Saturday 30 August 2014

Self Compassion and Knickers

Something has changed in me. I am slowly learning to be kind to myself.


Growing up in invalidating environments over time sucks all of the self worth and self compassion from the child until the adult emerges, uncertain of their feelings about themselves, the world around them, and their own intrinsic value as a human being. Rebuilding who I am from the wreckage of my childhood has been a long, slow process. Much of my self destructive behaviour in the past has its roots in feelings of self loathing born of the consistent invalidating messages of my key relationships as I grew up.

Invalidation has many forms, from the simple act of ignoring or discounting the voice of the child to the acts of abuse which say that every part of who I am is so worthless I can be used and abused at the whim of others. The distress and pain of these experiences takes a lifetime to emerge from. Perhaps, if you are in a relationship with someone who has suffered in these ways, you recognise the gaping emotional void, that you feel you are expected to fill.

In rebuilding my life I am in a long term process of learning to validate myself, of valuing who I am, of first of all accepting who I am. In the experience of Borderline Personality Disorder, one major building block of the personality, the sense of self, is damaged. I need to build relationships which patiently reflect back to me the value that others find in me, without me seeking to grab hold and cling to those relationships, or create the self fulfilling prophesy of rejection by my demands.

This means that boundaries, time and trust building are pre-requisites to any level of relationship for me. I used to be a 'hook line and sinker' committer to friendships and relationships. They burned bright and short, and always ended traumatically with major drama and self destruction. Given the emotional void within, this proved overwhelming to most who became involved with me in the past and I have lost many friends, and boyfriends in the process, confirming my lack of worth. 'No one can love me', was my mantra, or 'I am not worthy of love'. And my life was a process of confirming the 'truth' of those beliefs. Given the invalidation I have experienced from so many, including my own mother, over such a long period of time, these kind of thoughts and patterns are understandable.

In the end, having been rejected one time too many in 2000 I gave up on all human relationships. Life was safer that way. As I have gone through treatment and learned DBT interpersonal skills which take account of my invalidating background I have learned to set boundaries for myself. In essence I have learned to protect myself. This again is something which for the invalidated person is not natural. After all, I have to believe that there is something of value in myself to be protected. I have learned to articulate when I am not happy about situations - appropriately. In the past, I have not felt able to voice my needs, so anger at the world has built up until I have exploded at whoever is nearest to me. Not very pretty. It was a revelation to me that people can be interested in listening to me when I speak up about something I feel is wrong. That has taken time.

I realise that, as I keep moving forward and taking small steps, there is one range of skills that are critical in helping me repair and learn to build relationships. Self Compassion is essential to my ongoing recovery. It begins with the simple basics of looking after myself - the DBT PLEASE Skills (treat Physical iLlness, balanced Eating, off mood Altering substances, balanced Sleep and Exercise) and moves on to Mastery of those skills. If I feel I am worth the basics of eating, sleeping etc, then that is the most fundamental way in which I can care for myself.

As I have started to feel better about managing the swings up and down of my moods, I have been building up my mastery of these day to day necessities. This has now extended to my environment and I feel I am on top of my housework and have a reasonable living environment.

So where do my knickers come in? One of my responses to my childhood has been to hide away from who I am at heart. I am a sensitive, creative, articulate person. I love good things. I actually love feeling feminine. However, as a result of people disrupting my sense of my own sexuality and sensuality, I have swamped myself in tomboyish clothes and behaviours, which protect me from others by denying that I might be attractive to others physically. In essence I have tried to express myself as an asexual being. It has been safer that way, or so I thought, although this hasn't stopped perpetrators assaulting me as an adult, so maybe the fault is theirs. This is an essential building block of self compassion: I am not to blame for the wrong behaviour and damage done to me by others. There is nothing that I need to punish myself for. My bad feelings about myself are not accurate or reliable. When I do wrong, I need to do something to make a repair to those I have wronged. But feeling ashamed of myself simply because of what I survived in my past, will not achieve anything and serves to keep me trapped in the pain of the past.

At the risk of being accused of 'too much information', in the past six months, I have started wearing really nice underwear. I enjoy being feminine. I love perfumes, bubble bath, pampering, and the feel of silk against my skin.

I wore a skirt last week for the first time in years along with my favourite perfume and accessorised with jewellery, handbag and boots. 'elegant' was one word used to describe me. With a shock instead of dismissing the compliments, I accepted them, at face value, no critical analysis or suspicious thoughts about the motives of others. It helped that I had had nearly two hours pampering at my hairdressers and he had given me a new sleek haircut which he felt matched what he saw in me - or so he told me. I have a great relationship with him and trust him with my hair! I felt really good about myself and it was not a mask. I've done that too in the past. Because it began from how I felt about myself inside, moved on to my underwear to the outer shell of my clothes.


Learning to love myself is still a new skill in my arsenal. It has had to start with small things like getting help from the GP when I feel ill. The pressure is no longer on me to achieve in my working life, driven to try and find the validation that was missing from my childhood. I don't need to be in a 'successful' relationship to be a person of value. I am enjoying doing the things that give me satisfaction in life. I am able to feel that I have something to offer the community around me and I am free to accept the gifts that they offer me, in return. I think I'm actually ok and I do deserve that really nice lingerie set. Gives me a whole new reason for my 'secret smile'.



Tuesday 26 August 2014

Learning to Ride the Emotional Waves

Emotions for most people naturally seem to come and go. Most people experience either euphoria, grief or anger as passing extremes. For me, I get stuck with damaging emotions, experiencing the emotional pain as a groove I cannot break out from. Hyper emotions are similar I find it hard to manage myself in social situations when I am 'up'. I have been known to follow urges to self destruct in an effort to short circuit emotional distress. After these periods of extreme emotion I am exhausted and vulnerable. Unlike other conditions which can cycle between extremes of emotion over longer periods, I can experience the extremes of the swing from extreme grief and distress to euphoria several times in a day. These periods of swinging emotions can last for hours or can last up to two or three days. It is like constantly riding a roller coaster, without any hope of being able to escape from the constant rise and fall of feelings. Feeling sick (a lot of the time physically) over and over with the constant, sudden changes in mood. My overall experience of life has been lack of control.


It was a revelation to me when I was told during DBT skills group that my moods were not constantly either up or down, that they actually come and go, more swiftly than I thought. For anyone who struggles with emotional dysfunction this seems to contradict the day to day experience. For me, the distress I felt was so overwhelming that it felt as if I was experiencing my feelings as emotional 'white noise'. I cycled constantly through distress, relief, exhaustion so rapidly I was unaware of any distinctly identifiable feelings.

I worked for some time with people who struggled with addiction to Class A drugs. I learned a lot from them about the extremes of cravings and the need to give in to the urge to use their drug of choice. One of the skills they learned was to 'surf the urge'. I could not imagine at that time the extremes of the pain of their cravings. However, as they developed the urge surfing skills a number of them would talk about the moment they realised that the height of their cravings was relatively short lived. Of course managing Class A drug addiction takes a lot more than the realisation that cravings are not actually constant even if it feels like it. But it was a small step in helping those who were ready to regain control from the ravages of their addictions.

It is not an exact parallel but for those of us with a diagnosis of Borderline Personality Disorder (BPD) the realisation that the extremes of our emotions do not have to be out of our control, is also a key moment in recovery. In DBT the Emotion Regulation Module includes the skill of 'surfing the emotion wave'. For me this skill has been all about first recognising that the fast cycling of emotions can be slowed down. I no longer see myself under a constant cloud of unidentified emotional mists.

There are a number of steps towards 'surfing the emotion'. Here is how I see them:

1. I press the 'pause' button. Using Mindfulness I focus on what is certain around me. 'This is a cup of coffee, I can smell, it, I can notice the warmth spreading to my hands from the mug, I can enjoy the sensations and taste as I drink it'. I allow myself to use my senses, I take the time to experience what I am doing in that moment, noticing my feelings, but not allowing myself to get stuck with them. I also slow myself down by using breathing skills. Either deep breathing focusing on my lungs, the rise and fall of my tummy. In these ways I take my mind away from trying to analyse feelings which cannot be rationalised and simply focus on what is certain. Grounding myself in my surroundings.

2. Once I am able to focus on my breathing or on my surroundings, I try to name the feelings. Often the most immediate feeling is not the problem. My main problem is when my immediate emotional response to the present trigger connects with feelings about and from my past. Often these historic feelings are painful and linked to past traumas. I need to be able to separate present feelings from those from the past. If I can name my 'enemy' I have a better chance of winning.

3. Accept that 'this too will pass'. No matter how I feel about the intensity and life of my feelings, they don't last forever. And there is a rise and fall in the intensity. Again, using mindfulness exercises which allow me to observe my feelings without losing control, helps me to notice and observe the rise and fall of the feelings. They do come in waves. If I can survive the 'crest of the wave' for a time, it will ease. This is a safe place visualisation I use when I need to calm myself and cope with waves of intense emotions: It's a You Tube video, https://www.youtube.com/watch?v=pPBxNLpOLNU

4. Sitting with the emotion. If I recognise that the feelings are not permanent, or that they don't have to remain as painful all the time, I can then allow myself to learn that no matter how painful, they cannot kill me. Sitting with the emotion has so often been the last thing I have wanted to do. However, DBT acceptance skills tell me that trying to avoid or push away the emotions will not help in the long run. In a sense I need to allow the wave to wash over me, in the knowledge that I will be safe and once the wave has receded I will still be standing. Again, the ability to allow myself to feel the emotion is a mindfulness skill. I use a mindfulness visualisation which identifies the feeling, then gives the feeling a visual form in my mind. As I breathe through the waves of emotion, I return to my image of the feeling and observe it. I continue to switch focus between my surroundings and my image of the emotion until finally I can observe it grow smaller and disappear. There is a version of this in The Dialectical Behaviour Therapy Skills Workbook (2007, McKay, Wood and Brantley - New Harbinger Publications, Inc).

5. Another way of managing the wave of emotion is to listen to classical music. Popular music is not complex enough, I feel, to be able to help ride the emotion wave, although I do listen to pop music as Opposite Emotion exercises. However, movements from the classics have shades of emotion. They rise and fall, the orchestra builds to crescendo then dies away. Allowing myself to focus on the rise and fall of the music, allows me to naturally fall into the concept of waves. Once I am comfortable I can connect my emotions in a similar way and allow them to rise and fall along with the emotions. I have explained a bit more about how this works for me in this blog: http://bpdlifeinthemoment.blogspot.co.uk/2014/07/my-dbt-classical-music-playlist.html

I have found these explanation of the DBT Emotion Wave helpful too:



Wednesday 20 August 2014

Nanny McPhee and the Therapeutic Relationship


"When you need me, but don't want me, then I'll stay. When you want me, but don't need me, then, I'll have to go" Or words to that effect. It has only just struck me that this quote from Nanny McPhee sums up the crux of the therapeutic relationship. I am into the second month since full discharge and have been reflecting on the transition from needing the support of services through wanting it more than needing it, to finally realising I no longer need the levels of intervention I have previously required.

I recently had an interesting discussion with a friend of mine who is also a service user. He now works as an Expert by Experience and told me about a psychologist colleague who had been arguing with him about the nature of the therapeutic relationship. She believed that such relationships should not be considered as friendships. My friend and I both profoundly disagreed with her. Boundaries and professional distance are essential to ensure the efficacy and the emotional health of both the practitioner and service user, naturally, that's a given. However, there is an emotional bond, or at least there has to be in order for 'unconditional positive regard' to have any hope of developing. If there is not an emotional trust, based on some aspects of friendship, then the relationship may well work to an extent, but, certainly in working with Borderline Personality Disorder, at least, a level of warmth is essential in order to bring about progress. Otherwise how can I learn what a positive relationship established with effective boundaries, but also warmth and compassion, looks like?

I guess it depends what you consider 'friendship' to be. I recognise in my friends different needs and different gifts to me from each one. Some meet my basic social needs. Some are based on shared interests and enthusiasms. A handful are deeply rooted in genuine affection and deep emotional bonds. As someone with BPD much of the therapy I received was focused on my relationships with my therapists. DBT as a therapy model, recognises this and builds in these relationships and working through the ups and downs as they develop to its methods of working.

I find it interesting that when Nanny McPhee first arrives into the chaos and mayhem of the unkempt and undisciplined children, she appears hideously ugly to them. I'm not saying that all therapists are ugly! However, it is a truism when discussing therapy that 'things get worse before they get better'. Part of this process is the setting of boundaries, and the inevitable challenging of behaviours which are generating real distress and pain on the part of the service user. So, in a way there are times when I may find it hard to 'like' my therapist, and vice versa. Such is the stuff of developing relationships of any ilk. If the relationship is allowed to continue and works in addressing the key characteristics of my emotional issues, then my perception of my therapist is likely to become more positive. So with Nanny McPhee, her warts and whiskers disappear, as genuine affection replaces her challenging discipline and the children blossom under her care.

I don't think friendship as an element of the therapeutic relationship need be a threat to the professional. It is a natural part of genuine positive regard and compassionate practice.

Tuesday 19 August 2014

Horses for Courses - One Therapy Cannot Fit All


This blog primarily shares my experiences of my practice of Dialectical Behaviour Therapy skills. After a lifetime of undiagnosed Borderline Personality Disorder symptoms, it was a huge relief to find a therapy that fitted with me and my needs. Having experienced as a Probation Officer the brick wall times of belief that BPD was 'untreatable', it seems that DBT has broken on Mental Health services as a sudden revelation, that 'something' can be done to offer a way forward for BPD sufferers. Great! A solution....except it's not that simple is it?

I know I bang on about how much I have benefited from DBT, but I am not so blinkered that I cannot conceived that this is not the whole or only therapy which can offer help for my condition. There is, nor can there be, one size fits all solutions for any Mental Illness - even if everyone engaged with Services had all of the same symptoms.

To advocate that DBT is the best and only way forward for everyone with a diagnosis of Borderline Personality Disorder, is to deny the complexities inherent in helping people to manage disorders and conditions which impact on every aspect of our beings. I was clear on discharge that completing the eighteenth months intensive therapy was only the first step in managing my BPD for the rest of my life. I have needed to address issues around my physical health following the impact of my emotional symptoms over the past 20 years.

Acquiring DBT skills also does not mean that I no longer suffer the symptoms of my condition. My discharge plan includes the continued prescribing of two medications to help me maintain my emotional stability. This is primarily to manage the accompanying Clinical Depression and Anxiety that I live with alongside the symptoms of BPD. I am only one person, I cannot hope to represent every person with the same or similar symptoms. Therefore, just because this combination of interventions is working for me at the moment, does not mean that it can be applied to all who may share my experiences of mental illness. Nor, does it mean that this combination will continue to maintain my stability forever. But for now, it is the right treatment path, for me.

A major problem faced by NHS Mental Health service providers is the pressure to 'justify' spending on intensive therapies. At this point numbers, rather than people, take priority and compete with what professionals know is best practice. Many NHS Trusts are hamstrung by funding issues which mean that they have to decide on one treatment pathway for individuals with the same diagnosis. Although research and practice indicates the complexities of helping human beings to manage complex conditions, funding issues seem to dictate basic, solutions. Or to put it simply, one size has to be made to fit all.


Reading other service users' experiences of what is on offer locally for BPD, I realise that in the UK there is a vast gulf between different parts of the country. In my area, I am lucky that there have been two evidence based therapy paths, both vastly different from one another, on offer via the local NHS Trust. Many other areas, are still grappling with managing people 'like me' without any specialised therapy on offer. I have gone through the trauma of 'failing' at one model, but thankfully there was another very different and more suitable model that has really helped me. How many people with various mental health conditions have that luxury?

Having said funding issues are the main reason for not considering a more integrated approach to Mental Health treatment, it is difficult to avoid the conclusion that such money saving approaches are short sighted. Certainly, if inpatient beds are perceived as being too expensive to continue to invest in, why is investment not then being made into developing a range of treatment options which can be adapted to individual needs? If you remove the 'place of safety' for people, where is there a safe place in the community if the one treatment on offer to some, is not effective.

I know I am looking at things rather simplistically, however, I am currently benefiting from the support of a physical fitness team run by the same Trust who run local Mental Health services. I get free gym and swim for three months along with an individual programme that is realistic and takes account of my emotional needs. I am in the process of dealing with my obesity in order to prevent long term illness and disease. A good investment? I think so, I feel so much better physically. In addition, taking care of my physical well being is one of the DBT skills for emotion regulation. Looking after my physical health is definitely supporting my ongoing practice of DBT and emotional stability.

We are all complex beings, unfortunately, the politics of funding seem to have swamped the instincts of best clinical practice and research. While the NHS is still in existence there is an opportunity for different teams to work together in co-operation with one another, rather than being made to compete for ever dwindling pots of money. If the focus can move away from numbers (referred to services, or successfully completing treatment compared with others) back to the whole person, there is maybe some hope that service users will be able to be treated more effectively.

Believe it or not, I actually recognise that just because DBT works for me in managing my BPD, does not mean that I expect it to work for everyone else with BPD. Although, I will keep sharing when I find something else that has worked for me in DBT...cos it excites me when I continue to be able to manage my emotions.

Monday 18 August 2014

Whatever Happened to Gratitude?

'Yes, it's so rare to receive thanks from people, that a bunch of flowers, one time, made our team cry.' I was sitting with some friends, sheltering from the rain during a good old British BBQ. I had started the conversation because I had been taken aback by a comment from an NHS Manager, who was asking me to tell him about my recent experiences in Mental Health Services. I mentioned one or two issues that had happened during my five years in the local area, but overall I expressed my profound gratitude to my Care Co-ordinator, my DBT Therapist and my GP practice. His response was such shock, that he stopped me in the middle of my story to tell me that such positive stories of treatment are unusual. It was then it occurred to me, it wasn't the first time I had come across this shock at gratitude when talking to healthcare professionals. My friend at the BBQ is an OT working in Palliative Care, she confirmed that thank you cards, etc are exceptionally rare.


As we discussed whether or not we give thank you cards or small gifts to people helping us, we came to the conclusion that as a profession, Teachers do really well from thank you gifts, compared with other public service professions. I know this from my own time in teaching. Teenagers, in particular, are very good at saying 'Thanks' (at least to anyone outside their immediate family who they feel helps them) and I still have so many cards and thank notes from my students. The chocolates and flowers are long gone. I was a Secondary Teacher for only five years.

When I completed my DBT skills group I gave the team a large box of chocolates to share and a thank you card. I did the same for my one to one therapist and for my Care Co-ordinator. I have always given Christmas chocolates or biscuits to my GP and continued this with my Care Co-ordinator and Therapists. When I was finally discharged from Services in July I gave my Care Co-ordinator a small gift and some chocolates. After a relationship both of us had committed to for over four years, not saying 'thanks', to me would have been unthinkable. Yet, once again, she told me it was so rare to even get a thank you card from Service Users.

To me it is not just polite and good manners, although it is. It actually acknowledges that we were all committed to helping me manage my condition. I wouldn't have learned my skills, or managed the ups and downs of the last four years without these people. I give gifts to my friends. The relationships we have with those who care for us are equally as important, for the time we need services. That is why discharge is such a painful process. Especially if it is effective, both sides have invested emotionally as well as in terms of time and effort. I expect to be praised for the progress I make in managing my condition, why shouldn't my Care Co-ordinator expect to be praised and thanked for her part in that process? We absolutely know when things go wrong, we are willing to let anyone who will listen know about it. However, when things are going well with our treatment, I think sometimes it is easy to slip into the 'They're only doing what they're paid to do' view of good practice.


I think there is a wider principle that affects us in our therapeutic relationships. Gratitude generally has fallen out of favour in our society. In the US customers are better at complaining directly for bad service. In the UK, we think we are less forthright, but any time spent on any social media, or bus, will tell you that we are no slouches in the complaining department. Another of my friends told me she recently felt she should phone customer services at TESCO to tell them that she really felt their online service was a godsend. She spoke to a call centre worker, who did a double take, then thanked her for her comments. Later on that day, she received a phone call from the Supervisor who was checking she had made the call. Again, she was told that gratitude was so rare.

Don't get me wrong, I think pointing out when things are wrong in the service we receive, is important so that others don't suffer from poor service. We need to be able to know when things are going wrong in order to fix them. How often, though, do we feedback when we have received good or excellent service? It is all very well for services to speak to one another about 'best practice' but in operation, what does best practice look like?

When I read on social media the many stories of those who experience lack of people skills, lack of compassion and lack of professionalism in the care they have received, it makes me more grateful for the good experiences I have had.

I was brought up to show gratitude. We never went visiting, or for a meal without bringing something for our hosts. I witnessed my parents buy gifts for staff in hospitals that were thoughtful, hand creams, chocolates, things to be shared among teams. We gave Christmas bonuses (or boxes) to the milkman, paper boy etc. And we always gave soap or chocolates to our teachers.

I wonder if it is a practice that is dying out. I do know that when I was at the beginning of my battles with BPD and Depression I was not emotionally equipped to think about the people around me, I was too busy just struggling to get by. But today, I have made such progress that when I am able to look back and recognise how far I have come, I am also able to acknowledge the part that the healthcare professionals involved have played in my recovery. Why wouldn't I say 'Thank you'? My whole life has changed, with their help.

The NHS is under attack from all sides. When I look at the alternatives I realise that, whilst there are problems and services that are performing below par, overall I am grateful that I have been able to access five years of intensive treatment without a huge debt burden to worry about. The NHS means that I can access physical health services that enable me to manage my emotional health more effectively, again, without having to worry about finding the money to access this help. I want to be able to highlight the good practice and positive relationships I have experienced in my relationships with healthcare professionals. If you haven't done so in a while, look at your therapeutic relationships and try saying 'thanks' when things are going right. It may just reinforce best practice.

Monday 11 August 2014

How does Your Mindfulness Smell?

Smells - I'm sensitive to them. I used to be plagued by regular severe migraines and strong smells, either pleasant or not, could trigger them for me. Since I've been practising mindfulness and managing my life stresses more effectively through DBT skills, I have found that I am only suffering migraines about two or three times a year. As a result I am re-acquainting myself with the power of smell. I am learning not to fear this neglected sense.


When I started practising mindfulness I would focus on sound, sight, touch and taste. It's easy to focus on really enjoying the touch, sight and taste of chocolate, for example. I can really savour the moment, taking my time to taste and enjoy the melting, soothing flavours. But how often do I stop once I have unwrapped it to really absorb its smell? I've been slower to first notice and then learn to practice smell as a mindful practise. Yet, along with listening to music, this is probably the most evocative and vivid of my senses. Who can resist the smell of cooking bacon? There is a reason why supermarkets pipe the smell of freshly baked breads. Even more unpleasant smells can bring us quickly into the present. The 'country' smell of manure definitely grounds me in terms of where I am, geographically.

As I have developed my awareness of the world around me and my own experience of the present moment, I have found myself building up a bank of smells which have different emotional impacts for me:

1. The smell of freshly ground coffee beans. This smell has become part of my daily morning rituals. I find I am beginning to be
able to detect different 'nuances' in different blends and roasts of coffee beans. I am drinking less alcohol than I used to, so freshly brewed coffee from freshly ground beans has become one of my regular luxuries. It is an important part of my self soothe routines. It also helps when I am finding myself facing overwhelming feelings of grief. I get a bag of fresh coffee beans from the freezer (best for keeping that freshness) and I stand and inhale the gorgeous aroma. This also benefits me because it is another way for me to practise mindful breathing whilst combining it with self soothe skills. I also love the smell of the fresh brew when I return to my house - it is definitely better than some of the rancid smells that used to greet me when I was too overwhelmed to care about myself or my environment. As I have recovered smells in the house are an important indicator of how much I am caring for myself and my home.

2. The smell of grass in the summer. For a long time this was a problematic smell for me as my Dad was a landscaper and the smell of freshly cut grass mixed with oil, became an ambiguous scent for me, evoking some unpleasant feelings. Now, though, it is part of the freshness of spring and summer. As I am learning to leave my fear of these seasons behind (I think these times of year seemed to be times when I was more vulnerable for reasons I have never explored) I am learning to really savour the smells of summer plants and water, like rivers through woods etc.

3. Citrus smells. There is nothing better for making me feel fresh and clean, than the smell of lemons, oranges and limes - preferably fresh ones. I can just cut a lemon in half and stick my nose right in and really inhale - way to go in getting me awake!

4. The smell of my dog and cat when I snuggle my face into their (dry) coats - it is safe physical affection and the warmth of the touch along with the smell just reeks of comfort. My dog is just the right size for me to lie beside and envelope her in my arms, whilst burying my face in her wonderful furry coat. I need to feel safe with touch and my pets are helping me to enjoy the safe touch and smell of another creature.

5. The smell of my favourite 'smellies'. I love perfumes, soaps and bubble baths. My favourite shower creams and gels are usually from aromatherapy ranges and I love standing in the shower enjoying the smells of my soaps and shower gels. I have always worn perfumes and love that blast of aroma through the day as I move about. It is a pleasant reminder of self soothing baths and showers, again a good way to practice self care.

Other smells I love: fresh cotton sheets, shirts; fish and chips; curries; any Mediterranean cooking smells; nutmeg; all spice; Vimto; melons; fresh paint (yes, paint); the sea;

Of course the sense of smell is most powerful when it is combined with the other senses. Touch and taste in particular enhance my experience of smells and help me to be mindful in my experience of smell.

So go on, get your olfactory juices flowing and really stick your nose into some things that are just passing you by at the moment. You might find yourself rediscovering some old 'friends' along the way.

Wednesday 6 August 2014

Me, My Dog and Tigger


I have an inner Tigger. I know, another myth about depression and anxiety sufferers hits the wall! I believe this aspect of my character - the irrepressible, fun, bubbly part of me, has helped me to keep going when I really felt like giving up completely. I love Tigger's refrain 'The wonderful thing about Tiggers is Tiggers are wonderful things, their tops are made out of rubber, their bottoms are made out of spring!'. For me, the rubbery, springy part has been my ability to bounce back - both emotionally and physically.

The problem with Tiggers (T-I-doubleG-er)is that we bounce into rooms and situations without really 'reading' the people involved and sometimes there can be a backlash. I have a Tigger dog too. Recently, she was involved in a couple of incidents when she became aggressive towards other dogs - or so I thought. I continued to observe her interaction with other dogs both known and strangers. With her best friend, Farai, a black lab, there are few problems - except when Farai has something that Smilla wants. I will admit this could be my fault, she suffers from only child syndrome and she is spoilt. When it comes to stranger dogs though, she has always got on well with all sorts. She is not an aggressive dog, although I have often heard people remark about the 'Snow Wolf' approaching - she is more likely to lick you to death than anything. So, these incidents when she became angry at other dogs baffled me.

Then I came across an interesting article by an american writer on dog behaviour. It spoke about 'Impolite Dogs'. These are dogs who bounce into another dog, or group of dogs and immediately launch into (often boisterous) play. No butt sniffing or nose touching to introduce herself. With relief I recognised my Tigger like dog in this description. When an impolite dog bounces into a situation without reading the other dogs' signals she/he is likely to be met by defensive and aggressive reactions. This did explain her out of character reactions. Now I have to take control and help her to introduce herself to a new dog or group of dogs. I also check out with other owners if their dogs can cope with a Tigger-like playdate!

Once again, my dog has taught me about my own mistakes in social situations. Another parting piece of advice from my DBT Therapist was to learn to read rooms before I launch myself into social situations. I am still learning the skills of reading my own and others' emotional responses. I have been known to be able to change the temperature in a room. For either good or ill. Most times I have been oblivious to this 'power'. What I have noticed is that I may be perceived as an 'impolite human'. I don't stop to 'sniff butts' (so to speak) and take stock of where others are. Back to the awful moment at school, aged fourteen, when a friend and her whole family had been killed in a car accident at the weekend. It had been all over the local news. On Monday morning, I bounced into the normally buzzing lockers, looked around at my obviously distressed friends and said 'You all look as if someone has died!'. Ouch, I felt bad about that for ages. But it demonstrates my tendency to leap in where angels fear to tread.


Of course there is always a flipside to being Tigger. Tiggers can lift a mood, when they are up to it and when it is needed and appropriate. Again, though I still need to be aware of the mood and therefore the likely response of my 'audience'. Sometimes I have used this ability in running groups or in teaching to bring a group along with me and encourage some participation. On a personal level, I need to be self protective in when I choose to bounce in and enthuse. When I don't have the protection of a professional role to maintain, I am likely to expose myself to very negative responses, if I am not careful to become aware of the signals of others in a group. I realise this tendency of mine to launch myself into group situations without first assessing the emotional temperature, has resulted in very painful moments, when groups as a whole, or individuals have rejected the Tigger in me. When you are feeling down or shy, or uncertain, then a Tigger can be annoying at best and unbearable at worst. I need to be able to control my inner Tigger not only for my own sake, but for the sake of others.

The irony is that I am emotionally sensitive and so can recognise what is going on around me emotionally, but I need to give myself time to weigh up before bouncing in.

A plea then, to bear with me when my inner Tigger bounces into your presence. I will always feel bad if I have misread the situation, just tell me to come off the ceiling. I am good at receiving advice and will always consider it carefully - as well as being a Tigger I am also a bit of a Pooh (so to speak) for 'I am a bear of very little brain, and long words bother me.'

Tuesday 5 August 2014

How on Earth do you 'Deal with the Past'?

This is a question that used to really vex me. For years, because of a lack of understanding about my underlying emotional sensitivity in many counsellors and practitioners dealing with me, I came across comments like 'you need to get over the past', 'you need to simply acknowledge what was done to you', 'you need to recognise the hurting child inside' - simples, huh? Except no one seemed to be able to recognise that there was something missing in my ability to even recognise my emotional responses to my abusive past.


One rape counsellor, who I think was compassionate and probably usually effective in her work, became frustrated with my lack of ability to acknowledge the trauma I experienced as a child. Firstly, I tended to either describe my remembered experiences without any outward evidence of any emotional attachment or response to the experiences being described. Secondly, because they were my experiences, I did not perceive them in the same way as my hearers, because it was me, I minimised the trauma.

It was around this time that my GP and a Graduate Mental Health worker who was offering me brief CBT for work stress, began to ask if I thought that there was more to my emotional issues than met the eye. So began my journey to discover what my diagnosis was and how that related to my childhood experiences.


I have referred before to the description by Marsha Linehan of people with a Borderline PD diagnosis as having 'emotional third degree burns'. I have always assumed this refers to the unbearable emotional distress experienced by those with BPD. I think to an extent this aspect of the picture is true, although it was when watching a documentary about a burns unit, that I learned more about 3rd degree physical burns, and thereby shed additional light on Linehan's statement. 1st or 2nd degree burns are extremely painful, however the damage done when someone suffers third degree burns is so extensive as to destroy all normal physical sensations, this means that there is a point at which the pain is so severe as to render the wound site numb to all sensation. When I applied this aspect of the original image to my own experience of the emotional impact of my past on my psyche, it made absolute sense.

I have previously described how I was not aware I was experiencing high levels of distress prior to the crisis which prompted me to seek help once and for all for my emotional 'issues'. I was incapable of feeling anything at all, either good or bad. There had been times when the pain of my life was excruciating, but I had passed through first and second degrees to the third degree, in order to survive. Many survivors of childhood abuse recognise this distancing from the experiences they have survived. Dissociating or depersonalising my own experiences helped me to survive the experience of abuse in the past. It causes problems in the here and now because I have been so successful in separating myself from my experiences, that I am unable to connect in any meaningful way with my experience of life as an adult. Either good or bad.

In a very real way for most of my life, emotionally and mentally, I remained trapped in a loop reel, whereby the most traumatic experiences of my life were on constant replay, regardless of how long ago they happened to me.

"In a sense Music, along with the sense of smell tends to be the most powerful of ‘time machines’, usually with a default to the past....Mindfulness training and DBT exercises were focused on bringing me to and keeping me in the moment. However, one of my true pleasures in life was in danger of inadvertently causing me to ‘time travel’ to the past. I didn’t want to lose out on one of my real pleasures in life, just because of my overwhelming emotional responses to it. Not every memory is painful and it’s important to acknowledge that, even before recovery, my life was actually made up of shadows AND light." (from Blog: Music My Own Special TARDIS )

With this never ending stream linking me to the past, even the most seemingly everyday problem or difficulty would connect to the torrent of emotional distress just below the surface, so that terms like 'overreaction', 'out of proportion' and 'drama queen' were applied to me. For those on an emotional 'even keel' it seems almost impossible to imagine the almost physical pain caused when I face disappointments, dilemmas, arguments and problems which are the stuff of everyday life. For the survivor of childhood abuse these experiences are reminders and directly connect to the emotional pain of the abuse perpetrated. Everything seems to rip the scabs from the wounds over and over, so that even the most benign of human relationships becomes a minefield of anticipated terrors to be avoided.

The wrong thing to tell me is 'to just get over it'. Recent exposure of the issues around victims of historical abuse has brought to light the reality that for survivors of abuse, you just don't or can't 'get over it'.

Having survived my abusive life, I continue to be in the process of leaving it behind. I always thought that once I had gained the skills I needed from DBT I would be in a position to finally, 'deal with the past'. I assumed this would mean some form of Trauma counselling. However, I have found that the very practise of mindfulness and the emphasis in DBT on Acceptance of life ('It is what it is'), in this moment seem to be enough for me to feel I have begun to leave my past behind.

This blog post reflects my own journey, it is not a blueprint for dealing with the impact of trauma - my symptoms of trauma are my own and my path through is my own. Hopefully, if you continue to deal with the stream of painful memories and feelings from the past, then this may offer you some hope that there is a way through.

1. I Finally Accepted That I didn't ask for or 'deserve' what happened to me. This means accepting that I am maybe worth better than happened to me - something that was an alien thought even six months ago.

Acceptance is an important group of skills in DBT treatment. The original version of DBT does not offer specific therapy for PTSD. (Recently, however, a specific DBT skills module for PTSD has been developed. I am not sure how widely this is currently available in the UK) The DBT skill of Radical Acceptance, allows me to accept what happened and to begin to leave my experience of trauma in the past. I have accepted that not only have I survived, but I have been strengthened by my survival. The abusers can only have power over me, if I allow myself to remain in the prison cell of the past. I carry the scars of the past and they may have shaped me, but I do not have to remain imprisoned by past experiences.

2. I have learned to trust my experience of the present as I have used mindfulness skills to focus on life as it is in this moment. I am no longer 'absent' - I've stopped 'time travelling' and am able to be 'present' - this means that I don't get bored as often as I used to. Also, it means I am able to give more effectively to those I am engaged with.

3. I have learned to name my feelings and to recognise when anxiety, fear, sadness, guilt etc from the past is distorting my perceptions of the present. I used to distrust pleasant feelings, like hope and happiness because they meant that the darker feelings and moments were more painful in contrast. Now I have learned to enjoy what I am able to enjoy for what it is. It has taken me a long time to say goodbye to the damaged child of yesterday and to reconnect with the adult I am today. That child remains a part of who I am, but her emotional paralysis no longer keeps me frozen in the past.

4. I have decided that the skills I have learned to manage my BPD are enough for me to accept the pain and grief about the past, without having to go back and relive it or do any sustained work on addressing what happened to me. Having denied and minimised it for so many years, the fact that I have been able to accept that I was a victim of abuse has been enough for me to be able to move forward.

It is important for me to emphasise that specific PTSD therapies are helpful for others as the symptoms of PTSD may continue become intrusive following other therapies for complex mental health conditions - each person knows their own needs better than anyone else.

'Dealing with the past' is not something that we can 'do' as a one-off-give me-the-silver-bullet solution. From the moment I first experienced the trauma I have been dealing with it. What I have learned is that at different points in my life I have developed strengths and skills that I have used to deal with the consequences of the past.

"When I finished my DBT therapy, my Therapist reminded me that I had begun the process of healing from the 3rd degree emotional burns, which are at the heart of the BPD experience of life. I have probably managed to develop a thin layer of emotional skin over deep, deep wounds..." (my blog 'Return to the Forbidding Planet:

I am pleased that I am no longer a hostage to a torrent of pain and distress streaming into my day to day life. Looking back I realise this is because of a process and time, along with the moment by moment determination to use my mindfulness skills to keep me focused on life in this moment. I have also permitted myself to enjoy the good things in life, gradually.