When the Fight is too much - Stop Fighting

I'm a fighter. Some would say I'm stubborn, obstinate, belligerent. Others might use words like, determined, resourceful, persistent. Whatever, if I feel strongly about things I will fight.

It is this character trait which more than any other has kept me going - for those of you who are old enough to remember I am an emotional Weeble - for those of you too young - these were little toys which were essentially egg shaped. The most important thing about them was that 'Weebles wobble, but they don't fall down.' No matter how many times they were dropped or fell over or 'wobbled' they would bounce back and right themselves.

It's okay to be a bouncer, backer - it means that I have been able to survive a lot of challenges and trauma I never thought possible. Like many who suffer from mental illness, there is a core of steel within me which means that I keep going, even when the situations I battle against are seemingly overwhelming. Recently, however, I have found myself feeling weary of the fight. I know that this is part of the fluctuations in my emotional, mental and physical strength as I seek to manage my mental health.

Suddenly, the other day whilst bemoaning the ongoing struggles I've had, including the day to day struggle to keep body and soul together, I found myself saying 'I am so sick of fighting'. Since Christmas, which is so often a period after which I need acknowledge the need to rebuild myself in nearly every way, I have been hit with one challenge after another. It is hardly surprising that I have found myself at a low ebb: Illness, family crisis, uncertainty about the future and ongoing daily financial pressure. Yet, I continue to drain my resources by constantly battling against intractable situations that are beyond my control.

In particular, I have found myself emotionally battered by the prospect of another Conservative government, by a fear of the impact on my well being from their continued assault on the most vulnerable on society. Usually, my interest in politics and current affairs is more intellectual than emotional - which is probably the best way to view our democracy. However, the survival instinct in me has meant that I have been using my precious emotional strength in railing against people who are oblivious of my very existence. So, I have had to stop fighting against situations and environments I have absolutely no hope of changing. As I sat helpless watching political debates and interviews on Television, the emotional impact in terms of my anxiety and anger levels was extreme compared to any likely impact I could have on the situation.

It is one example of the numerous times I have fought against situations that are beyond my control or abilities. Having, been overwhelmed by a feeling of weariness and its associated thought, 'I'm so weary of fighting', I focused on the dishes I was washing and came to the conclusion that I should just 'stop fighting'.

Once again, I have learned another aspect of Radical Acceptance and its importance in helping me to manage the emotional impact of the world around me. I cannot stop my elderly parents from declining in health, I cannot control the outcome of the coming election, I cannot even predict whether or not I am likely to be soaked by rain on my daily dog walks. The only things I can do, is care as much as I can for my parents, use my vote in May to make my choice and ensure that when I do go outside I am prepared with the right clothes for the weather in that moment.

Radical Acceptance means that I need to recognise when I should be Weeble-like, when I should and could fight against injustice. Through my involvement as a Mental Health volunteer I have been able in small ways to help in situations where the environment is not too powerful for me to have an effect. Long ago, during a period working alongside displaced people, in refugee camps in Africa I became overwhelmed by the suffering and need around me every day, as well as the relatively short time and few resources we had to make any impact. A very experienced NGO worker talked to me about how you get it in perspective without such suffering overwhelming us. It may sound trite, but in that context it helped me refocus my efforts into an individual, case by case way of seeing my way through an environment which was far and away the most powerful environment I had encountered at that time: 'You may not be able to change the world, but you can try to change the world for one person.'

If I keep seeing my life as a whole campaign of war, rather than separate battles, some of which are behind me, then it follows that I will always feel as if I am fighting. When I feel that I have to sort my whole life out, and, while I'm at it, to stop all the injustices in the world around me, then it is hardly surprising that I often feel overwhelmed.

Radical Acceptance tells me that I can keep banging my fists against the wall, or accept that it is there, is too big for me to batter, but maybe if I stop fighting and take a step back I may be able to see a door or gap in it, which will allow me through. Or, and this is the most radical thought of all, maybe if I stop fighting against its existence, I can find a way to live with it. I think my attitude to BPD (Borderline Personality Disorder) has been like that. For most of my life I applied the weeble principle to my emotional storms. Because storms come and go, this worked for a time. Until, I found myself faced with environments, people and situations that were too powerful for me to overcome.

Let's face it, I am not a superhero, I'm not even a true Weeble. Sometimes I do fall down. That's okay because who wants to have an egg shaped bottom.

What's in a Name - the Impact of the BPD Label

Mind have done an excellent job of highlighting the problems of 'coming out' to friends, families and employers about mental illness. More than many conditions, Borderline Personality Disorder has received a very poor press. I know I used to have a number of cases with diagnoses of BPD when I was a Probation Officer. 'They' were seen by some colleagues as 'a pain in the arse', 'difficult', 'unpredictable' and 'frustrating to work with'. I found myself enjoying my encounters - colourful, dramatic, often artistic and articulate. Good job, because, after ten years in the probation service I was diagnosed with BPD myself. And, Yes I did encounter the same comments, or detected them in attitudes and behaviour directed at me.

I have been privileged and fortunate to live in an area which has quickly responded to the government policy change of BPD from 'untreatable' to 'treatable'. A seismic shift in attitude, hopefully closely followed by Mental Health professionals. There is a specialist Personality Disorder Service in our area, with two intensive group therapies aimed at BPD sufferers, both have been running now for over two years.

In my experience of this service over the past five years, I have had my individuality acknowledged and been supported well by my CPN when my first attempt at therapy failed. I have been supported through crisis times without being over medicated or admitted to hospital, which I would have found highly aversive. The level of support on offer during periods of instability enabled me to recover from setbacks, (which I was given time to do) and to be referred to different specialist therapy offered by the same service.

I know this is rare. I know that I am lucky. I hope that blogging and talking about my experience (positive) of being diagnosed with BPD will show good practice. Unless I am seen as a person with unique needs, with the willingness to learn how to manage my emotional turmoil, then I will continue to show up in distress and will seem to be 'impossible to manage'. Thing is somebody actually did help me to learn to manage myself and my BPD. Is it rocket science to recommend that others try to offer the same level of service?

I really urge you to copy the link and go to this blog by Rebecca in response to some videos made by others with a different experience of BPD than her. All are available on the same link. http://www.mind.org.uk/information-support/your-stories/having-a-bpd-diagnosis-my-reality/#.VG9-hvmsUnp

I'm Still Standing - But I'm Not Standing Still

Pilgrim
by Dom Helder Camara

when your ship,
long moored in harbour, gives the illusion
of being a house;
when your ship
begins to put down roots
in the stagnant water by the quay: put out to sea!
save your boat's journeying soul and your own pilgrim soul,
cost what it may.

I had my final DBT therapy session nearly a month ago now. Contrary to my fears about it, my world didn't end, I didn't suddenly forget everything I have learned and practised over the past year or more and I didn't suddenly revert to the worst self-destructive crises of my BPD. Suddenly, I realise I am still standing - more than that I have not stopped making progress. I know from cycling and other 'balancing acts' that if you stop moving forward, you fall off. Choice: keep going forward, go back or fall off. Seems simple when I put it like that. Having decided to keep going forward, I am noticing that my BPD and the emotional storms that accompany it no longer control my decision making and day to day experiences of life.

Don't get me wrong. I still experience moments of panic, anxiety, sadness and anger, but no longer are they extremes of these emotions which take me over and leave me empty and desolated. More than anything I have noticed that I am no longer overwhelmed by formless clouds of nameless emotions. Instead, I am able to slow my mind down enough to recognise what the emotion I am feeling is. I can name them. In the past they felt like formless ghosts haunting me and attacking me seemingly at random.

I have had to work hard to get to this point. On a daily basis I need to practice good self care - eating, sleeping, drinking, exercising, not letting my emotions control my routines, but allowing my routines to help me manage my emotions. Primarily, rather than me relying on medication or on 'experts' who appear to know more about my BPD than me to help me, I have learned skills that can help me without having to phone an anonymous voice, or wait on someone else's diary for consultations or treatment. I have the ability to 'manage' what used to control me. It does not mean that I no longer suffer moments of panic or crisis, instead it means I no longer have to risk rejection by asking again for help.

More than that, I am beginning to build a life that is less turbulent and prone to significant 'meltdowns'. It has taken me some time to adjust to life without the battles. Almost like taking time to unwind on holiday - we never manage to be able to relax from day one, because it takes time to let our minds and bodies 'know' it's okay not to be on high alert. In the past I expected to be betrayed in all relationships, I anticipated moments when suddenly my ability to cope with everyday life would end and my life as I was living it at any given time would grind to a halt. These patterns had repeated for me so often, that I even managed, on occasions, to self destruct and pre-empt rejection, abandonment and failure. By doing this I was reinforcing destructive patterns throughout a period of 40 plus years. Then, I realised that it was possible to stop anxiety from distracting me from enjoying 'the moment' about 9 months into practicing mindfulness. What I wasn't so certain of was, whether I could continue to be able to do this outside of the structures of group skills and the regular one to one sessions of therapy.

It is frightening when you have battled to ask for the help that you need for most of your life, finally be offered it, then accept it and find that you are able to move forward, to then realise, that, because of that progress the help will come to an end. However, just as it is sad when adult children are unable to move away from the family 'nest' and establish lives and 'families' of their own, so any therapy which creates dependence rather than helping me to achieve the management of my condition, is not helpful to me in the long term. I continue to require anti-depressants and anti-anxiety medication as part of my stabilisation. I have learned to accept that, for the moment, that is okay. I am so much better than I was, but I still have a complex mental health condition to manage. I welcome the help and contact that is offered, but one day this support will be withdrawn. If it is managed well, as with the ending of DBT, then I will be more than ready for it. If not, then as so many have found it can be traumatic and detrimental to the progress made.

I have only started on my journey to overcome BPD. I am beginning to test myself and my new skills out in different settings. I am pleased to have sustained some honest relationships where I can begin to trust myself to 'feel' close to other human beings. Only in the past couple of weeks have I begun to be able to express affection towards my friends. I know this process started when I realised I was 'fond' of my dog and learned to speak to her with affection. Now, difficult people don't distress me in the way they did in the past. They have not changed, I have learned to recognise the emotional responses in me, to name the emotions and manage those emotions appropriately.

In the past it was easier to not even try to have any significant human interaction. In return my close friends are supportive and encouraging. I have surrounded myself with positive people who aren't dependent on funding or resources to stick by me. They accept me in the real world and what is best of all, I am able to sustain my relationships in the real world. So, there is no fear of what happens when 'reality' steps in. This is the main difference between coping in the therapeutic setting and coping in 'live' situations. One is 'safe' and allowed me to explore and practice skills to manage my triggers appropriately. My transition from therapy has helped me to see that I can use those same skills in everyday life and though I can't control the outcomes, I can accept that I am doing my best to manage my own life. And that brings a real sense of achievement. I was so encouraged the other day when a friend said to me 'Look at you, you are doing so well and it is shining out from you.' I hadn't sought validation, it was a natural part of our interaction together and an indication that we have a positive relationship. Now I can recognise people who are good (and bad) for me and stop wasting time on those who will bring me down. What is crucial to recognise in this process is that from day one my therapy was preparing me for the ending. However, because I was offered nearly two years of therapy (which included tapering and 'proper' exit strategy) I have been given time to move from intensive to 'light touch' therapy seamlessly. 'Ciff Face' endings particularly for BPD only create distress and ongoing need and dependence - in my humble opinion.

At the heart of DBT is the twin concept of 'Acceptance' and 'Change'. I accept my life as it is today, but I continue to work towards changing those things that I want to change, to continue to make my life better. I'm still standing, but I don't stand still I keep moving on and actively pursuing 'a life worth living' (Marsha Linehan).

My DBT Validation Treasure Box

This is my 'treasure box' full of positive things to remind me that when I am having a bad day, the whole of my life has not been bad. The box is full of little things and big things, achievements sometimes, but mostly little notes of thank you and appreciation. It has been said before and will be said again, why is it that the most appreciation we give to people is reserved for when we lose them? A few years ago a friend challenged me about this and since then I have tried to remember to say that I appreciate what other people have done, or mean to me, when I can. I used to think it was cheesy, but I know it means so much to me, when I receive little notes of cheer and encouragement and hope it can be an encouragement in turn to others.

In my box, I have:

1. A programme from the first school play that I was stage manager in.

2. A 'Certificate of Adoption' as an honorary Auntie to my friends' children. This was lovely at a time when my own nephews and niece have grown out of childhood, so I'm able to extend my role as 'fun aunty' for a good ten years more! This was all the more meaningful as both boys are themselves adopted and so they know the value of the 'Adoption Certificate'.

3. Emails, letters, cards saying thank you for little things I've done - reminds me that I'm not as selfish as my depression tells me I am.

4. Photos of different groups and clubs I have belonged to - reminds me that I do belong, especially when I'm feeling isolated.

5. Ticket stubs, maps and information from special days out with special people who lift me up. I can read through them and remind myself that I can be good company and people enjoy spending time with me.

6. Some of my first published blogs - someone else was interested in reading my story!

7. Leaving Cards from previous employers - often full of specifics about what my managers were going to miss about me - again why wait until I'm leaving to tell me I'm good at my job? Still very much appreciated since my redundancy to remind me that I was once useful and can be useful again.

8. Letters from important people like my uncle and aunt who really helped me to survive my childhood - much of their wisdom was written down when they were able to, I still read their letters to remind myself of important truths that counteract my negative experiences in life.

9. During my time on DBT I started writing down little positive comments, that usually I would ignore or discount. I have a little rainbow post-it note pad which I use for this and add to my treasure box. This was a form of 'exposure' to counteract my internal negative running commentary of invalidation and is taking time to filter through. It works in much the same way as the jar of coloured beads, two for each positive experience, comment, event etc, one for any negatives. Often with BPD it is easier to discount the positive and it is important therefore to keep an objective tally of positive versus negative.

10. Tickets for my first Graduation Ceremony - this was so precious because I had suffered my first breakdown in my final year and had to repeat the year to graduate.

Above all, this box is amazingly uplifting. It is so easy to focus on the people who have hurt us and the times when we have failed in relationships or work situations. How often do I pore over photos of lost loves and memories that are painful, why not instead focus on the relationships I still have and memories that will build me up? So often I'm my own worst enemy - anyway,another reason why my Treasure Box is so important to me.

So seldom, especially when struggling against the invalidation of childhood, do we appreciate ourselves as members of teams, groups, friendship groups or even just as we are. As much as we are touched by the lives of others, we bring something to the lives of those around us. If we can learn to listen to the positives we can begin to balance the negatives of our memories with the positives. Life is, after all, light and shade. No life is all good, or all bad. Often our emotional struggles strand us in waves of negative thoughts about ourselves, but little tools like this can help us bring balance back to our perspective.

Do you have something similar? What sort of things are you able to put in? How much weight do you give to positive comments about you? Try something new, just saying thank you and accepting it at face value - it's starting to make me feel better.

My 'Me Against the World' DBT Playlist

Some days, regardless of paranoia, it seems the whole world is out to get me. The depth of sensitivity of the BPD person cannot be overstated. Hence, when some sleight or unintended (or intended) insult comes our way, the impact on us is devastating and longer lasting than for the average person. Marsha Linehan has expressed the extent of emotional pain for the person with BPD in this way: "People with BPD are like people with 3rd degree burns ...Lacking emotional skin,they feel agony at the slightest touch or movement."

My problem is with 'apparent competence' and a theatrical confidence, developed through the professional experiences of teaching and probation work over a twenty year period. Because of this 'shell' a lot of people consider that it is not possible to hurt me. Unfortunately, none of us are mind readers and therefore we have no idea of the weight or force with which our words and actions are carried to the heart of another person. Most people have some kind of emotional armour, but as Marsha Linehan's words point out, the heart of the person with BPD is raw and it is as if those hurtful things are hitting an exposed and beating heart lying on a table. It is as if the wounds opened long ago are fresh and, further hurt (however minimal to the average person) feels like salt rubbed into those wounds.

One of the good things about being an 'emotionally sensitive' person is that my own vulnerability has taught me to weigh my words and actions very carefully. I have no idea what devastation I may unleash unwittingly on those around me, because I can never understand fully the life experience of any other person. No matter how similar our experiences may seem.

When I feel the pain of these kinds of moments I know that they are connecting with numberless moments from my life when I have felt abandoned and rejected. These moments have become so much a part of my life, that in expecting, fearing or anticipating it I often create the rejection I fear. I know I act in ways which produce the opposite result to that which I intended. Such is one paradox of being emotionally sensitive - I have written about the toll this 'push-me, pull-you' yo-yo of emotions has taken on past relationships in previous posts.

Although I have completed a period of DBT treatment and am better equipped to manage my emotions than before, I continue to be an emotional 'burns victim', in the process of growing new skin over the exposed wounds. So, more often than not I find myself feeling like the world is out to get me and I feel I am alone in my battles.

Anyone who has followed this blog for any length of time will know that all types of music are my refuge when I am struggling with emotional issues. So it is in this case - I have a range of songs which allow me to express my grief and sadness, while at the same time reminding me that I am a strong person to have managed to survive to this point in my life. Sometimes we all need reminders that even if it is not just our paranoia, when we feel alone and embattled, we have more fight in us than we thought.

1) Something inside so Strong - Labi Siffre (No need for explanation)
2) The Impossible Dream - Camelot (listen to the lyrics - to fight the impossible fight)
3) Towerblock - Julia Fordham (1980s chanteuse - deep deep lyrics, worth looking up just to listen to this one song, if you've ever felt cursed by the strength that has helped you to survive)
4) I am What I am - Gloria Gaynor (?)
5) Somewhere - from West Side Story (any decent version will do - somewhere there's a place for us...)
6) Anthem for a Lost Cause - Manic Street Preachers
7) Shadows Fall - The Proclaimers (an album track which beautifully captures the pain of just getting through life)
8) High Flying Adored - From Evita (great version by Madonna and Antonio Banderas) lyrics about the public persona versus the private - never assume anything about other peoples' inner lives - we don't know unless they share that part of themselves with us.
9) Pavane for a Dead Princess - Maurice Ravel (I know the title isn't very appealing, but the expressive music allows so much letting go of sadness - I find I am able to sit with difficult emotions like grief and sadness when I either play this or listen to it....just let the music affect your emotions)
10)Town Without Pity - Eddi Reader (Or Gene Pitney if you fancy the original) Great when you feel people have been getting at you - a kind of musical finger to the small minds that have been picking on you for whatever reason - personally I love the brass arrangement on Eddi Reader's Version.

(Nearly Made it: Beautiful, Christina Aguilera, Beneath Your Beautiful, Labrinth, Over and Done with - Soundtrack Sunshine on Leith (The Proclaimers), I'll Find my Way Home, Jon & Vangelis, Never Had a Dream Come True, Stevie Wonder...)

When I am licking my emotional wounds I need this soundtrack, along with a healthy dose of solitude, crammed with positive things which reinforce the good things about my life - which I need to keep acknowledging are many and many-faceted. My dog accepts me unconditionally and loves me. I have learned through owning her, that I am capable of loving other creatures and have managed to begin to transfer that knowledge to humans! And when people have hurt me I no longer give up on people all together. I am now able to look at the friends who have stood by me, who understand that friendship is a two way street (that I am capable of giving back) and who assure me that I am indeed, lovable.

Self Care - Do I really 'Get it'?

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

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

Credit: Tweeted by @jessisheron

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

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

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

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

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

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

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

Dealing with Panic and His Friend, Anxiety

Anxiety comes over me like a cloud of indefinable darkness and confusion. My heart starts beating faster, my stomach goes into overdrive (like a washing machine) and my abdominal muscles go into spasm. Two years ago these spasms had gone on for over five days, which resulted in my suffering from vomiting reflex once or twice every hour. Eventually, I was exhausted and in total despair and so was forced to go to A&E. Anyone who has never suffered the effects of truly debilitating panic or depression may wonder at the impact on the body, but do not tell me that there is no link between my physical and mental well being.

Since beginning Dialectical Behaviour Therapy I have learned to focus on the signs from my body, including my breathing patterns, so that I recognise anxiety before it can develop into full blown panic attacks. Essentially, when under stress, I actually stop breathing for short periods of time. It doesn't take a genius to work out that if you stop breathing your body will get the signal that something is very wrong and that it is time to ignite the 'fight or flight' response. In other words, I was signalling my body to release as much adrenaline as possible - guess what? Heart rate rises and blood rushes away from where it's needed to where the body 'thinks' it's needed. The same goes for shallow, rapid breathing. Does that make sense? It did to me when my therapist pointed it out to me. So, the very first thing I do is acknowledge that my body is in panic mode which indicates that I am anxious about something.

Mindful Breathing

1. Notice your breathing, what it is doing and focus on returning it to a more measured level.
2. Just focus on the in...and...out, no need for deep breathing, just breathe normally and naturally.
3. Observe, the effect on your nose, in your lungs.
4. Watch the rise and fall of your ribcage and stomach.
5. Don't let worry thoughts distract you from this task.
6. Just focus.

But what about the trigger to the panic? First of all it helps to be able to name the emotion. Sometimes anxiety causes our thinking to become muddled as the reality is that the things we worry about don't come in one by one so we can manage them easily. Instead, they gang up on us and crowd in, bullying and badgering us for not finding immediate solutions. Having acknowledged that I am anxious, I focus on my breathing to relax my body, so I am not entering an inexorable physical and emotional spiral as I did previously. There are a number of mindful exercises that I have learned.

Thought Diffusion

The first and easiest one for me to manage is to attach my worries in my mind to the leaves of a tree and allow the leaves to drop gently towards a flowing river, which carries them away one by one. This exercise takes practice and a basic knowledge of mindful breathing, but is effective in everyday situations.

Guided Imagery (The White House)

Another one I use is called 'The White House'. (Here is the link: http://www.themindfulword.org/2012/guided-imagery-scripts-children-anxiety-stress/) This is a guided imagery exercise for children, but is so effective for anyone. I have found it very useful when I am overwhelmed by the size or number of my problems and worries. The most important thing about this exercise is that you cannot move into the part where you can relax until you have set down the large 'rucksack' of worries at the bottom of the stairs to the big White House. (obviously if you haven't read the instructions yet this won't make much sense, so please take a moment to have a look).

Problem Solving Questionnaire

I have recently found myself working through the 'Yes', 'No' questions of problem solving:

1. Are you worried about a specific Problem? If No, then don't worry. (Accept)

2. If Yes, is it a problem that can be solved? If No, then don't worry. (Accept)

3. If Yes, do you know the solution? If Yes, then don't worry. (Change)

4. If No, then don't worry because there is nothing you can do by worrying. (Accept)

Acceptance and Change
This process reveals two of the principle skills of DBT, in fact they are foundational: Acceptance and Change. The serenity prayer is so called because it holds these two truths in balance and releases us from wasting our energy on those things that are outside our control. My Anxiety can be controlled by using these skills, and by realising that if I can change the circumstances of my problems, then I don't need to worry. Also if I cannot change them but can learn to accept them as beyond my control, then there is no point in my worrying and I am losing out on the here and now.

Not one of these ways of managing my anxiety is either natural to me, or easy. As long as I have had panic attacks and suffered from anxiety I have defaulted to spirals which mean that the anxiety has controlled me. I therefore need to put in as much effort and time to developing the habit of preventing anxiety from (literally) taking me over and making it impossible for me to function to any effective degree.

Maybe you've tried some ideas like these and they've not worked immediately - stick with it. I know there are times when I still slip back, but never again has my whole body gone into spasm from an emotional response.

Again, I would say the key to me making use of these skills is, practise, practise, practise. I cannot change as and when the panic will rise, but I can change my responses to it and its little friend, anxiety.

The Long Road to Self Compassion

When most of your life has been about trying and failing to earn parental validation then internal expectations can become exceptionally distorted. From the outside I look fairly successful, I have completed three degree courses, am fully qualified and experienced as a Teacher and a Probation Officer, from an early age I was a successful athlete, swimming for my school and regional teams of elite swimmers. I am considered to be an effective communicator and have managed to write and perform comedy sketches in a range of contexts. Yet, yet, yet...I consider my life at best to have been a triumph of mediocrity and at worst to have been a complete failure.

I am writing this post at the end of an exceptionally stormy week when I have perceived myself to have failed utterly in my attempts to manage the symptoms of my BPD. What has prompted this castigation of yourself? You ask. I lost my temper in a DBT group and (in my mind) caused a scene by storming out of the room. Suddenly, after months of managing to regulate my emotional life and remain relatively balanced in my perception of the world and people around me, I found my emotions spiralling out of control. So much so, that after the group finished I had to wait nearly an hour before my emotions were stable enough for me to feel safe enough to drive home. That was actually progress because in the past I wouldn't have been able to use wise mind about the risks of driving while dysregulated.

This in itself has not been the greatest battle I've faced this week, such escalation in emotional intensity is common for those with BPD. What I have battled with has been in 'giving myself a break'. First of all, in response to my initial reaction of ending my participation in the DBT Graduate group, my therapist pointed out to me that my outburst was neither out of proportion, nor unexpected. Secondly, most of my anger was not related to the incident in the group, but was directed entirely towards myself for 'losing it'. Again, my therapist pointed out that I was wrong to assume that my emotional outburst had 'ruined' the whole group. She also pointed out that the statements I was making were not based on fact but on judgement - primarily of myself, for being a failure.

I know the DBT skills I need to use: wise mind, mindfulness focusing on my feelings in this moment, thought diffusion and emotional regulation skills to return me to balance in my responses. I could maybe try a 'loving kindness' meditation (UCLA Website: https://itunes.apple.com/itunes-u/mindful-meditations/id434136047?mt=10#ls=1) But I have struggled with one massive obstacle - suddenly the old default to self punishment has reignited and I am finding it very difficult to find reasons to be compassionate towards myself.

The heart of the problem is the problem of my heart towards myself. Suddenly, my assumptions about myself are challenged by the time I've spent in treatment, by the stable relationships and friendships I have been learning to accept. Where do I begin to find validation? I am no longer capable of returning to the old failed ways of coping with extreme emotion and am on a long road towards new ways. Trouble is I'm not there yet, so I am having to take slow, baby steps that focus my mind on what compassion in general feels like and then, in turn, seeking to get used to what compassion for myself feels like. I am a work in progress:

1) Peeling off the 'protective skin': I am now aware of the protective covering which has prevented me from truly feeling the warmth and acceptance of true friends. It is for me to practice accepting their love, without anticipating rejection or abandonment - in a sense I am unlearning 'mind reading' which, in reality, I was never particularly good at. I am learning a new skill and that is taking people at face value - if someone is kind, it doesn't mean that there has to be a sting in the tail. The people in the here and now are not the same people who have hurt me in the past and they should not be punished for the wrongs of others. The song Innocent Man by Billy Joel comes to mind. If I can learn to risk myself in friendships in small steps and learn that now is not then, maybe I can allow the protective 'skin' to be removed.

2) The Child inside Me deserves some Compassion:I need to learn that the child who was so hurt and whose fears and pain still surface from time to time, doesn't deserve punishment, but actually requires some compassion from me. I am the adult who gives voice to the pain of that child and therefore, I need to be able to acknowledge that we are one and the same. If it were any other child, I would weep. If it were any other adult I would understand the struggles and seek to help. That's my challenge.

3) The Adult Survivor deserves some Credit: At some point I have to give myself credit for getting this far in life. Despite the pain of my childhood, in spite of my BPD, I have achieved a lot. Most of all, I have lived through real suffering and trauma. Too often I am looking at myself through the critical eyes of the abusive parent and I owe it to myself to accept that I am one strong woman simply by virtue of the fact that I am still here. Anything else is a bonus and credit to the skills and character that drive me on to be the voice of the child I was and to become the person who has taken every twist and turn of my life and used it as a stepping stone to a better quality of life, than I have known previously.

4) Healing and Recovery take Time: Time is not a luxury but a necessary gift to myself as I move towards healing. It took me well over thirty years of breakdown and rebuilding to get to where I am. Healing will take time and I won't always get it right - skills can be learned quickly but take a lifetime to master. DBT skills can help me to manage my BPD, but they will have to become an intrinsic part of my life if I am to manage my condition effectively, long term. In addition, sometimes I will still need to find time and space in which to recover - and that's ok, because surely taking 'time out' has got to be better than self destructing as a response to difficult days.

If you are like me, someone who is a perfectionist, someone who has exceptionally high expectations of yourself, try to open your heart to yourself, in the same way as you open your heart to others. You know how to be compassionate, just try turning it on to yourself.

My DBT House

This morning I have been preparing a session for my DBT Graduate Group which is due to meet on Tuesday. I found it on a website for counselling for children. I thought it would help our group as we try to set ourselves medium and long term goals. You see, for a group of people for whom identity is an issue which is central to our disorder, even being certain about who we are at any time is a struggle. So, we have been struggling as a group and as individuals to set any definite goals.

When I came across the DBT house, it didn't matter that it had been designed for children. As a former teacher and communicator I understand the effort which goes into engaging children in learning. Why do we inflict static learning on adults so often, powerpoint, anyone? Who said learning couldn't be fun for adults too?

First draw a house. It can be any style, but must have: a floor, a door, a roof, a chimney, 4 floors or levels and above the house a Billboard.

Now on your drawing write or draw the following:
1. On the floor (foundation) list the values you hold dear.
2. Along the walls write anything or anyone that supports you.
3. On the roof name the things or people that protect you.
4. On the chimney list ways that you ‘blow off steam’.
5. On the Billboard list the things you are most proud of.
6. On the door write the things you keep hidden from others.

Now draw the following on the levels of the house:
1. Level One: Behaviours you are trying to control or areas of your life you want to change.
2. Level Two: List or draw the emotions you want to express more, or more effectively.
3. Level Three: List all the things you are happy about or want to feel happy about.
4. List or draw what a life worth living would look like for you

It's a simple idea. One that actually builds on what has already been achieved. Despite what the storms and instability inherent in our experience of BPD tell us, we can only have survived if some basic essentials of identity have remained in place. Once again we are reminded that relying on our emotions and the thoughts driven by them are not reliable foundations on which to build our sense of self.

Instead, as I have worked my way through this exercise I have recognised that I do have some very strongly held values: kindness, compassion, a belief in justice. I have also learned that rather than being abandoned by every friend I have ever made, I have maintained some key relationships that have survived the ups and downs of my life. I am essentially likeable - that is what a fact based assessment of my relationships tells me. My feelings no longer drive my life, I am free to set myself small goals to help me achieve a more balanced way of living. More than anything, this exercise encourages me to see my recovery as a work in progress, one which is positively building a 'life worth living'.

Why do you have to be so mean?

This week I have come across what can only described as 'hatred' for people with Borderline Personality Disorder. It shocked me. Don't get me wrong, years ago, before I was diagnosed with BPD, I used to work in the Criminal Justice System, and my specialism was Mentally Disordered Offenders, the majority of whom were diagnosed with some form of Personality Disorder.So, I was aware of negative attitudes to people with Mental Illnesses, and in particular, those with diagnoses of PD.

My colleagues used to groan if case notes included the dreaded BPD diagnosis. 1) because people with BPD are 'difficult' 2) because at the time, BPD was considered 'untreatable' by local NHS Trusts and refused to admit even suicidal cases 3) because there was a high likelihood of suicide/self harm from this 'group'. In short I believe BPD sufferers as a group have received and continue to receive a bad press from a number of sources.

I found that being consistent and listening closely to what was being said to me, often helped me to manage my cases, in other words: compassionately treating people, regardless of labels, as if they were human beings seemed to work. (not rocket science is it?)

Anyway, back to the guy who has obviously had a bad relationship with someone with BPD. His take was that BPD doesn't deserve to be treated as a mental illness, but is just down us being some kind of 'crazy ass' (his words). He even managed to intimate that the abusive backgrounds of a large number of people with BPD was actually the fault of the victims. Initially I felt defensive of myself and others who have suffered from what some describe as 'emotional sensitivity' rather than BPD. Then I considered that perhaps, following a messy break up (I've been involved in my fair share of those!) his anger was robbing him of his humanity. Which is understandable.

How do I respond to his point that I'm just an emotional mess? That I do not deserve treatment? Well, I think that I would point him to Marsha Linehan's (the creator of Dialectical Behaviour Therapy for BPD) explanation of BPD as equivalent to suffering 3rd degree burns.

Imagine suffering emotional and psychological pain that is so deep and so painful that the only solution you can think of is either to inflict physical pain to distract from it, or to believe that dying is the only way to stop it? Does that sound like something that you could sustain while maintaining a functional life? Yet many sufferers of BPD do manage to do just that, while holding down very respectable jobs and being creative and dynamic in certain spheres. This 'apparent competence' in certain spheres, my BPD-hating 'friend' points out as proof that BPD is made up by selfish women seeking to justify messy love lives and as an excuse to be nasty to men.

I think at this point we can recognise the ignorance and stigma evidenced here towards Mental illness in general. I mean you can't possibly run a country with a severely debilitating clinical depression, can you? Winston Churchill, anyone? Just because my professionalism and training allow me to carry out a job from 9-5 does not mean that the emotional distress I am experiencing is not real and does not have an impact on my mental and physical health.

If I may, I need to return to the burns analogy, even when time allows a skin to grow over the burned area, there remains a sensitivity that often never leaves. The levels of abuse I suffered as a child have left me with emotional and psychological scars. My diagnosis whilst not perfect, has allowed me to access help to develop skills which mean that I no longer consider death to be a solution. My treatment means that I am able to begin to 'function' again, after a complete breakdown two years ago.

I am responsible for the people I may have hurt throughout my life. I would say, though, if you rip the dressing off a burns victim, you can expect a strong reaction! My plea is: try to listen, try to understand, try to give space, and, if you think you are too angry or too hurt to see the human behind the label, make it a clean break.

http://bpdlifeinthemoment.blogspot.co.uk/

Help I can't be Mindful, because my Mind is Full...

As I have moved through my recovery I am noticing that my mind is swinging from being full of 'cotton wool' to being full of ideas and thoughts to keep me 'occupied'. It is only in the last couple of days, and a few weeks of disrupted sleep patterns, that I have recognised that it is becoming an obstacle to me practising mindfulness. So I'm going back to the basics of Mindfulness to move from Mind Full to being Mindful...

1) The first thing is to notice that my mind is crammed. And to notice that these thoughts, a lot of them 'worry thoughts', are preventing me from seeing the positives around me at the moment. My Therapist did an exercise with me using my interlaced fingers to help me realise that the 'wall of thoughts' is preventing me from living in the moment, simply because I cannot see anything beyond these thoughts. So I need to let go of them and not stop with noticing the wall of thinking in front of my eyes.

2) Practice the exercises which allow me to diffuse thoughts and feelings - I use my safe place (a river bank in the Yorkshire Dales) and my thoughts attach to the leaves on a tree overhanging the river. I watch as they detach, float down onto the river and let the flow of the water take the thoughts away. At the moment, because I am in a 'hyper' mood I need to begin with focusing my mind by mindful breathing.

3) I need to be aware that activity is not validating on its own - where does my real validation come from? Can I accept myself as I am, that I am worth something without a paid role? This is an ongoing battle and is critical and foundational to my long term recovery. Self compassion and self acceptance, again, are something that I have to practice. So I am using self soothe, and some mindfulness exercises based on 'Loving Kindness' that I've downloaded from t'internet.

The human mind is an amazing gift, but it needs to 'tamed' and brought into line with life as it is, right now, so that it is not getting in the way of my enjoying the present.

The Alien in the Therapy Group

We sat down in a circle, me and five members of staff. I had been left on my own in the 'group room' while the staff sat in a side office drinking coffee and, as far as I believed, discussing me. suddenly I burst into tears. I felt like a five year old, in the wrong clothes, doing something wrong, in the wrong building, on the wrong planet. It didn't help that I was new to Mental Health services.

I was still working four days a week while attending this group every Tuesday, all day. I wanted so much to understand my condition and to be able to manage it better than I had managed it for over 40 years.

When I arrived at the centre I made myself at home, making a cup of tea and arranging enough cups for everyone, very unselfish and 'functioning'. I entered the meeting room which was empty so, eager to please, I set out eight chairs in a circle. After a while of sitting on my own in the circle I plucked up the courage to knock on the closed office door where the five staff were talking - I assumed - about me. So I knocked, they opened the door, looked shocked, then closed the door, without telling me what was happening or when the 'group' would start.

Then they started, the stream of endless judgements and negative thoughts: why am I the only one? I knew it I've done something wrong and now they're punishing me, they don't get me, they think I'm wasting their time, they think I'm a waste of time, I am a waste of time, just look, they can't be bothered to come out and see if I'm ok, I knew I was a waste of space.

Then 30 mins late, they paraded out of the staff room and entered the room. 'Oooh, someone's put the chairs out, that's nice. Wonder who thought to do that?' Ignoring the Alien in the corner. It felt odd in a 'Miranda' kind of way: me, alone sitting in a circle of eight chairs and once all five staff members sat down, I was still sitting isolated, with no one either side of me. And then the stream of powerful thoughts gave way to an overwhelming deluge of painful emotions: anxiety, humiliation, embarrassment,anger, frustration, confusion. One after another they crashed on me, as my sense of alienation worsened. Suddenly, the waves of emotion were out of control and my sobbing broke through the matter of fact (patronising) repetition of the agenda for the morning.

Instead of stopping the farce they proceeded as if the whole group were present. I was clearly very distressed by now, but none of the professionals (or the Service User consultant for that matter) seemed to have the common sense to enquire as to the source of my distress. Being someone who had not had very much contact with Mental Health services, despite struggling with BPD for over 40 years, I didn't know if this was typical and to be expected. All I was aware of was that whatever this process was, it wasn't helping me: I had taken a reduction in hours and pay to attend, committed myself to it for the next two years and THIS was making me feel WORSE - not in any expected therapeutic or cathartic way, but in a way that felt like I was being traumatised.

Suddenly, it seemed a member of staff noticed ME - the large eyes and green skin must have betrayed my presence! 'Maybe the number of staff here are making Alma feel uncomfortable'. No Shit Sherlock! Still, no one thought to ask me what was upsetting me to such an extent - not that I was capable by that stage of articulating anything resembling an accurate picture of what was going on inside me. Eventually, I was left alone with two members of staff, who then proceeded to deal with a recalcitrant child. No mean feat as, by that stage, my willingness to open myself up to further pain and distress, had disappeared.

Perhaps, professionals reading this may recognise the brick wall of resistance in my response. Perhaps, it helps to suggest that professionals don't try to break through this wall, by the time I have constructed it you would be on a hiding to nothing. I would suggest to staff how about acknowledging there is a problem in the relationship and suggest a restart.

I am glad to say that this false start did not put me off persevering with other treatments, but certainly, it reinforced a number of my defences and made it harder for me to open up to staff in succeeding therapy. I am also pleased to say that my experience of DBT has been positive, with staff being consistent, human and willing to acknowledge when they don't have the answers.

Here are some thoughts and suggestions for staff when dealing with someone feeling like an Alien in the Group:

1) Even if a service user presents as really together and confident - please don't assume that is the full picture. If I have been assessed as suitable for treatment then there must be more than meets the eye.
2) If you misinterpret the situation or a person's mood, don't be afraid to apologise, start again and ask for the person's help to understand. Above all listen to the response.
3) Be aware of how your locking yourself away in an office appears to patients, particularly from an individual person left in a group room. Remember, you are often dealing with people who are super sensitive to rejection, ridicule and paranoia.
4) Ask yourself how you would feel if you found yourself in the situation that seems to be distressing to the person you are trying to help - your answer may give you an idea what questions to ask.
5) If you are trying to get someone to open up who has closed down - please give them time to answer, don't jump in with your assumptions as these may well be wrong.
6) Even if you have some idea what is wrong, don't put words in the other person's mouth - all of us have our own ways of explaining things and even if you are close to the truth your experience will not be the same as mine.

Above all, show the person that they are not aliens, but individuals with real needs that deserve to be met and that merit the best of your skills and professionalism.

Housework - the forgotten symptom....

My house I've realised reveals a lot about my mental health. When I'm up and when I'm down.... it's like a barometer of my emotional life. I remember a cartoon from my childhood with a dog called 'What-a-mess'. I loved that dog: I think I am that dog!

Most of the time my public face is usually fairly presentable, which is why anyone who looked inside my mind or my home (at times) would probably be surprised to see the extent of my inner 'What-a-Mess'. Someone asked me today, 'do you think that you have a problem with people thinking that you're competent and confident?' Now, I know he doesn't mean, that people find me so overwhelmingly competent and confident that they can't relate to me. I think he meant that people have a hard time accepting that I could be suffering from complex mental health issues. Maybe if I were more like What-a-Mess, ie people able to see the extent of my 'disarray' then there would be less questioning of the fact of my struggles and perhaps more acceptance when I need 'space' from people and the world around me.

The thing is, when people have entered my home (which has happened on just four occasions in the past year) it is obvious that all is not well in the 'State of Denmark'. In fact, I am rather ashamed of my 'bolthole'. I realise that using all my energy to manage my 'public face' leaves me relatively little energy to take care of my most important environment.

I am realising more and more that this reflects the biggest struggle I have as I move forward towards full recovery - a lack of self validation. My home reflects the value I place on myself. All my energy seems to be directed at maintaining my competent image to the world outside. Would I be better served letting out my inner 'What-a-Mess' to the world outside, or is the answer about finding more balance in my life, between my public and private lives?

Balance is always preferable to living at extremes of different spectrums. I don't have to choose between being What-a-Mess and Aggie and Kim, I just have to be able to invest in my home so that it is somewhere that does not generate negative emotions like 'shame'. My aim is to improve the environment to which I retreat from the world to recharge my batteries. To do so means that I should be trying to have enough energy left in each week to allow me to take care of myself: cooking, personal hygiene, housework, relaxation etc. In practical terms, I need to see my physical environment as being part of the nurturing relationships that are helping my emotional life.

I need my home to be a retreat, a nest, a safe place, when my mind and emotions are very much 'What-a-Mess'!

My DBT Self Soothe Playlist

Here's my list of songs currently on my ipod for when my 'savage breast' (or should that be 'beast') needs soothing! Music helps me avoid food as a self soothe!

1. Moon River - Andy Williams

2. Sarah McLachlan - pretty much anything

3. No Frontiers - The Corrs

4. High Flying Adored - Evita

5. Adagio for Strings - Barber

6. Bach (Unaccompanied Cello Suite No 1 - Prelude) - Yo Yo Ma

7. For the Beauty of the Earth - John Rutter (The Cambridge Singers)

8. Nimrod - Elgar

9. Sunshine on Leith - The Proclaimers

10. Daydream in Blue - I Monster

Some of these tracks were anchored in the pain of the past, but when I choose to listen mindfully, I find I am able to hear the soothing aspect of the music itself, not what I have learned to attach to them. Sometimes I listen mindfully so that it is:

1) The one thing I am doing at that moment
2) I focus on just noticing and describing what I hear
3) I don't judge myself for any difficult feelings that may arise
4) I let go of any distracting thoughts or feelings about the past or future and Listen!

Can Success replace Parental Validation?

I was six when I won my first competitive swimming medals. Two golds and one silver. Although very young, this event had a profound impact on my life. What it did for me was let me know that here was a world in which I could be noticed - not only that but it dawned on me that I might be considered valuable, certainly by the coaches and club which 'head-hunted' me, along with my brother, after this auspicious start in schools swimming. So began a determination to work hard at being the best - always in the hopes of my parents noticing - however, unusually for parents of competitive swimmers, they rarely attended our appearances at galas and Championships. We were always the kids who were picked up from training etc by the waiting car.

By the time I had left home aged 18, leaving behind my parents and their casual indifference to any part of me as a person, the only validation I registered was from over-achieving. Ironically, I was so numb to encouragement and praise that I have always considered myself to be a failure - despite being a county level swimmer, despite completing three successful degree courses in my life, despite holding down very responsible jobs for over 25 years.

I didn't notice that my periods of 'instability' had a regular pattern to them, or that there was a link between the emptiness I felt inside and the childhood traumas I had survived. (It has taken three years of hard work and therapy to accept that much of my childhood was indeed traumatic). It was only at the age of 42, when an amazingly compassionate GP (now, alas retired) persevered with a sustained period of emotional instability and considerable time off work, that I was diagnosed with Borderline Personality Disorder. For the first time people started to make sense of what I thought of as my worst faults: 'och, she's highly strung', or 'she's just oversensitive'. Not to mention my white hot temper and inability to live with myself, let alone, anyone else!

I found giving up work almost impossible because that was where I was most comfortable, where I felt confident, where I had a professional persona which had defined boundaries and rules for dealing with people. I didn't have to divine people's motives about me personally. Although emotionally demanding, my caseload allowed me to ignore my own problems and focus on helping others manage theirs. Problem was that I had shut myself off from all relationships outside work - not that I had no friends, it was just that I had learned it was easier to skate along on the surface of relationships.

In the end, though, I had to acknowledge that I had run out of 'emotional steam' and stopped 'functioning' as my GP so nicely put it. Now, just over a year since I gave up paid employment to focus on attending DBT therapy and recovering, I've realised that feeling successful was the only means of validation I had built into my life. And that obviously didn't work.

Now I'm facing a major shift in my attitude regarding what it means to lead a successful life. Do I return to similar demanding roles as the past? Or do I acknowledge that even Christmas was too much for me to handle, let alone contemplate returning full time? For me it has been a struggle to accept that even without a defined, paid, role I am worth something. If the message from your parents was that you didn't matter, then no amount of achievement (as defined by external values) can help fill the emptiness inside.

What has helped me is to accept that there is a purpose to my life, as it is, regardless of certificates, salary scales or other measures. My belief in God is a starting point - I am taught that He loves me as I am. As with my basic practise of Mindfulness, focusing on truths about myself takes so much time and practice. I am only at the beginning, but I know that reversing the lack of validation in my childhood requires that I dedicate myself to focusing on and accepting myself. Not that I'm advocating self obsessed introspection - no I mean focus on what is enjoyable right now, including what I am able to contribute towards helping others. When I can feel that I have a purpose and root in this world, then I can accept my experience of each moment.

Success for me now is not about replacing something that can never be replaced or changed, because that is in the past, but it has become the ability to knit my experiences from the past into my life as it is now, accepting the strengths and gifts it has given me that have brought me to this moment. In this moment I can accept that success is still being here after everything I have been through, beginning to be able to love and be loved by others. In this context, I don't need to seek a successful career - I just need to be content with my life as it is - right now! That I think is the essence of Radical Acceptance.

Learning to love my inner 'Gleek'

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

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

This is what my Cheesy Pop songs have given me:

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

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

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

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

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

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

Fashion is the tyranny of the young!

People Need People - the forgotten DBT skill?

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

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

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

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

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

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

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

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

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

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

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

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

BPD Blessing or Curse?

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

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

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

Some observations of me and my 'diagnosis'.

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

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

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

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

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

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

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

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