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

Knowing Who I am - the Crux of the Matter

One of the aspects of a diagnosis of Personality Disorder, particularly that of Emotionally Sensitive (ESPD) or Borderline PD, which causes controversy, is the idea that someone's personality can be fundamentally flawed or 'disordered'. There is also currently much discussion around the issues of diagnosis in general, not to mention the perenniel problems of labelling. Whatever it is called, or whatever diagnosis clinicians and practitioners seek to use in order to identify shared symptoms among those who suffer from PD, the diagnosis, for me, remains simply a signpost indicating areas in which my experience of the world may differ from that of others and help them to provide me with guidance as to the best possible therapies or approaches available to help me overcome my difficulties.

The fact that one cluster of BPD symptoms centres around issues of identity and, therefore human relationships, means that even the most basic understanding of myself and my place in the world, ie who I am, is problematic for me. My understanding has grown around this area as I have learned to observe my own functioning especially in the area of inter-personal relationships.

One of the key consequences of the invalidating childhood environment is to make me doubt entirely my expectations and understanding of the world as I experience it. In essence, the very fact that my emotional responses to pain, or neglect were, ignored, ridiculed or contradicted by my main care givers means that I cannot trust my emotional responses to the world. The problem is exacerbated by the fact that those of us with the symptoms associated with ESPD or BPD experience emotions at a much higher intensity than the average person. Fear, anger and anxiety are primary emotions in terms of helping us survive, particularly when we are at risk of physical harm. However, once again even these most primal of emotional responses have been distorted by the messages we received when growing up, particularly if we have survived childhood abuse, whether sexual, physical, or emotional. For many the intense emotions lead to hyper-vigilance, hypersensitivity and therefore, often result in what appears to the casual observer as inexplicably extreme reactions to everyday situations.

How I feel about the world informs how the world reflects messages about who I am, or who they think I am, back to me. If my emotional messages to the world come through a distorting prism, then the messages I receive back about who I am and how I relate to the world around me, comes back to me as a distortion - sometimes it jars with me, sometimes it confirms my deepest fears. So, I find it difficult to believe I am a likeable person, because even my parents had no time for me. If friends try to give me the message that I am likeable, this feels alien to me and I manage my discomfort with this by imagining reasons for them saying they like me - If I never check out my assumptions my ability to trust others will always be on shaky ground and I will not be able to learn new ways of seeing myself. In other words, I will constantly prevent myself from seeing me as others see me. Unless I am able to counteract the internal distortions by beginning to learn about myself as I am now, then I will continue to find myself in cycles of intense relationships where I try to mould myself to how I think I should be, followed by ongoing rejections which reinforce the distorted views of myself as unlikeable.

I have always struggled with statements which begin 'I am...', yet being able to complete these statements is an important first step in helping me to look at myself in a mirror which is not twisted by my internal emotional responses. I found this sheet from a website for teachers looking for ice breakers for the start of term. As I read through it and applied it to myself I found that I am able to fill in more of the statements about how I view myself, than a year ago. It is good for me to complete this exercise on my own and remind myself that the more clear I am about the 'I am' statements is a reflection of the progress I have been able to make in becoming more secure in my identity. This also reflects the stability in my current close relationships and friendships. It is so positive to be able to say I can measure some friendships in decades now, I've also never lived so long in one place since I left home at the age of 18. I am growing more secure in who I am and my place in the world.

From Riding the Roller-coaster to the Art of Gliding

Gliding is an activity I have long been fascinated by since I was child and we lived in the vicinity of a gliding club. In fact, I love all kinds of flying, I enjoy travelling by air, the smaller the aircraft, the more enjoyment I get out of the journey. I've parascended, zip wired and enjoyed flying in a helicopter through the Grand Canyon. Learning to fly is high on my Bucket List. Gliding, I think is a good way to learn the rudiments of flight, so I plan, in time, maybe to start there.

This past week I have hit some turbulence in my emotional equilibrium. It has come as a shock to my system especially as I have experienced a longish period of relative stability, particularly in what I refer to as my 'baseline'. Since early January my baseline has taken a dip towards depression, again. The symptoms are familiar to me. In the past it would have taken much longer to even notice this foundational dip, let alone take action to adjust myself to the change.

Initially the symptoms of depression and the consequent negative thought processes which have been part and parcel of my story for so long, have made me feel like I am 'failing' in my recovery. Before this becomes a cyclical thought/emotion dash to self destructive behaviour I know I need to take a step back and think more clearly about what is going on. This is when I started to think about gliding.

In the past, I experienced most days as roller-coaster rides. Massive shifts between negative and positive emotions happened in the space of one or two hours and back again, over and over again until I exhausted my emotional and physical reserves and ended up completely empty. Everything was out of my control, without me having access to any means to manage, direct or control my experience of life.

Today, I think, I am more like the glider pilot. I am still at the mercy of the 'thermals' of daily life. I cannot predict when the actions of others, or the simple process of being a human being are going to challenge me to negotiate a drop in emotional pressure. Unlike the experience of the funfair passenger, the glider pilot is capable of 'riding' the thermals, the forces which dictate the movement of the glider. In addition to having a vessel capable of negotiating the air pressure, there is a simple object - the joystick, which allows me, as the pilot, to determine the overall direction of the glider. Only if I let go of the joystick and give up on getting anywhere in the glider, am I in danger of crashing. Most of all, as that pilot, I need to acknowledge and use what nature throws at me.

I have never piloted a glider - yet, but I have enjoyed sailing in the past. In the same way, in sailing, I cannot change or determine where the wind is going to come from, how strong it is likely to be, or its effects on the waves around. I can, however, use the tiller and sails to negotiate my way through the water, making the most of the power the wind and waves supply. Again, I am able to determine the overall direction in which I want to go.

Right now, I would only be wasting my emotional and physical energy if I deny or resist the fact that I am depressed. In accepting that is where I am at the moment, I give myself permission to look after myself, to not try things I cannot achieve - for the moment. Nor do I need to give up on the hope of keeping moving forward with my life. This month, is not going to determine the progress of the rest of my life, any more than the glider pilot or yachtsman, are unable to steer their way through the thermals or waves - provided they use the tools and skills at their disposal.

For now the tools and skills I am using are Distress Tolerance, to cope with negative thoughts and emotions and Looking after myself physically (DBT PLEASE Skills) and using my DBT inter-personal skills to set aside some tasks that were causing me additional anxiety.

Above all, I am so pleased that the ups and downs are now less roller-coaster and more glider. The dips I am facing don't feel insurmountable. I have also learned that, as quickly as this storm has blown up, it can and will change - 'This Too Will Pass', as some of the worst moments in my life already have. I don't know how long it will last, but it will change to something else, something different, another part of the experience of life. I'm with Carole King - it is all part of the rich tapestry.

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.

Ya Get Me?

I love the English language. I toy with it, play with it, take words and mess with them, a bit like a trick footballer playing with a ball. Sometimes it's a bit random - especially when a word enters my head and I need to hear what it sounds like out loud. I especially love it when I discover some new 'in' word or phrase.

Recently I've been fascinated by people saying, 'ya get me?' after almost everything they say. I guess it is a way of making sure that your listeners are, in fact, listening. On another level though, it's also a way of checking out you are being understood. That started me thinking, maybe I need to start using it especially when talking about my mental health.

For most people with BPD (Borderline Personality Disorder) there is a sense of unease, a lack of belonging that is all pervasive. I had grown up with a sense of not being able to connect with the world and, more especially, with the people around me. I had a sense of otherness, of being an alien in a world that failed to notice how much I was struggling to belong. My nickname as a child was 'Moonman'- says it all really. I also did not communicate with adults, seeking to communicate through one childhood friend in particular, until the school in their wisdom removed him from me and forced me to try to speak to teachers and others at school. I was six before I was really able to do that.

This sense of alienation is a hallmark of BPD, a condition which creates a gulf between me and those around me, and which no one, but me is aware of. The only way I found to describe it when trying to help GPs and others understand, before my diagnosis, was a sense that I was 'locked inside my own heading screaming'. When I was most distressed I kept repeating 'I am not made for this world. The problem for me was that in my day to day life no one could see my distress, or if they did, they didn't understand its causes.

Lack of stable identity, caused by an inability to make emotional sense of the world around me is a symptom of BPD which goes to the core of the social theories of its causes. If we learn about our place in the world through the responses from those around us, then the invalidating home and family environment becomes a twisted mirror in which a distorted image of the self is formed. So, paradoxically the relationships which are most problematic to me are those which value me - they just clash with the internalised invalidated image and so are often rejected as untrustworthy. If the internal monologue of self criticism and self hatred meets with evidence to the contrary the resulting dissonance can be unbearable.

I am more comfortable with the feelings of failure and disconnection with the relationships around me, than I am with affirming, loving relationships. If my fundamental belief about myself is that I not worthy of life affirming love, then it is hardly surprising that I allow myself to become involved with destructive and abusive relationships. They are where I believe I belong.

As I work on my recovery I am trying to learn to find validation in small things at first. However, one of the ways that I still struggle to make people 'get me' is that I do probably need more affirmation in work and social situations than most people. The twisted mirror image of myself is still in the process of being untwisted. Slowly, I am trusting myself to develop new relationships. Trust takes time.

Being an alien, in a strange planet it is often easier to spend most of my time alone. This was one of my major coping mechanisms in the past. I deliberately retreated from intimate relationships because I just couldn't make sense of them, nor could my boyfriends make sense of the contradictions in me. On the one hand I craved affection, but on the other I behaved constantly in ways which would drive a wedge between us. The role of alien was so much more comfortable to me, then, than the sense of belonging to and with someone. There were times when I could happily go for weeks on end without any meaningful contact with anyone. It was safe, unchallenging and didn't cause any jarring or contradiction to my internalised view of myself. What I didn't realise for years, was that this was reinforcing the sense of isolation I was trying to combat.

Where am I today? I am trying to find new ways of connecting with the world around me. I am having to learn that patterns of invalidation established from early childhood will take time to change. I am trying out new ways of relating to friends, without retreating into becoming a recluse in order to protect myself from kindness and affection. The structure offered by the DBT Inter Personal Effectiveness Module helps me to find my place in most relationship situations. In the past I would swing wildly between shutting myself off and exposing myself too early in relationships usually sharing way too much about my struggles and my past history. I am consciously holding back when I need to in order to build trust on both sides of relationships.

So do 'ya get me?' The reality is that there are many times when I don't get myself. I am working on rebuilding my sense of self, without the overlaid turmoil of out of control emotions and moods, and the non stop internal self condemnatory commentary. All of which is a new experience for me, not all of it comfortable or pleasant. Slowly, but surely I am untwisting the mirror image.

Recovery is not a Straight Line

I've had an interesting couple of weeks. I am facing a lot of change in my life, positive change. The problem is that, in the past, I have struggled with new situations and people simply because my trust in the relationships around me were shaky. It is now nearly six months since I completed the DBT programme and nearly three months since I was fully discharged from mental health services entirely. As with any routines and structures, the skills which have replaced my previous coping mechanisms have bedded in and become habit.

The problem for me comes when I find myself lapsing into old familiar patterns of coping and thinking, and allow myself to go back to the familiar rather than the helpful. After all, I am in the process of replacing over 30 years of self destructive behaviour with skills I have only been practicing for just a couple of years.

As ever, the problems for me have lain not in practical problems. I am currently organising and running a public event, I am more than capable of doing so. However, relationships and my emotional response to them remain a major challenge to me.

One working relationship has been particularly problematic to me. I am used to dealing with difficult people. I guess some would say I am a bit of a challenge myself! I have found myself shocked at how destabilising I have found this working relationship. My concerns grew when I found myself becoming disruptive in a training session. The result was that I have decided not to attend that particular group and to withdraw from that team for the time being. Initially I felt this as a failure - it has been a default response to many situations for me for so long. However, after a couple of days beating myself up about letting the world down, I actually took a step back and was able to reflect on positive steps forward.

1) I recognised that my response to the training was not helpful to my recovery.
2) I took action to look after myself in the situation.
3) I recognised my emotional limits had been reached before I exploded in frustration.
4) I managed to withdraw from the team by using the DBT FAST (be Fair, don't Apologise for being alive, Stick to your values, and stick to the Truth) interpersonal effectiveness skills.
5) I have found a way to continue with my work without putting myself under this emotional stress
6) I have managed not to damage any of the working relationships involved

(This sheet from DBT Self Help website explains in detail: http://www.dbtselfhelp.com/html/ie_handout_10.html)

In the past such interpersonal issues have resulted in me 'behaving badly', often making myself feel really bad about behaving like a stroppy teenager. In the past my self respect has taken a battering as a result of my out of control responses to professional situations.

For a number of days I grappled with conflicting emotions, I forgot to use my mindfulness skills to enable myself to be able to identify and manage the problem emotions in the situation. I was in danger of spiralling downwards. At certain points, I even found myself trying to resist self harming urges. The good news is, with some effort, I was able to use my DBT skills to avoid relapse. More than that, I have been able to manage both myself and a difficult situation. Most of all, I have not been left feeling that I have destroyed working relationships and I am able to reflect on where the difficulties have arisen within that particular relationship.

Incidents like this would have caused crises for me in the past and would have had a detrimental impact on my ability to even be in the same room as people involved. Not good for team cohesion! Although I was tempted to despair of my progress on recovery, I am pleased that this situation has been manageable for me. This is vital, because I am currently in the middle of applying for jobs after more than two years of redundancy. If I am to successfully move back into working life, I need to be able to build up my confidence in using the skills which have been helping me in my personal life.

Life is not a drift through a glassy calm mill pond. At least, my life hasn't been. Having learned skills to manage distress, emotions and relationships, it follows that there will inevitably be situations where I will need to use those skills. I think one of my mistakes which led to me feeling shock at how quickly I felt destabilised was that I had deluded myself into thinking that acquiring the skills in itself would protect me from life's problems. D'oh - I'm with Homer Simpson - when I see it in black and white, of course that is daft. Any skill takes practice - when I was a competitive swimmer there were times when I was training for six days a week. Perfecting the stroke technique, building up my physical fitness, practicing starts, turns, finishes. I didn't really make use of those skills and that fitness until I raced. So it is with managing my condition. There are routine practises which are designed to keep my stability: I need to keep taking my medication, I need to maintain my physical health, my sleep patterns, my eating, mindfulness should be part of my day to day emotional life. However, I will not really know how effective my DBT skills are until I use them in situations which in the past I would have avoided or I would have responded badly to.

Recovery is not a procession, it is part of my life journey. There will be ups, downs, twists and turns along the way. My challenge is not to put my energy into looking back at the things I fear creeping up on me, but to keep my focus and energy facing forward.

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.