Man I’ve just been crazy lately. Crazy busy anyways. Anytime I tell Therapist that I feel crazy or have a crazy brain she tells me I shouldn’t say things like that because I’m not, but man. Frazzle. Sorry for my lack of posting yesterday, I have been swamped enough to work through lunch so I didn’t have time to post.
Moving on to Impaired Autonomy and Performance Domain! Yay a new Domain.
Typical Presentations of the Schema
Often this type of person presents as childlike and helpless. They feel unable to take care of themselves on their own, experience life as overwhelming, and themselves as inadequate to cope. The schema has two elements. The first is incompetence. The people lack faith in their decisions and judgments about everyday life. They hate and fear facing change alone; they feel unable to tackle new tasks on their own and believe they need someone to show them what to do. These patients feel like children too young to survive on their own in the world: Without parents they might die. In the extreme form of the schema, patients believe they will not be able to feed, clothe, and shelter themselves, navigate from one place to another, or fulfill the simple, everyday tasks of life.
The second element – dependence – follows from the first. Because these patients feel unable to function on their own, their only options are to find other people to take care of them or not to function at all. The people they find to take care of them are usually parents or substitute parents, such as partners, siblings, friends, bosses – or therapists. The parent figure either does everything for them or shows them what to do at each new step along the way.
The core idea is “I am incompetent; therefore, I must depend on others.”
Typical behaviors include asking others for help; constantly asking questions as they work on new tasks; repeatedly seeking advice about decisions; having difficulty traveling alone and managing finances on their own; giving up easily; refusing additional responsibilities (i.e. a promotion at work); and avoiding new tasks. Difficulty driving is often a metaphor for the schema. People with the Dependence/Incompetence schema often fear and avoid driving alone: They might get lost; their car might break down, and they would not know what to do. Something unforeseen might happen, and they would not be able to handle it. They would not be able to come up with a solution on their own. Thus, they need someone with them who can either give them the solution or handle the problem for htem.
A small percentage of patients with the Dependence/Incompetence schema overcompensate for the schema by becoming counterdependent. Even though underneath they feel incompetent, they insist on doing everything on their own. They refuse to rely on anyone for anything. They will not be dependent, even in situations where it is normal to be dependent. Like pseudomature children who have h ad to grow up too soon, they manage alone, but they do it with a tremendous amount of anxiety. They take on new tasks and make their own decisions, and they may perform well and make good decisions, but inside, they always feel that, this time, they are not going to be able to pull it off.
And here I was worried that I wouldn’t be able to relate to this Schema. Psh. If anything I am that small percentage that overcompensates by becoming counter dependent. I HATE, hate, hate, hate, having to rely on anyone. I feel like this is somehow cheating if I need to ask for help. If there’s something I don’t know how to do, have never done before, need assistance with… I can’t claim that I did it or did it well if I had anyone’s help because really it wasn’t me doing it. If it’s not me accomplishing the thing then that means that I wasn’t good enough, smart enough, clever enough. I have to do things myself to prove that I can. That anxiety is gnawing. In the back of my mind I always believe that if I show that I need assistance then I will be fired for not knowing everything already. It’s gut wrenching and keeps me pushing myself harder.
Goals of Treatment
The goals of treatment are to increase the patient’s sense of competence and decrease dependence on other people. Increasing the patient’s sense of competence usually involves building both confidence and skills; decreasing his or her dependence involves overcoming avoidance of trying tasks alone. Ideally, these patients become able to stop relying on other people to an unhealthy degree.
Giving up the dependence is the key to treatment. The therapist guides patients through a kind of response prevention: Patients stop themselves from turning to others for help, handle takss on their own, accept that making mistakes is how they will learn, persevere until they are successful, and prove to themselves that they can eventually generate their own solutions to problems. Through trial and error, they can learn to trust their own intuition and judgments rather than disregarding them.
Special Problems with This Schema
One of the greatest risks is that the patient might become dependent on the therapist rather than overcoming the schema. The therapist mistakenly assumes the role of parent figure and runs the patient’s life. The amount of dependence the therapist allows is a delicate balancing act. If the therapist does not allow any dependence, the patient will probably not stay in treatment. Realistically, the therapist has to start by allowing some dependence and then gradually withdrawing. The therapist should strive to allow the least possible amount of dependence that will keep the patient in treatment.
One of the greatest challenges in treating patients with this schema is overcoming t heir avoidance of independent functioning. Patients have to become willing to trade short-term pain for long-term gain and tolerate the anxiety of functioning as adults in the world. Building motivation is important.
So this isn’t really my Schema. I was raised to be independent to a fault. That’s probably where all this counterdependent stuff stems from for me. I was constantly told that if I wanted something, I had to earn it. So I feel like if I need to ask for help then it isn’t completely my doing, and therefore I haven’t earned it.
I do think all people with Borderline Personality Disorder have something of a Dependence issue though. We’re emotionally dependent on other people for our own happiness. When I’m not in a relationship my world is relatively ‘calm’ and ‘normal’ but I feel empty and hollow. When I’m attached to someone I remember and can feel what it is to be happy. These feelings of happiness are entirely dependent on 1.) being with someone, and 2.) their own emotional wellbeing/happiness. I can’t remember being truly happy just on my own. With someone I can be happy for moments, or hours, but it’s not really a lasting happiness. It’s rather like catching fireflies in a jar. The chase is exhilarating, once the moment is captured it’s beautiful, but eventually there isn’t enough air in the jar and the bugs die. Occasionally shaking the jar makes them light up even brighter, but eventually you either have to let them go so they can continue to live and grow or cling to them caged, and watch the feelings slowly wither.
Well there’s an analogy for you.
The problem with all of that is…. No one can make you happy. You are responsible for your own happiness. I think we get so caught up in desperately reaching to one source of positive emotion that we forget about everything else out there that can also contribute to our happiness. There’s a world of delight and adventure to explore, and endless possibilities for joy. Or so I’m told. I once told my Therapist that I didn’t know what joy, real joy, felt like. She found this to be very sad. The problem is I’m not content with myself. I need to work on accepting myself, and worry less about the acceptance of others. Joy comes from within. At least, that’s what I’m told. Hopefully one day I’ll find out.
*Schema Therapy: A Practitioner’s Guide – Young, Klosko, Weishaar