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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Twitter chat: #therapybreak – what does it mean to you?

I am very excited about the fact that Alison Crosthwait (from ‘The Good Therapists‘) and I will be hosting a Twitter chat next Monday 25 April, at 9pm BST/4pm EST, on the subject of therapy breaks, and we would love it if you could join us – whether you are a therapist, a therapy client, both or neither! The hashtag we will be using for the chat is #therapybreak (nothing beats obvious!).

We chose the subject of therapy breaks for a number of reasons, including the fact that many people will recently have experienced such a break over the Easter holidays. We were looking for a subject that would be of interest both to therapists and clients, and was broad enough to allow discussion to range over a number of different themes. We thought about our most popular blog posts, which for Alison centre around change, and for me centre around attachment, including attachment to a therapist. We realised that thinking about therapy breaks provided the perfect opportunity to explore both areas, as such breaks can be the cause of considerable distress for clients who may experience feelings of loss, abandonment, or exclusion; but they can also be very powerful opportunities for reflection, consolidation, and change. Speaking personally, as a client, I have experienced both these aspects of a therapy break and I am intrigued to hear what Alison has to say on the subject, both from a therapist’s perspective, but also as a client herself. Other than agreeing the subject of the chat, Alison and I have decided to keep each other in the dark regarding the questions we would like to raise – we thought it would be more interesting and spontaneous that way (and I quite like the idea of us surprising each other!). And of course it would be great to be surprised by all the questions you might bring as well, if you are able to join us.

Alison and I discovered that we enjoyed each other’s writing and that our interests are complementary – and I think it’s fair to say that as therapist and client respectively, we share an interest in hearing ‘the other perspective’ in writing – though I tend to feel that often as ex-clients themselves, therapists have rather an advantage here, in terms of understanding how it feels to sit in the ‘other chair’…..

We are greatly looking forward to this ‘little experiment’, and have a couple of other ideas up our sleeve if it goes well. If you have an interest in the topic and would like to chat, please do join us! I’ll be online with a cup of tea and a comfy cushion, fervently crossing my fingers that the kids stay soundly asleep in bed……!

 

[For any novices at Twitter chats, don’t do what I did during my first ever Twitter chat – I spent half the chat in conversation with a lovely Twitter user, which was really interesting, but I didn’t realise that I was actually on my ‘Notifications’ page rather than on the main page containing all the tweets for the hashtag. I was therefore completely oblivious to the chat that was happening all around me!]

 

 

 

 

 

 


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Friendships with Ex-patients: Why I Say “No”

Although this post by Dr Stein was written last year, it feels like a logical conclusion to the series of posts I recently shared (both his, and my own), on the topic of feeling excluded from your therapist’s life, and the related question of whether a friendship between therapist and client would be possible. Even for clients who are persuaded (though painfully) by the reasons behind this ‘exclusion’, the question remains – why should a friendship be prohibited once a client becomes an ex-client? And if there are reasons for prohibiting it for a period of time, why should such a friendship not be permissible at a later point?

As with the reasons behind why therapists and clients would find it very difficult to maintain a ‘dual’ relationship, the reasons in this post are also very persuasive. I wish it were not so, because everything within me dreads and fears the day (hopefully far far in the future) when I will come to the end of my current therapeutic relationship. But I have been fortunate to have received an email from my ex-therapist, following a desperate plea from me for ongoing contact, that was kind and compassionate, and made the ‘no’ slightly easier to bear. I hope that if you too are in a similar position, the response that you receive is as honest but compassionate and caring, as the one described by Dr Stein above….

Dr. Gerald Stein - Blogging About Psychotherapy from Chicago

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I recently received an invitation from a former patient to meet for coffee. This warm-hearted offer came from a man who is as principled and decent as anyone I know. What’s more, he is funny and bright — just the sort of person I’d enjoy having as a friend.

I said no.

Now you might ask, why did I make this decision? This was not the first such request since I retired over two years ago and not the first from a person I thought companionable. I’ve said no to all of them. What I’m about to do is explain how I reasoned this out. I’ll finish with my response to this terrific guy.

First, nothing in the American Psychological Association’s Ethical Principles of Psychologists and Code of Conduct forbids me from having communication with former patients. Nowhere does it say I can’t be friends with them. We are, however…

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How Would a Friendship with Your Therapist Work?

Another very interesting post by Dr Stein, using a ‘thought-experiment’ to elicit the difficulties inherent in the notion of friendship between therapist and client. This follows on from both Dr Stein’s original post on the reasons behind clients’ ‘exclusion’ from their therapists’ lives, and from my own post on how that feels, from the patient’s perspective.

As with Dr Stein’s other posts, I believe his points are very well-made and hard to argue with, and are put forward both carefully and compassionately. In common with many, I think, the challenge for me is to somehow turn this intellectual knowledge and acceptance of ‘how things must be’ into an emotional understanding and acceptance. It will come, with much work and with digging deep; but in the meantime, every time, as clients, we come face to face with feeling excluded and ‘bump up’ against the boundaries of therapy, we have an opportunity to talk about how it feels, to discover the origin of those feelings, and to start to heal from them. It’s all ‘grist for the therapy mill’, as a friend of mine would say….!

Dr. Gerald Stein - Blogging About Psychotherapy from Chicago

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The fantasy of having a closer relationship with one’s therapist occupies the mental space devoted to imaginary things. It must, because few counselors permit such a connection. Professional ethics generally prohibit the dual role of therapist/friend and therapist/lover. Yet, there is value in fleshing-out what this double-bond would look like in practice.

Responses to my recent post, Being Excluded From Your Therapist’s Life, suggest the fantasy dies hard. What follows is an effort to describe how the relationship would function if brought to life — the day-to-day lives of a shrink and his patient. I invite you, dear reader, to think along with me. Let me know if my concerns are off-base. Even more, once you finish reviewing my ideas, I’d love to read your own notion of how to create the connection some of you want with your therapist: an outline better than the current prohibitive model you…

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Even the hairdresser’s made me cry

It was with completely unexpected pleasure and excitement that I re-found a copy of Susan Hill’s ‘Howard’s End is on the Landing’ on the bookshelf this morning, as I was about to dash out of the door to the hairdressers. I was looking for a ‘back-up’ book, in case my tablet malfunctioned (not an unusual occurrence) and I was unable to access one of the many half-read books on it. I knew there were a couple of weighty Ken Follett tomes somewhere, and apart from the challenges of fitting one in my handbag, I wasn’t particularly taken with the idea of starting something I wasn’t likely to finish for the next year. So finding the slim and enticingly entitled Susan Hill (which I had forgotten I had received for Christmas) was the perfect start to my long-awaited annual three-hour session to have my full head of highlights done. (Three hours? I have long hair).

It’s hard to describe the way in which I look forward to my annual trip to have my hair done. It’s not vanity, though I do enjoy the way my hair looks good for all of a day or so while the shape that’s been blow-dried into it is still there, and while the colours are still vibrant and before they fade into my very dark natural shades. I have small children, and borderline personality disorder. The first is common to many, who will immediately understand why three hours out, just sitting, drinking coffee, and reading a book, is a pure luxury. The second is not quite so common, and you can’t take time out of it, but if you know, you’ll understand the value of getting away with your thoughts, and getting some space from your triggers. And of doing something that helps you to feel cared for, even if you are the one having to do it, for you.

There’s a particular type of book I look for on these occasions, but it’s difficult to articulate what that is. I just know it when I find it. Past highlights (what a very poor attempt at a pun) have included Bill Bryson’s wonderful biography of Shakespeare and Jon Ronson’s ‘The Psychopath Test’. My books for these trips must be not-too-long, so that I can read a sizeable portion while I’m actually there, and can truly immerse myself in them and have them take me over. For me, there’s no better way to read a book, than in one sitting. They must be interesting page turners, and something I may not normally have thought of reading. I’m not particularly interested in Shakespeare, and ‘The Psychopath Test’ was something my husband was given for his birthday. But the writers of both books carried me along on a fascinating and funny journey, which I look forward to reliving when I pick up the books again in a few years time.

On this occasion, I had imagined that I would be flitting between the various partially-read books on my tablet, including a Jodi Picoult and an interesting volume entitled’ The Buddha and the Borderline’. Deborah Meaden’s book, ‘Common sense rules’ was also on there and would have qualified as a ‘highlights’ book, had I not already been half-way through it, and so the excitement of opening the pages, starting out afresh, and finding out what it had to hold, was already in the past, and my reading of it had already become very fragmented. I was already feeling the disappointment of not being able to make the best use of the upcoming precious reading time, when my hand brushed over ‘Howard’s End is on the landing’, while I my eye was looking for ‘The Pillars of the Earth’.

Susan Hill has been one of my favourite authors since I fell in love with “Strange Meeting” as a teenager. Some of my most vivid memories are of intense feelings felt as a result of reading a book, or reading a poem, or watching a film. ‘Strange Meeting’, and the central relationship within its pages, triggered that intensity for me.  More recently, I have greatly enjoyed her crime novels, and it was in looking on Amazon to see if she had published another, that I came across this particular offering. ‘Howards End is on the landing: A year of reading from home’, is an autobiographical tour through Susan Hill’s personal library – a memoir hung on books, using her discovery and rediscovery of her collection to tell of the stories and memories they evoked.

I’m not surprised that I loved it from the very first sentence. It was interesting, it was funny, it was warm, it was honest, it was beautifully written, and intimately revealing of its author. What surprised me, is that I read it with tears barely held back and lingering constantly just below the surface. What surprised me is that reading it was filled with poignancy and pain, and although the first was at least to some degree present in the book, the second was mostly present within me.

How could a book that some reviewers called ‘light-hearted’, evoke such sadness? I think it was the ‘looking back’. I think it was the idea of a full-life, long-lived; the idea of being able to pick memories off a book shelf, that could be pondered with contentment, and made sense of in the context of a coherent life, true to some underlying core. Those things, in themselves, are the very opposite of sad – but they are things that I find it impossible to believe can be true of me either now or in the future, and that is where my sadness lies. It also lies, very much so, in the resonances that ‘looking back’ has for me at the moment. I have been doing a great deal of ‘looking back’ – in therapy, and outside it. It’s a painful process, and I know there’s much worse to come. The key Pandora’s boxes have been skilfully avoided – my grief over having to cease therapy with my previous counsellor being a very genuine, but also very convenient, distraction from those things that I would rather not talk about.

Though it’s all leading to the same place in the end – grief is loss, and loss is everywhere. It bubbled up occasionally in Susan Hill’s accounts of authors that she knew, but it bubbled up continually as I was reading, in my sense that ‘the past’ is defined by what I have lost or never had, and that ‘the future’ is defined by the losses to come. What should have joined the two, a stable thread of enduring identity, is shaky at best. When I hold up a mirror to the past, or try to look into a crystal ball, what I see depends entirely on who I was mirroring at the time, or who I am longing to ‘merge’ with now. The ‘therapy-honed’ eye of self-awareness picked up on it even as I was reading – the more I lost myself in the text, the more attracted and the closer I felt to its author. Its author who, like many of those who I have felt drawn to recently, is an older woman. Yet another source of sadness. Yet another closed box waiting to be opened.

The time passed all too quickly. I had read half of the book, and knew that the other half would probably have to be read in toddler-attention-span-sized chunks, or far too late at night when I knew I should be sleeping. I had beautiful hair – I’d been well looked after. When I got home no one commented, and I tried not to feel too hurt. Another borderline day – but with a difference. I wonder what my memories of this day will be, when I ‘re-discover’ the book in two, five, ten, twenty years from now? Will the actual memory be, as the prospective memory was, laden with sadness? Maybe. But I hope that I will remember that this was a day when I was able to conceive of a future; that an existence beyond the immediate chaos made sense and held, if not promise, at least possibilities. And that’s a little way further on than where  I have been in the past.