Apologies in advance if this comes out as a disjointed stream of consciousness - I'm just home from seeing my (MY!!!) psychiatrist and my head is reeling, I feel like every single emotional nerve ending I have is currently exposed and I need to write this down before I either forget it or put a disordered spin on it.
She was wonderful. Just like the last time that I actually saw her personally, she listened, really listened, and I felt safe. We put a plan in place both to keep me safe in the short term (meds are now only to be dispensed weekly, I'm to continue to ask for, and more importantly, accept, help), and to help me get over this chaos in the long term. All this stuff with Therapist, all this sense of abandonment, rejection, pushing me away, not supporting me - all this stuff is at the core of bpd. Things have been really inconsistent with Therapist this year between bank holidays, holidays in general and me deciding I didn't need her any more, so all of the abandonment stuff has been magnified hugely. She reckons that it's this, and the need to work through it, that has caused me to become so unstable (the official term is emotionally dysregulated) the last while.
'Individuals with BPD feel the same emotions that we all do. The difference is that whether they're good or bad feelings, they're off the charts. "People with BPD are like people with third degree burns over 90 percent of their body," says Marsha M. Linehan, Ph.D., founder of Dialectical Behavioral Therapy. "Lacking emotional skin, they feel agony at the slightest touch or movement." '
We talked about the difficulty in understanding this, both for me and for other people. Depression, anxiety, bipolar etc are one thing, and people are starting to come to some kind of an understanding of these, albeit slowly and with a long way to go. But this? This is a whole other ball game. The language to adequately describe it in a way that most people can understand barely exists.
She also said something else that had me literally dissolve into tears - 'It's not your fault'. All this stuff with Therapist - it's transference. It's exactly what's supposed to happen, that's where the work is, but I guess transference of this kind through a bpd filter might explain why I find it almost impossible to tolerate and then become so tied up in knots when I get to see her. I had no difficulty explaining this to my psych, because there's no transference there. I was just telling her what was going on, she was listening, and that was it. I was able to cry (a lot, which is actually surprisingly unusual for me considering how ridiculously emotional I am, I generally will stop breathing in an effort not to cry) because I didn't feel she was judging me. To be honest, I was barely aware of her being in the room for quite a lot of the time. I suspect that's how it should be in therapy, but I'm so caught up with the intensity of feeling that it brings up that I'm all but cowering in the corner waiting for her to laugh at me and walk out.
We talked about the boundaries Therapist sets, about whether or not she's professional with me. She is, to the nth degree, no matter how hard I push. But I think what's causing problems for me this last few months is that the limits imposed on her by her role, primarily no contact between sessions, coupled with more frequent gaps between sessions than I'm used to, have in fact made things far more complicated, because every time I look for contact and it doesn't happen (and I do this far more than I should) it intensifies the abandonment and rejection even more and I spiral.
So the solution? DBT
. Hopefully. I'm to see the hospital psychologist next week, with a view to starting a programme of DBT therapy. Unlike the brief group sessions which I had last year, this will be an intensive year long programme of individual therapy, homework, and crucially for me,
access to support between sessions when I need it. She's firmly convinced that this is what will sort me out. We talked about an increase in meds but she decided against it because it really isn't the answer for bpd and I struggle with side effects. So, drugs will stay as they currently are. In the short term, until I get going with DBT, distraction is to become my new best friend, so when I find myself getting overwhelmed or feel the urge to hurt myself, I need to find something else to replace it with and try and get me out of my head. So much easier said than done, but I'll give it a go. She thinks it's important for me to continue at work as much as I can for that very reason. Pick up the phone. Go and be with other people. Find something I enjoy and go and do it.
I am SHATTERED. I woke up tired and that half hour with her was so intense I feel like I could sleep for a week. What I actually have to do now is put game face on and go to work. But it'll be ok. I feel like we are finally, finally getting to a point where I'm going to get the support I need. I don't know that I'll be able to continue working with Therapist but that's not something I'm prepared to think about right now because that's a whole other shitstorm right there. I've just calmed down and for now, all I'm feeling is tired and relieved. I don't want to throw anything else into the mix for at least a little while if at all possible and finishing with Therapist, for all the reasons outlined above, will quite likely send me off the deep end.
I cannot tell you what a difference it makes to feel like I've been heard, and more importantly, understood. The system as a whole might be woefully inadequate and under resourced, but there are some really good people doing their best working within it. I'm very, very grateful to have found one of them.
Labels: attachment, borderline personality disorder, coping mechanisms, DBT, distraction, impulse control, listening, Medication, psychiatrist, relief, self harm, support, treatment