Monday, December 27, 2010
Friday, December 17, 2010
Symptoms of BPD
Before talking further about treating BPD, I thought it might be important to talk about the symptoms of BPD and the underlying pathology which the treatments are designed to heal.
Most BPD persons are drawn to the attention of the medical community when we show up in emergency due to a suicide attempt or cutting.
While I myself, have been often suicidal, I am not a cutter. I think what is underlying the behaviours of BPD persons is a sense of being overwhelmed, unable to cope, which then results in self-destructive behaviour.
From what I understand, we get overwhelmed, partially due to the fact we are misperceiving what is going on around us.
Some of the symptoms (collected from a variety of sources) of BPD are:
* Unstable relationships
* Distorted thoughts and perceptions--especially in relationship to others (Idealization and then demonization)
* Impulsivity & instability
* Repetitive self-destructive behaviours
* Hypersensitivity
* Emptiness
* Unstable self-image
* Lability (rapidly changing emotions)
I'd like to add to this my own observations of myself: hyper, perfectionist, inability to love, insomnia* and frequent bouts with eczema when I'm stressed.
Sometimes when I'm not well, I can feel like I'm vibrating in my own skin and I want desperately to get out. This was often one of the times I would drink. Alcohol has the amazing ability to immediately calm me when I'm feeling like this--at least initially.
Something I've noted when in treatment for alcohol abuse is that many of the other women with whom I've spent weeks in residence are also hyper. Very reactive. We are not a calm bunch.
Perhaps that's why mindfulness is an important aspect of DBT--we need to learn how to calm ourselves without self-medicating.
*Insomnia: For most of my adult life, I have been an insomniac. It is only in the past 2-3 years, while living with family members, I have calmed myself down and felt safe enough to be able to sleep through the night.
For me, sleep is a huge luxury. During recent years, when I feel overwhelmed and anxiety ridden, and choose not to drink, I will sometimes cancel everything, unplug the phones, and go to bed (if I can).
I know from the outside, this looks as though I am lazy. Nonproductive. But for me, if I can get some sleep--or even if I can calm myself enough to stay still, read, regroup--this is better than drinking or running away.
Most BPD persons are drawn to the attention of the medical community when we show up in emergency due to a suicide attempt or cutting.
While I myself, have been often suicidal, I am not a cutter. I think what is underlying the behaviours of BPD persons is a sense of being overwhelmed, unable to cope, which then results in self-destructive behaviour.
From what I understand, we get overwhelmed, partially due to the fact we are misperceiving what is going on around us.
Some of the symptoms (collected from a variety of sources) of BPD are:
* Unstable relationships
* Distorted thoughts and perceptions--especially in relationship to others (Idealization and then demonization)
* Impulsivity & instability
* Repetitive self-destructive behaviours
* Hypersensitivity
* Emptiness
* Unstable self-image
* Lability (rapidly changing emotions)
I'd like to add to this my own observations of myself: hyper, perfectionist, inability to love, insomnia* and frequent bouts with eczema when I'm stressed.
Sometimes when I'm not well, I can feel like I'm vibrating in my own skin and I want desperately to get out. This was often one of the times I would drink. Alcohol has the amazing ability to immediately calm me when I'm feeling like this--at least initially.
Something I've noted when in treatment for alcohol abuse is that many of the other women with whom I've spent weeks in residence are also hyper. Very reactive. We are not a calm bunch.
Perhaps that's why mindfulness is an important aspect of DBT--we need to learn how to calm ourselves without self-medicating.
*Insomnia: For most of my adult life, I have been an insomniac. It is only in the past 2-3 years, while living with family members, I have calmed myself down and felt safe enough to be able to sleep through the night.
For me, sleep is a huge luxury. During recent years, when I feel overwhelmed and anxiety ridden, and choose not to drink, I will sometimes cancel everything, unplug the phones, and go to bed (if I can).
I know from the outside, this looks as though I am lazy. Nonproductive. But for me, if I can get some sleep--or even if I can calm myself enough to stay still, read, regroup--this is better than drinking or running away.
Wednesday, December 15, 2010
Treatment - Dialectical Behaviour Therapy (DBT)
Any conversation about DBT will start with a reference to Dr. Marsha Linehan of the University of Washington who has developed this form of therapy especially for BPD clients.
So far, the only place I have found in Ontario offering DBT is the Centre for Addiction and Mental Health (CAMH) in Toronto and their treatment program is full. I call the beginning of each month to see if there are any openings.
My psychiatrist suggests that DBT therapy is fairly complex, and a team of specialists trained in various aspects of DBT delivery is required to do it properly. Thus, only places like CAMH are likely to have such a group of professionals available in one location.
So, in the meantime, what do I do? Can I cobble together a treatment plan for myself with the resources I can find locally?
I've taken a look at DBT to see if I can break it down into segments I may be able to access from various sources:
* mindfulness * interpersonal skills (managing conflict)
* validation * distress tolerance skills
* talk therapy * emotion regulation skills
* cognitive behaviour therapy
There may be more to it than this. Every article I read seems to have another nuance or suggested approach; but I hope I've identified the core aspects of DBT. (If anyone sees an important element I've missed, let me know.)
I'll try to address each of these areas and how I've accessed resources in subsequent posts.
So far, the only place I have found in Ontario offering DBT is the Centre for Addiction and Mental Health (CAMH) in Toronto and their treatment program is full. I call the beginning of each month to see if there are any openings.
My psychiatrist suggests that DBT therapy is fairly complex, and a team of specialists trained in various aspects of DBT delivery is required to do it properly. Thus, only places like CAMH are likely to have such a group of professionals available in one location.
So, in the meantime, what do I do? Can I cobble together a treatment plan for myself with the resources I can find locally?
I've taken a look at DBT to see if I can break it down into segments I may be able to access from various sources:
* mindfulness * interpersonal skills (managing conflict)
* validation * distress tolerance skills
* talk therapy * emotion regulation skills
* cognitive behaviour therapy
There may be more to it than this. Every article I read seems to have another nuance or suggested approach; but I hope I've identified the core aspects of DBT. (If anyone sees an important element I've missed, let me know.)
I'll try to address each of these areas and how I've accessed resources in subsequent posts.
Monday, December 13, 2010
Treatment - Drug Therapy
One of the first things that will happen, no matter where you go and even before being diagnosed with BPD; whether you are seeing a GP, a Nurse Practitioner, or some other health practitioner, is that you will probably be prescribed something to help with mood.
In my case, I presented as someone who was often depressed and suicidal. Self-medicating with alcohol. So, for many years, I was prescribed anti-depressants: Prozac, Zoloft, Paxil, etc. I am currently on Effexor.
Do they help? To be truthful...I don't know.
The way I like to think about it, is that I'm stacking the cards in my favour. I want to know I'm doing everything on my end to get well. Or at least function to the best of my ability where I am now.
One thing I want to caution anyone starting out with drug therapy is that they are not "happy pills". They will not give you the immediate relief a couple glasses of wine, or whatever your drug of choice might have been, can give you. They can also take weeks or months to begin to be effective. There is no "quick fix", so we must be patient and committed in following this aspect of therapy.
However, if the medications lessen the frequency, the duration, the depth or height of the depression...then they are doing their job. Even if it is only a placebo effect, it is worth it to know I'm doing all I can to get well.
On the note of moods, emotions, feelings: I think we are supposed to be able to feel our emotions and learn from them, learn how to deal with them. Learn how to cope. I know that for most of us, how we feel is something we want to avoid, get away from--even to the point of wanting to die, so as to not feel this way anymore.
At the moment, I am early in therapy, so I don't yet have the tools I would like to have in managing my emotions. For the moment, all I know how to do is to sit with the emotion. Quit avoiding it. Breathe into it. Talk with other people about it. Even go to bed and try to sleep. Sleeping may be seen as a form of escape--but I compare it to getting drunk--and consider it an improvement.
I just need to get through now. I've lived long enough to know that the feelings will eventually pass, and I'll be better. There is an end to the pain...even if it comes again. And eventually, I will garner the tools to cope with these feelings.
Post script: Cost. To my knowledge, none of the medications used to treat BPD are covered by OHIP (Ontario Health Insurance Plan). If you don't have a secondary health insurer (usually through one's work) it may be difficult to afford drug therapy.
I know when I was working (part-time, minimum wage) I could not afford my medication. One of the great benefits of receiving Ontario Works support (a form of welfare) is the drug card. For the first time in years I am able to acquire and faithfully take my medication.
In my case, I presented as someone who was often depressed and suicidal. Self-medicating with alcohol. So, for many years, I was prescribed anti-depressants: Prozac, Zoloft, Paxil, etc. I am currently on Effexor.
Do they help? To be truthful...I don't know.
The way I like to think about it, is that I'm stacking the cards in my favour. I want to know I'm doing everything on my end to get well. Or at least function to the best of my ability where I am now.
One thing I want to caution anyone starting out with drug therapy is that they are not "happy pills". They will not give you the immediate relief a couple glasses of wine, or whatever your drug of choice might have been, can give you. They can also take weeks or months to begin to be effective. There is no "quick fix", so we must be patient and committed in following this aspect of therapy.
However, if the medications lessen the frequency, the duration, the depth or height of the depression...then they are doing their job. Even if it is only a placebo effect, it is worth it to know I'm doing all I can to get well.
On the note of moods, emotions, feelings: I think we are supposed to be able to feel our emotions and learn from them, learn how to deal with them. Learn how to cope. I know that for most of us, how we feel is something we want to avoid, get away from--even to the point of wanting to die, so as to not feel this way anymore.
At the moment, I am early in therapy, so I don't yet have the tools I would like to have in managing my emotions. For the moment, all I know how to do is to sit with the emotion. Quit avoiding it. Breathe into it. Talk with other people about it. Even go to bed and try to sleep. Sleeping may be seen as a form of escape--but I compare it to getting drunk--and consider it an improvement.
I just need to get through now. I've lived long enough to know that the feelings will eventually pass, and I'll be better. There is an end to the pain...even if it comes again. And eventually, I will garner the tools to cope with these feelings.
Post script: Cost. To my knowledge, none of the medications used to treat BPD are covered by OHIP (Ontario Health Insurance Plan). If you don't have a secondary health insurer (usually through one's work) it may be difficult to afford drug therapy.
I know when I was working (part-time, minimum wage) I could not afford my medication. One of the great benefits of receiving Ontario Works support (a form of welfare) is the drug card. For the first time in years I am able to acquire and faithfully take my medication.
Sunday, December 12, 2010
The upside of BPD
I haven't seen anyone talking about what is positive about BPD; but here is my take on it:
As much as we can feel pain, we can feel exquisite joy and beauty. It is my hunch I notice things more than most people.
Yes, my sensitivity to light, touch, sound and scents can drive me crazy and make me want to give up and die; but at the same time, I'm fairly certain that same sensitivity can provide me with far greater pleasure than the ordinary, "normal" person.
By the same token, I like to think my sensitivity to emotional states gives me greater insight into what is going on with other people in the room than most people would pick up on.
Additionally, all this risk-taking impulsive behaviour. Risk-taking behaviour has discovered continents and brought us many scientific breakthroughs.
Aside from the potential of death or harm, I like to think that at least some of my risk-taking and impulsivity has resulted in experiences and a form of education, sets of reference points, I wouldn't otherwise have.
Perhaps BPD people are more creative--as a form of survival.
If anyone discovers my theories regarding the "advantages" of BPD are scientifically incorrect, don' tell me. I need to feel there is some compensation for the grief, pain, sadness, losses I have experienced and caused others to experience over the years.
As much as we can feel pain, we can feel exquisite joy and beauty. It is my hunch I notice things more than most people.
Yes, my sensitivity to light, touch, sound and scents can drive me crazy and make me want to give up and die; but at the same time, I'm fairly certain that same sensitivity can provide me with far greater pleasure than the ordinary, "normal" person.
By the same token, I like to think my sensitivity to emotional states gives me greater insight into what is going on with other people in the room than most people would pick up on.
Additionally, all this risk-taking impulsive behaviour. Risk-taking behaviour has discovered continents and brought us many scientific breakthroughs.
Aside from the potential of death or harm, I like to think that at least some of my risk-taking and impulsivity has resulted in experiences and a form of education, sets of reference points, I wouldn't otherwise have.
Perhaps BPD people are more creative--as a form of survival.
If anyone discovers my theories regarding the "advantages" of BPD are scientifically incorrect, don' tell me. I need to feel there is some compensation for the grief, pain, sadness, losses I have experienced and caused others to experience over the years.
Friday, December 10, 2010
Causes
I've been on a life long journey, always knowing something was wrong, but not understanding what it was. Why was I so sensitive and deep? Why did things in my environment--both physical and emotional--bother me so much? Things other people didn't even notice.
So often, on so many days, the world was too much, and I wanted to die. People telling me to lighten up. Not be so serious. Grow a skin. Toughen up. I felt like a hot house flower trying to grow in an igloo. I kept trying to find a place and people who were sympatico, who had similar sensibilities. A place and a community where I could belong. I was so alone.
One of the positive aspects of finally being diagnosed, is to understand what is happening and I know I'm not alone with this problem.
The best article I've read thus far regarding the causes of BPD is by Dr. Joel Paris (I have highlighted what speaks to me):
"We are only beginning to understand the causes of BPD. As in most mental disorders, no single factor explains its development. Rather, multiple risk factors, which can be biological, psychological, or social, play a role in its etiology.
The biological factors in BPD probably consist of inborn temperamental abnormalities. Impulsivity and emotional instability are unusually intense in these patients, and these traits are known to be heritable. Similar characteristics can also be found in the close relatives of patients with BPD. Research suggests that the impulsivity that characterizes borderline personality might be associated with decreased serotonin activity in the brain.
The psychological factors in this illness vary a great deal. Some borderline patients describe highly traumatic experiences in their childhood, such as physical or sexual abuse. Others describe severe emotional neglect. Many borderline patients have parents with impulsive or depressive personality traits. However, some patients report a fairly normal childhood. Most likely, any of these scenarios is possible. Borderline pathology can arise from many different pathways.
The social factors in BPD reflect many of the problems of modern society. We live in a fragmented world, in which extended families and communities no longer provide the support they once did. In contemporary urban society, children have more difficulty meeting their needs for attachment and identity. Those who are vulnerable to BPD may have a particularly strong need for an environment providing consistent expectations and emotional security.
Most likely, BPD develops when all these risk factors are present. Children who are at risk by virtue of their temperament can still grow up perfectly normally if provided with a supportive environment. However, when the family and community cannot meet the special needs of children at risk, they may develop serious impulsivity and emotional instability. "
This article rings true to me. In another environment, my sensitivity and awareness might have been nurtured and celebrated. The difficulties I have had with environmental aspects of urban/modern life might have been accommodated or modifications made.
As it was, my poor parents were children themselves, without healthy parenting, nurturing models to emulate. As one therapist put it, I am a child of benign neglect. I couldn't get my needs met. So, as I understand it, aspects of my inherent temperament got blown out into BPD. Which of course, complicated matters--but at least now with a diagnosis, I can get treatment.
So often, on so many days, the world was too much, and I wanted to die. People telling me to lighten up. Not be so serious. Grow a skin. Toughen up. I felt like a hot house flower trying to grow in an igloo. I kept trying to find a place and people who were sympatico, who had similar sensibilities. A place and a community where I could belong. I was so alone.
One of the positive aspects of finally being diagnosed, is to understand what is happening and I know I'm not alone with this problem.
The best article I've read thus far regarding the causes of BPD is by Dr. Joel Paris (I have highlighted what speaks to me):
"We are only beginning to understand the causes of BPD. As in most mental disorders, no single factor explains its development. Rather, multiple risk factors, which can be biological, psychological, or social, play a role in its etiology.
The biological factors in BPD probably consist of inborn temperamental abnormalities. Impulsivity and emotional instability are unusually intense in these patients, and these traits are known to be heritable. Similar characteristics can also be found in the close relatives of patients with BPD. Research suggests that the impulsivity that characterizes borderline personality might be associated with decreased serotonin activity in the brain.
The psychological factors in this illness vary a great deal. Some borderline patients describe highly traumatic experiences in their childhood, such as physical or sexual abuse. Others describe severe emotional neglect. Many borderline patients have parents with impulsive or depressive personality traits. However, some patients report a fairly normal childhood. Most likely, any of these scenarios is possible. Borderline pathology can arise from many different pathways.
The social factors in BPD reflect many of the problems of modern society. We live in a fragmented world, in which extended families and communities no longer provide the support they once did. In contemporary urban society, children have more difficulty meeting their needs for attachment and identity. Those who are vulnerable to BPD may have a particularly strong need for an environment providing consistent expectations and emotional security.
Most likely, BPD develops when all these risk factors are present. Children who are at risk by virtue of their temperament can still grow up perfectly normally if provided with a supportive environment. However, when the family and community cannot meet the special needs of children at risk, they may develop serious impulsivity and emotional instability. "
This article rings true to me. In another environment, my sensitivity and awareness might have been nurtured and celebrated. The difficulties I have had with environmental aspects of urban/modern life might have been accommodated or modifications made.
As it was, my poor parents were children themselves, without healthy parenting, nurturing models to emulate. As one therapist put it, I am a child of benign neglect. I couldn't get my needs met. So, as I understand it, aspects of my inherent temperament got blown out into BPD. Which of course, complicated matters--but at least now with a diagnosis, I can get treatment.
Wednesday, December 8, 2010
My BPD
BPD is one of 10 personality disorders as defined by the Diagnostic and Statistical Manual of Mental Disorders published by the American Psychiatric Association. Some better known personality disorders would be Obsessive Compulsive Personality Disorder or Schizoid Personality Disorder. (Think: Jack Nicholson in "As Good as it Gets"; Russell Crowe in "A Beautiful Mind".)*Note below
As someone with BPD, I have personality characteristics which have had consistent, serious negative effects in my life at work, school, and in interpersonal relationships.
I am also an introvert, so a lot of my anger and destructive behaviour goes underground, and has been hidden--except sometimes people find out--especially those closest to me.
So what happens? Much of the time, I am quite controlled and disciplined. I seem "normal". I can function, sometimes at quite a high level. Everything looks good.
Then. Something "bad" happens. It could be anything. Typical things that happen in life with which healthy people would and could cope. It could be a bad review. A low mark on a project. A disappointment. A let-down. A desertion. And then I am suddenly spiraling down into a suicidal depression and a range of self-destructive impulsive behaviours: drinking, indiscriminate sex, quitting everything and taking off on a trip, attempting suicide...
Impulsive and unstable. No sense of boundaries--an inability to form them or realize I need them. For a time, I look up to someone; then I become disenchanted or disappointed. I disconnect and discard. To the point I have pretty much cut relationships with anyone, even friends, out of my life. It is just too painful and upsetting.
***
There is an experiment I read about in first year Psychology that describes how I feel. (Warning: this experiment seems unnecessarily cruel and would probably not be permitted in today's ethical climate.)
Some researchers decided to measure resiliency in rats.
They put a rat in a bucket of water and timed how long it took for the rat to give up and sink to the bottom. Then, they removed the rat, gave it a rest, and put it in again.
They found the rat swam even longer in successive trials. The conclusion drawn: The rat swam longer because it had the experience and hope of being rescued.
Then, for some reason, they decided to cut the whiskers off a different rat and conduct the same experiment. As expected, the rat eventually gave up and sank to the bottom. As with the first rat, they removed it, gave it a rest, and and placed it in the bucket again.
To their surprise, the rat immediately gave up and sank to the bottom. They fished it out, gave it a rest, and tried again--with the same result.
I gather the conclusion would be that the damaged rat lacked resiliency, even when it had been given a reprieve and the chance of rescue.
I've always felt, all my life, like the rat without whiskers.
~~~
*Note: After reading more about personality disorders, I realize these movie references are probably incorrect. i.e. There is a difference between Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder. The movie references indicate my knowledge at the time I wrote this entry.
As someone with BPD, I have personality characteristics which have had consistent, serious negative effects in my life at work, school, and in interpersonal relationships.
I am also an introvert, so a lot of my anger and destructive behaviour goes underground, and has been hidden--except sometimes people find out--especially those closest to me.
So what happens? Much of the time, I am quite controlled and disciplined. I seem "normal". I can function, sometimes at quite a high level. Everything looks good.
Then. Something "bad" happens. It could be anything. Typical things that happen in life with which healthy people would and could cope. It could be a bad review. A low mark on a project. A disappointment. A let-down. A desertion. And then I am suddenly spiraling down into a suicidal depression and a range of self-destructive impulsive behaviours: drinking, indiscriminate sex, quitting everything and taking off on a trip, attempting suicide...
Impulsive and unstable. No sense of boundaries--an inability to form them or realize I need them. For a time, I look up to someone; then I become disenchanted or disappointed. I disconnect and discard. To the point I have pretty much cut relationships with anyone, even friends, out of my life. It is just too painful and upsetting.
***
There is an experiment I read about in first year Psychology that describes how I feel. (Warning: this experiment seems unnecessarily cruel and would probably not be permitted in today's ethical climate.)
Some researchers decided to measure resiliency in rats.
They put a rat in a bucket of water and timed how long it took for the rat to give up and sink to the bottom. Then, they removed the rat, gave it a rest, and put it in again.
They found the rat swam even longer in successive trials. The conclusion drawn: The rat swam longer because it had the experience and hope of being rescued.
Then, for some reason, they decided to cut the whiskers off a different rat and conduct the same experiment. As expected, the rat eventually gave up and sank to the bottom. As with the first rat, they removed it, gave it a rest, and and placed it in the bucket again.
To their surprise, the rat immediately gave up and sank to the bottom. They fished it out, gave it a rest, and tried again--with the same result.
I gather the conclusion would be that the damaged rat lacked resiliency, even when it had been given a reprieve and the chance of rescue.
I've always felt, all my life, like the rat without whiskers.
~~~
*Note: After reading more about personality disorders, I realize these movie references are probably incorrect. i.e. There is a difference between Obsessive Compulsive Disorder and Obsessive Compulsive Personality Disorder. The movie references indicate my knowledge at the time I wrote this entry.
Tuesday, December 7, 2010
Resistance to therapy and treatment
It is said BPD clients are resistant to treatment--much to the despair of anyone trying to help.
From my own experience, I can understand the BPD resistance. When we feel well, we are highly functioning. How many times have I made appointments when I am depressed and suicidal, only to cancel. By the time the appointment comes around, I am feeling better and don't think I need help. No one wants to be sick.
It is said that BPD clients are often highly intelligent. But this too is a stumbling block--and no doubt a great frustration to others who see and relate to the sparks of intellect, while watching it go nowhere, be wasted, and the BPD client seemingly unable to utilize that intelligence to get well.
The BPD blogs I have read are diffuse with literary references, points of brilliance and insight. Highly operating vocabularies, descriptive; some well-versed in mental health lingo and the idiosyncrasies of their particular health care system.
The truth is, this intellectualizing and superior intellect (real or imagined) can get in the way of getting help.
How many times have I sat in meetings or groups and thought: this isn't for me. There is nothing grabbing my attention here. This is elementary--too simplistic. This may work for other people; but I need something more.
Or sat with a therapist and hoped they would "guess" what is wrong. Or even in my mind, question the intelligence of the people helping me.
It is sad to admit. Perhaps part of the problem with BPD is we can be pretty nasty and superior. Possibly this is part of why we don't come back. Why we don't finish programs of treatment.
We make idealized demands on ourselves and others. Often we ourselves cannot measure up; and we are unrealistically disappointed in others. The source of much self and other, loathing and disdain.
Perfectionism and idealism, while admirable and desirable in certain contexts, can be maladaptive. These characteristics in me, have made much of my life hell, as I destroy and throw out what doesn't measure up--myself included.
Monday, December 6, 2010
Getting diagnosed II
There are other factors critical to getting a diagnosis, and these factors are contingent on me.
Humility: I have to be willing to accept whatever help is offered in whatever form it comes, whether I think it applies to me or not.
Openness: I have to stop running and hiding. I have to be open about everything, and open my mind to whatever therapy, counselling or situation is offered to help me get well. Motto: Try everything and try to garner something from it.
Stop trying to hide my illness or deny it.
Acceptance: Start where I am and work from there. Baby steps.
Speak: Don't let things get swept under the carpet or bottled up. Speak up when things don't feel right. (In as kind and gentle way as I can manage--skills I need to learn.)
Motivation: I am committed to seeing this through and doing whatever I have to do to get well. This is not short-term. Getting well is my work. It is my focus. I do my best to finish whatever program I start.
Accept Responsibility: This is something I started to do after my second marriage broke up. Stop blaming others for what is going wrong in my life. Stop blaming family, old boyfriends, events, therapists, etc. While I still look for reasons and understanding about the past--attempting to learn the lessons--how I interpret and deal with the external world is up to me.
This, of course, is made more difficult by having BPD; but I anticipate therapy will help me learn to cope with life more constructively.
Humility: I have to be willing to accept whatever help is offered in whatever form it comes, whether I think it applies to me or not.
Openness: I have to stop running and hiding. I have to be open about everything, and open my mind to whatever therapy, counselling or situation is offered to help me get well. Motto: Try everything and try to garner something from it.
Stop trying to hide my illness or deny it.
Acceptance: Start where I am and work from there. Baby steps.
Speak: Don't let things get swept under the carpet or bottled up. Speak up when things don't feel right. (In as kind and gentle way as I can manage--skills I need to learn.)
Motivation: I am committed to seeing this through and doing whatever I have to do to get well. This is not short-term. Getting well is my work. It is my focus. I do my best to finish whatever program I start.
Accept Responsibility: This is something I started to do after my second marriage broke up. Stop blaming others for what is going wrong in my life. Stop blaming family, old boyfriends, events, therapists, etc. While I still look for reasons and understanding about the past--attempting to learn the lessons--how I interpret and deal with the external world is up to me.
This, of course, is made more difficult by having BPD; but I anticipate therapy will help me learn to cope with life more constructively.
Saturday, December 4, 2010
Getting diagnosed
Why so long to get diagnosed? Well, BPD hasn't been identified as long as other disorders.
It's a bit slippery in its various symptoms and manifestations. E.g. Not everyone cuts themselves. Yet I'm certain an aspect we all share is some form of self-destructive behaviour. And in some cases (mine included) we are treated for the symptom, rather than the underlying condition.
For example, I have been treated in the past for alcohol abuse and/or depression without anyone ever looking further. I was certainly a candidate for self-destructive behaviour in the form of sexual promiscuity during various eras. But perhaps my most pervasive and consistent form of self-sabotage was running.
Whenever something "bad" happened I would move. Break up with someone--I would feel I had to leave town. Get overwhelmed and drop out of school? I wouldn't just take a break and return the next semester. I'd suddenly disappear without saying goodbye or talking to anyone. Leaving everything and everyone behind.
Nothing felt better than packing my suitcase, and getting on a bus or a train or a plane. Destroying everything I had built. Letting go of everything I had acquired. Cleaning out my bank accounts, cashing in my investments, running up my credit card.
Rubbing out my old life and starting all over some place new. I did that over and over again and it felt good. Psychologically, I was cutting myself, watching my previous life bleed out. I was relieved.
As a consequence, when eventually I did go for counselling, or someone took me to the hospital; my records were all over the place--in many different cities--even in different countries.
Initially, I was somewhat resistant to getting help. But even when I did, no one could put the pieces of the puzzle together. The pieces were scattered everywhere. Some weren't even on the table.
Add to this my fear of the stigma of mental illness and the belief I was intelligent enough to figure this out on my own, you have a recipe to never be diagnosed nor receive the help I needed.
Perhaps only my family knew something of the crazy tangents of my life. And I believe it is primarily through the advocacy of my sister that I have finally been diagnosed and am beginning to build the life supports I need.
It's a bit slippery in its various symptoms and manifestations. E.g. Not everyone cuts themselves. Yet I'm certain an aspect we all share is some form of self-destructive behaviour. And in some cases (mine included) we are treated for the symptom, rather than the underlying condition.
For example, I have been treated in the past for alcohol abuse and/or depression without anyone ever looking further. I was certainly a candidate for self-destructive behaviour in the form of sexual promiscuity during various eras. But perhaps my most pervasive and consistent form of self-sabotage was running.
Whenever something "bad" happened I would move. Break up with someone--I would feel I had to leave town. Get overwhelmed and drop out of school? I wouldn't just take a break and return the next semester. I'd suddenly disappear without saying goodbye or talking to anyone. Leaving everything and everyone behind.
Nothing felt better than packing my suitcase, and getting on a bus or a train or a plane. Destroying everything I had built. Letting go of everything I had acquired. Cleaning out my bank accounts, cashing in my investments, running up my credit card.
Rubbing out my old life and starting all over some place new. I did that over and over again and it felt good. Psychologically, I was cutting myself, watching my previous life bleed out. I was relieved.
As a consequence, when eventually I did go for counselling, or someone took me to the hospital; my records were all over the place--in many different cities--even in different countries.
Initially, I was somewhat resistant to getting help. But even when I did, no one could put the pieces of the puzzle together. The pieces were scattered everywhere. Some weren't even on the table.
Add to this my fear of the stigma of mental illness and the belief I was intelligent enough to figure this out on my own, you have a recipe to never be diagnosed nor receive the help I needed.
Perhaps only my family knew something of the crazy tangents of my life. And I believe it is primarily through the advocacy of my sister that I have finally been diagnosed and am beginning to build the life supports I need.
Friday, December 3, 2010
The beginning
When I think of a life journey, I think of The Fool in the Tarot, or Christian in Pilgrim's Progress. I know I am here to learn, to transform. If anything I have experienced or am experiencing can help someone else, I want to pass it on.
Finally diagnosed at the age of 53 with BPD (Borderline Personality Disorder) explains so much of what I have been through since infancy. As someone else has written, it is like being born without a skin. (Williams 1998)
While I am relieved to know what is wrong, my preliminary reading on this subject is scary. Yes, this is me--especially as I have been at certain times in my life. But I imagine there must be a spectrum of behaviour...even within one's own life span. And I feel hope.
I can move forward now, to work with my problem--which finally has a name.
Finally diagnosed at the age of 53 with BPD (Borderline Personality Disorder) explains so much of what I have been through since infancy. As someone else has written, it is like being born without a skin. (Williams 1998)
While I am relieved to know what is wrong, my preliminary reading on this subject is scary. Yes, this is me--especially as I have been at certain times in my life. But I imagine there must be a spectrum of behaviour...even within one's own life span. And I feel hope.
I can move forward now, to work with my problem--which finally has a name.
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