Tag: personality disorder

Sitting with uncertainty – Part 2

Sitting with uncertainty – Part 2

I apologise for not writing this Part 2 yesterday as hoped.  I had a weekend away for a very dear friend’s 80th birthday. It was special and lovely but I was very drained when I got home and I did not manage to write. I’m sorry.

***

I am starting to realise that it is terribly difficult for me when I realise that my thoughts or emotions are different from someone else’s about a certain situation or matter.  It could be about a particular situation or experience we are both sharing in right now, or a memory of something that happened before, or a matter of belief (religious belief, a principle, that kind of thing), or any case of sensing someone’s strong emotion. It was my therapist and someone else in a therapy group I’m part of who identified this first, then went on to identify that this difference of emotion/thought between individuals is another instance of uncertainty we must learn to sit with.

I sense other people’s emotions more strongly than my own. I find it hard to identify and name my own emotions. When I do feel them they can be very frightening and overwhelming; I may feel them so strongly that they block out anything else, becoming to me everything that there is, frightening me about what will happen and what it means about who I am. They can feel as if they physically pain me. I may feel physically utterly drained or consumingly panicked and driven, unable to sit still, pacing constantly for hours (compulsively, despite the physical pain this causes by aggravating my joint conditions). Times of overwhelming emotion are times I often self-harm.

Other times, I may feel numb and nothing at all. I may be painfully conscious that the other people I’m interacting with feel very strongly but I feel unable to reach out, to come to any connection with them. I may want to say something and know I should and know I should and want to empathise, but feel frozen and unable to respond, and know that by this I am hurting the other person still further.

Or, despite not knowing at all what I feel, I may feel the other person’s emotion (especially sadness, anxiety or anger) so strongly that beyond what I think would be described as empathy, I actually feel their emotion myself to a level that I cannot stand it. It can happen very fast and I do not make any conscious decision or any particularly strong attempt to pick up the emotion. It just happens. Sometimes, I have as little as passed people on the street, sat beside someone on the bus or had a minimal “meeting and greeting” interaction on the reception at work, and this wave or wall of emotion will hit me and stop me in my tracks. I passed someone on the street the other day and was suddenly hit by a wall of such strong anger and hurt that I stopped walking. It was like a physical presence around me and in my lower chest and I gasped and this was swiftly joined by extreme fear. The person had done nothing to me, not even noticed me nor interacted in any way.

A couple of people who share my religious faith have told me that it is a particular gift to be able to empathise to a particularly great extent – it could allow me to help someone, be there for them, pray for them, understand their needs, know if they are in danger, and so on. I think perhaps it can be a gift and could be something from which good can come. Not that I think I have any particular ability, certainly not any power, but it is a sensitivity that could lead to good.

The problem is the intensity is so great it is frightening – as frightening as my own emotions can me. It can be there to such an extent that I can no longer continue to be with the person / people, and withdraw completely in exhaustion and confusion and fear and feeling huge guilt that I cannot resolve what is happening to the person and can’t be sure – there’s the uncertainty again! – is it my fault they feel this way and how should I respond? Then I end up back in the numb place of then not knowing how to respond and not being able to give anything at all.

Whichever of these happens, I’m left unable to interact socially. I haven’t yet unpicked quite why sitting with the uncertainty of the differences and unpredictability of emotions between people is so very frightening and overwhelming to me.  However it does seem to be shared by several people I know who suffer with personality disorder.

A particular problem where thoughts, emotions, intentions and communication are involved is that you can never check enough. You can never get to be completely sure what the truth is and what is right or wrong and if you are good or bad.

In Part 1 of this post, I gave some examples of other kinds of anxieties in situations of uncertainty. All of these are around things that are more concrete, if that is the right word, where eventually you will find out some answer.  For example, to go back to the same examples I gave: tomorrow will come and I will find out what will happen, I can ask my friend which colour she prefers and be sure to choose the mug that colour, and in time I will eventually find out the interviewer’s opinion of me and whether I get the job or don’t. If I’m trying to overcome an obsessional activity or belief, for example, if I don’t wash my hands 10 times before I speak to my friend she will get sick because of me, it is possible to test out this belief in the concrete world – it will be extremely distressing to me at first and cause a huge amount of anxiety, but I can if I dare to, not wash my hands 10 times the next time I speak to my friend and see what happens. If she does not get sick, and if I dare to keep testing this out, eventually perhaps I may be able to see that I do not need to keep doing this ritual to keep my friend safe and I will be able to stop washing my hands so much. I have suffered and still do suffer to some extent with this kind of obsessional checking and in the past, CBT therapy I’ve tried has focussed on changing behaviour and seeing that the awful things I fear do not come to pass.

But where the internal world of thoughts and feelings are concerned, I find it is not possible to check or “see what happens” in the same way and I never find peace.

For example, in the above instance I can see at least to a large extent without doubt that my friend does not get sick physically. But if I am fearing that I have hurt someone emotionally, how can I be sure? If I ask them, how can I be sure they are not just saying something to reassure me? If I think that someone is having a particular thought or a particular emotion, can I be sure that I got it right? Often it’s harder to ask in these situations (and I suppose I feel that it would be socially inappropriate to do so in many situations – I don’t want to inconvenience other people with my own obsessions and fears). If I say something, can I be sure that the other person understood it the way I meant it?

Often, if I have said something that I intend as encouraging, helpful, etc, I worry afterwards that I have communicated a message that I did not intend, which is bad and that is going to be terribly hurtful and upsetting to the other person because they will get that message rather than the one I intended. Then I worry that I actually, unbeknown to myself, subconsciously intended and thought the bad interpretation, and that’s why I said what I did. This must show that I’m actually evil and nasty and need to punish and hurt myself to make sure I don’t hurt anyone else. Then I will self-punish or self-harm. For example, a friend was worried about her baby girl who could not be with her during her medical appointment, and was instead with a babysitter in the waiting room outside. I said to her something like, “It looks like she is with someone who’s looking after her very well,” intending to reassure my friend that her baby was well. Immediately I’d said it, I panicked that this sentence could have implied “she’s with someone who’s looking after her well, because you don’t” and that my friend would think I was saying that she didn’t look after her baby properly. And my mind spiralled out of control thinking that although I didn’t know it, I was really being nasty to my friend and judging her as a bad mother and my intention, although I thought that I wanted to encourage my friend, was actually to upset her because I’m such a bad person inside. I wanted to check with my friend and say, oh no no I didn’t mean this, I meant… etc, etc, but I didn’t dare to, in case that would only make it worse, because if she had not seen the bad interpretation, it would only make it even worse to mention it. I felt the desperate urge to self-harm immediately to punish myself for being so bad inside.

In these kind of instances, nothing whatever will ever reassure me as to what my intention or thoughts really were (whereas, in the earlier example about obsessional hand-washing, I could obtain the concrete proof that my friend did not get sick). There is no way to check for certain what my real intention was, that it is not unconsciously something terrible which I’m not aware of and can’t control. There is no way to check for certain what effect emotionally I’ve had on someone else, or what they have understood from something I have said.

So I don’t know what the way out is.

For some reason, self-harm does seem to be the only (maladaptive) way that I do cope with this kind of uncertainty. When I can’t check enough that I’m not actually doing bad, or intending bad, then I have to hurt myself. The one thing that does seem sure is that if I’m doing something to hurt myself, it will somehow keep other people safe, because I can make sure I’m hurting myself, not other people. I can make sure I’m punishing the evil greedy part inside me so that it doesn’t burst out.

I don’t know how to begin to deal with these kinds of uncertainty. In time I think I am going to give this a Part 3, to look at ways of trying to sit with uncertainty in communicating with people. I’ve a feeling that it’s going to be an important part of my therapy as so much of my interpersonal problems, and perhaps for others with personality disorders too, are connected to these themes.

Thank you for reading, as ever.  I would love to hear your thoughts and experiences and what you find good, or difficult, in interactions with others and in communicating about emotions.

Also, an important note: I know that in this article, I have contrasted examples of anxieties and obsessional thoughts surrounding what I have referred to as things I can check in the concrete, external world, with obsessional thoughts and fears about what is going on in one’s head / emotionally / internally. I say that it is harder for me to find the way out of the latter obsessional thoughts and fears. Please note that in no way do I wish to belittle or minimise the distress experienced by those who are struggling with OCD thoughts and actions and fears relating to the external world, for example checking doors or switches, or cleaning. I know from my own experience and from hearing loved ones’ experiences, that these struggles are deeply distressing and the thoughts just as consuming. I empathise very much with what you are going through. All I wished to do here is draw a distinction which I have come to in my own mind and to suggest that the way out of the two sides of these obsessional thoughts may perhaps be different. As I’ve said from the start, I am neither a clinician nor medically trained, and these are just my own thoughts.

Ginny xx

Not working out….

“I shudder to think what the state of my in-tray would be if I was away from work for five days!”

“Yes, someone might slip dragon dung in it again, eh?” said Fred.

“That was a sample of fertilizer from Norway!” said Percy. “It was nothing personal!”

(JK Rowling, “Harry Potter and the Goblet of Fire”)

 

Well, I haven’t found any dragon dung yet, but I certainly have been having problems with my in-tray.  It has really not been a good few months at work and now everything has finally come crashing down.

All my life I’ve found a kind of escape in work.  As a primary school age child, I was taught at home by my mother who suffered severe mental illness.  Achievement, excelling and perfection was of such importance to her and the only way to avoid her accusations, threats, shouting, violent distress, which would erupt when I could not do something or did not do as she wanted. It was the only way to be safe by avoiding this explosion and avoiding the harm I appeared to cause, escaping the danger and catastrophes I believed would ensue or did ensue. (This probably warrants another post at some point.)

When I went to secondary school, I physically escaped her illness for a portion of the day. Soon I worked out that if I stayed at school as long as possible (extra clubs, volunteering, staying on to do some of my homework at school rather than going straight home at the end of the day of classes) I could escape for longer. Working in my bedroom in the evenings was preferable to staying under her intense gaze, or risking conflict if I was around her. Being used to the need for excellence, I worked as hard as I could, so though I was nothing particularly special or noteworthy I got good marks by virtue of the time I put in, and this too was “safe”. It secured her approval too sometimes.

I continued to work as hard as I could and give my all in every job I’ve had.  Perhaps it’s something that comes fairly naturally to me in my character.  If so it’s a gift I am thankful for.  It is very important to me to do a good job, give my best, serve the people I am working for properly, offer my work in prayer and dedication.

It has been a way to escape from the noise in my head, the hollow emptiness and uncertainty, flashbacks and panic attacks. Focussing on work takes me away from myself, to look outside and to others, to keep my concentration on the task in hand. Although I have never had much self-confidence, I have gradually learnt there are some areas I have some strengths and where, even if I may never be satisfied, my managers at times do seem to be. So whereas pervading most areas of my life I have suffocating fears that I am going to hurt someone, that I’m bad inside really, at work at least I can hope objectively to do some good, give a good service, help someone.

All that has come crashing down in the last few weeks. I’ve been on a phased return to work since I was last off sick after being in hospital.  I’d got up to about 4 days, to accommodate therapy appointments at hospital.  For several months the pressure of the workload seemed to be increasing.  I was getting more and more stressed and though it was agreed in principle for me to go to my appointments, there was not any support in terms of managing the workload or anyone covering during my absence, so work built up, causing more stress for me and more anger from my managers.  I tried to address this, together with the general atmosphere, which was becoming more and more uncomfortable and hostile.  I did manage to have a few brief discussions with managers and was never told that there was a problem with my work and my appraisal earlier in the year was, to my surprise, good as well.

A month or so ago the pressure built up to a point I could not cope with and I insisted that something needed to change.  At this point, I was told that there is not much on, it is not busy, nothing much is expected of me, everyone knows I cannot cope with the work, and people hold back giving me work because they know I can’t cope with it. The fact I do extra hours was used as a fact to support the idea I cannot cope with the work because it shows I can’t get the work done in the standard working hours (whilst I would say there was simply too much work to get through).

There were many other things said that were very upsetting which I won’t go in to here, partly because I don’t want to say anything directly identifiable to my employer.

But basically, I was told that I’m rubbish and I cannot cope with the job an don’t get through the work, and that I am not providing the kind of service that I am supposed to because people know I won’t be able to cope with it.

So many feelings went and are still going through my head over this.  Partly anger and shock, because I had found that it was busy and was giving everything I good even to the detriment of my health.  This was so contradictory to all the feedback I’d had before – why? Then fear and anxiety. I didn’t even know I was doing so badly or that people were so unhappy with me.  I mean, I knew they were unhappy with me, and thought they think I’m stupid and don’t do what they want quickly enough, but I hadn’t realised how incompetent I actually was.  It’s even worse that I did not realise how bad I was, because I fear so much in my life that there is something horrible and bad in me which I’m not aware of and can’t control, which hurts people and I don’t even realise it, means that my family even can’t stand to be around me.

I had hoped work was one area in which I could do some good but now this is gone too.  It was what I was clinging on to and trying to keep going.  Even though I could see in a way it was doing no good to me because I was so stressed and couldn’t cope with other areas of my life at the same time (not looking after my flat, not cooking, getting mixed up over bills, so drained I did not socialise with anyone outside of work).

I know that my concentration is not good, that I dissociate for periods of time and lose track of time when I am stressed and very upset.  I know I do not work as quickly as I used to.  I didn’t realise the extent of the effect it was having.  That I can’t do my job.  That my perception of the situation should be so different from other people’s – I thought I was giving everything, I thought there was pressure, when other people are saying there is no pressure, it isn’t busy, and I can’t do it. That is frightening to me.  According to my therapist, a disconnect between one’s own experiences and other people’s, and a difficulty dealing with this, or dealing with situations in which our emotions and feelings are different from others’, is common in personality disorders.

I don’t know where I go from here.  I called a couple of advice lines and they told me that possibly I have some case to say that more could have been done to support me, with more “reasonable adjustments” at work.  I looked into this and wrote down a case around this but I couldn’t go forward with it in the end.  I doubt my own perceptions and feelings too much and even writing it for myself, I felt like a complete fraud, that I’ve invented everything and the problems lie all with me not my employer.  The voices in my head are telling me I’m nasty, disgusting, invented it, liar, fake, you’ve invented a story to accuse people of things… I just cannot cope with that and know how much more intense it would be if I actually tried to put anything in. Crazy, I know, but that’s what goes on in my head.  I’m scared in the end that I’m just bad and evil and greedy inside.

In the end, my employer has told me I’m not coping with the job and not competent and I think I’ll probably be dismissed.  Even if not my GP and specialist have told me it’s too stressful an environment.  I need to get out of this role and do something less pressured and stressful and where I can engage in the therapy I’m doing at the minute, get to appointments and get support. I agree with them.  Even if I am dismissed or do have to take the decision to leave, the one good thing I can see is that at least I am choosing to try to do something to put my health first, for the first time. Not admitting what I need to do in the past has just led to things getting worse and worse.

But it’s scary right now. I’m signed off sick at the moment. I feel empty and frightened and anxious all at once and there’s too much space for the spiralling thoughts and fears in my head.  I’m trying to focus on positive and creative things. I don’t know how to trust myself at all because even in the last things that I trusted I could do properly, it seems actually I wasn’t doing a good job at all, and everyone except me knew it. So many jobs have ended in the past  and I so want to find something that is sustainable but where I can engage with my therapy as well.

I’d love to hear your thoughts on work if you’d like to share them. Is work a good experience or a bad one for you? What kind of work you find is good for you and something where you can give your skills and abilities? If you find part time work is helpful and how much flexibility you find employers can give to be able to go to therapy appointments as well as working?

It seems like a very anxious and uncertain path at the moment.

Ginny xx

Lullaby 3 – what I can never share

Warning – this post contains some of the thoughts that I have when I am pushed to self-harming or suicidal plans. It contains mention of some of the ways in which I self-harm.  If this may be distressing for you, you may not wish to read further.

There is nowhere I fit.

The rare times I felt any safety as a child were:

  • Talking to Dad about what had happened just before Mother went into hospital, when her behaviour had become so wildly bizarre it could no longer be ignored.  At last I was heard.  My fears were heard.  This was short-lived.  As soon as she was back home, the admission of the strangeness was lost, explained away, forgotten… her world returned again, her world consumed ours.
  • When I had some academic success. Did well in a test, or an essay, or an exam. Got good marks.

Now, perhaps, it’s also “safe” if I’m “recovering” at the pace and in the way my family want.  For a while, it’s as if a bridge of some kind of expression or understanding can be built.  Sometimes they startle me with understanding and acceptance and support and encouragement and say they are there any time I want to talk.  But it’s laced with fear because as soon as I can’t keep up the progression, keep “moving forwards” – so just when I’ve started trusting, and just when I most need help (maybe I’m distressed, anxious, the voices are worse again, something has gone really wrong in my life) – they pull away, they are angry, they limit contact, I’m the problem, I just have to make more effort and try harder, I have to realise how impossible I am to be around, I’m a spoilt brat, everyone says how rude I am, on and on and on. Shift into a different gear, we don’t know anyone else who’s done as little as you, reaffirming the embarrassment and failure I am.

So the only way to cope, to avoid yet more pain of starting to trust and then yet again failing, hurting – others, and myself – is to only have contact when I can act how they want me to, present what’s acceptable and what they want to see.  That won’t be rejected.  The rest I’ll hide, and when I cannot hide, I’ll make sure I’m alone.

I do not fit in their world and I do not think I will ever be a part of it.  Constantly I am too much to cope with.  “Why isn’t it enough for you? Look what everyone has done for you! It isn’t anyone else’s responsibility to make you feel better. Look what I’ve done. It would be nice if you responded.  It would be enough for most people.  Why isn’t it enough for you?”

I hear the voices joining in the chorus and the guilt settling like a weight crushing my shoulders, fighting with the anger rising within me, mixing to a block of lead in my chest.

Why isn’t it enough for you? You didn’t say sorry! You didn’t say sorry enough!

I don’t know. I don’t know why it isn’t enough. I don’t know how to say sorry enough for the failure and rubbish and disgusting thing I am.  Some part of me wanted to show you the razor marks then, the cuts down my arm, they still weren’t enough, but that was how sorry I was – though I still couldn’t do it well enough, I was too weak.

I don’t know why it isn’t enough. But there’s this weight on my heart and on my brain, there’s a noise in my head, the voices, screaming, white noise, sucking me back into flashbacks and memories of pain and fear and disgust and hurt and desperately, desperately wanting someone to protect me and see.

I don’t know why it isn’t enough.  But I did try to tell you, and I did really want you to see my fear, back then.  But all you could see was her, and she was perfect, and I was the problem, the one that had to change, that was acting weirdly, not trying hard enough. I did try to tell you and you were there, but now you say I didn’t speak and you didn’t see.

I don’t know why it isn’t enough. But inside every part of me is breaking and crying and I’m fighting the urge to run away and not stop, hope I will freeze or collapse or die, lie down and sleep to get away, because I am so, so tired, of what the voices say to me, of being so weak I can’t do what they say, when they tell me to pour the boiling water from the kettle over my hands, to cut deeper, to take the handfuls of pills not just look at them, to actually step on the train tracks this time, it would be so so easy, you vile disgusting selfish pig, why don’t you do it? You’re ugly, you’re dirt, you can’t ever get rid of the evil thing in you, everyone will see in the end, everyone knows you’re evil. Go on, do it, cut, starve, throw up, you disgusting bitch, what right do you have to this…

I don’t know why it isn’t enough. No matter how much I wash or cut or starve, it can’t be sure to get out the evil in me, that errupts dangerously and contaminates and hurts everyone around, and I don’t ever know when it’s next going to happen, that someone gets hurt. Mother told me for long enough that I was punishing her, plotting against her, deceiving, greedy, fat, selfish, getting my own way, hurting her repeatedly, driving her to suicide, driving her away from the family, going to have them sent to prison, and nobody would ever know it was really my fault, they’d think it was hers, but really deep down I’d know it was me, and so would she. So whatever they say, I know it’s me that’s evil really.

I don’t know why it isn’t enough.