Tell Tale Signs I'm Middle Aged #3

I can remember 'dancing all night' on five inch stiletto heels - now that all seems so unnecessary when I can schlep around in comfy trainers, birkstocks and other 'sensible' shoes - better for the bunions, corns, dodgy knees and hips, which just didn't seem to exist in the heady days of yore - not to mention they're good for Scottish Country Dancing, such fun and good for fitness too!!

Why I'm not Making any Resolutions!

I'm not making any New Year Resolutions this year. I've decided that in the past they have not been effective for a number of reasons:

1. Human Nature. It is a truth that the 'road to hell is paved with good intentions'. Too often my intention to become a slimmer, fitter, better tempered, more cultured, creative, more altruistic version of myself has foundered within an embarassingly short period of time.

2. Too High Expectations. Unsurprisingly, when setting myself a goal of losing five stone within three months I also set myself up to fail - perhaps it's an inbuilt protection against change - after all I know what failure feels like and change is scary!

3. The Wrong Goals. Too many times in the past I have tried to set resolutions which are more about what other people think I should be aiming at. Rather than about my own happiness and contentment.

4. A tendency to want to take over the world. In the past I have tried to take responsibility for all the world's ills and seek to resolve them with my own efforts. I have learned that I cannot change the world, but I can try to change the world for one person at a time.

So, this year it will be different.

1. Every day I set myself small goals - achieving the ongoing small victories over my battles with mental illness. These include keeping to a routine. So change needs to happen in a stable framework, acknowledging each positive step forward.

2. If I am not stuck in the past and I am moving forward with my life, then change must be happening, because that is the nature of growth and maturity. Recognising that I am not stagnating means that I don't need to create momentum falsely, it is already happening as a process of choosing to live.

3. My life has meaning beyond fitness regimes and diets, which often are the focus of resolutions. My beliefs inform the direction of my life - change, long term change, requires hope. Hope is born from engaging actively with something larger than ourselves, whether that is God or being part of the wider world around us.

In 2014 I will have only one goal - to keep moving forward to wellness, taking each step forward and accepting each moment as it is.

Tell Tale signs I'm Middle Aged #2

In my 'stocking' I have received creams, soaps and other 'smellies' which include 'Oil of Evening Primrose' and 'Lavender' in their contents!

Tell Tale Signs that I'm Middle Aged #1

I used to throw them to one side - the growing pile of junk mail used to irritate me until the morning when I could self righteously place my enormous mountain of unwanted paper into the recycling.

Then, somewhere between 35 and today I discovered the unknown joy of seeing my 'innovations', kleeneze and other brochures plop through the letterbox: promising a life of ease and warmth!

Now instead of a customary Tut they are greeted with a frisson of anticipation as I put them to one side to 'read later with a nice cup of coffee'!

Who wouldn't melt with desire over the electric foot warming boot (in brown) or the Blanket with arms to snuggle up and watch Downton in of a winter's night. Here I have a found a world of many, many things I never realised I can't live without..the famous 'must haves' of this season (or should that be middle age?)... And now for the next stage in life - old age, when I buy these for myself. At present my mother is a past master at sending these items randomly to each of her, (admittedly) middle aged children - and so I bow to the inevitable march of time and acknowledge I am, indeed middle aged and I do secretly enjoy snuggling in my enveloping tent with my TV Remote tidy securely fastened to the arm of my chair!

Learning to love my inner 'Gleek'

Cheesy pop has been my salvation. There is something inherently irresistable about the relentlessly cheery pop tunes of ABBA or even Steps (Remember them?). When I was really into the charts - say in the '80s, such an admission was impossible. I mean before there was 'street cred', we did know that there were certain things that you did not admit to liking - let alone finding therapeutic and uplifting! But I have to say that my IPod is liberally smattered with Andy Williams, Ken Dodd (oh yes!), Barry Manilow and many, many downloads from Glee - I am officially a Gleek!

When I presented this fact to my DBT Grad Group the other (much younger) members derided me for not being in tune with my emotions. I would beg to differ - through my liberal exposure to 'Cheese' I have resurrected my love of all musical forms. Songs and soundtracks which were imbued with unbearably painful emotion, because of history, have become, not only bearable, but I find myself truly enjoying them again.

This is what my Cheesy Pop songs have given me:

1) Permission to dance badly about the kitchen - ignoring looks from pets, neighbours and passing birds!

2) The realisation that music doesn't have to be used to bring me down - certain tunes just lift your spirits - and that's ok because that's 'opposite to emotion' and is a DBT skill - and it works!!

3) I have regained my enjoyment of all music and musical forms - I used to avoid certain songs as they were tainted by past hurts and history - but each time I listen to music, I realise I am in a different place and each time I listen there is an opportunity to create a new emotional response - because I have stopped being a prisoner of my past.

4) I am learning to use music to help me 'sit with' difficult emotions - without linking into past trauma.

5) Music is one of the best and quickest ways I've found to change my mood - either lift my spirits or soothe the aggravated 'savage breast'.

5) I have reached an age where 'trends' (of any kind) don't matter so much and this means I am free to enjoy ANY genre of music in my own way and in my own time.

Fashion is the tyranny of the young!

People Need People - the forgotten DBT skill?

When I was at my lowest, there were times when I would lie under my duvet brooding on how isolated I was, how I could die under my duvet and no one would be the wiser...or even care! It took effort and the skillful use of distress tolerance and emotion regulation skills to get out of bed and keep body and soul together. Having decided to live life and engage with the world outside again, I discovered that there is a paradox which can help to end my isolation: When I immerse myself in working with or helping others,suddenly I feel better about myself and talking to people becomes easier; when I hide myself away for fear of being hurt I become more vulnerable to rejection.

I started 'contributing' by helping with a kids' holiday club - I found it easier to talk to the kids (no judgements - perceived or otherwise!) at first, but soon I was able to talk to other 'helpers' and then to parents.

In DBT, getting involved in the lives of others is called 'contributing' and it is a skill that I had not considered key to my recovery until I looked back over the past 18 months of treatment. There are some key things that I have learned about this skill:

1) It helps me to become involved in a world that is bigger than my own pain and distress. Although under the duvet is a safe world - I am not engaging with the world outside of my own emotions and thoughts when I stay there longer than is helpful.

2) It helps me to know that I am not alone in feeling what I feel about the world. How can I know if anyone else is dealing with the same issues as me, if I don't talk to people?

3) Joining in with organised 'helping' is a good way to get across the gaping chasm between feeling isolated and trying to get to know new people. When you have a role, however basic, you have a place in the world and there are simple lines and boundaries which make initial relationships easier to manage.

4) It reminds me that I have something to contribute to the world and people around me - I am not a failure, nor am I totally useless - sometimes being part of a team (with no defined role) is enough - just being there for the elderly or vulnerable as company is enough to feel I am giving something.

5) Often rather than feeling emotionally spent I am nurtured emotionally by the people I am helping and the people I am helping with.

6) So often, we forget that our very presence in the world is valuable - hard not to think of 'It's a Wonderful Life' at this time of year - but it's so relevant our lives touch and impact on so many others - even if we have felt that we don't for a long time.

7) My first experience of contributing was not with people but with pets. I couldn't take the risk of rejection from people, but having a dog and getting out to make sure she was well exercised and happy actually helped me to look up and see other people around me as we walked. The dog walking community is a surprisingly open one and so many conversations when walking my dog, helped me to feel I had made some human contact. At some point I must have felt that I could cope with risking deeper human friendships, but I know it started with caring for my dog.

8) I feel good when I have done something for someone else - there is a reward emotionally from seeing someone appreciate the shopping you have brought them, or the fact that you have taken them for a coffee.

Barbra Streisand was right... People need People! And people like me, need people so we can heal.

BPD Blessing or Curse?

I love detective shows. One of my favourites is Wallander. He struggled with an illness for most of the first series before reaching crisis point and finally being diagnosed. Now, the exact name escapes me, but his diagnosis both troubled him and made him laugh as it was called something like 'blob'. Each time he told someone his news and the name of his 'diagnosis' he both laughed and took the opportunity to explain what he understood of his condition and how this would affect his life in the future.

If only Mental Health diagnoses were as simple as Wallander's 'blob'. I have a friend who thinks that I shouldn't be as comfortable with my diagnosis of Borderline Personality Disorder with co-morbidity of Clinical Depression as I am. He feels that the word 'disorder' is an insult to me and the stigma of the diagnosis will hinder me rather than help me.

I understand his reservations and I have, as a professional, encountered the assumptions prevalent in some areas that this is not a treatable condition,that those of us who exhibit 'emotional sensitivity' to the extent that we require intervention, are among the most difficult of service users and that we absorb more resources than is warranted. In short, I have heard BPD sufferers described as 'manipulative', 'difficult', 'emotionally blackmailing' and 'highly volatile', by fellow professionals when working in the Criminal Justice System. Unfortunately, the most prejudiced views came from colleagues within Mental Health teams who sought to distance themselves from managing 'these people' and kept telling us that the anti-social behaviour displayed by some BPD offenders was a 'criminal justice' problem and one that had no answer within the psychiatric or psychological community. Then slowly, just before my own diagnosis in 2009, whispers began of a 'treatment'(Dialectical Behaviour Therapy) available for BPD which began in America. Suddenly, this has become a diagnosis with hope for management if not cure. However, I wonder if the optimism of those working within DBT has communicated itself to other medical professionals who have limited contact with BPD or DBT?

Some observations of me and my 'diagnosis'.

1. Although the title 'Borderline Personality Disorder' indicates that I have a fundamental flaw in my very being I don't see it as such, but as a failure of language and semantics to adequately explain complex emotional distress and its impact on my ability to live a fulfilled life.

2. The reality of resource allocation determines that resources follow need and risk. If a nomenclature encapsulates a cluster of symptoms which are shared among a significant group using local resources, then it follows that it is easier to identify the need for those resources to be directed towards treatment of 'blob' or 'BPD', whichever is most convenient to refer to at the time - this one is for the bean counters! For good or ill, for the sake of the accountants we all need to be fitted into neat little boxes that can be counted!!

3. What is important about BPD is the relatively recent acceptance in certain areas that there are treatments available to help 'sufferers' (for want of a better word) manage the worst symptoms of emotional dysfunction.

4. I am lucky to live in a postcode which quickly established an intensive DBT programme lasting nearly two years, with adequate aftercare and staff willing to see beyond labels and perceived 'difficult behaviour'.

5. Despite the name of my 'disorder' I am not BPD - I am an individual with a large number of characteristics - some of which make me more susceptible to certain emotional struggles - some of which provide an inner core of strength which allows me to make the most of the treatment offered to me.

6. There is a reality about a significant proportion of mental illness, which clearly links to significant trauma in childhood. Too often the question asked by practitioners has been 'what's wrong with this person?' rather than 'what has happened to this person to make them react to life in this way?'

The willingness of DBT therapists to ask this question, to listen to the answer and to acknowledge that my previous ways of coping with life were understandable in the light of the answer, is one of the keys to the success of this programme in helping me manage patterns of emotional dysfunction which had lasted over 30 years.

For me BPD is not a diagnosis of stigma - that is other people's problem. It has given me clarity about what had been an undefined pattern of self destructive behaviour. Like the label or not it has opened the door to hope of moving forward with my life.