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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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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Approaching the end of the therapy break

When I returned to therapy last month after a short one week break, it was with a sense of excitement to be able to talk to my therapist about how things had been, and a sense of safety and relief at being ‘home’ again. I’m returning to therapy in a couple of days, after my therapist’s four week summer break, and it’s with the knowledge that this has been the worst break for a while. I’m nervous, afraid, in need of reassurance, low and sad – in that sense, we will be picking up from how things were for several weeks leading up to the break. It was a tough summer of sessions, with a horrendous ‘muddle’ (as my therapist called it – rupture, in other words) back in June. I muddled through after that, but I don’t think I fully recovered. And my big worry, of course, is that in some sense, perhaps neither did she, or our relationship.

In these last few days before I go back, I’ve been trying hard to ‘give myself a talking to’, to clear my head of all the scare-mongering, worrying, and self-critical thinking, and to remind myself of the good sessions that we had in the run up to the break, and the close moments; but much more than that, of the fact that this is a four year relationship with a history and a solid basis , with deep trust and genuine caring, that doesn’t just get wiped out or set back by a few difficult months, or the seemingly real fears in my head. It’s what I should have been doing for the last four weeks, not just the last four days. But I didn’t. And I was in a bad place. And I can put part of the blame on lots of things, some of them external, and others also external but more within my control. But I did not exercise control – over what I read, or allowed to influence my thoughts. I made poor choices, or no choices. I didn’t feel very much, because I was completely overwhelmed by feeling too much – too much filthy, contaminating, miring, all-consuming unhappiness and hopelessness; unhappiness that covered so much ground it ate up everything else. Unhappiness born of being unreconciled – to myself, and to my past, present, and future.

‘There are a thousand thousand reasons to live this life, every one of them sufficient’ – this was by far the most challenging thing I read during the break. There were many more that were far more depressing, but even this challenge, rather than becoming an inspiration, turned into a self-judgment – a pinnacle I couldn’t scale, a personal quality I was too flawed to possess. In a book full of challenging passages on humility, forgiveness, vulnerability – this was the one that hit me hardest at the time. There are a thousand thousand reasons to live this life; yet during the last four weeks only one of them seemed sufficient – my children.

I think what I have learned during the last four weeks, from a range of different sources, is that it’s hard to be reconciled – to yourself, to others, and to your circumstances – when you are under judgment – your own, and the perceived judgment of others. If you pray – as autumn approaches, pray for me that like the trees, I will be able to let things go. I don’t want to be or to feel under judgment. I want to be reconciled – I want to feel at home.

 

[Quote is from ‘Gilead’, by Marilynne Robinson, the first book in a trilogy, with the other two being ‘Home’ and ‘Lila’.]


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My therapist was right – again!

[The text below was written a few days ago, straight after one of my therapy sessions. I waited to publish it, because I wanted to share its content with my therapist first. Particularly since we started curtailing email outside of session, I really want to try and keep our work spontaneous and ‘within the room’, otherwise it almost feels as though the very difficult process of changing our previous email pattern, will be undermined. I will continue blogging about my therapy, and writing is still a valuable way for me to process material – but it will more often, these days, be ‘after the fact’, rather than when I am in the very middle of a situation.]

Having spent weeks finding it really difficult to write, I now feel absolutely compelled to do it. Why? Because I’ve been driving home after my therapy session feeling incredibly grateful, and for some reason, for a moment, I’m allowing myself to be one of those people I sometimes find very irritating on Facebook, who go on about their gratitude while many of the rest of us are feeling anything but. So I sincerely apologise for inflicting that on anyone. But on the other hand, part of the problem with Facebook is only seeing the positive parts of the picture that others are happy to present to the world, whereas my gratitude today is part of a bigger, messier, darker, and un-straightforward picture, which I have tried to present as honestly as I can.

I have written so often about the feeling of having a bottomless ‘pit of need’ inside me, and how painful that is to encounter within myself. As I was driving this evening I was conscious of the contrast and of the excitement and pleasure of feeling as though I was a container overflowing, rather than a pit needing filling.

I’ve just had two therapy sessions on consecutive days, after a short therapy break, and both times my feelings upon entering my therapist’s house were different to other ‘returns’. This is the shortest break we’ve had (a week) so perhaps that helped – it was long enough to trigger break-related feelings and also to function as a period of consolidation, but short enough that I still had a sense of connection to the material we had been covering before the break. There was therefore less uncertainty about what it would be like to resume; but even so, I don’t remember feeling quite so excited before, about ‘coming back’. I have always longed to resume sessions, and couldn’t wait, as well as getting frustrated and anxious about the return – but unafraid excitement was something a little new.

I felt like running up the stairs to the therapy room, and just entering it had a real sense of safety, comfort, and of coming home. I literally cried with relief (and other emotions) at a couple of points during yesterday’s first session back, and even today couldn’t quite get over how good it felt to be back. And not just back – but back in a really engaged and open and undefended way. It’s how I really wanted to be, in session, before the break happened, but I couldn’t really manage it at that point.

I’ve been wondering why – where this sense of excitement and ability to be open, came from. It’s not as though the break was easy or my feelings positive the whole way through. As I mentioned in my previous post, though the break started well, my mood changed completely part-way through, and rather than feeling confident and secure in the therapeutic connection, I felt fearful and very self-critical.

I did try and think myself out of that state  – and was helped both my own realisation that the change in mood and my perceptions of my therapist came from within myself and were not triggered by anything she had said or done; and also by a brief email exchange that we had. She was open and supportive, and posed a couple of interesting questions for me to think about. And I did…..

My therapist has sometimes expressed surprise that I have not shown more curiosity about my dreams or about my subconscious. One of the things that was different about this break and the return, was that I was more curious about what had been going on during the break, and I was more invested in trying to understand it. I returned to therapy excited to talk about what had happened and my attempts at unpicking it; but also excited about trying to understand it with my therapist, and not just on my own. The first session back was emotional and difficult in parts, but also thought-provoking; and with the luxury of some time to myself after the session, I felt as though I took a number of important steps forward in getting to grips with the material we’d covered.

I couldn’t wait to tell her, and had an even greater sense of excitement and anticipation when I arrived at session today, knowing that I would share these steps and that we could talk about them further.

If I try and think about why there has been this change in my curiosity and excitement about the material of therapy, I suspect I may not be able to identify a single factor, and that a range of elements contributed. However, it’s also possible that among the range of factors there may be a single very important one; and that I might have to acknowledge that maybe this is part of what my therapist meant when she said that the reason for reducing email contact outside of sessions was to ‘free me up’ so that we could interact in a more ‘lively way’ in person. It’s a little irritating when she’s right…..!

But it also makes me feel very very grateful for her, and for everything she’s done and is doing for and with me. I’m enjoying this feeling of overflowing, because I know that while the fact of overflowing may continue, the feeling will come and go, despite wanting to hold onto it.  When I look at the wider picture, there is a great deal that continues to be very painful. Outside of therapy, my husband and I are finally in couples counselling, but probably at least a year too late – we have essentially withdrawn and become used to ignoring each other and only talking when the need arises. In therapy, despite the connection, trust, and gratitude I feel, I’m still a little too afraid and insecure to read an article I saw on Twitter about what happens when therapists dislike a client, and I feel renewed pain at the question of touch in therapy, when I read about others’ current struggles with the very same issue. And I’m still jealous of my therapist’s daughters, and the place they occupy in her life. In no way have these things been suddenly ‘fixed’ and nor do I expect them to be – resolved, at some point, perhaps, but who’s to say in what way, and when?

But the feeling of overflowing is there together with those other things, and they can co-exist, and I think that that is different, too. It reminds me of some passages in a beautiful book that my therapist recommended to me a while ago, which had a big impact on me. “This is not to say that joy is a compensation for loss, but that each of them, joy and loss, exists in its own right and must be recognised for what it is. Sorrow is very real……life on earth is difficult and grave, and marvellous…..so joy can be joy and sorrow can be sorrow, with neither of them casting either light or shadow on the other.”*

I think that pretty much sums up how I’m feeling right now – and I wanted very much, to share that with you.

*from ‘Lila’ by Marilynne Robinson


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Constant shifts and comforting words

I wrote this almost three weeks ago, over a weekend, and meant to take it to the first therapy session of the week with me and show it to my therapist. It was during the very early days of our ‘new approach’ of trying to restrict (or cut out) email contact outside of sessions. And so in that spirit, I wanted to show her the poem in person, rather than send it electronically.

However, my mood and attitude in session were different to how I had been feeling when I wrote the poem, even though there was no obvious reason behind the change. The change wasn’t even apparent until I was in the room – perhaps something that happened very close to the start of the session (and which I now can’t remember), triggered my defenses, or perhaps it was something else entirely.

By the end of the week, things had recovered, but there was a similar replay the following week; and by the time I hit a short therapy break (which I’m nearing the end of), I still hadn’t managed to show her the poem. I now suspect I simply won’t get the chance as there will be too much else to cover before we then hit a longer, four-week break.

The break itself has followed a similar pattern to those previous two weeks – a few ‘good days’ where I feel connected, vulnerable, open, and determined, followed by a fairly sudden change where it’s almost as if a switch is flipped. I then suddenly see everything through a lens of fear, self-hatred, and potential judgment, which closes me off and puts up my defenses. Whichever lens I’m looking through, it colours everything from my perceptions, to my thoughts, to my feelings, to my behaviour. It feels as though my worldview shifts into a different state, and that the changes in thoughts and feelings are symptoms, rather than causes of that shift. Which still leaves me searching for an explanation as to why this happens, and that in turn leaves me feeling incredibly frustrated and demoralised. It feels as though I have little control over these shifts; they are regular, and unpredictable, and I feel completely at their mercy. That is difficult at the best of times; but during a therapy break, when I need to try and maintain my equilibrium, it is even more problematic.

Thinking back, I think these shifts have always been there, but they are more noticeable in the context of no contact outside of sessions, where I cannot seek reassurance and try to reconnect ‘in absentia’. It also means that whatever is going on, the changes are much more clearly something to do with me and my own thoughts, as they are not happening in connection with anything my therapist might have said or not said, over email (or even my expectations of what she might have said, or not said). That is both a consolation (as it means I still feel secure in who she is) and a concern (as I have no easily identifiable trigger or explanation for what is going on).

As I was writing this poem, some of the language evoked images and memories of self-harm. Though initially it was unconsciously done, as I worked on the poem it became more intentional. Some of the images felt a little incongruous with the subject matter, which is essentially a positive statement about my determination, despite these mood/worldview shifts that I appear to be caught up in, to be open to everything my therapist has to give me, including the tough lessons that preparing to lose her, and then losing her (at the end of therapy), will bring. However, something about the images also felt right; if they are a little radical or a little unsettling, well, so is complete openness and vulnerability – at least for someone who is used to the very opposite of those things. They are unsettling because to someone who is not used to them, exercising them can feel like leaving one-self wide open to hurt and harm. And so it seemed fitting that the poem should somehow be a kind of re-interpretation of self-harm; that its words should give a different meaning to the images that they invoked.

Thoughts and images of self-harm have resurfaced more frequently since my therapist and I have virtually stopped email contact. However, I’m hoping that now, when that happens, the words of this poem will come to mind. And that instead of feeling desperate and afraid, I will remember that openness may hurt, but – just as oxygen binds to blood and keeps my body alive, the internal bond with my therapist and the love that I carry for her, sustains me. If she’s reading, I want her to know that I know that – even when that knowledge is a little buried or veiled from view, and even when that knowledge is difficult to feel.

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Self-care strategies for the summer therapy break – Part 2

Part 2 of my recent post for therapy website welldoing.org contains seven more strategies I find helpful for coping during therapy breaks, and it can be found here:

https://welldoing.org/article/7-acts-self-care-better-mental-health

If you have your own tips, it would be great to hear what works for you! My thoughts are with anyone who has a therapy break upcoming….


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Self-care strategies for the summer therapy break – Part 1

Over the last eighteen months or so, I have found myself developing a number of strategies for trying to cope with therapy breaks, and in particular the long summer break, which for me tends to be between four to six weeks long. I recently summarised thirteen of those strategies in a two-part post for the therapy website welldoing.org, and this is the link to the first part, containing my first six tips. I hope you find them useful!

https://welldoing.org/article/this-is-why-self-care-makes-such-a-difference-in-mental-health


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Easter therapy break – Part 2

The first part of the Easter therapy break was, after all, okay. I was pleased that, after an unexpectedly difficult last session (described in Part 1 of this post), I ‘pulled it back’ and felt connected, secure, and held in mind, for the first week. Snatching victory from the jaws of defeat is not something I’m used to, relationship-wise. I tend to catastrophize if things don’t start out well, or as I expect them to be. The relationship with my therapist is my first in which things were rocky (understatement) at the start, and then blossomed over time. For many months it was difficult to believe that whatever might ultimately be gained, would not be weaker, or somehow permanently sullied, because of the fact it began in adversity. It shows how wrong I can be.

I was also wrong about needing to start the therapy break in a particular way (a supremely positive way, of course), in order to be able to feel connected. The first few days were difficult, and I was much more unmotivated than I have been at the beginning of the last few breaks. As with the last two breaks, I daily-tweeted my way through this one, despite my initial reluctance to do so. By Day 4 my #therapybreak tweets were showing a return to openness, vulnerability, security, and connection.

But as with all good stories, things had to get worse before they, um…..got even worse.

***

To cut a long story short, my therapist went away without telling me – which of course she has every right to do. That is, she went on holiday and was out of email contact for a week, and I had no idea. And when there was no reply to an email I sent, for several days, sadness and catastrophizing set in. Although the major part of me continued to believe in her caring and in our connection, I had to fend off the part of me that didn’t. For the first time in a long time, there was a physical dimension to my distress – I had difficulty falling asleep, and I had vivid and complex dreams. I know that the situation was intensified by a number of other factors I had been worrying about over the break, but in essence, I just didn’t understand my therapist’s thought process behind acting as she did.

It was another example of the unexpected throwing me for a loop. It happened at the start of the break, and it was happening at the end. It was not how I imagined my therapist would act – in the past she had told me (as far as I know) when she would be out of contact. But we had no explicit agreement that that would always happen, and in the absence of her telling me otherwise, I simply assumed she would be spending the break at home. I never thought to check my assumption. I told a wise friend, who thought my expectations of my therapist were unrealistically high – he put it more kindly than that – and though I hope that’s not as true as it used to be, perhaps I still fall into the trap of idealisation.

When I found out my therapist had been away, my mind came up with several possible options for why she might not have told me, and eventually settled into the firm belief that she had gone away to look for a house to buy for her retirement, in another part of the country. I was so fearfully convinced of it, that it was quite difficult not to go into my first session back and say “So, you bought a house then?”.

As far as I know, she hasn’t bought a house. Instead, it seems that she simply had confidence in me, and the progress that we have made over the past year. I think she thought that I would be okay, based on how the previous three breaks have gone. I’m very glad that she believes in me – though I did object that she ‘took the risk’ without my permission. She used the metaphor of a parent taking their hand off the bike seat to show their child that they can manage for themselves without stabilisers. I did the same to my own children, so I could understand that – is the decision wrong, and the confidence negated, if the child falls over and ends up in a heap? I don’t know….but they may well be scared of trying again.

***

At least the way the break ended meant that my first session back was a very different story to the versions of it that I imagined during the first part of the break. As you may be able to tell by now, I run scenarios in my head – a lot. And as a lucid dreamer, I’m used to stepping in and changing direction when things aren’t working out so well – in my daydreams, as well as in my night-time dreams.

*

“So, I brought a list of questions”, I said, as I handed over a sheet of paper. My therapist reached for her glasses, and I felt apprehensive; the last time I had a list to work through, she wasn’t that enthralled at the idea and felt it got in the way of the session. And as for asking her questions – on the whole that doesn’t tend to go too smoothly either.She started to read the questions silently to herself.

I said, “These are things I thought about a great deal over the break, and that I really need to talk about. They’re on my mind a lot, and I’m anxious about them, and it would help to have some answers….”.

I went over the first couple of questions in my mind: “is your daughter still living here?; how many years do you think it will be until you retire?”. Gulp. What was I thinking?

“What were you thinking?” she said.

No, hang on a second, she wouldn’t say that. And this is clearly a really bad idea…..

*

“So, I had a list of questions, but I decided it would be a bad idea to bring those and hand them over”. She looked at me quizzically, waiting for me to go on. “They were things I really wanted to have answers to, because I needed reassurance, I needed to feel better”. More waiting for me to go on. “But I didn’t bring them…..”.

“Why did you decide not to bring them?” .

“Um, because I didn’t think you’d answer them? And because it didn’t feel like the right thing to do – it would get in the way”.

“Get in the way of what?”

“Of speaking freely about what was on my mind, of seeing where the session takes us….”.

“What sort of questions had you wanted to ask?”.

I went over the first couple of questions in my mind: “is your daughter still living here?; how many years do you think it will be until you retire?”. Gulp. What was I thinking?

“What are you thinking?” she asked, as I went silent for a while.

HHmmm……not quite sure this version will go any better.

*

“So, I think she should take the questions in with her”.

“No, she won’t do that, she knows it’s a bad idea”.

“Still, I think she’ll do it. It’s what she wants to do, and she needs the answers, the reassurance”.

“As if your judgment can be trusted – you wanted to send her into session two weeks ago, with no underwear on”.

“I won – partly. No bra”.

“Not that therapist noticed….”.

“Well, I say she’ll take the list of questions in anyway – betcha”.

Oh, seriously, come on – are my ‘internal voices/parts’ really going to start taking bets on how much I can humiliate myself at my first session back?

*

After that, it was a strange sort of relief to spend the first session back, talking about why my therapist went away without telling me.