As you may know if you stop by regularly ( 🙂 thank you lovely people!!) I’m finding it very hard to trust the personality disorder service at the hospital (where I go for therapy) at the moment. It has become harder and harder over the last few months, in part due to repeated occasions where, in my experience at least, I’ve been let down, not had the promised support, or been turned away when in desperate need of help. I feel they do not believe me and do not think I deserve help and the more I’m in crisis the more they don’t believe me. Everything that happens confirms this now. In my last care coordination appointment I felt again completely dismissed, not listened to and that what was recorded on my care plan did not reflect what I was going through or needed, until I’d insisted time and time again that my care coordinator write what I actually said rather than re-phrase it in a way that minimised and avoided a lot of the issues at stake. Aargh….
I can’t explain it more than this right now because I will get so angry and out of control. Plus you’ve all probably heard me go on about it so much you’re bored 😉 ! Sorry.
I’m trying to be curious about my feelings about trusting the service and how they see me, as Mentalisation Based Therapy focuses on this and trying to be curious and open to different feelings and uncertainties about what is in our mind and other peoples’.
Right now, although I can try to examine different possibilities, I’m certain in my heart that the service don’t believe me. This doesn’t apply so much to my 1:1 and group therapy sessions. In some way the group feels honest and safe. Perhaps it’s something to do with my commitment being to the other people in the group, listening to them and being there for them, present with them, and sharing honestly as much as I’m able, rather than it being a relationship just with the service or the therapists. It applies more to when I need support between sessions, or when I’m in crisis, or talking about support outside therapy with managing daily life, or in my care coordination appointments.
After the experiences I have had so far, I am not sure what would now reassure me that they did and do believe me and do want me. I got on to thinking about how my recent falling out with a close friend N. involved my absolutely unchangeable feeling that she didn’t believe me, didn’t really want me, didn’t think I deserved help, and I was just a burden and irritation. I don’t know what would convince me otherwise (except, just perhaps, if she had come to help me when I was at my worst, in some of the times she was adamant she could not or should not come).
Not being believed and not deserving help is a big theme for me. Ultimately, I do it to myself too, because I can’t really believe myself. Some of my psychotic symptoms feed into that, with the voices in and outside my head telling me I’ve lied, I’m a fraud, that everyone knows and is thinking and saying I’m a disgusting fraud, cheated people to get help, and no matter if I may think I want to be good and try to do good, there’s all the bad things in me really and everyone else knows and I’ll hurt everyone in the end. Only self-harming in some form quiets this.
In my last 1:1, we talked about my recent falling out with N. We started going slowly through my feelings and thoughts step by step from the beginning of the day things really fell apart between us. We didn’t get very far through. Nevertheless it brought back a lot of the feelings of that day. I’d been feeling very bad about things I said and how things were left at our meeting and in our exchanges the week after (since which, we haven’t been in touch – I couldn’t anymore and felt she didn’t want to either, really). I’d been trying to write to apologise. But in the 1:1, what was even harder than this was that guilty as I felt (and still feel), a lot of the hurt is still there too.
As the memories of these feelings, and more of the feelings, surfaced in the 1:1, I suddenly felt sure that my therapist must think I’m a horrible, childish, needy, jealous, selfish, demanding, nasty person who thinks terrible things about people. Then I started thinking these things about myself together with feeling guilt, disgust that I was so evil, and worry about what would happen to my relationship with my therapist now she thought these things – I couldn’t say what I thought would happen at the time but now I think it was feeling that, oh now she’s started to realise that I really am bad after all and she’ll leave me and not want me around any more.
I was certain about what my therapist must think. Just as I was/am certain about what N. thinks about me. It was actually very hard for me to think curiously about what N. (or my therapist for that matter) would feel. I spend a lot of time certain and horrified about what the people I’m interacting with think about me, and feeling bad for what I am (because of what they’re thinking), what I cause, and the feelings that are then in me, confirming my self-disgust and self-hate. My self identity is somehow, in a way I can’t yet express properly, bound up with what I am certain the other person is thinking about me. My own feeling follows immediately being so certain of their thoughts. I am not necessarily at all able to access beforehand what I am feeling, and I am not necessarily able to think about what the other person is feeling (separate of me, as opposed to being convinced about their thoughts about me).
I am not necessarily bad at picking up what other people are feeling. Actually, I can be very accurate in it, and sense it before other people do. I’ll post about that separately and will put a link here when I’ve posted. However, in these situations, I’m entirely sucked into the certainty of their thoughts.
I am not at all able to “mentalise” – to reflect and be curious about what is in their minds and what they are feeling and what I am thinking and feeling. There is no possible questioning or genuine entertaining of different possibilities about the other person’s mind. I am absolutely certain of their thoughts about me and I have absolutely certain thoughts and feelings as a result. Even though I may at some level be able to come up with a distant idea of other possible thoughts that could be in the other person’s mind, it is completely disconnected from my beliefs and emotions.
Written down like this, it is quite easy to see that this could lead to or be part of my psychotic experiences. I am certain of other people’s thoughts about me. The voices repeat them to me. I feel disgust and guilt and horror of what I’m doing to people. Somehow I become linked with the thoughts I think the other person is having and I am all those horrible things.
I am starting to wonder whether I am actually having the thoughts (which I attribute to the other person) myself, and having the resultant feelings myself, but I am unable to recognise them or feel them in myself, and then for some reason attribute them to the other person as though I know for sure that they are thinking these things. Really they are just my own thoughts or feelings about myself.
Perhaps my certainty nobody believes me or wants me and my resultant inability to trust, is in fact simply nobody else’s thought but rather just what I think of myself – and the fact that I cannot trust or believe myself because I always doubt my own motivation for good or evil, because I have no identity except what I find in what I think are others’ thoughts.
I don’t know quite where this came from. Certainly my mother’s very unwell beliefs about thoughts and emotions during the time I was growing up, clouded my learning about my and others’ feelings and thoughts and the demarcation between them. Her deeply psychotic beliefs were pervasive and persistent. She believed that I knew exactly her thoughts even in advance and when I did not, she told me this was deceptive; she believed she knew my thoughts and intentions; she frequently presented to me my intentions as malevolent and manipulative in incredibly complex ways, when I was unaware of any such motives or thoughts (precisely because they didn’t exist, but I didn’t know that as a child); she made inconsequential, morally neutral actions (such as being able to do some particular thing or not) have a moral value or manipulative power (“repeatedly punishing her” for example); she perceived my emotions as controlling her and done to her (unless they perfectly matched hers); and this was coupled with dire threats (including her suicide, my father’s death, the family breaking apart, my parents being taken away) because of my emotions and thoughts – and of course, with the abuse.
I don’t know quite how to unpick that to find out how much does it explain how I now feel about others’ thoughts about me. Maybe I don’t need to and just need to find out how to change my certain, set-in-stone thought patterns now.
Oh my days I’m tired now and I need a hug. Think I’m going to have a hot bath and curl up under my blanket when I get home.