Nanny McPhee and the Therapeutic Relationship

"When you need me, but don't want me, then I'll stay. When you want me, but don't need me, then, I'll have to go" Or words to that effect. It has only just struck me that this quote from Nanny McPhee sums up the crux of the therapeutic relationship. I am into the second month since full discharge and have been reflecting on the transition from needing the support of services through wanting it more than needing it, to finally realising I no longer need the levels of intervention I have previously required.

I recently had an interesting discussion with a friend of mine who is also a service user. He now works as an Expert by Experience and told me about a psychologist colleague who had been arguing with him about the nature of the therapeutic relationship. She believed that such relationships should not be considered as friendships. My friend and I both profoundly disagreed with her. Boundaries and professional distance are essential to ensure the efficacy and the emotional health of both the practitioner and service user, naturally, that's a given. However, there is an emotional bond, or at least there has to be in order for 'unconditional positive regard' to have any hope of developing. If there is not an emotional trust, based on some aspects of friendship, then the relationship may well work to an extent, but, certainly in working with Borderline Personality Disorder, at least, a level of warmth is essential in order to bring about progress. Otherwise how can I learn what a positive relationship established with effective boundaries, but also warmth and compassion, looks like?

I guess it depends what you consider 'friendship' to be. I recognise in my friends different needs and different gifts to me from each one. Some meet my basic social needs. Some are based on shared interests and enthusiasms. A handful are deeply rooted in genuine affection and deep emotional bonds. As someone with BPD much of the therapy I received was focused on my relationships with my therapists. DBT as a therapy model, recognises this and builds in these relationships and working through the ups and downs as they develop to its methods of working.

I find it interesting that when Nanny McPhee first arrives into the chaos and mayhem of the unkempt and undisciplined children, she appears hideously ugly to them. I'm not saying that all therapists are ugly! However, it is a truism when discussing therapy that 'things get worse before they get better'. Part of this process is the setting of boundaries, and the inevitable challenging of behaviours which are generating real distress and pain on the part of the service user. So, in a way there are times when I may find it hard to 'like' my therapist, and vice versa. Such is the stuff of developing relationships of any ilk. If the relationship is allowed to continue and works in addressing the key characteristics of my emotional issues, then my perception of my therapist is likely to become more positive. So with Nanny McPhee, her warts and whiskers disappear, as genuine affection replaces her challenging discipline and the children blossom under her care.

I don't think friendship as an element of the therapeutic relationship need be a threat to the professional. It is a natural part of genuine positive regard and compassionate practice.

Horses for Courses - One Therapy Cannot Fit All

This blog primarily shares my experiences of my practice of Dialectical Behaviour Therapy skills. After a lifetime of undiagnosed Borderline Personality Disorder symptoms, it was a huge relief to find a therapy that fitted with me and my needs. Having experienced as a Probation Officer the brick wall times of belief that BPD was 'untreatable', it seems that DBT has broken on Mental Health services as a sudden revelation, that 'something' can be done to offer a way forward for BPD sufferers. Great! A solution....except it's not that simple is it?

I know I bang on about how much I have benefited from DBT, but I am not so blinkered that I cannot conceived that this is not the whole or only therapy which can offer help for my condition. There is, nor can there be, one size fits all solutions for any Mental Illness - even if everyone engaged with Services had all of the same symptoms.

To advocate that DBT is the best and only way forward for everyone with a diagnosis of Borderline Personality Disorder, is to deny the complexities inherent in helping people to manage disorders and conditions which impact on every aspect of our beings. I was clear on discharge that completing the eighteenth months intensive therapy was only the first step in managing my BPD for the rest of my life. I have needed to address issues around my physical health following the impact of my emotional symptoms over the past 20 years.

Acquiring DBT skills also does not mean that I no longer suffer the symptoms of my condition. My discharge plan includes the continued prescribing of two medications to help me maintain my emotional stability. This is primarily to manage the accompanying Clinical Depression and Anxiety that I live with alongside the symptoms of BPD. I am only one person, I cannot hope to represent every person with the same or similar symptoms. Therefore, just because this combination of interventions is working for me at the moment, does not mean that it can be applied to all who may share my experiences of mental illness. Nor, does it mean that this combination will continue to maintain my stability forever. But for now, it is the right treatment path, for me.

A major problem faced by NHS Mental Health service providers is the pressure to 'justify' spending on intensive therapies. At this point numbers, rather than people, take priority and compete with what professionals know is best practice. Many NHS Trusts are hamstrung by funding issues which mean that they have to decide on one treatment pathway for individuals with the same diagnosis. Although research and practice indicates the complexities of helping human beings to manage complex conditions, funding issues seem to dictate basic, solutions. Or to put it simply, one size has to be made to fit all.

Reading other service users' experiences of what is on offer locally for BPD, I realise that in the UK there is a vast gulf between different parts of the country. In my area, I am lucky that there have been two evidence based therapy paths, both vastly different from one another, on offer via the local NHS Trust. Many other areas, are still grappling with managing people 'like me' without any specialised therapy on offer. I have gone through the trauma of 'failing' at one model, but thankfully there was another very different and more suitable model that has really helped me. How many people with various mental health conditions have that luxury?

Having said funding issues are the main reason for not considering a more integrated approach to Mental Health treatment, it is difficult to avoid the conclusion that such money saving approaches are short sighted. Certainly, if inpatient beds are perceived as being too expensive to continue to invest in, why is investment not then being made into developing a range of treatment options which can be adapted to individual needs? If you remove the 'place of safety' for people, where is there a safe place in the community if the one treatment on offer to some, is not effective.

I know I am looking at things rather simplistically, however, I am currently benefiting from the support of a physical fitness team run by the same Trust who run local Mental Health services. I get free gym and swim for three months along with an individual programme that is realistic and takes account of my emotional needs. I am in the process of dealing with my obesity in order to prevent long term illness and disease. A good investment? I think so, I feel so much better physically. In addition, taking care of my physical well being is one of the DBT skills for emotion regulation. Looking after my physical health is definitely supporting my ongoing practice of DBT and emotional stability.

We are all complex beings, unfortunately, the politics of funding seem to have swamped the instincts of best clinical practice and research. While the NHS is still in existence there is an opportunity for different teams to work together in co-operation with one another, rather than being made to compete for ever dwindling pots of money. If the focus can move away from numbers (referred to services, or successfully completing treatment compared with others) back to the whole person, there is maybe some hope that service users will be able to be treated more effectively.

Believe it or not, I actually recognise that just because DBT works for me in managing my BPD, does not mean that I expect it to work for everyone else with BPD. Although, I will keep sharing when I find something else that has worked for me in DBT...cos it excites me when I continue to be able to manage my emotions.

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.

Me, My Dog and Tigger

I have an inner Tigger. I know, another myth about depression and anxiety sufferers hits the wall! I believe this aspect of my character - the irrepressible, fun, bubbly part of me, has helped me to keep going when I really felt like giving up completely. I love Tigger's refrain 'The wonderful thing about Tiggers is Tiggers are wonderful things, their tops are made out of rubber, their bottoms are made out of spring!'. For me, the rubbery, springy part has been my ability to bounce back - both emotionally and physically.

The problem with Tiggers (T-I-doubleG-er)is that we bounce into rooms and situations without really 'reading' the people involved and sometimes there can be a backlash. I have a Tigger dog too. Recently, she was involved in a couple of incidents when she became aggressive towards other dogs - or so I thought. I continued to observe her interaction with other dogs both known and strangers. With her best friend, Farai, a black lab, there are few problems - except when Farai has something that Smilla wants. I will admit this could be my fault, she suffers from only child syndrome and she is spoilt. When it comes to stranger dogs though, she has always got on well with all sorts. She is not an aggressive dog, although I have often heard people remark about the 'Snow Wolf' approaching - she is more likely to lick you to death than anything. So, these incidents when she became angry at other dogs baffled me.

Then I came across an interesting article by an american writer on dog behaviour. It spoke about 'Impolite Dogs'. These are dogs who bounce into another dog, or group of dogs and immediately launch into (often boisterous) play. No butt sniffing or nose touching to introduce herself. With relief I recognised my Tigger like dog in this description. When an impolite dog bounces into a situation without reading the other dogs' signals she/he is likely to be met by defensive and aggressive reactions. This did explain her out of character reactions. Now I have to take control and help her to introduce herself to a new dog or group of dogs. I also check out with other owners if their dogs can cope with a Tigger-like playdate!

Once again, my dog has taught me about my own mistakes in social situations. Another parting piece of advice from my DBT Therapist was to learn to read rooms before I launch myself into social situations. I am still learning the skills of reading my own and others' emotional responses. I have been known to be able to change the temperature in a room. For either good or ill. Most times I have been oblivious to this 'power'. What I have noticed is that I may be perceived as an 'impolite human'. I don't stop to 'sniff butts' (so to speak) and take stock of where others are. Back to the awful moment at school, aged fourteen, when a friend and her whole family had been killed in a car accident at the weekend. It had been all over the local news. On Monday morning, I bounced into the normally buzzing lockers, looked around at my obviously distressed friends and said 'You all look as if someone has died!'. Ouch, I felt bad about that for ages. But it demonstrates my tendency to leap in where angels fear to tread.

Of course there is always a flipside to being Tigger. Tiggers can lift a mood, when they are up to it and when it is needed and appropriate. Again, though I still need to be aware of the mood and therefore the likely response of my 'audience'. Sometimes I have used this ability in running groups or in teaching to bring a group along with me and encourage some participation. On a personal level, I need to be self protective in when I choose to bounce in and enthuse. When I don't have the protection of a professional role to maintain, I am likely to expose myself to very negative responses, if I am not careful to become aware of the signals of others in a group. I realise this tendency of mine to launch myself into group situations without first assessing the emotional temperature, has resulted in very painful moments, when groups as a whole, or individuals have rejected the Tigger in me. When you are feeling down or shy, or uncertain, then a Tigger can be annoying at best and unbearable at worst. I need to be able to control my inner Tigger not only for my own sake, but for the sake of others.

The irony is that I am emotionally sensitive and so can recognise what is going on around me emotionally, but I need to give myself time to weigh up before bouncing in.

A plea then, to bear with me when my inner Tigger bounces into your presence. I will always feel bad if I have misread the situation, just tell me to come off the ceiling. I am good at receiving advice and will always consider it carefully - as well as being a Tigger I am also a bit of a Pooh (so to speak) for 'I am a bear of very little brain, and long words bother me.'

Caught between Two Minds - the problem of 'Apparent Competence'

'Treating someone with borderline personality disorder can be one of the toughest challenges a [social worker] encounters. Life for such a client is like trying to drive a car that is constantly careening out of control. Emotional vulnerability, fear of abandonment, and a seemingly invalid environment push the car from one side of the road to the other. The tiniest stressors can force the car into a ditch.'

Quote from: Dialectical Behavior Therapy — Treating Borderline Personality Disorder
By Christina Olenchek
Social Work Today
Vol. 8 No. 6 P. 22

I have found myself grappling with some old familiar 'friends' (or rather enemies) this week. If I may borrow from the quote above, anyone observing the ‘car’ of my life would have seen significant progress. Success in life, even. I had achieved academically, I was a champion swimmer, I had managed to hold down highly responsible and well paid jobs, for significant periods of time. However, look closer at the ‘driver’ and any casual observer could see the panic as I struggled to keep my ‘car’ from careering from one side of the road to the other. My life had developed into a pattern of emotional collapse, which resulted in my resigning jobs, selling houses and usually prompted the dissolution of all relationships.

As I learned more about BPD and particularly the research and therapy of Marsha Linehan, who developed Dialectical Behaviour Therapy, I came across a phenomenon known as ‘apparent competence’. This relates to the ‘Swan Effect’ where on the surface I was not obviously struggling with life, but underneath I was frantically trying to keep myself going, paddling wildly against the waves of emotional distress which threatened to drag me under.

Paradoxically, whilst constructing a mask of competence and coping with excessive levels of stress and responsibility, I would vilify those closest to me along with medical professionals for not seeing my real needs. Effectively, I would blame everyone around me for not being mind readers. This is one of the greatest challenges to professionals trying to help those with BPD who display apparent competence. I will not openly tell you about my emotional distress, but I will hold you accountable for not seeing 'through' my mask of competence and I will make you 'suffer' as a consequence. My outward co-operation as a service user was tempered by a harsh assessment of those seeking to help me, particularly if I felt they couldn't see through my outward competence. If anyone failed to ask the 'right' question, or misread my mood on any given day, then progress for that day would be painful if not halted. Of course this is another example of my own self defeating behaviour prior to DBT. A practitioner is not responsible for the management of my BPD, I am. If I frustrate the learning of those skills which will help me manage my emotions, then I am going to end up frustrating myself. I managed to reflect on this when I was hard on DBT facilitators a couple of times and was helped by my one to one therapist to recognise when I was in danger of preventing myself from moving forward. It was a hard learning curve, but absolutely necessary for me to learn to manage my BPD.

The other issue is that there are times when I really can cope, when I do possess the skills to manage - to undermine that competence by putting me in an environment which patronises me is to undermine my sense of self validation. So, for me, my treatment plans have all stated clearly that inpatient treatment is detrimental to my progress, no matter how desperate I may be at times, admission to hospital at this stage of my life would be retrograde, except in the most risky of circumstances.

The problem comes for me when I do need help. I have had to learn how to ask for it effectively. This has been one of the most challenging DBT skill sets for me to learn. Interpersonal Effectiveness includes the ability to break down my mask of apparent competence so that I can be honest with those around me about the times when I know I am BEGINNING to struggle. If I wait until the point where it becomes painful for me to keep going, then I am likely to swing to the other end of the dialectic and expect the rest of the world to sort me out.

In the past week I have found myself swinging back to this see saw, despite having real encouragements in my voluntary work. When I consider the past six months with my 'wise mind' I can see that I have achieved a lot and it is real competence, not just apparent competence, because I have found myself enjoying the moments of success, without short circuiting them, or trying to negate them by self-defeating statements or actions.

However in the past couple of weeks in my role as Mental Health Volunteer, I have had meetings with other service users who are also going through recovery and discharge processes. I have found myself asking 'Why don't I get that level of support?' 'Does my experience not rate in being acceptable to professionals looking for 'lived experience?' 'Why do I have to forge my own path?' 'Can't they see that I need support and help too?' Maybe these thoughts are familiar to you. A friend who was discharged before me reminded me that, 'aren't we lucky that we don't need ongoing support workers? And isn't it great that it's been over two years since you were last near an A&E or phoned the crisis team?' And, in the cold light of day, of course it is. My life is good, I have managed to devise and write a Mental Health well being, course that has been running for nearly a year. It has helped people with a range of mental health problems, as well as some who are family or friends caring for them. I have a strong network of friends and support that has no links with Mental Health services. My therapy group, however supportive, was not and is not my main social group.

For many who are coming to the end of their contact with services, due to much of the stigma around mental health and, perhaps, the intensive nature of the treatment offered, the skills and time needed to build up support and social networks outside of services has not been possible. A number of people who came through services with me, felt really bereft when contemplating discharge, because of this. I am grateful that from day one of DBT I was prepared for the day the therapy would end, that the main goal of my treatment was to prepare me for a life without professional help.

That is what I need to remind myself of, when the 'apparent competence martyr' rears her head. If I need support and emotional validation I need to either find it in reminding myself of how far I've come, or seek the reassurance of those who I am accepting care for me and love me as I am. I love the fact that many of my friends are straight talkers, they have earned the right with me to challenge my faulty thinking in much the same way that my group facilitators and therapist did when learning DBT skills.

Instead of feeling invalidated because I am meeting other BPD sufferers who have support workers and are being offered ongoing treatment and counselling, I should really reflect on the fact that I have come a long way. I do have competence in the skills that are keeping me on an even keel. I would be frustrated by having to refer to someone else, or go through a team for approval of my plans. I am trusted to manage myself in my role, with some management support. It is validating to be trusted to develop my own ideas and resources. The skills I have built up over many years in a number of arenas are now helping me to move from unemployment to voluntary work and hopefully on to paid employment. Essentially, I was ready for discharge, I have not looked back since I finished the skills acquisition of DBT and I am actively building 'mastery'. It is still an ongoing battle with the voices from the past who tell me I am unworthy, but slowly I am able to validate myself and know that my competence has moved from 'apparent' to real.

Why Not Me?

Yesterday I was discharged from Mental Health Services after four years. Unlike many people I read about on here my discharge was well managed and took account of some moments a few months ago when it was not appropriate to end the relationship. So it was a positive ending of a relationship with my Care Co-ordinator. I was able to express my gratitude to her and she in turn reinforced the positives in my progress. My week began with a visit to a Breast Cancer Unit following a routine screening which revealed some suspect lumps. In one way I had to laugh - timing was perfect - one week bookended with physical and mental health issues - I'm nothing if not equal opportunities with regard to illness!

In the past the uncertainty caused would have resulted in a whirlwind of thoughts and emotions centred on my (imagined) ability to mind read, predict and anticipate the future. At some points I found myself 'reading into' the kindness and professionalism of the clinic staff as confirmation of the worst news possible. I certainly felt the shock of the speed of appointments offered - not to mention the fact that within the space of two hours the clinic had: confirmed the presence of five tiny lumps, the fact that they couldn't tell from the range of tests whether they were benign, and then to have them removed, a dressing applied and instructions given about care for the small wound and details of the appointment to receive the results of the biopsy taken. However, I found myself using my mindfulness skills to keep me focused on what I knew, which was exactly what I had been told by the consultant, and what my senses could tell me was happening around me.

In the past I would have collapsed under the weight of the uncertainty, whilst being swamped with the pain of every trauma I had lived through in my life - quite an emotional burden, I'm sure you'll agree. I would also have been plagued by the constant thoughts centred around 'Why Me?'. Such an event would have confirmed my life role as 'victim'.

This week, though, something had changed - the pain of the past is where it belongs - in the past. I really don't need to be carrying all of that as I deal with life as it is in the here and now. After all as the Bible says 'Today has enough trouble of its own.' (Jesus on the Sermon on the Mount). The other thing that has changed is that I have learned that I am not some toxic person who attracts trauma. Unfortunately, the term Borderline Personality Disorder does seem to confirm this thought, but just because that's the label they've chosen doesn't mean that it has to be a prediction of who I am or who I can become. I may have been a victim of circumstances, or other people in the past, but right now I am not a victim anymore. I am a human being who is experiencing the sort of difficulties that any other human can face. My thought has changed to 'Why not me?' In a week when children and whole families have been indiscriminately murdered in the Middle East and Ukraine, why not me, why should I escape the pain (both emotional and physical) of life in this world?

Pain and suffering is not something I have sought out. The trauma I have experienced throughout my life, has been survivable. The burden of guilt from the abuse perpetrated by others is where it belongs - with them. If they have any conscience about their actions, then it is only right that they bear the emotional burden of their own guilt - not me. Again, I continue the journey away from feeling guilty for the actions of others towards me. The pain and the emotional scars that were left have FELT as if they would kill me, but they didn't and they haven't. I have grown stronger through the life experiences I have gone through and today, along with all survivors, I am one strong 'Mama'.

My current health concerns have a physical pain associated with them - I have managed to cope with needles going into a sensitive part of my body. I know there are many who suffer unending physical pain, so why would I complain about something that has hurt only for a time? And yet I need to acknowledge that this is my pain, I have a right to feel it. My ability to cope with it is different from everyone else. I do not know what the limits of my coping are until I reach them.

With my mental health issues, though my biggest battle will always be with my emotional impulses and the circular thinking that has fed them in the past. I am learning through this experience that the DBT skills that have helped me to manage my emotional issues are helping me cope with the physical discomforts of my current experiences.

How Time Heals - a meditation from Henri Nouwen

I read one of these meditations from Henri Nouwen every day. It is one week to go until my final discharge. So today's meditation I found very apt. Sometimes glib cliches have become glib over time and due to over use. Because my diagnosis only came in my forties I have had a long time without help to manage my condition, not always in the best ways for me. That means that I need to grasp hold of the truth that I need time to let the new skills I have developed through therapy to help me manage my BPD need time to bed in. When there has been a lot of pain and distress in the past, I also need to acknowledge that time passed does not mean those things suddenly cease to hurt. I found these words from Henri Nouwen say it so much better than me:

"How Time Heals

"Time heals," people often say. This is not true when it means that we will eventually forget the wounds inflicted on us and be able to live on as if nothing happened. That is not really healing; it is simply ignoring reality.... "Time heals" implies not passively waiting but actively working with our pain and trusting in the possibility of forgiveness and reconciliation."

I would add that due to the nature of so many past hurts there is only a 'possibility' of forgiveness and reconciliation. Sometimes we need to radically accept that those who have hurt us cannot accept our forgiveness, nor is it possible to reconcile the relationships, simply because usually those relationships were dysfunctional and destructive, and therefore can never, nor should they be, restored.

The Pain of the Unfrozen Heart

TRIGGER WARNING: IN THIS BLOG I DISCUSS VERY PERSONALLY THE IMPACT OF DISSOCIATION AND OTHER WAYS OF MANAGING SEXUAL ASSAULT - MAY TRIGGER SOME, BE CAREFUL WITH YOUR OWN HEARTS.

Franz Kafka once said 'Literature is the axe which shatters the ice around the heart.' Colourful, but I'm not sure he got it right. I think it would be more accurate to say 'Time and therapy are the axes that shatter the ice around the frozen heart.' This has become painfully clear to me as I make progress through the recovery process.

I can tell you almost to the moment, when my heart finally was broken, nearly fifteen years ago now. I was exhausted from all the pain and distress, from the constant battling of emotions I had no control over, from the pain of broken relationships, feared and realised rejection after rejection and the constant internal commentary which was boosted by those experiences and feelings, confirming to me that I was worthless and unloved and unlovable. I didn't think of myself as resilient up to that point, but looking back I realise that I had crashed and burned so many times, that it was almost an automatic response for me to move to a new area, and begin again - new home, new job and, most drainingly, new relationships and friendships. In the moment my heart froze I suddenly felt all the accumulated effort and pain as a burden I could no longer sustain. In that moment, my mind decided that I needed to stop feeling, rather than constantly keep feeling the pain of my life so keenly.

It has been easier in some ways. I was, once again, the victim of sexual assault, but instead of being capable of reacting in any way that any onlookers would deem 'appropriate', I walked out of the situation and continued as if nothing had happened. Why not? It was just another example of how worthless I was, a confirmation, from a stranger this time, that the abuse I had suffered at the hands of those close to me, was indeed down to me - after all I was the common factor in it all.

There are those, particularly in the media, who tell us how victims SHOULD behave. How would they know? If you have never had your spirit broken, been convinced that there is no one out there to hear your screams or cries for help, how could you know what it is like? Being a victim of sexual assault once, makes you more vulnerable to such abuse in the future, (although it is not always inevitable). That seems to be so hard for many people to understand, I mean isn't it a case of once bitten? Let me ask you, if you have constantly been told that what is happening to you is as a result of you and your behaviour. If you are told that something about you meant you 'deserved' it. If one of the voices telling you these things is your own thoughts. If you have become accustomed to abuse as an expression of 'love' and been told that you are 'special' because of it. Is it any wonder that as an adult when you encounter the same behaviour towards you, you don't fight back, you don't 'just walk away'. Survival means that often survivors divorce what is happening to them from their conscious experience. I was passive - a victim - because this was the way I had managed to survive numerous abuses from my childhood onwards.

Having, stopped, short, never to feel again, my heart was incapable of feeling anything, either good or bad. Now, having begun the process of healing I am learning to recognise the tingles and pangs of the ice cracking. Sometimes, it's ok, I realise I can survive feeling again, but at other times even the good feelings are problematic. The other day I mentioned that I was worried I was being 'hyper' to a friend who is familiar with my cycles of mood - 'No,' she said, 'That's happiness'. My immediate impulse was to panic, in case I couldn't handle it, but I sat with it for a moment and realised it didn't have to spiral till my behaviour was out of control, prior to the inevitable crash to the emotional floor. Instead, I allowed the feeling of contentment and enjoyment of the afternoon to run its course and it was ok, in the end I enjoyed the whole day.

I'm off on a break for a week soon. As I contemplate dropping my dog off at the kennels I have encountered a pain from separation anxiety of sorts. Last night, I shed tears. Initially, again my immediate response was panic, what if this is the start of a depressive episode? Then, I allowed myself to sit with the feeling. I tried to use wise mind. After all, we spend every day with one another and she is good company. It's ok to miss her.

The fact this relationship with my dog is having such an impact on me emtionally worries me. I realise that this is part of my natural fear of fondness or love. My dog has been a big part of helping me to heal. I can tell her 'I love you' and I feel that is natural. It is a huge step for me to transfer that ability to humans. As a survivor of abuse the emotion that I am most confused about is 'love'. It is a huge task to separate the sexual from this emotion and to be able to recognise the different nuances of love that are part of the full range of human relationships. For me there is a yearning just to be held, by someone safe, without it leading anywhere. So many times, people touched in ways that were damaging without asking permission, or without a bond of trust to enable me to feel that I had any say over what would happen next. It scares me that my unfrozen heart could respond to another human being and it not lead to an abusive relationship. I wouldn't know how to handle it.

The other reason I fear my love for my dog is that, along with the love emotion, I have always, before my heart froze, feared the ending of any relationship. I have always anticipated the loss long before it arrived. When I realised how fond I was becoming of my dog, I started to fear how I would cope when she dies. This is the benefit of not connecting with any other creature, death doesn't have to hurt so much. Except that's so not the way it works, is it? Even if I don't acknowledge it, I am connected to others around me and losing them even temporarily will be FELT by me, that's part of being human.

In the past, often, rather than wait and see, or trust the relationship I would behave in a way which would hasten the ending I feared so much. That way I believed the pain was somewhat controlled by me. I believed that it was just me fulfilling what I always 'knew' would happen.

In the here and now I am learning new ways to be in relationships. Rather than impulsively rushing in where angels fear to tread, I am learning to be 'careful' with my heart - it is after all heavily scarred and rather fragile. I have managed to focus on friendship at the moment - anything more intimate is beyond me right now. I noticed the other day that there is a lot of change in a number of friendships. This has meant changes in routines - a friend who may have been available to go for lunch is no longer available. Forgetting this the other day, I phoned her at work. We had a quick conversation and I put the phone down. My old familiar panic feelings, followed by shame and then embarrassment flooded over me. In the past that would have meant me backlashing by cutting myself off from her and self harming for being so stupid. Instead, I spoke to myself (out loud) and used wise mind to query if the interaction really meant an end to the friendship. I also used a mindfulness breathing exercise to calm myself and focus on the positives of the friendship, which include a face value honesty that I have always appreciated. When she phoned later in the day, I picked up the phone and we agreed to meet as normal later in the week. For those not familiar with BPD this may seem something very small, but not making this exchange an all or nothing matter, and thereby saving the friendship is a massive step forward for me.

I guess that the pain I am feeling now is not unlike when you are in the process of trying to warm your hands after a good game of snowballing. You know you need the blood to flow again for your hands to function, but you also know that as the blood does so you will feel a world of pain - for a time. As the emotional blood flows back into my heart - I know that it is painful at the moment and will continue to be so, as I risk my heart with others. That pain will remain for a time, but one day my heart will be able to function as it was designed to, maybe with one or two little twinges from the scars it bears, but it will be fully, finally, unfrozen.

Not all Memories are to be Feared

I used to fear remembering my childhood. There was too much pain. One thing I have learned in managing the symptoms of BPD is that even in one hour of time, there are different shades of light and dark that make up my experience. As I have developed skills to enable me to cope with distress and painful emotions I have tried to 'redeem' the good things from my past. I started with music. I love music too much to allow the bad things that have happened to me, stop me from listening to music that can bring me real enjoyment in the here and now. Things like places to visit, films, music don't have to attach to negative memories.

I have a tendency to ruminate and I used to 'wallow' by listening to what I call 'slit your wrist' music - but as I have started to recover I realise that feeling wasn't within the music or the experience I am remembering - it was coming from me. Different visual and musical arts express the range of emotions, that's what draws me to them. It's great to find outlets for my overflowing emotions. Or should I say, it's great to find 'safe' outlets for my overflowing emotions. That is what has been so liberating about redeeming expressive things like photos, paintings and music.

Recently, I have started to move on to redeeming my memories of favourite places. And there have been many. I come from a beautiful island - Ireland. There is so much to see and we did get out and about as kids. Today is a Bank Holiday and it is sunny the kind of day we would get in the car and drive (not far - nowhere is far in Ireland) down to the coast or into the country to visit amazing places. I love history and history was all around me growing up. For so long the enjoyment and escape I enjoyed in visiting these places was lost as I was overwhelmed by painful things from growing up. It is so vital to reclaim those things that actually fed me emotionally and kept me going, even when I didn't realise it at the time. I wanted to share two particular places that have been so special to me.



This is Portavogie Harbour. We would end days out sometimes here where we would buy 'potted herring' take them home and have them for tea. The fish here was always snap fresh.



Mount Stewart is my favourite historic place to visit. We had school trips and day trips as family to this wonderful house with amazing grounds. It is on the shore of Strangford Lough as well. Strangford is famous for having 365 islands and being a unique area of natural beauty because it is a sea inlet.

In places like this I could escape and enjoy imagining life in different worlds from my own. They provided a sense of safety for me that helped me to survive. In addition, they helped to feed my creativity - something which has stayed with me into my adulthood.

Meet George - My Shaggy DBT Coach

During the past week I met some animals who helped me remember how to use 'opposite emotion', 'Distraction' and 'self soothe' skills. They also reminded me of the key principles of mindfulness: notice, describe, participate, non-judgemental, one mindful, in the present moment.

George, is the runt of his litter of ten pups, he is a true 'shaggy dog', but when I met him during a difficult week at home with the family he greeted me with unadulterated delight and affection. Somehow, he managed to help me feel accepted and validated. And yet he's considered to be a not very bright dog.

George doesn't care what anyone thinks of him. He launches himself with enthusiasm and overwhelming fondness, at all visitors to my uncle's farm and most people consider him a nuisance. I loved him at first sight. He was a bundle of unconditional acceptance and affection, just when I needed it most.

We became immediate friends and he followed me all over the farm yard, even pressing himself between me and the miniature horses as I petted them behind their gate. He helped me manage my emotions and reminded me of the importance of not missing out on the simple joys in the present moment, which I often miss when flooded by pain from the past or anxiety about the future. If I could have managed it, I would have smuggled him back home with me, so that he could join my own shaggy mindfulness coach, Smilla. I will remember the lessons he taught me and I will remember him with affection.






And his friends the miniature horses:

Return to the Forbidding Planet: Going back to the Invalidating Home

TRIGGER WARNING: Some discussion of childhood sexual, emotional and physical abuse

I am an adult child - my parents are elderly and infirm. As a family we face the same issues as all adult children with elderly parents, but for me I also face battles with caring for the people who created the environment which conspired with my biological disposition to create the Borderline Personality Disorder (BPD) I have struggled with all my life. To all intents and purposes I am a fully fledged adult with my own home and responsibilities. I no longer have to maintain relationships which damage me emotionally,

I am now in a position where I can choose where to invest my resources, both physical and emotional. Which begs the question, why go on holiday with the people who continue to invalidate my value as a human being? And in the response to that question lies the paradox at the heart of the relationship between the adult child and invalidating parents.

I have survived a week with my family. Before I started the week, I felt safe doing so, after all I had more than survived my childhood. I have learned to accept that the approval I have always sought from my parents will never be forthcoming. There is no point in me waiting for some miraculous change or realisation in them. After all, no amount of success or achievement in my life ever evoked any level of validation, or at least none that I could assimilate. Instead, the medals I won in my swimming competitions were dumped by me in one of my drawers at home. Even my winning the Ulster Championships and appearing on the back page of the newspaper failed to evoke any level of praise or approval that I could detect as a child. There was no showing them with pride to friends and family, no display cases full of our achievements as children. To all intents and purposes myself and my siblings were a separate entity from my parents, little people who lived under their roof, and who required 'firm discipline'.

Our emotional needs didn't enter into their reckoning of the parental 'contract', after all, we were fed, we were clothed and we had a roof over our heads. The only emotional contact I had with my Dad growing up was when he was angry. And when he was angry he was out of control. The level of physical abuse we suffered would result in our being subject to 'safeguarding procedures' today. However, my parents were good at sidestepping any outside scrutiny of our treatment - for me, it was all I knew. On one occasion, aged 6, I walked to school with a huge red hand mark visible on my bare leg. I thought I had done wrong when the teacher asked me to wait in the cloakroom. I waited until I was taken to the Headmaster's office to find my Mum waiting for me with a face like thunder. I don't remember the conversation with the Head, but I do know I was 'walked' home where I was beaten with the wooden spoon. I had no idea what I had done wrong, I hadn't said a word to my teacher, I didn't know that anything was amiss. As a family we have laughed since about the fact that Mum beat me so hard one time that she broke the wooden spoon on my legs. Then, she replaced it with a Tupperware spoon, which I attested was stronger - oh how we laughed about that one! No wonder that my BPD means that I am confused about appropriate emotional responses in numerous situations.

The conundrum for me as an adult is how I have managed to understand the complexities and deficits in my upbringing, but still I crave the approval of my parents. At times in the past week, my brother and I reverted to competing for our parents' attention. It hurt that no one asked about my recent health issues, or about the exciting opportunities offered to me in church to help use my experiences to help others. I was once again relegated to my familiar role of observer and silent child in the family.

In my first two years at school I was already so traumatised by my home life, that I was effectively mute around all adults including my parents. My friend spoke for me for the first year at school, until they removed me from the same class as him. I was traumatised and ended up lashing out at the teacher - I was the five year who kicked the teacher - hard, in the shins.... no Daily Mail shock headlines in those days, though, just ongoing punishment for the reported infringement at home.

When I finished my DBT therapy, my Therapist reminded me that I had begun the process of healing from the 3rd degree emotional burns, which are at the heart of the BPD experience of life. I have probably managed to develop a thin layer of emotional skin over deep, deep wounds. If I needed a reminder of that truth, then time back in the invalidating environment soon reminded me as my thin protective layer was ripped through once again. Little things, like talking over me, ignoring what I'm saying, ridiculing my weight, reminding me that I am indeed 'a nutter', 'weird', often pre-empted by me in an attempt to take the sting out of the teasing, took me right back to my childhood.

I was always the 'highly strung' one, the one who cried at the pain or suffering of small animals, who cried at the Little House on the Prairie. My family enjoyed laughing at me for my 'softness', but the truth was those occasions were the safe places to release my sorrow over the emotional pain I was struggling with at the time. All my life I've been told that I'm making mountains out of molehills, that I'm overreacting, that my emotional responses don't bear any relation to reality. Is it any wonder that, as an adult I have struggled to recognise what I'm feeling in any given situation, or that my reactions are out of proportion to the triggers, especially to the onlooker.

One of the biggest legacies of the invalidating environment is a lack of confidence in my own reading of situations. Aged 10 I told my Mum that my music teacher had been touching me in places on my body which made me feel uncomfortable. Her response was to tell me that this was a 'sign' that I was growing up and that I should expect men to be interested in me in this way as I 'developed'. My problem was I was an 'early starter' I had my first bra and period by the age of 11 (before I left Primary School). My Mum's response to my first attempt to speak up about something that felt so wrong (it wasn't my first experience of sexual abuse) convinced me that my feelings about what he was doing were mistaken. She told me that I was 'growing up' and that I should expect men to become interested in me in that way. She hinted that it was flattering. This caused me to doubt my own misgivings and feelings of discomfort about sexually abusive behaviour.

My Mum's response laid the foundations for me to ignore my misgivings and led to me suffering more serious sexual assaults and violations from that age, right into my adulthood. After all, I had told an adult about something that felt really wrong only to be told that, I needed to 'grow up' and accept it as something that just happens and is some kind of rite of passage. Why would I, as an adult, trust my own feelings of distress and pain when I had been so wrong in the past? Such is the ongoing conflict for me between what I know as an adult and survivor and what I 'feel' I deserve in terms of justice. I have moved on, I have learned to begin to protect myself and to fight back.

May I make a plea on behalf of any of your friends or family who suffer from the effects of BPD? Please never tell them that they are 'overreacting', or that they need to 'just let the past go'. If it was that easy for me to manage the overwhelming emotional responses I am swamped with at times, then I wouldn't have needed 18 months of intensive therapy. I wouldn't have had to learn to manage them and to learn to live in the present moment, without letting the pain of the past or the anxiety about the future drown me in waves of distress. Imagine if you will that you have a severe burn. How long before such a wound stops being sensitive? My own experience of minor burns tells me that even when new layers of skin have grown, sensitivity to pain remains a long time. 3rd degree burns, will always remain sensitive. So it is with me. I am learning to allow myself to heal, to let new layers of emotional skin grow. My new life is one which is helping me to heal. However, the reality is that a return to the invalidating environments and their complex relationships, rips through new growth and healing.

Therapy means that I am equipped to manage my distress better, it does not mean that I stop feeling things deeply. During my time with my family I used a variety of different DBT skills:

- Distraction - my ipod equipped with positive playlists and some Loving Kindness meditations. I played with animals. I kept to my room when I needed to restore my emotional energy.
- I prayed
- Self Validation - I texted supportive friends, I listened to positive Mindfulness exercises
- Opposite Emotion/Opposite Action - Instead of getting embroiled in family rows. I focused on my environment, read an absorbing book, or watched other people in the hotel. I didn't explode, which is easier to do in my family environment than in other settings.
- Mindful Breathing - I constantly refocused on my breathing and posture when starting to feel distressed.

Above all, I returned home to my world, where I am in control of my environment. I am able to manage my time and space. I am able to choose the relationships that are positive and validating for me. The realities of family life, dictate that as I have chosen not to confront my parents with the impact of their behaviour during my childhood, I then have a duty to relate to them as an adult child. I choose to treat them according to my values and beliefs, not according to how they dealt with me. That means I will continue to face times when I need to return to the invalidating planet of home. More and more they are becoming dependent on me and my siblings. My own sense of compassion and humanity tells me that it matters that I care for their needs, as I am able. I have learned in the last week that I can survive that. I have learned that I don't have to remain hurt and locked away because of those experiences. I have learned that I am able to manage my BPD and allow my wounds to heal. One brilliant realisation is that my resilience against my family has developed - I am able to recover from my visits home quicker.

My DBT 'Let that Emotion Out' Playlist

Sometimes I don't want my self soothe to be an opposite emotion - sometimes I'm right to feel angry or frustrated - it is after all only a human response to some things in life. Not all these songs are obvious choices, but for me, sometimes the real power is in the lyrics and the expression of thoughts, particularly about injustices in life. Some you will naturally already guess at, just cos they let you bounce around the room and shout your feelings out - safely!

1. It's my Life - Talk Talk (beautiful expression of becoming an individual - No Doubt also did a brilliant cover).
2. Caught out There - Kelis (!)
3. My Life - Billy Joel
4. The Frog Princess - The Divine Comedy (best ever break up revenge song so clever and funny! - don't miss the guillotine)
5. I know where I've been - Hairspray soundtrack (This is righteous anger well articulated - great build up to crescendo)
6. Just a Girl - No Doubt
7. Not Ready to Make Nice - Dixie Chicks (for when you encounter assumptions and prejudices!)
8. Gives you Hell - All American Rejects (Just angry)
9. He had it coming - Chicago soundtrack
10.Road Rage - Catatonia

I guess this falls into Emotion Regulation rather than Distress Tolerance as it is a way of accepting emotions such as anger, but equally being able to express it safely is part of managing distress. Listen and move to the music until the crest of the wave of emotion has died down - it should be easier to manage and 'sit with' afterwards. HINT: Don't focus on the cause of your anger as you listen, try to focus on letting the song express your anger or frustration and let it go at the end.

Learning to Manage the Calm

I have found myself in a strange place recently. More often than not, my life has taken on the tone of routine, almost humdrum and certainly lacking in anything approaching crisis mode. Suddenly the corkscrew roller-coaster that has been my emotional life since childhood has untwisted. I no longer start my day with a spasm of gagging and/or vomiting due to overwhelming feelings of panic and anxiety. The dramatic swing of moods from one hour to the next has slowed down and I find myself better able to recognise and manage both the up and the downswing of moods to which I was once a martyr.

So far, so good. Over two years of DBT skill building and therapy have brought me to a point where I am no longer confused by the overwhelming clouds of emotion that used to swamp and overwhelm me. I find myself better able to reflect on difficult emotions, I no longer run from them, but accept them as evidence of my humanity in the face of significant trauma throughout my life. I still have moments, usually when I have tired of my new structured life. I have caught myself being tempted to familiar path of self destruction, perhaps in a different way than in the past, but nonetheless, I have found myself short circuiting good things in my life.

I know that now, rather than being plagued by capricious emotional storms completely outside of my control, I can learn to recognise the signs earlier. The storms still come, but I am better equipped to survive them.

Except, that I sometimes petulantly, deliberately choose to ignore my emotion regulation skills. In my last 1:1 DBT therapy session the admission that I am regularly staying up through the night, brought an almost exasperated response from my therapist - I mean she's right, just 'what am I playing at?' It's bothered me as I reaped the whirlwind this week and found myself tossed about on the kind of emotional storm I haven't really experienced for at least a good few months. I've realised I haven't been practising my skills when things are good, so that they are second nature when I really need them. I didn't need to go through the exhausting emotional maelstrom and the exhausted aftermath, (still feeling it three days later). Or at any rate, I could have used my new skills to limit the damage from my negative emotions quicker.

Instead, I revisited some familiar old feelings and reassured myself that I could indeed consider myself a total failure, as my internal monologue has convinced me of since my childhood. So, what does this tell me? It tells me that we are indeed products of our past. It tells me that when we have had the mirror of our minds distorted by our childhoods of invalidation then it is all but impossible to recognise a fair reflection of ourselves in it. It tells me that I am not finished healing and recovering from my BPD symptoms. Just because the untwisted mirror image of my 'good life' seems shocking to my invalidated mind, does not mean that I cannot become accustomed to it.


There is something else that this has taught me about certain emotions. Having spent so long learning to manage and 'sit with' negative emotions, I am having to learn to use the same skills to manage positive emotions. One of the reasons for my disturbed sleep has been a propensity to allow the lightness of emotion lead to 'hyper' behaviour, the energetic surges from feeling 'happy' have resulted in really productive moments, but I have not controlled these moments and channelled them, but allowed myself to be carried away into the wee small hours of the morning.

As a result it's back to the basics of distress tolerance and emotion regulation for me. Looking after myself and my lifestyle in order to provide a stable foundation to keep going on a day to day basis. In a sense I am fighting the same enemy, but at a different end of the spectrum. Positive emotions are equally difficult for me to manage, mainly because I find them uncomfortable as they are a dissonant voice challenging my self critical inner monologues. As much as I need to use my Mindfulness skills to 'sit with' my grief and sadness, I need them to 'sit with' and become comfortable with feeling good about myself and what I can achieve in life.

In a sense I am fighting a battle that is familiar to me. I am using my skills to keep me and my emotions in the here and now. Where my negative emotions tethered me to the past, my positive emotions risk catapulting me into anxiety and the future. So, when I started to feel nauseous and was throwing up at the end of last week, I maybe could have been more aware that all was not well.

What is most encouraging for me is that I am no longer unable to articulate an amorphous emotional cloud, but I am naming the emotions and how they are affecting me at the moment. I know what I have to do to regain my equilibrium, it will take more time and effort on my part. I have the skills I need I just need to use them. I don't need to beat myself up for this latest storm. As Scarlett O'Hara memorably said 'After all, tomorrow is another day.'

Taking off the Training Wheels

I've never liked endings. That's because I've always been very bad at them. In the past, due to the 'push-me, pull-you' emotions of BPD I'd never managed to maintain any relationship for longer than three years. So when my CPN and DBT Therapist are giving me actual dates for 'discharge' my natural suspicion of my ability to cope raises its ugly head. Especially as I started working with my CPN in 2010.

It's not that this is a shock. After all, from day one on DBT they prepare you for life after DBT and emphasise the fact that the therapy will end. The problem is that most of my endings in my life have been accompanied by some form of relationship, or other, trauma. To be honest, one of things I am getting used to is the lack of trauma in this ending. I mean, suddenly I am aware that I am coping better with all sorts of new experiences - stable friendships and lack of crisis in my family relationships. Or should I say, I am not allowing my emotions about these relationships to overwhelm me - one result of the DBT skills I have learned and practised over the past 18 months.

I still have anxiety about the future - will I ever be employable? When treatment ends, will I continue with my recovery? How do I cope with the realisation that some very key relationships with my CPN and Therapist are ending? I'm bound to have anxieties because I have never travelled this road before and certainly never been equipped with the tools to manage my overwhelming responses to the world before.

What I have learned is 'do not worry about tomorrow, because today has enough troubles of its own' (Matthew Chap 6 v 34 The Sermon on the Mount). Rather than racing ahead in anticipation of everything coming crashing in round my ears, as it has so many times in the past, I have learned to accept each day as it is right now. It has included ups AND downs over the past 18 months. Treatment has not changed my life into an amazingly problem or crisis free road.

Rather, I have changed, I have learned not to trust the extremes of my thoughts and feelings - the Black and White thinking symptomatic of BPD. I now check out some of my knee jerk reactions to life and have moved from the rocking to and fro of a small boat tossed about in stormy seas, to being able to wait for the storm to pass, as I have learned that both thoughts and emotions come and go. The most important thing I have learned about my feelings is that they won't kill me, no matter how intensely I feel them. I have also learned that my thoughts and feelings, alone are not reliable enough to build my life responses and choices on. As the serenity prayer says: 'Lord, grant me the serenity to accept the things I cannot change. The Courage to change the things I can and the wisdom to know the difference.' This is a summary of the DBT skills I have learned. Learning to manage BPD depends on a balance between acceptance and change. Acceptance of the things that are an essential part of my experience and character. Ability to change those things which are in my power to change in my response to my environment and relationships.

Given that it is over a year since I last self harmed, I have been managing my BPD with the skills I have learned. The training wheels came off a long time ago. My therapist has been coaching me from alongside, having pushed me off to balance on my own some time ago. The problem at the moment is that the impending end date has made me suddenly aware that I am moving forward with only myself and my new skills to keep me balanced. Wobble I may well do, but I am moving forward and, (to carry the bike riding analogy to breaking point), as long as I am moving forward I will keep my balance and I am unlikely to fall off. However, I have also learned that even if I do fall, it is not the end of the journey. I can pick myself up and continue on my way.

Don't forget your laughter muscle...

I'm a bubbly character.

For years, this was a handicap in terms of helping people understand my struggles with Mental Health. I mean, when you suffer from mental illness you're supposed to be 100% miserable all the time - right? Wrong. Just because life is a struggle doesn't mean that we lose our capacity to smile altogether - although there are periods of time when it feels as if life is drained of all colour and enjoyment. And there are moments when it FEELS as if the darkness that envelopes us will never lift. However, the reality of depression and distressing emotions is that they come and go in waves, some are more powerful and overwhelming, others are ripples on the surface of our lives.

Even at my lowest points I have found that I have never lost my wry view of the world and I have found myself laughing my way through therapy sessions focused on some of the most painful experiences of my life. It's a survival technique, one that kept me going through years when I was struggling without any diagnosis or support. Other people's perceptions of Mental Health is such that, due to my propensity to be able to laugh at myself and even the darkest of situations, most people who had contact with me at work or in other social situations would find it hard to accept that I suffered from periods of really black moods, brought on by my struggles with BPD and Clinical Depression. In fact, I lost a number of friends who thought I had taken some bizarre turn in my life when I shared my diagnosis with them. They couldn't reconcile the person they knew with their preconceptions of mental health conditions.

So, now that I'm recovering and am more on an 'even keel' emotionally, do I neglect my sense of humour because I no longer need a mask? My feeling is that my laughter muscle has always been there, it is a part of who I am, but now, rather than being part of my 'armour', it is anchored more and more in my enjoyment of life as it is. I have added it to my DBT skills and use it as opposite action - I mean really, how can I be angry (it used to be white hot and last for hours, if not days on end)when I see myself in the mirror in full flow? Laughter, releases so much tension, in so many situations (caveat: well chosen humour takes account of the needs and feelings of others). Laughing with others, too becomes opposite emotion, so my library of comedy programmes is extensive - an essential part of my 'recovery kit'.

Ultimately, I think that those of us who have seen the world through the prism of mental illness, have the ability to see the quirky and unusual in the world around us. How many comedians struggle with darker emotions? Those of us with BPD are also creative and dramatic, so we are able to see some nuances in life that others miss. When you're in the depths, don't forget your laughter muscle and if something makes you laugh, enjoy the feeling for that moment and observe how your laughter affects you physically as well as your emotions.

Sometimes Self Soothe Doesn't work...

This caught my eye on @HealingfromBPD Pinterest board. Can't help think that there are days when using my DBT skills seems harder than others.... or is that because the people/relationship I'm dealing with is being more difficult? Am realising that when I feel like smacking someone - self soothe won't cut it and maybe I need to learn more about 'surfing the urge' or 'opposite action'. Note to self: I can't control the bad behaviour of others, I can do something about my reaction to them...gosh, was that 'wise mind' in action??

Music, my own special TARDIS

I have always loved music, playing it, singing it, listening to it. Emotionally, of all my pastimes, I have found music the most evocative in terms of conjuring memory. When I was growing up I was selectively mute for many years. Music became the way that I expressed myself. It helped me to survive. I just didn’t speak to adults, I had one friend in school who spoke for me. After my first year at school, aged 5 my friend was taken from me as they put us in different classes. Due to my non communication I was labelled as ‘remedial’, requiring ‘special help’. When teachers started to ask questions about my physical and emotional welfare, my parents took me and my brother out of our local school and we then attended a private school in the city centre. In 1970s Northern Ireland, child protection was a taboo subject. During this period, from the age of seven, I discovered the joy of playing music. I would lock myself away with my piano and play for hours on end. Then in my teens, I learned to explore every nuance of my pain through other people’s music, again, locked away with my stereo/radio for hours on end. Perhaps, an extension of my choice not to engage with the world around me.

It is when I attach personal feelings and memories to my music that I believe it finds its real power. Music has the power to lift your spirits, to articulate your grief, to take you back to specific times in the past. In a sense Music, along with the sense of smell tends to be the most powerful of ‘time machines’, usually with a default to the past.

It was at this point that I found music to be a potential obstacle to my recovery. Mindfulness training and DBT exercises were focused on bringing me to and keeping me in the moment. However, one of my true pleasures in life was in danger of inadvertently causing me to ‘time travel’ to the past. I didn’t want to lose out on one of my real pleasures in life, just because of my overwhelming emotional responses to it. Not every memory is painful and it’s important to acknowledge that, even before recovery, my life was actually made up of shadows AND light.

Because of my tendency to use music as shorthand to express important emotions, it follows that when trying to build up the skills to manage my overwhelming emotions more effectively, I needed to find a way to either use it as an aid to my recovery or lose it by limiting my exposure to it.

It occurred to me that the waves of emotion evoked by music, had a tendency to recede if I focused on the music itself, rather than use the music to unpick my emotional scars. So I recognised that the way forward was to perhaps treat the emotions evoked by music in the same way that I had learned to let go of unwanted thoughts and feelings which arose during mindfulness exercises in DBT skills group.

In practice, this means that my focus is not on the emotional impact of the music on me, but is on the notes themselves, the instruments and voices listened to. When my feelings arise and are in danger of taking me into the past, I notice them, then return to my musical focus. Listening mindfully is an excellent practice, simply because music is all around us and could become a problem, with songs evoking flashbacks and unwanted feelings and thoughts in all sorts of environments. It has taken me some time to extricate my emotional memory from music and learn to enjoy it as it is in each moment. Equally, music can express emotions effectively so that it can soothe, or change emotion, or help us to ‘sit with’ painful emotions. For me the important factor is about ‘when’ I am feeling the emotions: am I ripping the plaster off painful feelings from the past, or am I experiencing sadness, grief etc. in the here and now? In which case, music becomes an aid to observe, describe and then let go.