Tag: mentalisation based therapy

The pain is no longer numbing

I’m finding this physical crash really hard. I feel useless. I’m scared by the pain though I don’t know exactly why. I can’t face going outside. I don’t feel safe. At home feels slightly safer. Outside is too much and I’m tired so quickly. I’m not frustrated, I don’t think, but I do feel sad and the pain is scaring me. I don’t know why. Nothing bad is going to happen just because of the pain. What am I scared of exactly? I don’t know.

I’m sure when things were this bad last time, a few years ago, I dealt with it “better”. I got on with things better. I stayed on more of an even keel outwardly and kept going. It didn’t affect me so much emotionally. Last time it actually shut my emotions down more. The pain felt safe. It was a bit like my self-harming. It was as if, though the pain from my physical illness wasn’t self inflicted or chosen, it absorbed some of my emotions and deadened them and the voices in my head said that was safe because it stopped me being a danger to other people. I wasn’t afraid. I didn’t feel so shaky and tired and vulnerable and exposed.

Now the pain and physical disability doesn’t seem to be swallowing up my emotional being and numbing me anymore. This must be something to do with changes the therapy is working in my mind and the fact that I have stopped self harming.

It’s quite scary to admit that this change and separation is occurring. Physical pain no longer equals safe and numb inside my head and not a danger to other people.

Now in my current physical struggle I feel the fear and vulnerability and even heightened emotions. Now I just wish someone were here to hold me. But at the same time I know I have to find out how to do this when I am on my own. Because that’s the day to day. Because I can’t ultimately depend totally on another person – in the end that puts an unfair weight on to someone else and puts me at risk if I can only go on depending on someone else every moment needing them always to protect me, allow me to to feel, allow me safety…. I don’t mean that I want to be isolated or want to reject other people. I really don’t; I long for the opposite. Just I meanthat I have to learn how to exist and experience physically and mentally for myself. This probably doesn’t make much sense yet. I’ll try to explain in better in another post.

In trying to learn some kind of ability to exist alone, exist without total dependence on others, I can trust totally in the unchanging love of Our God. The God who says fear not, for I am with you; the God who loves us first so that we can learn to love Him; the God we can count on as our hope just as surely as daybreak follows the night; the God who comes into our darkest, poorest times when we are lost and delights in us as His children.  In times of pain and alone-ness His presence is often now all the clearer to me and gives me hope that even when I fail totally at simple things and fear I disappoint everyone by being able to do so little, my life is not too little for Him. He loved each one of us before He even brought us into being. That has to mean HOPE.

Ginny xxx

Pop goes the weasel…

Do you ever have so many things in your head it feels ready to go “pop”?!

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In therapy group on Friday, I felt I could identify really strongly with what a couple of other group members were saying. We talked about so many themes that are really pertinent to my life right now. My thoughts started spiraling and firing off faster and faster in my head and I felt I couldn’t keep hold of them all. I wanted to write them all down right after group as it seemed so important they didn’t get lost. There were so many things I wanted to ask the group members.

I often get spiralling thoughts. In my 1:1 therapy we identified this often happens when I’m starting to experience a strong out of control emotion. The spiralling thoughts are somehow safer or more possible to name than the emotion. Focusing on them can suppress some of the emotion. If I can’t – like in group last week where they were just too fast and I was trying to stay focused on what others were saying – the emotion intensifies and is really uncomfortable, though I can’t name it or understand it. I just know I feel panic. I’m working on trying  to sit with the emotion and explore that rather than plunging straight into compulsively following the thoughts.

Interestingly, my thoughts used to do something similar when I was studying. I’d frantically try to get them all down. They seemed important. Sometimes they were and sometimes they were not. But it was often really hard for me to explain the links between them to other people or get them down coherently.

Writing this, it’s occurring to me – does this sound like I experience manic episodes? I have never felt as though I have manic periods in terms of hyperactivity or boundless energy but can manic episodes affect your thoughts alone? The spiralling thoughts can stop me sleeping and if i miss any medication doses at this time i can end up going all night without sleeping. Though the thoughts take the focus away from the uncomfortable emotion at first, eventually it returns, often more extreme than before and together with a lot of anxiety and physical exhaustion.

After the spiralling thoughts have squirmed and pushed their way round my head for a while, it’s as if part of my brain shuts off. I feel frozen inside my head. It’s a huge effort to fight to interact with people and speak and respond appropriately. I can’t bear the emotion and spiraling energy. It hurts. I can barely understand what’s happening round me. I want to get out. Go home, shut off and curl up somewhere safe, or have someone hold me (though there’s almost never anyone. ..) If anyone talks to me and I’m required to interact I am likely to somehow jump to irritation and frustration, though it isn’t really irritation I’m feeling inside.

I’ve never talked to my therapist about the idea of manic states but perhaps I should. Do others with Borderline experience this kind of thing, I wonder? Do you struggle with this?

It’s been worse in the past week or so because I’ve had more stress with my Tax Credits being stopped and consequent further financial panic. I’ve also been exhausted from low physical health with a lot of pain. Every day off has been taken up with hospital appointments and trying to sort out my finances. I’m worried I won’t be able to keep up my job as I’m struggling with the physical aspects of it and it is also very discouraging that pushing myself to the limit of what I can do to keep working, I’m left without enough to meet basic expenses. I’m so fortunate I have a very good friend and a family member who are helping me from time to time. Without them I think I’d have ended up on the street by now.

Ginny xxx

 

I wish we knew we’d get to the end of this together

I feel so sad today. Too many people are leaving in all areas of my life.

Someone has left our therapy group and will not be returning. I can’t post too much about it so as not to break confidentiality. I’m scared for her. We don’t know why she left. We did not get to talk with her about it because she stopped coming suddenly a few weeks ago and then the therapists told us today that she isn’t coming back. I miss her. Already. She saw herself as so bad but clearly had so much good about her. I really really wish we could have helped her. I’m scared for her – for what will happen to her, where she’ll get help and what she may do. I felt a lot in common with her. Often she spoke what I was too afraid to. She had been so so hurt by terrible experiences in her life. I so wanted to keep her safe but feared she was so hurt and kept running into so many circumstances of further pain and not being able to trust people, that she would not be really happy this side of heaven. I have to accept her decision and know I can only give her into Our Lord’s hands and pray for her now.

In the last couple of sessions people have been leaving group early because it has been too distressing or unhelpful for them. I panic when someone leaves. Or people withdraw and don’t want to talk anymore. Again I panic. I don’t want anyone else to go away. So often it seems to be my fault and so often I’m flashing back to being a child and my mother threatening to go away because of me or that she and my dad would be taken away because of me. ..or to the times she stopped speaking and I couldn’t elicit any response or her “absences”… and I wish, please please don’t go away. I wish we knew at least in group that we’d all get to the end of the course together.

I miss N, I miss two other people I thought were close and I’ve lost in the past weeks. I miss the hope there was in the existence of that relationship that I could do some good for them or be needed. I miss what little sense of safety there was that I wouldn’t be left that time and wasn’t doing harm.

I miss any sense of there being a few narrow circumstances at least, where I could think I did a good job or the right thing. The last part of that was lost with my failure in my last job and the loss of so many important relationships.

I cry and cry again but it doesn’t go away.

Ginny xxx

A shaky week

This week I planned to get all caught up here on comments and visiting your blogs. However as so often happens, things took a different term and I seem to be as useless as the proverbial handbrake on a tortoise. And moving at a similar speed too!

This hasn’t been a very stable week. I had a meeting with my new support worker, a difficult consultation with my GP, two relationships breaking down very painfully, an important but emotional group therapy where something that occurred brought flashbacks of a frightening incident in my childhood for which I feel responsible. Also I got some very unexpected news and had a conversation that seemed to throw everything. I’ll post about it in due course once I’m more able to cope.

Not big things in the grand scheme but I’ve got behind again. So once again, I’m sorry for being so slow to answer messages. I care and I’m praying for you and I’m sorry for how I struggle to write.

Ginny xxx

Trying to be curious about trust #1

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.

Ginny xxx

Scared I’ll lose it again

Tomorrow I have my usual weekly group therapy, then I have my monthly care coordination appointment (it’s supposed to be monthly but has been canceled more often than not since October last year). It’s challenging at the best of times when this appointment comes round, especially when it closely follows therapy group on the same day, which is draining in itself.

I’m very worried about the care coordination tomorrow. Last month I was really upset and desperate in the appointment, didn’t get the help I felt I needed to stay safe and left wanting to end my life and overdosed. There was a complete lack of understanding between me and my care coordinator.

I’m scared something similar may happen. I’m scared that I might lose it like I did a couple of weeks ago. I’m so so ashamed of that and I feel dread when I think of it. I’m scared I won’t be able to control what I do and it’ll happen again because I’m so unstable right now, flicking into distress and hurt and anger so quickly.

Also, I’m scared because there are really difficult things I want and need to say. I can’t say everything’s good and fine or that I’ve made progress; I can’t say I think I have the support I need because there are massive issues and have been huge failures in communication and so many things promised have not been acted on. I now operate by expecting nothing from the service and expecting whatever is arranged not to happen. It’s “safer” that way. It doesn’t open me up with hope and trust then twist the knife with another let down or betrayal. It means I don’t ask for help either.

I need to communicate these things. I never do, usually, but if I don’t there’s no going forward. So I’m going to try to say at least some of them and write a letter as well in the next few days.

I do not know how to stay calm whilst I do it. How do you stop yourself losing it? How do you control the aftermath of feelings without harming yourself? How do you keep your emotions level when things that are really deep hurts to you, are unanswered or ignored?

I’d be seriously thankful for any suggestions!

Ginny xxx

Group and no more trust

Tomorrow is MBT (mentalisation based therapy) group. I don’t know whether to go.

All trust I had in the service has gone. It’s been completely wiped out by the lies and let downs of the past months, the proofs they don’t believe me, the tricks, the cuts that open me more and more vulnerable then leave me with nothing and noone.

I don’t really want anything to do with a service that does this, but I’m desperate and have nowhere else to go. I’m desperate for help but it’s denied, it’s promised then withdrawn, or I’m deemed not in need or not believed. I want to do the therapy but I can no longer go forward safely with it. I cannot cope between sessions except by overdosing to black everything out and self harming to punish myself, temporarily quiet the voices, temporarily be something other than the utter pain. I’m not allowed any of the things that would keep me safe between sessions.

If I go tomorrow, I will be so angry. I can’t say I’ll keep it under control in the session. I can’t say I’ll stay “stable”. Nothing keeps it in anymore. I can’t mentalise like this and really I don’t want to. These things just are as they are. There’s nothing to be “curious” about or explore my feelings or someone else’s thoughts. Their thoughts have been made totally clear – they don’t believe me, I’m not allowed help, they’re tricking me, they’re cutting me open then leaving me and finding more and more ways to do it. My feelings are exploding and total. Fury. Hurt. Trapped. Over the edge. Liar. Fake. Fraud. Pain. Screaming.

If I go to group I can’t avoid it being clear I have no hope and no trust left. If everyone or anyone else does trust the service and does believe they’ll help them, then maybe that gets them through and helps them and is a lifeline for them. I don’t want to destroy that.If I say what’s happened to me, even in the last couple of days, I could destroy it.

I could go and just try not to talk about anything to do with me and just be there for other people and listen to them and try to mentalise about what other people bring. But I’m so far gone over the edge I don’t think I can trust myself not to explode.

When the group started committed to do it all. I committed to not leaving. I committed it to everyone in the group – not out loud, we didn’t do that, but in my head I did. I promised to God and Mother Mary too. If i leave I break my commitment to everyone, not just the service. I really don’t want to do that.

Yet at the moment I’m just ending up in more and more danger. It seems as if I should just accept this’ll never end, dissociate as much as possible, hope for something sometimes bearable…. but I think I’m too far gone for that. I wish I’d never trusted them.

Stupid little things like coffee

Stupid little things like coffee

It’s evening. I got to the end of the day at work. I told myself if I got through my shift I could get a nice vanilla latte on the way home. Not always the coffee I choose but the kick and the warm sweet milk is comforting for some reason.

It doesn’t really make sense. I’m still feeling confused and like it isn’t quite my life. It doesn’t seem to make sense. Not that it didn’t end exactly. But just that it doesn’t make sense. Therapy and the crowded bus stuck in the traffic; getting out and feeling I couldn’t make my legs work right because the balance and weight was all in the wrong place and I wanted to curl up and hide; pushing and pushing;  work – faster than I thought it would go, though staying listening to the real world was hard; out; coffee. It doesn’t make sense. How can this be when yesterday and Saturday and Friday were what they were, when it so “was” the end. I’m not expecting to get an answer to that or not right now anyway. It’s just a state that doesn’t seem to make sense. I suppose. ..the answer is that even the worst passed. The answer is I was helped. God is merciful and I have such need of His mercy.

Ginny xx

Somehow

[TRIGGER WARNING FOR SUICIDAL THOUGHTS AND ACTIONS, SELF HARM AND OVERDOSE This post may be disturbing please read with caution if this may be unhelpful for you. ]

Somehow it’s nearly morning. Well, it is morning. I’m numb and “out of it” like it’s not really me, but everywhere at the same time. I thought I came to the end. That was supposed to be it. But I’m still here.

I’m scared to write this because it makes it real. What I did. And what is. And that I’m still here and that it’s morning. No question.

(“The watchman counts on daybreak and Israel on the Lord” I can’t remember what Psalm that is right now. ..)

I’m scared to write because I don’t want anyone to hurt and it was noone’s fault but mine and no one’s doing but mine and my responsibility. I lost it, I snapped and gave in. I didn’t deserve it but they cared for me.

I know I was so nasty to someone who has only cared for me. I needed too much. I still do. I’m so sorry.

But I have to write this. I have to write this in order to go on. I’m scared and I can’t remember chunks of time.

So…

I got to the end on Saturday. I screamed. I smashed things in the kitchen. I cut. I took an overdose. A lot more this time. This time it was the end.

But it wasn’t because I’m still here. And I have to get up soon. I have to get up and get dressed and go out and get something to eat and then go to the hospital to see the psychiatrist and my therapist. I promised I’d do it.

I’m okay. I don’t want to scare people. I’m okay physically. I got help. I’ve been in the hospital Saturday and Sunday. I came home late last night. They monitored me – blood tests and ECG and blood pressure and everything – so I’m fine physically. They were kind. They looked after me. I ate. I saw the duty psychiatrist. They’ve sent a report to the personality disorder team. I already had an appointment set with my therapist this morning and I’m to go early to see the psychiatrist too. So I’m safe. I don’t want people to worry.

I’m going on. Nearly time I can get up. It’s cold this morning. I have to decide what to do about work and what do I tell them. I’m meant to be in this afternoon.

“The watchman counts on daybreak and Israel on the Lord.” Keep saying that and get up and it’s morning.

Ginny xx

What do you hold onto in the darkest times?

I’ve posted before about how, like many people with Borderline Personality Disorder, one of the things I find hardest when I feel really bad is to hold on to any knowledge that it will not always be this way. The overwhelming emotions – especially fear, sadness, loneliness, anger, pain, frustration, self hatred, self disgust, hurt, distress, longing or needing, or the feelings I can’t yet name that come with flashbacks – they eclipse everything else and become all that exists.

I wonder if their power is greater if I fear the emotion I sense. But the totality of the experience, their consuming nature, makes them the more frightening.

Descriptions of this emotional experience in BPD often term the feelings intolerable or unbearable. It is that but it isn’t quite either; it’s not all of it. Intolerable, more than I can stand, yes… but it’s not something I can’t stand because it’s me. In that state there is nothing but the emotion and there is nothing of me but the emotion. I cannot stand it but neither do I exist apart from it.

I hate it so I hate myself. I must get rid of it, purge it, so I must get rid of myself and cut away the bad – so I cut.

I can name some of the emotions afterwards. Maybe the therapy is helping me to do that. But in the experience, I cannot. I cannot recognise anything but hurt and pain and hate and evil (me); I cannot hold in mind anything but the impulses to cut, run, scream, end it, reach back for numb. .. and I am gone. ..and I spin between cut off and unable to feel and any attempt to engage being painful, and the state of total emotion, of only existing as that pain.

I cannot control it. I cannot bridge that gap. Therapy is helping me identify what feelings are. But it doesn’t separate them from me, from time, from permanent reality, from right and wrong. It doesn’t tell me how to feel, rather than be, the emotion. It doesn’t tell me how to bridge the gap between the different people I become – the cut off numb one;, the one that hides everything to cope day to day and do what I’m meant to and fulfil my responsibilities and pretend and hope I could ever be good but knowing all the time that everyone really knows how fake it is and how evil I am deceiving everyone; the frightened needing child; the angry, vengeful and impulsive one. More and more they seem to be separate personalities. I am fragmenting. I am more unstable. I lose more periods of the day – when I’m in one state I cannot “access” the other and I can’t remember things that happened (though I may remember the state). I flick so quickly between states without being able to engage my rational mind and try to employ any grounding techniques or DBT techniques to control my behaviour or my experience.

I guess it’s good that I can start to be curious about the process, from the temporary relative stability of my “coping” state. It must show I do have some ability to learn to mentalisa about what’s going on in my mind. Usually my “coping” state would be trying to suppress what I’m exploring right now. Perhaps eventually I’ll be able to build a more curious and stable personality at least alongside these others.

What do you hold on to when your whole reality, your whole existence, is unbearable sensation and emotion? It sounds utterly stupid. It sounds utterly out of proportion. It sounds self centred and I am forced to admit that though it’s the very last thing I want and one of the things I most hate in myself, in a way it is, though at the same time self has got totally lost in the feeling and emotion coming from everywhere.

What do you hold on to when you can’t access your coping strategies or even your most rooted beliefs and deepest cares? I love my God and know God is mercy and compassion, but in the bad states I can only conceive of a vengeful God or a God casting me out. I love my godchildren, I care about keeping my commitments at work,  but in those states I can conceive only that I do everyone harm and everyone knows I’m bad really and would rather I weren’t around. The centre of my beliefs and values warp according to the state I’m in.

What to I hold on to?

Ginny xxx