learning curve, but the process of taking a raw manuscript and making it into a novel with the help of my fantastic editor Deb Nemeth and the rest of the Carina Press team has had such a profound influence on my writing. And then seeing my books out in the world, receiving praise and reviews – even the gut-wrenching negative ones – has been amazing. People have read my words! They paid money to buy them and then they told other people to buy them!

In 2015, I will write more books and send them into the world.
I am writing more Amy Lane, because I have many more stories to tell for those Cardiff friends of mine. I’m hoping to share more news about Book #3 soon, and a short story – #2.5 Car Hacker – will be released in February, via The Amy Lane Mysteries mailing list.

I’m also writing The Deaths of Miss Gray, which I started for NaNoWriMo 2014. When it’s fully baked, I intend to polish it up and send out to some literary agents later this year. I hope I’ve learned my lessons from my last round of querying – rejection is encouragement, after all. I’ve ready for another bout in the ring, but my novel isn’t quite there yet.

In 2014, I wrote a script.
Now, this doesn’t sound like much at all. In fact, it sounds like something I first accomplished in 2010 and what I should be doing every few months.

However, I note this script because it is my first feature-length script to enter pre-production. After many, many months of work in development with indie producer Nicholas John of Changeling Films, we are ready to take our next brave step.

In 2015, my first feature film will start production.
My optimism may be ill-founded by I have all my fingers and toes crossed that we can gather momentum behind out film. If we don’t quite make it to production, I would like to be significantly further down the road to making this film a reality. Watch out for updates on Doormats and Jezebels!

In 2014, I co-founded #psywrite
psywrite

With the peerless Vicky Newham, I started a monthly Twitter chat about mental health and psychology in writing fiction. It was aimed at combating stigma in the writing community by promoting the accurate and sensitive portrayal of mental health problems and psychological understanding of characters and plot, an endeavour I started with my Freudian Script series in 2012.

In 2015, I will keep fighting to end mental health stigma.
We are a lot further down the road to a public understanding of mental health problems and social acceptance that these crippling diseases need equal precedence in our consciousness to physical health issues. I will continue #psywrite and Freudian Script, I will answer your questions on Twitter and Facebook, and I will keep writing about characters with mental health problems.

In 2015, what will you do?

When Sidekicks Take Centre Stage

crime-fighting-partners-jam-watson
Hark, a vagrant: The Case of the Two Watsons

In any fictional universe, the world revolves around the protagonist. Any “extras”, sidekicks or love interests are very much subservient to the hero – though, if they are well-realised, they all think they’re looking out for their own interests. It’s only the writer who is leading them on to serve the hero and the narrative.

Over at the Crime Readers’ Association website, I wrote about Supporting Cast: Breathing Life into Secondary Characters. I even made reference to my favourite Hark, a vagrant webcomic.

I mentioned Cerys Carr, who started life as nothing more than a gobby teenage sister to one of my protagonists and ended up playing a major part in Code Runner. She’s also prominent in Book #3, and shows no sign of fading away.

The beauty of a well-developed supporting cast of “sidekicks” to your hero is that they can leap to the fore at any moment. In television, this may even progress to them gaining their own show – for example, Angel started life in Buffy and Frasier was part of the cast of Cheers. Joey’s leap from Friends is a much less successful example – partly, I think, because that character’s strength is in how he reacts within that specific ensemble.

A truly excellent author plans ahead that their supposedly minor characters are, in fact, pivotal. If you read only The Philosopher’s Stone, you would be incredulous that Neville Longbottom could be significant in any way to Voldemort.

In some cases, the high-profile or cult casting in a supporting role can bring an audience, like Anthony Head and Richard Wilson in Merlin. Other shows take note of the surprise success of some of their supporting characters. The rise of Castiel in Supernatural has been the result of vocal fan feedback, and The West Wing was never meant to feature Martin Sheen in such a large role.

For me, the development of all your characters beyond a name and a face is a no-brainer. If you are writing a project with longevity, whether that’s a series for television or in novels – or even if you just want your audience to make it to the end of the book – a compelling cast of characters is vital.

And who knows? Some of them may surprise you.

Read What You Don’t Know

read-around-the-edges

In last week’s post for the Crime Readers’ Association, I encouraged folk to read around the edges – straying into genres where they would not normally roam in anticipation of finding new jewels to discover.

Today, I’m looking at you, writers – what have you done to “read around the edges” this year?

The old, overused maxim “write what you know” looms large in the mind of the author, but it is fundamentally flawed. It assumes that we are static creatures, incapable of growth or new learning, stuck in some pot of knowledge gained up until the age of eighteen.

This is, of course, bullshit.

If you want to write what you know, get out there and know it! When I embarked on writing this period fantasy mystery, I knew my Victorian London knowledge was all but absent. So I enrolled on a distance learning course about The Victorian City, I bought and borrowed a few light history books, and I learned.

To say that knowledge is incomplete is an overwhelming understatement, but now I know what I don’t know, which is good position to start from.

psywrite

If you’re writing about mental health but don’t know where to start, our monthly #psywrite Twitter chat can help. The last chat of 2014 is TONIGHT (December 16th) at 8pm GMT, so I hope you’ll join us. You can find all the storifys from previous chats on the Facebook Page.

I’ve seen a few writers already writing their New Year’s Resolutions (procrastination, much), so why not think about adding to yours:

Read What You Don’t Know.

Rosie Claverton: CRA Featured Author

I am honoured to be the Crime Readers’ Association Featured Author for December.

weather-cra My first post was on a typically British theme: the weather:

It’s always raining in Wales.

This is, of course, a fallacy. It only rains on about half the days of the year in Wales, less so in Cardiff. However, I feel a particular sense of homecoming when I arrive in the Welsh capital and it’s tipping down with rain.

I lived in Cardiff for five years and it always seemed to be raining, particularly when I had forgotten my coat or on the way home from a night out. Cardiff is the reason I gave up on umbrellas, too many falling victim to the wind or threatening to give me a Mary Poppins effect. I took my driving test one sodden July, where the bridges all harboured dark pools and the instructors wouldn’t let us out on the lanes. Though there were surely sunny days, my overwhelming memory of Cardiff is rain.

Speaking of Cardiff, Amy and Jason are returning for a short adventure in Car Hacker, which I’m calling Amy Lane #2.5. You can find out more by signing up for The Amy Lane Mysteries newsletter.

Finally, I stumbled across a couple of lovely Binary Witness reviews which I wanted to share because they focussed on little things not considered usual in the mystery department.

The first was from the CRA site, about the use of Cardiff as a setting and UK crime fiction in general, how we find joy in the mundane, everyday environment where we live instead of far-distant, exotic locales:

It is Rosie Claverton’s evocation of Cardiff which completely won me over. I can’t say it’s a city I know well, and, from Rosie Claverton’s vivid descriptions, there are parts of it I am happy never to venture into, but what she does manage to do is to create an utterly convincing and solid world in which her characters can function (however outlandishly at times). It is a world which she builds around us as we read, brick by brick, shadow by shadow, alleyway by alleyway, until we inhabit it, or it inhabits us, completely.

The second was on the subject of intimacy in fiction from A Library Girl’s Familiar Diversions. She talks about how it is intimacy in fiction which draws her in, how the little moments can make or break a novel:

Most of my bookmarked spots were lovely little moments between the two of them: Amy fussing over Jason and fixing him a cup of tea after he’d been badly hurt, Jason cooking Amy a real meal, the ongoing issue of Jason’s password strength (who knew talk of passwords could be adorable?), and more.

Are you only happy when it’s raining? What criminal locations are your particular favourites? Do you rate intimacy in fiction? Lemme know in the comments!

NaNoWriMo and Beyond

Winner-2014-Web-Banner

Yesterday, I woke up with 6,500 words left on my NaNoWriMo target. Somehow, I stumbled across the finish line, completing 50,000 words of my latest November novel. Congratulations to all my fellow wrimos and thank you to everyone who cheered me along the way.

Suffice to say, I don’t have a lot of energy left for updating my blog after running that marathon. Thankfully, I sorta planned ahead and wrote some other things that were kindly hosted and highlighted by my fellows in the writing community.

5-ways-nanowrimo

Over at Bang2Write, I wrote about 5 Ways to Keep Writing After NaNoWriMo, because real authors don’t get to retire in December.

Writing is not always writing. Sometimes, writing is thinking about writing, preparing for writing, or deleting writing. Confused yet?

Writing a novel is a process far beyond just putting words on a page. It is certainly more than typing each individual letter. Hopefully, before NaNoWriMo, you put together at least a rudimentary plot and some characters before you started your journey. This was thinking about and preparing for writing. Sometimes, that takes two days at the end of October. Sometimes, that takes months of notes, research, mood boards and talking it out with someone you trust.

Writing is not the first draft. It is taking a raw diamond and chipping away at it until it becomes a flawless jewel (although folks also wear emeralds and topaz and cubic zirconia, y’know). When you get to editing your novel (and you will have to edit it), you may add some words but you’ll probably delete a whole lot. Entire scenes, whole chapters, maybe even a character or three. All of this is still writing, even if your word count is actually falling.

first-draft-workspace

I was also interviewed about my first draft process by the lovely Rebecca Bradley (whose debut novel you can have a sneak peek at here).

Watch me flail my way through answering the question What’s Your First Draft Like?:

Does the outside world exist or are you lost to us for a period of time as the magic works?

I try to shut myself away. I have a study space now, which is invaluable, and keeps the work separate from relaxing on the sofa or clearing clutter off the dining room table. I use the Pomodoro technique to keep myself on track – nothing but writing for 25 minutes, goof off for 5 minutes (Twitter, fresh tea, etc.), back to work for 25, break for 5, lather rinse repeat. It works well for my focus, as I’m very distractable.

What does your work space look like?

I have a bureau in our guest room, where I use my ancient laptop. The cupboard doors have some postcards from the British Museum on them and my reference books are on an adjacent bookcase. I also have a Sherlock Holmes coaster from 221B for my tea mug.

NTN-2014-logo-courier-300

Last but certainly not least, I received a wonderful review from Crime Fiction Lover for Code Runner as part of New Talent November 2014.

“The warm and beating heart of this novel is the relationship between Jason and Amy. It is much more than a ‘will they, won’t they?’ teaser, and the writing describing their relationship is of the highest quality…Rosie Claverton has played the alchemist here, and created literary gold from very base metals.

As we enter December, I will be featuring articles written by me or about my books from all about the web, including some highlights from this year’s blogging. Series such as Freudian Script and Writers’ Tools will return in the New Year.

Happy writing!

Writers’ Tools: Scene-by-Scene

scene-by-scene-conflict

As NaNoWriMo drains words from me like a gigantic novel leech, I have to take that tried-and-tested piece of November advice and silence my inner editor. The emphasis of Nano has always been word count above all else, with the idea that we can fix all in the edit – in a similar way that film-makers “fix it in post”.

If you’re an intricate plotter, you probably start any new project, novel or screenplay or other, with a thick wedge of notes and an exact play-by-play of how your finished project is going to look.

If, however, you’re like me, you probably start with broad brushstrokes and then fill in the finer details as you go on. You may have a beginning, a middle and an end but how exactly those are going to fit together may be a complete mystery.

I hold an interesting position in that I am both a screenwriter and a novelist. Screenwriting tends to be much more heavy-handed when it comes to structure, particularly meeting the expectations of directors, producers and others with whom you will share a script during development. Novels are a lot more free-form, though thriller-type crime novels tend towards the pacey end of the novelling spectrum. Your audience wants to know what happens next and you have to keep their attention.

In an attempt to form a bridge between the waffley first draft of a novel and a thrilling page-turner, I like to utilise a technique I learned when I first started scriptwriting. I call it the scene-by-scene breakdown.

What is a scene-by-scene?
For me, a scene-by-scene is part of my first pass edit. It involves me looking at every chapter of my novel and addressing each scene by checking its relevance to the work as a whole.

Before I go into exactly how I do this, let me tell you a little bit about how I came to it in the first place.

Scene-by-scene – the origins
I owe my discovery of this breath-takingly simple technique to Blake Snyder’s Save the Cat. Mr Snyder was a bit of a stickler for screenplay structure and he permitted writers only 40 index cards for a feature-length film, each representing a scene or sequence.

Only 40! Like most screenwriters, I live and die by my index cards and the idea of culling them like this makes me want to cuddle them to my chest. However, he makes a very good point about what each card must contain and its this that I use as the basis for my scene-by-scene.

A screenplay card might look like this:

INT. THE BAR – NIGHT
Erin confronts Dee about her relationship with Saul, but Dee denies it.
+/- Erin is angry with Dee but pacified by her response; Dee is defensive, but feels uneasy that she’s not telling Erin the whole truth.
>< Erin wants reassurance that Dee values her opinion; Dee wants to live her own life.

The symbols that Blake suggests represent:
+/- emotional change within a scene
>< conflict

Conflict is the bread-and-butter of screenwriters. Without conflict, there is no drama and your characters just pootle along in their vacuous lives without being changed or challenged. That does not an interesting film make.

While novels are less rigid, you still need to keep the reader's interest. If your scenes are heavy on exposition or emotional outpourings, your audience may wander off and find something else to do. If you want a reader to turn pages, you need to give her a reason to do so.

How I write a scene-by-scene
I started writing scene-by-scene breakdowns when I was editing Binary Witness, the first Amy Lane novel. The below examples are from the edit of the second book, Code Runner.

Because novels are quite a bit longer than screenplays, I tend to write my scene-by-scenes in Evernote or Word, not on index cards. I also use a slightly different format to Blake Snyder and add some extras to help with my edit:

Chapter 7: The Devil’s in the Details
Amy finds the murder victims on Facebook and Jason wants to go downtown (BRYN: Amy v Mystery; Jason v Amy; Jason v Bryn); Jason cleans the oven and leaves Amy alone (AMY: Amy v Jason) [too long?]

Breaking the note into its composite parts, we see:
– Chapter # and title
– Brief summary of scene events
– POV character – name in all caps
– Conflicts, including emotional
– Edit notes [in square brackets]

If there’s more than one scene in a chapter, they are separated by a semi-colon.
scene-by-scene-povcount
By adding the POV character, I can also check the balance of POVs in the novel. When I wrote Binary Witness, Jason had almost double the number of POV scenes than Amy did and they are supposed to be co-protagonists! I recently completed a scene-by-scene for Amy Lane #3 and you’ll see that the POVs came out a lot more balanced between the protagonists, with Bryn always a lesser third.

It’s perfectly placed at the beginning of an edit, because it can serve as a reminder that a plot was dropped in the first third and never picked up, or a question was posed in Chapter 5 but the characters only remembered it in Chapter 19. It’s also useful to see all my terrible chapter titles in one place so I can flag up the ones which desperately need a rethink.

I’ve found this technique particularly useful for highlighting my personal weaknesses. For example, I have a tendency to write a lot of emotional scenes that don’t really go anywhere – especially for Amy, a character who lends herself to wallowing in angst. It also picks up if a supporting character has disappeared for a stretch of scenes or we’ve been too long without slipping into the Killer POV or catching up on the police investigation.

How do you kick off your edit process? Do you think a scene-by-scene could be useful in shaping your novel? Let me know in the comments!

Freudian Script: Emotionally unstable personality disorder (EUPD)

balance-eupd
Emotionally unstable personality disorder: balance, understanding and acceptance

This week’s Freudian Script concentrates on a mental health problem that is not often in the public eye. As opposed to correcting stereotypes about this condition, I will instead look at what emotionally unstable personality is, common stigma problems, portrayals in fiction, and how writers can consider the condition in their work.

WARNING: This post contains discussion of self-harm, suicide and abuse.

DISCLAIMER: Freudian Script discusses mental health problems for writers of fiction, to encourage accurate and sensitive portrayals. If you or someone you know is experiencing mental health problems, please seek help from a doctor.

What is emotionally unstable personality disorder (EUPD)?
Perhaps a better starting question is: what is a personality disorder?.

A personality disorder is when an adult has a set of personality traits that cause problems for them in their lives. These have likely developed from difficult early life experiences and were at one time useful to help survive those situations. However, as the person grows older, these are no longer helpful to them and instead create problems in work, relationships and coping with stress.

Current feeling among mental health professionals is that personality disorder is not a very helpful term. Nonetheless, I will use it here for clarity and to fit in with the classification systems we work by. I have previously mentioned a different personality disorder when discussing The Psychopath – that being antisocial or dissocial personality disorder.

Emotionally unstable personality disorder relates to a set of personality traits that are rooted in problems with emotional regulation. The person may feel their emotions are out of control or they have very rapid mood swings. For this reason, EUPD is sometimes mistaken for bipolar affective disorder, though the two can also co-exist.

There are two main types of EUPD:

> Impulsive type – The emotional instability predominates here with a lack of impulse control, so thoughts can be acted upon suddenly with later regret.

> Borderline type – Called “borderline” due its historic position between the “psychotic” and “neurotic” disorders, this type sees more disturbances in self-image with frequent self-loathing. This can be accompanied by chronic feelings of emptiness, intense but brief interpersonal relationships, and self-destructive behaviour, from self-harm to suicide attempts.

Why do people get EUPD?
There is a movement in psychiatry to re-brand EUPD as a “complex trauma disorder”. This is because this group has a very high incidence of childhood abuse, trauma and neglect.

If a young child doesn’t feel safe and nurtured, their ability to form secure attachments to others doesn’t develop as it should. Instead, they learn to protect themselves by withdrawing – but also continue to look for an attachment that is fulfilling, because relationships are an important part of human sustenance.

This constant push-pull on those close to them puts a strain on the relationship and they frequently break down. This reinforces the person’s beliefs about themselves as unlovable and they experience an increase in negative emotions, which they find difficult to regulate. This can then lead to increased self-harm, either directly from cutting or related behaviour or through other “punishment”, such as self-starvation.

Self-harm and EUPD
There is a lot of stigma, both outside and inside the medical community, of self-harm and personality disorder. Common ideas that I have heard expressed are that people with EUPD are “attention-seeking” or that their self-harm should not be taken seriously.

Let’s deal with these two thoughts:

“Attention-seeking” implies a conscious desire to act merely to gain attention. It is likened to a toddler throwing a tantrum. Instead, it can be viewed in the context of the difficult in emotional regulation. With secure support and appropriate role models, children learn to self-soothe their emotional distress. Most upsets may provoke an emotional reaction but it can be dealt with by the person with only minimal support from outside.

However, without that ability, any emotional upset can become a calamity. One of the most frequent is the break-up of a relationship. If you have a large amount of negative emotion, how do you deal with it? Self-harm can be used by people to relieve tension, to form part of that coping mechanism. It also attracts attention of people who can care for the person – however, if that is operating in the situation, it is on the unconscious level.

Secondly, self-harm should always be taken seriously. It is the strongest predictor of future suicide attempts, even without the immediate risks. Talking therapy to enable that person to understand the reasons behind their self-harm and explore alternate coping mechanisms, without adding to the guilt and shame that often accompanies being “found out”, can be a helpful stage in moving on.

Management for EUPD
Like many mental health problems, there is no “quick fix” for EUPD. Some people develop alternative coping strategies spontaneously, usually supported by developing appropriate relationships and proving their worth to themselves, and appear to “grow out of” their personality disorder.

However, the more severe end of the spectrum requires more support. Specific talking therapies form the main basis for assistance from mental health services, though some medications may be useful in blunting anxiety or helping mood stability.

I have previously talked about psychodynamic psychotherapy, which looks at how childhood experiences influences adult behaviour and interaction. This can help understanding of present difficulties and aid in coming to terms with previous distressing experiences as a child.

One type of therapy that was specifically developed for EUPD is dialectical behaviour therapy (DBT). It is particularly for people who use self-destructive behaviour as a coping mechanism and attempts to address both harmful behaviour and the underlying emotional difficulties. It takes place over a year, with both individual and group sessions, and has two distinct phases. The first phase is about safety and reducing the self-harm behaviours, to gain a measure of control and encourage the person to take on responsibility to aid the development of self-soothing. The second phase then works on the underlying emotional problems.

Examples of EUPD in fiction
anakin-eupd
The works that commonly look at EUPD are memoirs, like Girl, Interrupted (though the film is less accurate).

When researching this article, I found a theory that Anakin Skywalker could have EUPD, which is a very interesting take on that character. He has the early childhood trauma and absence of appropriate role modelling to precipitate a problem, with a very intense relationship with Padme and a definite lack of emotional control. However, he reinforces the stigmatising stereotype that people with EUPD are harmful to others where this is vanishingly rare in reality.

elsa-eupd
The most compelling example I’ve found is that of Elsa from Frozen. She has the early childhood trauma of hurting her sister Ana, coupled with an emotional and physical distance from her family due to her powers. The lack of control of her magic provides a parallel to poor emotional control – with the “conceal, don’t feel” attitude one which some children and teens grow up with from parental example, with the result that strong emotions come out sideways – in anger or explosions of ice. She has great difficulty with self-soothing, imposes isolation to prevent developing a potentially painful relationship and exposing her emotions, and reacts chaotically to any change in circumstances. For Elsa, her relationship with Ana can be seen as a positive force for change, to prove her self-worth and ability to form meaningful connections.

Writing EUPD
I think this is a very difficult topic to address as a writer. The risk of straying into bipolar affective disorder is quite high, and a word of caution in YA – some aspects of this presentation are normal teenage expression, part of personality development. It’s a failure to move beyond that phase that can lead to a personality problem.

If you do want to venture down this path, I recommend reaching out to someone with EUPD who can guide you through, or reading memoirs and personal accounts to get a good sense of what it is and what it isn’t. Good luck!

NaNoWriMo: A Survival Guide

The clocks have gone back, the nights are drawing in and the supermarkets are full of pumpkins. It is almost that time of year again…

nanowrimo-2014

For those not in the know, NaNoWriMo is short for National Novel Writing Month. The goal is simple: write a 50,000-word novella in the 30 days of November.

This year will be my fifth NaNoWriMo. I’ve participated in 2006, 2007, 2011 and 2013. 2011 and 2013 birthed my two published novels, Binary Witness and Code Runner.

If you are thinking of taking the plunge and participating in your first NaNoWriMo, I have a few words of advice to help get you through…

Plot as much or as little as you need
You may heard the question “plotter or pantser?” addressed to authors. Basically, do you plot our everything that happens in your novel or do you just write whatever you feel like at the time? I’m somewhere in the middle. I need to know how the novel begins and ends but the middle is a little more free-flowing. If I over-plot, I get bored because if I already know what happens, why would I bother writing it? I have to write for me as well as my imagined audience.

If this is your first piece of creative writing, you may not know what suits you best. However, don’t take the advice of anyone who says “you must plot” or “you must go with it” – everyone is different. I recommend starting with a basic beginning, middle and end, but you can fill in the gaps with reams of notes or nothing but air. Go with your gut!

Aim above your word target
If you’re aiming for 50k overall, you need to write 1,667 words per day to meet your target. I recommend setting up a simple spreadsheet to monitor your progress.

However, there will inevitably be days when Real Life gets in the way and you cannot write. The time to prepare for those days is at the beginning. This year, we are fortunate that NaNoWriMo starts on a weekend. For folks with full-time jobs, weekends are often the best time to build up words.

Some folks aim for 5k on the first weekend, to get a good head start. Do what feels right for you – don’t get burned out and disheartened by putting too much pressure on yourself right out of the gate.

Apologise to your friends and family in advance
Unless you are a demon-fast writer, you are going to be a recluse for the next month. You are going to be spending time every day writing, time that you would usually spend elsewhere.

The most probable area to take the hit will be socialising. You might have to decline a few parties or set your box to record all your favourite TV. Your spouse may have to cook a few more dinners.

If you want to compromise your people time as little as possible, look for areas where you can squeeze in some writing time. And remember to recharge – you can’t write all the time. Spending time living is where the creativity springs from.

Hang out on the forums
Between frenetically typing your magnum opus, you should spare a little time to check out the NaNoWriMo forums. For me, this is one of the best parts of the experience.

From bizarre fact-checking requests (“how can I poison someone underwater?”) to fun writing games (“write the demise of the last commenter”), this is where the spirit of NaNoWriMo really lives. Take encouragement from the thousands of people sharing the journey with you.

Finish – and then WAIT
When you’ve won NaNoWriMo, you feel on top of the world. You have done it – you are a novelist.

You are, of course, eager to show your masterpiece to the world. DO NOT DO THIS. You may have written a novel, but it is a raw, baby proto-novel. To send your novel out into the world now would be like enrolling your toddler in university. You are not yet done!

Put your novel in a drawer and wait. Wait at least a month and do not look at it. Do not even think about it. Catch up with all the people and hobbies you’ve been neglecting over November. Binge on Gotham and do your Christmas shopping.

In January, after you’ve recovered from New Year, you can look at your novel again. And then the real work begins.


Doing NaNoWriMo this year? Add me as a writing buddy! Writing a novel that involves psychiatry or psychology? Check out the #psywrite Twitter chat on November 18th at 8pm GMT – and, if you can’t wait, ask me on Twitter or Goodreads.