Friday, April 15, 2011

Quotes from the Borderline

"To grasp life and meaning, we assume constancy where it does not exist. We name experiences, emotions, and subjective states and assume that what is named is as enduring as its name. Human beings blessed and cursed with consciousness - especially consciousness of their own being - think in terms of names, words, symbols."
     ~ James F. T. Bugental
 

 

… But what happens when you no longer connect to the terms you think with?


Thursday, April 14, 2011

Judging Me: Stigma of Borderline Personality Disorder

 Please, don’t judge me before you know me.

I’ve mentioned this in various posts but I wanted to pull it all together. I’m talking about the stigma that accompanies Borderline Personality Disorder.


What is a stigma: a mark of disgrace or infamy; a stain or reproach, as on one's reputation; a distinguishing mark of social disgrace; any sign of a mental deficiency or emotional upset.

Stigmas are a negative judgment based on a personal trait.

What is a stigma: a mark of disgrace or infamy; a stain or reproach, as on one's reputation; a distinguishing mark of social disgrace; any sign of a mental deficiency or emotional upset.

Stigmas are a negative judgment based on a personal trait.

These are a very real problem for anyone with a mental illness/difference/disorder Personality disorders especially and notably for someone with a Borderline Personality Disorder. Compared to many other disorders it seems to have a surplus of stigma.

1) theories on the development of the disorder, with a suspect position placed on parents;

2) frequent refusal by mental health professionals to treat BPD patients;

3) negative and sometimes pejorative web site information that projects hopelessness;

4) clinical controversies as to whether the diagnosis is a legitimate one, a controversy that leads to the refusal of some insurance companies to accept BPD treatment for reimbursement consideration.

Many clinicians and people believe that Borderline Personality Disorder is not a characterological problem and merely a learned response to environmental factors. This thought process leads to an inability to treat patients properly. To believe that someone with BPD is just acting our or trying to get attention. Tragically it is often believed that these environmental factors are the parents fault (though in many cases this may absolutely be a contributing factor: Nature vs. Nurture). What’s truly horrible about this is that parents may be afraid to get their children help or may alienate their children once diagnosed for fear of being judged themselves.

All Borderlines are ‘angry, violent, and explosive’, in other words, very hard to cope with. All of us. Instead of getting to know a patient individually we are judged on the behavior of a few. Clinicians will discriminate against someone with BPD because of what others have said, not what they have experienced. Yes, the moods of someone with BPD can be all of these things. Hell, my behavior can be all of these things at time, but I’ve never brought it to therapy. However this is not the most predominant mood. These occurrences are much more rare (if they occur at all) compared to the day to day operating mode of someone with BPD.


“People take a couple of bad examples then deems everyone else with the same disorder through one very narrow perspective and then tells all of their friends of this belief who continue to pass it along but it seems like no one stops this communication to actually take the time to understand the disorder so all of this false information is allowed to saturate through society until everyone takes it as common knowledge and then uses it to judge others”

Extension to above: Borderline Personality Disorder IS characterized by mood swings between anger, anxiety, depression, and temperamental sensitivity to emotional stimulus. We can be destructive and prone to self-destructive behavior. Because of this, it is one of four related pathologies classified as Cluster B (“dramatic-erratic”) in the DSM IV. This is hallmarked by disturbances in impulse control and emotional dysregulation. Someone with BPD is often very sensitive and reacts strongly. They may have love/hate relationships with everyone and themselves, substance abuse, and impulsive behavior, or a multitude of other problems. Because of these potential qualities many professionals will not treat someone with BPD as they may not be comfortable doing so, and this is their prerogative. So while it is not as severe a stigma as the last one, it is still a problem. It does not make them bad doctors or therapists, it just makes them not right for the person suffering with a personality disorder. I can understand this. We do have a lot of things to deal with and some people simply are not equipped to handle as much as we tend to bring with us.Extension to above: Borderline Personality Disorder IS characterized by fluctuations between anger, anxiety, depression, and temperamental sensitivity to emotional stimulus. We can be destructive and prone to self-destructive behavior. Because of this, it is one of four related pathologies classified as Cluster B (“dramatic-erratic”) in the DSM IV. This is hallmarked by disturbances in impulse control and emotional dysregulation. Someone with BPD is often very sensitive and reacts strongly. They may have love/hate relationships with everyone and themselves, substance abuse, and impulsive behavior, or a multitude of other problems. Because of these potential qualities many professionals will not treat someone with BPD as they may not be comfortable doing so, and this is their prerogative. So while it is not as severe a stigma as the last one, it is still a problem. It does not make them bad doctors or therapists, it just makes them not right for the person suffering with a personality disorder. I can understand this. We do have a lot of things to deal with and some people simply are not equipped to handle as much as we tend to bring with us.

Since there is no medical treatment professionals think there is no hope. I hate this. I think it’s a lazy attitude because especially with recent development in therapy it has been clearly shown that there IS hope. Medication may not work to cure all of our problems, but that does not mean we can’t learn to cope and recover from our problems. We just need a different approach than throwing drugs at it.

Those with BPD are treatment resistant. This is often a problem in the therapeutic technique, not that someone with BPD is resistant. Some styles of therapy are not conducive to treating Borderline Personality Disorder or one technique is simply not enough. It’s often difficult for us to internalize some concepts because the nature of BPD is so transient. What may work for someone without BPD probably won’t work the same for us. Or what does work for us one minute, may not work for us in another because our moods shift so rapidly. All this means though, is that we need to focus on changing our overall mentality, not just on techniques to get us through a situational development (though these can be helpful!). We can’t just record, talk through, and repeat new behaviors and expect them to work right away because these are things that are ingrained in our character, not a learned behavior that we’re just trying to reverse. It might take a variety of integrated techniques, not just one, but treatment is absolutely possible!

Someone with BPD will never get better. With this attitude many clinicians adopt an attitude of hopelessness for someone with a Borderline Personality Disorder. They won’t even bother to treat someone with BPD because they don’t have the knowledge of current treatments and options for the patient. Because it requires more effort to change characterological problems many won’t read updated information and therfore remain stuck in outdated modes of thinking.

.

Someone with a Borderline Personality Disorder is intentionally manipulative. This is one of the worse stigmas in my opinion. Borderlines are just manipulative, "bad" and hurt other people on purpose. The truth is we don’t always know that we do these things. We don’t know what the behavior itself is that comes to this conclusion, let alone know how to change these behaviors (more on this in a separate post).

Everyone with BPD is a self-injurer.
1.) All people with Borderline Personality disorders engage in self-harm practices, and

2.) That it is merely a cry for attention so it should be ignored and the person will stop doing it.

First, I know of quite a few people with BPD that do not cut, burn, bang, or engage in these kind of tendencies. BPD presents in a huge variety of ways and this is only one potential aspect. Second, many of us that do have these self-harm/cutting tendencies do not tell people about it at all. It is a way to take control of our lives, emotions, stress, or a dozen other things. Yes, some people may do it for attention, but ignoring it is never a good answer because this is harmful and in some cases could lead to death.



Because of all of these things someone with BPD may not even consider finding treatment. If they’re pre-judged by the mental health industry, if their attitudes are already set, what hope is there of getting effective help? It’s a defeatist attitude that bleeds into the thoughts of the patients themselves. If the psychiatrist, the psychologist, the therapist have no hope, what hope can we have for ourselves? I was aware of most of these stigmas when I was diagnosed. I was already seeing my therapist when my psychiatrist diagnosed me with BPD. I was actually very reluctant to tell my therapist about the diagnosis because I was afraid she’d drop me as a patient. This fear is not okay. Especially for someone that is so afraid of rejection! Without the ability to be open and honest with the person that is trying to help you it makes it almost impossible, at least very difficult, to get effective treatment. This is a very sad thing to me. Hopefully with understanding and new therapeutic developments this mentality will begin to change. Pulling these things together and taking a good look at them will be beneficial. That’s the goal at least. 

Wednesday, April 13, 2011

Listen. Breathe. Relax.


 
It’s stress.
I was planning on running errands on my lunch break.  At the last minute I decided to not.
Instead I picked up my book and went to see an Orchestral Recital by the winning Trio from an acclaimed Chamber Music Competition (yes, I like chamber music, hush). I sat in the back of the theater, opened my book and let the music wash over me. Lost myself in the words on my pages. Occasionally closing my eyes and letting the music run through me. Breathing. Nothing more.
The shift in my mood is palpable.
Stress is very triggering for me. It’s hard to find time to sit back and relax when there is so much stuff looming. However, it is so very necessary. Especially for someone that has such explosive moods like me.
Just an hour. Relaxing. Doing something I enjoy.
I need to remember to take time for myself.
It’s amazing how much something so small can affect such great change.
Remember things like this is difficult for me, it’s part of the reason Cognitive Behavioral Therapy is not sufficient for treating personality disorders. Holding onto these ideas is often overridden by our nature.
I need to try harder to remember.
Manage stress better. Take time to relax.
Just breathe.

Rage against Very Good Advice


I’ve been ridiculous angry lately. No idea why. Seething. In general.
I’m mad at my therapist.
I’m mad at my sewing.
I’m mad at my chieftain.
I’m mad at Friend.
I’m mad at everyone that bothers me for any reason whatsoever.
I’m even made at my lovey cat. Especially at Roommates cat.  
I’m mad at Time itself. I need more of it to get all the things done that I want to do! I’m devising a system to kick the Earth’s orbit back a bit to lengthen the amount of time in a day. You’ve been warned.
I just don’t understand why people have to be so flipping annoying? Why do people need to jump on the band wagon every time someone else has a good idea? Can’t I have something that is just mine? Does everyone have to try and weasel their way into my little world and steal what small comforts I create? They don’t even know they’re doing it. I could tell them, but it would be telling them with my Sith aggressions invoked and likely someone would lose a face. If I open my mouth to these people, I will lose my shit. I will completely alienate myself. Then I’ll freak out and have to apologize. I won’t actually feel apologetic, I’m completely justified and I plain just don’t care, but I know it will be the’ right’ thing to do. I’m trying to be mindful of how I act, but I WANT to rage, I WANT to lash out, break everything around me, and the relationships I’ve built. I don’t feel bad at all, I don’t give a shit what these people think. I want what I want because I’ve freaking put in the work and now they just want to piggyback on the things I’ve put so much time into? Fuck that, and fuck them.
I’m sick of sharing everything. I just want something that’s mine. Is that too much to ask?
But look! It’s progress right? I’ve learned a lesson here. I am actually trying to apply my own lessons to my life. It would be so easy for me to let go, give in, and act out. I KNOW I would feel so much better… for about 10 minutes. Having people in my life is so difficult sometimes. I have to cater to so many different feelings that aren’t mine. How am I supposed to be mindful of everyone else when I can barely be mindful of my own?  It would be so much easier to not have anyone. Until the crushing loneliness sets in.  
I’m stressed out with a to-do list a mile long. I need to have all of this done by Friday because I need to implement Saturday. Sci-Fi convention! I’m trying to be excited about this, but I’m too stressed out. My costume is near complete. I’ve put a ton of work into it and with a little more maintained discipline I’ll be hot. (Btw, I had to explain to my therapist what it meant to ‘look hot’, seriously?) This may be in part from my severely restricted lack of caloric intake, but it hasn’t been bothering me until the last few days.
I doubt it. I’m always angry. Usually I’m better at hiding it.
Every minute of last weekend/this week/upcoming weekend is scheduled away. Every. Single. Minute. I make spreadsheets to organize my bleeding time just so I have some structure and I’m not running around with my brain dribbling out of my ears.  But hey, at least I won’t be bored.

Very Good Advice
I give myself very good advice
But I very seldom follow it
That explains the trouble that I'm always in



Be patient, is very good advice
But the waiting makes me curious
And I'd love the change
Should something strange begin


Well I went along my merry way
And I never stopped to reason
I should have known there'd be a price to pay
Someday...someday


I give myself very good advice
But I very seldom follow it
Will I ever learn to do the things I should?
Will I ever learn to do the things I should?


BTW: Costumes for this weekend:
1.             Dark Lady of the Sith: species Twi’lek
2.             50’s red/black rockabilly pin up.
Should be amazing. Also, plans for our next gen light sabers. I’m such a geek.

*Real post sometime soon. I can’t focus right now.

Tuesday, April 12, 2011

Lucid Analysis: Trials in Therapy - 2


Oh therapy.
Yesterday in therapy we talked a lot about my summer vacation and how the impending changes are causing me a lot of anxiety. I don’t deal with upheaval well, and while most of the changes aren’t huge, they feel huge. I feel like my stable unit is being split and broken up.
We also discussed, surprise, my trip to the psych ER. How I am easily capable of switching from one mode to another. Moreso, that I can recognize when I’m doing this, in  hindsight anyways. On a cognitive level I generally know what is going on. My problem being that what I think and what I feel are often completely at odds and I have no way to resolve this.
This was another week when I think she’s just too positive. Sometimes I think she wants to believe that I’m not so messed up. That she downplays my issues, associations, and shifts. I’m not sure I should keep seeing her or find someone new. I know this is an impulsive thought. If I dropped her and found a new therapist I’d have to reset all my progress. But I need her to see me, and not just want the best for me. I get so bloody frustrated and angry. Lately she’s been focusing almost exclusively on my dissociation too. Yes, I have problems here, but that’s NOT the extent of it. I have other problems I need to work through. I need her to listen but I can’t always express it. I’m floundering between showing my anger and holding back because I don’t know how to do it in a way that isn’t destructive. I’m also worried that if I flip out she’ll get scared. It’s part of the reason I switched the conversation to my trip to the ER. She needs to understand what goes on with me when I’m more turbulent.
Note: Make sure your therapist has a more rounded perspective of who you are is just as important as having a therapist that is compatible with you.
 Homework: Think about the things I want for my future. Meditate on these things. Plant the seed in my conscious mind. In planting that seed it will be able to grow, and in time, manifest. This strikes me as ‘the power of positive thinking’. There is some truth to it. You can’t reach a goal without first setting one.
My therapist often brings up, buying a house, finding a healthy partner, getting married, having  children. I don’t know if I want any of these things. I can’t fathom the idea of having a house. I’ve never had a stable home. Ever. I’ve never lived in a place for longer than a year since high school.  Since graduating University I moved, in 4 months, in 6 months and then ever year since. My home life before college was incredibly unstable. At one point I ran away. I have no concept of a stable home. Living with my current roommate has been wonderful. We’re reaching the one year mark now. I can’t internalize it though. I’m just waiting for it to change or fall apart. A healthy relationship? What the hell is that? Marriage? I can’t even fathom someone wanting to put up with my brain crazy for any amount of time, let alone want to spend their life with me. Children are right out. I refuse to even consider the concept. I have no clue what I want, what direction I want my life to go. Granted, I suppose that doesn’t mean it’s not a good thing to think about.
Finding a healthy relationship always makes me laugh whenever she brings it up. I wouldn’t know what one of these looked like if attached to my head like a Facehugger from Aliens. She wants me to reassure her that I won’t make the same mistakes that I’ve made before. Since I know that my choices have been unhealthy that I won’t make them again. Except I don’t know they’re unhealthy until they are. My history shows that no matter how much I know about something, I’m attracted to what I’m attracted to and that’s rarely a good choice. The only time I get worked up over someone and don’t want to lose them is when we’re in conflict. When we’ve fought or one of use pushes away (usually me). Otherwise I just feel smothered and bored.
I can barely see a few weeks down the road. I’m not even sure I see a future for myself at all. I have a job, a very good job. I’m getting by, taking care of myself. I have no evidence that there will be more. Thinking about it makes me angry, frustrated and depressed. Why hope for something that I may never have? I’ll just be even more depressed in the end.
 For whatever reason this homework just makes me angry and I don’t want to do it.
Homework Extension:  She wants me to think of things I need to resolve as I’m falling asleep so they may take root in my dreams. Try and remember my dreams.  In my dreams I work out a lot. The symbolism and interpretation of what my subconscious shows me is incredibly insightful and accurate. I love to dream. Of course, in order to do this I need to stay asleep first. This waking up at 2am and not falling back to sleep, at all, and having to get up for work at 6:30am is just not cool.
Cripes, she’s going to have a field day with what I was dreaming about last night.

Monday, April 11, 2011

Morals of the Psych ER Saga


I was actually very reluctant to post this experience.

So why am I telling you this? Because this is the ugly side of having a Borderline Personality Disorder. It’s not just the therapy and the research or relatively harmless. It’s explosive and uncontrollable. It’s frantic impulse, threats, self-harm, and actual suicide for some. In that moment I felt crazy. I was in tears, feeling hollow and abandoned, worthless. With nothing to hold onto. My mind screaming, thoughts rattling around until I couldn’t tell the difference between reason and reality. When you can’t see the next minute because your entire world is dissolving in the one you’re in; there is no next minute. Just the one you’re living in.

It is meant to scare you. It is meant to make you think. To help you understand how extreme the emotions can be, and the things they can make us do. How difficult it is to control and not get swept away in the maelstrom that is the borderline mind. This is my reality.

I really didn’t belong there. It’s certainly not something that I’m proud of. I absolutely made a very bad choice. The reason I was there was a death threat even though there was absolutely no way I would have ever done it. I do not believe in suicide as an answer. As long as you’re alive, there’s a chance. A chance that things can change. Change is a powerful thing. As long as there’s change there’s hope for something better. This is my belief.

A belief that my ex knew very well that I held. I later found out that he’d been in my position for this kind of situation too. He made a dumb impulsive decision that he had no intention of acting out and had to take the consequences. There was a little vindictiveness in his refusal to listen. That’s what I get I suppose.

I wanted attention. I certainly got it from this. Not in the way I wanted though. These things never really turn out how you want them to. Everything about it is unhealthy. This type of behavior is part of why Borderline has such a stigma for manipulation. I’ll talk more about this some other day, because I’m really just now beginning to understand what this means in terms of BPD.

I wasn’t afraid of anything that happened to me in there, though maybe I should have been. This was a very dangerous situation to be in. There is no predicting who you will be kept with. No predicting how monitored you will be. No predicting what could happen to you. Most people would not have been so calm in the face of a huge guy about to rampage. Mostly I was annoyed and inconvenienced by the whole thing.

Not to mention I lost an entire evenings worth of sleep. I ended up being awake for almost 40 hours because I couldn’t rest once I got home. No sleep is never good for me. This usually deteriorates my mental state even more. 

I was afraid that this would come back to bite me in the ass though. That it could potentially leak out, and bar me from future employment, make it impossible to get a job. This was my biggest fear.

That and the fact that my landlords were not pleased. I could have lost my apartment, which I had just moved into.
It doesn’t just affect me/you either.  I felt like utter shit once I thought to consider the other people in my life. The people that care about me. I scared my roommate. I terrified my family. I had no right to put them through that. I never stopped to consider that this could affect them too. It’s something I won’t forget again.

The consequences of things like this hit you from all sides.

Like the bill. The whole experience, most of which was just sitting around, cost $2000. No extra zero there. Two thousand dollars. The nurses that have to watch you, the psych that has to be on call, the blood work they had to do, all of it is very, very expensive. This gave me something of a heart attack. Fortunately, I was on unemployment at the time so I could get this waved, but still. Very, very expensive. In money, time, and sanity.

Always, there are consequences to my actions. I reiterate. Actions that I will never indulge again. Mistakes that I have learned from. Having been through it once, believe me, once is enough. I am not altogether unhappy that I had this experience. It has made me consider the impulsive decisions that I am prone to, want to make, and rein them in. I take full responsibility for the mistakes I’ve made, but sometimes you need a swift kick in the ass to make you remember that, had I not been so impulsive in the first place, the whole thing could have been prevented. Prevention is something I work very hard on. It has helped me control my impulses. It has helped me consider my actions. It doesn’t necessarily stop the thoughts, but it has made me work harder to control them, get help for them. I don’t want to be controlled by these kinds of thoughts and behaviors. I’ve never wanted this, but now I have a little more motivation to really work to overcome them. It’s the nature of having a Borderline Personality Disorder to act this way, but we still have a choice in the matter, and the ability to change.

All these things are what I hope people see and understand. If this experience can help someone not make these kinds of poor choices than it was worth putting this story out there. I hope it helps someone. It sure opened my eyes. 

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