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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Why therapists frustrate their clients

“It feels as though you want me to learn through deprivation” I tried to argue through my tears. “But why can’t the same lesson be learned through positive means? If I ask a question, why not answer it first, and only then ask me to think about why I asked, and what it means to know the answer? That way, all the distress and disconnection of not receiving a reply can be avoided; we can start thinking about the matter, from a place of confidence and trust”.

“It’s a good theoretical question”, my therapist replied. “But sometimes I think it’s necessary to frustrate, to really get at what might be going on”.

***

Not just frustration, but distress. Distress that cut me off from her and immediately caused me to switch from a fairly adult mode, to a hurt child just wanting to protect herself. For the second time in the last few weeks I asked my therapist where she would be going on holiday, and for the second time, she did not answer. Instead – no prizes for guessing the stock therapist phrase that came next – she asked, “What does it mean to you, knowing where I will be going? Why is it significant?”

The distress was very real but it also felt predictable – it was a case of ‘here we go again’. I knew that precious time would be lost while I clammed up and found it impossible to speak. Whatever it was that I had come to session wanting to talk about, would be waylaid and sabotaged by that one question. It seemed to me that it would be a mark of progress if I could just put the distress to one side, and carry on – as if the question had never been asked. I wouldn’t let my internal saboteur win this one – my therapist had encouraged me to be wary of him, often enough.

But unusually, (as she tends to let me lead), my therapist seemed to want to steer me back into conversation about the question. She has an acuity of judgment that seems to be able to differentiate between the saboteur, and an altogether more straightforward, vulnerable side of me, even though the two often sometimes look the same. I think she saw the question not as a distraction, but as hiding something important. And she wanted us to work on getting to the bottom of it.

***

Years ago, her comment about frustration would have lit my internal touch paper and I would have seen red. It would have felt uncomfortably close to the idea that suffering can be good (which makes my skin crawl) as opposed to the idea that good things can inadvertently result from it. I would have wondered at how she could choose a path that she knew would lead to distress, when it seemed to me there was a perfectly suitable alternative. But I know her better than that now. I trust her vastly more than that. I know she cares deeply and will do what she believes is right and in my best interests. When I asked her why I needed to learn through ‘deprivation’, I couldn’t yet see why she was right. But I was willing to trust that she might be, and willing to work with her, to see what we could find.

***

It’s very easy to settle for the obvious, simple answers. I think it’s what I tend to do, when the time isn’t yet ripe for other answers. I said that in many ways, knowing the place where she would be on holiday was not in itself a hugely significant piece of knowledge. It meant that I could look up a picture of the place and envisage her there; it meant I could use that picture as the home screen on my phone, and it would be a helpful way of connecting with her during the summer therapy break. I said that much more significant than that piece of knowledge, was what it would mean if she told me. “And what would it mean?” she asked. It would mean a little less exclusion. It would mean feeling trusted. It would create a deeper feeling of relationship, and strengthen our bond. It would create another memory. All of those things seemed self-evident, natural, and in need of no further explanation. And yet she still seemed to think there was more to discover. That we hadn’t yet got to the bottom of it. She didn’t quite understand why the withholding of what still seemed to her a fairly insignificant piece of information, could create the level of distress that she was observing.

***

The pain lingered between sessions. Her belief that there was more, the fact that she still didn’t quite understand what was going on, troubled me. I wanted, desperately, to understand. Despite myself, her curiosity became my curiosity, fuelled by my despair. I’m not sure whether I thought that an answer to my question would ever be forthcoming, but the desire to know the answer was soon completely eclipsed by my desire to understand what was going on.

Why did it matter so much that she should tell me? Why was it significant? What on earth did it mean? My mind buzzed with the questions; I was taken over by them. In the car, at home, carrying out tasks, moving about. And quite suddenly, an internal voice – definitely me, but appearing out of the blue, somewhat like free association – gave me an answer. And it stopped me in my tracks. It was blindingly true, but also difficult to swallow, as it ran counter to my ‘natural’ way of thinking. It was unexpected, staggering, and it put not just one thing but many things, into a completely different light.

***

I went to bed shortly afterwards, my mind still buzzing, feeling blown away. It’s fairly rare for me to remember dreams, particularly in great detail, but that night I had three dreams which I remembered vividly, and which I knew the minute I woke, were inter-related. I usually struggle to interpret my dreams and to link them to the work of therapy, but as I drove to session that morning, the meanings started unpacking themselves with startling clarity. I was awed by the way in which our minds can put together images with purpose to help meaning float up out of them. I felt fortunate that a couple of weeks before that, I’d had a similar sequence of three dreams in which I realised that what was important was to pick out what was consistent across all three sequences, rather than pondering the meaning of each detail. Sometimes the details were there purely in order to demonstrate that the details didn’t matter – what mattered were the themes.

The dreams added further layers of understanding to the flash I’d had the night before. I’d come to a surprising realisation, and the dreams helped me to see the different ways in which it was true. The dreams showed me the less self-evident, and vitally important ways, in which it really did matter that my therapist talked to me about where she would be going on holiday.*

***

What followed was a session that was both very moving, and deeply joyful. It felt as though something had finally clicked into place; as though a missing piece had been found. There was a clarity of vision I rarely experience, but which always feels striking and humbling when I do.

And part of that clarity was the slightly reluctant but unequivocal realisation that my therapist had been right. Of course it’s a matter of conjecture, but I tried to think honestly about what I thought might have happened, if my therapist had answered the question first, and asked me to analyse, second. Much as I wanted to believe that the outcome would have been the same, I knew that I didn’t really believe that.

I had been very distressed, and I wish that there had some way around that. I imagined how good it would have felt if she had replied to my question straight away, and I imagined turning my attention to thinking about why my question was important, with a joyful heart, and feeling close and connected. And yet lovely though that picture was, it lacked the all-consuming motivation, the fierce curiosity, the absolute drive to understand so that I could somehow try and make sense of my pain, even if I couldn’t make it go away. I can’t honestly say that I think the same outcome would have been achieved if I had had her answer first. In fact I believe the opposite – that it’s unlikely the breakthrough would have happened – at least, not at that time. And I’m very glad that it did.

***

As my therapist is prone to reminding me, ‘good therapy sessions’ aren’t defined in terms of whether I go away from a session feeling uplifted and joyful. ‘Good work’ in therapy is very often painful, very often involves distress. I know that my therapist does not like seeing me in pain; I know that she would never cause it intentionally. Sometimes, pain is the unintended consequence of her being just as human as I am; sometimes, it is the by-product of a sound therapeutic judgment and the decision to withhold and frustrate rather than to provide and satisfy. And all these situations are absolutely compatible with wholehearted caring and commitment, which is what she continues to show to me, five years down the line.

I didn’t ask her again, where she would be going on holiday. She did tell me, in a subsequent session, and I thanked her, without asking her why. I know that withholding the information was never a matter of principle, the information was never a secret. I think she told me because it felt straightforward to do so. I don’t think there was an ‘agenda’, or a particular reason. I think it probably just felt like the right thing to do at the time, and there was no good therapeutic reason for not doing it.

For both of us, therapy is hard work, and very often involves sifting and working through a great deal of non-straightforward conscious and sub-conscious ‘stuff’. But sometimes it doesn’t. Sometimes things just are. Sometimes, we just are. But to get to ‘just be’, we often have to bear with the frustration of not knowing quite how, who, and were we are at, and why. At those times we need to try and trust that even though it may be our therapist ‘doing’ the frustrating, they are not the same person as the many others who may have frustrated us in the past, for quite other reasons. They simply know that we will be more likely to gain insight into our pain and to heal, if we can stay inside our predicament and our hunger to understand our dilemma, rather than observe it from the sidelines, from the perspective of satiation.

 

*[Interestingly, when I proof-read this post I realised I’d written ‘where we should be going on holiday’, instead of ‘where she would be going on holiday’, transposing the ‘sh’ and w’ of ‘she’ and ‘would’. A Freudian slip? Perhaps it was the echo of my therapist’s light hearted comment that unlike Freud, she didn’t take her patients on holiday with her!].

**I haven’t given the details of the realisation I mentioned here, but only because it will be the subject of another post in future.

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