I look better 

I’ve been hearing a lot about how well I look at the minute. This is because I’ve lost a fair bit of weight. I was obese at 96kg (BMI 33.2) and now I’m slightly overweight at 74kg (BMI 25.6). Losing 22kg (or 3st 6lb in old money) is certainly noticeable. I just find it really odd how I’ve been losing weight for months and a months (6 to be more accurate) but it’s only in the last couple of weeks people have noticed.


I mean, I’ve been losing it at a steady rate so it’s not like it’s all just fallen off in a few weeks but now I seem to have reached some point where everyone feels the need to comment. And it’s nice, don’t get me wrong. To be getting compliments is lovely but it just seems weird. Why now? 


I’ve been working at it for so long, logging what I eat every single day – including over birthdays, meals out and Christmas. The first few months were done privately but then I had to let my husband know for Christmas, to help me. Now that everyone is commenting I have to admit that yes, I am watching what I eat. I tell them it’s because my medication can cause weight gain (which is true – quetiapine) and people seem happy with that. I tell them that the weight loss has slowed, that I feel better for losing it and I’m enjoying exercising – all true.

It seems to make everyone happy that I’m smaller now. My husband in particular loves it, commenting and praising my body every day. He always makes sure to add that he loved it before too! When I tell people that I’m still overweight they tell me that it’s fine, bmi is only a guide and I look great. That’s nice of them so I don’t tell them that I really want to lose another 10kg+ (1st 8lb) to be in the middle of the healthy bmi range. Instead I reassure them my weight loss appears to be plateauing. 

I make sure to eat in front of people. Every evening we sit down and have a family meal. These are often calorie busting so I’ll have to eat very little in the day to save up for them. I wish I didn’t have to do this. Yesterday my mother-in-law offered me some home baking; I didn’t want it. However I knew that we were staying for dinner and I’d be wanting to eat less then so to balance it out I accepted the crumble slice and ate something I didn’t want at all so that come dinner time it wouldn’t be so bad that I turned down the bread and the ice cream. I still ate more then that I’d have liked and that irritates me. Losing weight is slow and hard and having to do it in such a way that stops people prying feels very restrictive. I feel I can’t choose to eat when and what I’d like but instead have to eat all sorts in front of people to stop any unnecessary concern. The irony being of course that everyone tells me how good I look! 

Yargh!

And yes I do look a lot better and I do feel a lot better in myself…physically. It sort of feels misleading. People who know I’m ill tell me I must be doing so much better…because I look better. Well, no. Not really. Not at all actually. I still wake up and my first thought of the day is I want to die. But I can’t bear to disappoint them so I agree that it feels much nicer to be smaller – which is true but says absolutely nothing about my mental health. 

I’m the master of the mask. I just can’t help myself can I? I look so much better.

But I’m not.

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I feel bad

I feel like I’m tied to reality by fine threads. Sometimes I can pull and reel reality right back in. Other times I worry that reality is going to entirely slip away  from my grasp. Today I’ve veered between these two states uncontrollably. And it’s not even 5pm.

I’m so tired.

I met a friend for coffee at 1030am. As I drove there I was wondering if I should ask her if we were really alive or was this all a dream. The fine threads of reality tugged and jolted me back. I parked up and my feet hit the real ground when I got out of the car and I was back in reality. Coffee went well. I gave my friend a lesson plan (she’s a teacher and had asked for my advice). The lesson plan had come to me in my dream last night so I wrote it this morning. It was pretty good I think!

Then I went to DBT group. I think I might have been in and out of dissociation. I spent a lot of time focusing on objects or closing my eyes. In the break I sat on the floor curled up in a ball. Then I went back in and was sort of ok. Then I wasn’t again.

Home and so tired. Confused. What’s going on? My head hurts. I want to sleep, rest and be cared for. My jaw aches. 

I’m really unsettled by these feelings. Then my dad emailed. It was weird. That doesn’t feel real either. 

I can try and tell my care coordinator tomorrow but I expect she’ll tell me this is normal (for people like me) but it doesn’t feel very normal. I must use all the wrong words. I don’t know the right words but I know I feel bad.

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.