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 under the name Clara Bridges.


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Writing about psychotherapy – clients and therapists

There are a number of us – psychotherapy clients, that is – who write about what it is like being on ‘our side’ of the equation; what it is like sitting in that most uncomfortable of seats (though, if one is looking for at least physical comfort in the therapy room, this post describes what you need to do!).

But the blogging psychotherapist is a much rarer phenomenon; understandably, I think, in the light of the various difficulties and questions I raised in ‘Therapists who blog – I have some questions for you….!’. Nevertheless, just as therapists are fascinated by what goes on in their clients’ minds, many clients are equally fascinated about the contents of their own therapists’ minds, and in the absence of such concrete information, they are fascinated to know more about ‘how therapists think’. Of course, generalisations are as impossible to make about therapists, as they are about clients; but there is some comfort for clients, I think, in hearing other therapists’ views on questions they may feel unable to ask their own – “is it okay to be angry with you”, “what will you say or do if I tell you I love you”, “do you think about me outside of session”, “do you care about me”…to name but a few!

I follow two blogging psychotherapists – Dr Gerald Stein (now retired) and Martha Crawford from ‘What a Shrink Thinks‘ – and today I wanted to introduce you to a third, who I feel fortunate to have come across recently. Alison Crosthwait is the author of ‘The Good Therapists’ website and, as with the other two therapists I mentioned above, her writing is beautiful, moving and thought-provoking. She has published a wonderful book called ‘What it feels like to change‘ which is available through her website, and is a collection of some of her blog posts. The posts cover everything from ‘preparing’ for therapy sessions, to love and caring in therapy, to the process of understanding between therapist and client, to rage in therapy, and much more. I read it on my Kindle, and it is liberally highlighted – so much so that I really struggle to pick a sentence or paragraph to share here, but I will go with these two, which really spoke to me both in terms of my relationship with my husband, and my relationship with my therapist:

Every human being struggles in intimate relationships. The ability to sustain this struggle is a sign of health. This involves the ability to recognize the humanity of another person even when they have deeply wounded us. The ability to ask for help. The ability to speak of our experience even when it feels risky. The capacity to tolerate the ways in which those close to us do not meet our needs”.

I come in. I sit down. I say what is on my mind. And we talk. And I have to bear being who I am. Not the person I want to be, plan to be, strive to be. But me. And my therapist has to bear being who she is too. And who she is with me. And me with her. Owwww. It hurts to think about. It is so raw.”

And that’s one reason why the words of a writer-therapist can be so important to us, as clients – they write both as therapist and as client (or ex-client). They have been where we are, and can empathise with us, and we with them. They are the ‘proof’ that this process, which often seems so mysterious and indefinable, has worked for them and they see it working every day, for others like us. We can do it – even when we feel that we can’t. And we feel that we can’t, a lot.

But my favourite quote from Alison is this one, which I saw on ‘The Good Therapists’ Facebook page and which is by far the best description I have come across of what it feels like to change: “In order to change you need repeated exposure to your own coming apart, to the border between conscious and unconscious, and to the parts of yourself that you resist being with”. These questions of change and resistance have been ones I have grappled with immensely over the last few months, and I continue to go through that very painful (but rewarding) repeated exposure to my own coming apart.

Having enjoyed her book so much, I feel really honoured that Alison has included my blog in a ‘Psychotherapy Client Resource List’ that she has compiled for her new venture, ‘Therapy School’. Alison has kindly allowed me to share this fantastic reading list which you can find here (though it is normally part of her course), and I am very grateful to her for that. I really hope you find it useful – I have read a small number of these books so far, and have found them helpful and inspiring.

I am thankful for to all those – therapists and clients – who take ‘the risk’ of writing  about their thoughts and experiences, sometimes incredibly intimate ones. They have added something to my own and to others’ experiences of this amazing process of psychotherapy which, as Alison has written, is “not just about relief of suffering…it is about living a good life“.

 


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Memory Monday – “Even the hairdresser’s made me cry”

This week’s Memory Monday coincides with the first anniversary of my entry into the blogging world, and so I am linking to my first ever post:

https://lifeinabind.com/2014/03/23/even-the-hairdressers-made-me-cry/

Eighty-nine posts and around 72,000 words later, and I am very much looking forward to my second year as a mental health blogger! I have gained so much from the process: community, friendship, support, information, insight, advice, humour, encouragement, challenge….I could go on. Writing, and processing thoughts, experiences and emotions through writing, has also become a key part of my therapy. So much so, that when I’m not writing, I don’t tend to feel as connected to my therapist – an interesting question in itself, for discussion during a session….

I want to take this opportunity to say a massive thank you to anyone who has read or commented on a post over the last year – it’s been wonderful interacting with you and getting to know you. I always appreciate it when someone takes the time to let me know that something I have written has struck a chord or has been important to them. I have been struck in this way by so many wonderful posts by other bloggers, it’s humbling to know that sometimes others relate in the same way, to one of my own. So thank you – and apologies for the occasions when it takes me a little while to respond to a comment! I like to reply fully while approving every comment, and so I’m not always able to be as quick as I would like.

For those who follow, read and comment regularly, whose wonderful words and encouragement I treasure – an extra special thank you. You inspire me, challenge me, comfort me, and you are always thought-provoking.  I feel like I’ve got to know you a little, and some of you I am in touch with outside of WordPress, and I am privileged to think of you as friends. I very much look forwarding to continuing our discussions over the next twelve months. 🙂

As for the book described in my first ever post – I did eventually finish it, but not until around six months later. I hate to read a few pages at a time, and so I saved it until my next opportunity to spend several hours reading, when I could really immerse myself in it. The second half of the book was just as wonderful, and had exactly the same effect on me. For reasons I still don’t fully understand (I even asked my therapist to read it, in case she had any insights about it), I once again felt sadness, pain and longing while reading. And when I finished the book lying in bed at the end of the day, I spent a long time in hard sobbing. The only possible reasons I can still come up with, are the ones given in my post; but I am hoping that further along in my therapy journey, I will be able to understand them better. The reaction was so powerful, so visceral, that I do think that it must have therapeutic significance. But sometimes that significance takes time to uncover, and time to understand.

Perhaps I shall read it again just before the end of my second year of blogging. I wonder if I will have some fresh insights on it then? Or perhaps if you read it too, you can help me with some of your own! Happy reading – and THANK YOU again, for making my first year in the blog-o-sphere, such an extraordinary one….

 

 


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Book Review: Psychodynamic Counselling in a Nutshell

I am very grateful to Dysthymia Bree for writing this excellent review of an excellent book, which I can heartily recommend to anyone interested in the process and nature of psychotherapy. I read it a couple of months ago, and it was one of the few books which I wanted to pick up straight away and re-read, the moment I had finished it.

It was an interesting, informative and thought-provoking read, and for me, it played a crucial role in helping me to overcome some big obstacles I had been struggling with in my own therapy. Before starting with my current therapist, I had spent five months working with a psychodynamic psychotherapist to whom I formed a very deep and idealised attachment, despite the fact that I knew from the beginning, that our work was time-limited. For me, she came to define ‘the perfect therapist’, and the way in which she conducted therapy became the model I looked for in my subsequent experience. In consequence, my commitment to, and my relationship with my current therapist suffered, due to constant comparisons and very particular expectations on my part. I did not feel cared for or understood, and that fact led me to seriously consider leaving therapy (or at least therapy with her) on a number of occasions.

Reading ‘Psychodynamic Counselling in a nutshell’ had a profound impact on me, in that it really brought home to me, two key points about therapy.

Firstly, when my therapist withholds reassurance, she is not doing it because she is evil, difficult, controlling, or because she does not understand or care for me. She is not rejecting me or abandoning me, however much I may not understand the reasons for her withholding. Withholding reassurance can be immensely difficult for therapists, who may long to provide what they know is being sought from them, and who know that the implications of not providing it, may be that the client (temporarily) hates them or withdraws from them. Sometimes, providing reassurance may be the easy path, but not the one which has the longest-term therapeutic benefits. In those situations, far from acting uncaringly, the therapist is acting more like a loving parent, ‘holding’ the client in their distress while at the same time acting for their long-term benefit in order to try and teach them how to trust and to reassure themselves. Realising that not always rushing in with reassurance may sometimes be as difficult for my therapist, as it is for me when I don’t receive that reassurance, helped me to have a much more ‘human’ view of her, when I might otherwise be tempted to view her as callous and uncaring.

Secondly, the nature of short-term therapy is very different to the nature of long-term psychotherapy, and therapists use different strategies in each case. Some of the things I remembered and valued most about my ex-therapist, were the statements that she made which ‘bound us’ and ‘bonded us’ together (for example, talking about how we both recognised that we worked well together), and the things she said that made me feel cared for (for example, worrying about whether she had hurt me with something she had said, or offering me a ‘metaphorical hug’). I remembered the statements, and criticised my current therapist for the absence of similar statements, but what I never considered was WHEN those statements were made and WHY.

How quickly and successfully a therapeutic alliance can be made, is key to the success of short-term psychotherapy. My current therapist had the freedom to allow an alliance to develop gradually (which was particularly difficult given my attachment to my ex-therapist), whereas previously, a relationship had to be forged quickly, and my ex-therapist had to lead that process. As for the statements I treasured because they made me feel cared for – they may have occurred ‘only’ fourteen sessions in, but my fourteenth session was also my penultimate session. So although those statements felt as though they happened ‘early’ or ‘quickly’, it’s not the time elapsed that is significant, but the fact that they happened at the very end of our therapy together. The time-scales in long-term work are very different, and things unfold and develop at a very different pace and in a very different way. Direct comparisons between the two can be very unhelpful, and they certainly held me back for a long time, in terms of trusting and committing to my current therapist.

I am grateful that I came across this book recommendation when I did, as it contributed to changing the course of my therapy, and the view of my therapist. I hope that it may be similarly helpful for you!

Living Well With Depression

Readers often ask me about psychodynamic psychotherapy; the whole concept of a therapist who works hard to be unobtrusive can seem strange – as my mother once exclaimed, “So he just sits there and listens?!”

What a psychodynamic therapist actually does is far more than listen, and  Psychodynamic Counselling in a Nutshell offers a readable yet rigorous introduction to the field for patients and even professionals reading about psychodynamic therapy for the first time.

Susan Howard walks the reader through both the theory and practice of this style of counselling, and also addresses ethical issues, its history, and potential pitfalls for the both practitioner and patient. The pitch and tone of the book are accessible without being condescending.

While there are other books about psychodynamic psychotherapy I’m fond of – The Science of the Art of Psychotherapy (Norton Series on Interpersonal Neurobiology), for example, provides a more rigorous…

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