Self Care - Do I really 'Get it'?

I can talk about recovery till the cows come home. I understand the DBT skills that help me manage my emotions and thoughts. I find them relatively easy to practise and use when necessary. However, when it comes to 'self care', especially of my physical well being I am in need of 'remedial' help or a 'refresher' course. I know the obvious question in DBT terms is, 'so what's the obstacle to using self care?' My honest answer is that at the core of my feelings towards myself is a fair amount of self loathing.

It's a knotty old problem that rears its head in all sorts of situations and causes my responses sometimes to be out of proportion to the stimulus. Whether I am succeeding or failing (in my own eyes) I will always have a 'director's commentary' running in my head telling me either that my current failure is confirmation of all that I believe about myself, or that my success can only be a fluke, or people flannelling me. Basically, I have never learned to trust my own instincts about how I am doing in work, relationships or any sphere. I think that is why people on the outside consider me to be an overachiever. I have always needed the confirmation of cups, medals and prizes as totems of my value. Strangely enough, no amount of outward success has ever made up for my own doubts about my intrinsic value or worth to the world.

Credit: Tweeted by @jessisheron

This lack of self validation has affected me in a number of ways, but perhaps most obviously in my inability to care for my health. My GP in the past has described me as 'stoic', 'strong minded' and 'a bit of a martyr'. She had earned the right to speak to me in that way, having taken an interest in my mental health and recognised the link between this and my lack of self care over a long period of time.

Given that I have been an athlete and been at the peak of fitness into my 30s before my mental and physical health broke down, I know how good it feels to feel 'good' - physically. My biggest problem for my health has been the overwhelming ennui that sucked all energy and motivation to exercise out of me. The Black clouds of depression which hung around my life in long, black days, were accompanied by the desire to cram junk food and large portions of 'bad for you' snacks into my body, in a failed attempt to fill the emotional void inside. No need to undergo major analysis or large numbers of tests to discover the cause of my burgeoning weight and loss of fitness. Easy to ignore until earlier this week, when I ended up in A&E because I had been vomiting up blood.

I know the cause of the waves of retching which caused the bleeding; years of chronic anxiety and panic attacks which included emptying the contents of my stomach as my abdominal muscles went into spasm. Most recently the continued lack of care about the contents of my diet,has been the main cause of my feeling sick. So, the easiest thing is to take care of it. In other words, take care of myself. Except, there it is, that nagging little voice from all the way back in my childhood - 'I am not worth looking after'.

It wouldn't be so bad if I hadn't started on the road to recovery from those emotional scars, so instead of ignoring these thoughts as just a part of who I am, I am starting to feel uncomfortable with this negative view of myself. Slowly, I am aware that the messages from my faith, friends and other sources is getting through to me that I might be worth caring about. And, on a simply practical level, I know that if I want to maintain my emotional equilibrium I need to live as if I believe I am a whole person who needs to be cared for physically as well as emotionally.

On Monday afternoon for the first time in my life, I picked up the phone and asked a friend to go with me to A&E. I told the Dr how badly I felt and what was worrying me about my symptoms. I then followed the instructions to contact my GP, the next day - was given an emergency appointment and received top class care, advice and reassurance. I will commit to attending the follow up appointments which will continue to monitor my condition and provide me with ongoing treatment. That is all simply because I want to feel better about myself, because when I am fit physically I am better able to make the most of every day of my life.

In a sense up to this point I have been deluding myself that I have left my self destructive tendencies behind with overt suicidal feelings and self harm. Instead, I have continued to punish myself by neglecting my physical well being, perhaps on a different level from all the self destructive behaviour before, but nonetheless still not prepared to let myself 'off the hook' as regards punishment. Essentially, I need to stop and acknowledge that punishment is only effective if there has been a crime which requires justice. Being myself, having the life I've lived is not a crime. The following words have been difficult for me to articulate but they are an essential step towards my healing: I have done nothing that deserves me punishing myself over and over. No one else is holding me to this account but me and it is time for me to truly be released from the prison of self loathing. Taking care of myself is a good start.

Self Care is important and is something which will help me to sustain the progress I have made in managing my BPD. It has taken me a long time, but I am beginning to get it and to get the importance of feeling good physically to feeling good mentally.