So how do I proceed now? Now I don’t trust any of them? I still want to get better, of course, but that means working with them and can I even get better working with people I don’t trust?

I’m in knots trying to monitor myself and it’s driving me even madder. I feel the rational bit of me getting quieter. Tired of arguing. What is the point? What is the fucking point?

Temptations abound; to self-harm; to overdose; to run away; to let my anger out; to tell them what I really think of them; to smash up their ever so bare and carefully arranged therapy rooms; ha! And the diary card? I want to rip that pointless fucker to shreds. Perhaps I will. In group. No one looks at them anyway. Alternatively I may fill it in with a load of fantasist data and see if anyone notices. 

Hmmmm. I think that might…just maybe…be seen as being wilful…well, if a jobs worth doing eh? 

I feel like if I don’t get this out then I’ll die. Fed up holding it in. 

I’m managing 

Trigger warning: self harm and suicide.
I’m managing. That’s what I tell myself or anyone else who happens to ask. I look pretty good outwardly actually.

There isn’t anyone watching over me. No one is asking any monitoring questions. They haven’t in weeks. So no one knows that:

  • I’m struggling with dangerous impulses.
  • I can’t go near painkillers in shops despite my feet naturally pulling towards them
  • I’m self medicating with cocodamol 
  • I took 3 cocodamol the other night and was so close to taking the rest of the packet that I nearly went to give the packet to my husband. Nearly.
  • I’ve closed my eyes when driving just to explore what happens.
  • I’ve accelerated towards certain objects quite a few times now, slamming the brakes on and shouting at myself – what the fuck are you doing?!
  • I cut my own neck last week. It didn’t bleed. I found where the vein was, avoided it and took a knife to my neck. I have a couple of creases on my neck so I cut in one of them so it wouldn’t be noticeable. It was more a scratch really.
  • I cut my thigh and panicked because it wouldn’t stop bleeding. It did eventually though.
  • I’ve had thoughts of having superpowers, and maybe I should test this out.
  • I’ve been scared in the supermarket and felt the urge to scream and shout at people because they are a threat.
  • Sometimes I think I might see little things that aren’t there.
  • I faced my abuser with a letter.
  • I’ve lost 3 stone (actually a few people have noticed that and congratulated me on it).
  • I’ve been trying Quetiapine and have been on it for what 5 weeks? And increased my dose and not a single hcp has checked how it’s going.

My usual GP has disappeared. My care coordinator is new after my last one resigned and my relationship with my DBT therapist has broken down. 

So all this stuff is going on with me and no one knows any of it. Except me. I did pluck up the courage to ring my psychiatrist a week ago. I left a message and it was never returned. I’m just not ill enough – which is a blessing I suppose.

So it’s a good thing that I’m managing. Just like I managed all this stuff before. Until I can’t manage anymore and decide to take a break. And then… ? 

Well, it so totally doesn’t matter does it? 

Transference is a Bitch

Transference is an absolute bitch. I get it bad with older men in authority. Always have, starting with teachers back when I was a kid in school. I feel like I’m in love with them and all I crave is their desire back. If they wanted me then I’d know I was doing it right.

*sigh*

Knowing what it is helps but, despite knowing that it’s an illusion, it still feels real. I’ve never acted on these feelings. I couldn’t. That’s the whole point – he has to choose me; so that I am seen, worthwhile, not invisible. So that I can believe I have good qualities or attractive features it has to all come from him. And then there’s the White Knight part of it all. He will see the good in me and come and rescue me and I’ll be saved. 

None of my White Knights have ever approached me. Once…just once…there was one and he created a situation which felt very much like he was testing the water, saying come on… It was terrifying so I ran away! I could never act on these feelings! I don’t actually want to! Not really.

I love my husband. I hate that I have these issues. In my defence they were there long before I met him, just hidden away like all of this crap in my head. I know I don’t deserve my husband. He is a good man. Not perfect, of course, but good. He gives me a solidity and predictability which is reassuring to me after such a chaotic start in life. He shows me affection in a way I’ve never experienced. He was the first person to love me for who I was. He believes he loves me although I’m not so sure. I doubt sometimes that he really knows me but he definitely saved me. He is steady.

Transference happens though when you want to have a need met doesn’t it? My husband doesn’t really do emotions. That might seem odd given my BPD but actually that’s why it works I suppose. I have all the emotions for both of us. It used to drive me crazy in the early days e.g. He wouldn’t be excited if we booked a holiday but I’d be soooooo excited and want to chatter away about it but couldn’t because he just wasn’t feeling the same thing or even close to the same intensity. What I’ve learned though is that that just isn’t him. I’ve accepted that. I’ve accepted that he’s brilliant and marvellous in lots of different and important ways; ways that mean we function well as a couple and as parents. There is balance.

However that doesn’t stop my need for a man (has to be male) to see, and appreciate, my emotional side, or my creativity, or my love of music or art etc. My husband doesn’t see those things. He comments on his appreciation for my breasts and/or arse on pretty much a daily basis but never anything else. My empathy? Or way with the children? My sense of fun? Or my adventurous attitude? And I want those things to be seen, to be acknowledged spontaneously by someone else (because that makes them real. I can’t trust my own opinion of myself!). 

So when a man, an older man, does acknowledge some of those qualities – completely spontaneously – then wow! Wow! Just you try and stop the transference! He sees me! 

It’s not real of course. It’s all just in my head although Dumbledore did say to Harry Potter:


Transference is a bitch. Real feelings for an illusion. And real consequences too. Just another secret to carry around and feel ashamed about. 

A Therapy Breakdown

Yesterday I had my meeting with the head of the DBT programme, a lady, D. This was to discuss my future in treatment now I was refusing to work with M (with good reason: My Last Appointment).

D immediately put me at ease and cut to the chase – what were my options?

  1. Leave DBT, the only treatment and support I have.
  2. Suspend DBT until an alternative therapist becomes available (predicted 7 months away) leaving me with nothing in the meantime.
  3. Continue DBT with M as my one-to-one therapist.

Not an appealing whole bunch of choices but that’s the situation. This is the overstretched NHS. There just isn’t another therapist available. It’s a strange thing though as I asked to continue attending my weekly DBT group which would also give me access to the dedicated helpline but that was refused. The argument given was that I could not continue in DBT without the one-to-one appointments for my own safety, because of my life threatening behaviours. Damn. It didn’t occur to me at the time but it does seem a bit odd that they would rather leave me with nothing rather than provide a limited service, given that I have life threatening behaviours…but they have their rules and there are reasons for those rules that are much bigger than my own individual situation. I told her that this felt punitive to me. I had done absolutely everything asked of me and have approached this whole process in good faith, to have it taken away when I’ve done nothing wrong just seems so unfair (predictably unfair). She said it wasn’t punitive. I said I knew that but that was how it felt. It also made me angry. Hello radical acceptance!

Hmmmm. We then spent the next hour discussing how I had found myself in this situation. It was good conversation: open, honest and on my level (I can feel quite patronised by health professionals). I felt that D succinctly got to the core of the problem: in my sessions with M I had not been validated. Her approach had wandered more into other therapies. However, in DBT the approach is to validate and change. So I was turning up every week, working my socks off and never feeling like I could do anything right, constantly criticised and just worn down. M always had this saying “In DBT we say we acknowledge you’re working hard but think you can always work harder”. I explained to D that I just didn’t think this was the case – sometimes I can’t work harder! I really, really can’t! And she agreed. She told me that that particular phrase comes with the caveat unless change is happening. So, no, I couldn’t work harder because change was occurring and I have been regularly applying the skills I learn in group. I didn’t know if she was playing along or if her some of her shock and concern was genuine. It felt genuine and I’m pretty good at telling. After we had discussed why I no longer wanted to work with M she seemed to really get it and, in fact, this meant that I really was in a tricky situation.

D told me that M had to make a repair to me. I started to cry because I didn’t want to upset M and I’m really sorry that all of this has happened. I didn’t mean to hurt anyone. D gently reassured me that she could see that. I said I was happy for M to make a repair to me because I knew M would be feeling bad about what happened and I didn’t want her to feel bad. D told me that the reason M was to make a repair to me was because I deserved a repair. I was uncomfortable with that so I’ve to do radical acceptance work on that. I’ve also to do a cope ahead plan for the repair meeting. I’m dreading it.

The final piece in the puzzle was what I bring to the relationship and there is a problem with that. M has to try and read me in our appointments but yet I am extraordinarily difficult to read. To be fair I often don’t process challenging information immediately. Instead I take it in, file it and then, when I get a chance (when it’s safe), I have a look at it – that’s when the emotions generally come. So in my last appointment with M I outwardly appeared fine. I laughed and held conversation and reacted appropriately because that’s what I do. This makes it really hard for the therapist and leads to another problem. It may be that M feels unable to continue with me because her own confidence is so dented that her self-doubt would really get in the way. I get that. It’s not good though.

It’s unsurprising of course because it’s what always happens. I try and believe that it will be different but deep down I know it’s only a matter of time before anyone who tries to help gets taken away from me. I reckon M will say she can’t work with me anymore and then? Well, here I am. Just me and my life threatening behaviours for company, because they never leave.

 

Falling Apart

I thought I was pulling myself out of that last black hole. Slowly and tentatively I really thought that I would improve my functioning and coping. I know with BPD that things can turn on a sixpence and here I am, standing in an emotional tornado, trying to think. 

Observe and describe they say in DBT. Yeah done that. Panic continued to rise. Then I start pacing and want to mutter to myself but my son is in the next room so must stay calm. Stay calm stay calm stay calm. Breathe. That helps a bit. Shit! Tears now? Can’t cry. Choke them back. What am I even crying about anyway? My skin feels extra sensitive. It’s crawling just from the sensation of my own clothes. In the kitchen I pretend to shout at an invisible force “I CAN’T CRY! I’M NOT ALLOWED AND YOU WILL NEVER SEE ANYONE AS GOOD AT HOLDING IT IN AS ME!” I only mouth the words, no sound owing to boy in next room. I imagine throwing a glass vase at whatever this entity is.

The panic builds and builds because I  in charge of one child, have a 2nd to pick up from nursery soon and a dinner to make. Need to stay with it. I’ve used DBT skills and grounding techniques all day but it’s doing diddly squat now. This is what happens. I try and tell them and they never take me seriously.

I’m wondering wtf to do and remember that I have lorazepam for emergency use. This counts. I take it and 2 propranolol too. I make my son a hot chocolate and do so mindfully…stay with it, stay with it.

I realise I need help and then I remember that there is none. Why is that the story of my life?! So I write this waiting for the meds to kick in, breathing and wishing that someone could remove me from this tornado. That’d be great.

Fear of Abandonment 

I’m not afraid of abandonment. I expect abandonment. No one enjoys being abandoned do they? So why would I be any different?!

It’s funny because people always like to reassure me that I have nothing to fear and then, somehow, they leave. I’m not cross with them for leaving (usually) but I do wish people would take on board what I say!

I’m feeling really quite abandoned at the moment. Nursery Nora left me about 4 weeks ago. She retired so it wasn’t personal but neither was it a surprise. She helped me, really helped me so I knew she would be leaving me. We spent 8 months developing a relationship and I trusted her. She seemed to understand me(ish)! And then she was gone. 

I could really use Nora right now seeing as how my relationship with DBT Monica has also broken down. I refuse to see Monica again after her cruel character assassination of me. So that’s that then. I didn’t see it coming but hey, I knew she’d leave one way or another. It wasn’t self sabotage. Quite the opposite in fact. So that was my 2 main support people gone, both within a month.

I had a 3rd arm of support; my GP. Yeah, that’s over too. Again it’s nothing personal (I think) just facing reality. There is nothing they can do for me. My meds can now be requested online so fingers crossed they’ll barely have to see me anymore. Great.

And all of a sudden I’m abandoned again. Not surprised but I’ll admit I’m bitter. People shouldn’t act like I’m unreasonable when I expect this to happen. 

But now what do I do? Who do I lurch towards now? I’d much rather I didn’t need anyone. That would make it all a lot simpler. They want me to trust them each time…because it’ll be different… and it never is. 

I humour them, of course. And wait. And then, out of nowhere, they leave again. And sad and painful though it is, at least I get to breath a sigh of relief whilst silently saying told you so.

Another Crisis Survived 

Another crisis survived. It’s a victory but a quiet one. No one cares. They’d have cared, presumably, if I hadn’t managed the crisis. Although when I say cared I mean be angry at me for being selfish etc. 

But I did manage yet another crisis. I’ve had a lot of these crises over the last few weeks. Each time I get through it, without professional help, without much of a fuss and, I suppose, that may invite judgement:- these can’t be real crises if I’m managing them on my own. Hmmmm. I disagree. When I can’t leave my house for fear of buying pills to overdose, can’t care for my children, just can’t manage much at all other than crying, or being vacant, or sleeping? When I have a constant narrative to harm myself or to be dead? When I find my hands moving to my own throat to choke myself? I think that counts but I guess it doesn’t because I am managing it.

I was very depressed yesterday. I went to DBT group and that was quite good actually. We started Interpersonal Effectiveness and I think I need this more than I had realised. I enjoyed the session because I felt like I was learning. I enjoy learning. If something interests me then I just want to soak it up. Pretty much as soon as I got home the emotions became intense. Although I was alone I felt harassed. I had so much to do, too much to do. Every time I tried to tick something off the list it created another job. I was totally overwhelmed.

By evening it was too much. The emotion was overwhelming. Be dead, be dead, be dead. Urges. So I started thinking about my crisis plan and recognised that it was pretty pointless. The crisis team can’t do anything so no point ringing them. My husband can’t help, he gets emotional and overreacts and makes it worse. I looked at the NHS Suicide section on their website. It suggested emailing the Samaritans. I could do that! So I did, I emailed jo@samaritans.org I knew that they couldn’t do anything but listen but, to be honest, that in itself was hugely helpful. It’s funny how many professionals I speak to but rarely feel listened to; they have their specific questions. Everything is lead by want they want from the appointment. 

After the Samaritans I chose self-soothing. I had a little Graze box treat and a hot chocolate, took my quetiapine, made a hot water bottle and retreated to bed. I put lavender on my pillow, cuddled up to my blanket and bunny. Then I took 3 cocodamol for good measure and downloaded an audiobook (The Humans by Matt Haig). With my headphones in I drifted into the safety of unconsciousness. It’s the next best thing. 

My night was full of vivid dreams of the past. Some of it was reliving abuse and some of it was comforting. The important thing was how I woke up and I woke up ok. Ok. Tired, mentally bruised and battered, but ok. Another crisis survived. It’s a quiet victory and no one will celebrate it, not even me. For me the feeling is relief. I know that this is temporary. I expect that I’ll hit crisis point again in the next few days so I’ll try and make plans now with the aim of avoiding crisis. I get scared. How many times will I successfully negotiate these urges? I’m so used to this; to having to survive. I do get resentful about it, about having to fight so hard for something that I’m not sure I want. Having to fight for something that other people want (my survival) on my own.

Still, survival brings options, death doesn’t. So quietly I’ll just go about it. Invisible. 

Don’t Care Do Care

I don’t care. I do care. 

So what if I feel horrendous? Big deal. Just shut up and get on. I can’t even imagine how bored everyone must be of my shit. 

I cut my wrist the other day. Not attention seeking I just really wanted to do it. It felt great but afterwards but I was worried about explaining it. I needn’t have bothered. No one mentioned it last time I did it on the other wrist and no one has mentioned it now. Good?

No one has checked my DBT diary sheets in weeks. Lucky really because this way I don’t have to discuss why I’m rating my suicidal urges at 4/5 – the highest I’ve ever rated them. I don’t have to explain my self harming or self medicating or the little notes that I’ve been in crisis because fortunately no one is looking or asking. Bit weird when they make a big deal about my – apparently – life threatening behaviours but whatever, at least I’m left in peace. I should just start lying on the diary card, tell them what they want to hear. It’d be easiest on all of us I think.

No one has actioned my quetiapine prescription. Apparently the pharmacist rang the GP on Monday but there’s no record of it so I need to actually see a GP and explain the whole fucking saga and hope that she actually believes me – Ha! That’ll be 50/50! Last thing on a Friday too! 

I wonder if I should see the psychiatrist again and then I remember there’s no point. My diagnosis hasn’t changed and clearly I’m on my own with my medication. What can he do? Same as everyone else – nothing. It’s funny cos he told one of the ladies in group to call him rather than struggle. She’s been in mental hospital before though so he considers her proper ill; not like me who’s basically fine…

Yup. Don’t care. Whatever. Do care. Help me. Never mind. Go away. I sort of wish I could just go away. Just go somewhere and see what happens when I stop trying to hold it all together. But I can’t. 

Is It True?

I’m confused. Was that therapy? 

I was terrified going into my one-to-one with Monica today and I told her so. She briskly went about business, about how this therapy wouldn’t work unless we were more specific about my behaviours. It felt like being told off. I wasn’t sure what I’d been doing wrong. She asks questions, I answer them and that’s how it goes. How could I be doing that wrong?

She told me that she hadn’t read all of my letter, my chain analysis I had sent her. I was embarrassed. I had opened myself up and it was viewed as the warbling of a madwoman. She hadn’t even read it all. God I’m so foolish. 

She said we had to be more specific about my behaviours. I was confused. I thought she knew but I answered as we matter-of-factly went about creating an itinerary of the awful things I think and do. It was shameful for me. Trains, guns, throat cutting. She categorised each thing in front of me. I felt disgusting, like I was standing naked and being evaluated. 

Then it was therapy interfering behaviours. This is hard to explain. She spoke about the way I am and that this causes problems in our sessions. I felt my trust drain away. I don’t understand. I am who I am and I’m trying to change. In our last session she had sensed my stifled anger and it had made her want to be away from me so I needed to change this behaviour for therapy to work. Now I was beyond confused: but I was trying to keep the anger in as best as I could – what else could I do? She suggested I let it out. No, I can’t, I’d destroy the room, smash it all up, be vile – how is that not therapy interfering? If I shouldn’t keep it in and shouldn’t let it out then what the actual fuck was I supposed to do?! 

I changed my posture to a slouch so she told me that was another thing I do: slouch and become wilful. Then she mirrored my posture. I laughed but it was awful, like being mocked. She criticised my behaviour but I do these things subconsciously whereas she was choosing to behave in that way. She said it was like talking to her 16yo son. I said I wasn’t being wilful – I was disagreeing. There is a difference. 

A different tack – she reminded me how in one of our first meetings I spoke about my lack of friendships, and that I hadn’t understood why this was. Well, if she got the urge to leave the room because of how I was then that would also be happening in my other relationships. I think this was supposed to motivate me to change. I’m already motivated to change! I didn’t need a fucking character assassination. My sarcasm so unpleasant. This confused me too. I’m never sarcastically horrible to anyone (but myself), it’s generally my dry sense of humour which is actually quite a bit part of my character. 

She said I looked despondent. Well, seeing as how we’d already categorised how fucking suicidal I was and I’d just endured a blow by blow account of how bad I make others feel despite only trying to be good YOU BET I’M FUCKING DESPONDENT. Instead I told her it was a lot to take in and I needed time to process it.

Well, I’ve been processing it for a few hours now and nope, I still feel despondent. Worse than ever. I had always hoped that these bad things I believed about myself weren’t true but they are. And I don’t know how I can live with that. 

One Mindfully Flashback 

Mindfulness is at the core of DBT. We learn the what skills (observe, describe, participate) and the how skills (one mindfully, non-judgementally, effectively). Personally I find these formal labels really confusing and tie myself up in knots trying to figure out which mindful skill I’m using, or trying to use.

Anyway, at the end of each module we revisit mindfulness. None of us in group like this. We all bitch and moan and roll our eyes about fucking mindfulness. Still, yesterday’s session (week 20 I believe) was about revising the how skills.


So, I still find DBT group extremely stressful and I’ve discovered that if I sit and colour in then it allows me to concentrate on what is being said, stops my mind wandering and allows me to participate much more effectively. I am calmer and remain an adult. This is good. Everyone in group gets it so they’re fine with me doing it. So yesterday I was sat colouring in, participating and all was going well. Psychologist Amy then says the whole group are going to do some colouring in and we are each going to focus on this work one mindfully. Awesome! There is an initial scrabbling for pictures, pens and pencils. I have my own so I just carry on and internally have a rueful little smile to myself; they remind me so much of the students I used to teach. Amy is teacher so gets everyone settled and instructs us all to focus and be one mindful. And we do. The room falls silent. The only sound is the rhythmic ticking of the clock.

Amy, being teacher, is now a bit lost. She doesn’t want to disturb the silence, the focus, the concentration so she starts getting bits out ready for the next bit of the session. I know exactly how she feels. I have felt that way countless times in front of my classes when they are absorbed in a task and I have become surplus to requirements. Yes I know that feeling very well and I see it in Amy. She is the teacher and I am the student…the child. Uh oh

I won’t have that sensation of leading a class because I am not a teacher anymore. A great sadness arises within me. A sense of loss. I used to be a teacher but now I sit and colour in. I let the sadness come, acknowledge it and try and focus back on the colouring one mindfully.

Tick. Tock. Tick. Tock. Tick. Tock.

Just like my gran’s grandfather clock. Tick. Tock. Tick. Tock. It’s warm like my gran’s house too. Gran’s house; a place of safety. Tick. Tock. Tick. Tock. Focus: which colour for these berries? Gran was a teacher too. I wonder what she’d make of this. She’d probably quite like it, she liked arty stuff. 

Then the smell – the smell of gran’s house. Comforting. A place of safety. Tick. Tock. Tick. Tock. Sometimes when things became too dangerous at home I would take the kids round to my gran’s and we’d stay there. She only had a tiny flat and the grandfather clock was in the hall. Sleeping there was always so special. She would make tea and toast before bed, she would make us brush our teeth and wash our faces, we’d be tucked into a warm, cosy and clean bed. We’d say our prayers (like that helped) and then I could read. Gran had loads of books. They were old. Old book smell (yum!), tucked up in a safe bed listening to the tick tock of that grandfather clock. The rarest of moments for me, feeling safe, feeling cared for. 

But I wasn’t at my gran’s house. She is dead. Long dead. More sadness at the loss. Made so much more bitter by her dying 5 days after my son’s birth. This prevented me attending her funeral. I never said goodbye. I was given nothing of her possessions. Our relationship not even acknowledged by the rest of the family. I was out of sight, out of mind. I am no one to anyone. Every year the family travels back to where gran is buried, to remember her and to keep the family ties. I can never go because I have my son’s birthday stuff going on, which no one thinks of. To be honest I often wasn’t even invited. That hurts. A family gathering of my parents, 3 aunts, 1 uncle, their partners, my 3 brothers, my 11 cousins (and their partners and children too as they’ve grown) – but not me. And no one misses me. 
And I know it’s all part of the fucking Universal balance thing. I fucking know it. Every year I am punished. Special was she? Ha ha ha. Take her away in a way where you can never say goodbye and be always excluded. Ha ha ha. Know your place. And not to be outdone, exactly 7 years after she died (5 days after my son was born) my daughter was born. Her birthday is my gran’s date of death.

Tick. Tock. Tick. Tock.

I’m supposed to be colouring in. Pick up another pen. Focus one mindfully. Fight the flashback; my vision is going dark and grainy and I feel faint – this is often how flashes come for me. But I fight it. I breathe deeply and mindfully. I fight the urge to run out of the room. God, the sadness. It’s overwhelming. If I start crying I won’t stop. I look at the chimes they use to signal the beginning and end of each mindfulness practice. I’m willing Amy to chime them. Please, please, please. 

Finally she does. With a peaceful smile she asks how we found that. I speak up. I share the sadness, the wanting to run, the near flash but I don’t share the details. Amy asks how I am now. I shyly bring my hand out from under the table. It is shaking violently. I feel faint and sick. I’m sweating. This is fear. I know this. There is no insight or conclusion about what happened and I manage it skilfully. 

When group finishes I am still shaken. Another ghost has been awakened. And I feel alone with it. Again back to the psychotherapy argument – why won’t anyone help me with my ghosts? They awaken them with their stupid mindfulness bollocks and then I am left with them. As if I didn’t have enough to manage already. 

At home that night I want to obliviate everything. Instead of taking all the meds that I want I make, what I consider to be, a wise mind choice. Instead of taking an amount of substances that would be dangerous I take 2 cocodamol, drink one beer and pop my quetiapine. Good night.

No doubt I can look forward to being bollocked for doing that later today. Sometimes I think…wilful? Wilful?! You have no fucking idea how wrong you are. Since when is fighting for survival wilful?