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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Twitter chat 6 March: Connecting in therapy – do touch and love have a place?

It’s been ten months since psychotherapist Alison Crosthwait and I held a Twitter chat on the subject of therapy breaks; we said then that we enjoyed it so much we would do another one, and finally, we’ve set a date, time and subject!

Our next chat will be called ‘Connecting in therapy – do touch and love have a place?‘  and it will take place on Monday 6 March at 9pm GMT/4pm EST. We will be using the hashtag #therapyconnection.

I believe these are difficult and contentious topics, for both therapists and clients, and I’m very much looking forward to discovering Alison’s take on them. From a personal perspective, they are subjects I have struggled with in my own therapy, and touch, in particular is a ‘live issue’ for me at the moment. But I won’t be bringing my therapy into the chat – the aim of these chats is that they are an ‘equal’ exchange of views, looking at a subject from different perspectives. They are about therapy, but they are not therapy, and both Alison and I are careful to avoid ‘falling into’ our respective roles of therapist and client, which, as I personally discovered during our last chat, is a real temptation!

We would love for you to join us in our chat, and let us know your thoughts, whether you are a therapist or a client. Please do just ‘turn up’, even if you feel more comfortable observing rather than joining in. If you’re interested in the chat but will not be around during that time, we will be publishing a ‘transcript’ using ‘Storify’, shortly after the chat.

We look forward to seeing you there!


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More reflections on googling my therapist

This is my ‘client’s perspective’ contribution on googling one’s therapist, for the therapy website welldoing.org which has already published a number of posts (by therapists) on this subject. Although I have written about this topic in the past, my therapist and I spent a session talking about it again last week. She asked me how I felt about my googling, and those reflections resulted in this article – I hope it is helpful!

https://welldoing.org/article/what-learned-googling-my-therapist

 


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I wrote this post – and it turned out to be a postscript

After I finished last week’s post, ‘A story about reassurance’, I realised that there was a second important lesson that the incident I wrote about, had taught me. In the story, I described a few sessions recently in which I was feeling vulnerable and childlike, distressed and alone, but was unable to fully verbalise that in session. My therapist spoke mainly to the more ‘adult’ part of me, and though at various points I wanted to ask her to stop or to tell her I was feeling overwhelmed, I was unable to. The sense of increasing hurt and isolation led to me starting to withdraw and to put up walls. However, unlike other occasions when I might have dwelt on how my therapist ‘should’ have acted differently, I ended up focusing much more on the fact that I wanted to stay present with her and vulnerable, rather than start building defenses.

This incident was a valuable lesson about reassurance, accepting ‘the other’, and realising that past defenses can be counter-productive and can hurt us, if they are no longer necessary. But it was also, I realised, a lesson about the person that I am in therapy. Or rather, the people that I am, in session.

For some time now, I have thought of myself as composed of a number of different internal characters, or ‘parts’ (not in the sense of the distinct identities of Dissociative Identity Disorder). But it was only after this incident that I realised that I tended to make the assumption that only one of those parts was properly present, or uppermost, at any one time. Now that I think about the assumption, it seems odd to me that I could ever have made it – after all I’m used to feeling conflicted about situations, or feeling like two different people at work, for example. But still, somewhere in there, I know I harboured some sort of idea that at any one moment, however short, I was communicating – or being communicated with – as one of my parts, and one only.

But what the incident above showed me, was that both my adult part and inner child were present at the same time, even though the only one I was conscious of was the child. Even though I felt my therapist was ‘talking to the wrong person’, the ‘wrong person’ was listening, and even absorbing what was being said (though to the child the experience felt overwhelming). I was operating in two modes – but only one was visible, and only one was felt. The reason I know that the adult was present and capable of taking something from the session, unlikely as it seemed, was that the tools that my therapist spoke about that day, I managed to put into practice over the next few days. Though I had desperately wanted my therapist to stop talking and change the focus, the adult part of me had found the session useful – she had received and then used what was discussed. Perhaps that is one of the reasons I found it so incredibly difficult to say anything about how I was feeling to my therapist – not just because the child part of me tends to find it very difficult to communicate anyway, but also because the adult part of me recognised the value of the session, and didn’t want to change direction.

A similar thing happened again, a few days later, but in reverse. I brought my ‘adult self’ to session, and though I had come in ‘with a plan’ of what I wanted to talk about, we found ourselves on a different track, and I decided to go with the flow. It was a useful, connected, interesting conversation, and I even remember thinking I was pleased with myself for being able to allow myself, without anxiety, to see where the session took me rather than being fixated on sticking to my plan. However, the moment I got into my car after session, it was as if my mind started to attack itself; or rather, a few of my ‘internal parts’ decided to go to town on the ‘adult me’, for ignoring what they wanted to talk about, particularly as they had already ‘held onto it’ for days over the weekend. ‘You f****r’ they accused me, in my head – needless to say, I didn’t stay feeling pleased with myself, for very long…..

Perhaps my biggest reaction, was surprise. I hadn’t realised, until I left, just how important it had been for me – for parts of me – to talk about the topics that were in my plan. I hadn’t even realised that there were other aspects of me present, waiting for their moment. I knew I had had a ‘mental eye’ on the time, thinking that I would ‘get to it eventually’, and that we still had time. Until we didn’t. But I didn’t really register, while I was congratulating myself on ignoring the plan, that there were parts of me that were still strongly invested in following it.

It was the first time that I had really thought about the fact that perhaps it was necessary to make space for multiple parts of me, during a session. That perhaps it was possible to take things in even when it felt impossible; and that perhaps it was wise to do an ‘internal scan’ even when things felt okay, to see if I was missing anything. I’m not sure I can say that I wish I’d changed focus, in either session – particularly as the sessions described in ‘A story about reassurance’ were so immensely valuable for the reasons highlighted in that post. But perhaps I would have made a little space – or asked my therapist to make space – for other parts of me at the same time. I don’t think that would have taken the focus off, and I don’t think it would have taken much time. Just an acknowledgement of presence, could be enough; or validation of the pain and confusion being felt. Perhaps it would even help to ask other parts of me to ‘bear with’ the conversation, because it was of value, even if not so obviously to them. Perhaps I need to make time to do that in words, in my own head, even if I am unable to ask my therapist to do it; though when I am feeling like a child in session, even an internal dialogue might be difficult to achieve.

I know that all of this must, on some level, must seem incredibly obvious. We are all a mixture of personas, we carry them with us every day, and we all sometimes feel conflicted. And if we are self-aware we recognise that there can be internal conflict, at a sub-conscious level, even if we don’t realise it. So why did the events and train of thought described in this post seem so surprising and important to me?

I think it is because often, when I have a ‘need’, particularly a ‘need’ in the midst of distress, it feels dominant and overwhelming. It feels self-evidently necessary and true, and it calls out to be met and to be answered. The idea that something positive could be going on, in parallel, that something could be being ‘taken in’  – while at the same time this need and this distress are going unanswered – would have been, in the past, unthinkable. It would have felt necessary for that need to be met before anything productive could happen, and before anything could change.

And so perhaps the reason that the realisation that I can be two people at once in session, feels so ‘radical’, is that it is fundamentally tied into my ‘Story about reassurance’. It is fundamentally tied to the idea that there is more than one way to meet a strongly felt need, and it may not be the way originally envisaged. Perhaps it feels so radical because, rather than being a second lesson that the story taught me, it is all part of the same lesson. The lesson that the child can never be the child it used to be. It is always, by necessity, also the adult – and vice versa – and their needs are not separate, but always linked. One cannot meet one set of needs, without impacting those of the other – sometimes positively, and sometimes not. The child often seeks instant gratification, whereas the adult knows that it is possible, and often desirable, simply to wait……

 

[As I thought of ending my post in this way, I went to look at ‘A story about reassurance’, and saw that under ‘Related posts’, WordPress had itself inserted as a relevant link, my post ‘Waiting revisited’ – precisely the one I had in mind as I wrote the last sentence above. I don’t believe in ‘signs’, but this was a pretty good one that I should leave the ending as it is!]


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A story about reassurance

I want to tell you a story.

It’s a story about a girl and a therapist.

The first time the girl met the therapist, she wasn’t sure. The therapist didn’t talk very much; and she also seemed to be more interested in individuals rather than their diagnoses. The girl was very wedded to her diagnosis, for it provided a sort of identity, something she felt she was missing. But the therapist was good with grief; and the girl felt a great deal of grief – she was drowning in it. And so the girl started seeing the therapist, though she still wasn’t sure, and for a long time she cried, and cried, and cried her way through sessions. And wished that her therapist was a different therapist – the one she’d had before. The one she was grieving the loss of.

The grieving continued, but there came a time when the girl turned a corner. A time when the girl turned towards the therapist, and started to listen. She realised that though she still felt grief, she also felt attachment. Attachment to the new, and not just to the old. But with attachment came a new kind of need, and a new kind of pain.

The girl was desperate to be cared for; desperate to be loved. She wanted reassurance, and she wanted it explicitly and clearly, in words. The therapist told her about the importance of waiting – but the girl didn’t really understand why it was important, or what she was waiting for. The therapist told her about the importance of being open to receiving care in the different forms it may arrive in; but to the girl, words seemed like the simplest, and easiest form, the thing she was most open to receiving. The therapist told her about the importance of the small, every day things; but to the girl, a single phrase – ‘I care about you’ – was the biggest thing, the need for which eclipsed everything else.

The girl refused to sit in her therapy chair and sat on the sofa instead, cross-legged, defiantly refusing to ‘play the game’, saying that she was thinking of leaving. The girl accused the therapist of being in some way personally deficient – incapable, because of something in her past, of telling her that she cared about her. It was inconceivable to the girl that anyone could refuse to give reassurance when it seemed so obvious that it was needed. The therapist talked about the fact that, ultimately, the aim of therapy was to enable the girl to find that reassurance within herself, because that was a more enduring and ever-present source of comfort.

The girl moved back to her therapy chair. The relationship grew; trust grew. The girl told her therapist that she loved her. And throughout that time, and the months and years afterwards, there were often times when her therapist reassured her; not always in the way the girl was expecting, and not often directly – but it was always a great comfort. Her therapist had a sense of the girl’s capacity to sit with distress, a better sense than the girl had herself. And sometimes her therapist saw that she needed to give, rather than hold back; that in that moment, giving was the better approach to healing.

But the girl found it hard to remember those times, when her need for reassurance and to feel cared for, overwhelmed her. And so the girl and her therapist went through cycles of rupture and repair, where the girl would pull back because she wanted her therapist to speak, to reassure, to reach out –  but her therapist didn’t meet her in the way that the girl wanted to be met. The girl was in anguish because her therapist felt cruel to her. The girl was angry because she thought that her therapist was ignoring the needs of the child part of her. Again, the girl couldn’t understand why the words ‘I care about you’ should be withheld, when they were so easy to say. But throughout this time, her therapist was caring for her in ways that were much harder and required more of her, than words.

Each time, her therapist explained that though the child part of the girl felt a strong need, it didn’t follow that that was what the girl as a whole ultimately needed. That the girl was an adult, as well as a child, and had capabilities and thought process that she didn’t have when growing up. Her therapist said that the child’s needs could now be met in other ways; that talking about the child’s feelings, and validating them, could be one such way. That the girl herself could, in time, help to meet those needs.

The battles continued. The cycles repeated themselves. Sometimes it was about the fact that the girl wanted her therapist to hug her. Sometimes it was about the fact that the girl wanted her therapist to reach out to her first, to say something to help her feel better, without needing to ask. And sometimes, because everyone, even therapists, are fallible, it was because the girl and her therapist kept missing each other. The therapist addressed the adult part of the girl, rather than the parts that were hurting; and the girl was unable to let her therapist know what was happening insider her. When these ruptures took place, it took several sessions to resolve them. And the girl found it very hard not to dwell on the things that she felt she was missing out on, rather than being open to receiving the things that her therapist tried to give her.

But therapy is a mysterious process, and over time, things began to change. Sometimes, battles go on for what seems like forever, and it feels as though things are moving backwards. And at other times, the pace of change can be so rapid that it feels like too much. One day there was a large, and frightening rupture – and so it was, that when the girl was stretched to the limits of her resources, her resourcefulness kicked in. The girl drew a picture, because she didn’t know what else to do. It was a picture of the different parts of her, including the child and the teenager, who were so often involved in the ruptures with her therapist. The girl began to find relationship within herself – among those different parts of her – and at the same time she gained a greater internal sense of her therapist, both in her presence and in her absence. The girl also gained a more enduring sense of her therapist’s benevolence, while at the same time beginning to see that she herself might have some ‘redeeming features’.

And then, sometime later, the girl felt terribly, terribly alone. She cried, and cried, and wanted desperately for her therapist to reach out to the part of her that felt vulnerable and young. She wanted reassurance, but for two sessions, the therapist and the girl missed each other again. The therapist spoke to the girl’s adult self, and the girl felt even more alone. The therapist said important things – things that the girl’s adult self managed to absorb, and use. But the distress and isolation were too much for the girl’s inner child, and she immediately started to put up walls, and to defend herself from further hurt. The girl felt cut-off, and didn’t contact her therapist that weekend, though she would usually send a message or two.

But for the first time – the very first time – the girl spent that weekend thinking about her reaction, rather than her therapist’s response. She saw that what she was enacting, sped-up a thousand fold, was her childhood progression from feeling invalidated and unseen, to shutting down her emotions and closing herself off. And she felt strongly that she did not want to react to her therapist in that way. She spent all weekend wondering what she could do if this happened again – and why would it not? –  and trying to figure out a way to stay open to her therapist, and to remain emotionally vulnerable.

She spoke to her therapist about it when they met. Her therapist apologised, and said that she hadn’t realised how strongly the child parts were present and suffering; and the girl appreciated what her therapist said. But the girl’s focus was still very much on her own reaction. The girl told her therapist that she wanted to stay vulnerable and connected to her, irrespective of what her therapist said and did. The girl told her therapist that she didn’t want her to change, she just wanted to change her own response. The girl said that she knew her therapist was safe, and caring – and that if there was anyone that she should be able to stay vulnerable with, and not build walls against, it was her. Otherwise, how would she ever learn to do so with anyone else? Her therapist nodded, and spoke about the fact that once upon a time, such defenses may have served an important purpose for the girl; but it was problematic when defenses were erected, when they were not needed.

Over the next few days the girl thought about what she’d said, and how she had felt, and it was almost as if someone else had been speaking, thinking, and feeling. It didn’t seem possible that she could mean what she had said, given how strongly, how certainly, in the past, she’d felt that her therapist should be responding differently to her. But she did mean it. She trusted her therapist, and her care, and she wanted her therapist’s free, genuine response, even if it didn’t always meet her needs in quite the way that she was hoping for.

It wasn’t that she didn’t feel she could or should ask for what she needed; on the contrary, she trusted more than ever that her therapist had her best interests at heart and cared deeply for her. It was that she seemed to accept, more fully than she had before, that the answer to her request may not take the form she was expecting. Sometimes her therapist met those needs in ways that required openness to different forms of receiving; and sometimes her therapist met them by encouraging the girl to rely on the version of her that the girl had internalised; the version that she would carry with her, after the process of therapy had ended. And the girl also accepted that if, as we all do, her therapist ‘got it wrong’ on occasion, that did not detract from her care; and the only thing the girl could control, in that situation, was her own response, and her own vulnerability. And she knew without a doubt, from those repeated cycles of rupture and repair, that vulnerability was far more effective at healing the relationship, than distancing, control, or accusations.

The girl felt good about this realisation. At the same time, the girl felt scared by the realisation of change. She knew she still had a great deal of work to do with her therapist, but every so often, it felt as though the relationship was gradually slipping through her fingers. Not its emotional reality, or its significance, but its physical reality – the existence of two people together, at the same points in time and space, slowly, being pulled through the infinitesimal moment of ‘now’. The number of times she would sit in that therapy chair, steadily diminishing.

But the story is not ended yet. It continues with its twists and turns, with its changes of pace, with its moments of closeness and laughter, and moments of not knowing what to say. There are more obstacles to encounter, and more lessons to be learned – but for now, an important one has been absorbed into the girl’s being, and the relationship between the girl and her therapist, and between the girl and herself, is the better for it.


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Book reviews – some of my favourite reads about therapy

As part of the WiseWords series on the therapy website welldoing.org, I wrote a post on some of my favourite books about therapy, which you can find here:

https://welldoing.org/article/wisewords-14-irvin-yalom-to-stephen-grosz

My only caveat with recommending books about therapy, is that I think it’s important to be mindful that they do not get in the way of one’s own therapeutic process. My own therapist rightly pointed out that I was reading about therapy because I was still looking for answers on to ‘how to do it right’ – a tendency which causes me difficulty in multiple areas of my life. The same tendency to seek for answers elsewhere was part of my reason for reading about others’ therapy experiences; in addition, sometimes I would find myself playing out my own issues in session through the framework or vehicle of someone else’s story, rather than the specifics of my own. And though my therapist was kind enough not to comment on this (!), reading accounts by other therapists also gave me some distinctly unhelpful bouts of ‘the grass is greener….’ . Whereas I’ve come to the conclusion that comparing one’s therapist to anyone else’s is rarely productive, and completely misses the point of trying to develop an accepting, trusting, and unique therapeutic relationship between two unique people. It misses the person sitting right in front of you, by wanting them to do or be something other than the person – or therapist – they are. Nevertheless, and bearing those caveats in mind, reading about therapy can be helpful and illuminating, particularly near the beginning of the process, I think. I hope you enjoy these suggestions, and it would be good to hear from others who may have read them!


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Therapists, clients, and the internet – a dilemma on both sides

Following on from an incredibly interesting and thought-provoking article in the Guardian Weekend today by Louise Chunn (founder of welldoing.org), entitled ‘Search me: should you google your therapist?’, I wanted to share links to two posts I wrote some time ago, on my experience and thoughts on this difficult subject:

https://lifeinabind.com/2015/04/26/have-you-googled-your-therapist/

https://lifeinabind.com/2015/10/04/staying-connected-to-my-therapist-and-trying-to-be-kind-to-myself/

I was honoured and pleased to be able to talk to Louise about this subject, and to be quoted in her article, and excited by the fact that this important topic is being raised openly for discussion. I’m sure it is a challenging area for therapists to grapple with, and it fascinates me to find out more about how different therapists deal with these questions. From the client’s perspective, the subject is one that is often laden with feelings of shame, confusion, and distress. I hope that the article helps clients to know that if they engage in some ‘internet sleuthing’ they are not alone, and it’s okay to talk about it. In fact it can be ‘therapeutic gold’ and incredibly beneficial to talk about it in session, and I would encourage any client to be up-front about their actions, desires, curiosities and feelings in this area. The very act of discussing a ‘googling episode’ can alleviate any negative feelings associated with it, as well as (in my experience) make it less likely to happen in future. I have found that the ‘googling’ decreases as trust and depth of therapeutic relationship increases – and talking about difficult subjects and feelings, such as these, is itself a key part of building relationship.  I hope you enjoy the article and the posts!