Cocoons

I've been thinking a lot about cocoons lately. In the past I believed that wellness for me would mean that I would no longer have need of safe places, bolt holes, places to retreat when the world became too much. Recently, however, I've realised that it is not the need for cocoons which has changed in me, but the type of retreat and how long I need to remain there so that I can rebuild, or rest, or restore myself ready for the day to day battles which make up every day life.

In the past I would cocoon myself away for weeks, months on end. In many ways I was entombed within emotional cocoons for so many years. That's the effect of refuges which are not designed to release me to live a meaningful life, but those which enclosed around my internal pain, so that all my effort and strength was used up trying to live with the prickles on the inside of my 'safe places'. In some ways I was like a porcupine or hedgehog which had curled in on its own prickles, stabbing myself repeatedly as waves of emotional pain assailed me.

In nature, when caterpillars are wrapped up in their cocoons they are enclosed around nourishment, stored up fuel which sustains them until they are ready for release and new life. I have had to learn to experience nurturing refuge, time and space which rebuild positive emotions. At first leaving my pain outside the cocoon felt strange and awkward. I had to fight against the hardened belief that I did not 'deserve' to feel better, that I was not worth protecting from whatever was draining me at any given time. Instead I have had to work hard to focus on ways to be kind to myself. I have written about my 'self soothe' and 'Validation' treasures boxes, here: http://bpdlifeinthemoment.blogspot.co.uk/2013/11/my-self-soothe-kit-whats-in-yours.html and http://bpdlifeinthemoment.blogspot.co.uk/2014/03/my-dbt-validation-treasure-box.html

Some who misunderstand emotional and mental pain assume that there is a laziness, or desire to be miserable, which stops us from 'getting better'. Think about that for a moment. Is it credible to believe that someone who has suffered so much really 'enjoys' feeling that way? That someone who feels so much distress that they believe the only way out is to either cause more physical pain to themselves or to die, actually doesn't want to find another way?

I have learned to use cocoons to heal. It is tiring to carry both internal, historic pain and the day to day weariness of every day life. If I cannot accept and leave the past pain behind, then it will continue to turn up the volume on my current pain. So, I don't just carry the disappointments, sadnesses and pain of today, I also carry every moment someone or something has hurt me all my life. It is the focus of experiencing the present moment as it is, unfettered to the past which has helped me to let go of the store of pain so that I don't feed the present with the past.

Instead of wrapping myself in a cocoon around intense pain, so that I emerge exhausted and unable to function, I build into my cocoons activities and actions which soothe me until the pain has gone and I feel able to tolerate the company of others.

The other most important thing about cocoons which is helpful is that I set time limits, so that I am not tempted to stay there. Whether it is a matter of hours or a day, this means that I focus on making the most of my time, rather than letting hours drift into days, as I have in the past.

Here are some ideas to help you make the most of your cocoons:

1) Plan the time ahead. This is a Bank Holiday, I have made sure I have built in time with some good friends. However, after a week or two with intensive meetings and lots of thinking, I need to be alone. I have planned one whole day.

2) Make sure there are things which can keep my focus - I have stored up whole series on Sky+, am colouring in using 'The Secret Garden', I have enough food to make some delicious recipes.

3) As I move through my activities I do so mindfully, being aware of what unwanted emotions may arise and dealing with them using my DBT skills. I do not want the focus of my emotions to end up draining me - that would defeat the purpose of the cocoon.

4) Allow myself to enjoy it - even if I begin to feel guilty I must use 'non-judgement' skills to let it go. The aim is to rest and relax - that is okay I am practising self care and it will help me to be able to engage with and care for others.

5) Plan how I will re-engage with the world outside my cocoon - I cut myself off from Facebook and other social media. It is also important when I need cocoons that I don't engage with UK and World news - particularly at the moment I can become emotionally sensitive to injustices.

Above all, cocoons are as much a part of my toolkit as other DBT skills, I can emerge from my cocoon either drained or restored. I am learning to do the latter, the more I practice these moments of calm in a turbulent life.

If I can't love myself, where do I begin with self care?

Being able to feel secure in my place in the world is vital to my ability to engage with the world around me. I cannot contribute to the communities I may want to be part of if I don't feel that I am accepted or, more accurately, acceptable to those around me. I will not be able to sustain relationships if I do not believe that I am worthy of that most basic of human needs - human contact and interaction. For most who suffer from BPD (Borderline Personality Disorder) a lack of basic self esteem underlies most self destructive behaviour. I will not care for myself, because I don't believe 'I'm worth it'.

One of the hardest things I was asked to do in DBT was to say 'I love myself so much'. It still hurts to even write that. I cannot say that I've reached a point where I'm able to say it with any level of belief. A lack of self love in the past evidenced itself in behaviours which often resulted in crisis in one or other area of my life. I would spend until my debts were so overwhelming they affected my physical and mental health. I neglected my physical health - I rarely went to the doctor, what was the point? I reasoned, it would be a waste of resources - because it's me.

No therapy in the here and now can undo the experiences and relationships in the past which have stolen any sense of self worth. Even the most loving relationship in the here and now cannot hope to permeate the depths of my sense of self loathing. A friend of mine who has gone through the adoption process told me about some of the training they received on expectations of the children's ability to absorb the effects of a loving home. During training they were told that the child is like a cup with a layer of cling film wrapped over the top. Pouring love into the child is like trying to pour liquid into the cup. It cannot get through. There is a certain acceptance of the reality of the impact of invalidating early environments.

I can relate to that image. I have been unable to understand or feel that I am loved, despite having some very high quality friendships. It is true that the hurtful, rejecting relationships have been the ones that I have gravitated towards over and over again. Again I return to the core belief that 'I am not worth' any better treatment. People wouldn't ask questions about why abused women and children don't seek help, if they truly understood the cumulative impact of experiences which reinforce again and again, that I am less than, that I am someone whose needs don't matter, that I am someone who can be used and abused at will and no one feels is worthy of rescue.

So, given that has been my experience of life, where do I begin with self compassion and self care?

1) Start with the simple things. I began to regulate my sleep. As I practised mindfulness I found that I was able to fall asleep and stay asleep easier. Under the DBT Emotional Regulation skills module, the PLEASE* skills give me a guide to what to do. Sleep is the S of the skill. I don't need to worry 'HOW' practising these skills affects my sense of self worth. I just have to try something different and see if that helps me feel better. P means take care of my physical ailments - so get myself to the doctor when I need to. I started by doing that, getting help with oft recurring migraines - they used to last 3-4 days, happen 1-2 times a month and resulted in me vomiting for at least 48 hours. Getting help with medication which prevents attacks as well as practising DBT skills means that I have only had 2 attacks in the last six months. It doesn't take a brain surgeon to work out that the impact on my emotional health of getting these under control has been immense.

2) Give it a go anyway. Even if I don't think I deserve it - by practising the non-judgemental aspect of mindfulness all I have to do is experience a bath, a walk in the sunshine, massaging hand cream into my hands, putting together an ace playlist for my ipod, watching a favourite TV series in the middle of the afternoon. It took me a long time to lose the guilt, but I kept 'acting' on my plans to treat myself. After nearly two years I am able to take stock of my needs and decide how to care for those needs in any given day. This of course needs to be balanced with using other times to care for others.

One of the difficulties of being introduced to DBT Skills in a group is that not every exercise or suggestion suits every member of the group. Having said that, if I am to find what works for me, I need to get over myself and give things a go. This is one aspect of DBT Willingness, which I understand better as a willingness to engage fully with the world and people around me. My therapist asked me to try saying 'I love myself so much' using Miss Piggy's voice (remember I enjoy drama - it was tailored for me as an exercise!). This made me less fearful of the emotional power of the words and has allowed me to keep trying to say it for real - as I have said earlier - still working at it.

3) Do what you can. Initially I found it difficult to look after my health by way of my diet. So much emotion was carried in my relationship with food. I have been obese for some time, but it was only when I had been out of therapy a number of months that I decided I was ready to do something about it. I needed to build up my ability in using other core skills such as mindfulness, long before I was ready to deal with my weight. Be realistic about what you can do. Care for yourself in basic ways such as sleep, enough water and regular meals before you try to tackle things you have used in the past to help you cope with your emotions, like smoking, overeating etc.

4) Accept any help on offer. Lack of self care results in avoiding asking for help from others OR it results in me becoming so ill that I have no option but to rely totally on others for my care. There is nothing more strengthening that being able to ask for help, knowing that I have made the decision and I know how such help fits in with my own plan of self care. Having decided that I needed to feel fitter I asked the GP about help with diet and exercise. I am so glad I did because I need additional support to keep going - in our area there is a Fit Squad which means that if you are suffering from Mental Health issues you can access three months individual support to improve fitness as well as a Food for Thought programme. I've lost over three stone and have ground to a halt - so I need to go back to my advisers and ask another boost of motivation to complete the transformation. Overall, by caring for myself I feel so much better physically and am able to enjoy activities a lot more. In addition because I am practising mindfulness, I am able to enjoy the changes.

The most important thing to remember when embarking on this journey of self care is not to blame yourself or mistaking self care for selfishness. It is not selfish to care for yourself and just because your parents or others have discounted you in the past, you do deserve to be able to enjoy good things. If you keep going with looking after your physical needs, then you will find your emotional needs easier to meet too.

* DBT PLEASE Skills can be remembered as follows:

"P L E A S E M A S T E R."

treat Physical illness
balance Eating
avoid mood-Altering drugs
balance Sleep
get Exercise
build M A S T E R y

I have downloaded the Loving Kindness meditation from the UCLA website (http://marc.ucla.edu/body.cfm?id=22) This again is something which will feel painful if you are starting to work on self care, but over time allow yourself to keep going - non-judgement will be your friend.

I have found these tools on American website and have pinned them on my DBT Pinterest account. They are a good graphic representation giving some ideas about how to begin with self care:

It's one of those days... again

I still have them. Days when for no reason an overwhelming sense of grief sits on my heart. Now, I am aware of the deep source of the grief. Now, I can say 'this too will pass'. It doesn't make it any less painful to live with. Nor does it suddenly make it 'all right'.

On these days I need to remind myself that I need to be kind to me. I tell it to others and I believe it. My biggest problem remains an underlying belief that ultimately, I am not worth caring for. That somehow, somewhere in my history is a reason, a factor in me that means I deserve the suffering I have lived through. I carry the emotional hangover of the survivor of abuse, the belief, that somehow, somewhere in my past I must have done something bad.

Because this has been a lifelong belief which has resulted in self hatred and the behaviours which have made shipwreck of important moments and relationships in my life, I still have battles to fight. Today is one of those battles.

Unlike other days which I used to fear would stretch into the rest of my life, I am learning that this day is not all the days of my life. This day can be measured and will end. Today, the overwhelming sadness and grief comes in waves, in moments. I am becoming more aware of this as I recover.

So, here it is another day of painful emotions. Today, I will be mostly looking after me. That includes eating bacon butties, watching trashy TV, taking my time over my shower, and most of all not berating myself for grief and painful emotions which come from having lived through and survived some very difficult events. Most of all, this day and these emotions are not the whole of my story. This pain means that when I have a different day, a better day, it can shine even more brightly. Today, if I can be kind to myself I am replacing another more painful moment from my past and I am able to say, I am worth caring for.

Routine - Bars of Protection or Restriction?

One of the most difficult things about completing a long period of intensive therapy is the loss of routine. I used to think I was quite a random person, I'm not sure that I come across as needing structure in my life, that I'm a spontaneous, carefree person - WRONG! I don't cope well with unpredictability in relationships or life.

I arrive routinely at least fifteen minutes early for most appointments, no matter how trivial. If I've made a commitment I will be there! I will do practice runs to new locations, either in real life or online through google street view (that has saved me so much time I love it!). Even informal arrangements have to be made and pinned down for me in good time. This helps me manage anxiety that has in the past led to panic attacks. So, it is hardly surprising that after nearly two years of intensive therapy and five years of having the same Care Co-ordinator a certain level of apprehension flooded me when contemplating final discharge.

For over a year I had two, weekly appointments around which to build my routines. This was more than enough to provide stability as the levels of exhaustion experienced by me just trying to get by meant that any more structured activity was unsustainable.

I have come to the end of a period of two months during which I have tried to transition from those routines to new ones around which to structure my day to day life. As well as changes to formal appointments, I had major changes to two friendships which were part of my care plan throughout my time in therapy. One friend moved away and another got a job. These things happen - it's life. The challenge becomes, when you don't have work to structure your routines, where do you begin?

What has helped me is to take an idea I first came across in the film 'About A Boy'. In it the feckless hero didn't need to work, but rather than be bored he divided his days into 'units' of time - 1 unit equals 30 mins. So, Breakfast and Coffee counts as two units. Haircut could extend to four units etc. I have adopted this attitude and have begun by trying to establish a daily structure. I know for some people with PD issues this sounds like madness - but it is very much part of my managing my life in order to maintain stability in my emotions. This is how I structure my day:

Before breakfast - quiet time, pray, take time to be mindful. 1 Unit (30 mins)

Breakfast & large pot of coffee 2 units

Walk Dog - 4 units

Lunch - 1 unit

Blog/Gym/Meet Friends 4 units

Dinner - 3 units

Relaxation - 6 units (Includes Self Soothe activities, take a bath, watch good tv and films, Wii Sports, read, listen to music)

The daily structure works for me because it has the flexibility to include meeting with other people as well as allowing me space and time to care for myself and my animals.

I have taken more time to establish a weekly routine because, along with my therapy appointments I also had two fixed times in each week when I would spend time with my Care Plan friends. Now, I have used my voluntary work and socialising to build a loose routine which can be changed depending on whether I feel like 'people' or not.

Monday - Evening Course

Tuesday - time to self

Wednesday - Women's group & spend afternoon with friend

Thursday - time to self/blogging/volunteering

Friday - Running Group - time to self

Saturday - time to self

Sunday - Church

You may notice there is a lot of time for myself - I enjoy my own company, but I need to ensure I make myself spend time with others. So, I have developed a balance of social and group activities that I can cope with. As long as I have space to myself and/or for writing then I feel my life is balanced. The amount of self space also allows me to build in more activities as and when I feel able.

I have found that, as I have recovered, I have been able to tolerate more social times than previously. Above all, if I can't keep to the routines, I don't just give up all together, I allow myself to have a Vacation (DBT Skill) and then begin the routine again at the next natural point. Usually the following day. For example, if Sunday at church has exhausted me, I give the dog a shorter walk on the Monday morning, take the afternoon to myself, so that I am better able to cope with the course on Monday evening.

Everyone is different, but, for me, structure and routine are essential elements of my long term recovery. It's also a good early warning sign that things may be going awry because both myself and my close friends can tell if I am struggling when the routines are disrupted for any length of time.

Self Compassion and Knickers

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

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

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

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

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

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

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

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

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

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

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

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

How does Your Mindfulness Smell?

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

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

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

1. The smell of freshly ground coffee beans. This smell has become part of my daily morning rituals. I find I am beginning to be

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

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

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

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

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

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

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

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

50 Ways to Give Your Emotions a break

This is from a Pinterest board run by the Black Dog Tribe - thought it was excellent for generating ideas for self soothe, getting active, opposite emotion to name just three DBT skills. I've noticed too it's got a good range of different senses involved in activities. Am going to try a few that I've not tried myself yet, biggest challenge - have a complete break from electronics!! A fun read and worth trying to use if you've got into a rut with self soothe and self care.

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.