Life in a Bind – BPD and me

Borderline Personality Disorder, Generalized Anxiety Disorder, and my therapy journey. Listed in Top Ten Resources for BPD in 2016 by goodtherapy.org. I write for welldoing.org and for Muse Magazine Australia, under the name Clara Bridges.


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Unapologetic about making everything about therapy

You would be forgiven – and entirely justified – in accusing me of trying to turn almost any piece of writing or poetry into something about therapy or the therapeutic relationship. If there is even the glimmer of the possibility for drawing the parallel, I will do so with unashamed enthusiasm, however tenuous the connection.

I recently finished reading ‘Unapologetic’ by Francis Spufford, and wanted to share with you another example of this, my favourite past-time of imbuing everything with the one thing that often seems to take over my life and my every thought. ‘Unapologetic’ is, as it says on the cover, all about “why, despite everything, Christianity can still make surprising emotional sense“. Now, this is not at all a post about religion, Christian or otherwise, though if you are interested in such things, I can highly recommend the book. Any text which talks about the relationship between God and the universal HPtFtU as the author calls it – the Human Propensity to Fuck things Up – in an amusingly irreligious but also searingly honest and abundantly compassionate way, has my vote. It has certainly helped me to come to a renewed emotional understanding of the faith I have been struggling with so much with over the last few years, and it has challenged me to try and be more loving, not just towards others (however difficult the circumstances), but also towards myself.

And that challenge summarises one way in which, for me, the book is full of resonances with the therapeutic process and relationship. Themes of unconditional acceptance, love and compassion, in the face of the ever-constant HPtFtU; themes of self-hatred and self-sabotage and the struggle to feel loved, by ourselves or by another. I’m not suggesting my therapist in any way resembles God – though I must admit that in the past, some of the language I have used to describe my feelings for her, has had distinctly religious overtones. My therapist, I have come to grudgingly accept, is just as prone as the rest of us – though perhaps a little more forgiving of it than most – to the Human Propensity to Fuck things Up.

If you think this is all sounding a bit far-fetched, I wouldn’t blame you. But consider these passages, which jumped out at me today – and just replace the word ‘forgiven’, with something akin to ‘the process of therapy’, or to the concept of ‘progress in therapy’:

What does it feel like to feel yourself forgiven? I can only speak for myself, but, speaking for myself: surprising. Just as it comes from a direction you hadn’t considered, viewing your life from an angle you hadn’t expected, it also comes with a sensation that isn’t necessarily one of conventional release or relief. In my experience, it’s like toothache stopping because a tooth has been removed. It has the numb surprisingness of something that hurt not being there any more. You explore the space where it was, and you feel slightly changed, slightly self-alienated. Something has been reconfigured a bit. There’s some unfamiliarity close in. You’re glad, of course, that it doesn’t hurt, but you can find that you almost miss the familiar signal of your own distress, especially since the memory of how much it hurt fades fast, and it’s difficult to go on rejoicing positively over an absence. You may find, in fact, that you feel a sly temptation to restore the status quo ante, by going out and doing again the thing you needed forgiving for, whatever it was. After all, you’ve just discovered it was survivable, that there was a route out of desperation and self-reproach; and this way you won’t have to deal with the unsettling open-endedness of being changed.”

It’s hard to wait and stay in the tremulous uncertain state grace puts us in, not knowing what its changes may mean, not knowing where they may take us. Forgiveness has no price we need to pay, but it exposes our illusions of control. Forgiveness is not flattering. Forgiveness reminds us that our masks are masks. Forgiveness starts something, if we let it. Forgiveness comes with an invitation to find out what else we may become that we hadn’t suspected. Forgiveness carries you into new territory. Forgiveness is disconcerting.”

Go on, I dare you. Tell me I’m trying to make something out of – well, something very different. Tell me I’m trying to  draw a parallel where none exists – where the concepts are non-intersecting and where, therefore, ironically enough, ‘parallel’ would be a mathematically apt description of them. All I know is that this is exactly how it feels when I am running scared because of the progress I seem to be making in therapy. I feel slightly changed and slightly self-alienated. I miss the familiar signal of my own distress; the possibility of creating a rupture in therapy in order to experience the familiar and reassuring intensity of the ‘repair’, is very tempting; and unsettling is an understatement for how it feels to know that more therapy means more of the same – an open-ended capacity for change.

As for the second extract – if you’ve been in therapy for some time, I challenge you to replace the word ‘forgiveness’ with ‘therapy’, and tell me that this doesn’t accord with your own experience of the process. Therapy is not flattering. Therapy reminds us that our masks are masks. Therapy starts something, if we let it. Therapy comes with an invitation to find out what else we may become that we hadn’t suspected. Therapy carries you into new territory. Therapy is disconcerting.

Therapy has no price we need to pay….okay, so you got me there. It’s costing me a fortune, though it isn’t buying me anything (because understanding and acceptance cannot be bought), as much as it affords me an opportunity – an opportunity which is priceless.

But hey, no parallel is perfect, right?

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The Sticking Place

Sometimes I read a blog post which happens to be on a topic that has also been on my mind, and it provokes new trains of thought and inspires me to write my own take on the subject. And sometimes I read a blog post which happens to be on a topic that has also been on my mind and there are no words – because it says it all.

As I prepared to return to therapy after the six-week summer break, I had that same niggling sensation that comes towards the end of every break, that I know I will always ignore – the desire to never return. The thought of ending therapy and losing my therapist is incredibly distressing to me – and yet the thought of what it takes to go back, is enough to keep that niggling feeling alive.

What does it take? A willingness to immerse myself further in that trust, that caring, that security, in the face of the certain knowledge that it will end (at least, with her); the energy to go into an hour-long heart-and-mind work-out that I know could leave me utterly wiped-out, drained, and simultaneously emotionally full and empty, for days to come; an acceptance of the fact that this is a unique relationship in which my therapist is alongside me in extraordinary experiences of distress, but without the ordinary means of human touch as a comfort in that distress.

What does it take? More than anything, courage, which comes in all of the forms above, and more. Please read this wonderful post by a therapist who can witness to that courage both from within, and as an observer – but always as a partaker. This sort of courage is a joint endeavour; and that, more than anything, is what enables me to keep going back, over and over, again and again.

what a shrink thinks

Macbeth
 If we should fail?

Lady Macbeth:
  We fail? 
But screw your courage to the sticking place,
 And we’ll not fail.

Macbeth, Act 1, scene 7, 59-61

Committing psychotherapeutic acts takes extraordinary courage.

Facing down anxieties, digging down underneath painful symptoms, revealing vulnerabilities, casting out demons, seeking salvation, asking forgiveness, challenging abuse, severing damaging relationships, examining your failures, flaws, weaknesses, revealing your shames, contending with guilt, grieving, preparing to die, coming out, fighting for intimacy, encountering emptiness, apprehending your own murderousness, and the depths of your hungers and desires, setting limits and boundaries, saying “no”, tolerating exposure, baring your soul, withstanding the pain, changing your life, telling the truth…

Telling the truth.

Holy shit.

These are terrifying acts.

I can think of no psychotherapeutic action that does not require courage.

I cannot think of a single split second of the 30 years I have spent engaged…

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Therapy Tales No. Etc- Death and Trauma. Fun.

This wonderful post captures thoughts and feelings I have always had – am having right now – but have not yet articulated. Over the last two years I have been doing incredibly important work in therapy, but I’ve always wondered when I would be able to start talking about death, and about time, and about the fact that the latter is always running out, and running towards the former. Though I have spoken about some incredibly difficult and painful topics in therapy, I have always been conscious of those topics I have been trying to keep at bay. And yet, the amazing thing about therapy is that, eventually, you come at those topics obliquely. They may be too hard to face talking about, but eventually, the process of therapy, and the therapeutic relationship itself, bring them to the forefront of your mind – one way or another.

So many of the sentences in this post resonate with me, and stick in my mind: “Losses, fears, love – that’s basically it”. Yes, that’s basically it for what I’m experiencing in therapy right now. And somehow the loss of a cancelled session turns into the loss of therapy (eventually), which turns into the loss of my therapist (eventually, through death), and suddenly every loss going back decades is present in the imagined but real grief of those future losses.

“Memory is important to me. Memory is evasive to me”. I have so few concrete memories of my past; I find it so hard to remember. But because I’m petrified of death and of ‘time running out’, I am consumed by making the most of my time, and the way that I know I have done that, is by ‘making memories’. I find the first few days of any holiday incredibly stressful and put a huge amount of pressure on myself to ‘do stuff’. Once I have ‘made some memories’ I calm down a little. But it is for me, as the author of this post has written: “….he thinks ‘experiences’, I think ‘memories’. Already living in the past tense”. And when I think of the future, it’s about how the future will become the past, and must be ‘captured’ and ‘stored’ – forgetting about the fact that the most important thing is for it to be experienced.

But when memory is so important to you, it is so painful when it is also evasive. Because it becomes another form of loss – loss of memory, of the very thing that links you to the object or person you lost in the first place. My therapist often talks about the importance of memories, particularly when I am very distressed about the fact that our therapy will end at some point, and I will lose her. She talks about how I will have internalised her, and will have our memories to hold onto. “Memory is all we have, really”. But what if I cannot remember? What if all those memories of her, become evasive too?

I love the phrase: “…[we’ve] pulled a thread, and I want the jumper back”. I have wanted certain things to stay covered up. I have wanted not to tackle the things that may unravel me. But a few months ago I started pulling that thread, and more and more, death and loss keep staring out at me through the growing holes in the jumper. I can’t evade them anymore; but perhaps I will discover some memories that I thought I’d lost – and create some new ones in the process.

The Secret Life of a Manic Depressive

Therapy is ending soon.

Losses, fears, love- that’s basically it. Losses of things I loved- including animals (I know pets die, but mine in sudden, cruel ways I can’t go into here but which haunt me) and people. They all died lonely, premature, unfair, painful deaths. As soon as I really understood what death really was (which happened when I had another loss- my friend who killed herself when I was 15), I have been completely heartbroken ever since. Of what life is. Of feeling. Of finality. Of memory. I can’t bear it, any of it. That’s when the fear really started. I’d always been afraid of my parents’ death, i obsessed over it. But that was my first big loss, of someone I’d seen so recently, so young, so similar to me. We were all steeped in bullshit pop music mythology, playing with self harm. But she died. Alone…

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Sometimes, this is what therapy feels like, after

under the coversI come through the door, therapy-wiped-out, and head for the bathroom. Afterwards, I manage to pull my tights up only half way, and proceed to climb the stairs with them still around my knees. I fall into bed and pull the covers right over me, where it is dark and warm. I remember shivering with sobs, not cold, earlier. But now I am cold.

I just want to be hugged tightly, so tightly. I wish I had carried on crying when I was with you, because now I want to cry, but I can’t. When I was with you I felt I should be talking, not crying the time away. And yet I wasn’t finished with the crying, and now it feels too late, and what if it stays unfinished? When I was with you, I felt I had to stop. It was a hard, un-pretty sort of crying, and I didn’t want you to see. My jacket was too small to cover me and there was nowhere to hide and so I stopped the thoughts that were causing the pain that was causing the tears.

Under the covers, the sound is like the soft hissing of a shell held up to your ear. Every part of me feels alone – from the end of my toes to the tear suspended on the edge of my eyelashes. It is as if my body is covered by ‘loss buttons’ and every one has been pressed. And now, to stop the sense that I am dissolving, I try to stay very still. I feel the indentation that I make against the mattress, and it feels almost impossible to move. I may not be leaking tears, but it feels as though something is leaving me, seeping out slowly into the dark. If I curl up tight, and stay very still, perhaps I will stay contained. Perhaps that sense of alone-ness will not spread – but where is there for it to go? We are full of emptiness already, the house and I.

Now that I’m still, that convulsing feeling in my stomach has stopped. It’s where I feel emotional pain. I bend and fold, but with a force that comes from within and twists and pulls at my insides. I don’t mind – it lets me know that my pain is real and undeniable – even by me. Especially by me. Sometimes I wonder how much you notice other things apart from words – the contorted shapes of our faces when we cry; of our bodies when we hurt.

Once, I make it out from under the covers and sit on the edge of the bed, and take those half-way-up tights, down, and off. But then I go right back under the duvet, even further, holding on  – to myself – even tighter. It reminds me of playing under the covers when I was twelve or thirteen and everyone thought I was asleep. I created and inhabited stories: I was a mermaid under the sea; I was hiding in a cave; I was a baby being born.

What did I imagine that was like? I wish I could remember. I don’t suppose I thought it hurt, like this hurts. But being born must be a type of loss as well. You probably think it will always feel like this – surrounded, warm, held in her presence – until the cold light of day intrudes; and the separation of physical distance.

When I think about seeing you, you have no idea how much I often long to just sit on the floor next to your chair. To close the three foot gap by two foot. To close my eyes and to be able to feel your presence in the silence. My eyes are closed but my own presence in this silence is too singular and although I want to stay still forever there is an impetus inside that pushes me to move. MOVE.

And so I move. I pull the covers back, and put my tights back on. My sixty minutes in bed are up; and now, so am I. I hug my ‘therapy jacket’* – and I get to work.

 

 

[My ‘therapy jacket’ is one that I bought during the Easter therapy break, on the day of the first ‘missed session’. It’s soft and warm and it became an immediate transitional object to help me get through the break. It has continued that function since then, and it lives on my bed when I am not wearing it. During a particular period when therapy was very tough, it stayed under the covers with me, where I could embrace it. When I came back from holiday during the summer, one of the first things I did was hold it tightly. The thought of ever losing it makes me feel panic.]


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Home

I wrote this while out of the country on holiday, during my summer therapy break. I felt my therapist’s absence even more keenly due to the physical distance, and these words just came into my mind one day, as I thought of her. The concept of a house or a home as a metaphor for therapy arose quite early in my time with her, and it is a metaphor that has often appeared within my dream imagery as well. In so much as the words came unbidden, I think of them as a sort of ‘free-association-by-poetry’ whose meaning, particularly in the second verse, is still to be explored – any interpretations are welcome!

my therapist is my home 2


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My ally against self-harm

*TRIGGER WARNING: SELF-HARM*

Five minutes before the end of my last therapy session before the summer break, I asked my therapist if she would be disappointed in me if I self-harmed that evening. I think I took her by surprise – I hadn’t mentioned self-harm for quite some time. She didn’t say ‘no’ – but then, she rarely gives a direct answer to my requests for reassurance! Instead, she encouraged me to think about why I wanted to self-harm, and why I wanted to punish myself. She said that I had other coping mechanisms – for example, I had talked about communicating more with friends, and about learning to play a particular piece on the piano. She would never tell me not to self-harm, and in the past our conversations about it have focused on trying to understand why I do it and what it means. So I think this was the first time she had actually gone as far as to try and encourage me to resist. It was a risky strategy – I’m incredibly sensitive to control and she couldn’t be sure I wouldn’t react against it.

But the strategy (if it was one – she hardly had time to think!) paid off. I saw her encouragement as caring – it felt good that she trusted me and our relationship enough, to tell me something that might be hard to hear and that I could so easily misinterpret. It felt good that she thought I might have come far enough to be able to consider the possibility of resisting the impulse to self-harm, without simply feeling panic at the thought of a vital coping strategy being taken away. Not that it was physically being removed as an option; but I would find it very difficult to do anything that I knew would disappoint her.

As well as encouraging me to think about why I wanted to hurt myself, and pointing out I could use other strategies to deal with my intense feelings, she did acknowledge that I may, despite those things, feel that I needed to do it. But she didn’t ‘let me off the hook’ of having to really think about it if I were tempted, by simply telling me she wouldn’t be disappointed. And perhaps she knows that in many ways, she has already done all that she needs to do, to reassure me in that regard.

Strangely, though I sometimes doubt her acceptance in other ways, I am confident that she does not judge my self-harming. I cannot doubt it, after I asked her many months ago if I could show her some recent cuts, and she said that I could. I was shocked, and completely unprepared for the fact that she might say yes. It was an incredibly important, personal, and emotionally intimate moment. I had shown her something no one else had seen, and however she might have felt about it, she was prepared to see what I had to show her and to share that with me. For me, it was a very bonding experience, and it spoke of her acceptance. I am sure she feels it would be better if I did not hurt myself in that way – but I have never felt any pressure from her to stop, and her comment at the start of the therapy break, did not change that.

I emailed her during the break to let her know that I was happy she had responded in the way that she did. I said that I had felt that she trusted me and that she’d taken a risk in encouraging me to refrain, when I might have reacted negatively. She turned my email on its head, and said that I had taken a big risk in asking her to support the part of me that wanted to stop. And until she wrote that, I hadn’t realised that it was true.

I think that ultimately, the only way to deal effectively with self-harm is to deal with the underlying issues that give rise to the urge to harm, and at the same time to learn to try and sit with those feelings until their intensity diminishes. But the very very first step, I think, is that some part of you must want to stop. I’m not sure how that happens – for me, there was a realisation at the start of the Easter therapy break, that part of me wanted to stop for her (my therapist). Although lasting change would need to be based on internal motivating factors, I’m not convinced there is any harm in taking motivation, initially, where one finds it! And then waiting for that motivation to shift, and for it to become something that you want for yourself, and not ‘only’ for another.

I had wanted to discuss these feelings with my therapist a few months ago, but somehow never got round to it, and they faded. And so when I asked her in late July, if she would be disappointed in me if I self-harmed, those feelings were the furthest things from my (conscious) mind, and I genuinely believed I was asking for reassurance and ‘permission’ to self-harm. But her interpretation was exactly right. Part of me did want to stop – and unlike a few months ago, I think it may even have been more for my sake than hers. I was asking for her support – even if I hadn’t realised it. But I’m so grateful that she did; and that she provided it.

Did I let her down? Yes and no. ‘No’ because she accepts me and that acceptance doesn’t depend on whether or not I turn my pain in upon myself, or express it in a less self-destructive way. And ‘no’ because this is not a question of ‘balancing’ the harming acts against the non-harming acts, and nothing can negate the fact that for the vast majority of the therapy break, the way in which I approached the desire to self-harm was different to how I have approached it in the past. In the last couple of months I have played the piano more than I have in the last few years. As well as giving me an insight into how significant it must have been in helping me to deal with my emotions and circumstances when I was growing up (even though I didn’t realise it at the time); it also gave me an immediate and concrete way of both seeking and expressing connection with my therapist, while also putting a distance of time between my desire to self-harm, and the possibility of acting on that desire.

But eventually I did self-harm, a few days before the end of the therapy break. And so although I know that she is not disappointed, it’s still difficult to completely eradicate the sense that I let my therapist (and myself) down. The incident was not directly connected to her – it was related to an argument I had had with my husband. However, it may be that my feelings of being alone (and possibly of being abandoned) during the last few days of the break, contributed to the fact that I did not even try and resist. I realised afterwards that it had felt as though there was absolutely no part of me left that wanted to stop, or refrain. And that was what was different at the start of September, compared to the start of August.

Earlier in the summer, a few mental health charities put out through social media a number of strategies or alternatives for dealing with the desire to self-harm (for example, holding an ice cube, ‘pinging’ an elastic band against the skin). For me, there has been no better strategy for trying to resist self-harm, than postponement, although I can appreciate that this won’t necessarily work for those whose self-harm is very ‘immediate’ and ‘of the moment’. For me, it’s often the case that I cannot self-harm when the feelings are most intense (for example, because my children or my husband are around), and the passage of time, even sometimes of short duration, allows the intensity of the feelings to subside a little, and with it, the intensity of the desire to harm. Although I know they work for many people, the difficulty I have with a number of suggested strategies is that they are essentially seen as ‘alternatives’ – and yet self-harm is such a very complex thing, that it feels very difficult to simply try and substitute something else in its place. Whereas ‘postponement’ does not try and replace it or forbid it – it very much leaves the option open, but it simply says ‘later, in a little while, in a few minutes – you can do it later’. And that, particularly in the absence of other motivating factors, has often been my biggest ally.

But what this therapy break has taught me is this: with my therapist’s support, I have an even more powerful ally in my struggle against self-harm; and that ally is, quite literally, a part of me.


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World Suicide Prevention Day – 10 September

World Suicide Prevention Day is observed on 10 September every year. It promotes awareness, commitment and action towards preventing suicide, with events and activities being held around the world. Suicide is still a taboo subject, though more people die through completing suicide than through murder or war – more than one million every year worldwide, with twenty times that number attempting suicide. Over the last few months I have written about the importance of talking more openly about suicide, and the factors that might prevent us from doing so.

But for this World Suicide Prevention Day I wanted to re-post I poem I wrote just as I started to come out of a three week period of feeling suicidal in August 2014. What prompted the poem, and the start of that emergence from suicidal feelings, was the incredibly supportive response to a post I wrote describing my depression and desire to escape from life. That support helped me to turn a corner; and as I drove past a beautifully lit medieval castle at night, which only days before had triggered mental images of falling from its crumbling walls into the shadows below – words of strength started to flow through my mind instead. I hope this poem can be an encouragement to anyone who is struggling with suicidal thoughts now, on 10 September itself, or in the days afterwards. An image of death and despair can become an image of strength and survival, and sometimes all it takes are a few words from some one or some others who can see that you have a place in the world – however impossible that might feel to believe right now.

The poem is called ‘If the shadow falls’.

when shadows fall final