Lucid Analysis – Trials in Therapy

The Relationship Issue.
Right away Therapist said I looked centered and happy. She asked how things are with Tech Boy and all that. Good. Cute. We’re texting and talking all the time. I feel silly and cute (read: euphoric and high).  She asked me if I think this is on track to being a healthy relationship.
How would I know?
I’ve never had a healthy relationship. Surprise! Don’t look at me like that. That’s not saying they’ve all been bad, just not healthy. I dated a couple guys in college that were really great guys, but I felt no emotional attachment to them. For all intents and purposes the relationships were ‘normal’ but emotionally void b/c I was cut off from feeling (Boring-Ex can basically fall into this category as well except of course, that ended with me in the Psych ER). Unhealthy. My relationships with women were often more affectionately intense, but shorter lived as I would freak out at the speed of closeness. And then, there were the notable abusive messes that have hallmarked my existence. I fail at relationships. I think people are crazy for wanting to be involved with me. I actually TELL PEOPLE that I’m a terrible girlfriend and that they shouldn’t want to date me. I come with a disclaimer ß——– This is a common phrase.
Or like this morning when Tech Boy and I were going out to my project site he was like… “You carry my equipment, drive me around, you’re just a generally good person ::insert cute smile::” To which my immediate response was to laugh that off and say “Clearly, you don’t know me that well”. I’ve tailored responses like that to sound joking, even though I mean it whole heartedly.
Therapist doesn’t see a bad person in me. She sees someone that has had a lot of bad things happen to them, but that doesn’t mean I am bad. I still feel bad. I feel like I’m going to destroy everything I touch. Which is awful because I want to touch things. I want to be touched.
Not literally. Don’t get too dirty on me there. Ok, maybe a little bit literal. Ok, a lot.
I mean I want to be with someone in a meaningful way. Therapist asked if I felt Tech Boy was someone that I felt I could share with? I want to be the kind of person that can be open and share myself with someone in a healthy way. But I have so much unhealthiness in my past. I told Therapist I’m not sure I can be open with Tech Boy (not just him, anyone). What right do I have to dump all that trauma on someone? How can I expect someone else to be ok with the things that have happened to me? That I’ve done to me? How can I expect someone to see all of this and not judge me and think I’m a terrible person? A damaged person?
I have to hide it all. It’s what I’ve always done. Eventually though, when people push to get closer and the walls begin to come down it all eventually comes out. Once my walls start to slip it’s hard for me to maintain that mask that I’ve kept in place for so long. It’s never quite the same.
The first thing people usually ask me is about my arms. For the first time I’m starting to dread this explanation. Therapist was like, well, maybe he won’t think they’re unusual. What? I don’t think she’s ever really taken a good look at my arms. I showed her and she had to admit it was pretty obvious. It’s not like Tech Boy hasn’t seen {some of} them. I don’t hide my scars, but it’s not the kind of thing people ask about in a professional setting so no one has ever brought it up. Then again, maybe I can assume that he’s noticed, and decided that it doesn’t matter, as he clearly has a thing for me.
Aside: When I say ‘clearly’, this didn’t stop me from freaking out about him not being able to see me last weekend because he broke his freaking ankle. I was actually paranoid that this was just an excuse to not see me at first. Yeah, I know. Don’t start.
Also, I don’t assume. And even if I did, I would ignore the assumption and think the worst anyways. I’m just going with it.
Coming back around to my point, I don’t need to unload all of my past at once. That should come slowly over time. I feel like I’m hiding who I am though and thereby not being honest. Bleh. I’ll figure it out.
So of course we ended up talking about Friend. I’m having a bizarre sort of mashup between Splitting and Abandonment here. I can’t let go of my friendship with Friend. I don’t want to. I can’t. I can’t even think about it. But he’s like a disembodied character to me. Every time I see him it’s like I’m seeing someone new that has all the characteristics of the last Friend I talked with. As soon as Tech Boy and I started getting close, my feelings snapped off for Friend (unless his wife is doing something to rub things in my face, then I just want nothing to do with them at all). I split from the love and hurt I felt to utterly neutral and not needing to be around him, or even talk to him anymore. I’m cancelling plans, changing dates, breaking my structures I built with him… in favor of something new. I still have a lot of anxiety about this, but it’s not for fear of his disapproval so much as for fear of breaking what’s familiar and fearing that I won’t be able to maintain that familiarity.
Therapist thinks I’ve done a remarkable job holding onto this friendship. What I went through with Friend and his wife was incredibly hurtful. She still thinks it was healing in many ways though. She asked me what kinds of things I want to remember from my relationship with Friend.
I couldn’t think of a single thing. I am completely blocked and dissociated from the feelings that I had. I only remember the bad, the hurt. I don’t even want to think about writing my letter to him. I don’t want to think about him like that. Split. I’m thinking about someone else now, I don’t want to think about what I felt before. What did I love about him? About us?
Homework: What positive things have I taken from my relationship with Friend?
She thinks this would be good for me to remember because I have such a hard time holding onto people. My lack of object permanency. I feel like I’m not a part of people’s lives if I am not in their immediate presence. If I can write down the things I valued about him, that I believe he valued about me, and relate that to how it is still displayed in our current friendship, maybe it will help me hold onto the idea of fluidity through time. It will also help me recognize the things that I want in a future relationship, that I should hold onto, and not allow myself to settle for things that don’t meet a healthier standard.
We’re really trying to work on forming new, healthy, relationships now. She’s very proud of me for taking all the safe risks I’ve been taking lately. She’s trying to caution me to think further into what it is that I want exactly, instead of just throwing myself into the moments.
Homework: What do I envision for a healthy relationship? (I remembered this week!)
I don’t even know. What do you think is part of a healthy relationship?

Thought Control is Mind Control

I found an article written by Dr. Amen who’s a psychiatrist, neuroscientist and brain-imaging specialist. It’s about how to conquer negativity and encourage positive thoughts. It’s not about Borderline Personality Disorder per say. It’s aimed at people that do have negative thoughts but are basically ‘normal’ (meaning: don’t have a personality disorder). However I found what he had to say runs parallel to BPD.
The article is about negative thinking, what he calls ANTs = Automatic Negative Thinking. These are thoughts that automatically pop into your head, but don’t necessarily have any rational hold. Or if they do, they run away with you instead of allowing for the ability to come up with solutions instead of dwelling on them. The thoughts that jump into your head automatically after something triggers them and refuse to go away. For me these thoughts run rampant and spin me down into a dark hole that I can’t climb out of.
He goes on to say that powerful thoughts can lead to physical reactions. Negative thoughts actually release chemicals in your brain that do make you feel bad. The opposite is true too, the happy, the positive can lead to chemical release that makes you feel good.
Therapists have identified 10 ‘species’ of the automatic negative thoughts. (I think the term ANTs just sounds ridiculous. I can’t take it seriously.)
1.)  All or nothing (thinking in black and white).  This is what Splitting is.
2.) Always thinking (overgeneralizing). Well, yeah.
3.)  Focusing on the negative (ignoring the positive). When things are always bad, when nothing turns out how you need it to, when every little thing shakes your foundation, it’s hard to think about the positive. On the other hand, if you swing {hyper}manic, it’s the opposite, everything can be positive, everything is superhuman, everything is achievable. I think the mood swings of someone with BPD can be a little too changeable for this, but generally speaking I think the principle here is true.
4.) Think with your feelings (believeing negative feelings without evidence). Obviously. BPD is all about emotional dysregulation. Emotions that take control, cloud your judgment, and make you act in ways that most people wouldn’t.
5.)  Guilt beating (thinking in words like “should”, “must”, “ought to). I do this a lot. Believe I should be other than I am, should have done something better, was not good enough at something else, failed myself in some way… I tell myself that I’m not good enough if I can’t be perfect.
6.)  Labeling (attaching negative labels to yourself and others). For someone with BPD I think this is an extension of Splitting. I label someone as all good (ex. Roommate). I label someone as all bad (Friends wife). It may be both all good, or all bad for the same person at different times, depending on the last interaction (ex. Friend or myself).
7.)  Fortune Telling (predicting the future in a negative way). Hopelessness, abandonment, believing that eventually everyone will leave, things will always turn out devastatingly wrong. Just walking into a situation and knowing it’s going to turn out bad for you. I find this usually happens worse when it’s something I really want.
8.)  Mind Reading (believing you know what someone else is thinking). This goes hand in hand with hypersensitivity. When you’re so attuned to what someone does, if there’s any variation, anything to shake that tenuous stability, there’s no helping the wild thoughts that run away to figure out why someone has changed in some way. Even if that change is miniscule.
9.)  Blame (Blaming others for you problems). If he just did this, if she felt this way, if I wasn’t so misunderstood… these tend to be the kinds of thoughts I have to give ‘reasons’ for my negative feelings. 
10.)               Denial (refusing to admit you have a problem). Heh, I don’t think this is really my issue, or anyone’s issue that has BPD and is seeking help or treatment. Well, maybe. Identifying ALL the areas that need helping I can see where there can be denial.
The first step is to realize these things are a problem. Keeping in mind that these thoughts happen may help figure out how to change them.
Everybody lies
To combat these he makes a good point: Thoughts can lie; they lie a lot. However you don’t have to believe every thought that pops into your head. But how do you determine which thoughts you can believe? All things in life aren’t positive, some things are negative. Just because you’re paranoid doesn’t mean you’re wrong, sort of thing. The problem is they feel like the truth. These are what automatically popped into my head, and it’s pretty obvious to me that they’re self-defeating in term of incorporating a helpful idea. I often fight against things that are good for me, and I don’t know why.
In order to get ahold of these thoughts and recognize which ones are not rational he makes a suggestion. Write them down. “The simple act of writing down your thoughts helps get them out of your head and begins to diffuse any negative feelings so you start to feel better”.  This is something I do almost daily. I’ve kept journals since I was 12/13 years old. For me it only tends to be a temporary fix. It doesn’t help the irrational thoughts from coming back in the future, or even the next day, but it does help me get ahold of them and allow me to work through them at the time. I can’t always write as soon as I have ridiculous thoughts, so often they  stay with me for days, weeks. When I do have time to write I do feel calmer. I’m able to look at the problem and try to sort things out. If nothing else, it reminds me of the things I need to talk about in therapy. My therapist encourages me to write every day. If I’m comfortable I read what I’ve written in session so that we can work on these things.    I try to write everyday but sometimes I’m just too busy or I don’t want to… and sometimes I want to dwell on my problem. I want to hold things to me, believe that these things are true, not my fault, feel misunderstood so I can believe these kinds of thoughts are justified. I know this isn’t rational but sometimes I hold things to me and don’t want to let them go.  I know this is something I need to work on. I can generally get my thoughts down on paper, and it does help me put things into perspective for a while.

Continue with: write down the ‘negative’ situation that brought about the negative thoughts and feelings, identify the moods felt during the situation, write down the automatic thoughts that were experienced when that certain mood was felt, identify the evidence that supports these thoughts, identify the evidence that does not support these thoughts, next identify the fair and balanced thoughts about the situation, and finally observe the new mood and think about what to do.

The problem with this article, for me, is that when you have a personality disorder you can’t just think your way out of the barrage of overblown thoughts that accost you . Beat you into submission mastered by your emotions.  You feel them whether you want to or not and no amount of telling yourself otherwise alleviates them. If it was as simple as remembering a few principles**, PDs wouldn’t be a problem for anyone that wants to change.  I can’t internalize a lot of these, and unless I read them every single day, my neurotic thoughts will crowd out the helpful ones. Maybe other people can remember them and use these techniques to keep some calm. Find a little relief. A way of infusing some rational explanation into the irrational behavior.  
** This is the point of therapy. However therapy realizes that it takes time, practice, and work to change these behaviors. It’s not as simple as reading an article.

Distortion: Conceptions of Borderline Personality Disorder – Part 3

Getting back to our look at Gundersons’ Conceptions of BPD… 

– Distorted thoughts/perceptions, particularly in terms of relationships and interactions with others
Ugh. Yes. These come in various forms for me. 

Wanting there to be more than there is. ::sigh:: I do this at some point, in almost every relationship, be it romantic or platonic, that I’ve ever had. There’s an time where I could fall in love with everyone I let close. If I have a significant other, this can be a fleeting moment. More often I want to be more to people than I want them to be for me. Once I’ve let someone in, once they’ve become very close to me, the relationship builds in my mind. I have a hard time distinguishing between healthy platonic love and romantic love, almost obsessive desire. I want it to become more. I see more. If there’s more, then they won’t want to let me go. They won’t walk away, won’t leave, won’t abandon me. If I’m more, if I can provide everything someone needs, they’ll need me in a way that does not make me expendable.

Or, the extreme opposite… wanting someone to want absolutely nothing more than there is. To not be any closer, to not confide in me more, to not touch me, sit near me… keep a very distinct distance. I have a very difficult time with blurry lines and familial relationships. They’re either very close, or a mile apart.
Splitting. All good. All bad. Hero or villain. I generally give people a wary benefit of the doubt at first.  I can take a lot. I can deal with a lot. I put up with a lot. Until I can’t. Sometimes this fluxuates. It depends on how things were the last time I saw someone. If I’ve been slighted, hurt, embarrassed, clearly this person doesn’t give a rats ass about me anymore. Everything we’ve been through together has been a lie. All they’ve done is use me, to torment me, to push me further from people that would actually care in an attempt to break me. They’re terrible. And so am I. If they could treat me this way, I must deserve it in some way. Right? Wrong. Or they’re wonderful, considerate, closer to me than anyone else in the world.  I can trust them completely and know they always have my best interest in mind. I’m someone of value to deserve such wonderful friends. They can do nothing wrong. Until they do. Then redeem themselves. Back and forth. There’s no middle ground. No grey area. No understanding that just because someone messes up, that it doesn’t nullify every other aspect of the relationship.

Or in some instances, and really there have been a lot…. I take so much, I absorb so much of people’s energy, believe them so good, for so long.  Give them more support than I can manage for myself, be there at all hours of the night, providing everything I can to comfort or console or provide some semblance of happiness… until they’ve sucked up all I have to give, and I can’t give anymore. Oh somewhere along the way I usually fuck something up, something not terribly important, but I’m human and it feels more important than it should be, then everything I do is wrong. Nothing I do is good enough anymore, they keep putting more on me until finally the weight of their needs and expectations and my guilt, breaks me. And they’re forever ruined to me. Once this happens, it’s done. There’s no going back, no longer anything to salvage. It’s just over. The near endless energy I have, is severed. If you’re close enough to me that I will pour every emotional ounce into you, leaving very little to take care of myself, and you refuse to allow me any flexibility to be human, I break under the pressure, and some things simply cannot be rebuilt. And I no longer want to try. I move on.
Paranoia. Paranoia isn’t such a problem for me. Well, I mean, it is, just not my biggest problem. I always think people are taking digs at me, trying to make me uncomfortable or alienate me, undermine my intelligence… but I can usually keep these thoughts controlled enough that I don’t make a scene from them. I hold them in, let them fester, and then silently implode instead of directly confronting the person(s) that make me feel this way. Which if I would do from the onset, civilly, ask if that was what they meant or if I was just interpreting it wrong, but that would be rational, and when you’re rather paranoid, well, it would also be embarrassing to show people just how paranoid you really are.
It’s always intense. Wild euphoria, heady love, blistering revenge or seething wrath. Not, slightly prickly or mildly satisfied. In between states of emotion are uncommon. Sure there are calm days. Days of relative contentment, but they’re disproportionately rare. 

I’m sure there are other ways for other people. Anyone experience other ways? These were the three things that popped out at me as I’m writing this. 

Perpetual first impressions

No calm acceptance. The feeling of dread never goes away.

I can be friends with someone for so long, years, but there’s never a quiet comfort. At least not one that lasts. Moments sure. Hours, sometimes. Something always creeps back. Doubt. Fear.

Always feel like I’m intruding into someone else’s life. Never sure if I’m wanted. Never quite sure if our relationship has changed or stayed the same. Reading too much into the subtle variations of each encounter. Everyone has off days, everyone has behaviors that change a bit, vary from mood or stress or some extraneous factor. For me, it feels like these things happen as a direct result of something I did or as a reaction to me. Did I say something wrong? Did I do something offensive? Is he mad? Does she not want to be as close to me now? These things probably did not happen as a result of something I did (or didn’t do), but I feel like it has, fear it. There’s never a constant, steady feeling of acceptance. Everything is dependent on the last meeting, the moment before. There’s a constant second guessing of Self. When so many things can go wrong, be taken wrong, how can you be secure that people don’t see each instance the way you do. But they don’t. At least, I don’t think they do. Friend told me I was a little more ‘verbally assertive’ the other night. I’d had a few too many drinks and had let down my usual filters. I asked him if that was a polite way of saying I was a bitch? He didn’t respond b/c I think he took it as a rhetorical question but now I worry that I won’t be invited over, that his wife will make things more difficult for me. Forget all the things I’ve ever done for them (watched their daughter when she was in the hospital, cleaned their house, made countless meals and desserts for them, etc.).  It all feels dependent on that one thing.

Like a perpetual first impression.

I’ve been best friends with Friend for almost a year, known him for years longer, and I can’t hold onto the belief that our relationship is stable. That it’s as strong or as close as it used to be. Even though aspects of it are changing, I can’t imagine that it doesn’t mean things will be less meaningful.  We were talking about ‘middle ground’ friends, having friendships with people that aren’t close confidants, but not held at arm’s length either. The whole time I was wondering if he still held me as a close confidant, wanting reassurance of this, and fearing that new middle ground friends would detract from our friendship.  I didn’t ask for this reassurance, this validation of the closeness of our friendship, mostly because I realize how incredibly annoying it is for people to constantly repeat this. Especially when he does randomly remind me that I’m his closest or dearest friend. I want it though.  More reassurance. Validation to calm inner voice for another few minutes. There’s no quiet slip into comfortable familiarity.

There are still times when I want more beyond our friendship, mostly because I see this as some kind of savior from my turbulence, but I wonder, would it really change anything? I have never had relationships where I didn’t second guess my thoughts and behaviors, didn’t obsess over the multitude of potential meanings from the words and actions of others (with one recent exception but I think I was already so tired of the emotional turmoil she put me through that I couldn’t care anymore).  Or if I didn’t constantly worry, I quickly became bored.

Can I have a comfortable familiarity without losing my interest? Without that hint of fear and anxiety gripping my heart and making me worry about losing someone, would I care as much at all if they left? Once that calm sets in, I no longer need to be there. I begin to look for other avenues of entertainment.

The fear makes me crave it. The comfort makes me tire of it. It’s impossible to just settle in.

Psychological Factors: Origins of Borderline Personality Disorder

Some of this information is a bit repeat-o from things I’ve mentioned previously, but I feel it’s important to provide the findings of various experts on the subject of BPD as it is all relevant and useful. So continuing on with the theories of John G. Gunderson M.D…. 
Psychological Factors

Like most other mental illnesses, Borderline Personality Disorder does not appear to originate during a specific, discrete phase of development. Recent studies have suggested that pre-borderline children fail to learn accurate ways to identify feelings or to accurately attribute motives in themselves and others (often called failures of “mentalization”). Such children fail to develop basic mental capacities that constitute a stable sense of self and make themselves or others understandable or predictable. 

One important theory has emphasized the critical role of an invalidating environment. This occurs when a child is led to believe that his or her feelings, thoughts and perceptions are not real or do not matter. About 70% of people with BPD report a history of physical and/or sexual abuse. Childhood traumas may contribute to symptoms such as alienation, the desperate search for protective relationships, and the eruption of intense feelings that characterize BPD. Still, since relatively few people who are physically or sexually abused develop the borderline disorder (or any other psychiatric disorder), it is essential to consider temperamental disposition. Since BPD can develop without such experiences, these traumas are not sufficient or enough by themselves to explain the illness. Still, sexual or other abuse can be the “ultimate” invalidating environment. Indeed, when the abuser is a caretaker, the child may need to engage in splitting (denying feelings of hatred and revulsion in order to preserve the idea of being loved). Approximately 30% of people with BPD have experienced early parental loss or prolonged separation from t heir parents, experiences believed to contribute to the Borderline patient’s fears of abandonment.

People with BPD frequently report feeling neglected during their childhood. Sometimes the sources for this sense of neglect are not obvious and might be due toa  sense of not being sufficiently understood. Patients often report feeling alienated or disconnected from their families. Often they attribute the difficulties in communication to their parents. However, the BPD individual’s impaired ability to describe and communicate feelings or needs, or resistance to self-disclosure may be a significant cause of the feelings of neglect and alienation.

Persons who have been adopted are statistically more likely to develop BPD than the general population. Adopted children often fantasize that their “real” biological parents could have and would have protected them from the frustrations and hurts they have experienced. Indeed, the hope and belief that if only such idealized and nurturing caregivers could be found, then life’s problems would be solved, is central to what BPD patients (whether adopted or not) pursue in relationships with others.
I can NOT attest to physical or sexual abuse when I was a child. But as mentioned in this post I have very strong, distinct memories of having my feelings and accomplishments invalidated. Also the ‘traumatic’ experience of thinking my mother abandoned me when she was in the hospital giving birth to my brother. For many years following this though, I didn’t see my mother much. My parents believed that one of them should ALWAYS be home with us so my dad worked days, and my mom worked nights. Subsequently when my mom was home, she’d be asleep, and when she would wake up it would then be time for me to go to bed. So I didn’t get to see her very much until high school and I had a greater attachment to my father, who was not the most adept with an emotionally challenged daughter. I was often expected to respond like a boy would respond; no emotions, no crying, suck it up, deal. With my mom so often being absent during my weekdays, I didn’t really have a chance to learn to express or deal with my emotions properly. I felt the need to suppress part of myself, couldn’t relate to myself, or my dad. I definitely don’t think he understood what I needed. Hell, I still don’t think he understands what I need emotionally, but I’ve since given up trying.

My problems with this may have started with my parents, but they relationships and friendships I developed when I became older certainly did not help. My splitting developed in much stronger ways once I was older. Probably starting around the time I was 13, and amplifying steadily through high school and especially over the last few years.
I’m intrigued by the adoption theory. I can easily see how this would manifest in adopted children. Especially when I was a teenager I used to WISH that I was adopted. I had these same fantasies that I might be adopted and my real parents might actually understand me, might actually care enough to fix me, could actually save me from myself. Of course this wasn’t the case. I’m not adopted. What’s more? I actively refused help and pushed away anyone prohibiting the possibility that someone might understand me.
It’s odd writing about this some days. I have these very clear memories, but writing them down, writing about them, seems so clinical. Like it wasn’t me that went through this, I just watched someone else that looked like me go through it all.  Recording objectively.