Saturday, 22 February 2014

I can see clearly now the Rain has Gone...

'Black and White Thinking' and 'a pervading sense of emptiness' are two symptoms of Borderline Personality Disorder (BPD). I like to avoid thinking about these two symptoms, simply because they are the hardest for me to manage.

Black and White thinking reduces any person or situation to a basic choice between one extreme and another. So, when I am in a relationship, you may encounter me saying 'I love you',and 'I hate you' with the same level of conviction because at the moment in time I am saying each statement it is what I believe with every fibre of my being. It's hardly a surprise then that those who are closest to people with BPD tend to feel confused a lot of the time. Most people I have ended relationships with have felt as if they have been tossed around in a tornado and then, spat out. One minute they were my universe and were my everything, the next the most despicable creature on earth and capable of inflicting incredible pain simply by being there. It is equally problematic being the person who experiences this see-sawing from the inside, shifting endlessly from one extreme view to another. There is no opportunity to feel settled in life or in relationships. Constant fear and expectation of rejection and abandonment, inevitably become self fulfilling prophecies, reinforcing the belief that I am impossible to be loved or to love another human being.

Black and White thinking also pervades my assumptions and views of everyday life. So, I believe that there can be no neutral or middle ground between liking and hating me. My way of managing almost every situation was to 'learn' the rules. It is my assumption that everyone else in the world is living by a set of rules that I know nothing of, if something goes wrong, I assume it's because I've broken a rule. So, if someone removes something from me, for example, if a medical professional is late for an appointment or cancels at short notice, my default thought was always 'they hate me'. It would never occur to me that they may have been delayed due to everyday hurdles such as traffic, or they may cancel simply because as humans they may get sick or have training etc. Nothing to do with me. So, inevitably any situation regardless of the setting or people involved becomes a catastrophe to me and another indication that my whole life is a failure.

While the see-sawing thinking described joins with the emotional see-sawing of BPD to create frequent emotional 'storms', these are not the most damaging of the underlying symptoms of BPD.

When you have been told that you were an 'accident' of birth, a 'mistake'. When your parents tell you that your emotional response to pain is not the right way to react. When you are never praised by your parents no matter how successful you are at school or at sport. When your parents essentially focus all their emotion on their own relationship and only connect with you as a child through physical, emotional or sexual abuse, then your ability to identify your place in the world and universe becomes severely impaired.

This loss of identity and feeling of dislocation is one that pervades many explanations of distress from BPD sufferers. When I first came to the notice of Mental Health services, I repeated over and over again 'I am not made for this world', while the sense of isolation and disconnection resulted in an almost unbearable, physical sensation in my chest. I felt as if someone were reaching into my chest and was squeezing my heart to the point that my breathing was compromised, often prompting panic attacks. The trigger for these feelings, reactions and episodes?

Sometimes, something as small as a colleague or client, questioning something such as, 'when did you last make a brew for everyone?' This kind of office jokery could result in a rumination that might last three or four hours and limit my ability to associate with my colleagues for up to a week. I could be so dysregulated that I was often unable to focus on my work, after such comments. Such a level of sensitivity is highly debilitating not only in working life, but more importantly in my social life.

By the time I was diagnosed with BPD in 2010, I had misread so many situations and ruined so many relationships and friendships due to my black and white thinking that it was easier for me to isolate myself and try to survive entirely on my own. This fed the belief that I was unlovable and reinforced the sense of isolation and emptiness caused by my sense of personal invalidation. I had learned the hard way that no matter how intense the feelings in intimate relationships, no matter how close the friendships, no one person could cope with my need for validation. My intimate relationships quickly burnt out - the longest relationship I have ever had lasted three years. Eventually, rather than put myself through the pain of total engagement and almost obsessive love for one person, I learned to not even notice if anyone was interested in developing a relationship with me. I have lived in a self imposed 'purdah' for a long time now - it feels safer.

As I have worked my way through the DBT programme I have learned to accept friendships at face value. I am pleased that some new friends I have made since 2010 have not got fed up of my constant 'mind reading' and extreme mood swings and doubts about their motives. I have learned to question my assumptions about situations.

I try to help my friends understand that BPD is not just about being 'sensitive' but that some reactions to life which are second nature to them, such as the process above, have to be learned and practised by me. I am not able naturally, automatically to question my initial emotional response, but first I must manage the extreme rise in emotions such as embarrassment or panic, by self soothing, then I have to work through the rational responses to the situation one by one until I have assured myself that the thought which triggered the negative emotion is not'reasonable', using 'wise mind'.

In this way I am learning to manage those moments when emotions have clouded my thinking, but I also must learn to love myself and accept myself in order to stop the flow of negative thoughts and emotions. If I can feel fulfilled in my life, if I can find meaning and hope, a purpose, acceptance of myself as I am, then I can learn to manage and confront the invalidation which is at the heart of my lack of self. If I can treat myself with kindness and not hold to extreme views of the universe that remain entrenched. Then I can begin to see the nuances and grey areas in human relationships and in situations that I am involved in. I know that the clouds and the rain are clearing - some days, due to lack of emotion regulation, (usually my sleep patterns are disrupted) I may find myself slipping back - but more and more I am seeing clearly the positive in my life. I just need to see me as a positive too.

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