Leap Before you Look – Insufficient Self Control/Discipline

“The trouble with immediate gratification is that it’s not quick enough” ~Carrie Fisher
Let’s skip the pleasantries and jump right in, shall we?
Insufficient Self-Control/Self-Discipline
Patients who have this schema typically lack two qualities: (1) self-control – the ability to appropriately restrain one’s emotions and impulses;  and (2) self-discipline – the ability to tolerate boredom and frustration long enough o accomplish tasks. These people are unable to restrain their emotions and impulses appropriately . In both their personal and work lives, they display a pervasive difficult in delaying short-term gratification for the sake of meeting long-term goals. They seem not to learn sufficiently from experience – from the negative consequences of their behavior. They either cannot or will not exercise sufficient self-control or self-discipline.
            At the extreme end of the spectrum of this schema are people who seem like badly brought up young children. In milder forms of the schema patients display an exaggerated emphasis on avoiding discomfort. They prefer to avoid most pain, conflict, confrontation, responsibility, and overexertion – even at the cost of their personal fulfillment or integrity.
            Typical behaviors include impulsivity, distractibility, disorganization, unwillingness to persist at boring or routine tasks, intense expression of emotion, such as temper tantrums or hysteria, and habitual lateness or unreliability. All of these behaviors have in common the pursuit of short-term gratification at the expense of long-term goals.
            Every child is probably born with an impulsive mode. It’s a natural part of every human being. However the failure to bring impulsivity under sufficient control and learn self-discipline is what is maladaptive. Children are by nature, uncontrolled and undisciplined. Through experiences in our families and in society as a whole, we learn how to become more controlled and disciplined. We internalize a Healthy Adult mode that can restrain the Impulsive Child in order to meet long-term goals. Sometimes another problem, such as ADHD, makes it hard for the child to accomplish this (this is not a schema issue).
            Often, there are no specific beliefs and feelings that go along with this schema. It is rare for patients with this schema to say, “It’s right to express all my feelings” or “I should act impulsively.” Rather, people experience the schema as being outside of their control. The schema does not feel ego-syntonic in the way that other schemas do. In fact, most people with this schema WANT to be more self-controlled and self-disciplined: They keep trying, but cannot seem to sustain their efforts for very long.
            The impulsive mode is also the mode in which a person can be spontaneous and uninhibited. A person in this mode can play, be light, and have fun. There is a positive side to the mode, but when it is excessive – when it is not balanced by other sides of the self – the cost exceeds the benefit, and the mode becomes destructive to the person.
Goals of Treatment
            The basic goal is to help patients recognize the value of giving up short-term gratification for the sake of long-term goals. The benefits of venting one’s emotions or doing what is immediately pleasurable are not worth the costs in career advancement, achievement, getting along with other people, and low self-esteem.
Strategies Emphasized in Treatment
            The basic idea is: Between the impulse and the action, you must learn to insert thought. It is important to learn to think through the consequences of giving in to the impulse before acting it out.
            Occasionally the Insufficient Self-Control/Self Discipline schema is linked with another schema that may be more primary. For example, sometimes the schema erupts because patients have suppressed too much emotion for too long. This often happens with the Subjugation schema. Over long periods of time, people with the Subjugation schema do not express anger when they feel it. Gradually, their anger accumulates, then suddenly bursts forth in an out-of-control way. When patients display a pattern of swinging between prolonged passivity and sudden fits of aggression, they often have underlying Subjugation schemas. If a person can learn to express what they need and feel appropriately in the moment the anger will not build up in the background. The less people suppress their needs and feelings, the less likely they become to behave impulsively.
In terms of this schema, this is exactly where my problem lies. From the age of 8 years old I was raised in the martial arts. Control and Discipline are two words that are deeply ingrained into my mindset. If you lose control, people get hurt. Outwardly I always appear in control. However for me, this also means suppression of my emotional states. I was told not to express my feelings, not to let people see my next move. So I suppress, subjugate, what I’m actually feeling. This is coupled with the fact that, despite how much I know my father loved me, he was the parent that was primarily responsible for me growing up and he taught me to “suck it up” and not show when things were upsetting to me. I don’t ever recall a time when he tried to understand what was upsetting me. I only remember being told to stop expressing any negative emotion. To this day, any time I feel any kind of emotion that is not ‘positive’ or ‘strong’ I hide it from showing and refuse to express it. I put on a tough face and let people believe that I am unphased. This would result in the most magnificent explosions of anger and violence from me. By the time I turned 12 I began to lose my ability to control my temper. My frustration tolerance was non existent. One morning I was having trouble getting my hair perfect (I was borderline OCD was many things) and put my fist through the bathroom wall in a fit of rage. I would having screaming arguments with my parents almost every single day. I broke down doors, put my fists through windows and walls, my rage was absolutely uncontrollable. It wasn’t just anger that was impulsive though. Stealing, vandalism, sex…. I needed to feel better and I needed to feel better now.
            It’s often helpful to imagine past and current scenes in which insufficient self-control or self-discipline was displayed. From here the scene can be revisited but from the perspective of how a Healthy Adult would act in the situation and exert self-control. This is especially important for people with Borderline Personality Disorder. Because of their Subjugation schemas, people with BPD feel that they are not allowed to express their needs and feelings. Whenever they do, they feel they deserve to be punished by their internalized Punitive Parent. They repeatedly suppress their needs and feelings. As time passed, their needs and feelings build up, beyond their ability to contain them, and then the person flips into the Angry Child mode in order to express them. They suddenly become enraged and impulsive. When this happens, it’s important to vent the frustration fully, treat the situation with empathy, but also reality-check to measure the magnitude of the reaction in proportion to the actual event that triggered it.
I also completely relate to this aspect of Subjugation and needing to punish myself. I absolutely do not believe that I could express what I needed or felt. Hell, I still feel like this. I feel like I have no right to expect others to think about what I need. It’s my responsibility and my responsibility alone to think of myself (though I desperately wish someone would, at least every now and again)… usually after I’ve thought about everyone else first. Letting other people know that I need things is akin to admitting to weakness. Weakness means being vulnerable. Being vulnerable means someone has the chance to take advantage of you. That is not acceptable. So I hold it all in. Bottle it all up. And that works. Until I’m shaken by something. The internal pressure becomes too much. And then it all explodes.
            When the lack of parental involvement in childhood is the origin of this schema it’s important to establish limits and set boundaries.
Special Problems with This Schema
            Sometimes the schema appears to be biologically based and therefore very hard to change with therapy alone, for example, when the patient has a learning problem such as ADHD. If the schema is biologically based, then even when patients are highly motivated and expend tgreat effort, they may be unable to develop sufficient self-control and self-discipline. In practice, it is often unclear how much the schema is linked to temperament and how much it is related to insufficient limits in childhood. Medication should be considered for patients who have persistent difficulty fighting the schema despite an apparent commitment to therapy.
I wonder if this isn’t why so many kids are diagnosed ADHD these days. Instead of taking a good look at the parents and the home life, doctors just jump to the conclusion that it’s biologically determined. They don’t stop to consider that maybe kids aren’t being raised with any/enough discipline or boundaries. Doctors don’t want to make a judgment and blame the parents so they avoid the potential for uncomfortable truths and push for the prescriptions instead.

Trust Issues

How close I get to men is inversely proportional to how much I trust them.

The more I get to know them, the more of myself I share, the more convinced I am that I’m going to get hurt.

I’m either paranoid… or right.

I can feel myself getting more attached. At the same time all I can do ruminate on all the reasons I shouldn’t be.

I want him to want to be closer… as I run far, far away.

Lucid Analysis – Trials in Therapy

 I’m good at allowing myself into other people’s live, but not at letting them into mine.
This was the main point I took from therapy yesterday.
Therapist says I’m incredibly perceptive when it comes to determining other people’s emotional spheres. I tailor myself to match what I have picked up in another person. She says she sees me doing this quite often. I mirror people well. I don’t even realize I do this most of the time. It comes naturally. Though I do catch myself veering more towards positive stories and spins of experience when she seems to indicate that it’s what she expects to hear. Therapist often tries to explain my feelings on a subject before I’ve finished talking about what it is that I’m saying. Sometimes I correct her, other times I feel like I’ll be disappointing her if I’m not fitting her more pleasant description/expectation. I see how she interprets me, I understand how she wants me to be, I pick up on all the little body, facial, and emotive signals that tells me what she is thinking.
Her point, was that if I’m feeling a certain way about someone, it is often justified, because I am so perceptive and in tune with how other people feel.  Little of my hypersensitivity coming through. I’m hyper vigilant when it comes to paying attention to how people react to me.
This came about mostly because I was fretting about Tech Boy. I’m worried that I may be starting to like him too much. I’m still not sure if he’s ‘right’ for me. I’m starting to get paranoid if he doesn’t text me. He mentioned a female friend’s birthday is coming up and I felt a stab of jealousy (though I didn’t say anything ß— I know better).  I’m worried I’m getting too sucked into this, and I’m not comfortable with myself right now. I don’t know where this is going, or if it’s going anywhere. All the signs point to him liking me, but I don’t like me, so I think I’m projecting my fears onto him where they don’t exist.
I wanted to push away yesterday. Maybe the day before too.
Don’t do it, Snow!
I have trust issues. I’m still trying to figure out how much I can trust him, or if I can trust him at all.  What it boils down to is I don’t trust my own judgment when it comes to trusting other people. I’ve made too many bad decisions, misplaced my trust in too many people and had it come back to bite me in the jugular as I lay bleeding out on the sidewalk. Not that I haven’t made some good decisions. I have, but the good do not outweigh the bad for me. Especially when it comes to men. Sorry guys, I’m sure one or two of you are alright. (Aside: I feel pretty shitty thinking this way after what my boys at work just did – geezus I’m a terrible person). I don’t trust. I do believe people will hurt me in the end. This has been too much of my experience. I am very, very guarded. Justifiably.
However it makes me feel like I’m lying.  I hold back from the people that try to be close to me. I do not share my genuine self because it would make me vulnerable, open me up for the potential to be taken advantage of, and also because I feel like it is too much of  burden to place a lot of the badness that I’ve had in my past on someone. Instead of sharing, I shut down, or re-direct the conversation.
For example: On one of my dates with Tech Boy we were talking about how we felt about living in NY (we’re both originally from out of state).  I mentioned that my first couple years here were pretty rough b/c of my living situation but in general I liked NY. His response was a natural sort of “Well it couldn’t have been all bad”…. “No, I suppose it wasn’t all bad…”, but I wasn’t going to tell him about Evil-Ex. He does know that I had problems with an ex that I was living with in a vague general sense, but I’m afraid to get into the details of just how bad it all was. I don’t want him to think I’m weak. I don’t want him to know how much damage has been inflicted on me. I don’t want him to think I have too much baggage (because this is just unattractive).  I’ve had bad things happen to me and somehow I feel like this will make me a bad person in other people’s eyes. At the very least, it will clash with the impression that I give people of myself. In short, I don’t trust that him to not reject me. So I’m not open about everything there is about me. Since I’m not full disclosure, I feel like I’m hiding things, being secretive (which I am), and therefore not being honest.
Something like that.
If I’m always closed and guarded, it’s going to push him away in a different way. I’m sure he thinks I’m a little closed off. Therapist thinks I need to open up. I don’t need to come out with the worst of the worst, but I should let him in to some of the problems I’ve had in my past.  This will help him understand why I am guarded.
To my credit, I give people a chance ß— Both Roommate and Therapist have told me this. For everything that I’ve been through I haven’t shut myself down completely towards other people. I have in the past, but presently, I’m still trying to meet and get to know new people. I only share what I want people to know of me though. People open up their lives to me very easily (apparently I come across as very open and trustworthy), and I let myself stroll right into their worlds where I can take a look around and judge whether it’s safe for me…. But I don’t actually open up my own doors to them in what I believe to be a meaningful way. I may crack a window, but the drawbridge stays up and I have a few strategically placed snipers looming in the battlements. Overkill.
Therapist talked a lot, but I felt like I was pretty dissociated and floating through a lot of the session. I couldn’t really concentrate on what she was saying. I’ve felt like that the last few days. People will talk to me and it’s a struggle for me to pay attention, to retain the information they are telling me.

I also feel like if I get to invested in someone something is going to happen and it’ll fall apart and all go to hell. It’s just a vague sense, nothing specific, but I always believe that if I let myself get to close to someone that is exactly when everything will go wrong. Catastrophizing, maybe?

Anyways, so I’m very attune to people’s emotional spheres. I have trust issues. I expect the worst. But maybe my issues with Tech Boy are a result of my own closed off-edness (ß– not really a word, I know). I’m closed off because I expect something bad, so he’s picking up on the fact that I don’t want to let him in and is therefore respecting my boundaries, which I perceive as him not trying to get closer, when it’s me that won’t let him even if he was trying, and that makes me paranoid and want to push away which actualizes as something bad happening. Is it all me? Or maybe he just wants something casual, light and fun, which is exactly what we have now, so he doesn’t feel a need to dig deeper and it’s just me wondering if there’s more scenery in Kansas (I’m totally stereotyping Kansas here – Sorry Kansas-anites (?)) .  That may not have made any sense.
Open Up, Stay Closed, Open Up, Stay Closed …. It’s not a simple decision. Therapist says small steps. The things I’ve been through are not too much for someone to handle if they’re someone that cares about me. Someone that cares won’t be judgmental. He’s already proven himself to be open to various aspects of my lifestyle that others might shy away from– shady stripper past, my bisexuality (Boring-Ex was super threatened by this), my extreme Geekery with +10 Nerdiness, isn’t threatened by my intelligence or that I make more money than him. I guess it’s time to do exactly the opposite of what I want to do (Push away) and start letting him in to the more intimate details of my life.  Slowly.
Does anyone else find it ironic that I can easily post the most intimate details of my life here for thousands of anonymous viewers to see, but I have the hardest time opening up to one person in real life? Yeesh.

It’s a nice thought anyways.

Appreciation

I got a bit of a surprise today. Every day we have coffee break for our group of engineers and technicians in one of our shops. Once or twice a week I bring in some kind of home-made, from scratch, baked treat that I’ve created, concocted, or experimented with for the guys to try and hopefully enjoy.
This week was Honey-Orange-Lavender Biscotti and Pumpkin Spice cookies with Cranberries and Pecans.
The cookies are what I brought in this morning. I was just like, Happy Friday guys, I made cookies. One of the techs was like “Well we appreciate it; in fact, we have something for you too”.
As a token of their appreciation they got me a greeting card and gift card to Trader Joe’s (awesome organic grocery).  I didn’t actually look at the gift card right away other than to glance at where it was from. I’m still looking at the card and what everyone wrote and signed. Later I looked at the gift card and it was for $100! Holy crap.
I was absolutely floored. And speechless. I didn’t have any clue how to respond other than to say that thank you and they didn’t need to over and over.  Tech Boy later told me they’ve been talking about doing this for a while now. They figured I must spend a ton of money on them with all of the stuff I make (which I guess is true, but I don’t even think about it. I just like that they let me experiment on them haha) and they wanted me to know how much they appreciated it all. He also told me it took them 2 days to figure out what to write in the card. Too cute. Too sweet. I love the guys I work with. They’re absolutely the greatest.

Borderline Personality Disorder: 8 Dangerous Myths

Sleep. Yesterday was a bit excessive. I’ve been in a bit of pain lately so I took a couple prescription strength pain killers and BAM, out like a freakin’ light. It’s not like I wanted to download Skyrim for PC anyways. (Gamer girl, don’t judge).

So in my ever evolving search for information on BPD I stumbled upon this CBSNews slideshow that I thought I’d share.

 
I’ve linked to it, but I’ll also write them all out for those of us that don’t have Flash or have slow computers or just don’t feel like flipping through a slideshow.

1.    Myth: Borderline personality disorder is rare
“BPD is much more common than most people think,” says Dr. Manning. It affects approximately 2 percent of the general population – or one out of 50 people.

2. Myth: Bad parenting is to blame for BPD
It’s a common misconception that all people with BPD grew up with abusive and emotionally distant parents. BPD is believed to be a result of both nature and nurture.
Although BPD is often linked to childhood abuse, some people with BPD come from perfectly functional families that were ill-equipped at teaching the extremely emotional child how to manage emotional sensitivity.

3. Myth: People with BPD don’t know how to love
People with BPD have difficulty controlling their emotions – but that doesn’t mean they don’t feel them. Dr. Manning says people with BPD have a tremendous capacity for love and are often compassionate and caring towards humans and pets.
While it can be exhausting and exasperating at times, it’s entirely possible to have a lasting, loving relationship with someone who suffers from BPD. Dr. Manning says there are several strategies you can use if your partner has BPD. It helps to keep your own emotions in check when the person with BPD is acting emotional. So does acknowledging their emotions by saying things like “I can see that this must hurt a lot” rather than dismissing them.

4. Myth: BPD only affects women
More people diagnosed with BPD are women- about 70 percent – but plenty of men suffer from the disorder. Researchers believe that BPD is underdiagnosed in men.

5. Myth: People with BPD are unbearable
It may seem like people with BPD are doomed to careen from one crisis to another. But Dr. Manning says they can learn problem-solving, emotion-management strategies that can help them gain control of their emotions and lead happy productive lives.

6. Myth: People with BPD can’t take care of themselves
Even though BPD is a serious illness, sufferers don’t need to spend their lives in and out of psychiatric hospitals. Many people with BPD have families, friends, and jobs once they learn how to regulate their emotions.

7. Myth: People with BPD don’t really want to kill themselves
It’s a sad misconception that people with BPD only attempt suicide to get attention. In reality around 10 percent of people with BPD die by suicide, says Dr. Manning.
Some people with BPD also harm themselves by cutting, burning, or scratching. People often self-harm to provide relief for their intense emotions without intending to die.

8. Myth: There are no treatments for BPD
There are several treatment options for borderline personality disorder. The most effective is called dialectical behavior therapy. It’s a form of psychotherapy that lets people with BPD learn new behavioral skills to help them manage their emotions, relationships, and stress through problem solving strategies.
Dr. Manning says, “It’s a misconception that people with BPD will never get better.”


I’ve covered these before in my Myths, Misconceptions and Controversy series. What I found most remarkable about this little slideshow? The compassion. It does not attempt to villain-ize people suffering with BPD. It’s almost encouraging in its brevity even if it is overly simplified.
By Haven Posted in myth

It’s not the fall that kills you, or is it? – Failure

I’m ready for November to be over. I don’t want it anymore. I’ve never had a particular problem with November but I’m starting to get paranoid and obsessive and I just want it to stop. Ugh. I really didn’t want to write today but I forced myself to anyways. So here’s the next schema.
Failure
Typical Presentation of the Schema
Patients who have a Failure Schema believe that they have failed relative to their peers in areas of achievement such as a career, money, status, school, or sports. They feel that they are fundamentally inadequate compared to others at their level – that they are stupid, inept, untalented, ignorant, or unsuccessful, and that they inherently lack what it takes to succeed.
Typical behaviors of these patients include surrendering to the schema by sabotaging themselves or performing halfheartedly, avoidance behaviors such as procrastinating or not doing the task at all, and overcompensating behaviors such as working nonstop or otherwise overachieving. Over compensators with Failure schemas believe that they are not as smart or talented as other people, but they can make up for it by working extra diligently. They are often quite successful, yet still feel fraudulent. These patients appear successful to the outside world but feel underneath that they are on the brink of failing.
This is me all over. All three aspects: Surrender, Avoid, and Overcompensate. I cycle or shuffle through them all because I’m afraid I don’t have what I need to do what I need to do. Despite all the evidence to the contrary. I always feel like a fraud. No matter how well I know something, how well I’ve done something, no matter how much effort I’ve put towards accomplishing a task well.
            It is important to distinguish between the Failure and Unrelenting Standards schemas. Patients with the Unrelenting Standards schema believe they have failed to meet their own (or their parents’) high expectations, but they will acknowledge that they have done as well or better than the average person in the same occupation. Patients with the Failure Schema believe they have done worse than most others in their occupation, and very often they are right. Most patients with the Failure schema have not accomplished as much as the average person in their peer group. Failure has become a self-fulfilling prophecy in their lives. It is also important to distinguish between the Failure schema and the Dependence/Incompetence schema, which has more to do with daily functioning than with achievement. The Failure schema involves money, status, career, sports, and school; the Dependence/Incompetence schema involves everyday decision-making and taking care of oneself in daily life. The Failure schema often leads to a linked Defectiveness schema. Feeling like a failure in areas of achievement, the person feels defective.
This distinction is important for me. I constantly feel like a failure though I can admit when I have achieved some goal or accomplishment. I think I fit the Unrelenting Standards schema must closer in this respect. While I constantly fear I don’t measure up and am a failure or will fail, this has thus far never been proven true. My fear of failure creates an anxiety to succeed.
Sounds simple enough, right?
Goals for Treatment



The central goal of treatment is to help patients feel and become as successful as their peers (within the limits of their abilities and talents). This usually involves one of three scenarios. The first is increasing their level of success by building skills and confidence. Second, if they are, in fact, successful relative to their potential, it involves raising their appraisals of their level of success or changing perceptions of their peer group. The third scenario involves patients accepting unchangeable limitations in their abilities, while still feeling they have value.
Strategies Emphasized in Treatment
It is important to assess carefully the origin of the Failure schema for each patient, because the strategies the therapist emphasizes will depend on this assessment. Some patients have failure due to an innate lack of talent or intelligence. In these cases, the therapist tries to help the patient build skills and set realistic goals. Other patients have the talent and intelligence to succeed but have never applied themselves fully. Perhaps they have lacked direction or focused on the wrong areas. In these cases, the therapist aims to provide direction or to shift their focus to areas in which they have more natural talents. Perhaps patients have another disorder that has interfered with their development (such as ADD)., in which case the therapist needs to treat the other disorder. Perhaps they lack discipline: Many patients with the Failure schema also have the Insufficient Self-Control/Self-Discipline schema. In these cases, the therapist allies with the patient to fight Insufficient Self-Control/Self-Discipline schema. Perhaps patients are flooded with negative affect from another schema, such as Defectiveness or Emotional Deprivation, which they spend a lot of time and effort trying to avoid – by abusing drugs, drinking alcohol, playing the stock market, surfing the Internet, gambling, viewing pornography, or having sexual affairs –  and the avoidance interferes with their dedication to work. In these cases, treatment involves working on the underlying schemas. It is important to assess why the patient has failed, in order to design the proper treatment for the problem. In most cases, the cognitive and behavioral aspects of the treatment take precedence.
            Another cognitive strategy is to highlight patients’ successes and skills. Typically, patients with this schema have ignored their accomplishments and accentuated their failures. The therapist helps correct this bias by teaching patients to notice each time they are successful. It’s also important to set realistic long-term goals. 
Ugh. I hate it when Therapist does this. I hate it when she lists my positive attributes and ticks off all the things I’ve accomplished. It feels so phony. I hear these nice words and it feels hollow, like someone trying to make you feel better. All surface, no substance. I think Therapist hopes that with repetition I will begin to internalize these positive attributes as my own. Currently they belong to my not so evil doppelganger. I’m sure her life is lovely.
            Experiential techniques can be helpful in preparing patients to undertake behavioral change. In imagery, patients relive failure experiences from the past and express anger at the people who discouraged them, or mocked and devalued them for failing. Doing this helps patients reattribute the failure to the other person ‘s criticalness rather than to their own lack of ability. Getting angry at parents and others for not recognizing and accepting their strengths and limitations is an important part of the process of letting go of the schema emotionally.
Get angry. I like this strategy. I can’t say that my parents failed to realize my limitations and pushed me anyways. Well, I can and I can’t. They failed to recognize my emotional limitations. Physically, I’ve managed to accomplish everything I’ve set out to do. I may not be perfect the first time, but I push myself harder and harder until I get it and move on to the next even harder thing. Yeah, for me this is Unrelenting Standards, not so much Failure. But I can definitely get angry. Anger focused in an appropriate manner can be a very constructive tool. It’s a source of strength and motivation. I get caught up in being angry with myself. I get angry and blame myself for things that others have done because I believe “I’ve allowed” others to do those things to me, when really, I did not ask for it, it was not my choice. It was their doing, their fault. The blame is theirs. My anger should be for them as well.
            Alternatively, the patient’s parents may not have wanted the patient to succeed. Although the parents may have been unaware of it, they did not want the child to become too successful. They were afraid that the child would surpass or abandon them. The parents gave the child subtle messages that they would reject him or her or withdraw emotionally if the child became too successful. The child developed a “fear of success”. Experiential techniques help the patient identify this theme and relate to it emotionally. Getting angry with the Undermining Parent helps the patient understand that this was an unhealthy message, and one that the patient need no longer believe. Healthy parents do not punish their children for succeeding. Getting angry can help patients fight the view that people will reject them if they are too successful.
My parents certainly wanted me to succeed. I think I’m afraid of succeeding in my own way though. If I accomplish something it still means there’s more to go, something harder, something more challenging. One more opportunity for me to prove that I won’t measure up to what is expected of me. One more opportunity to fail. Not-so-amusingly, I also have an inability to say ‘No’ to projects, so while I may not want to do them for fear that I might fail at them, I also am incapable of saying ‘No’ and letting someone down or allowing them to believe that I can’t handle it, so I wind up with the task anyways. Then I balk and waver between doing it, pushing it around on my desk, finding other things that ‘are more important’, and finally tacking it with a single minded ferocity that gets it done efficiently and flawlessly.
            The behavioral part of the treatment is usually the most important. No matter how much progress patients make in the other areas, if they do not stop their maladaptive coping behaviors, they are going to keep reinforcing the schema. It’s necessary to replace behaviors that surrender to, avoid, or overcompensate for the schema, with more adaptive behaviors. Patients set goals, set grade tasks to meet them, and then carry out the tasks as assignments.
Behaviorally I act as though I will succeed. Hell, I act as though I’ve already succeeded at whatever I’m doing. Perception is important. If you appear successful people will believe you are successful, so hiding the insecurities is crucial.
Special Problems with This Schema
The most common problem is that patients persist in their maladaptive coping behaviors. They keep surrendering, avoiding, or overcompensating for the schema instead of trying to change. Patients are so convinced they are going to fail that they are reluctant to commit themselves fully to trying to succeed.
I can see my problems being in fooling the people that are trying to help me. I know what I’m supposed to say to appear as though I’m not a failure. I suppose it helps that I also have the evidence to back up these claims. For me it’s really just a feeling of failure. It’s not a reality of failure. Except in the reality of not being able to feel like a success. I fail and feeling properly. But we all knew that. That’s pretty much why we’re here. Regardless of how I feel I HATE admitting to being anything less than perfect, so admitting that I feel like a failure or a fraud is just out of the question.
*Schema Therapy: A Practitioner’s Guide by Young, Klosko, and Weisshaar

You! Who are you? – Enmeshment/Undeveloped Self

Alright! So who’s sick of listening to me complain about my body? Ooh Me! OK, enough of that.

Today let’s get back into schema mode! I know I’m going through these pretty slowly but I have so many ideas for things that I want to talk about and address that I feel like it’s good to switch it up. That way it doesn’t get too boring.
Enmeshment/Undeveloped Self
Typical Presentations of the Schema
When people with an Enmeshment schema enter treatment, they are often so fused with a significant other that neither they nor the therapist can say clearly where the patient’s identity begins and the “enmeshed other” ends. This person is usually a parent or a parental figure, such as a partner, sibling, boss, or best friend. People with this schema feel an extreme emotional involvement and closeness with the parental figure, at the expense of full individuation and normal social development.
            Many of these patients believe that neither they nor the parental figure could survive emotionally without the constant support of the other, that they need each other desperately. They feel an intense bond with this parental figure, almost as though, together, they are one person. (People may even feel that they can read the other person’s mind, or sense what the other person wants without the other having to ask.) They believe it is wrong to set any boundaries with the parental figure, and feel guilty whenever they do. They tell the other person everything and expect the other person to tell them everything. They feel fused with this parental figure and may feel overwhelmed and smothered.
            The characteristics discussed thus far represent the “Enmeshment” part of the schema. There is also the “Underdeveloped Self”, a lack of individual identity, which people often experience as a feeling of emptiness. These people often convey a sense of an absent self, because they have surrendered their identity in order to maintain their connection to the parental figure. People who have an undeveloped Self feel as though they are drifting in the world without direction. They do not know who they are. They have not formed their own preferences or developed their unique gifts or talents, nor have they followed their own natural inclinations – what they naturally are good at and love to do. In extreme cases, they may question whether they really exist.
            The “Enmeshment” and “Undeveloped Self” Parts of the schema often, but not always, go together.  Patients can have an undeveloped self without enmeshment. The undeveloped self can develop for reasons other than enmeshment, such as subjugation. For example, patients dominated as children my never have developed a separate sense of self, because they were forced to do whatever their parents demanded. However, patients who are enmeshed with a parent or parental figure almost always have an undeveloped self as a consequence. Their opinions, interests, choices, and goals are merely reflections of the person with whom they are merged. It is as though the parental figure’s life is more real to them than their own: The parental figure is the star and they are the satellite. Similarly, patients with undeveloped selves might seek out charismatic group leaders with whom they can become enmeshed.
            Typical behaviors include copying the behaviors of the parental figure, talking and thinking about him or her, staying in constant contact with the parent figure, and suppressing all thoughts, feelings, and behaviors that are discrepant from the parent figure. When patient do try to separate from the enmeshed person in any way, they feel overcome with guilt.
Goals of Treatment
            The central goal of treatment is to help people express their spontaneous, natural selves – their unique preferences, opinions, decisions, talents, and natural inclinations – rather than suppressing their true selves and merely adopting the identity of the parent figures with whom they are enmeshed. People who have been treated successfully for enmeshment issues are no longer focused to an unhealthy degree on a parental figure.  They are no longer fused with a parental figure and are aware of how they are similar to the parental figure and how they  are different. They set boundaries with the parental figure and have a full sense of their own identity.
            For people who have avoided closeness as adults in order to avoid enmeshment, the goal of treatment is for the patient to establish connections with others that are neither too distant nor too enmeshed.
Strategies Emphasized in Treatment
Bleh, let’s just list some of these things:
         Cognitive strategies challenge the persons view that it is preferable to be enmeshed with a parent figure than to have an identity of one’s own. It is important to explore the adveantages and disadvantages of developing a separate self. Patients identify how they are boht similar to and different from the paretnal figure. It is important to identify the similarities: The goal is not for patients to go to the opposity extreme and deny all similarities with the parental figure i.e. overcompensation. 
         Experimentally, patients visualize separating from the parental figure in imagery. In this sense they might remember scenes or memories and reinvent them by imagining what they really want to say or do or truly felt in that situation. It is possible to discuss differences from the parental figure.
         Behavioral strategies work to identify what a person’s own preferences and natural inclinations are. This is begun by listing experiences a person finds inherently enjoyable. From here they can use that basic feeling or sensation as a marker of enjoyment which will be a guideline to determine other things a person may enjoy. They even list what they do and don’t like about partners and work to act on their own preferences even when those differ from a parental figure.
Special Problems with This Schema
            The most obvious potential problem is that the patient might enmesh with the person trying to help them (therapist), so that the person becomes the new parental figure in the patient’s life. The patient is able to give up the old parental figure, but only to replace the other person with the therapist. Ass with the Dependence/Incompetence schema, the therapist might have to allow some enmeshment at the beginning of treatment but should quickly begin encouraging the patient to individuate.
Boundaries. Setting boundaries is important. ß— This will be a topic for future discussion.
I don’t really relate well to this schema either. Underdeveloped sense of Self is very common with Borderline Personality Disorder. I think my own sense of self is underdeveloped and my sense of identity is unstable, but there’s a difference between UNDERdeveloped and completely UNdeveloped. That being said I do often have a very strong sense of who I am at times. For instance it’s very easy to have a strong sense of who I am when I’m single or unattached to my partner, but given a situation where I am INTENSELY attached to someone I have definitely felt that enmeshed problem of adopting everything my partner is in to. In fact I’ve talked about Engulfment before. It’s incredibly intense. I usually retain my interests, what I like, my preferences, what I’m attracted to… those things don’t go away… but when you’re engulfed with someone else, all those things no longer seem to be important. It’s the things that the other person feels is important that become your priority, not your own needs.  Disentangling yourself from that mentality is hard. You often forget what it was like to have your own opinions, or how it felt before you became engulfed/enmeshed with another person. That person has taken over your mind and they become all you see, making them happy, doing things that they are pleased with is all that matters. It sounds kind of creepy actually. Probably because it is kind of creepy. No one should have that kind of power over you. I know this. I say this. But I’ve fallen into this. It’s not something you can help or you try to do, it just happens. And often it happens gradually. The more you become involved with someone, they more their interests are presented to you, the more you are exposed to what they like, the more you want to have things in common, the more commonalities you want to share, until you wake up one day and it seems like you’re absolutely perfect for each other because you REALLY ARE into all of these things that they like. Somewhere in the constant exposure you may actually {think you} enjoy all these things that your partner likes. These things do become a part of you on some level.
I can’t think straight today. I’m arguing with Friend about Occupy Wall Street and he’s getting under my skin because all his arguments are elitist bullshit or poorly thought out and he’s making me mad and argumentative.  ß— No longer engulfed. Yay me.

Mirror, Mirror on the Wall – Body Dysmorphic Disorder

I actually started writing this with every intention of doing a Sunday post, but wouldn’t you know, I got distracted and ended up doing something entirely different. So here it is for Monday.  Since this is something that is constantly on my mind and has been the subject of my latest therapy session; let’s talk about Body Dysmorphic Disorder. I’ve talked about dysmorphia before but not about the extent of the disorder.

So what is it?

Body Dysmorphic Disorder (BDD) is a kind of mental illness or somatoform disorder where a person is exclusively concerned with their body image. It manifests as excessive concern and preoccupation with a perceived defect of one or many physical features; or even vaguegly complains about appearance in general to the point where it causes psychological distress that (and this is important) impairs either occupational or social functioning, or both.

Snow White had it easy.
I’m going to reiterate this because as something that I’ve noticed a lot with self-diagnosing … you can run through the checklist of criteria for any disorder and say ‘yes’, ‘yes’, ‘no’, ‘yes’, ‘yes’ to any number of qualifications and on the surface it may look like you’re a good candidate for the illness or disorder, BUT, and this is a big ‘but’, if the problems do not create a SIGNIFICANT problem of functionality in some form of your life for an EXTENDED period of time, you may not actually have the disorder or illness, just passing symptoms of it that may be something else entirely. Being generally self-consciousness does not mean you have Body Dysmorphic Disorder. Being a cutter with mood swings does not make you Borderline (Yeah, I’m looking at all the pre-teen emo attention whores out there).

For years, starting in middle school, high school, and college… I could not go out in public. I could not do anything in a crowd of people. I would lock myself away in my room, wear baggy clothes (fortunately skater goth was a look that worked with my sense of style), and refuse to see anyone because the thought of anyone looking at me, seeing the “flaws” that I perceived induced a paralyzing anxiety. And I do mean panic attack, hyperventilating, dissolving into a puddle of self loathing kind of social anxiety. I could make myself go to work and school, but I would bundle myself up in shapeless clothes, avoid any kind of social contact, and steal myself away as soon as it was done.

BDD can occur to a degree that causes severe emotional depression and anxiety, and even may lead to the development of other anxiety disorders, social withdrawal, or social isolation. It sucks.

I remember having plans for events that I’d been looking forward to for months. For weeks I’d be even more strict about my diet and exercise so I would feel in control enough of my body to go out and enjoy myself. I would get all dolled up and decked out. Then an  hour before I was suppose to leave I would freeze. Literally on the threshold of my house, incapable of moving another foot out of the door because the thought of going out in public where people could see me felt like the world would come crashing down around me. I’d cancel my plans at the last minute, disappoint my friends, disappoint myself, strip off all the pomp and fancy and hide in bed for the rest of the night.

Like many mental disorders it’s caused by a variety of different things and is different for each person; biological, psychological, and environmental factors can all contribute. Maybe you’re predisposed to this kind of mentality, have suffered mental or physical abuse, or emotional neglect can be the cause. As you’d probably suspect, dysmorphic symptoms usually begin in adolescence or early adulthood when it’s common for self-criticism of a persons appearance to begin. From here it goes further than just criticism to an atypical aesthetic standard created from some internal perception of beauty or perfection between the persons ‘actual self’ and the ‘idea self’. What a person actually sees versus what you want to see.

However, what a person actually sees may be entirely different from what actually is.

According to the DSM patients are so overly concerned, or convinced, that they are misshapen or deformed in some way, despite all evidence to the contrary. Patients are generally concerned about some aspect of their appearance or with the possibility that they have some deformity. The specific “deformity” depends completely on the person. Maybe their facial or scalp hair is not right, maybe their nose is too big, their breasts are uneven, or their eyes are too far apart. Seeking help is actually common, but not by a psychiatrist. Because the person is so convinced that this is a legitimate problem they’ll go to their primary physician, dermatologist or even eventually to a cosmetic plastic surgeon. After being examined the physician usually finds no abnormality at all, or if one is present, it’s so trivial that no one would ever notice it. Reassurance does nothing though.

“Only a small minority recognize the groundlessness of their concerns; the vast majority are more or less convinced, and in a significant proportion the conviction becomes a delusion. Patients are often in torment over their “defect,” and the majority repeatedly check themselves in mirrors: in some cases such “mirror-checkers” may be so distressed by what they see that they may avoid mirrors, or cover them up. Most patients avoid contact with others, and a minority become housebound; ideas or delusions of reference may appear.”

I’m a mirror checker. Oddly I often avoid looking at my face, but I constantly check other aspects of my body that I perceive as out of proportion or that need to be hid. Constantly. It’s a compulsion. With me it’s my upper arms, thighs, and jaw. I have a very specific idea of what I need to look like and any deviation from this is a monstrosity.

Therapist has commented on more than one occasion that I have a beautiful figure and that my clothes are very professional and flattering (I go to session straight from work). I’m a master of disguise. A chameleon. I know exactly what I need to do to hide my flaws, create the illusion that they aren’t there, and appear in a way that is acceptable to the environment that I am forced to interact in. I wear a very specific cut of pant, I wear tailored jackets that emphasize other features and draw the eye to other areas like my tiny waist. It’s all a matter of tricking the eye of the beholder into seeing what I want them to see. This is often how I manage my Borderline issues as well. I draw the eye to positive attributes that I want people to focus on and gloss over the areas that I need to keep in shadow.

When I was younger my dad used to accuse me of vanity. He would see me looking in the mirror and say something like ‘you’re beautiful, quit checking yourself out’. Sort of a compliment I suppose, but he never understood. It’s not vanity. It has nothing to do with being vain. I hated how I looked. I NEED to see what other people see though. I need to be prepared for how others will look at me. What they will see with their own eyes. I needed to make sure that I was taking care to only show them what I wanted them to see. I needed to make sure I was perfect so there would be nothing to criticize.

“People with BDD say that they wish that they could change or improve some aspect of their physical appearance even though they may generally be of normal or even highly attractive appearance. Body dysmorphic disorder causes sufferers to believe that they are so unspeakably hideous that they are unable to interact with others or function normally for fear of ridicule and humiliation about their appearance. This can cause those with this disorder to begin to seclude themselves or have trouble in social situations. More extreme cases may cause a person to develop love-shyness, a chronic avoidance of all intimate relationships. They can become secretive and reluctant to seek help because they fear that seeking help will force them to confront their insecurity. They feel too embarrassed and unwilling to accept hat others will tell the sufferer that he or she is suffering from a disorder. The sufferer believes that fixing the “deformity” is the only goal, and that if there is a disorder, it was caused by the deformity.” (Thanks, Wiki.)

This is certainly how I think. If I could just fix these 3 things, everything would be perfect. If this was just a little more streamlined, if that was just a little more toned, if that was just a little more concave, I could be the marble statue I’ve always wanted to be. Roommate doesn’t believe this. She thinks that even if these things were “fixed” then my focus would just shift to something else.

Last session Therapist asked me to name 5 words that described how I view myself. 1) Ugly, 2) fat, 3) uncomfortable. I couldn’t’ actually think of two other words. I’m 30 years old, though I look like I’m 22. I’m 5’3”. I have a 24.5” waist. I’m athletic. In college I would be stopped on the streets by modeling recruiters. Professional photographers routinely seek me out at the many costuming events I attend to post for them. No, I’m not bragging. But since I’m maintaining a relative anonymity and won’t post my pictures on this blog I’m relaying my experiences to give you an idea of the massive discrepancy of what I see and what others do. Therapist looked like I broke her heart when I told her those words. I just don’t understand how others can see me and see someone that is attractive.

Another important thing to note is my weight obsession. Body Dysmorphic Disorder and Eating Disorders are not interchangeable. In fact, a preoccupation with weight and the development of eating disorders is something that is specifically taken into consideration in diagnosis. If a persons symptoms are better accounted for by another disorder: weight concerns are usually more accurately attributed to eating disorders: then BDD may not be the problem.

My eating disorder is incredibly psychologically complicated. In regards to BDD it’s almost opposite. I developed this disorder as part of my attempt to control my flaws. But there are many other facets to it as well; like my need for structure and control, as an attempt to fill the void of loneliness that I can’t otherwise fill at the moment, etc. So I’m one of those with both.

In fact, co-morbidity is common with BDD.

         76% will experience major depressive disorder at some point
         36% may develop agoraphobia
         32% are affected by obsessive-compulsive disorder
         But the most common disorders found are Avoidant Personality Disorder, Social Phobia, Social Anxiety Disorder, and Dependent Personality Disorder
         Eating disorders are also sometimes found in people with BDD.
I’m curious about the Avoidant and Dependent Personality Disorders. It makes me wonder if there isn’t a higher ratio of Borderline Personality Disorder with Body Dysmorphic Disorder as well.
Here’s the part where I list the symptoms and expressions and see just how neurotic I am!

Symptoms

Common symptoms of BDD include:

         Obsessive thoughts about (a) perceived appearance defect(s). <~~~~ And how.
         Obsessive and compulsive behaviors related to (a) perceived appearance defect(s) (see section below). <~~~~ I can  hardly wait
         Major depressive disorder symptoms. <~~~~ Gee, let’s think…. Yeeeaaah.
         Delusional thoughts and beliefs related to (a) perceived appearance defect(s). <~~~~ So I’m told, of course it could just be that everyone else is wrong.
         Social and family withdrawal, social phobia, loneliness and self-imposed social isolation. <~~~ Years, and years of this. Though admittedly I’m working hard despite my ridiculous anxiety to push through this, it is still always in the background of my mind bullying the happy thoughts off the playground.
         Suicidal ideation. <~~~~ Been there, done that.
         Anxiety; possible panic attacks. <~~~~ Possible? Can you say understatement?
         Chronic low self-esteem. <~~~~ Not that I’d let anyone see this.
         Feeling self-conscious in social environments; thinking that others notice and mock their perceived defect(s). <~~~~ I wish I could be social without people looking at me.
         Strong feelings of shame. <~~~~ I just want to be perfect.
         Avoidant personality: avoiding leaving the home, or only leaving the home at certain times, for example, at night. <~~~~ When it’s harder to see me.
         Dependent personality: dependence on others, such as a partner, friend or family.
         Inability to work or an inability to focus at work due to preoccupation with appearance.
         Problems initiating and maintaining relationships (both intimate relationships and friendships). <~~~~ It’s hard to be close to someone when you don’t want them to look at you.
         Alcohol and/or drug abuse (often an attempt to self-medicate). <~~~~ You can’t worry when you’re passed out.
         Repetitive behavior (such as constantly (and heavily) applying make-up; regularly checking appearance in mirrors; see section below for more associated behavior). <~~~~ Mirror mirror on the wall ::SMASH::
         Seeing slightly varying image of self upon each instance of observing a mirror or reflective surface. <~~~~ This is maddening.
         Perfectionism (undergoing cosmetic surgery and behaviors such as excessive moisturizing and exercising with the aim to achieve an ideal body type and reduce anxiety). <~~~~ I just want to be perfect, and redundant.
Note: any kind of body modification may change one’s appearance. There are many types of body modification that do not include surgery/cosmetic surgery. Body modification (or related behavior) may seem compulsive, repetitive, or focused on one or more areas or features that the individual perceives to be defective.

Compulsive behaviors

Common compulsive behaviors associated with BDD include:
         Compulsive mirror checking, glancing in reflective doors, windows and other reflective surfaces. <~~~~ Vanity is its own problem, but has nothing to do with this.
         Alternatively, an inability to look at one’s own reflection or photographs of oneself; also, the removal of mirrors from the home. <~~~~ We literally have a hall of mirrors.
         Attempting to camouflage the imagined defect: for example, using cosmetic camouflage, wearing baggy clothing, maintaining specific body posture or wearing hats. <~~~~ It’s really not that hard.
         Use of distraction techniques: an attempt to divert attention away from the person’s perceived defect, e.g. wearing extravagant clothing or excessive jewelry. <~~~~ You can see what I want you to see.
         Excessive grooming behaviors: skin-picking, combing hair, plucking eyebrows, shaving, etc.
         Compulsive skin-touching, especially to measure or feel the perceived defect. <~~~~ Hey, maybe I just like how my jaw feels.
         Becoming hostile toward people for no known reason, especially those of the opposite sex, or same sex if homosexual. <~~~~ In my defense, my hostility towards other people is usually because they’re dicks. And I’m irrationally angry.
         Seeking reassurance from loved ones. <~~~~ If I sought reassurance they’d know there was something wrong.
         Excessive dieting or exercising, working on outside appearance. <~~~~ 6 days a week, 15 hours in the gym, constantly monitoring everything I eat… Excessive? Nah.
         Self-harm <~~~~ I like to think of it as keeping myself on track.
         Comparing appearance/body parts with that/those of others, or obsessive viewing of favorite celebrities or models whom the person suffering from BDD wishes to resemble. <~~~~ Who doesn’t compare themselves to others.
         Compulsive information-seeking: reading books, newspaper articles and websites that relate to the person’s perceived defect, e.g. hair lossor being overweight. <~~~~ Maybe I just like to be in the know.
         Obsession with plastic surgery or dermatological procedures, often with little satisfactory results (in the perception of the patient).
         In extreme cases, patients have attempted to perform plastic surgery on themselves, including liposuction and various implants with disastrous results. <~~~~ Holy crap, if I ever get this bad I’ll just have myself locked up.
         Excessive enema use (if obesity is the concern). <~~~~ Um, Ew. Just, ew.

Now I certainly recognize a lot of these symptoms in myself but I don’t know if I attribute them all to BDD. Some of clearly a byproduct of my Borderline Personality Disorder or aspects of other problems I have. Where’s the line though? Often these things overlap and collide like a maelstrom of emotional turmoil.

Surprisingly in my research I found that this actually affects men and women equally. It sounds like it would be another ‘female problem’, but apparently not. As many as 1-2% of the world’s population might even meet the diagnostic criteria for a diagnosis of BDD.

My final thought: Not just in physical appearance but in every aspect, I’m obsessed with how people perceive me. Not because I have some need to be complimented or anything like that. But I need to know how others see me, what they think, so I can gauge how different it is from how I think of myself. 

Lucid Analysis – Trials in Therapy – The Body Issue

I know I usually do this on Friday, but I was a little, busy, yesterday ß—- Secret.

I like to think of my session on Thursday as I Hate Everything but I’ll do it anyways. And by everything, I really just mean my body.  I’ve been bumping up my workouts like mad, started a food journal again to track everything I’m taking in, and I’m still not seeing the results I want to see as fast as I want to see them. But let’s face it, if it didn’t happen yesterday it’s not going to be fast enough for me.


I’m freaking out about putting on weight because I’m trying to kick a really bad habit. Maybe habit isn’t really the word so much as addiction. I’ve been addicted to diet pills for longer than I care to remember. I hate them, I need them. I stopped taking them. They’re a major crutch for me. I don’t overdose on them, but I take the max possible. Every day. The same times every day. If I don’t, or I miss a dose, the panic starts. The thought of gaining weight is terrifying to me. The thought of taking these pills for the rest of my life disgusts me.

I hate talking about this stuff in real life. Guys don’t like to hear you obsess about your weight or pick apart your flaws, I don’t like to show that things like this bother me. When you see me in person I’m confident and I have a very “I am the way I am, if you don’t like it, get the hell out of my way” attitude. Which isn’t all an act. I don’t care what other people think of me (unless I’m very emotionally attached), I care what I, me, think of me. And I’m not happy.

Therapist wondered what triggered this because I don’t usually harp on about it. I talk about my bulimia often enough, but I don’t usually tear myself apart to her out loud. She actually thought that I didn’t have these thoughts very often. ::blinks:: I OBSESS about my body.  
I’m sick of it.

My health is really important to me. I am worried about the affect these things will have on my healt. I just got so disheartened when Psychiatrist put me on the drugs that made me gain weight. I won’t even see him anymore. I see his PA, and I like her a lot better. I worked so hard to get my body to a place where I was truly comfortable with myself and in ONE MONTH he destroyed that for me. I’ve been struggling ever since. 

And what’s ridiculous, is no one else sees it. Everyone tells me that I have a killer body, but it’s not what I want. Even when I got my tattoo, it took a lot for me to post the pics of my body, b/c to me, I am over weight in those.

Homework: Pull out my pencils, pens, and/or paint, and draw how I perceive my body to be.


I have a completely distorted view of myself and I’m not sure how to fix this. Therapist absolutely can not relate to this at all though. She’s the kind of person that’s always had to work to GAIN weight. Boo hoo. So she wants to get a better idea of the difference between what actually is and what I see in myself. 
Regardless of all this body image weight phobia I’m doing something that I need to do for me. I kicking this addiction.  It’s been about 3 weeks already. I think about it every day. Not opening up that bottle is still really difficult, but I’m doing it.

And despite all these bad thoughts, and these overwhelming feelings that I should be hiding myself away so no one can look at me, I’m still going out. I’m still working to put myself out there. Hell, I’m still dating! In fact I had a date with Tech Boy right after my session.

So, we haven’t had sex yet (not to be confused with not doing a lot of other stuff though haha). This actually freaks me out. He hasn’t pressured me for it at all. I don’t know if it’s because his ankle is still broken or what.  It makes me paranoid though. Even though he’s like super cuddly, eye contact, really into everything I say… wtf? I have to say, he is a Borderline’s dream to sleep with. Let me tell you how much I love waking up next to someone like him. If I even try rolling away from him he pulls me back and wraps his arms around me. And then says he could stay like that all day. So I guess all in all things are going relatively well there.

I’m still struggling with how much I can trust him with. I have such a hard time trusting anyone, especially men. I know there are some decent ones out there, they just haven’t been very prominent in my life. Sorry guys. I’m still struggling with how much I should invest too because I don’t know how right we are for each other. Then again, sometimes I think I could fall in love with anyone.

Alright I’m a little drugged up at the moment, so I honestly can’t think straight. I have no focus. Spin spin spin.

I think I’ll go make Honey Lavender Biscotti and Buttermilk waffles for Roommate.

I love food. I hate food. There is no in between. 

The Sky is Falling! – Vulnerability to Harm or Illness

Holy $h!t such a busy day. Non stop non stop rush rush rush. Met a cute guy though. And he’s from my alma mater. I actually found myself appreciating a nicely constructed male backside today. This is so not my style. Girls, yes. Guys? Not so much. But lemme tell you, he had a nice booty. So you’re probably wondering what this has to do with today’s schema. Absolutely nothing.
On that note. Today I’m talking about the Vulnerability to Harm or Illness Schema.
Vulnerability to Harm or Illness
Typical Presentation of the Schema
These people live their lives believing that catastrophe is about to strike at any moment. They are convinced that something terrible is going to happen to them that is beyond their control. They will suddenly be struck with a medical illness; there will be a natural disaster; they will become victims of crime; they will get into a terrible accident; they will lose all their money; or they will have a nervous breakdown and go crazy. The predominant emotion is anxiety, ranging from low-level dread to full blown panic attacks. These patients are not afraid of handling everyday situations, like patients who have Dependence schemas’ rather, they are afraid of catastrophic events.
            Most of these patients rely on avoidance or overcompensation to cope with the schema. They become phobic, restrict their lives, take tranquilizers, engage in magical thinking, perform compulsive rituals, or rely on “safety signals,” such as a person they trust, a bottle of water, or tranquilizers. All of these behaviors have the goal of stopping the bad thing from happening.
This strikes me as very OCD and Paranoid PD, not that it can’t present in other personality disorders or even those without. Again, this is not a schema I relate to very well. While yes, I do have massive panic and anxiety attacks, it’s usually triggered by a real situation or perceived threat (which ok, may not be strictly real). Meh, even that isn’t strictly true because I have an anxiety disorder and I’m very familiar with that constant low level of dread, but this is due to other schema triggers I believe. And I do have the fear that I’ll just have a nervous breakdown and go crazy, but let’s face it, that isn’t exactly irrational. I think my point here is, there’s a difference between having panic/anxiety attacks for different reasons, and having panic/anxiety attacks because you think a meteor is going to spontaneously crash through the atmosphere and land on your house. One is not necessarily this schema, the other is.  
Heh, in fact, I have a tendency to live like the world IS about to end and I want to do everything I can. Or if the world is going to end then there’s nothing I can do about it, I’m going to go out with my own kind of bang.
Goals of Treatment
The goals of treatment are to get patients to lower their estimations of the likelihood of catastrophic events and to raise their evaluations of their ability to cope. Ideally, patients come to recognize that their fears are greatly exaggerated and, even if a catastrophe did occur, they would be able to deal with it adequately. The ultimate goal of treatment is to convince patients to stop avoiding and overcompensating for the schema, and to face most of the situations they fear.
Strategies Emphasized in Treatment
            Patients explore the childhood origins of the schema and trace its pattern through their lives. They count the costs of the schema. Patients explore the changes they would make in their current lives if they were not overly afraid. It is important to spend time building motivation to change. The patient should stay focused on the long-term negative consequences of living a phobic lifestyle, such as lost opportunities for fun and self-exploration; and on the positive benefits of moving more freely in the world, such as a richer, fuller life.
            It’s important to do both cognitive and behavioral work to overcome this schema.
            Patients counter their exaggerated perceptions of danger. Challenging catastrophic thoughts – or ‘decatastrophizing” – helps them manage panic attacks and other anxiety symptoms. Cognitive strategies also build motivation by highlighting the advantages of changing.
            Behaviorally it’s important to face the situations that are feared by undergoing gradual and graduated exposure to phobic situations in homework (try to face it on paper before you face it in real life): Picture entering specific phobic situations and, with the assistance of the “healthy Adult” coping well. Anxiety management techniques such as breathing exercises, meditation, and flash cards help patients cope with the exposure as they go through them.
            Reassurance is important. It’s necessary for a person to know that they will be able to cope in a healthy way.
This sounds easier than it is. It’s been my experience that when you have an irrational fear, you pretty much know it’s irrational. However that doesn’t change how you feel or think or act. So just having someone tell you that what you’re doing is irrational is not going to change anything. And the longer you’ve done a particular coping strategy, the harder it’s going to be to undo all that habit and reform new, healthier, habits. However, that’s what time is for. You take the time. You work on it little by little with someone you can trust.
I think this is a problem that a lot of nuero-typical people have with the personality disordered. They think that since we’ve been told a better way, have had our problems pointed out, that it’s easy for us to change. Because their brains work in a fundamentally different way they just do not understand that we cannot always follow the path from point A to point B. We have monsters hiding down some paths that they can’t see.  
Special Problems with This Schema
            The greatest problem is that people with this schema are too afraid to stop avoiding and overcompensating. They resist giving up their protections against the anxiety of the schema. As we mentioned earlier, mode work can help patients strengthen the healthy part of them that yearns for a fuller life.
I can relate to this. I’ve mentioned before how I’m afraid to ‘lose’ my Borderline Personality Disorder, my depression, my anxiety…. It’s such an ingrained part of me that the prospect of living without something that I’ve had my entire life is just, foreign. I can’t wrap my head around it, and it’s scary. However I’m also not the kind of person that’s afraid to try new things. So I keep doing what I’m doing to get healthier, despite these irrational fears that I’ll lose a part of myself by healing. Being who I’ve always been is comfortable in it’s own dysfunctional kind of way. I don’t want to lose who I am. However, I think this is a faulty way of looking at it. I won’t be losing myself. I will always be me. I’ll just be me in a different stage of growth. Maybe it would help to look at all these coping mechanisms and faulty habits as skills or tools. You grow up learning how to use a certain tool a certain way. It’s not until years later that you realize you’ve been using it wrong, or there are better ways of utilizing that skill. It can be impossible to recognize the problem if it’s what you’ve always known. It’s not until you have someone that knows how to properly use the tool and can show you that there really is a better way of going about doing the work, that you finally can see a different way. It’s upgrading your toolbox. Toss out the broken screwdriver and trade up for the power drill.
Something like that.
*Schema Therapy: A Practitioner’s Guide – Young, Klosko, Weishaar