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: the process of therapy


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I have a mother – when things shift in therapy

[This post talks about the uniqueness and importance of ‘mother’, and for me, that has a particular meaning. But for others it may be more appropriate to invest this word with a different meaning – it may relate to a father, grandparent, or adoptive parent, or any other primary caregiver. I don’t mean to exclude by my use of the word; but it is so intrinsic to my own experience and what I’m writing about here, that I cannot avoid it.]

“You can hear something over and over again, but until you hear it at the right time, in the right context, in the right frame of mind and with the right understanding, it makes no impact. You can hear words and you may comprehend their meaning, but it may still not be clear what the words are meant to change, and how . “

That’s a paragraph from a post I wrote two years ago called ‘A new experience of mother – Part 3’. It was one of five posts on the same theme. It continues to surprise me, the way that therapy returns over and over again to the same topics, to the same ground, but in subtly different ways. The return is an indication that there is more to think about, more to say; an indication that there is still something unresolved, and something hidden to unearth. It continues to surprise me that the merest fraction of a degree in the angle at which we look at an issue, can make an enormous difference to our perception, and can lead to a revelation. And that the ‘revelation’ can be both so close in content to what we already knew, and yet so far from it in terms of its impact, that it seems both ludicrous and impossible, not to have seen it any earlier.

Elsewhere in the same post, I wrote the following:

“My therapist often made the point that she was different to my mother, and she made it in numerous ways. She made it by actually being different; by responding in ways I didn’t expect and then drawing my attention to the fact that I’d been anticipating the reaction my mother would have had. She was understanding when I expected judgment; caring when I expected criticism; comforting when I expected shaming. She made the point quite explicitly by saying that therapy offered me  – she offered me – a different experience of mothering. I heard the words, and thought I understood them.”

And so I never expected to come back, two years later, and write what is effectively Part 6 of my series of posts on ‘A new experience of mother’. But I’m returning in order to add something absolutely vital to the things I realised then. Something that arose directly out of thinking about the distress I felt when my therapist did not answer my question about where she would be going on holiday this summer. I wrote about that incident in my post ‘Why therapists frustrate their clients’, but I wanted the realisation that came out of it, to be part of a separate post – this one.

***

When my therapist asked me to think about why it mattered so much to me that she had not answered my question, I said that it wasn’t so much the knowledge itself that was important, but what it would mean if she told me. I told my therapist that “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.”

Sometimes ideas occur to you in a way that is more like a voice speaking in your head, than your mind thinking a thought. That’s what it was like when all of a sudden, completely out of nowhere, I heard an answer to my therapist’s question about why it mattered and what it would mean. “It means I have a mother”, the voice said, “and that is the most important thing”.

***

I was at home at the time, and it was a couple of hours after session. I stopped, utterly taken aback. What was going on? On the one hand, it immediately felt as though there was a weighty truth in the statement the voice had made. And I already knew I had a therapy-mother – my therapist had been using that terminology (and also the phrase ‘therapy-daughter’) for some time. But on the other hand, there was something not quite right about the statement. The voice said “and that is the most important thing” -but how could that be true? That, right there, seemed to be the voice of my biological mother, who insisted that she was and always would be the most important, the only truly trustworthy person in my life, the person who would love me in a way no one else could ever love me. This seemed to be the voice of the person who elevated mothers, and specifically herself, above every other person and type of relationship I might ever encounter. And I already knew, in so many different ways, what a negative effect on me her narcissism had had. So how could the voice be right, if it seemed to agree with her?

***

The next morning I awoke having had three dreams that felt clearly linked to each other, to the question I had been thinking about, and to the ‘answer’ I’d received. In various ways, the dreams drew attention to three aspects of the mothering I’d received when growing up. They showed me that I had a mother who wanted intimacy with me but at the same time couldn’t cope with it because she could not deal with her own emotions, let alone my own. She left me, therefore, with the sense that she was afraid of me, and that I was a threat to her. They showed me that I had a mother who never wanted me to grow up and was full of nostalgia for the days of my childhood, not seeing or wanting to see who I really was and was growing into. They showed me that I had a mother who wanted to appoint herself as the most significant person in my life, and wanted to exclude others from my affections.

But very importantly, the dreams also showed me something that I could never consciously have accepted as a possibility. They showed me that at one time in my life, even if I couldn’t remember it, I had wanted that intimacy and that exclusivity too, even though I knew that the former would lead to rejection and invalidation, and the latter would be poison. I didn’t always reject my mother and everything she stands for, as forcefully as I have done for the last twenty years or so. I didn’t always reject completely out of hand, any idea that came from her, or any association with her. And I didn’t need to reject everything that sounded like her voice, now. It was possible that she could speak some truth about mothering, even if she herself had not been a good-enough mother.

***

I grudgingly realised that my mother was right – and I never thought I’d say that about her! Having a mother is the most important thing. Mothers are unique, and there is no other relationship like it. Wrong though she was in the way that she interpreted that relationship, its meaning, and its implications, I now believe that she was right about the importance and uniqueness of the relationship. And I’ve read enough articles over the years, about the impact on individuals of losing their mothers, to know that for many people, the importance and uniqueness of that relationship continues well into adulthood, and up to death and beyond.

Two years ago, I came to understand that my therapist was providing a new experience of mothering. I knew my therapist was very different to my mother and I was grateful and full of joy to have a type of mother-daughter relationship with her. But what I didn’t understand until a few weeks ago, was that for the last two years I’ve been holding two somewhat contradictory positions alongside each other. Because while accepting that I had a therapy-mother, I also believed that my mother was wrong about the importance of the mother-daughter relationship. I believed that I didn’t really need a mother, and had never needed one. I knew I had a therapy-mother, but I still thought of myself as being without a mother. On numerous occasions I had caught myself thinking ‘if I had a mother…..’, as if my biological mother were dead, rather than me being emotionally estranged from her.

In placing such an emphasis on my therapist’s difference to my mother, and in deriding so strongly the very concept of the uniqueness and importance of the mother-daughter bond, I was inadvertently preventing the experience I was having with my therapist from becoming a fully healing and transformative experience. She was providing something wonderful – but I couldn’t see it as being the very thing I had lacked for so long, while I still refused to acknowledge the importance and the necessity of what had been lacking. Inevitably, my therapist was providing what I had lacked in a rather different, and a more intensive and more concentrated way to that in which it would have been given through the longer period of childhood and growing up – but she was providing it nonetheless.

***

When I saw my therapist the morning after my ‘answer’ came, along with my dreams, I told her that it finally felt as if something had shifted, and that I had been missing a vital puzzle piece that had now fallen into place. More than that, I had been missing something vital, and things had shifted internally so that somehow I now felt more complete. She said she was very glad the ‘penny had dropped’! I kept repeating to myself, inside my head, ‘I have a mother, I have a mother’, and every repetition was full of joy. Whenever she or I made reference to it, I couldn’t help smiling; I still can’t.

As well as being accepting and validating, I have a mother who is not threatened by me and is not afraid of me; a mother who sees, values, and enjoys the ‘adult me’ as well as the ‘child me’; and I have a mother who does not want or need exclusivity and is confident of her position in my heart. Unconsciously, that was the type of mothering I associated with my therapist feeling comfortable enough to talk to me about her holiday plans, and that is why it was so distressing to feel that that experience was being withheld. But if it hadn’t been, I may not have realised the things I did.

I may not have realised, finally, that in my therapist I have not just a new experience of mothering, but a good-enough mother – and absolutely nothing can take that away from me. I have a mother. The relationship I thought I didn’t need, is in fact vital. The relationship I had been missing, I now have. The experience I thought I would always have to do without, is now a part of me. I know that I will lose her, as the majority of mothers are lost, at one time or another, to their children. And that will be devastating. But not even that can take away from me the fact that what I was missing I am no longer missing, and will never miss again. That is indescribable. I have a mother. It is the most important thing.


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Let it grow

flower in iceI am going to start by owning up to the fact that this post has nothing to do either with the film ‘Frozen’ or with gardening. So for those hoping for some insight on either topic – I am sorry to disappoint. Having said that, if you have any interest in the subject of therapy, or if you are in therapy yourself, I do hope that you read on.

A couple of months ago I had one of those ‘revelatory’ moments through therapy, that it is easy to live for, but hard to come by. It was a significant realisation for me, as it challenged my assumptions about the nature of therapy itself. Those assumptions had affected both my engagement with the process, and also my relationship with my therapist. The ‘revelation’ had an enormous impact on the way in which I approach therapy, on how I relate to my therapist, and on the expectations I have of what ‘should’ happen in session. (“There is no ‘should’, there are no rules”, I can hear my therapist saying….).

In ‘A matter of choice – BPD and self-worth’, I started by saying that therapy has twin tasks – to reveal the ways in which we really think about ourselves; and to ‘make up for’ what has been missing, and that those tasks can be more broadly described as dealing with content (or process) and with relationship. In that post, I said that both of those tasks were important – but that wasn’t the position I started with, several months ago.

So much of what BPD is about is concerned with relationships, and my absolute desire for connection had led me to place the therapeutic relationship at the centre of my therapy. It was my primary interest, and I thought it should be my therapist’s primary interest too. All the reading I had done had pointed to the fact (or so I thought) that the key vehicle for change, particularly with a ‘condition’ such as BPD, was the transformative power of the therapeutic relationship. I thought about it, and I talked about it, endlessly –it was my key preoccupation. Those with BPD are often said to have an ‘all or nothing’ approach to life – and this was certainly the case with how I thought about therapy. The therapeutic relationship mattered – and in the context of sessions, it mattered to the exclusion of all else.

Whenever my therapist suggested that content  and process were important too – or that her task was also to uncover my unconscious thoughts about myself – I argued that that was not possible until the ‘re-provision’ of what had been missing in my life, was well under-way. If the ‘patient’ has not already forged a rock-solid relationship of trust with the therapist, and has not yet been ‘re-parented’, how will they be in a position to cope with the potentially devastating realisations surrounding how they think about themselves? Nothing could have shifted me from that position (or so I thought) – and any attempts by my therapist to try and ‘re-focus’ me, I simply construed as rejection.

My husband often grumbles that I listen to my friends but not to him. He can make a point over and over again, but it’s not until I hear it from an ‘independent source’ (whatever that may mean!) that I actually take it on board, and trust it. In this case, it was only when I read the point my therapist was trying to make, in two separate books by Irvin Yalom (a well-known American psychotherapist and author), that it truly hit home. It grabbed me, in only the way that something can when it truly makes its home in the innermost parts of your being. It made both intellectual and emotional sense and I felt it as a conviction at the deepest level.

In his book ‘Love’s Executioner and other tales of psychotherapy’, Yalom describes his work with a client who, amongst other traumas, had suffered sexual abuse by her father. In that context of that tale, Yalom writes the following (the highlighting for emphasis, is my own):

“When I first began to work as a therapist, I naively believed that the past was fixed and knowable; that if I were perspicacious enough, I could discover that first false turn, that fateful train that has led to a life gone wrong; and that I could act on this discovery to set things right again…..But over the years I’ve learned that the therapist’s venture is not to engage the patient in a joint archaeological dig. If any patients have ever been helped in that fashion, it wasn’t because of the search and the finding of that false trail (a life never goes wrong because of a false trail; it goes wrong because the main trail is false). No, a therapist helps a patient not by sifting through the past but by being lovingly present with that person; by being trustworthy, interested; and by believing that their joint activity will ultimately be redemptive and healing. The drama of age regression and incest recapitulation (or, for that matter, any therapeutic cathartic or intellectual project) is healing only because it provides therapist and patient with some interesting shared activity while the real therapeutic force – the relationship – is ripening on the tree.”

In his book ‘The Gift of Therapy’, Yalom puts the same point in this way:

“But it is not the content of the intellectual treasure trove that matters but the hunt, which is the perfect therapy mating task, offering something to each participant: Patients bask in the attention paid to the most minute details of their life, and the therapist is entranced by the process of solving the riddle of a life. The beauty of it is that it keeps patient and therapist tightly connected while the real agent of change – the therapeutic relationship – is germinating.”

As Yalom also states, “In practice, there is a great complexity in the link between the intellectual project and the therapist-patient relationship”. And he does not deny that the key therapeutic force is the relationship itself. So my focus on this aspect was not misplaced – but my focus was certainly too narrow and too exclusive. The therapeutic force  – the relationship – needs feeding in order to maintain its momentum, and its food is both process and content. Its food is ‘the hunt’, ‘the intellectual project’.

I have a tendency to want to ‘do everything right’ – and therapy is no exception. It would be easy for me, therefore, to substitute an exclusive focus on ‘getting the therapeutic relationship right’, with an exclusive focus on ‘getting the content and process right’ – or to try and do both. But I think that would be to both misunderstand the nature of therapy, and also to misunderstand what Yalom is trying to say. In the same chapter in ‘The Gift of Therapy’, Yalom writes that he discovered that what he and what his clients remembered and valued about sessions, were very different. He tended to value intellectual interpretations, whereas they tended to value small personal acts that were relevant to the therapeutic relationship. The precise intellectual interpretation was not what made the crucial difference. He writes that, instead, “…the search for explanation kept us engaged and our engagement ultimately made the difference”.

I take that to mean that it is not necessarily the precise content of sessions that is most important, but the process of talking about the content, and indeed that it what Yalom said when he talked about the ‘treasure hunt’ being more important than the contents of the ‘treasure trove’. And I have seen this borne out in my own therapy. Recently we discussed a difficulty in a friendship, for which I felt a failure and was blaming myself entirely. My therapist kept offering up suggestions for what might have been going on with my friend at the time, and when I thanked my therapist in my next session for the fact that I had since felt much better, she said she had been trying to give me a different perspective. However, what I took away from that session was a sense that she was on my side. Without that sense, I would have been unable to get through my distress and take on that different perspective. The intellectual interpretation and the personal act: two different views on one session, in which our relationship was made stronger through our shared endeavour and exploration.

What I learned from my reading, and from experience itself once I applied that reading to my sessions and ‘widened my focus’, is this: therapeutic alliance is central to change, but it doesn’t have to be central to the conversation.

I was ‘majoring’ on our therapeutic relationship, but in doing so, I wasn’t giving it room to breath or grow. By constantly putting the spotlight on it, I was freezing it in time. By neglecting the importance of content and process, I was completely missing the fact that the relationship grows, in the background, using the process and the content as its sustenance. I was not feeding our relationship – I was stifling it, and starving it of oxygen. I was expecting a flower to grow, in an expanse of ice. I wanted, desperately, for my therapist to care about me. But what was I giving her to care about? What was I telling her about myself, or my life? We all know that our best and deepest friendships are based on shared experiences, and a shared journey (emotionally, even if those friends are not physically present). My therapist and I need to go on a journey together, and to get to know each other through the things we encounter. If we only encounter each other, in isolation from the world around us, there is not enough ‘grist for the mill’, and there is no way to deepen the relationship.

I still have the urge to spend most sessions talking about ‘the relationship’, just as I spend so much time thinking about it. But when I do leave room to talk about other things, it’s amazing how often and how naturally ‘the relationship’ comes into it, whether that’s through the interpretation of  a dream, or the way I reacted following a session, or some other situation. But it comes up in a way that is not forced, and which provides continuity and a deeper understanding between us.

So for those who are also struggling with what to expect of the therapeutic relationship and who find themselves constantly engaged in thought or in talk about it, my suggestion would be – take your eyes off it for a little while. It will grow – if you let it. But it will do so in the background. It will germinate, it will ripen on the tree, while you are engaged in turning over and ploughing other fields. And when you turn your attention back to it again, you will have a rich harvest of shared experience, understanding and mutual caring. You relationship will have matured, and it will be beautiful to behold.