Many years ago I would spend a week deciding what to wear. Should I wear this skirt because it was bold and flowing or these jeans because they were tight and hugging – leather or lace, denim or Doc Martens? What stylish, stunning threads would be the right ones in order to illicit the response I wanted? It all depended on my intention – was it to entertain and seduce, defend and demand or gain hope and heal?
Years ago I used to dress according to the role I wanted her to play with me, whether it be best friend, favourite aunt, smart sister, emotionally devoid mother, or secret lover and I would spend an inordinate amount of time getting my clothes and hair just right to illicit as many compliments as possible. When I was more regressed and should have been wearing a onesie to therapy, she would always comment on my hair and I’d forgotten about that until she mentioned how nice my new hairstyle looked recently and the memories came flooding back. In the past she always appeared to have a special weakness for my long blonde hair, one that I used to exploit mercilessly for her attention and approval. I always gave her compliments the more sinister interpretation of a seduction scenario.
Whether a cigar is just a cigar depends if you have a psychoanalytic bent or a cognitive-behavioural one. I finally realised that I had a therapist who prefers to stay in the present moment and lets you know that your hair looks nice today and that her compliments should be met with a simple “thank you.” Ever since that time ten years ago I have met similar compliments from other people with a similar response. Much of her firm, common sense therapy has sunk in over the years.
Since I stopped worrying about impressing her and more time asking her to challenge my belief systems, we spend …
The difference between my young Borderline self and my older, somewhat wiser Borderline self is that I may still have the same intense feelings of rage, paranoia and injustice, but I now sit in those feelings and try to discover what they mean to me and channel them into a different, more positive direction. Instead of hating civilisation and its discontents I embrace the suffering, look inward and transform it into a learning opportunity for personal and spiritual growth. Part of that was learning to love what I already had instead of seeking out what didn’t belong to me and never would. The Buddha said, “Suffering is inevitable.” And it is – sometimes. It is what we do with that suffering that counts. I had to learn to lie down beside the Borderline bull, embracing her lacerating horns at a level we were both comfortable with.
After fifty years of eating disorders, lap bands, a small bowel obstruction, kidney cancer, malnutrition, metabolic syndrome and diabetes type 2, I was further diagnosed with a lump on my ovaries in August 2012. So I went to see my disease-free, de-toxed, slim, fit, healthy, yoga-inspired, meditative, free-range, organic, body-centred clinical psychologist who advised to me to do what she had been advising me to do for the past 17 years. Look after myself, be kind to myself, be gentle with myself and start to eat and exercise accordingly. What would you know about life? I thought, as I threw my last sugar binge in her outdoor bin before taking off on holiday with my husband.
Bali for me is usually one long, eating/drinking self-indulgent binge punctuated with cheap shopping sprees in and around Kuta – buying clothes I never wear and items I would sneer at back in Australia. This time we stayed at Lovina Beach and Ubud and I made the epiphanous decision to eat organic vegetarian, drink detox blends and spend as much time as possible being mindful at the Yoga Barn. I also relished the idea of torturing myself by hiking 500m almost vertically down (and back …
It’s been a long time since my last blog because I felt I had run out of things to say about BPD. However, since working in peer support work for the past year with a caseload that comprises of 75% women with BPD, I thought it prudent to resurrect my blog because I now have lots more to say both now and in subsequent blogs and I also need your valuable input for something I feel is incredibly exciting.
In Western Australia, we have no non-clinical psychologist run Dialectical Behaviour Therapy (DBT) services for BPD sufferers. We do have three teams in the metropolitan area of Perth run by fantastic, dedicated clinical psychologists who are the only MH professionals able to deliver this service. This is not nearly enough though. Only a small percentage of people can get help in this public sector which means they don’t have to pay. Medicare-refunded therapy (mostly with a considerable gap payment) is six sessions per year, an extra four if there are exceptional circumstances. Seeing as many people with BPD are on disability pensions, unemployed or under-employed, self-payment is not an option.
The new Clinical Practice Guidelines for the Management of People with BPD by the National Health and Medical Research Council states that “Health professionals at all levels of the healthcare system and within each type of health service, including general practices and emergency departments, should recognise that BPD treatment is a legitimate use of healthcare services. Having BPD should never be used as a reason to refuse health care to a person.”
It is great that this is finally recognised but the reality is that long term clinical and non-clinical treatment options are simply not widely available in Western Australia. Through my role as a peer support worker I am hoping to start up a non-clinical self-help support and friendship group under the existing umbrella of government and non-government services. My long-term vision is to be trained and train others in DBT skills to set up other groups all over the …
Is Google-stalking your therapist morally wrong, a self defeating masochistic exercise in futility, considered Borderline Personality Disordered behaviour or worse, or downright creepy, dangerous and illegal; or is it healthy curiosity and something everyone does but would not admit to – or perhaps all of the above?
I was surprised to find “Good Will Hunting” on our DVD recorded movies list. Apparently my oldest son, Matt recorded it thinking it was about guns. A great movie, and it was the bit at the end that settled an eternal question for me. Matt Damon hugs Robin Williams and says: “Doesn’t this violate the doctor/patient relationship?” and Robin Williams replies, “Only if you grab my arse.”
So, let’s get to the bottom of this once and for all. If it is OK for therapeutic couples to hug, then here are some types of therapy room hugs that might be considered appropriate:
The Stealth Hug: This happened for me about eight years ago. I saw her in the corridor wearing a green jumper and a black pleated skirt and I made a snap decision, so when I got into the room, I launched myself at her. She was quite startled, but put her arms around me and hugged. That, by the way, is the only correct response when a client stealth hugs a therapist. Had she refused, my mortification factor would have been stratospheric and I would have had to leave immediately – never to come back again. When a therapist refuses a client’s stealth hug it can make the client feel contaminated at best and the embodiment of evil at worst.
Sometimes, I catch myself having fierce arguments in my head with people I have never met, about situations that have not happened, followed by resolutions that are never satisfying. My headspace is cranky and irritable and there is no logical preceding incident; it is just where my head automatically ends up when let off the leash and wanders free range. I call this IBS – Irritable Borderline Syndrome.
Now, when I catch myself doing this, I redirect my thoughts into something else. I discovered I was doing this on the 45-minute journey to and from work. Without external noise distraction (my radio/CD broke) and only my thoughts to keep me company on the stop/start traffic jam journey to and from work, I was mentally irritable from plotting evil thoughts, arguing with my inner self and ruminating long before I reached my destination. My armpits and skin would itch with stress induced hormones and my bowels and intestines would cramp into knots.
Borderline Personality Disorder is not just about mental illness and emotional distress, it is also about social skills (or lack of them), empathy, manners, conflict resolution and self-care. Most children learn these vital social skills early on at pre and primary school where they observe other children’s behaviour, learn a “theory of mind” or how other children think and feel (mentalising) and experience compassion and empathy for others. These things come naturally to them.
But some children, through no fault of their own, are unable to learn and remain totally clueless about how to survive socially in the playground. These are the kids who suffer social neglect, rejection and abandonment. These are the children who need a step by step guide or a “recipe” on how to learn empathy, how to be a team player, how to get on with other children, negotiation skills, conflict resolution, the rough and tumble of give and take and sharing toys with grace and dignity.
These kids need to learn that when this happens, this is the correct response. I was not one of those naturally cluey children; I lived in social Siberia most of my school life and became a library refugee.
Here are five survival techniques desperately needed when suffering from BPD:
There is a saying in a self-help group I used to be in back in the eighties. When a “normal” person gets a flat tire, they call the Automobile Association. When someone with (what’s now known as BPD) gets a flat tire, they call the suicide hotline. There’s an awful lot of truth in that.
My goal recently has been to respond rather than react to what I perceive are excruciatingly provocative circumstances and situations. I want to think and act with grace and dignity, to deep breathe, turn around, walk away, move on, learn the lesson and get a life. This attitude has, in the past, kept me in relationships, out of the law courts, out of jail, out of psychiatric hospitals, in employment and in therapy (or life coaching as we are now doing).
No longer is my therapist my nurturing supporter, smothering me endlessly with loving/kindness, reassurances of never abandoning me and justifying my bad behaviour and lack of social skills as a result of my environment. We have a more pragmatic egalitarian relationship where I feel mentored, rather than mental.
When you suffer from Borderline Personality Disorder (or complex trauma) one person’s constructive criticism or negative response is another person’s life-threatening narcissistic injury. I received a narcissistic brain hemorrhage this week when my challenging and authoritative therapist decided it was not relevant to our therapy to watch a video link I had emailed her.
My borderline reaction went to DefCon One in less than a nanosecond and I thought my brain would implode.
To be fair to myself, my thoughts remained relatively mindful (she’s said no before for the same reasons and yet I continue to email her things; it could be said that an idiot does the same thing all the time and expects a different response. If that is the case, then I am that idiot) but my body was transported instantly back to the mid-seventies where school bullying and parental fighting had finely tuned my fight, flight or freeze response.
At my last therapy session my therapist turned into a savage rottweiler; baring her sharp teeth at me, picking me up by the scruff of my neck and shaking the living daylights out of me. The doggone woman deliberately picked a fight about nothing, provoked me into a snarling row, called me a liar and then threatened to sue me for slander.
Interpretation of unfolding events is always a personal perception. I have been seeing her again for some workplace issues that need resolving. I was having problems accepting constructive criticism from the top dog in my organization. I found I was getting deeply triggered when told I was not achieving what I was supposed to achieve in the way she wanted it achieved and I was getting my feathers ruffled in a big way, getting upset, huffy and resolving the issue by fleeing or freezing.
So when within five minutes of arriving, my barking mad therapist activated every button on my panel and almost blew us both up, I almost called her a bitch, walked out the door and planned on brooding, ruminating and plotting impotent revenge against her for the rest of my natural life. Talk about an idealizing transference killer.