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 …
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.
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.
Learning how to accept criticism graciously is a form of art, but for me it is a work of art in progress. This is because I was diagnosed with borderline personality disorder and part of that syndrome is being unable to tolerate critical comments, no matter how well-meaning.
So what happens when I get criticized? No matter how mindful my brain wants to be, my body has an anaphylactic reaction. I feel as though someone has thrown acid in my face. I feel my body disintegrating and my internal organs shutting down and psychological and physical death is imminent. Does that sound familiar to you?
This isn’t planned, this isn’t about me being a Drama Queen or a Princess with a slipped tiara; it’s about staying alive. I go into survival mode where I have to sit in a chair, breathe deeply, count my fingers and toes and make sure that I am all here. I have to detoxify my body before I can even start to work out cognitively what was said, why it was said and what the ramifications of the criticism were.
At what point does a therapist decide to terminate a client because their relationship has broken down? Over the past three years writing my blog I have received many emails from therapy clients telling me that their therapists terminated them, either for no reason or for a small infraction within the relationship.
Are therapists being over-sensitive or are clients diagnosed with borderline personality disorder unaware of their own personal lack of empathy towards someone who is on their side? Being terminated for relationship issues with the therapist does not make sense to me. The entire reason we are in therapy is because we have huge external relationship problems and this plays out in the therapeutic relationship and the therapist should be aware of this.
When Borderlines and Narcissists clash, it makes When Worlds Collide look like two butterflies locking wings together in a mid-air prang. As someone diagnosed with Borderline Personality Disorder I had the misfortune to run up against a Narcissistic Personality Disorder and I would describe the experience like running full speed, head first into a brick wall without a helmet.
For me, it is exceedingly rare to come under the microscopic scrutiny of a dangerous and mentally unhinged person who appears to be made out of concrete in such a manner that a nuclear bomb would be unable to dislodge their black and white thinking. For this person it was either night or day, there was no pearly pink twilight or early misty mornings.
This person was highly and appropriately right and I was incredibly stupid and wrong. I know this because it was hammered into my skull at every given opportunity.
The therapy “hour” is anywhere from 45 – 60 minutes, which is clearly not nearly enough time to arrive, get down and get dirty before you have to leave, half way through, without finishing what you started out and feeling like something has not been completed. The therapist might be left gasping and glowing with satisfaction, but essentially if this was sex you’d be faking your orgasm and walking out with your head held high and having to wait till next week when you get to do the same old frustrating exercise all over again.
If the session was 2 hours long, I might start to feel as though the earth had moved for me as well. It would be wonderful if you could just radiate in the afterglow of the warm therapeutic space that had been created by the two of you, but after 45 – 60 minutes it’s time for you to get out still feeling hot and bothered (and for the next client to come in cold) all the time brooding and ruminating that the earth might just move for them in a way it did not for you.
It used to be that if I ever ran into my therapist at a café, at the airport, in a restaurant, or walking down the street, I would have to walk out, catch a different plane, leave my meal or cross the street and get hit by a bus. She once said to me that I would have moved on when I could pass her in public, either wave or not wave, and my care factor would not be there.
So how do I avoid either the impending feeling of doom and chaos or the sheer guilty pleasure and excitement of seeing my therapist outside of therapy for free? I have had a mixed reaction on the handful of occasions I have seen her or her car out in the wide, wide world.