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 and for Muse Magazine Australia, under the name Clara Bridges.


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When I realised how much therapy has helped me change – Part 2

[The first part of this post (without which this Part may not make as much sense!) can be found here. Though originally I thought this would be a two-part post, it has now become clear it is at least a three-part (and possibly a four-part!) post. Part 3 will follow next week….]

Tuesday

When I got home I was still reeling from the shock of my therapy session. I was intensely hurt, upset, angry, confused, afraid……I sent this email to my therapist:

“I clearly made a mistake in addressing my email as I did at the weekend. But if you think I was looking for a particular response, you’re wrong. Right now I really really don’t want to come back on Thursday. You know I will, anyway. But I’m in shock and it feels like everything is under threat and about to come tumbling down.”

It felt as though everything had been destroyed – or was on the verge of being so. It felt as though I had built a convenient fabrication around our relationship, and that she had let me do it, only now to try to jettison her ‘therapy mother’ role when it had become too uncomfortable, and when I got too close. Suddenly I didn’t really know what was real anymore. I felt as though she had lied, if not directly, then by omission. I didn’t see how we could possibly carry on working together when the picture I had built up of our relationship, and what I thought I had been experiencing – which formed the supporting structure of the therapy – had just been torn down. Or at least, that was what I was afraid had just happened. I recalled the many occasions when my therapist had herself used the terminology of ‘therapy-mother’ and ‘therapy-daughter’, and wondered how I could trust her when she was apparently trying to tell me that I was ‘seeing her all wrong’ (my words)?

And yet…….this is when I first noticed something was different – about me. Because though my feelings were very intense, and though part of me wanted never to see her again, I still went to sleep that night, as I always do, holding onto the small stone that she gave me as a transition object just before our long summer therapy break last year.

Wednesday

I woke with the same intense feelings that I had experienced the night before. I felt lost in a fog, circling the edge of a chasm that I could not see. My therapist replied to my email, to say that she could see that this was difficult for me. She also said that I did not make a mistake in addressing my email, and that “therapy is not about getting it right, but about discovering about yourself”. I was at work and could not reply – and I did not feel like replying, at that stage. I suspected that she wasn’t really aware of the enormous impact her words had had on me.

Strangely, as the day wore on, I began to feel a little better. On the one hand, this was not surprising, as I switch very quickly and effectively into ‘work mode’, compartmentalising and shutting off other parts of me, and their feelings. In addition, it’s routine for me to simply shut off very painful feelings and prevent myself from feeling them.

But I sensed that my feeling better was not simply a result of those two factors. I sensed that it wasn’t just that I had locked the intense feelings away, but that they were actually becoming less intense. The thoughts that the night before had seemed so all-consuming that they felt like a certainty, felt more like frightening possibilities (even perhaps probabilities), which were laced with doubts. The sense that my therapist had not been honest with me, that I needed to run because our relationship had been undermined, was slowly changing into the rational thought that I knew her and trusted her, and there must be some explanation for what had happened. Gradually – though with lightning speed compared to the rate at which my reactions would have changed two years ago – I was coming round to the idea that I needed to stay open and vulnerable. I needed to face whatever it was that she had meant by her words on Tuesday, and to go forward from there, with her, whatever that ‘with her’, looked like.

The night before, I had experienced two mental images, two choices that were open to me. On the one hand, my ‘internal parts’ (my inner child, teenager, and others) were ‘putting my therapist to death’ – removing her, that is, from my inner world, from my thoughts and my feelings. On the other hand, there was an image of my therapist destroying that ‘internal family’ – which is what I was afraid would happen, if I continued to ‘let her in’.

That evening, I sent my therapist the following email (only extracts are included here). I started off by replying to her statement that I was finding things ‘difficult’:

“No, it was more than difficult – it felt catastrophic. Last night it felt as though between us we may have undone almost four years’ worth of work. It felt as though everything I had built up or been allowed to think or believe was a lie, or just my own fabrication. I didn’t want to see you again, or I wanted to end therapy soon – because I didn’t trust you and therefore how could we carry on. Strangely, I didn’t cry. I think my protective side jumped in immediately to stop me feeling too much. I started to dismantle my inner world and images – it felt as though you had no place in it anymore. Something can only be internalised, if there is a corresponding external something, to internalise in the first place. Otherwise it’s just a construction and a fabrication. If what I thought I was internalising didn’t actually exist….then the internalised version had no claim on that inner space.

……I want to trust you and I don’t want confirmation that I have been deluding myself or that you have been lying by omission. But I do want you to be honest with me, at the same time.

I’m just trying to convey what it felt like last night and this morning. I wouldn’t be writing this if part of me didn’t still trust you and didn’t still, strangely, feel a bit connected, despite what felt like a threat of annihilation….”

Amazingly, I did still feel connected, and I rapidly followed up my email with this one:

“I keep thinking about all of this, I can’t switch my mind off. I think I want to work through this with you, whatever the outcome. Because you’re the same person that you were before; even if you think my perception of you or how I think of things, is not quite right. And so it feels as though I stand to lose a huge amount- stuff without which I’m not even sure how I would make sense of things/therapy anymore. But you would be there and would be the same person even if I felt as though I’d lost you. Whatever was left would still be worth a lot. I don’t know if any of that makes any sense…..”

My abiding sense, as I went to sleep that night, holding my therapist’s stone once again, was that I knew her, and she was the same person now, as she had been before. She was the person that I loved, respected, and trusted, and with whom I had shared so many difficult and joyful times in therapy, and who had been there for me and present with me, supported, upheld, and accepted me, and cared about me.  That hadn’t changed, I felt absolutely sure of it – irrespective of what had happened, or how I felt. My core inner view of her stayed constant, and I wasn’t ‘splitting* her’. In that respect, at least, it was as if I hardly recognised myself anymore.

 

[* – In 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, and the criterion is worded as follows: “A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation”.]

 


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When I realised how much therapy has helped me change – Part 1

This post, together with Part 2 (still to come), describe in detail the recent events referred to in my post Memory Monday – “Progress in therapy – being ‘all in’ “. The article mentioned below, is the one linked to from my post ‘How does therapy work?’.

Friday

We had had discussions about dreams before. I struggled to remember my dreams and to interpret them, but I knew my therapist believed them to be valuable for gaining insight into one’s subconscious. Last year, she said that I brought my dreams to session almost as if they were a bunch of flowers I was giving her. She was right – I was treating them like a gift, because I knew she would find them interesting and I wanted to please her. When she asked for my thoughts on them, I often just said I didn’t really know. I always asked her what her own thoughts were, and she would say that my own interpretations were the most significant.

Last week, after a ‘dream dry spell’ lasting many months, I remembered a number of dreams in a row and brought them to her. Or rather, I just dropped them into her lap. I made some comment about the fact that I am a lucid dreamer and love dreaming; to my surprise she replied that she wondered therefore, how it was that I did not show more interest in engaging with my dreams and what they might have to tell me. She emphasized again how valuable she believed they could be to our work, and noted that I appeared to be very wary of delving into my subconscious. She said that she would ‘love’ for me to engage with dream work. It was at that point and with that word, that I realised quite how passionate she was about the subject and how much she cared about it – and not just the subject in the abstract but specifically about my own engagement with it.

She encouraged me to write down a recent dream and try and think about who or what the characters might represent. The dismissive part of me that is essentially the voice of my mother, told her that dream interpetation just felt like a game with little substance. I could come up with a number of interpretations, but they seemed to tell me little I didn’t already know, and in any case, how could I ever know which interpretations were informative, and which were simply pure invention? I left the session feeling resistant and resentful, and I sent an email telling her as much.

Sunday

I was brave. I debated with myself, but the desire was so strong, I took a risk. I sent my therapist an email on Sunday night, that started ‘Dear Mum…’. It was the first time I’d addressed an email in that way – and I wasn’t planning on making a habit of it. But it felt like the most fitting way of conveying the incredibly strong connection, love and security that I’d felt for the last couple of days. It was an expression of me, just as much as it was an expression of how I felt. I took courage from a past conversation in which she had implied that I had the freedom to address her as I chose; and from the time when she had referred to me using ‘I love you’ at the end of an email, as an expression of self.

Earlier that day, I read an interesting article on ‘inner child work’ in therapy. It discussed the importance of working in therapy to grieve what we never had as children, so that we can heal, rather than expecting to be ‘re-parented’ by a therapist acting as a substitute for what was missing. I wanted to talk to my therapist about it, but it felt like a ‘distraction’ from the topic of dream work, and so I refrained from sending it to her at that point.

When it came to dream work, Friday’s resistance and resentment had melted away, largely as a result of hard work on my part to self-soothe and maintain connection by talking to my ‘inner child’ and summoning up images of my therapist comforting her. But I had not conveyed that change to my therapist, in the forty eight hours since Friday’s email. And so, though I didn’t realise it at the time, to my therapist Sunday night’s email was a case of discordant misattunement, and a baffling surprise.

Tuesday

It’s ironic that during a weekend when I felt so utterly connected, my therapist felt disconnected. As far as she was aware, she had completely failed to get through my resistance and help me to understand why working with dreams might have benefits. When she read Sunday’s email, it simply did not fit with where she was at, at that time (or indeed with where she thought that I was at). That is not speculation – it came from her directly. She rarely shares details about her reactions, but when she does, it is invariably helpful.

I tried to explain to her how my change in attitude over the weekend had come about, and as ‘proof’, I showed her my ‘homework’ – the pieces of paper on which I’d written down a recent dream, and tried to analyse it. Despite what I’d said in Friday’s email, once my resistance faded I had resolved to be more vulnerable and open to my subconscious, and to make a real effort to work with my dreams. I trust my therapist – and it was hard to ignore the obvious value she placed on this work. I also wanted to gain as much as I could from our sessions, and to immerse myself as fully as possible.

Perhaps it was that thought that led me to mention, almost as an aside, the article I had read regarding the work of therapy. I said that I still wasn’t quite sure what it would look like to grieve the mothering I never had. Despite having written about the subject some time ago, and having experienced at least some of that grieving, I didn’t know if I was ‘doing it right’. Was I missing something? Was I gaining as much as I could? I felt as though I was doing the work intellectually, but was I immersing myself as much as I should, emotionally?

The privilege (but also the pain) of working closely together for a number of years, is that my therapist is able to be more direct and more overtly challenging, than she could have been in the past. It is a sign of my progress and of closeness. But, like my email from Sunday night, her reply was unexpected, and did not seem to fit with where I was at.

She said that I did sometimes approach things intellectually, and without emotional engagement. She said that part of me did want a replacement mother; that I wanted her to be someone other than her, and that I wanted her to respond to me in a particular way. She said ‘I am [name]’ – did I draw the implication ‘and not Mum’, or did she actually say it?

I can’t remember. By this point I was in shock, and I spent almost the entirety of the rest of the session in silence, even when she tried to encourage me to talk by asking me, ‘where are you?’. I wasn’t lost in thought, so much as lost in a thought – the only thought going round and round my head, which was ‘I am trying to stop my world from caving in’. The trying consisted in the repeating of the phrase – the monotony prevented any other thought from rising up and destroying me. It also somehow kept me physically immobile so that I didn’t collapse, or move, or somehow disintegrate under the weight of her words.

If this had been a lucid dream I would have pressed rewind, to the point just before I mentioned the article and asked those questions. But I was all too conscious of the reality and immutability of her words that still hung in the air, with an annihilating quality far more frightening than any nightmare I had ever had.

 


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How does therapy work?

I wanted to share with you an article that I found, that played a role in the difficult (but ultimately step-changing) experience that I had in therapy recently, which I touched upon in my previous post. It is an article about the importance of healing past wounds, rather than ‘making up for them’. In particular, it talks about the importance of therapy enabling grieving what he did not receive as children, rather than becoming a substitution for it:

http://howtherapyworks.com/working-inner-child/?platform=hootsuite

I’m very aware this is a hugely contentious topic, both amongst therapists and amongst clients. Even amongst those whose blogs I read and love, and amongst the bloggers who follow me, there are those whose therapists believe in very direct ‘re-parenting’ and in trying to provide what was missing for their clients; and those whose therapists believe they cannot and should not try to substitute for those missing experiences, but believe in emphasizing the grieving part of the process. And amongst the clients of the latter group, there will be many who yearn for that re-parenting and find it incredibly difficult to accept their therapist’s apparent ‘with-holding’, and those who have come to accept it, understand it, and even agree with it.

I would urge you to consider avoiding this article if you believe it could be triggering at this time for you – for example, if your therapy is progressing well in a re-parenting context, and you do not wish to read something that carries any risk of being unsettling. I completely understand that perspective, and indeed I share it, in that particularly during therapy breaks, I am very careful about not reading anything that could be even remotely triggering. And I would be horrified to think that anything I share might undermine anyone’s confidence in their therapy or therapeutic relationship, even a little bit. Every therapist works differently, and every therapeutic relationship is unique.

But for clients those whose therapists do not seek to ‘re-parent’, and who find that difficult and distressing – which I think it understandable, to be expected, and something I have repeatedly encountered myself – I think this article may provide a helpful perspective. Its key messages are that therapists do not with-hold on purpose, and that emotional healing really is possible. And as part of unpacking those messages, the article makes a number of helpful observations about the dynamic between the therapist and the client’s ‘inner child’ – observations which I found tallied very closely with my experience.

I should add that I do not agree with everything in this article; and as with many things, it is a case of choosing what is helpful for you. For example, I think it focuses on grieving the past almost to the exclusion of talking about what is possible now, in terms of the relationship with one’s therapist. I wrote an extensive series of posts over the summer, talking about the ‘new experience of mother’ that I have discovered in the context of my therapy. It is by no means a substitution for what I did not receive as a child, and it is not the sort of relationship that would exist between an adult and an actual child.  But it is nevertheless an adult version of a deeply trusting and accepting relationship, that provides a different but incredibly valuable kind of ‘therapy mothering’. The article hints at that, when it talks about therapy helping individuals to develop a ‘core lovable self’. But in my view, it doesn’t say enough about it, and it also makes the statement that development of this self comes from the ‘goodbyes’ rather than the ‘hours of good time together’ – a statement I strongly disagree with, unless I have misunderstood its context and intent. The good experiences my therapist and I have had together have been just as important as the tough times we have been through, in terms of forging a close and trusting relationship, and helping me to better understand what a positive yet boundaried relationship can look like.

When I first read the article, one of the things that struck me most, was what an incredibly difficult job our therapists have, and what an immensely grey and delicate line, they have to tread. I feel incredibly grateful for my own therapist, and not just for her skill and experience, but for her humanity, sound judgment, compassion, care and humour. Despite our many cycles of rupture and repair, and the many times I have felt an undeniable need for ‘substitute parenting’, she has successfully kept my ‘inner child’ engaged in the work; giving what she could, when she could, and where she judged it would be helpful and necessary, and ‘with-holding’ when she felt it would be both possible for me to cope with, and ultimately in mine and the work’s best interest.

It is a point made beautifully by blogger ‘Tales of a Boundary Ninja‘ in her wonderful post ‘Why your therapist SEEMS cruel, but really isn’t‘. There is no better way to end this sharing of articles, by quoting her moving last paragraph:

“So the next time you are wondering how your therapist can be so cruel as to sit there and watch you be in pain and make no move to stop it, try to consider that it is an act of love which requires deep strength, compassion and discipline because so much of therapy is coming to grips with the deep grief over that which we deserved as children but did not receive. Our therapists must endure being the trigger that draws this pain out and then answer a pain not of their making with a deep compassion and understanding. I eventually learned a profound respect for BN’s ability to face and walk through that pain with me, instead of rescuing me which would have made both of us feel better immediately, because his sight was fixed on the long-term, on my healing”.