Revisiting Routine

In the past I have written about routine as an important element of recovery here "https://bpdlifeinthemoment.blogspot.com/2014/10/routine-bars-of-protection-or.html" For many, one of the most important parts of treatment or therapy, particularly when it lasts a lengthy period of time, is that it provides and external routine on my life. As well as the natural sense of loss at the ending of the therapeutic relationship and important structure is removed at the time of discharge.

Early in the recovery journey I found it difficult not to immediately go back to the routines I had before I asked for help and finally had to give up my job. Problem was the life I thought I was living was completely different. It had to be, after all the way I had been living my life before had led to me becoming completely emotionally and mentally exhausted.

It took me a while and several months during which there were moments when emotional exhaustion returned because I tried to do too much too soon. Any new skills, or routines, no matter how good they will be for me, can take additional mental and emotional effort, simply because I am still becoming used to them.

Be kind to yourself, has to be the refrain - my broken leg, may have had the cast removed, but the muscles around the healing bone need regular practise and exercise to be built up around the bone, in order to make the most of recovery.

Looking back I think I focused on mastering new and forgotten skills to help me rebuild, in stages. I would identify these now as follows:

1) Keeping 'Body and Soul' together. There are certain tasks, or routines which literally keep us alive. Eating, drinking, sleeping. When beginning to recover from any illness these are essential to keeping the body going, so the mind and emotions can recover effectively. I remember the time when getting out of bed, making regular time for meals and noticing when I was thirsty, actually used up all the energy I had. I would sleep in the middle of the day, because, emotions are exhausting - what told me that this was necessary was the fact that I could still go to bed at a routine time and sleep despite having had naps.

2) Building Self Management. DBT teaches me skills over a sustained period of time. The challenge without the group skills and one to one therapy is to continue to build habits which help me to maintain management of my condition. Because skills such as Emotional Management, Mindfulness and Relationships have routines built into them, the maintenance of them, helps to create a routine in itself.

3) Finding Joy'Glimpses of Glory' is a way a friend of mine heard about last year, when a group of friends were reflecting on the past year just after the Christmas Holidays. Since 2016 when both Brexit and Trump blew onto the world stage, there has been a tendency when reflecting to focus on the negative in the world around us. Instead, looking for 'Glimpses of Glory' encourages us as we reflect to ask that we see the moments of good, the joy we find in the small things in us. When we are rebuilding after a period of illness, we may struggle to see the positive, it can be a symptom of emotional exhaustion. In spite of the fact that I struggle to socialise, I know that there are nurturing relationships and friendships, which I need to build into the fabric of my life. Again, it begins with a small step in opening myself up to friendship....relationships take time to build, but by making meeting up part of my routine, I can begin to make a path out of isolation. To find people who may be good for me, I need to acknowledge the things in life that I enjoy. Where are my Glimpses of Glory....then the next step, are there others who share my joy in these things? It's hard to walk in somewhere new, but when I have a focus, a class, a hobby, a sport, it can help to distract me. It also helps me to connect with the community around me, if I can help in simple ways by volunteering - there are so many opportunities starting with making brews and washing dishes at your local parent toddler group, for example.

These are just small ways that I have rebuilt a routine, which is a safe structure in which to build a new life, where I can manage my condition effectively. Recovery is not a straight line, there have been hiccups and setbacks along the way. But the trend has been towards a more meaningful life for me. Looking back I wasn't ready to move on stage to stage until, the effort needed to maintain new routines has reduced - moving on overlapped at times - life isn't made with beautifully straight edges, like me, the pieces of my routine jigsaw, can be messy!

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.