MBT Psycho-educational Group

I have been a bit quiet again, my confidence has fallen and I have hidden myself away. Time to push myself back out there.

I saw my care co-ordinator on the 15th January and on Friday I received a letter from her. I have been placed on the waiting list for MBT (Mentalisation Based Treatment) psycho-educational group. This group will last for 12 weeks and I will not be able to have any one to one support which does worry me. But I have been without support for 7 months now.

The group will be structured following the themes of mentalising – how we can maintain or lose this capacity and how we can understand our own and others emotional responses within relationships.

As I have said I am on the waiting list but when the group starts I will detail what we are doing in the hope that I can help someone else who is thinking of undertaking this kind of therapy.

If anyone reads this who has attended something similar then I would be glad to hear from you.

My BPD

It wasn’t until I was in a long term relationship that I started to see that my behaviour may not be ‘normal’ compared to my partners, who is now my husband (we shall call him H).

In the first few years of our relationship it was very passionate but also very rocky. We went from one extreme to the other. Our arguments over the smallest of things threatened to end our relationship time and time again. I think sometimes I did want things to end, sabotaging relationships was something that I was good at.

I felt anger was an emotion to be hidden from others but when it did surface I wanted someone else to feel the pain that I was feeling. I wanted to hurt them, verbally not physically. That someone was H. I loved him one minute and the next I could feel such hatred towards him. I got angry and would start arguments over very small things. At the time I would never have admitted it was me that started the arguments. I had to press that button that would send H in to a rage. By doing this it took the responsibility of the argument from me and placed it firmly on him. I had achieved my goal at this point and could now play the role of someone who had been wronged.

It took me many years to see the patterns evolve in my behaviour. I was too afraid to admit that, when I got into an argument with H, I hated him. How could anyone understand that you could hate someone and then love them so deeply.

When I stopped and took a step back and acknowledged what I was doing during arguments with H this was the day that I took responsibility for my own actions and our arguments declined rapidly from that point.

It was several years later that I would be diagnosed with BPD, borderline personality disorder and got some help. My diagnosis was like a double edge sword. I felt relief that there was something wrong with me (maybe I was not a bad person after all) and it had been identified so that I could get help and possibly change or control this part of me. I also felt a lot of shame because I thought that others would not understand so that is why I have only told my husband about my BPD.

We still have arguments and it is me that starts them off but they do not resemble what they use to be. It wasn’t too long ago that I finally told H that when we have arguements I do hate him and I do not like feeling that way. I love him and do not want to lose him. He said he knew I felt that way as he had been online to educate himself on BPD. I felt relief that he knew.

New Year

Two days after Christmas we, that is my husband, children and myself, went to see some friends. Those friends invited us to spend New Years eve with them. That was very nice of them. The last time I was away from my own home for New Year was to see in the year 2000.

I find socialising very difficult. I guess that is due to my borderline personality disorder and also my eating disorder. I do not like being around other people and having to keep a conversation going just terrifies me. So here I was faced with an invite to spend New Year with some people that I do not really know too well and to have a meal with them as well.

My husband and I did not know how to say no and as soon as we had both agreed my thoughts turn very dark. I had that same thought that always pops into my head when faced with difficult situations. I thought that I would just take an overdose and that would be it. I would not have to deal with this awkward situation. The solution seemed easy.

Within a few hours I realised that my thinking was not rational but did not know what to do about it. I knew that I would not be able to go through with these plans for New Year. How could I sit and eat in front of other people who I have never eaten in front of before. My eating disordered head was screaming at me. How could I start or keep a conversation going because all I have to say is just not interesting. I felt that my world was falling a part.

I told my husband what was going on in my head and he said that we need to do this for the children. They must see us socialising just like any other ‘normal’ family. I kept repeating this and knew that I had to go through with things and attend this dinner party at New Year.

On Monday, New Years Eve I was not able to anything as I was so terrified. I remembered that my children got jigsaws for Christmas, so I asked if I could build one of their 1000 piece jigsaws. I spent most of the day doing that jigsaw just to take mind of what was going to happen.

So the time came to get ready and I did and I went to the dinner party. Dinner consisted of 8 courses. For someone with an eating disorder this was horrifying. But I got through it.

I did not eat all 8 courses, there was not need too really. I took plenty of breaks away from the table by using my children as an excuse. I ate slowly so that I did not have to eat as much as everyone else and I am sure no one noticed. Concentrating on the food and keep a conversation going was beyond me but my husband was able to do enough talking for both of us. A couple of times between courses as the table was cleared games were played. This gave me time to try and ground myself. I even spent five minutes in the loo just doing breathing exercises. The two years of Dialectical Behavioural Therapy (DBT) came in very handy.

However, I have not been able to look back at Monday evening and think that I handled that situation well. I look back and see the days full of darkness as I was so consumed by my depression.

I need to learn from this and keep moving forward…..

Understanding me….

BORDERLINE PERSONALITY DISORDER AND ME

I wrote the following in November 2009…..

Several months ago I was told by my therapist that I had Borderline Personality Disorder (BPD). All I knew about this condition was something that I had read in a book entitled ‘The Angry Heart’ by Joseph Santoro and Ronald Cohen. When I read this book, I was reading about myself. So when I was given my diagnosis it was not a surprise to me. In fact, at the time I felt relief. It was not until I started doing group work that this diagnosis started to trouble me.

I am acutely aware that I have problems identifying my emotions and regulating them. Text books refer to this as ‘emotion dysregulation’, which is the outcome of a combination of a biological disposition and environmental influences. In my case this is correct.

As I have trouble with my emotions this places me in situations that I can find almost impossible to tolerate. I am a very sensitive person and I understand that to others my reactions to things may seem ‘over reactions’. I also find it hard to organise myself. Something I have struggled with all my life but something I have managed, to a certain degree. I have had to otherwise I would not have graduated with a masters degree or functioned as a senior manager within the regions busiest retail outlet. All of those attempts to organise myself were always coupled with extreme stress that I was able to hide in front of others for some time.

So the oversensitivity to events and emotions are part of my biological disposition. My environmental factors are the ‘invalidating environment’ that I grew up within. As described by Santoro “Our family environment is our gift or our curse”.

I did not grow up in a very supporting environment. I was constantly worried about how my parents viewed me. Everything I did I worried about their reactions and of course how other people would view me. My parents did not hide their disappointment in me, if only I was more like my brother who was slim, bright, had nice friends and did what he was told. I tried everything I could to be accepted by my parents. I know they loved me but they did not love who I was. They could not accept that I was a large girl, even though they confused my eating from an early age. They could not accept that I had learning difficulties and just thought that I was lazy. The health problems that I had as a child were put down to me exaggerating and looking for attention so visits to the doctor were out of the question. Even when I had tonsillitis I was not allowed to see the GP for antibiotics.

As I got older I found things that I was good at, maths and music. I concentrated on those and my grades in other subjects started to improve too. But music could not make a good career, so I gave up something that I loved. I still regret that to this day. I was invited to join an orchestra and I turned it down for fear of my parents. It was not just verbal communication my parents used to discipline me; they also communicated using shoes, belts, dog chains etc.

As stated by Santoro when someone has a dysfunctional family environment this ‘creates a person whose heart is wounded by fear and anger and whose mind is often confused and impulsive. This is someone, who, because of his or her family environment, develops a personality disturbance and is at risk for addiction, failure, and even self-destruction’. The impulsivity of the borderline person is also described by Maccoby, who states that impulsive behaviours are used as emotion regulation strategies. Indeed I have impulsive behaviours which include: Self harming, Suicidal or parasuicide behaviours, Unsafe sex – (this was part of my past and not something I engage in now),Reckless driving (also a thing of the past),Excessive spending and alcohol abuse.

So to summarise as someone who suffers from BPD I have difficulties with my emotions and impulsive behaviours. But the official diagnostic criteria of the American Psychiatric Association’ Diagnostic and Statistical Manual (DSM-IV 1994) requires that five or more of the following be present before a diagnosis of BPD can be made.

1. Frantic efforts to avoid real or imagined abandonment.
2. A pattern of unstable and intense interpersonal relationships.
3. Unstable sense of self and identity.
4. Impulse behaviours.
5. Recurrent suicidal actions, threats, thoughts or self injury.
6. Unstable, intense moods or emotions.
7. Chronic feelings of emptiness, boredom or loneliness.
8. Inappropriate or intense anger.
9. Temporary, stress-triggered paranoid ideas or sever dissociative symptoms.

I have certainly scored 9 out of 9 at certain points in my life but I am working hard at reducing all of these. I believe it can be done and with the right help and support I know I can change things for the better for myself.

Written November 2009