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.

Tag Archives: self-care


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The road less traveled by

There is both a weighty and a light-hearted point to this post.

The weighty part is this. The way in which we are cared for in therapy, if we have a deep and trusting relationship with our therapist, changes our cells. It protects us in the sense of keeping us connected to our selves and to a richer and more complex understanding of the world. Though I haven’t thought of myself in terms of my diagnosis for a long time, this quote reminds me of Marsha Linehan’s words, that “people with BPD are like people with third degree burns over 90% of their bodies. Lacking emotional skin, they feel agony at the slightest touch or movement”. Being cared for in therapy gives us a protective, emotional skin. The world has less power to hurt us – not just because our greater sense of self and self-worth can withstand it, but because the way in which we see the world has changed. We see it through the eyes of someone who loves us and sees the ways in which we add to the world and are at home in it, rather than through the distorted lens of those who could not validate us and never really knew us.

As an aside, I find the image of my therapist’s caring being ‘in my skin’, particularly poignant. It is a way of experiencing her touch – something I have often wished for, but which, in its physical sense, is outside our therapeutic framework.

The light-hearted point is this. I discovered this quote because I finally got round to starting Harry Potter (having watched the films but never read the books). My therapist has, on a number of occasions, used examples or metaphors from Harry Potter, and she has often encouraged me (particularly for the sake of my kids!) to try the audio book versions, read by the wonderful Stephen Fry. But it was the recommendation of a different audio book, from another wise someone (you know who you are!), at the start of the Easter therapy break, that finally convinced me to try audio books, having previously had my reservations about them. I love reading – looking at words, absorbing them and savouring them in my own time, immersing myself in them – and it was difficult to imagine having the same experience listening to a book being read. I was right in one sense – it is not the same experience –  but it can be a fantastic one nonetheless!

Having listened to a handful of other books, I took up my therapist’s recommendation (though for myself, rather than the children!) and started listening to the first Harry Potter. I’m moving through the books and loving them – not just the stories and words themselves, but the wonderful way in which Stephen Fry conveys them, changing voices for all the characters, and moving (seemingly) effortlessly between them.

But even this light-hearted discovery has a weighty side to it. In discovering audio books, I have discovered something that I think will be vital not just to recovery, but to ongoing well-being and looking after my mental health. The Easter therapy break ended up being incredibly fruitful for me, in terms of new realisations, internalisation of new ways of seeing,and deepening of my relationship with my therapist. It felt as though I made numerous small but very significant shifts in my understanding and perceptions. Looking back, I believe that without realising it, I gave myself a break from rumination and down-spiraling thoughts for long enough that I was able to remain on a fairly even keel emotionally. The lack of ‘distraction’ from negative emotions and perceptions, then allowed a period of growth to take place. And the key way in which I gave myself a break from rumination and down-spiraling thoughts, was by filling the time and space when I would usually be engaged in those ‘activities’, with listening to audio books instead.

I tend to think of driving and cooking as being my ‘processing periods’ – but in reality, there is little ‘processing’ and much ruminating going on during those times. By giving my mind something else to do and concentrate on, I am essentially trying to rewire my brain so that the well-worn pathways of rumination and negative thoughts have a chance to start to ‘grow over’, and new pathways can begin to be laid down instead. My therapist likened it to walkers wearing a deep scar into the face of a mountain, by treading the same ground that has already been visibly worn down. It’s much easier to stick to the (literally and metaphorically) down-trodden paths, than to carve out new ones. However, if traveled on enough, the new paths become easier and easier to tread, and the old ones lose their visibility and appeal. I’m not sure there is enough Harry Potter (even with the later books!) to take me through that rewiring process, so I will have to find a new literary immersion, later. But for now, they are a great joy, and I can thoroughly recommend them! Metaphor and stories are great allies in the work of psychotherapy, and particularly in the later books, it is clear that J.K. Rowling has a deep and nuanced understanding of the demons of the mind….

 


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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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Update and a story by 12 year old me

I haven’t been managing to stick to my usual ‘posting schedule’  – and for some reason I feel I’m letting myself down, even though I know that that’s not the case. The ‘schedule’ has gone awry because of huge pressures of time, and sheer mental and physical exhaustion and low mood and motivation.

Things continue to be very difficult on the marriage front, and they continue to deteriorate. Following on from the situation described in my post ‘What now, marriage?‘, my husband and I are at an impasse. I have written a response to his ‘letter’ describing his fears for the future and the person he thinks I am becoming; but it is very long, I haven’t quite finished it, and so I haven’t yet given it to him. And so as we wait for the next hand (my own) to be played, I sink further into sadness and I think we’ve both stopped trying. It’s hard to try when you’re in limbo and you don’t know where you’re going.

Though work is a survival tool and a distraction, it’s been incredibly stressful and is about to get worse, in the worst possible way – I find personnel issues harder to cope with than big deadlines or volume of work. And I feel stuck in therapy, unable to really access the adult part of me that relates in a really positive way to my therapist. Either the ‘child’ or the ‘teenager’ in me have been more at the forefront, and given everything that’s going on at home which is triggering in a host of different ways, they are feeling a great sadness and a lack of love. There have been a few wonderful and connecting sessions, mainly involving the ‘child’; but on the whole I’m in that ‘teenage space’ where I’m struggling to know what to do or say, struggling to know where I’m heading in therapy, and struggling to know how to feel connected to my therapist while I feel so ‘stuck’.

On the positive side, I feel as though I’m managing to find new ways to make connections with my children, and I feel as though I’m more actively looking for those opportunities. I am still a much much ‘shoutier’ parent than I would like to be, but I hope that is balanced out by moments of fun, spontaneity, and affirmation. I am learning how to relate to them in ways that wouldn’t have been possible before I started therapy, because I wouldn’t have had the words, or concepts, or understanding (either of them, or of me). I’m also managing to exercise a bit more self-care – which unfortunately has resulted in less time to write! Though I’m still very undisciplined when it comes to getting enough sleep, I’m managing to book in events or treats for me or for the family, to add to my collection of ‘positive memories’ to hang onto, and to simply create space to be more myself.

I also try and respond creatively to opportunities to ‘do something different’ and be kinder to myself than I might have been in the past. After a painful therapy session a few days ago in which I was in a very ‘young’ and vulnerable state, I hung around the river near my therapist’s house watching and listening to a large group of swans in the peaceful quiet of the night. Somehow the sounds they were making were comforting and made me feel in good company – I wasn’t the only one being non-verbal and making strange little noises (as I had done in session, when I felt unable to speak).

Amongst all of this, I discovered some more early writings in an old box in the roof. As a child I wrote the opening chapter of many many ‘novels’ – I rarely made it past chapter two before becoming disillusioned or moving onto another story. Looking back on them now, I think they served the same function as the poetry of my teenage years – they were an expression of how I was feeling, a way of processing the emotions I kept hidden, or perhaps even the emotions I didn’t really know were there. This time, I found the very short first chapter of a book called ‘Anna’s paradise‘. Though there is no date on it, for various reasons I suspect it was written when I was around twelve years old, though it could have been earlier. The language and the style make me cringe – I wrote in the style of what I was reading, and so ‘frock’, ‘parlour’ and ‘eiderdown’ make an appearance, despite the incongruence in terms of times and culture!

When I look back on some of the things I wrote when I was younger, what strikes me most are the emotions I no longer remember, and the extent to which it seems I felt alone. I know intellectually that I dealt with all of my emotions myself, including those relating to loss and death, change and bullying. But I don’t know to what extent I thought of myself as alone at the time; I don’t remember what it felt like not just to deal with those emotions (or not to deal with them), but to deal with them with no support. I don’t know if I was self-aware or aware enough to know that that was a problem, rather than just accepting it as the way things had to be. Loss, sadness, and feeling alone – Anna’s tale is full of those things, but there is a perplexing note of hope at the end of the short first chapter. Perplexing because I have no idea what was about to happen next, and my twelve year old self is not around to tell me. I wonder what story I came up with, then, to deal with that sadness – and I wonder if it would help me to deal with my sadness now…..

***

Anna’s Paradise – Chapter 1

The evening sunset stretched out its long arms and embraced the cold grey stony building with its shattered glass and destroyed walls, which was Anna’s home. Usually when you look at such a building you get the feeling that the people living there are moody, unfeeling, sad. This was the case at Greyhall House.

Anna was a thin, short child of eight years old. If her green eyes had contained a sparkle, she could have been called beautiful, since she had a frame of wavy auburn hair round her face. Her cheeks were pale and you could see that her mouth had forgotten how to smile. Her clothes matched her mood; she wore dark colours, unbecoming of her. She rarely got a new frock, maybe once in three years. Anna had once been a happy child, full of laughter and overflowing happiness which she shared with her father, once…..but her father was now dead and she was living with her father’s sister, Aunt Elmira – sour, strict, old-fashioned Aunt Elmira. I can’t say Aunt Elmira was happy, being called out to look after Anna, and Anna felt it. It was really the mood of the people that changed the look of the house.

Greyhall House had once been called Flower Vale House. It used to be Anna’s Paradise, her dream place of delights. The gardens were always full of flowers and the forest behind the house was her chief delight. But now, even the little tree house in the forest had lost its charm and dream-like look and the thrill it used to give her every time she saw it. All Anna did nowadays was to sit in the long grey parlour with its covered furniture and china…..and think. There wasn’t much to think about, either, but Anna, blessed with an imagination that helped her at the worst of times, found plenty of things to think about, or dream about. Sometimes she might lie on her bed in her room, basking in the morning sunlight, which filtered through the shutters early on in the day. Her room was the only one in the house that was not painted grey – it was painted pink. She had a pink eiderdown and soft rosy pink curtains to match. She felt happier gazing at the pink around her and imagining she was living on the pink road of the rainbow. Altogether, Anna led a very sad and lonely life…..until….


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Therapy – a few thoughts

The process of therapy is often on my mind, for many reasons, and it’s something that I hope to write a great deal more about over the coming months. I don’t think I can avoid it, as it forms either the under-current or the overt subject of many of my current therapy sessions, particularly since I lost my ‘perfect’ therapeutic relationship a few months ago. I have done endless internet searching and reading into various aspects of therapy, desperate to find out more about what kind of therapy is ‘best’ for BPD, what I should expect from therapy and what the therapeutic relationship should ‘look like’. The well-known book about BPD, ‘I Hate You, Don’t Leave Me: Understanding the Borderline Personality’, has an excellent section on the various therapies available and the differences between them, and I have round the  ‘In Therapy (a user’s guide to Psychotherapy)’ blog on the Psychology Today website, to be another interesting source of information and views on a range of therapy related issues. Most recently, I have been very pre-occupied by my strong and all-consuming need to feel cared for in therapy, and on that point, I found the following post entitled “Does my therapist care about me?” very helpful.

But for now, I’d just like to make a couple of general points I have learned about therapy. However ‘successful’, or otherwise, my sessions might have been; whether or not I have ended up more depressed and in more anguish when I finished than when I started (!), therapy has undoubtedly made me think about myself, my feelings and my actions, far more than I have ever done before. For the first time, I connected my feelings and behaviour over the last three years or so, with what I went through over a ten year period from starting in the early 1990s. What I now think of as my ‘BPD remission’ period (which ended a few years ago), was preventing me from appreciating the entire picture, whereas I now regularly make connections and see patterns between current events, and past events.

Therapy has made me far more self-aware than I have ever been, although it has to be said that for me, that is a double-edged sword. On the one hand, I believe that self-awareness is fundamental to understanding behaviours, feelings and their origins, and enabling someone to change (if they want to). I have a deep-seated need to understand what I am going through, although ‘deciding to get better’ is something I am actively struggling with. On the other hand, however, self-awareness can feed the BPD individual’s lack of self-worth and perception of themselves as evil. Linehan put it perfectly when she said in Behavioral Treatment of Borderline Personality Disorder (1993): “The patient’s first dilemma, has to do with whom to blame for her predicament. Is she evil, the cause of her own troubles? Or, are other people in the environment or fate to blame? … Is the patient really vulnerable and unable to control her own behavior …? Or is she bad, able to control her reactions but unwilling to do so …?” If I am aware of my behaviour, does that mean that I am causing it? If I am aware of it but do not stop it, is it therefore intentional? And what does all of that say about me as a person?

Therapy has also made me realise that fundamental to the process, particularly for someone with BPD, is the therapist themselves. However appropriate the type of therapy, it simply will not work if the relationship with the therapist is not right. I’m not defining what ‘right’ means – it could mean different things for different people – but it’s paramount that that relationship works for you. I think this is particularly true for people with BPD, given that so often our struggles centre around interpersonal relationships, and our relationship with our therapist is not exempt from that – indeed, we often mirror the turbulence of our other relationships, with our therapists. Therapists who have worked with BPD before will know to expect this and will handle it appropriately, but unfortunately, this is not always the case with those who have less experience in the field, or who are dealing with those who have yet to be diagnosed.

We idealise and devalue our therapists; we test them; we fall in love with them; we fear rejection by them; we trust them one day and are suspicious of them the next; we get angry with them; we push them away; we want to be loved by them; we push boundaries with them; we want them to carry us and our pain, and then we want nothing to do with them. As well as being able to understand and deal with all of that, the best therapists will make us feel safe, understood, and, I would suggest, cared for – something that as people with BPD, we crave. They will also ask the right questions and they will make us think, but they will not judge –  they will empower us rather than try to persuade us into making ‘sensible’ decisions, and they will be honest and empathetic to our needs. A high bar to measure up to? Absolutely – but these therapists do exist and I hope that this will give hope and encouragement to those who may not have had the best experiences of therapy so far.

Therapy is often emotionally draining – without the right ingredients in place, it can also be frustrating, confusing, and potentially damaging. However, it can also be a safe haven – inspiring, supportive, transformational, and a much needed regular opportunity to share the heavy burden that we carry, with someone far more able to contain and bear our pain, than we are often able to. Sessions will vary – some will feel productive, some will feel emotional, some will feel difficult and stilted, some will feel as if you are making great strides forward, and some will feel as if you’re standing still, or even moving backwards. I’ve only recently started to come to grips with the idea that I don’t need to have a startling revelation, be overcome with tears, or feel intense emotions during therapy in order for it to be ‘working’. And some of the best and most ‘connecting’ experiences that I have had in therapy have been those sessions in which my therapist and I have laughed together. In the midst of a sad and somewhat tragic moment, we burst out laughing at something I had said  – not in a way that felt as if my therapist was laughing ‘at me’, but in a way that felt as though we were of one mind in recognising the bitter-sweet incongruity of the moment – from the sublime to the ridiculous and back to the sublime again.

I know that as people with BPD, we can spend our lives looking for ‘the perfect care’, and are repeatedly told we have to accept that this does not exist. Maybe that’s the case – but a good relationship in therapy is some of the best care that we can seek and give ourselves. If you’re reading this and have also been diagnosed with BPD, I really hope it makes a difference to you, as I’m hoping that it will to me.