I think I've shared before a picture of the traumatised child which explains how hard it is for adoptive and foster parents to successfully give that child an experience of unconditional love. A friend who is an adoptive Mum shared it with me and at the time it resonated powerfully with me. When someone has been shown nothing but proof that they are worthless, when a care-giver seeks to pour love into the cup of that personality finds the love running off without even touching the inside. This is because all that has gone before, the trauma itself, the coping strategies and the fundamental frameworks of belief about themselves as worthwhile human beings serves to form an often invisible film stretching over the whole of the mouth of the cup.
I have spent the past ten years of my life slowly working to remove that film from myself. I know that in reality some who have tried to break through it have encountered, not a feather light, flimsy film, which lets in light, but steel shutters. What I have learned to accept in the past few months is that despite learning a lot about trusting others, the key to opening these shutters lies entirely in my own hands. It is not enough for me to acknowledge that love is being given to me, but for me to accept, without reservation or justification that I am loved. There are many moments on the path to recovery from childhood traumas which are paradoxically painful and healing at the same time. No human love is perfect, nor is it without risk.
Because in reality there is no human being who can love us perfectly. But when we begin to accept that we can love ourselves without feeling like frauds, then we can begin to move towards receiving love as it is intended. For me, I know I have shared before that I have a faith in a God who is bigger than me and all my problems and one of the main things that I have learned to accept is that my belief tells me, I am loved because I exist. Simple as that. One of my favourite thoughts of this year has been: 'The grace of God means something like: Here is your life. You might never have been, but YOU ARE, because the party wouldn't be complete without you.'
With healing I can now see that life is not all bad, but there are also good things in life. Some of those good things exist in me and my personality and/or abilities and gifts. And some people, not all actually think I'm worth loving. Again, this has been a long hard path to accept. As I wrote the word 'loving' I battled myself because my instinct was to find a less powerful word, such as 'like', or 'appreciate'. How many times do we stop ourselves accepting love as it is given, by changing its strength in our minds, minimising what the giver has intended? How many times have friends and loved ones tried to reinforce the positive things they see to love in us, and found themselves frustrated by our reverting to our (comfortable) old patterns, minimising what is good in us. 'Oh anyone could do that', or my favourite one 'You're just flanneling me'.
Funny how easy it is to believe in the absolute truth of critical opinions given to us or in our own minds, but how easy we find it to undermine positive praise for who we are and what we do. It's a natural consequence of not being given validation as children. Self validation because an alien concept and a skill we need to be taught later in life.
I have had to look at the negative thoughts and critical voices from my past which constantly circulated in my mind and decide if they are something that I want to listen to, or if I am willing to listen to the (admittedly) strange and novel, voices that tell there is a balance to things. Sometimes I mess things up, sometimes I do really well.
Over the past few weeks I have been wrestling with positive thoughts, because they feel odd and sometimes accepting them means something painful. I am learning that I can do things I never thought possible, that I can build webs of friends and I can cope when the ups and downs of human relationships happen. I am not shaken to my core because I disagree with someone, because receiving love means that I accept there is core of belonging within the relationships which means we can cope with 'falling out'. This is a new experience. Such little blips in reality, would in the past have meant me walking away for fear of rejection. Now they are the warp and weft of accepting that I am loved, which in turn frees me to feel love for others, without fearing the pain of having that love rejected.
So here I am saying, the steel doors are opening and I choose to receive the love that is offered to me. I know I haven't arrived and my recovery means that I continue to take one step forward when I can. As long as the movement continues forward, then I can say that my heart which has been frozen for fear of the risks involved in connecting with others, is melting. If that's sappy - so be it.
Showing posts with label BPD and friendships/relationships. Show all posts
Showing posts with label BPD and friendships/relationships. Show all posts
Saturday, 20 June 2020
Monday, 16 September 2019
The Art of Connecting
I am preparing a talk to a group of Psychological Professionals talking about my story in the context of my journey through Mental Health Services. In considering the factors which have helped me most in my journey I have been reflecting on the central relationships along the way and the need to break out of the isolation of mental ill health and connecting with the world around me.
When the core building blocks of human relationships have been shattered by early experience of trauma where do we begin to rebuild trust, particularly within the restrictions of the realities of accessing Mental Health interventions? That is a message I want to communicate. Where to begin? People familiar with this Blog know that I have used the acronym CLANG for the five ways of well-being (Connect, Learn, Active, Notice, Give). That way I can truly call myself a 'Clanger'! I like this order as it begins with the C - Connect.
Connecting in relationship is at the core of our identities as humans. The truth about Trauma and its impact, is that while we survive it alone, there are few who can overcome it, effectively, alone. Healing requires relationship and, more importantly, relearning healthy relationship. ‘Most of us cannot carry these moments alone; and yet there are so few among us who will make peace with our despair.’ (Sarah Bessey – Out of Sorts) We cannot admit to our need of others if we do not admit to ourselves the extent of the burden we are carrying. When we remove judgement of ourselves for struggling with the effects of trauma and accept that the pain of despair is 'understandable' and 'human', we stop isolating ourselves from the rest of humanity and give ourselves permission to reconnect.
There is a complexity inherent in the destruction of relationship and connection caused by my early experiences of trauma. It follows then, that there needs to be complexity in the therapeutic approaches through which I make my way to healing. I wonder why group therapy is so often the central medium for some therapeutic approaches. I know within the NHS the answer is 'resources'. However, the argument can be made that those of us with experience of complex traumatic experiences 'cost' the NHS when time and resources are not appropriately allocated to helping us with this central issue of connection.
Healing takes time and commitment in relationship. Brene Brown says that we should only share with people who have earned the right to hear our story (The Gifts of Imperfection: Let go of Who You Think You're Supposed to be and Embrace Who You Are (2010)). Within the therapeutic relationship of many interventions, where is the time to earn that right?
The truth is that all of us relate to one another on a one to one basis. Groups are problematic to me, there are so many barriers to my engagement based on my experiences of relationships in the past. Social Media is a particularly difficult arena for connecting.
I believe this is because it is about quantity, rather than quality. How many mental health problems are related to or exacerbated by this medium for connection? The reality is that I have capacity for a few in-depth relationships and after that there are circles of intimacy emanating outwards from me at the centre of my social networks. Right on the outside are those I relate to only in groups, clubs, teams, churches, workplaces. There can be overlap between concentric circles of connection, naturally. On the whole I build trust in you when we spend time sharing moments that matter to both.
I have asked myself what it is about the DBT structure which helped most. The answer I think is that it offers a layered, complex approach which allows me to engage from my own experience with each element of the therapy. DBT groups work by introducing skills which then are taken up by me and applied to me to fit the life I want to live.
Our deepest relationships are those which are built, slowly over time. There are shared moments of trust. I need to learn the discipline of staying put, building or rebuilding friendships over time. In the past the fear of rejection, or even my anticipation of it, meant I would up sticks and run as fast and as far as I could the moment I felt myself beginning to rely on and (whisper it) trust in any relationship.
In the past I've written about rebuilding trust through animals. When every human relationship is laden with risk and reminds me of the pain of rejection and trauma from childhood, where do you begin rebuilding trust. I think that along with self-care for those of us suffering from PD diagnoses, connection provides the biggest challenge to recovery. Animals are wholly dependent, but they are entirely and completely non-judgemental and offer unconditional love. At a very basic level I can begin to connect with a living being who trusts me. At some point every year, within our group we discuss the fears about 'letting down' a pet. So we take it a step back and start by growing and caring for seeds. This may seem simplistic and reductionist, but if we truly do not believe 'we're worth it' we can begin to illustrate to ourselves the daily care of watering, feeding and spending time looking after a living thing. It becomes a reminder to do the same most fundamental things for ourselves in order to simply exist.
We are made for relationship and when we have our basic needs met through nourishment, sleep and hydration, we can start towards building a purpose for living. Here connection moves from a horizontal focus on those around us, to the bigger 360 degree, looking up and beyond our earthbound lives to finding a connection to something that is bigger than us and bigger than our struggles in life. For some of us, this is found in a faith in God, for others, in serving the needs of others, be it our families, or communities or even the wider world.
Connecting, ultimately says to the isolated 'you belong'.
When the core building blocks of human relationships have been shattered by early experience of trauma where do we begin to rebuild trust, particularly within the restrictions of the realities of accessing Mental Health interventions? That is a message I want to communicate. Where to begin? People familiar with this Blog know that I have used the acronym CLANG for the five ways of well-being (Connect, Learn, Active, Notice, Give). That way I can truly call myself a 'Clanger'! I like this order as it begins with the C - Connect.
Connecting in relationship is at the core of our identities as humans. The truth about Trauma and its impact, is that while we survive it alone, there are few who can overcome it, effectively, alone. Healing requires relationship and, more importantly, relearning healthy relationship. ‘Most of us cannot carry these moments alone; and yet there are so few among us who will make peace with our despair.’ (Sarah Bessey – Out of Sorts) We cannot admit to our need of others if we do not admit to ourselves the extent of the burden we are carrying. When we remove judgement of ourselves for struggling with the effects of trauma and accept that the pain of despair is 'understandable' and 'human', we stop isolating ourselves from the rest of humanity and give ourselves permission to reconnect.
There is a complexity inherent in the destruction of relationship and connection caused by my early experiences of trauma. It follows then, that there needs to be complexity in the therapeutic approaches through which I make my way to healing. I wonder why group therapy is so often the central medium for some therapeutic approaches. I know within the NHS the answer is 'resources'. However, the argument can be made that those of us with experience of complex traumatic experiences 'cost' the NHS when time and resources are not appropriately allocated to helping us with this central issue of connection.
Healing takes time and commitment in relationship. Brene Brown says that we should only share with people who have earned the right to hear our story (The Gifts of Imperfection: Let go of Who You Think You're Supposed to be and Embrace Who You Are (2010)). Within the therapeutic relationship of many interventions, where is the time to earn that right?
The truth is that all of us relate to one another on a one to one basis. Groups are problematic to me, there are so many barriers to my engagement based on my experiences of relationships in the past. Social Media is a particularly difficult arena for connecting.
I believe this is because it is about quantity, rather than quality. How many mental health problems are related to or exacerbated by this medium for connection? The reality is that I have capacity for a few in-depth relationships and after that there are circles of intimacy emanating outwards from me at the centre of my social networks. Right on the outside are those I relate to only in groups, clubs, teams, churches, workplaces. There can be overlap between concentric circles of connection, naturally. On the whole I build trust in you when we spend time sharing moments that matter to both.
I have asked myself what it is about the DBT structure which helped most. The answer I think is that it offers a layered, complex approach which allows me to engage from my own experience with each element of the therapy. DBT groups work by introducing skills which then are taken up by me and applied to me to fit the life I want to live.
Our deepest relationships are those which are built, slowly over time. There are shared moments of trust. I need to learn the discipline of staying put, building or rebuilding friendships over time. In the past the fear of rejection, or even my anticipation of it, meant I would up sticks and run as fast and as far as I could the moment I felt myself beginning to rely on and (whisper it) trust in any relationship.
In the past I've written about rebuilding trust through animals. When every human relationship is laden with risk and reminds me of the pain of rejection and trauma from childhood, where do you begin rebuilding trust. I think that along with self-care for those of us suffering from PD diagnoses, connection provides the biggest challenge to recovery. Animals are wholly dependent, but they are entirely and completely non-judgemental and offer unconditional love. At a very basic level I can begin to connect with a living being who trusts me. At some point every year, within our group we discuss the fears about 'letting down' a pet. So we take it a step back and start by growing and caring for seeds. This may seem simplistic and reductionist, but if we truly do not believe 'we're worth it' we can begin to illustrate to ourselves the daily care of watering, feeding and spending time looking after a living thing. It becomes a reminder to do the same most fundamental things for ourselves in order to simply exist.
We are made for relationship and when we have our basic needs met through nourishment, sleep and hydration, we can start towards building a purpose for living. Here connection moves from a horizontal focus on those around us, to the bigger 360 degree, looking up and beyond our earthbound lives to finding a connection to something that is bigger than us and bigger than our struggles in life. For some of us, this is found in a faith in God, for others, in serving the needs of others, be it our families, or communities or even the wider world.
Connecting, ultimately says to the isolated 'you belong'.
Tuesday, 6 February 2018
Groundhogs and Finding the Words
Groundhog Day is a bizarre American public holiday based around the behaviour of a brown, furry rodent, upon which the nation apparently bases its expectation for how much longer winter will last. Until the release of the film 'Groundhog Day', so far, so obscure. Now, we use the phrase to mean recurring events or conversations. Over the past two weeks, I've had that sense of 'Groundhog Day' as I have had conversation after conversation on the same lines. 'My husband/partner/brother/sister/friend/carer keep asking me how they can help me, they keep asking, how they can 'fix' me.'
It's a familiar conundrum, we wish we felt loved, but need to know that with love comes a desire to do 'something' to take the pain and hurt from us. For us, the issue is to prevent pushing the love away with the offer rescue. So often, the conversations continue, 'I wish (he/she) knew that all I want is a hug and reassurance.' So often, it seems that even to find a way to say something this simple is so hard.
I'm no expert, but I have gleaned some wisdom from those who have managed to voice their thoughts to their loved ones and found a way forward together.
1. If You Can't Say it, Try Writing It. Write a letter to your loved one and pin it to the family memo board, or to the fridge, or on the loo door; somewhere they can't miss it.
2. Relieve Them of The Duty to Be Your Saviour. I've stated before that it is an impossibility for one person to provide all of our emotional needs. Those closest to us need to know that we don't expect them to rescue us. Just as I have to accept that I can't rid myself of all pain, so I need to absolve those closest to me from the pressure of believing they have to take the pain away from me. Together we need to work together - I have lived my life, survived my trauma. I do not need to share the fallout from those past experiences as a burden on my current relationships. What I would welcome is someone to walk alongside me, to build me up with present positives, particularly when carrying the burden of my condition or my past wears me down. In the healthiest ways possible I need my current relationships to be nurturing and equal.
3. Be honest. Express to them what other things, practical things would really help when you are feeling overwhelmed. For example, it's okay for children to spend one to one time with a parent if that allows time for the other parent to restore batteries. Support one another in becoming involved in social and other positive activities outside the home. Empty vessels have nothing to offer others.
It's a familiar conundrum, we wish we felt loved, but need to know that with love comes a desire to do 'something' to take the pain and hurt from us. For us, the issue is to prevent pushing the love away with the offer rescue. So often, the conversations continue, 'I wish (he/she) knew that all I want is a hug and reassurance.' So often, it seems that even to find a way to say something this simple is so hard.
I'm no expert, but I have gleaned some wisdom from those who have managed to voice their thoughts to their loved ones and found a way forward together.
1. If You Can't Say it, Try Writing It. Write a letter to your loved one and pin it to the family memo board, or to the fridge, or on the loo door; somewhere they can't miss it.
2. Relieve Them of The Duty to Be Your Saviour. I've stated before that it is an impossibility for one person to provide all of our emotional needs. Those closest to us need to know that we don't expect them to rescue us. Just as I have to accept that I can't rid myself of all pain, so I need to absolve those closest to me from the pressure of believing they have to take the pain away from me. Together we need to work together - I have lived my life, survived my trauma. I do not need to share the fallout from those past experiences as a burden on my current relationships. What I would welcome is someone to walk alongside me, to build me up with present positives, particularly when carrying the burden of my condition or my past wears me down. In the healthiest ways possible I need my current relationships to be nurturing and equal.
3. Be honest. Express to them what other things, practical things would really help when you are feeling overwhelmed. For example, it's okay for children to spend one to one time with a parent if that allows time for the other parent to restore batteries. Support one another in becoming involved in social and other positive activities outside the home. Empty vessels have nothing to offer others.
Friday, 29 December 2017
Expectations (Not Resolutions)
We all have them. We've all suffered from our own and others'. Many times they are too high for anyone to fulfil. Sometimes we most misjudge our own of ourselves. Expectations and their failure or perceived failure have caused me untold tears of disappointment and frustration. I am certain I am not alone - that expectation is bound to be met!
Misplaced and excessive expectations can cause increased distress and emotional pain at any time, but never more so than in our yearly build up to Christmas and New Year celebrations.
For the past few years I have abandoned the frankly masochistic practice of setting resolutions - why do we have to become abstemious and self denying, immediately assuming we can rid ourselves of all the behaviours which cause us untold misery over years at the stroke of midnight on the 31st of December each year? Was it Einstein who said that the definition of insanity is to keep doing the same thing, expecting a different result?
So, now I tend to adjust expectations - a bit like the Team GB Cycling Team - I now aim for 'marginal gains' making small adjustments to how I've been doing things over the past year. Looking back at my path on recovery I recognise that I have changed so many of my habits and behaviours and honestly I can say that I am in a better place this year than last. Doesn't mean that everything is hunky dory or that the past year hasn't had its battles or disappointments.
What expectations do I have for 2018?
1. For Myself. Setting unrealistic goals for myself has put unnecessary pressure on me over the years. Aspiration is all very well, but honestly, I believe that expecting myself to be perfect, to hold myself to a higher standard than I have for others has meant that a significant level of anxiety has been a constant in my life. So I need to adjust my expectations.
I am living with a condition (Emotionally Unstable Personality Disorder) which means that my emotional stability is constantly adjusting to changes in my circumstances, my body, my nutrition, the presence of other people, the absence of other people, making plans, too much work, too little work etc. This means that I quickly become exhausted if I do not 'give myself a break'. I have had to adjust my expectation that I can keep on going without any regard for my own emotional and physical needs. In the past this has led me to experience repeating cycles of recovery, giving out too much, for too long and ending up exhausted and unable to function.
I now recognise that helping others requires me to look after myself as much as I care for others. Part of the healing process is accepting that I need to be cared for in order to care for others. I cannot expect to feel connected to others by either keeping myself locked away so I do not become exhausted or becoming unreliable as a friend because I wear myself out by giving out when I have run out of emotional resources. The goals I set for myself will be helpful if I keep an eye on my limits, my realistic strengths and my need to care for myself as well as others.
2. For Others When feeling intense emotional distress it is easy to expect way too much of others. In particular, I have demanded of professionals and my friends the impossible. No human being can remove my past from me, no human being can undo the harm done to me. I think sometimes within a service which is free at the point of delivery, we have expectations of staff which are not humanly possible.
If I have waited nearly a year for a treatment, there is a sense in which I expect that on day one the therapist will wave a magic wand and all the emotional turmoil and sense of emptiness will disappear. In black and white that is clearly unfair, and if you presented me with this as an objective observation I would be shocked and deny it as an expectation. However, the reality is that sometimes my anger and frustration has been directed at those who are seeking to help me, simply because deep down my expectation is that they SHOULD be able to stop me from feeling so much pain. I have often created barriers and 'tests' which have become self fulfilling prophesies as I maintained my expectation and belief that 'No one can cope with me' and 'I am incapable of being loved and giving love'. Of course people give up when they are pushed to their limits and beyond. Unrealistic expectations result in the very rejection I always fear and, ironically, expect.
Adjusting my expectations means that the limits of the therapeutic relationship and friendship which maintain effective connection can provide a stable framework in which they can survive my emotional storms. Friends and therapists alike have their limits. I have no right to expect a friend to carry the burden of my past hurts or my present struggles. A friend is someone who walks alongside - no one - not even in the most intimate of relationships can actually live my pain for me. The therapist is there as a sounding board, not a whipping boy, as a guide, or coach. They are not a fount of all knowledge, nor are they able to 'prescribe' chemicals which can remove every painful emotion or memory. In a sense, because I have survived the actual events, the emotional pain and distress I continue to feel are the 'aftershocks'. I have the strength to deal with them, I do not have to inflict the same distress on my friends or my therapist in order for them to come alongside and help me cope in the here and now.
The most pervasive expectation I have had has been that of the 'perfect relationship'. If my loved one really understood and loved me, they would know at every moment exactly what is happening emotionally to me. They would be so entwined with me that they would be able to read my mind. Most destructive of all is the expectation that if my partner loves me 'enough' then all the pain and emptiness inside from my early experiences, coupled with my physiological make up would end. Man, what a burden to put on any relationship let alone any individual. Often, this impossible expectation is coupled with the twin one of myself, ie that no matter how self destructive to me, I will do anything to 'prove' my love. Sometimes, this toxic combination has resulted in abusive relationships which have perpetuated the destructive experiences of trauma in the past. Adjusting my expectations to taking responsibility for my own emotional balance allows me to enjoy connection and relationships which are not burdened by unrealistic expectations. Accepting that our shared humanity means we all have our limits allows greater honesty and more secure relationships.
3. For Life Life is tough. For everyone. When we are at our lowest we often assume, wrongly, that everyone else and everything else is experiencing a life that is so much more than our own. The reality is that most of life is boring when people are not dealing with crisis or enjoying high points. Often I have assumed that no one else is struggling to extent that I am. It is a symptom of emotional struggles that we fail to perceive the daily grind of most people. No one exists on mountaintops in terms of their life experience. Mountains stand out because the terrain around them is lower. The lives and experiences of others we think are better, stand out because of the relative 'normalness' of those around them. I do not know what other people's experience is of life, nor can I tell anyone else what a meaningful existence consists of. I can only decide that for myself. I cannot possibly compare myself or my feelings about life to another. There are too many variables in our comparative experiences. Nor do I have a right to judge another person for struggling, particularly if I expect that their life experience has been 'easier' than mine. I have no right to call another person's mountain a molehill. Accepting myself and the life I am living as unique to me, without comparing it that of others means that my expectations of my own life shift and don't suffer in comparison. This means that material and physical circumstances become less vital to my expectations of life.
If you are finding yourself under pressure at this time of year, ask yourself what you expect, or expected from the festive period? What do you expect of yourself and others going into a new year? Are your expectations for recovery/managing your mental health realistic? Do you expect too much from yourself and others? Do you ignore the limits of living in the real world? Are your expectations of medications/professionals/human relationships for your mental health realistic? Accept what cannot be changed, change what you can, within your own limits and maybe learn to enjoy what there is to be enjoyed, moment by moment. Resolutions sound so definite, expectations can be adjusted.
Misplaced and excessive expectations can cause increased distress and emotional pain at any time, but never more so than in our yearly build up to Christmas and New Year celebrations.
For the past few years I have abandoned the frankly masochistic practice of setting resolutions - why do we have to become abstemious and self denying, immediately assuming we can rid ourselves of all the behaviours which cause us untold misery over years at the stroke of midnight on the 31st of December each year? Was it Einstein who said that the definition of insanity is to keep doing the same thing, expecting a different result?
So, now I tend to adjust expectations - a bit like the Team GB Cycling Team - I now aim for 'marginal gains' making small adjustments to how I've been doing things over the past year. Looking back at my path on recovery I recognise that I have changed so many of my habits and behaviours and honestly I can say that I am in a better place this year than last. Doesn't mean that everything is hunky dory or that the past year hasn't had its battles or disappointments.
What expectations do I have for 2018?
1. For Myself. Setting unrealistic goals for myself has put unnecessary pressure on me over the years. Aspiration is all very well, but honestly, I believe that expecting myself to be perfect, to hold myself to a higher standard than I have for others has meant that a significant level of anxiety has been a constant in my life. So I need to adjust my expectations.
I am living with a condition (Emotionally Unstable Personality Disorder) which means that my emotional stability is constantly adjusting to changes in my circumstances, my body, my nutrition, the presence of other people, the absence of other people, making plans, too much work, too little work etc. This means that I quickly become exhausted if I do not 'give myself a break'. I have had to adjust my expectation that I can keep on going without any regard for my own emotional and physical needs. In the past this has led me to experience repeating cycles of recovery, giving out too much, for too long and ending up exhausted and unable to function.
I now recognise that helping others requires me to look after myself as much as I care for others. Part of the healing process is accepting that I need to be cared for in order to care for others. I cannot expect to feel connected to others by either keeping myself locked away so I do not become exhausted or becoming unreliable as a friend because I wear myself out by giving out when I have run out of emotional resources. The goals I set for myself will be helpful if I keep an eye on my limits, my realistic strengths and my need to care for myself as well as others.
2. For Others When feeling intense emotional distress it is easy to expect way too much of others. In particular, I have demanded of professionals and my friends the impossible. No human being can remove my past from me, no human being can undo the harm done to me. I think sometimes within a service which is free at the point of delivery, we have expectations of staff which are not humanly possible.
If I have waited nearly a year for a treatment, there is a sense in which I expect that on day one the therapist will wave a magic wand and all the emotional turmoil and sense of emptiness will disappear. In black and white that is clearly unfair, and if you presented me with this as an objective observation I would be shocked and deny it as an expectation. However, the reality is that sometimes my anger and frustration has been directed at those who are seeking to help me, simply because deep down my expectation is that they SHOULD be able to stop me from feeling so much pain. I have often created barriers and 'tests' which have become self fulfilling prophesies as I maintained my expectation and belief that 'No one can cope with me' and 'I am incapable of being loved and giving love'. Of course people give up when they are pushed to their limits and beyond. Unrealistic expectations result in the very rejection I always fear and, ironically, expect.
Adjusting my expectations means that the limits of the therapeutic relationship and friendship which maintain effective connection can provide a stable framework in which they can survive my emotional storms. Friends and therapists alike have their limits. I have no right to expect a friend to carry the burden of my past hurts or my present struggles. A friend is someone who walks alongside - no one - not even in the most intimate of relationships can actually live my pain for me. The therapist is there as a sounding board, not a whipping boy, as a guide, or coach. They are not a fount of all knowledge, nor are they able to 'prescribe' chemicals which can remove every painful emotion or memory. In a sense, because I have survived the actual events, the emotional pain and distress I continue to feel are the 'aftershocks'. I have the strength to deal with them, I do not have to inflict the same distress on my friends or my therapist in order for them to come alongside and help me cope in the here and now.
The most pervasive expectation I have had has been that of the 'perfect relationship'. If my loved one really understood and loved me, they would know at every moment exactly what is happening emotionally to me. They would be so entwined with me that they would be able to read my mind. Most destructive of all is the expectation that if my partner loves me 'enough' then all the pain and emptiness inside from my early experiences, coupled with my physiological make up would end. Man, what a burden to put on any relationship let alone any individual. Often, this impossible expectation is coupled with the twin one of myself, ie that no matter how self destructive to me, I will do anything to 'prove' my love. Sometimes, this toxic combination has resulted in abusive relationships which have perpetuated the destructive experiences of trauma in the past. Adjusting my expectations to taking responsibility for my own emotional balance allows me to enjoy connection and relationships which are not burdened by unrealistic expectations. Accepting that our shared humanity means we all have our limits allows greater honesty and more secure relationships.
3. For Life Life is tough. For everyone. When we are at our lowest we often assume, wrongly, that everyone else and everything else is experiencing a life that is so much more than our own. The reality is that most of life is boring when people are not dealing with crisis or enjoying high points. Often I have assumed that no one else is struggling to extent that I am. It is a symptom of emotional struggles that we fail to perceive the daily grind of most people. No one exists on mountaintops in terms of their life experience. Mountains stand out because the terrain around them is lower. The lives and experiences of others we think are better, stand out because of the relative 'normalness' of those around them. I do not know what other people's experience is of life, nor can I tell anyone else what a meaningful existence consists of. I can only decide that for myself. I cannot possibly compare myself or my feelings about life to another. There are too many variables in our comparative experiences. Nor do I have a right to judge another person for struggling, particularly if I expect that their life experience has been 'easier' than mine. I have no right to call another person's mountain a molehill. Accepting myself and the life I am living as unique to me, without comparing it that of others means that my expectations of my own life shift and don't suffer in comparison. This means that material and physical circumstances become less vital to my expectations of life.
Monday, 15 June 2015
Friendship & BPD
I have a strong network of friends. In fact I have a network of strong friendships. It is the first time in my life that I have felt secure in such a network. Many of my friendships have been allowed to develop because the turbulence in my life has slowly stopped over the past twelve years when I have stopped the crash and burn pattern of my relationships, jobs and life. Before I was aware of my diagnosis I was a nightmare friend. I confused people. I was intense in my expectations of time, feelings and shared experiences. I burned many friends out because they found it exhausting keeping up with my constant needs and demands for time.
It was frustrating to be my friend, because on the one hand I constantly presented as being in need, but would refuse to explain my upset. I frequently disrupted social events by storming out or quietly disappearing. I went missing for weeks on end, then would return with obvious injuries but refuse to explain where I had been or what had happened to me. You see, I felt that if they were 'really my friends' they would just accept me and they would actually know what was going on without me having to explain - after all that was what my 'real friends' would be able to do.
I had no boundaries, it took a long time for me to trust people on one hand, but on the other, you could find me disclosing distressing details about my abusive past within minutes of meeting. One of my friends used to describe this as an 'Alma Grenade'. It was not uncommon for me to launch these highly explosive grenades into conversations at parties, then move quickly on to crazy comedy riffs, as if I had not launched an emotionally explosive nuclear bomb. My behaviour would swing from extremely distressed and tearful to what can only be described as 'dancing on the ceiling'. When I was feeling 'hyper' I would insist on reckless behaviour. Walking in risky areas at night, ignoring any risks to myself or any others around me. Frequent reckless driving particularly at speed along twisting country roads, frequently driving at high speed on motorways. If you were my friend you may have to be a passenger on one of these 'trips'.
I expected my friends to be there 24 hours a day 7 days a week, while at the same time, fully expecting them to 'let me down' - usually when they imposed reasonable time limits and or gave me limits on when I could call. Imposing such boundaries would inevitably result in the friendships ending. My reaction to endings was extreme, I could not tolerate even being on the same side of the street as former friends, and often, forced myself to relocate entirely (usually to the other side of the country or even abroad) following the ending of a friendship.
So, at the age of 48 I find that I have one friend (and her husband) who have lasted the course since university. I have no childhood friends left, having burnt my school bridges long ago. My journey is littered with friendships and relationships. At the time of my diagnosis at the age of 42 I was in the process of repeating patterns of friendship 'implosion', having lived here nearly five years. Up until that point, apart from my childhood home, that had been the longest I had managed to live anywhere, ever.
Six years on, I have completed nearly two years of DBT (Dialectical Behaviour Therapy) and five years of care under Mental Health services. During that time I have made and KEPT a number of friends and feel I've reached a point where I can be a good friend back. I no longer push friendships to breaking point, in some kind of perverse self fulfilling prophecy that 'I am unloved and unlovable', which is the best way to describe the emotional impulses behind my self destruct approach to friendship in the past.
I have found it helpful to use the DBT Inter Personal Skills particularly when I have been tempted to return to my old patterns of relating in friendship. This has meant that over the last three or four years, I have managed to weather typical friendship hurdles and misunderstandings, without entirely having to give up on my ability to make and keep friends:
The DEAR MAN skills aim to help me achieve objective goals - often feeling that I have a right to ask for fairness in service as a customer meant that I never questioned businesses, or was able to make clear, what were my preferences. After all, my needs have never mattered. Sometimes in friendships it is important to be honest about the practicalities which may mean that I can't do this or that. To tell my friends that I would prefer not to do something does not mean that the friendship has to end. If I'm honest this ability to express my needs as valid is something I continue to struggle with:
D Describe
E Express
A Assert
R Reinforce
M Mindful
A Appear Confident
N Negotiate
For the person with BPD the idea that I can negotiate disagreements and problems in friendships without being rejected is one of the most difficult to come to terms with. I have had occasions on which the following GIVE skills have helped me to explain any issues without feeling that I am risking the friendship. They have helped me to negotiate issues without them becoming 'do or die' moments for the friendships:
G Gentle
I Interested
V Validate
E Easy Manner
Feeling secure in myself and my value to friends has been vital in keeping balance in my friendships. It is hardly surprising that if I have no idea who I am, or that who I am has any value in any of my relationships, it is hardly surprising that I have experienced and persevered with damaging relationships and friendships, whilst rejecting those which valued me. This is a paradox for those who care for those of us with BPD. Sometimes we are so suspicious of genuine love and care, abusive relationships somehow feel more familiar. I regret the number of caring relationships and friendships that have foundered on the rocks of my lack of self esteem. The FAST skills are designed to help me to deal with issues and relationships which may be harmful to me, or continue to reinforce my lack of validation. One symptom of my lack of self esteem is a continual feeling that I must apologise for everything, just in case I am to blame for all that is wrong in the world!
F Fair
A Apologies (no Apologies)
S Stick to values
T Truthful
Learning what these skills are is only the beginning for me. Along with the basic DBT skills I have made some discoveries of my own, which are still working their way out in my day to day friendships.
1. Friendship is different from Intimate Relationship. One of the main problems I faced in friendships was the confusion between close friendship and sexual relationships. Given the experiences of confused sexuality born of the experience of childhood sexual abuse, it is hardly surprising that I have at times confused care and concern, for sexual interest. Inevitably this has led to mistrust and confusion in the boundaries within friendships and unfortunately opened me up to further sexual abuse in relationships as an adult. Boundaries are important for me as someone suffering the symptoms of BPD. I am not a hugger. It is important for me that physical intimacy is not a part of friendship. If you find me physically attractive and you want me to respond in kind, it is vital that you are clear about your expectations of me, this may seem a bit childish, but I am easily confused by 'signals' and need clarity. This is important because physical attraction adds problematic dimensions to relationships, that I may not be equipped to manage, particularly if I remain unaware of 'agendas'. For me, relationships cannot become games of flirting, my emotional responses are too erratic and my ability to read other people continues to be impaired. Clarity prevents unintended hurt feelings on both sides.
2.Ground Rules are Vital For the person with BPD all relationships and friendships are akin to trying to negotiate a minefield without any map or GPS. I have learned to be honest with people about the things I find difficult. I am a good actress and one of the coping mechanisms I have used in the past is to mimic more successful behaviour around me. The problem for me in relationships was that often I was only aware that my grasp of friendship dynamics was faulty after the fact. 'Learning from your mistakes' became a matter of 'that didn't work, let's see if this works'. The problem is that any models of 'acceptable behaviour' I followed were not necessarily right for me, because they took into account the personalities, values and beliefs of another person. In all my current friendships I have learned to listen to myself - it is easier as I have been using DBT skills which mean that I am no longer lost in a fog of indefinable feelings, which are swinging wildly out of control. So now, if I need some time to myself, I am able to say so. If I feel I need some company and have nothing planned I know who and when I can call as friends. I also have learned that unplanned calls or visits where friends are not available is not a rejection of me. I can therefore cope when friends tell me, No. This means that they in return don't feel they have to 'walk on egg shells'. They know I will not spiral out of control emotionally just because they have other plans. It has been important for me to be clear about this and to keep checking it out, instead of going into a corner and brooding until I believe I have been utterly rejected. It also means that I have a responsibility not just to disappear and blame friends for not knowing a) where I am or b) what I am feeling.
3. I take my Friends at Face Value. I no longer suspect motives or 'read minds'. If my friends say to me 'I missed you' or 'It's really good to see you', I do not assume either a judgement of my absence or that there is a suspicious motive in 'buttering me up'. I am learning to listen to them 'non-judgementally' and I am learning to accept that if they are spending time with me, it is just because they actually enjoy my company, or that I have to buy them things to 'reward' them for doing so. As a result I have found that my close friendships are no longer fraught, nor do I feel that I need to buy expensive (and embarrassing for the recipients) gifts to 'buy' their friendships. Learning to do this is validating in itself.
4. No Friend or Person can Undo the Pain of the Past. One of the impossible expectations I have put on all my relationships has been to
expect my friends to fill the emotional void within me. It has been a hard learned lesson that No One can every undo the traumas of the past. So many of my friendships foundered on the rocks of my need and expectation that their unconditional love for me could and would undo the distress I felt as a result of an invalidating childhood. No relationship however intense could withstand such an expectation. My friendships today have to be taken as they are in the here and now. In a strange way accepting them for what they are in the present, is managing to undo the damage of failed friendships in the past. They are gone, the pain from them failing is an echo of the past, it does not have to the reality of my present.
5. Friendships Aren't Bound by Vows. Unlike marriage, my friends and I are not bound together by legal or religious vows. It is not a contract as such. In the past I have tried to impose conditions that were unfair and binding on my friends. Conversations with friends which begin 'Promise me you'll never...' are deeply unfair. They are born of the desperation not to be abandoned and the fear of rejection. True friendship is given and received freely. Sometimes there is a natural ebb and flow to them, as people move in and out of our lives. Such flow of relationships is so difficult for me as a BPD sufferer, because, after all you're getting a job on the other side of the world is because I am such a hateful person - isn't it? If I were able to open up to my friends about the depth of my belief that I am so utterly unlovable that I must the cause of all separation and abandonment in my life and the lives of others, they would be shocked. But that is the reality behind my desperate pleas for you to promise, never to move away, never to change, never to get married etc... Accepting that I cannot do so has been freeing and has allowed me to grieve for the loss of friends who have had to move away or who have moved out of my life simply because we both have moved into different phases in our lives. Every now and then I need to be reminded that my life is a journey and not everyone I meet on the road will stay with me for the duration of the whole journey. In fact the only relationship in which I can expect a promise of a life together, is one which has been formalised in marriage, and even then, for many this relationship too can end.
As I have moved forward with my Interpersonal Effectiveness Skills and my basic friendship rules I have found that I am able to develop honest, stable friendships and I am willing to move outside a very narrow circle of one or two close and trusted friends. As a result my social life is developing faster than I expected.
Here are a series of Interpersonal Effectiveness Handouts which give excellent examples of when to use the different skills: http://www.dbtselfhelp.com/html/interpersonal_effectiveness_ha.html
It was frustrating to be my friend, because on the one hand I constantly presented as being in need, but would refuse to explain my upset. I frequently disrupted social events by storming out or quietly disappearing. I went missing for weeks on end, then would return with obvious injuries but refuse to explain where I had been or what had happened to me. You see, I felt that if they were 'really my friends' they would just accept me and they would actually know what was going on without me having to explain - after all that was what my 'real friends' would be able to do.
I had no boundaries, it took a long time for me to trust people on one hand, but on the other, you could find me disclosing distressing details about my abusive past within minutes of meeting. One of my friends used to describe this as an 'Alma Grenade'. It was not uncommon for me to launch these highly explosive grenades into conversations at parties, then move quickly on to crazy comedy riffs, as if I had not launched an emotionally explosive nuclear bomb. My behaviour would swing from extremely distressed and tearful to what can only be described as 'dancing on the ceiling'. When I was feeling 'hyper' I would insist on reckless behaviour. Walking in risky areas at night, ignoring any risks to myself or any others around me. Frequent reckless driving particularly at speed along twisting country roads, frequently driving at high speed on motorways. If you were my friend you may have to be a passenger on one of these 'trips'.
I expected my friends to be there 24 hours a day 7 days a week, while at the same time, fully expecting them to 'let me down' - usually when they imposed reasonable time limits and or gave me limits on when I could call. Imposing such boundaries would inevitably result in the friendships ending. My reaction to endings was extreme, I could not tolerate even being on the same side of the street as former friends, and often, forced myself to relocate entirely (usually to the other side of the country or even abroad) following the ending of a friendship.
So, at the age of 48 I find that I have one friend (and her husband) who have lasted the course since university. I have no childhood friends left, having burnt my school bridges long ago. My journey is littered with friendships and relationships. At the time of my diagnosis at the age of 42 I was in the process of repeating patterns of friendship 'implosion', having lived here nearly five years. Up until that point, apart from my childhood home, that had been the longest I had managed to live anywhere, ever.
Six years on, I have completed nearly two years of DBT (Dialectical Behaviour Therapy) and five years of care under Mental Health services. During that time I have made and KEPT a number of friends and feel I've reached a point where I can be a good friend back. I no longer push friendships to breaking point, in some kind of perverse self fulfilling prophecy that 'I am unloved and unlovable', which is the best way to describe the emotional impulses behind my self destruct approach to friendship in the past.
I have found it helpful to use the DBT Inter Personal Skills particularly when I have been tempted to return to my old patterns of relating in friendship. This has meant that over the last three or four years, I have managed to weather typical friendship hurdles and misunderstandings, without entirely having to give up on my ability to make and keep friends:
The DEAR MAN skills aim to help me achieve objective goals - often feeling that I have a right to ask for fairness in service as a customer meant that I never questioned businesses, or was able to make clear, what were my preferences. After all, my needs have never mattered. Sometimes in friendships it is important to be honest about the practicalities which may mean that I can't do this or that. To tell my friends that I would prefer not to do something does not mean that the friendship has to end. If I'm honest this ability to express my needs as valid is something I continue to struggle with:
D Describe
E Express
A Assert
R Reinforce
M Mindful
A Appear Confident
N Negotiate
For the person with BPD the idea that I can negotiate disagreements and problems in friendships without being rejected is one of the most difficult to come to terms with. I have had occasions on which the following GIVE skills have helped me to explain any issues without feeling that I am risking the friendship. They have helped me to negotiate issues without them becoming 'do or die' moments for the friendships:
G Gentle
I Interested
V Validate
E Easy Manner
Feeling secure in myself and my value to friends has been vital in keeping balance in my friendships. It is hardly surprising that if I have no idea who I am, or that who I am has any value in any of my relationships, it is hardly surprising that I have experienced and persevered with damaging relationships and friendships, whilst rejecting those which valued me. This is a paradox for those who care for those of us with BPD. Sometimes we are so suspicious of genuine love and care, abusive relationships somehow feel more familiar. I regret the number of caring relationships and friendships that have foundered on the rocks of my lack of self esteem. The FAST skills are designed to help me to deal with issues and relationships which may be harmful to me, or continue to reinforce my lack of validation. One symptom of my lack of self esteem is a continual feeling that I must apologise for everything, just in case I am to blame for all that is wrong in the world!
F Fair
A Apologies (no Apologies)
S Stick to values
T Truthful
Learning what these skills are is only the beginning for me. Along with the basic DBT skills I have made some discoveries of my own, which are still working their way out in my day to day friendships.
1. Friendship is different from Intimate Relationship. One of the main problems I faced in friendships was the confusion between close friendship and sexual relationships. Given the experiences of confused sexuality born of the experience of childhood sexual abuse, it is hardly surprising that I have at times confused care and concern, for sexual interest. Inevitably this has led to mistrust and confusion in the boundaries within friendships and unfortunately opened me up to further sexual abuse in relationships as an adult. Boundaries are important for me as someone suffering the symptoms of BPD. I am not a hugger. It is important for me that physical intimacy is not a part of friendship. If you find me physically attractive and you want me to respond in kind, it is vital that you are clear about your expectations of me, this may seem a bit childish, but I am easily confused by 'signals' and need clarity. This is important because physical attraction adds problematic dimensions to relationships, that I may not be equipped to manage, particularly if I remain unaware of 'agendas'. For me, relationships cannot become games of flirting, my emotional responses are too erratic and my ability to read other people continues to be impaired. Clarity prevents unintended hurt feelings on both sides.
2.Ground Rules are Vital For the person with BPD all relationships and friendships are akin to trying to negotiate a minefield without any map or GPS. I have learned to be honest with people about the things I find difficult. I am a good actress and one of the coping mechanisms I have used in the past is to mimic more successful behaviour around me. The problem for me in relationships was that often I was only aware that my grasp of friendship dynamics was faulty after the fact. 'Learning from your mistakes' became a matter of 'that didn't work, let's see if this works'. The problem is that any models of 'acceptable behaviour' I followed were not necessarily right for me, because they took into account the personalities, values and beliefs of another person. In all my current friendships I have learned to listen to myself - it is easier as I have been using DBT skills which mean that I am no longer lost in a fog of indefinable feelings, which are swinging wildly out of control. So now, if I need some time to myself, I am able to say so. If I feel I need some company and have nothing planned I know who and when I can call as friends. I also have learned that unplanned calls or visits where friends are not available is not a rejection of me. I can therefore cope when friends tell me, No. This means that they in return don't feel they have to 'walk on egg shells'. They know I will not spiral out of control emotionally just because they have other plans. It has been important for me to be clear about this and to keep checking it out, instead of going into a corner and brooding until I believe I have been utterly rejected. It also means that I have a responsibility not just to disappear and blame friends for not knowing a) where I am or b) what I am feeling.
3. I take my Friends at Face Value. I no longer suspect motives or 'read minds'. If my friends say to me 'I missed you' or 'It's really good to see you', I do not assume either a judgement of my absence or that there is a suspicious motive in 'buttering me up'. I am learning to listen to them 'non-judgementally' and I am learning to accept that if they are spending time with me, it is just because they actually enjoy my company, or that I have to buy them things to 'reward' them for doing so. As a result I have found that my close friendships are no longer fraught, nor do I feel that I need to buy expensive (and embarrassing for the recipients) gifts to 'buy' their friendships. Learning to do this is validating in itself.
4. No Friend or Person can Undo the Pain of the Past. One of the impossible expectations I have put on all my relationships has been to
5. Friendships Aren't Bound by Vows. Unlike marriage, my friends and I are not bound together by legal or religious vows. It is not a contract as such. In the past I have tried to impose conditions that were unfair and binding on my friends. Conversations with friends which begin 'Promise me you'll never...' are deeply unfair. They are born of the desperation not to be abandoned and the fear of rejection. True friendship is given and received freely. Sometimes there is a natural ebb and flow to them, as people move in and out of our lives. Such flow of relationships is so difficult for me as a BPD sufferer, because, after all you're getting a job on the other side of the world is because I am such a hateful person - isn't it? If I were able to open up to my friends about the depth of my belief that I am so utterly unlovable that I must the cause of all separation and abandonment in my life and the lives of others, they would be shocked. But that is the reality behind my desperate pleas for you to promise, never to move away, never to change, never to get married etc... Accepting that I cannot do so has been freeing and has allowed me to grieve for the loss of friends who have had to move away or who have moved out of my life simply because we both have moved into different phases in our lives. Every now and then I need to be reminded that my life is a journey and not everyone I meet on the road will stay with me for the duration of the whole journey. In fact the only relationship in which I can expect a promise of a life together, is one which has been formalised in marriage, and even then, for many this relationship too can end.
As I have moved forward with my Interpersonal Effectiveness Skills and my basic friendship rules I have found that I am able to develop honest, stable friendships and I am willing to move outside a very narrow circle of one or two close and trusted friends. As a result my social life is developing faster than I expected.
Here are a series of Interpersonal Effectiveness Handouts which give excellent examples of when to use the different skills: http://www.dbtselfhelp.com/html/interpersonal_effectiveness_ha.html
Monday, 29 December 2014
My Relationship Map
This is a tool I use in a course I run at our Church. It is used in the final session of five as a way to enable people to start to think about how much they are part of a community already. Some of you may be familiar with other relationship 'maps' such as the ripple effect with 'Me' at the centre and the people in my life in circles rippling outward depending on how close I feel to them. I have adapted that idea, along with the practicals of location to help people to identify where their nurturing relationships are as opposed to where their 'emotional blackholes' are ie the people who suck the emotional life out of them. It is a simple principle - how close are those who nurture me, geographically? Am I too close geographically to those who drain me? Does the location of those closest to me emotionally prevent me from building stronger relationships? etc.
When I use this tool I do not ask the members of the group to divulge any details of their relationships - it is designed as a tool to help someone to consider small changes they may want to make to their social lives to either manage damaging relationships or to encourage nurturing ones. It is a starting point and the only group discussion required is in general terms about practicalities of making and keeping contact with people who are important to us.
1) Take a sheet of A4 paper and divide it in two (landscape seems to work best) I tend to draw a line along the middle, some people fold the paper in half and make the fold the central line.
2) The central line represents ME, write this in the middle of the page.
3) On the left hand side of the line put the title EMOTION, on the right hand side, put the title LOCATION.
4) Now plot relationships along the left side of the line - the closer a person is to me emotionally, the closer to the central line I plot them. eg I am reasonably close to my University flat mate due to the length of time we have known one another. She has lived through most of my traumas without having rejected me or just let the friendship drop due to distance and time, so she is placed close to the ME line.
5) Once I have plotted relationships according to emotional closeness I then plot the right hand side of the line according to where they are in relation to me geographically eg my flat mate lives in a different part of the UK so is fairly distant from me geographically, so although she may be close to the central line on the emotion side I put her towards the extreme right hand edge of the page.
I plot as many friendships and relationships as I am able to, but focus on those who are important to me in terms of their impact on my life - for good or ill. Again, in the group I encourage people to use initial letters of names to avoid over sharing. The tool is most effective when left for individuals to reflect quietly on what they discover about their relationship networks.
It is not meant to be complicated, it is as simple as that. The important part of the exercise is in asking key questions about my relationships and how effective (or otherwise) they may be.
Some questions I have asked myself and the groups, are:
a) Is there any imbalance in the number of nurturing versus draining relationships in my life?
b) Are the people I am closest to near to me in terms of location ie am I able to encourage contact with these people easily?
c) Is there a lack of relationships that I consider close? What do I think has caused this? Are there any steps that I feel I am able to take to build new/renewed friendships that do not trigger negative emotions in me?
d) If I can't identify any close/nurturing relationships are there any relationships that I have identified as more distant that could become closer if I plan to build them?
e) Are there any relationships that are crossing boundaries and/or may be 'too close, too soon'? Do I need to put emotional distance into any of these relationships.
The questions about the map can be as challenging or easy as you want. What is important is to make a plan to change the things you may have identified that need changing. I usually give the groups I work with the homework of identifying one friend who is a positive relationship and aim to spend at least 30 mins in the following week with them doing something positive like going out for a meal or calling round for a coffee. For those recovering from mental illness, it can be a safe first step to rebuilding their confidence, socially. For those who fail to identify anyone they are close to, I encourage them to choose one person they would like to know better and do the same task of spending 30 mins in their company in the following week.
When it comes to relationships it is important to acknowledge that for most people with BPD the fear of rejection means that looking at the reality of our relationships can be extremely challenging. I do not ask people to look at all their friendships or relationships in one go. It is sometimes easier to begin with the least close emotionally first and then work towards those that are more significant as each person feels able.
One thing that repeating this exercise often has done for me is that I have been able to monitor the growth in the number and closeness of my friendships. It's lovely to be able to look back over the past three years and notice that I have been able to learn to trust people again. That's the thing, it takes time, and hard work, particularly when I fear rejection and am tempted to retreat to my previous ways of coping. What I need to keep telling myself is that, although I used to make friends easily, I often failed to sustain them long term. Now my focus is on 'building' relationships that I can rely on. Only time and steady, small contacts seem to work for me - that way I am not tempted to perform 'psychological striptease' in order to test friendships. In setting and keeping to my own boundaries, the friendships I now have are more secure and I feel less vulnerable - not least because few of my new friends know all about me and my past traumas. They just accept me as I am in the here and now.
When I use this tool I do not ask the members of the group to divulge any details of their relationships - it is designed as a tool to help someone to consider small changes they may want to make to their social lives to either manage damaging relationships or to encourage nurturing ones. It is a starting point and the only group discussion required is in general terms about practicalities of making and keeping contact with people who are important to us.
1) Take a sheet of A4 paper and divide it in two (landscape seems to work best) I tend to draw a line along the middle, some people fold the paper in half and make the fold the central line.
2) The central line represents ME, write this in the middle of the page.
3) On the left hand side of the line put the title EMOTION, on the right hand side, put the title LOCATION.
4) Now plot relationships along the left side of the line - the closer a person is to me emotionally, the closer to the central line I plot them. eg I am reasonably close to my University flat mate due to the length of time we have known one another. She has lived through most of my traumas without having rejected me or just let the friendship drop due to distance and time, so she is placed close to the ME line.
5) Once I have plotted relationships according to emotional closeness I then plot the right hand side of the line according to where they are in relation to me geographically eg my flat mate lives in a different part of the UK so is fairly distant from me geographically, so although she may be close to the central line on the emotion side I put her towards the extreme right hand edge of the page.
I plot as many friendships and relationships as I am able to, but focus on those who are important to me in terms of their impact on my life - for good or ill. Again, in the group I encourage people to use initial letters of names to avoid over sharing. The tool is most effective when left for individuals to reflect quietly on what they discover about their relationship networks.
It is not meant to be complicated, it is as simple as that. The important part of the exercise is in asking key questions about my relationships and how effective (or otherwise) they may be.
Some questions I have asked myself and the groups, are:
a) Is there any imbalance in the number of nurturing versus draining relationships in my life?
b) Are the people I am closest to near to me in terms of location ie am I able to encourage contact with these people easily?
c) Is there a lack of relationships that I consider close? What do I think has caused this? Are there any steps that I feel I am able to take to build new/renewed friendships that do not trigger negative emotions in me?
d) If I can't identify any close/nurturing relationships are there any relationships that I have identified as more distant that could become closer if I plan to build them?
e) Are there any relationships that are crossing boundaries and/or may be 'too close, too soon'? Do I need to put emotional distance into any of these relationships.
The questions about the map can be as challenging or easy as you want. What is important is to make a plan to change the things you may have identified that need changing. I usually give the groups I work with the homework of identifying one friend who is a positive relationship and aim to spend at least 30 mins in the following week with them doing something positive like going out for a meal or calling round for a coffee. For those recovering from mental illness, it can be a safe first step to rebuilding their confidence, socially. For those who fail to identify anyone they are close to, I encourage them to choose one person they would like to know better and do the same task of spending 30 mins in their company in the following week.
When it comes to relationships it is important to acknowledge that for most people with BPD the fear of rejection means that looking at the reality of our relationships can be extremely challenging. I do not ask people to look at all their friendships or relationships in one go. It is sometimes easier to begin with the least close emotionally first and then work towards those that are more significant as each person feels able.
One thing that repeating this exercise often has done for me is that I have been able to monitor the growth in the number and closeness of my friendships. It's lovely to be able to look back over the past three years and notice that I have been able to learn to trust people again. That's the thing, it takes time, and hard work, particularly when I fear rejection and am tempted to retreat to my previous ways of coping. What I need to keep telling myself is that, although I used to make friends easily, I often failed to sustain them long term. Now my focus is on 'building' relationships that I can rely on. Only time and steady, small contacts seem to work for me - that way I am not tempted to perform 'psychological striptease' in order to test friendships. In setting and keeping to my own boundaries, the friendships I now have are more secure and I feel less vulnerable - not least because few of my new friends know all about me and my past traumas. They just accept me as I am in the here and now.
Tuesday, 9 September 2014
Webs of Care
Since I started treatment I have come across requests from researchers for service users to take part in interviews about different aspects of the treatment received. Recently, I received one such request specifically looking at the discharge process from Dialectical Behaviour Therapy (DBT) and how I experienced it. It has made me reflect on my experience and consider questions such as, was this ending easier than previous endings in my life? How come I have found the removal of formal support easier to navigate than others I have spoken to?
On reflection there are a number of factors that have worked for me:
1) I had become very familiar with the Dialectical Behaviour Therapy model a couple of years before I was even diagnosed with Borderline Personality Disorder (BPD). After my diagnosis Marsha Linehan's theory that my symptoms had developed as a result of the confluence of biological and social factors actually made sense to me when I looked at my life story. This gave me confidence in the therapy when I was finally offered it. Because I had read Marsha Linehan's book behind the practice, I also understood the rationale of the skills training and one to one elements of the treatment.
2) From the beginning the message was consistent within the group and individual sessions that DBT would not and could not offer me a cure for my emotional distress. The first six months involved a process of me learning the skills to 'accept' the fact that I could not change the roots of my symptoms, but I could learn to manage the most damaging behaviours I had developed in an effort to survive my life. In addition I learned that I could also learn skills to help me manage the emotions behind the behaviours, no matter how distressing or painful they may feel.
3) Developing the ability to use DBT skills outside the group and one to one settings is a major objective of the therapy. So homework was central to the success of the therapy for me. I was shocked in talking to others with similar ages and symptoms who had undergone different therapies that their overwhelming feeling when approaching discharge was that of 'losing their family'. I have managed to build up a growing group of friends outside my therapy group so that, at discharge I did not fear that my whole social life was ending too.
4) Most significantly I recognise that throughout my life I have had strong webs of care. There have always been at least two or three significant relationships during periods of extreme crisis which have provided sufficient safety to prevent me from ever being admitted as an inpatient. This meant that I did not have this hurdle to overcome. If my place of safety becomes my default rather than a last resort, then my behaviours will centre frequently around accessing that place.
A Few Things to Consider about Weaving Webs of Care:
A) The isolation caused by mental illness means that at the worst of times we can be hanging by one slender spider thread. However, if you take time to observe spiders in nature, or in my lounge at the moment, that single thread is more than strong enough to hold the spider, no matter how high the ceiling. For me, many times in my life my single spider thread holding me up was a barely perceptible faith that I was held by a God who was capable of coping with my outbursts and emotional pain. In those times I didn't want any complexity to my relationships just a sense that something or someone was holding onto me. For a lot of BPD sufferers that one thread becomes a human relationship, either personal or professional.
B) At some point all therapeutic relationships need to end, if they are to effectively create independent functioning people. That means that the single central thread needs to be woven into a growing network of relationships. I started with two friends, one of whom had known me for over twenty years and, significantly, my pets. I could trust myself to look after my pets without being judged and my friends were close enough geographically to help me build routines - consistency takes time and repetition. In the beginning these relationships were practical and centred on meeting basic needs like walking the dog, making sure I was looking after myself and offering me meals. They didn't overwhelm me, but on more than one occasion they were able to step in when hospital admission might have been the only option and offered me a safe place and a bed for a couple of nights. These friendships were an essential part of my care plan and fitted together with the professional relationships I had.
C) As I developed DBT skills I was encouraged to look outward and to participate in the wider universe. By volunteering on a limited basis I developed a wider web of caring relationships and contributing to the needs of others. Apart from distracting me from my own distress this allowed me to enter relationships gradually rather than me launching myself at people and leaving myself psychological naked having given too much of myself away. By widening this circle of relationships I took pressure off the therapeutic and my central, close relationships. One mistake I had made in the past was putting my 'eggs in one basket' and investing all my emotional energy in one relationship. Inevitably, on both sides these relationships would implode with the pressure I placed on them. It takes a village to support me.
D) Usually, volunteering introduces you to wider communities. I became a part of a local community so there are webs of people who are acquaintances but who bring to me different gifts. Each relationship holds in it potential to either hurt or help, but because I no longer invest in all or nothing single relationships, if someone in the other layers of web hurts me, the stronger more central relationships that I have come to trust have the capacity to hold me, not simply because they are strong, but because I am also capable of using my DBT Interpersonal Skills to manage the normal ups and downs of friendship and caring relationships.
I have searched on-line for a web representation - my drawing is rubbish. This one crystallised for me how far I have come in developing networks of people who form my supportive relationships. It helps me cope with life and those people who would drain or hurt me - they will always be there, but they no longer have to have the power to drag me down. As I've grown stronger and started recovery I'm able to include some renewed friendships and family relationships that I can now manage and vice versa. It's a helpful exercise. Here are some things to consider as you fill it in or create your own web:
Ask yourself: 'Do I have a web of care?'
* If the answer is yes, put people into your web and show their importance and closeness to you by how near they are to you at the centre of the web.
* If the answer is no, ask yourself what is the single relationship that you are holding onto, it may not be human. Then honestly consider friendships that may have slipped - are they lost forever? Or could you get back in touch?
* If people scare you, consider swapping them for pets. My first pet was a hamster given to me by a friend at a time when a lot was going wrong - that wee chap really lifted me and gave me a focus outside of myself - a break from feeling emotional pain.
* If you have a good relationship with your CPN, Support Worker or Therapist talk to them about how you could find other webs of relationships to weave into your life. Taking advantage of the NHS Activity for Life programme has opened up the local leisure centre as a place where I can meet with people without any expectation of me emotionally. If I get to know people better (which takes time), then that's a bonus.
Above all remember, no matter how lucky you think others are with their partners or families and friends; it is still possible to be lonely in a crowd. Building quality rather than quantity takes time and not a little bravery.
On reflection there are a number of factors that have worked for me:
1) I had become very familiar with the Dialectical Behaviour Therapy model a couple of years before I was even diagnosed with Borderline Personality Disorder (BPD). After my diagnosis Marsha Linehan's theory that my symptoms had developed as a result of the confluence of biological and social factors actually made sense to me when I looked at my life story. This gave me confidence in the therapy when I was finally offered it. Because I had read Marsha Linehan's book behind the practice, I also understood the rationale of the skills training and one to one elements of the treatment.
2) From the beginning the message was consistent within the group and individual sessions that DBT would not and could not offer me a cure for my emotional distress. The first six months involved a process of me learning the skills to 'accept' the fact that I could not change the roots of my symptoms, but I could learn to manage the most damaging behaviours I had developed in an effort to survive my life. In addition I learned that I could also learn skills to help me manage the emotions behind the behaviours, no matter how distressing or painful they may feel.
3) Developing the ability to use DBT skills outside the group and one to one settings is a major objective of the therapy. So homework was central to the success of the therapy for me. I was shocked in talking to others with similar ages and symptoms who had undergone different therapies that their overwhelming feeling when approaching discharge was that of 'losing their family'. I have managed to build up a growing group of friends outside my therapy group so that, at discharge I did not fear that my whole social life was ending too.
4) Most significantly I recognise that throughout my life I have had strong webs of care. There have always been at least two or three significant relationships during periods of extreme crisis which have provided sufficient safety to prevent me from ever being admitted as an inpatient. This meant that I did not have this hurdle to overcome. If my place of safety becomes my default rather than a last resort, then my behaviours will centre frequently around accessing that place.
A Few Things to Consider about Weaving Webs of Care:
A) The isolation caused by mental illness means that at the worst of times we can be hanging by one slender spider thread. However, if you take time to observe spiders in nature, or in my lounge at the moment, that single thread is more than strong enough to hold the spider, no matter how high the ceiling. For me, many times in my life my single spider thread holding me up was a barely perceptible faith that I was held by a God who was capable of coping with my outbursts and emotional pain. In those times I didn't want any complexity to my relationships just a sense that something or someone was holding onto me. For a lot of BPD sufferers that one thread becomes a human relationship, either personal or professional.
B) At some point all therapeutic relationships need to end, if they are to effectively create independent functioning people. That means that the single central thread needs to be woven into a growing network of relationships. I started with two friends, one of whom had known me for over twenty years and, significantly, my pets. I could trust myself to look after my pets without being judged and my friends were close enough geographically to help me build routines - consistency takes time and repetition. In the beginning these relationships were practical and centred on meeting basic needs like walking the dog, making sure I was looking after myself and offering me meals. They didn't overwhelm me, but on more than one occasion they were able to step in when hospital admission might have been the only option and offered me a safe place and a bed for a couple of nights. These friendships were an essential part of my care plan and fitted together with the professional relationships I had.
C) As I developed DBT skills I was encouraged to look outward and to participate in the wider universe. By volunteering on a limited basis I developed a wider web of caring relationships and contributing to the needs of others. Apart from distracting me from my own distress this allowed me to enter relationships gradually rather than me launching myself at people and leaving myself psychological naked having given too much of myself away. By widening this circle of relationships I took pressure off the therapeutic and my central, close relationships. One mistake I had made in the past was putting my 'eggs in one basket' and investing all my emotional energy in one relationship. Inevitably, on both sides these relationships would implode with the pressure I placed on them. It takes a village to support me.
D) Usually, volunteering introduces you to wider communities. I became a part of a local community so there are webs of people who are acquaintances but who bring to me different gifts. Each relationship holds in it potential to either hurt or help, but because I no longer invest in all or nothing single relationships, if someone in the other layers of web hurts me, the stronger more central relationships that I have come to trust have the capacity to hold me, not simply because they are strong, but because I am also capable of using my DBT Interpersonal Skills to manage the normal ups and downs of friendship and caring relationships.
I have searched on-line for a web representation - my drawing is rubbish. This one crystallised for me how far I have come in developing networks of people who form my supportive relationships. It helps me cope with life and those people who would drain or hurt me - they will always be there, but they no longer have to have the power to drag me down. As I've grown stronger and started recovery I'm able to include some renewed friendships and family relationships that I can now manage and vice versa. It's a helpful exercise. Here are some things to consider as you fill it in or create your own web:
Ask yourself: 'Do I have a web of care?'
* If the answer is yes, put people into your web and show their importance and closeness to you by how near they are to you at the centre of the web.
* If the answer is no, ask yourself what is the single relationship that you are holding onto, it may not be human. Then honestly consider friendships that may have slipped - are they lost forever? Or could you get back in touch?
* If people scare you, consider swapping them for pets. My first pet was a hamster given to me by a friend at a time when a lot was going wrong - that wee chap really lifted me and gave me a focus outside of myself - a break from feeling emotional pain.
* If you have a good relationship with your CPN, Support Worker or Therapist talk to them about how you could find other webs of relationships to weave into your life. Taking advantage of the NHS Activity for Life programme has opened up the local leisure centre as a place where I can meet with people without any expectation of me emotionally. If I get to know people better (which takes time), then that's a bonus.
Above all remember, no matter how lucky you think others are with their partners or families and friends; it is still possible to be lonely in a crowd. Building quality rather than quantity takes time and not a little bravery.
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.
Saturday, 19 April 2014
The Robinson Crusoe Effect
When I was young I used to enjoy television on a Saturday morning and one of my favourites was an old black and white dubbed version of Robinson Crusoe. Apart from the ace title music I loved the story of a man who was on an island and was desperate to get off it. My child’s view was that, of course Robinson’s efforts were all about getting off the island and back to society. However, when I studied the original novel at University I realised that Robinson’s story was much more complex than that. After many years he had adapted to life on the island until the thought of rescue in the end became something that was bittersweet.
Life with a mental illness has been described in many different ways and one which resonates with me was from Sylvia Plath, the American poet. In an autobiographical novel describing her lowest points in her late teens and early twenties she described her life with Mental Illness as being like life inside The Bell Jar. I have related to this on many occasions, as sometimes it feels as if I have been trapped in a vacuum sealed glass jar; others could see me, but I had no way of making them hear me. At times the best way I could find to describe this was that I was 'inside my own head, screaming'. If you have felt the isolation brought by depression and other mental illnesses you may relate to this sense of being cut off from the rest of humanity.
Like Robinson Crusoe, depending on how long you may have struggled with mental illness, you may find yourself feeling in two minds about ending the isolation. On the one hand, emotional distress is exhausting and there is little energy to cope with others. On the other hand, remaining isolated from others only confirms some of the more negative thoughts about yourself and stop you from receiving emotional energy from others.
For me life on the island of Mental Illness was painful, but ultimately, I was 'safe' from humanity. Basically most of my emotional and psychological wounds were the result of the actions of others. This along with the combination of my biological predisposition has meant that I have battled psychological maelstroms all my life. When I was diagnosed and offered 'shelter' in MH services, I was able to find some respite from the dangers of relationships. I have been quite happy not engaging to any emotional depth with anyone over the past nearly fourteen years, since the last traumatic breakdown of a relationship. Being 'in treatment' has meant that I have had a focus on managing my BPD and it was a convenient excuse to ignore the need to engage with anyone outside my therapy bubble. Except, I have reached a point where I feel strong enough to manage relationships. I don't trust everyone yet, 'In God I trust, all others have some way to go to prove themselves...' But I have let some people in and it's been ok. I know I am healing because I can say I am fond of certain people and look forward to their company. I still enjoy my times of solitude, but I am no longer in danger of going for weeks at a time with no human contact. I would say that I have learned that in order to cope positively with my relationships and friendships I know I will continue to need those times on my own to recharge my emotional batteries - people I think will continue to tire me.
I have now been given a date for my final discharge from Mental Health services. I know that it is testament to the journey I am completing (at least this stage). I am happy that there is equilibrium in my life. It's not perfect. I still react emotionally in situations that other people take in their stride. I continue to battle some of the demons from my past. I have developed new skills and rather than my BPD (Borderline Personality Disorder) controlling me, I am feeling that I can ride it's storms and maintain a level of stability which will allow me to step off my island and sail back to 'the mainland'. However, I am aware that I have been sheltered on my island, I have had safe places and people to whom I can speak to about my ongoing battles with my emotional extremes. I am at the point on my journey to recovery where I can see the docks looming into view and will face the prospect of walking the gangplank back to the life I was ripped from about five years ago. It's a scary thought.
I still face the pain of the final separation from people who have been really important to me, who have helped me, who have been privy to the most intimate details of my heart and soul. That's not an easy transition to make. In the past I have moved on too quickly, I have not allowed myself time to grieve friendships and relationships. The process of leaving services is yet another opportunity to learn a new way of doing things. Of allowing myself to feel grief and know that I can live with it. What is different about these therapeutic relationships is they have been honest, straightforward and have delivered what was promised. When we have had issues I have felt confident enough to be honest about the impact of mistakes on me - what has been refreshing is the level of self confidence in my CPN and therapist which has meant that they could own mistakes and we could work through the implications together.
My journey out of services has above all, been well planned. This ending has not taken me by surprise, and though I can acknowledge that it will be a difficult transition, I know I am ready to return to life after the island.
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