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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Starting Therapy – the Twitter chat

Earlier this evening, psychotherapist Alison Crosthwait (from The Good Therapists) and I, had an interesting Twitter chat on the subject of ‘Starting Therapy’, and the story of that chat can be found here:

https://storify.com/lifeinabind/starting-therapy

Inspiration for our chat came from Alison’s new book, of the same name, which can be found here:

I can thoroughly recommend it, and not just for those starting therapy, though it’s an ideal introduction in those circumstances. It is also thought-provoking and a valuable reminder of some key concepts, for any client at any stage of therapy. I had to chuckle when I read the section where Alison describes how significant statements or connections by the client can often be accompanied by words along the lines of ‘I’m rambling…..’. That same morning, towards the end of a very productive week’s work in therapy, I found myself repeatedly saying that I didn’t think I was making much sense….!

One of the most important things about the book, in my view, is its emphasis on the uniqueness of every therapeutic journey, and the fact that it is a journey created and experienced by two people in relationship. As such, the book very explicitly is not a guide on ‘how to do therapy’, but a dip into a number of concepts and ideas that it is helpful to be equipped with, in that individual journey. I have read fewer and fewer therapy books the longer I have been in therapy, precisely because I was finding it too easy to be diverted by others’ stories, and to make comparisons with my own therapy, rather than focusing in on my own story. However, there is no such risk with Alison’s book – she encourages you to put your focus firmly and squarely on your own life and your own therapeutic experience, and the subjects she writes about are eloquent and insightful prompts to do just that!

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Twitter chat 6 November – Starting Therapy

Join us tonight at 9pm GST / 4pm EST !

Life in a Bind - BPD and me

I’m really excited to let you know that psychotherapist Alison Crosthwait and I will be holding our third twitter chat on Monday 6 November at 9pm GMT/4pm EST. The chat will be called ‘Starting Therapy’ and we will be using the hashtag #startingtherapy .

Even more excitingly, the topic of the chat is built around the title and theme of Alison’s new book, ‘Starting Therapy – a book for new therapy clients’, and I can’t wait to talk about it, and this whole topic, with her!

Whether you’re a therapist or a client, or both, or neither, it would be lovely if you could join us, either as an ‘observer’, or by taking part in the chat itself. Looking forward to seeing you there!

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Twitter chat 6 November – Starting Therapy

I’m really excited to let you know that psychotherapist Alison Crosthwait and I will be holding our third twitter chat on Monday 6 November at 9pm GMT/4pm EST. The chat will be called ‘Starting Therapy’ and we will be using the hashtag #startingtherapy .

Even more excitingly, the topic of the chat is built around the title and theme of Alison’s new book, ‘Starting Therapy – a book for new therapy clients’, and I can’t wait to talk about it, and this whole topic, with her!

Whether you’re a therapist or a client, or both, or neither, it would be lovely if you could join us, either as an ‘observer’, or by taking part in the chat itself. Looking forward to seeing you there!

 


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The work of therapy

I wish I could email my therapist. Sometimes you just want to reach out to the person your heart feels safe with. Not even for a reply or an acknowledgment, but to be received and wrapped in thought.

You know that it will pass. That you will talk about it tomorrow. But right now she is the only person you feel intimately connected to. And you miss her, very much.

I wish that I could say: “I’m crying, and you make me feel safe ; I just wanted you to know”.

But what could she do? And would it disturb her peace of mind? And one day you won’t be able to email her just because ‘you wanted her to know’; and she wants to prepare you for that.

When I was at university I held on at night through absolute fear during panic attacks, constantly fending off the urge to go and wake up a friend. It felt like I was going to die, and I needed reassurance that everything would be okay.

I never woke anyone up. It always passed. I didn’t die. But it always felt like terror and it always felt like death. I got through it alone. I got through it.

She would tell you that you’re not alone; that you have her with you because you are slowly internalising her. That you have the resources within yourself to get through it. That tomorrow is not so far away.

I know. But is it so wrong to want to reach out through words and say: “I’m crying and I’m so tired of battles and feeling hopeless and you – you make it better and even though you’re not here I wanted to share some of myself tonight”?

It’s not wrong – but……what feels like the greatest imperative is not always the things that makes the most relational sense. There is a shifting to adjust to each other, even when apart.

I don’t know, I don’t know. I need her, I want her, I’m confused. I’m sad, I’m lonely, I’m unhappy, I’m wretched. I’m.

Waiting for tomorrow. I can honour the space and relational language we are creating – that lives in session and abides in silent connection between times.

She told you once that you were brave. This is something that she sees in you. This is something you are living out. And yes, it is heartbreakingly hard.

Therapy is a work of faith, and ‘steadfastedness’, and love. Tonight, I’m doing the work of therapy.


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How do you pay your therapist? The answer could be part of your therapeutic work.

In therapy, anything and everything is up for discussion – whatever happens in and outside the therapy room, provides ‘grist to the mill’. But the material of therapy is not just about the experiences we bring; it can include how we experience therapy itself. The context in which it occurs, the practicalities that govern it, and the boundaries that contain it, can provide fertile ground for exploration and self-discovery. In the interactions that take place between two people in one room, even the practical and the mundane can become a vehicle for expression and a means of unconscious illustration of what is going on for the client, and what is going on in the therapeutic relationship.

Unless the therapist is using an online payment system such as that provided by welldoing.org, for many clients one of the first practicalities they have to contend with, is payment. Even those who are comfortable with the ‘great British taboo’ of talking about money, may find it awkward or jarring discussing payment in the same session as covering very personal or emotional issues.

In addition, the fact that they are paying for a ‘service’ can make it difficult for some clients to accept the very genuine nature of their therapist’s attention, interest, and caring. It is also a reminder of what many clients would rather forget – that despite the real closeness and intimacy that can be involved, the interaction is not a friendship, and it must retain some of the distance and imbalance of a professional relationship. Raising these issues and talking about them can feel embarrassing or painful, but they can be ‘therapeutic gold’, resulting in a rich exploration of clients’ doubts and fears around relationships, intimacy, and boundaries. They are also important to tackle because overcoming them and achieving a positive and secure attachment to their therapist, is what enables many clients to heal from past and present relational trauma or other difficulties.

The practicalities of payment can also function as the non-verbal equivalent of a Freudian slip and can be revealing of a client’s feelings and attitude at particular points in time. A few examples come to mind from my own therapy. Early on, my therapist wrote a note on one of her monthly invoices, asking me to pay by cheque or bank transfer (rather than by cash). Her simple request – made in that way, I am sure, to save me the potential embarrassment of discussing it face to face – triggered intense feelings of shame, anger and distrust. We spent a number of sessions talking about the childhood origin of those feelings, and my fear of ‘doing the wrong thing’ and not being communicated with directly. The same issues have come up again and again in the last four years, in a number of other guises.

I now pay by cheque, and I do so within a couple of days of receiving an invoice; however, my therapist recently remarked on how my payment wasn’t always this prompt. It used to take me several weeks to pay, though she kindly never mentioned it at the time. I felt too unwell to be organised; I kept losing my cheque book; I didn’t have time to look for it, or I kept forgetting. My therapist’s comment was not a complaint, but an observation on how things had changed. She interpreted the change as evidence of my commitment to and investment in the process of therapy and the therapeutic relationship, and the priority I now give to it. Though I never delayed payment deliberately, I think she is right in seeing the difference in the way I now approach it as a reflection of more than just an improvement in mental wellbeing, or greater organisation. It is a matter of the regard in which I hold her and her role in my life, and the importance of the task we are engaged in together. This has impacted me in several ways – including making sure I never misplace my cheque book!

I’ve also had a very recent realisation about the significance of a past payment habit of mine. I now feel comfortable handing over cheques in person, but for a while I used to send them in brightly coloured envelopes, imagining them dropping through her letterbox and onto the doormat and being instantly recognisable as having come from me. I was aware at the time of a desire to be seen as creative, and perhaps a little quirky. I shared a feeling that many clients experience – a desire to be ‘special’, their therapist’s ‘favourite’, and to stand out from the ‘crowd’ of other clients. It’s interesting to me now that it didn’t even occur to me that my personal qualities, our interactions, and the time we spend together in sessions, could be sufficient and special in their own right.

What I recently realised is that my behaviour was also driven by a powerful desire to be present to my therapist, when we were not together. The envelopes were a way of making contact, and of trying to ensure I was remembered, and kept in mind. This hunger for remembrance has become more obvious as I have become more adept at ‘keeping my therapist alive’ between sessions and holding onto a feeling of connection. It is as if my previous preoccupation with needing to keep her in mind was masking an underlying preoccupation with needing to keep me in hers. It’s a realisation I’ve come to after the fact, but it’s also another potent example of the way in which deep fears and desires can be communicated through the vehicle of the most ordinary and seemingly mundane things. I continue to realise that how and when you pay your therapist, can be so much more than a purely financial transaction!


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This was my #therapybreak

Since the 2016 summer therapy break, I have been posting daily #therapybreak tweets during my therapy breaks, as a form of self-care, and also as a record of the breaks. It started simply as a way of trying to count down the days and to self-distract, but it ended up as somewhat of my own personal take on a ‘gratitude journal’. I found that as well as posting about difficult times, I also ended up capturing, and then actively seeking to capture, the small little positive steps or events that kept me going, and lifted me up.

That is, until this summer’s therapy break, the #therapybreak tweets of which, can be found here:

https://storify.com/lifeinabind/summer-therapy-break-2017

In my previous post I talked about some of the reasons why this was my worst therapy break in a while. On a very practical level, I realised how valuable it is for me to be at work for the first parts of a therapy break. I am a different person when at work, and the distraction and interaction with other people forces me into a place outside my head, where I can appear competent and content, and can leave my ‘other selves’ at the door. Work also means a familiar routine, and that, in combination with my ability to compartmentalize and put on ‘work me’, places me on a more familiar and even keel. That even keel helps me to deal with the start of a therapy break and for me, a break that starts well, has a better chance of continuing well.

This time, however, the start of my therapy break coincided with my summer holidays, and therefore time off work. It had never occurred to me that that might be a problem, but in hindsight I can see how the sudden loss of both my therapy routine and my work routine, led into a rapid decline in mood and an inability to lift myself out of that place. Everything described in my previous post – in terms of poor decision making, the setting in of fear and anxiety, and difficulty in feeling connected to my therapist – crept in so much more easily and quickly. Low mood meant I had fewer resources to fight those feelings off, and giving in to them affected my mood even more, so that it became a very difficult circle to try and break out of.

My #therapybreak tweets stop fairly abruptly on Day 30, two days earlier than I had meant to stop them. I have thought about going back and retrospectively adding those days in, but it would feel somehow dishonest, and I think leaving the story as is, is a more accurate portrayal of what happened. I will pick up on that in a future post, tying it in with resuming therapy after the break. In summary, on Day 31 I received a brief email reply from my therapist to a long update I had sent her a few days before; and on Day 32 I had my first session back. In that session we spent most of the time talking about my reaction to that brief email, and how it had felt as though it reinforced all my fears from the previous four weeks. But by the end of Day 32 I also knew that all my fears belonged to the past, and that my therapist was the same as she had always been. I’ve been back in therapy for a week – my deep depression has persisted, but at the same time I feel the safety, security, caring, and metaphorical warm embrace that I was so missing and unable to feel, during those four long weeks. I feel I’ve come back home.

 


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Approaching the end of the therapy break

When I returned to therapy last month after a short one week break, it was with a sense of excitement to be able to talk to my therapist about how things had been, and a sense of safety and relief at being ‘home’ again. I’m returning to therapy in a couple of days, after my therapist’s four week summer break, and it’s with the knowledge that this has been the worst break for a while. I’m nervous, afraid, in need of reassurance, low and sad – in that sense, we will be picking up from how things were for several weeks leading up to the break. It was a tough summer of sessions, with a horrendous ‘muddle’ (as my therapist called it – rupture, in other words) back in June. I muddled through after that, but I don’t think I fully recovered. And my big worry, of course, is that in some sense, perhaps neither did she, or our relationship.

In these last few days before I go back, I’ve been trying hard to ‘give myself a talking to’, to clear my head of all the scare-mongering, worrying, and self-critical thinking, and to remind myself of the good sessions that we had in the run up to the break, and the close moments; but much more than that, of the fact that this is a four year relationship with a history and a solid basis , with deep trust and genuine caring, that doesn’t just get wiped out or set back by a few difficult months, or the seemingly real fears in my head. It’s what I should have been doing for the last four weeks, not just the last four days. But I didn’t. And I was in a bad place. And I can put part of the blame on lots of things, some of them external, and others also external but more within my control. But I did not exercise control – over what I read, or allowed to influence my thoughts. I made poor choices, or no choices. I didn’t feel very much, because I was completely overwhelmed by feeling too much – too much filthy, contaminating, miring, all-consuming unhappiness and hopelessness; unhappiness that covered so much ground it ate up everything else. Unhappiness born of being unreconciled – to myself, and to my past, present, and future.

‘There are a thousand thousand reasons to live this life, every one of them sufficient’ – this was by far the most challenging thing I read during the break. There were many more that were far more depressing, but even this challenge, rather than becoming an inspiration, turned into a self-judgment – a pinnacle I couldn’t scale, a personal quality I was too flawed to possess. In a book full of challenging passages on humility, forgiveness, vulnerability – this was the one that hit me hardest at the time. There are a thousand thousand reasons to live this life; yet during the last four weeks only one of them seemed sufficient – my children.

I think what I have learned during the last four weeks, from a range of different sources, is that it’s hard to be reconciled – to yourself, to others, and to your circumstances – when you are under judgment – your own, and the perceived judgment of others. If you pray – as autumn approaches, pray for me that like the trees, I will be able to let things go. I don’t want to be or to feel under judgment. I want to be reconciled – I want to feel at home.

 

[Quote is from ‘Gilead’, by Marilynne Robinson, the first book in a trilogy, with the other two being ‘Home’ and ‘Lila’.]