HW Kim is a trauma survivor, social activist and poet. She has worked with Asian Americans for Equality and the Dallas Area Rape Crisis Center. Currently, she is pursuing a degree in Medicine & Public Health at Hunter College. She is a kind human being who cares deeply about the world and people around her.
What’s been the hardest part about self-care for you?
The hardest part was simply knowing what was wrong or if there was even a problem. Because I grew up with a family that normalized trauma, it took me 16 years to realize maybe something was wrong. I didn’t realize that suicidal ideation and wanting to die was not normal. I still have a really hard time figuring out what is and isn’t normal.
I hate it when people go, “Oh, what is normal anyway?” I want to know what the mean, the majority of the population is going through versus what I’m going through.
You need perspective.
Yeah. So I find it very patronizing. We’re not talking about a hippie existential crisis you’re having. This is what I need.
We’ve discussed how sometimes diagnosing someone can feel like guesswork because there are overlaps in symptoms. Is that part difficult for you? Because I know you’ve had different diagnoses.
A lot of people have. The tricky part about mental illness is if you’re younger than 18, it’s hard to tell what is just teenage, hormonal stuff. I have borderline personality disorder (BPD), but even if I displayed some of those symptoms, it was still hard [to tell].
A lot of people also say, “Don’t label yourself.” But for people with BPD, we need labels. It’s helpful because we have no sense of identity. This is not an existential crisis that everyone goes through, a lot of people don’t know who they are but for those with BPD it’s like, “Am I just imagining that I like this color or do I really like this color?”
Or is it going to change suddenly.
It’s a mind game, so you’re constantly battling yourself. The hardest part is a lot of people with BPD have self-harming behaviors because that is our way to cope. It becomes tricky when you start attributing your illness with your identity.
I’ve met other people diagnosed with BPD and it’s really hard to separate what is everyday life versus when you’re being affected [by the illness].
It can be scary. I’m very well prepared for sudden changes in my life but that doesn’t mean that I like them. I’m not someone who likes being spontaneous.
Going back to identity, up until five I was raised by two people with eating disorders, so my relationship with food has been messed up since I was a child. I developed an eating disorder around 11 when my dieting went full out, and it never really goes away. Because I developed it before puberty and my depression started shortly afterwards (around 13), anyone would have a hard time with that, with or without BPD but because I have BPD, it’s harder. It becomes hard to know what you are outside of that when you grew up with it.
How do you deal with triggers?
For the longest time I didn’t know what my triggers were, but now I can look out for them. Now I can prepare, and also let people around me know. I over-prepare, but I still don’t think I deal with things very well. I have a very strong defense mechanism where I internalize and begin dissociating. I’ll become numb and block it out, and then it comes out later. So it’s hard, but knowing and identifying triggers is the first step.
Do you prefer to withhold telling people around you about the diagnosis, or is it something you wish to share?
One of my oldest friends says that I go from zero to 100, and I need to get that 50. Basically, I either withhold everything or spill everything, and I need to find that middle ground. Up until 18, I didn’t share anything about myself and it wasn’t fully intentional. When you’re in the mental health system, you have to tell your story over and over again, so you become numb to telling your story, and it also becomes a lot shorter [over time]. So I’m desensitized to it now.
Is that good or bad?
I think it’s both. It’s good because I can share things with people that I otherwise wouldn’t, but it’s a bad thing because I’m not really sharing because I want to, and I become numb to it.
What is your life like as an artist and does it relate to your diagnosis?
Most of my writer friends write fiction and I cannot do fiction to save my life. It’s like, I can’t draw but I can see it in images through my imagination. With poetry, I can hear the words. I’ll have one phrase that won’t leave me alone and I’ll have to write it down.
Poetry doesn’t have to be as narrative-driven.
It’s very freeform. I like spoken word the most. People have said I use my voice as an instrument, so it’s different hearing it versus reading it. It’s very personal for me so a lot of times it can be emotionally draining. I feel like a lot of spoken word artists draw from pain. When you go to a spoken word event you never walk out happy. “I’m sorry this is so depressing guys!” [My work] is sort of the same way. It’s a way for me to come to terms with things I wouldn’t otherwise be able to express. It turns something painful into something that is a lot more manageable.
So you’re not a sufferer for your art, like that stigma perpetuates?
When did you first start writing?
When I was little I liked doodling. Then I fell in love with reading and writing. My problem was that I thought they were bad so I would rip them up, and I went online and started journaling and would delete each post. It got a lot better once I realized that poetry doesn’t have to have a format like the iambic pentameter or whatever. Recording my work has been really recent.
Having been receiving treatment for a few years, what’s been your experience going through the healthcare system?
I’ve been through the healthcare system in three different states, and across the board what I hear from people is that it’s shit. Two of the facilities I stayed at lacked people of color. As someone who’s doing pre-med, you don’t learn a lot of humanities and social skills. It’s surprising how much cultural and social sensitivity some of these people lack.
Some psychiatrists wouldn’t know what to do with me because my affect is always very positive. I feel very pressured to be okay and perform happiness when I’m with other people, so I looked a lot better than I was. Many teaching hospitals accept state Medicaid, so you wind up getting a lot of residents or interns, which can suck because they’re just learning what to do.
I want to be empathetic because I want to go into this field, but it’s also frustrating because I would mistakenly get prescribed Effexor instead of Effexor XR and three weeks later I’d go in and say, “My medicine is making me feel worse.” And they’ll check then respond with a chuckle and a short “sorry.” When I was a teenager, I was a patient at a place affiliated with a teaching school where they switched the resident every three visits. It was hell because they would have my chart but they wouldn’t know me. By my third hospitalization, they realized my affect wasn’t matching with the severity of my suicide attempts. It took five years and countless doctors to get to this point.
There are good stories [out there] and good doctors, but it’s really hard if you don’t have great insurance or a lot of money. If you’re good enough, most psychiatrists will have a private practice [instead of working at a public hospital], and you can’t see them if you don’t have a disposable income.
I’m not saying western medicine is the be-all end-all, but a lot of the homeless or mentally ill with preventable crimes has to do with medicine. It’s something so simple, but it just shows in this country [the system] can fail a lot of people.
You briefly touched on your suicide attempts and going through treatment at hospitals. What about that experience was helpful to you and what didn’t work?
The first two hospitalizations were horrible mainly because of people believing it was normal stress and not thinking to ask more questions. Being a victim of abuse, having a horrible early childhood, being bullied—none of these things came out because I didn’t think to bring it up and they didn’t bother to ask.
They do their best. They try to separate violent patients and non-violent patients, but they mean physical violence. I’m really sensitive to emotional violence. If people are yelling at me, my body tenses up and releases stress hormones, so I’m always in fight-or-flight mode. I ended up being triggered and dissociated all the time. The first two hospitalizations, I ended up a lot worse coming out of them.
The third time I think was good because they separated me into a ward for just college-age kids with similar illnesses. I saw people going through similar things that were closer to my age. But overall, I would say everyone needs better cultural sensitivity training. A lot of the interns and doctors would talk crap about the patients and the patients would be right there! There’s a safety room that’s basically a windowless door that’s locked and you’re put in there to calm yourself down. Watching “Orange is the New Black” reminded me so much of being at the hospital. It’s dehumanizing and really scary. I feel like it would only calm people down because of fear and wanting to get out.
A lot of these things are adopted from asylums and prisons. That’s how people dealt with mental illness patients. A lot has changed, but a lot hasn’t changed.
Did you learn anything from this process that has benefitted you?
Medication and really good doctors. They annoyed me because they were on-point and asking the right questions. I’m so used to deflecting and they would call me out on it. I just wanted to get out of the hospital but they met me at every curve. It was also validation. People telling me this isn’t normal and this is serious. People from families that normalize trauma have perspectives that are completely skewed, so it’s important for the doctor to bring perspective to it.
The doctor at the last hospital kept walking me through how my friends might feel when we were talking about what happened and he kept going as he saw me tear up. He knew I needed that, so I was actually happy. He helped me go past my emotions and defense mechanisms and that was really helpful.
Based on what I’m hearing, do you feel that the medical professionals who had less sensitivity skills or were less empathic were less effective?
Yes, and I think they were also able to understand what was going on [better]. To be fair, I think I was a very tricky patient because of my affect and I would lie and not know I was lying. The combination of being a tricky patient and their lack of sensitivity training made it a very difficult situation.
For me, it’s been both really traumatizing and lifesaving at the same time.
Does your passion for social activism also come from your experiences?
Yes. A lot of the activism I started out doing was around race, class, gender and sexuality, but I am looking into disability activism. In terms of career, I’m aiming for a Medicine & Public Health (MD/MPH) degree. I don’t want to be a psychiatrist, but understanding that and what mental health looks like on a global scale is something I’m really interested in. Also, majority of the mentally ill people who are left to fall through the cracks [of the system] are generally those who are queer, poor or people of color. So I guess that adds to my interest/passion in this area.
Everyone’s a work in progress. In terms of self-care, what are some things you are hoping to improve?
For me, it’s validating my experiences and learning how to channel and manage my [conditions]. My therapist describes it as watching a wave that’s coming at you. It’s giant, but you have to wait and let it pass you. Another thing is asking for help when I need to. I’ll come up with a million reasons, true and untrue, to not ask for help. “No, they’re busy. I’ll be a burden. They’ll just be annoyed at me.”
The other thing is, I don’t know what other people can do to help sometimes. People ask me all the time, “What can I do to help?” And to be perfectly honest, I don’t know what they can do and I don’t know if what they do is going to help. Sometimes I just need someone to listen. Some of my friends who also deal with mental illnesses have a knack for dealing with this, so I often go to them.
What would you say to someone else who is having similar struggles?
I would be honest with them and tell them there is no magic answer. You won’t magically wake up one day and be happy. It’s going to be really hard, but the pain you’re going through doesn’t always have to be that intense. It’s okay to ask for help.
There’s so much stigma around mental health so I always say, look at mental illness like it’s a physical illness. I have asthma. I’m not always wheezing or coughing and I don’t always need an inhaler. But sometimes I do need medication and do things based my condition. You have to have that same mindset with mental health.
Look into resources around you. For example, I didn’t know about the free therapy and psychiatrists around me until I asked. I didn’t know that in New York City, if you go to a public hospital, you can get free medication. Even if you can’t get medication or therapy, it’s not the end of the world. There are other solutions. It’s just going to be a little harder.