Life in a Bind – BPD and me

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


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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

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What holds us back from talking to someone who is suicidal

The ‘National Attitudes to Mental Illness’ survey, carried out annually since 2003,  has shown a very encouraging shift in the attitudes of people in the UK towards those with mental illness. According to the mental health charity Mind, since the launch of the current Time to Change campaign in 2011, an estimated two million people (almost five per cent of the population) have improved in their perceptions of mental illness. More people than ever before are admitting to knowing someone with a mental health problem (more than 6o% of those surveyed in 2013) – and yet, almost half of respondents still say they would feel uncomfortable talking to an employer about their mental health difficulties.

The evidence of a general increase in tolerance is persuasive, and the worries individuals still have about trusting in that tolerance when it comes to their employer (a worry that I have to say I share),  may  over time start to lessen as more and more employers are putting time, money and often a great deal of passion, into promoting positive attitudes to mental health within their organisations. Employers are running raising awareness campaigns; they are training up staff members in mental health first aid; they are holding charity events to raise money; well-being and mindfulness events to reduce stress. It’s happening in the workplaces of my friends up and down the country, and my own workplace is no exception. There is definitely more talk about mental health in the corridors and in the tea room, than I have ever heard before.

It’s not just a welcome change – it’s an intriguing one. People are voicing what they actually think, what their own fears and reservations are around talking about mental health; and it demonstrates just why these campaigns are needed. When it comes to talking about suicide, there is a particular nervousness, and there are two completely contradictory views that I have often heard spoken – occasionally by the same people. It’s not necessarily that individuals are afraid that by talking about suicide they will almost ‘encourage‘ it or make it more likely to happen – most campaigns that I know of (for example, the excellent STOP Suicide campaign, which I have written about previously), tackle that particular myth head-on and make it clear that this is NOT the case. My feeling is (though I have no evidence to back this up) that this is also more of an ‘organisational concern’ (which includes a subconscious paranoia that suicidal thoughts might somehow be ‘catching’), than one which operates at an individual level. The two contradictory views that I am thinking of, can be summed up as “my words will have no impact and so I am not responsible/don’t need to do anything“; and “my words could have a huge impact, and if something happens I will be responsible“.

I have heard colleagues say that they would worry about talking to someone who was feeling suicidal, in case they ‘said the wrong thing’, or ‘made matters worse’. Though it is mostly unspoken, it is clear that there is an underlying fear here. “What if this person, who I am trying to help, does actually attempt or complete suicide? What if I said something which  made them feel worse; or what if I didn’t think of saying ‘the right thing’ that would have helped? Am I responsible?

NO. Assuming you are a genuine and caring person and that you have not been subjecting your colleague to harassment, bullying, or other words or behaviour which could potentially make you culpable in some way – you are not responsible for their subsequent actions and you are not responsible for saving them. If they have come to you in need and confided in you, you may well have a moral duty to try – but that is far as it goes. It would be entirely natural, I think, to feel guilty in such a situation -but that doesn’t mean that there would actually be something that you are guilty of. And I’m not going to lie to you and say that it will never happen. It is possible that, despite your best efforts, someone that you try and help, may complete suicide. They may even do it within a few hours or days of talking to you. But it is NOT your fault. Remember this – your conversation with them was part of a large and complex history of events and conversations, in all likelihood stretching way back in time, possibly before you ever met that person. The interaction of all those words and circumstances; the way in which they became linked with and interpreted in the light of the past, and through the lens of depression or another mental health condition – none of that is within your control. Will this situation happen to you if you start talking to people about their suicidal feelings? It is unlikely – and here’s why.

The vast majority of people are helped by talking about their suicidal feelings. And saying absolutely nothing, or walking away from someone who is clearly in distress, is likely to be much more upsetting than saying something which is ‘not quite the right thing’. And you really don’t have to say very much at all. Helping someone who is feeling suicidal is about letting them know that you’re there for them, that you see them and their distress, that you accept them and what they may want to tell you – and that you’re listening. Listening, and just being present. Your presence, and a small number of caring words, is all that is required. Everyone is different – you don’t know exactly how this person in front of you, got to this point in their lives. You couldn’t possibly know what the ‘exact right thing’ to say in this situation would be – they probably don’t know either. But it doesn’t matter. Emotional isolation is a killer – literally – and by interacting honestly and compassionately with someone who is feeling suicidal, you are doing the right thing in that situation. And yes, it’s okay – more than okay – to ask them if they have a suicide plan, and if they have the means to carry it out. Trust me, they are likely to see it as evidence that you care, and that you are not judging them, and that in itself, is a HUGE deal to someone who may feel invisible and worthless.

Which is why, your words are both less powerful than you fear, and more powerful than you hope. If you are concerned that the impact of saying ‘a negative thing’ would be so significant, why would you be unwilling to believe that the impact of saying ‘a positive thing’ could be significant? Acting on the belief that ‘whatever I say or do won’t make a difference because if someone really wants to complete suicide, they will’, is doubly flawed. Flawed because it significantly underestimates the power of a few caring words in such a situation, and flawed because fundamentally, you have no way of knowing whether any particular individual ‘really wants to complete suicide’. The individual themselves may be ambivalent about it – they may have an intense desire to die combined with an intense fear of death. They may be absolutely sure they want to leave this world – until hope, or at least doubt, enters in. And you can provide that. And it’s very, very simple for me to prove that to you.

Look at the story of Jonny Benjamin and his ‘Find Mike’ campaign, which tracked down the person who talked him down from the edge of a bridge in 2008. Look at the story, which has gone viral, of a young man who saved someone’s life by asking them if they were okay. Three words  – but packed with meaning. I see you; I care about what happens to you; talk to me, I’m listening; I’m here. A hundred words in three – with COMPASSION tying them all together. Compassion – from the Latin word meaning ‘to suffer with‘. To be really present with someone in their suffering.

I have said that you may never know what brought someone to the point in their lives at which all they want is to die. I have said that that journey may have been long, complicated, and multi-faceted. But here’s the beauty of compassion, and of ‘suffering with‘. It’s about the here and now, not about what has gone before. It stands out because it is different from the rest of the landscape in which that person is currently standing. It’s not that what has gone before is not important – it’s that ‘suffering with‘  shows that what has gone before is not all that there is. It’s that it enables the person to answer the question ‘Are you okay?’ with ‘No, no I’m not okay. And I’m so glad that you see’.

As for ‘no, I’m not okay – but will I be’? Well, that is for another day, a day beyond the brink. Because that is another way in which ‘suffering with‘ is powerful- it leads to hope. And hope is about knowing that what has gone before is not all that there will ever be.

So if you have been tempted to think, as some of my colleagues do, that when speaking to someone who is feeling suicidal your words may either too powerful or too weak – I would say that in the moment, they can powerful enough. Speak them with boldness, but most of all with compassion. Be present, suffer with.

 

[If you would like more information on how to talk to someone who is feeling suicidal, please do look up the resources on websites such STOP Suicide, Grassroots Suicide Prevention, and the Samaritans.]


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It feels like only blood

*TRIGGER WARNING – SELF HARM*

[Note: the picture on which the poem is superimposed is of red paint. The image was obtained from Morguefile at http://www.morguefile.com/archive/display/910529 . Although the image is meant to represent the subject matter of the poem, it is intended neither to offend nor to ‘promote’ self-harm.]

I wrote this poem a few months ago, possibly during a therapy break, although I cannot remember the exact circumstances. I remember thinking it was unfinished – but then when I came back to it a few weeks ago, it felt as though it was complete as it was. Trying to ‘tidy it up’ or add a more ‘positive’ ending felt like a denial, an attempt to ‘tidy up’ something that is anything but tidy. This is how it feels to me, when I want to self-harm – not the sum-total of how it feels; and not how it feels every single time. But it captures some key elements of most of my urges to hurt myself. I wrote it ‘in the moment’ – it’s un-tampered-with emotion.

And so I think it’s important to present it as it is.

It feels like only blood FINAL

 


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Why taking a pledge to talk about suicide, can be so powerful

Last Sunday I broke down in front of two people at church, and told them that I was desperate to die and that I had been on the verge of walking out and going to the spot where, when I had been feeling suicidal before, I had planned to take my own life. They weren’t horrified, or at a loss for words. They took me seriously, but they didn’t panic. They held me, and talked to me, and though the pain was still intense the sobbing died down, and some sort of connection had been made.

Less than a month ago, I signed the STOP Suicide pledge. The pledge is part of a wider suicide-prevention campaign working towards reducing the stigma of talking openly about suicide. It is one of a small number of similar projects across the UK (for example, Grassroots) which, inspired by a very successful suicide-prevention project in Detroit, are trying to reduce the more than 6,000 completed suicides (and many more attempts) that take place every year in the UK and the Republic of Ireland. Both STOP Suicide and Grassroots have been launched in particular areas/counties in the UK, but their pledges can be taken by anyone, anywhere.

When a friend of mine first drew my attention to the STOP Suicide pledge, I wasn’t prepared to sign it. I thought the campaign was incredibly important and I had no problem with points two to five of the pledge – reaching out to those who are struggling, listening without judgement, and helping them to get support. But I couldn’t hand-on-heart commit to point one – “tell you if I’m struggling and need help”. I was worried that talking about suicide would be too much of a burden for others; that they wouldn’t know what to say or would feel uncomfortable. That it was unfair of me to put them in a position where they would worry about me and might feel responsible for ‘saving me’. It didn’t occur to me that it might be unfair not to give them the opportunity to try.

I’m not sure exactly how or why I changed my mind about signing the pledge. I think it was part of the very gradual process, encouraged by therapy, of opening up a little about my mental health difficulties. But even just a few weeks ago, I could never have imagined talking in that way to anyone about wanting to kill myself. I am sure that even unconsciously, the pledge was a key part of that change, and I’ve been thinking during the last week about why pledging can be so powerful.

It seems to me, that the STOP Suicide pledge is a lot like the promises I made in marriage. When I got married I became part of something bigger – not just because I was part of a unit of two rather than a unit of one, but also because that unit was publicly recognised. Taking the pledge made me feel part of something bigger than myself – part of a community of hundreds of others who had also promised to reach out and to support. My suicidal thoughts tend to be accompanied by a severe case of tunnel vision, where the only thing I can focus on is my pain. Being aware of a ‘wider picture’ is extremely difficult, but the pledge is a reminder that though it may feel like it, my pain is not the only thing that exists. Possibility and hope are out there too.

Within my marriage, I am also accountable – I am a separate person, but there is someone else to consider in the decisions that I make. Taking the pledge somehow helped me to feel accountable – to the campaign, to those other individuals who have also taken the pledge, and to the people in my own life. Not in a way that felt burdensome or restrictive, but in a gentle way that reminded me that I’m connected, and although I may feel like an island, my actions have ripples and repercussions.

Taking the pledge was a bit like taking on board an anchor that you can throw overboard when you find yourself in a storm. Talking to others did not mean I was yet in safe harbour – it still felt as though I was being buffeted by desperation – but I felt a little safer. The suicidal thoughts were still scary, but I felt a bit more in control; less likely to be swept away by them. Like being in a relationship, I had something to cling to, something to help tie me to firmer ground.

And, as it has become increasingly clear since last weekend, taking the pledge is not just about a single decision, made once, and it’s not just about speaking up or supporting someone in crisis. It’s a promise that requires daily renewal, just as staying married requires a continual commitment to choose to love someone, however easy or difficult that may be. I noticed after the immediate ‘crisis’ had passed, that even though I still felt as though I wanted to die, I felt less willing to continue to reach out. Even though the two people I talked to had given me their phone numbers, I didn’t want to ‘bother them’ any further. But taking the pledge means I need to acknowledge that it’s not just about keeping me (or others) alive, but keeping me well. It’s not just about stopping suicide, it’s about support in a struggle and about starting a discussion – and then keeping that discussion going.

Suicide prevention and reducing stigma should be a national campaign – the various projects around the UK are doing fantastic work but this message needs to be taken up more widely. The more people who become involved, and the more that the impact of these campaigns can be demonstrated, the more likely it is not only that they will continue to be funded, but that other similar projects will also get off the ground.

Taking the STOP Suicide pledge means making a promise, a promise to yourself and to others; and we tend to like keeping our promises. For me, promises matter – even when I feel I don’t. Wherever you are, may I encourage you to think about taking the pledge. It may be the most important promise you ever keep.

 

 

 


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Memory Monday – “Escape” and “If the shadow falls”

This week’s Memory Monday is a ‘double bill’, with the first post feeling very apt right now:

https://lifeinabind.com/2014/08/30/escape/

The second post is a poem that I wrote shortly after ‘Escape’, as I was starting to come out of that period of severe depression and suicidal ideation:

https://lifeinabind.com/2014/09/02/if-the-shadow-falls/

This therapy break feels as though it’s hitting me harder than previous breaks, particularly given the length of time it’s been going on (only eleven days so far). I mentioned to my therapist when I last saw her, that it felt as though the separations were getting more, not less difficult, and we agreed it was because I was so much more settled and attached to our therapy. Things are bound to get worse, when it comes to breaks, before they get better.

I don’t know how much of my present depression is due to the therapy break, and how much might have happened anyway. I’ve been away for a period, on holiday, and although work was very stressful before I left, the break from my usual routine does tend to have a negative impact upon me.

Whatever the reason, I’m so very very tired. Physically tired, and mentally exhausted. I’m so tired of the constant battle going on in my head, between the part of me that has some interest in survival and in getting better, and the part that has no hope at all for the future, and doesn’t want to carry on. The latter part uses apparent logic, not just emotion; it plays on my frustration at the boundaries of therapy and it focuses me on the things I will never have; and when it comes to life outside therapy, it brings to mind all the invalidating and hurtful things that have been said to me and focuses me on the pain that being around other people, brings me. I have to keep trying to keep a lid on that part just to function and get through the day; and so that when, in a week’s time, I’m back in therapy, I’m more than a morass of tears, bitterness, frustration and anger, for someone who doesn’t deserve them.

 


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What’s in a name?

*TRIGGER WARNING – SELF-HARM*

I am in the grip of something that I don’t understand. It’s happened before, and it’s always disquieting, as unlike many of the symptoms or feelings I experience, this is one for which I don’t have a name. For a while I wondered whether it was a type of dissociation, but I thought dissociation was meant to protect you from painful emotions, and this is one of the worst feelings that I know.

There is something within me to which I don’t have access, and the frustration that this inaccessibility engenders, builds and puts increasing pressure on my insides. Sometimes the frustration builds and builds until the force of it is so strong I feel as though I need to explode outwards but I can’t. Sometimes I am dimly aware of it  – it builds for a day or two and then dies down, without any explanation, either for its arrival, or its departure. There is the feeling and the meta-feeling- the ‘inaccessible’ emotion, and the unbearable frustration.

My school friend who also has BPD was telling me that she feels bereft because she is struggling so much and yet is completely unable to put her feelings into words. I feel very grateful that for me, writing is not daunting, but a delight, and that it is one of the very few ways in which I am able to communicate emotion. But although I had to admit that I could not directly empathise with her ‘writers’ block, I do know how it feels to be ‘emotionally blocked’.

She struggles to capture feelings in words and to make them known to others; ‘inaccessibility’, for me, means struggling to capture emotions in feelings, and to make them felt to myself. And because I know that that sounds all but incomprehensible, I will try and explain it a little bit more.

This is what I wrote to my friend, when she told me about feeling bereft:

“I think I can understand the utter frustration of not being able to express something, though I don’t necessarily experience it in relation to words. Not being able to express something leaves you feeling deprived, because you can’t let ‘it’ out; and neither can you let someone else in to see ‘it’, because you cannot paint a picture for them. ‘It’ is inexpressible and incommunicable and that leaves you utterly isolated, with no bridge to another mind.”

That sense of being ‘cut off’, bereft, not being able to paint a picture of what is wrong, or to transfer the information to someone else where it can be understood and felt  – that is how I experience ‘inaccessibility’, but in relation to myself. That is how I experience ‘inaccessibility’ in relation to an emotion that I can sense but cannot feel; a disquiet that I can intuit, but that does not reveal itself to me.

‘Inaccessibility’ is always connected, for me, with a strong desire to self-harm. It is part of what grips me and intrudes upon my thoughts. It may be intended as an ‘antidote’ but it’s also part of the poison, as it feeds the meta-feeling with its own brand of frustration. My cutting has almost always been restricted to a small and easily concealed area of my body, in order to be able to keep it absolutely hidden. The need to be restrictive has always been frustrating, and occasionally that frustration spills over into minor cuts on more visible parts of my body.

In these times, the need within me is to start cutting and not to stop. The desire to be able to keep going, to fill up all of me with pain, and to blood-let out of every pore, is intense. The fact that I cannot do so  – that my life, as it is now, depends on not doing so – just adds fuel to the fire, and deepens the compulsion. In these times, the self-harming serves a double purpose. It tries to block and distract from the frustration by creating pain that is louder, more immediate. At the same time, it tries to make the ‘inaccessible’ present by removing the vacuum and giving me something concrete to feel.

I never know when the disquiet is going to arrive – and I never know how much it will build, or how long it is going to stay. I felt it when I visited that same school friend two years ago, and we spent an intense weekend closeted in her flat, sharing our experiences and talking about our relationship. By the end of the weekend, my internal state reflected the pressure-cooker environment we had immersed ourselves in, but I had no release valve and I felt as though I was bursting at the seams with anguish.

I felt it grow for about ten days last year, when I was having counselling sessions with my ex-therapist, Jane. It started off as pain that I could sense was there but could not feel or express, and it grew into something so unbearable that every day, I wanted to die. Our session over-ran a little one day, as I desperately clutched my arms around my body, folded over double in my chair, needing frantically to feel and cry but not being able to give birth to a single tear.

This time, my mind keeps coming back to a recent therapy session where I was describing thoughts and dreams I’d had, related to what it would have been like to be my therapist’s daughter. I can’t really describe why it felt like such a ‘special’ session. Particularly because other than ‘special’, I’m not sure it felt like anything much at all. I’ve been feeling ‘high’ following on from my recent Escape into suicidal ideation, but this seems to go hand in hand with a sense of not connecting with my emotions, and of being detached from them. But I keep wanting to come back to that ‘special’ session – to dwell in it. I want to talk about it all again, even though I’ve got nothing to new to say. Something powerful is drawing me, but it wants to stay unnamed and unfelt. And this ‘inaccessible’ something has flicked a switch inside my mind that keeps the same sentence playing on repeat: ‘I need to cut; I need to cut’.

I can’t pretend to understand it, though I do want to ‘name it’. I want to be able to look it up, to read about it, to have someone say ‘This, this, is what you are experiencing, and this is why it happens’. I want to know whether it is a fundamental part of my diagnosis, or something unrelated. I want to know whether others experience it too.

But would I really feel more in control of it, be better able to deal with it, if I knew what this ‘inaccessibility’, this ‘disconnect’ was called? Knowledge is power – I believe that. But at the same time, ‘a rose by any other name….’ – or perhaps by no name – would still be the same bloody set of thorns.