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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Trigger-unhappy: BPD and abandonment

Trigger – unhappy: that is me. The DSM-IV Criterion 1 for Borderline Personality Disorder has really been getting me down recently, and has been firing up the synapses in my brain left, right and centre (or maybe that should be just left and right).

Criterion 1, ‘Frantic efforts to avoid real or imagine abandonment’ is manifesting itself as hypersensitivity to anything that might be construed (or misconstrued) as rejection, being ignored, misunderstood, sidelined, or not being cared for. And as usual, it’s some of those who I feel closest to, those who I have ‘let in’ and confided in, who are setting off these chain reactions in me. I observe those reactions and responses within myself, and I find them on the one hand self-centred, irrational and abhorrent, and on the other hand completely irrefutable. ‘Intellectual knowledge’ of the reality of the situation doesn’t seem to affect how I feel about it, or the way in which I interpret it. I know one thing – but I feel another.

Triggered: A school friend who I told about my blog several weeks ago, has not yet mentioned it, and seems to be oblivious to the fact that I’m reliving the pain and grief of losing my ex-therapist all over again. I know that she hasn’t had a great deal of time to read it recently, as she has been away, and at my own request is reading posts in chronological order and may not have encountered the relevant entries. But I cannot feel what I know. Instead, I feel hurt and resentful. Instead, I regret ever telling her about my blog, or about my mental health difficulties in general, and I see this as just another reason why my pain should be kept private after all.

Triggered: Another school friend, who also has BPD, was meant to call last week for a chat but didn’t, because she was numbing her own pain with alcohol. A few days later she failed to call again, because she was taking a friend in trouble to the Minor Injuries Unit. I know that she had received some bad news on that first occasion, and that she could not have foreseen the situation with her friend, who obviously needed her. But I cannot feel what I know. Instead, I feel as though it’s just another example of how she responds to others and is emotionally available to them when they need her, but not to me. Instead, I feel angry at myself and at her for needing her, and for feeling helpless in the face of that need.

Triggered: My husband came back from a weekend away, and didn’t give me a hug or any indication that he cared or wanted to know how I had got on while he was gone. I know that he was just reacting to the fact that I was withdrawn and silent. I know that each one of us was waiting for the other person to act and speak first, and that the months and years of inadvertently misunderstanding and hurting each other, has led us each to try and protect ourselves first and foremost, from further hurt. Instead, I felt suicidal – utterly desolate and alone. I felt unreal and unloved and unworthy. I felt rejected and I retreated further into myself. He thought I was ignoring him and that I didn’t care. I was trying to cope with wanting to die, because I felt he didn’t care.

Triggered: My therapist took what felt like an age of silence to think and phrase an answer to the fact that I had just told her that I had been experiencing difficulties with our therapy for some time, and that I had a decision to make about whether we should continue. I know that she was just thinking, and trying to assimilate what I had revealed, and reply in the way she thought best. But I cannot feel what I know. Instead, I felt as though I was on the knife-edge of abandonment – that as I had just revealed that I was thinking of leaving her, she would decide that she could no longer see me. It took every ounce of effort not to break the silence and tell her how unbearable the knife-edge was. How I was both shattering inwardly and at the same trying to burst out of my skin to escape the feelings of rejection, disapproval, and uncertainty of what was coming next.

Triggered: My ex-therapist, Jane, responded to my frantic efforts to avoid the very real ‘abandonment’ of never seeing her again, by saying that she did not think it was advisable to have just a couple of sessions without the prospect of ongoing work, and did not maintain contact or have friendships with those she had seen in a professional capacity. I had followed ‘numbness and denial’ with a desperate plea for something more, though with the very real fear and expectation that it would come to nothing.

I know that Jane had to reply the way she did. I know that her reply, though devastating in its finality, was necessary, and everything I have come to expect from her. It was professional, maintained boundaries, and was written in the spirit of keeping us both safe. I asked her to be honest – and she was. But I also asked her to be gentle – and she was. Her reply was reassuring, validating, clear, and above all, caring. Not in any obvious way – I can only wish that she would come out and say it! But it was there, in every other way – in the things that she didn’t say, as well as in the things that she did. And here’s the curious thing. I do feel what I know.

I knew Jane for weeks, not years. I have had virtually no contact with her for months. But, despite all the odds, and despite the difficulty that I (and many others with BPD) have with object constancy, and holding on to the reality of another individual, in their absence – I still believe that she understood and cared about me. That she cares about me. Perhaps almost as much as being abandoned by her in the present, I was terrified her reply would shatter my perfect and idealised view of her. That I would be abandoned by that sense of caring and the reality of the work we did together. The sense of self-acceptance that she gave me has vanished. But the sense that I was cared for by her, is, miraculously, still there.

I’m not oblivious to the fact that I may be particularly trigger-unhappy at the moment because I could be splitting off any negative emotions I may have had about Jane’s ‘abandonment’ and am transferring them onto others. I have always been passionate about ‘protecting Jane from myself’ and from any possibility of devaluing her, or reducing the height of her pedestal even by a millimetre. I don’t feel angry at her. I don’t feel rejected by her.

But do I know what I feel?

 


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PayBACS – a tale of BPD splitting

“Please pay by cheque or BACS”.

An ordinary little phrase at the bottom at my most recent bill from my therapist, who I have been paying by cash for the last few months. Brief, polite, perfectly innocuous. And also the spark that lit the touchpaper of an almighty episode of splitting which occurred during and after my therapy appointment a couple of weeks ago.

Let me explain.

The evening started off perfectly ordinarily. That is, I felt usually dysthymic, and was driving to my appointment wondering what I should talk about that week. Grief over losing my ex-therapist? No – overdone. Feeling uncared for in my current therapy sessions? No, potentially too confrontational (at least, in my head), and I wasn’t sure I had the energy for either a lot of crying or a lot of criticizing. Rather serious difficulties in my marriage caused my long-term irritability, withdrawal, giving my husband the silent treatment, and a whole host of other BPD related symptoms? Probably – for one thing, my therapist actually tends to talk a little more when we are on the subject of my marriage. Which for me, is a good thing. An ongoing issue between us is her tendency to leave long silences and to let me do most of the talking, and my frequent paralysis in the silences, and desire for more of a discussion.

But I digress.

I entered the room and in an instant, the mood (not that there was one, other than in my own personal headspace) changed. Sitting on the table next to ‘my’ chair were three books by Susan Hill. I had talked to my therapist about the complex emotions I had felt while reading a Susan Hill book recently, and the fact that I had then blogged about it. We discovered a mutual love of the author (or, at least, I discovered that she had read a number of Susan Hill books, and this immediately became a peg off which to hang a ‘mutual passion’ and a ‘point of connection’ between us).

But this was something else besides.

On the one hand, my therapist was simply lending me some books. As she said in a later session, she was aware that there was a break coming up over Easter, and wondered whether the books might help to ‘tide me over’. But on the other hand, the little pile of books on the table (carefully chosen, it seemed to me, to cover the topic of grief and loss, which she knew was a preoccupation of mine), was an indication that she had actually thought about me between sessions. And not just thought about me – had thought about what I might like or what might be useful to me, and had then taken action to do something about it. Maybe, it was even an indication that she cared about me – just a little bit. Purely professionally, of course. But still, that was caring of a sort.

I was elated – smiley, happy, chatty.

The tone had been set for the rest of the session. I can’t remember exactly what we talked about, but it felt good. I  felt that we were getting on, that we were getting somewhere, that we were connecting. She felt friendly to me. When I looked at her, I saw laughter and kindness in her eyes. She didn’t seem stern, as she sometimes did when I felt suspicious, wary, or confrontational towards her. I know that a lot of it is projection – the way she looks to me, and how she comes across to me during a session, is very much a function of how I feel towards her at the time. I project my feelings about her, onto her, and see them reflected back at me. But somehow the intellectual appreciation of the fact, doesn’t change my ‘emotional reality’ – knowing it isn’t the same as emotionally believing it.

I was most definitely ‘splitting’.

And she was most definitely in the ‘good’ camp. In the ‘blazing white’, though short of a halo (as that status belongs only to my ex-therapist), camp. As I drove home, I had several ‘OMG I love her’ thoughts. Not in a completely obsessional, utterly taken over, ex-therapist kind of a way, but in a ‘isn’t she great, I just love her’ kind of a way. I felt warm and fuzzy inside. I was looking forward to the next session, and thinking I might even be able to broach the ‘wanting to feel cared for in therapy’ issue, without too much embarrassment and without it feeling too difficult or confrontational. I thought it might even feel safe. I arrived at home and parked in front of the house. I took out her bill that I had picked up just as I was leaving the session.

“Please pay by cheque or BACS”.

What the **** was she trying to do to me? It was an instant flare-up of anger. It was a physical sensation of being punched in the stomach when I least expected it. It hurt from head to toe. And there was an awful lot of swearing going on in my head. [That’s the only place it tends to go on – I’m sadly far too repressed to actually verbalise the swearing. I get a secret pleasure out of hearing my friends swear – of all the ways to live vicariously…..!].

I hated her. With a passion.

All my most deeply felt criticisms of her came flooding back into my mind, and any trace of positive emotion was gone. How could she do this to me? This was just another example of her behaving in an X, Y, or Z kind of a way. It may have said ‘Please pay by cheque or BACS’, but what it actually meant was…..

I sense a bit of interpretation may be required.

BPD can make you hyper-sensitive to criticism. It can make you hear or read things into words or sentences, that aren’t really there. It can assign meanings to something said or written, based on a huge amount of personal history and ‘baggage’, rather than on what was intended by the other person. When my husband asked me to fold my car wing-mirrors back when parking on our narrow road, in case they were hit by another car, all I heard was an attack on the way in which I chose to park the car, a demand that I should act differently, a desire to control me by getting me to do things his way, and a lack of willingness to help in car parking endeavours (as in the rest of life, or so went my train of thought…..).

Sometimes, it feels as though BPD is a rather defective and less amusing version of BabelFish in which some words go in, some inexplicable and rather bizarre process happens, and a whole set of different words and meanings come out, which may be a million miles away from the original. It’s a bit like one of those online binary translators. You put in a three word sentence and a whole paragraph of binary comes back. It’s like when you ask your husband to go to the supermarket and he comes back with a completely different set of items to the ones you requested – but far less funny. [Although I know that when repeated more than once, or on the day of a dinner party, it is not remotely funny].

It’s like a cruel form of Chinese whispers where the end result is not just a variation on the original, but a hurtful, painful and completely twisted version of the original.

These are the thoughts and feelings that ‘Please pay by cheque or BACS’ raised in me.

I have been doing something wrong, and you have not corrected me. You let me continue to pay by cash, when you didn’t really want me to. You let me persist in doing the wrong thing – how could you? It’s embarrassing, it’s humiliating. It’s making me hate myself. You have made me hate myself.

Once again, you have not been upfront with me. Why did you not mention it in person? You know I place huge importance on you being straightforward and honest with me. Why could you not have raised it at the start of the session, as my ex-therapist would have done? How could you not realise that I need you to be upfront and to enforce boundaries? You don’t understand me at all. Letting me pay you in a way which isn’t helpful for you, does not appropriately maintain your professional boundaries. If you don’t maintain those, I cannot trust you.

Why couldn’t you have talked to me about this? Why are you being so cowardly? If you can’t deal with talking about money during a session, how could you possibly deal with any of the horrendously embarrassing and excruciating things I might want to talk about during session? How could I feel comfortable being open with you, when you aren’t comfortable talking about this with me?

“I don’t understand you, I don’t care about you, I can’t talk to you, I don’t respect you, I can’t be honest with you.”

The physical pain continued. The intense frustration of having been dropped from a height and been massively let down, was building. I wanted to quit therapy. The pendulum had swung wildly. It had been a while since I had self-harmed in order to ‘punish’ someone else (although the ‘punishment’ was always completely ineffective, as the ‘someone else’, whoever they were, never ever knew).

But it was time for payback.

So I did self-harm. And I did feel better. I had an inappropriate mental vision of a sine curve with a very large amplitude and a very short period. And having tried to use lessons learned in therapy to rationalise my way out of the situation, I took one of my own Susan Hill books to the next session, to see if my therapist wanted to borrow it. It’s hard to squash the never-ending cycle of the desire to push away and the desire to connect. But that’s the subject of another post……

 

[Splitting is very common in BPD, and leads to ‘all or nothing’ or ‘black and white’ thinking (and, one might say, black and white ‘feeling’). In BPD splitting, an individual may see themselves, or another person, as either entirely good, or entirely bad. Fundamentally, ‘splitting’ is all about a difficulty in holding opposing feelings, thoughts or beliefs about oneself or about another person, and an inability to bring opposing attributes together, and to see them as part of a cohesive whole. Splitting is one of the nine DSM IV criteria for Borderline Personality Disorder (a manifestation of at least five of the nine is technically required for a diagnosis), and the criterion is worded as follows within the DSM: “A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation.”

I haven’t tried to give a factual overview of splitting in this post, but to describe how one particular ‘splitting’ episode felt to me. There are a number of excellent blog posts and online articles on splitting, which can be found through a quick google search, all of which do a much better job of describing it, than I would do! But reading about it is not the same as reading about how it feels, or reading an actual example of how it can come about. And for me, it is always those personal stories that resonate the most and mean the most, because of the immense relief and comfort of realising that others feel the way I feel, and are going through similar things. I didn’t even  realise that this criterion of the DSM applied to me, until I read others’ blog posts regarding their own particular examples and experiences of this phenomenon. To me, ‘black and white thinking’ had always been a question of ‘intellectual flexibility’, and as I was always fairly adept at arguing both sides of an issue, I thought this meant my thinking was rather ‘grey’. It took reading about others’ experiences of splitting to help me to realise that not only was it true of me, but it perfectly described the way I felt in a number of situations, and about a number of people. I finally realised that ‘black and white thinking’ wasn’t really about thinking at all – it was about feeling, and those feelings shaped one’s views of others and the world. I hope, therefore, that though short on facts, this account may be similarly helpful to someone who wants to know more about BPD splitting, either because they are wondering about it in themselves, or because they are seeing it or experiencing it from someone else. ]