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.

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Christmas, I am truly blessed.

Christmas is upon us once again. All I have left to do is wrap the presents and put them under the tree. I love watching my children open their presents on Christmas day. I am truly blessed.

This year I feel positive about Christmas, this has been a long time coming. Normally I feel too depressed and struggle with my eating disorder and the impulsive behaviour associated with my borderline personality disorder.

This year, I want things to be different for my children and husband. I want to be the ‘perfect’ mother and wife. But perfection is so hard to achieve.

Something has changed, I do not feel like the failure that I believed I was last Christmas and the Christmas before that etc. I have done everything with my children in mind and given myself a good kick when starting to feel sorry for myself. I have also started to accept the more ‘negative’ emotions I have and tell myself that it is ok to feel the way I do and not try to brush them under the carpet and pretend they are not there. So it is OK if I am not that ‘perfect’ a mother and wife after all.

It is OK to be me because no matter how difficult things feel at times I know they will pass and leave me and my husband and children will always be there for me. I am truly blessed.

Merry Christmas
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Today I saw my care co-ordinator

This morning I saw my care co-ordinator at the hospital. I have not seen her since January, so yes I was a bit apprehensive.  The purpose of this meeting was to have a review of the 18 psychotherapy sessions that I had with a doctor still in training.

I used these sessions to try to explore my feelings and understand the mess that is in my head. I may not have sorted out the mess in my head but I certainly let go of some things that I have been holding onto for a very long time. With only 18 sessions nothing was discussed in detail. No solutions were suggested or worked through. None of our objectives were met. Was I expecting too much? Were we too ambitious about our goals?

My care co-ordinator who I will now call ‘C’ from this point onwards and I will refer to the doctor I saw for psychotherapy ‘R’.

C  asked what I wanted to talk about. I had prepared a list of things but did not want to dive straight in to that. I wanted to know the format of the review and what could the possible outcomes of the meeting be. I was told that we would get to that later. I did manage to talk about most of the things on my list throughout the session. I am glad that I went prepared.

The first question she asked was how I felt my sessions with R went? My last session with him ended really badly, in fact I walked out. It placed a cloud over all the sessions we had together and to be honest it worries me that all therapists are like him. Deep down I know that they are not and that everyone is different.  It was just one bad experience and I need to move on from that.

I knew from the very first session with R that it would be difficult to work with him. He never introduced himself, said hello etc. The first time he saw me he stood outside the waiting room called my name and took me to a room and sat in silence. With no introduction and no guidance on what we were to be focusing on I started to worry about saying anything. Worried that anything I did say would be wrong. I need guidelines, especially in new situations.  I wanted him to introduce himself to show that he was human and approachable. Was I asking for too much?

After a few sessions I wrote R a letter to explain how uncomfortable I felt. He did say that he did not understand why introductions were needed. Heavens above, we were complete strangers, I think it would have broken the ice a bit! I felt he was an unemotional robot and felt embarrassed for writing that letter and so just told myself to forget it and get on with therapy.

I was not able to look at R from that point onwards.  I just looked at the floor throughout every session. He gave no reaction to anything I said, very rarely asked me questions.  But during one session I decided to approach a subject that has had a very detrimental affect on my life. Every day I think about  something that happened a long time ago. I told R that this was a huge and difficult ‘thing’ for me to do. It did take me almost a full session just to say a few sentences. But I was glad that I finally got it out in the open and was convinced that now I would be able to move on from this and reduce the influence this ‘thing’ had on my life. But most of all I wanted to work on finding a way to forgive myself.

At the following weeks meeting R never mentioned it. Maybe he was waiting for me to talk it. I understand that may have been the case but I told him that if I bring a new topic into our meetings and he does not ask about it then I will not mention it again. In my head I thought that because he did not ask me  about this ‘thing’ then it was not important. Not important to him but still very important to me. It made me think about the trust I had given him to tell him something so very private.

C did not know anything about this and asked if I could tell her what this big ‘thing’ was. That was not possible.  R had not included this in my notes so again that reinforced within me that he did not think it important. Am I making a mountain out of a mole hill in regards to this?

C also did not know anything about the lecture R gave me in our last session together. He upset me and kept pushing  me when I asked him to stop. I did not want our last session to end with me being upset. I wanted it to be light but R kept asking if there was anything that I wanted to revisit. No! Not on the last session but he kept going on and on and so I did get upset and cried.

In a desperate attempt to take control of the session and turn it around to something light hearted I thought I might end by asking him where he was going to work next. I only asked to wish him well. But he said that I had been inappropriate for asking such an innocent question. R was leaving to continue his training at another hospital after my last session with him. I was not really interested in where he was going to work next as he was my therapist not a friend. But he did not like this question. Why did he not just say that he did not want to answer my question instead of giving me a lecture? C did not even know that I had walked out. This was not included in his notes.

Anyway that is the past, so where do things go from here. I asked C this question and at the same time told her that I was angry with her for saying that I had to go through a period of three months without support (that turned out to be four months in the end). I did ask for this to be reduced, I did say that I was worried about how I would cope etc. I had come so close to taking another overdose. I had written my goodbye letter to my husband and written my check list of things to do. I needed her to know that the last four months had not been a bed of roses for me and that a little help would have been appreciated and that I would like more help now. I told her that her ‘not up for a review’ processes made me feel like a statistic and not a real person. She put these feelings down to my borderline personality disorder (that did irritate me to be honest).

Well I did manage to get myself through those four months. I pulled out all my old notes on DBT and took out the bits that I could use to get through.

So again, what happens next? C said she did not know and that she would have to speak to the team about things. I am not that great with DBT so would like to learn more about that, however the hospital is looking at introducing a mentalisation group that I could be considered for.

No real answers yet. We will have another meeting next month to discuss what the team thinks.

I came home today feeling alone, very angry and confused.

So I had a bad morning and it is OK to feel the way I do. But time does not stay still and things move on and I will feel different soon.

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