Saturday, 5 April 2014

I'm Still Standing - But I'm Not Standing Still

Pilgrim
by Dom Helder Camara

when your ship,
long moored in harbour, gives the illusion
of being a house;
when your ship
begins to put down roots
in the stagnant water by the quay: put out to sea!
save your boat's journeying soul and your own pilgrim soul,
cost what it may.


I had my final DBT therapy session nearly a month ago now. Contrary to my fears about it, my world didn't end, I didn't suddenly forget everything I have learned and practised over the past year or more and I didn't suddenly revert to the worst self-destructive crises of my BPD. Suddenly, I realise I am still standing - more than that I have not stopped making progress. I know from cycling and other 'balancing acts' that if you stop moving forward, you fall off. Choice: keep going forward, go back or fall off. Seems simple when I put it like that. Having decided to keep going forward, I am noticing that my BPD and the emotional storms that accompany it no longer control my decision making and day to day experiences of life.

Don't get me wrong. I still experience moments of panic, anxiety, sadness and anger, but no longer are they extremes of these emotions which take me over and leave me empty and desolated. More than anything I have noticed that I am no longer overwhelmed by formless clouds of nameless emotions. Instead, I am able to slow my mind down enough to recognise what the emotion I am feeling is. I can name them. In the past they felt like formless ghosts haunting me and attacking me seemingly at random.

I have had to work hard to get to this point. On a daily basis I need to practice good self care - eating, sleeping, drinking, exercising, not letting my emotions control my routines, but allowing my routines to help me manage my emotions. Primarily, rather than me relying on medication or on 'experts' who appear to know more about my BPD than me to help me, I have learned skills that can help me without having to phone an anonymous voice, or wait on someone else's diary for consultations or treatment. I have the ability to 'manage' what used to control me. It does not mean that I no longer suffer moments of panic or crisis, instead it means I no longer have to risk rejection by asking again for help.

More than that, I am beginning to build a life that is less turbulent and prone to significant 'meltdowns'. It has taken me some time to adjust to life without the battles. Almost like taking time to unwind on holiday - we never manage to be able to relax from day one, because it takes time to let our minds and bodies 'know' it's okay not to be on high alert. In the past I expected to be betrayed in all relationships, I anticipated moments when suddenly my ability to cope with everyday life would end and my life as I was living it at any given time would grind to a halt. These patterns had repeated for me so often, that I even managed, on occasions, to self destruct and pre-empt rejection, abandonment and failure. By doing this I was reinforcing destructive patterns throughout a period of 40 plus years. Then, I realised that it was possible to stop anxiety from distracting me from enjoying 'the moment' about 9 months into practicing mindfulness. What I wasn't so certain of was, whether I could continue to be able to do this outside of the structures of group skills and the regular one to one sessions of therapy.


It is frightening when you have battled to ask for the help that you need for most of your life, finally be offered it, then accept it and find that you are able to move forward, to then realise, that, because of that progress the help will come to an end. However, just as it is sad when adult children are unable to move away from the family 'nest' and establish lives and 'families' of their own, so any therapy which creates dependence rather than helping me to achieve the management of my condition, is not helpful to me in the long term. I continue to require anti-depressants and anti-anxiety medication as part of my stabilisation. I have learned to accept that, for the moment, that is okay. I am so much better than I was, but I still have a complex mental health condition to manage. I welcome the help and contact that is offered, but one day this support will be withdrawn. If it is managed well, as with the ending of DBT, then I will be more than ready for it. If not, then as so many have found it can be traumatic and detrimental to the progress made.

I have only started on my journey to overcome BPD. I am beginning to test myself and my new skills out in different settings. I am pleased to have sustained some honest relationships where I can begin to trust myself to 'feel' close to other human beings. Only in the past couple of weeks have I begun to be able to express affection towards my friends. I know this process started when I realised I was 'fond' of my dog and learned to speak to her with affection. Now, difficult people don't distress me in the way they did in the past. They have not changed, I have learned to recognise the emotional responses in me, to name the emotions and manage those emotions appropriately.


In the past it was easier to not even try to have any significant human interaction. In return my close friends are supportive and encouraging. I have surrounded myself with positive people who aren't dependent on funding or resources to stick by me. They accept me in the real world and what is best of all, I am able to sustain my relationships in the real world. So, there is no fear of what happens when 'reality' steps in. This is the main difference between coping in the therapeutic setting and coping in 'live' situations. One is 'safe' and allowed me to explore and practice skills to manage my triggers appropriately. My transition from therapy has helped me to see that I can use those same skills in everyday life and though I can't control the outcomes, I can accept that I am doing my best to manage my own life. And that brings a real sense of achievement. I was so encouraged the other day when a friend said to me 'Look at you, you are doing so well and it is shining out from you.' I hadn't sought validation, it was a natural part of our interaction together and an indication that we have a positive relationship. Now I can recognise people who are good (and bad) for me and stop wasting time on those who will bring me down. What is crucial to recognise in this process is that from day one my therapy was preparing me for the ending. However, because I was offered nearly two years of therapy (which included tapering and 'proper' exit strategy) I have been given time to move from intensive to 'light touch' therapy seamlessly. 'Ciff Face' endings particularly for BPD only create distress and ongoing need and dependence - in my humble opinion.

At the heart of DBT is the twin concept of 'Acceptance' and 'Change'. I accept my life as it is today, but I continue to work towards changing those things that I want to change, to continue to make my life better. I'm still standing, but I don't stand still I keep moving on and actively pursuing 'a life worth living' (Marsha Linehan).