A Typical Session

The beginning

There is obviously nothing such as a typical session, given the nature of what we discuss it is inevitable that each one is varied. However, there is a certain formula that each one loosely follows and whilst we may end up far away from where we started they usually begin in this way.

We go round the circle and do a 'check in' so see if anything has happened in the last week that has affected us or that we want to raise. Increasingly, this takes up almost the entire session. Some members tend to use this as their own private therapy session and will talk on and on and on. I myself take a different approach. I am still getting used to having to talk in front of other people and to be frank, I find it quite selfish and self indulgent to take up too much time. I therefore usually say very little, if anything.

At times I find myself transported back to the waiting room at the community mental health team. I sit and listen to people talk about quite serious, stressful, often hurtful things, and I struggle to emphasise. To be fair, not with everyone and as the sessions have gone on, I have found more in common with others. But there are a few who I simply don't care about. Ironically, these are the same members who tend to 'hog' the floor.

I find myself analysing the therapists as well. I notice the number of follow up questions each member gets asked, to see if it is fair. Most of the time it isn't, which greatly annoys me. I have a very strong sense of what is fair and I often find myself very irritated that the therapists do not better regulate the group. It may be that these sessions need to be less structured and more organic but as someone who loves organisation, I find this lackadaisical approach difficult to take.

The middle

We were told that for the first 8 sessions there would be an 'exercise' which would shape the session. This was to ensure that we all spoke and got used to each other. After the summer break the group are to shape the sessions but to begin with there would be a specific question which each member would have to answer.

These questions have been varied, some of them useful, some of them, frankly, not. The one I probably found the most engaging was to explain an interaction with someone else where we had to guess their motivation. I am often accused of 'mind reading' by my therapist who suggests that I never correctly guess what people are thinking or mean. I disagree. I base my decisions on past interactions, quite an evidence based approach I feel. Anyway, it was interesting to say it out loud and attempt to justify my thinking. Again, my answer compared to others made me fee slightly more 'normal'. To me, some members were very paranoid in their thinking. It got me wondering, is that how I come across to non BPD people?

The end

The end of these sessions are very odd for me. We all sit in the same seats that we chose on our first day, so I am sat fairly near the door. It feels almost like an anti climax. We spend over an hour discussing difficult issues and then once it hits 3 the therapists stop us and I immediately grab my bags and leave. There is no 'round up'. It is very unusual for someone to beat me out the door and I proceed to walk, almost run, out of the hospital. I don't want to see and definitely don't want to speak to anyone from the group.

It means I don't really have time to process what has just happened and what I said. Therefore when my boyfriend inevitably asks me, how did it go, I usually tell him I don't want to talk about it. Partly because I really don't, but also because I am not sure what to say about it. I am quite calculating in my thoughts and like to have planned out what I am going to say before I speak.

All in all, the sessions leave me in a worse mood and I often feel drained. Both emotionally and physically. I try and meet up with friends or do something nice in the evening so I have something to look forward to .

I have one more session to write about before we are 'back' to the present. My sessions start up again on Monday. I appreciate I have been a bit slack but will try and do the last one over the weekend so I am ready to start next week. Writing this blog post has been the hardest one yet, not sure why.

Until next time, over and out.

My understanding of BPD

What is MBT?

I need to go back a bit for this blog post. After a couple of sessions I began to realise that I had had my diagnosis of BPD for a lot longer than most of the others. I seemed more, I don't know, at ease with it. Sure, the name doesn't sound great and it does seem to suggest negative connotations, but I was so happy to finally have a name, a condition, a reason for why I felt the way I did that I saw straight past that. In the early sessions they tried, and in my opinion failed, to explain to us what was meant by 'mentalisation'. In basic terms I understand it to mean changing the way we think about things, our feelings and emotions in particular. How you change something as automatic and ingrained as the way you think, I just don't know. They are yet to fill me with confidence that this can actually be achieved. Still, it seems to me that, first, you need a good understanding of the condition before you can understand the treatment.

Extensive research

My phobia counsellor suggested to me that she had been reading up on something and wanted to share it with me. She stressed this was not her area of expertise and she might be wrong but from her time spent with me and her reading she thought I might suffer from something called a borderline personality disorder, had I heard of it? Like 99% of the population, I told her no, I hadn't. Immediately, my back was up, was she calling me a schizophrenic? No, as it turns out, she wasn't. She asked me lots of questions, but the one I always remember is 'do you still feel sad after watching a sad film or reading a sad book a long time after the event?' I thought, oh my god, yes I do. I don't watch sad films (Pay it forward ruined those sorts of films for me, didn't see it coming and cried, genuinely, for about a week after watching it) or read sad books (I have only just forgiven the friend who gave me One Day to read, over Christmas no less). For me, it just wasn't worth it. I can't watch or read something emotional, realise it is fiction and move on. It makes me so upset, in a really intense way. My therapist thinks I can't cry for myself so I use these things as an outlet for my own pain. Makes sense in a way.

Still, everything that she asked me about the condition applied to me. I had gone from feeling like a potential schizophrenic to feeling like I had an answer in a short space of time. I went home after the session and immediately logged on to google. The real test would be whether my therapist though I had it, but for me, I was already convinced.

Turns out there was more information out there than I was expecting, for a condition I had never heard of. I wouldn't say a lot, but I was pleasantly surprised, for example, that the NHS had a page on it. I became obsessed with reading about it, largely I think as the more I read the more I was convinced that this is what was wrong with me.

Relief

I had been lead to believe, largely by my family (my father in particular) that I was simply a 'drama queen'. There was nothing wrong me with, I was self indulgent and 'too sensitive'. With that message being hammered home for 28 years and no one around to offer an alternative I had begun to buy into it. I cannot explain the feeling of sheer relief I felt to discover that it was probably something I was born with. I say probably as it is a relatively new condition (first formally diagnosed in the 1980s) so the evidence is not as robust as one would hope. Still, from everything I have read and seen (there is one excellent video, American obviously, which I think brilliantly explains the condition from both clinician and patient perspective - I have watched it probably close to 30 times) the science suggests that people are born with a presupposition to the condition and the environment in which they grow up in can influence whether they develop it or not. There is evidence which shows our brains don't work in quite the same way as everyone else.

After the initial feeling of relief, I felt and still feel, vindicated. I knew, deep down I always knew, that there was something not quite right with me. For my family to make me believe otherwise was, a terrible thing to do which I am not sure I will ever recover from.

Back to the present

I think both my extensive research and my willingness to readily accept my condition put me in a somewhat unique situation in the group sessions. Some members are weary of the condition, others just don't know enough about it and some simply don't believe they have it. What they do have that I don't, is, currently, a genuine willingness to engage.

I think that, since I have had my diagnosis for a while and have talked about it at length with my therapist, I have a better understanding not only of the condition but more so of my interpretation of it and how it affects MY life. This, I have found, is not always a good thing. I have always been very sure about my feelings, or more importantly about being right. I guess, I felt them so intensely how could they be wrong? To feel this strongly about something must be right, no matter how 'irrational' it seemed. However, since I have gained a better understanding of my condition I now realise how irrational I truly am. Yet this does not stop the feelings. For example, I hate getting caught in the rain, not in a 'my hair will get messed up' kind of way, but a thoroughly depressed, crying kind of way. I don't know what it is but being wet in dry clothes is very distressing to me. Years ago, I would cry and feel sad and angry about it and think that was a perfectly acceptable response. Now, I still cry about it but I know how ridiculous and irrational I am being. Doesn't stop the intense feelings though.

I really do believe that sometimes ignorance is bliss and I was better off when I thought I was right.

Until next time, over and out.

And so it begins...

Apprehension

So, I shall begin my blog with what happened after I was told I would have treatment and was accepted onto the MBT programme. I assumed, obviously very wrongly, that with the bureaucracy out of the way, I could concentrate on the actual treatment. However, before I can get to that, there was, of course, more stress. The programme was to start in June with first a meeting with my individual therapist, followed up by my first group meeting. Out of nowhere the hospital called and told me my appointment had been cancelled. When I inquired as to what precisely had been cancelled (was it the individual therapy, the group therapy, the whole programme), I was given no information or reassurance. Following a very tense, and for me, very upsetting meeting with the programme head, it was made clear that due to staff shortages, I, for the the time being, would have no individual therapist. I would, however, still be starting the group therapy. It is interesting to note that, two months on I still do not have one. Still, I am getting ahead of myself. Finally, I was in a position to examine exactly how I felt about attending a group therapy session. The best word to describe my state of mind was apprehension.

As bad as I was fearing?

I don't know anyone who suffers from BPD so I don't know if my behaviour is normal or not, but I don't really talk to anyone about what's going on with me. Not my friends, certainly not my family and until recently, not with work either. Until this year most of my very large family had no idea I had had one overdose, let alone four and suffering from a mental health condition. Therefore the idea of talking about my extremely irrational and personal feelings was not something that in anyway appealed to me.

I mainly worried that I would not like the other people in the group, that they would not be 'like me' and that they would be more severely ill than I was. My main concern was that they would be psychotic and it would be like a longer, more intense version of the waiting room at the community mental health team. I had already decided that I would sit there, offering nothing and speaking only when I was directly asked a question. I entered the room on the first day, sat down, folded my arms and stared intently at the floor. This would become my default position for the majority of the next two months.

The reality was there were 6 of us, 4 girls and 2 boys of varying ages. I would guess I am at the younger end. I was half right and half wrong in my predictions. Not one of them appears to be suffering, at least outwardly, from psychosis. Although we all clearly have different problems and issues, I would say that we are of an equal-ish severity when it comes to the condition. Still, as I sat down and looked round the room, on an initial very superficial basis, I did not like a single one. Once we had all spoke and I had a chance to base my decisions on more than looks alone I concluded, yes I still don't like them. For some members this would change over time, for others it would not.

Ground rules

I won't say much about the therapists themselves (there are two leading the sessions) apart from to say imagine the most stereotypical therapist you can think of. Now double that and you are roughly where I am. I found it irritating to begin with, I now find it comical. Once we had 'introduced ourselves' they laid out the ground rules for the group, inviting us to suggest anymore as we saw fit. I won't bore you with all of them, they are exactly what you are imagining, respect others, confidentiality etc. There was one that I found odd. If you wanted to leave the group, you must tell the group in person and given them '4 weeks notice'. It seemed to me that I had decided that it wasn't for me, I would simply stop turning up, such as has happened with one member.

Going forward

I spent the first session sizing everyone up, putting them into the pigeon holes I love creating for people. I also spent a lot of time listening. I desperately didn't want to be there, but if there was a guarantee that by being there I would get better, then I wanted to make sure I heard it. I wanted to be able to call upon it, if after 18 months I wasn't fixed as advertised. But mainly, I sat there thinking, this isn't going to help me. This was my last chance to lead a 'normal life' and I can tell already that it isn't going to work. At that stage I wasn't thinking about dropping out but I was feeling very down about spending the next 18 months with people I didn't like, talking about things I didn't want to for no tangible benefit. Why then, had I decided not to drop out? Honestly, I don't know. I have a strong sense of fairness and, I suppose, propriety. I had committed to doing this programme, which probably has a waiting list, so whether I like it or not I am going to stick with it.

It is not an attitude I would maintain, but that is for another day.

Until next time, over and out.

The story so far...

Prelude

My boyfriend and my therapist think that writing could be a good outlet for me. I myself am not so sure. Whilst in theory I like the idea of a blog, in practice there are a number of blocks. Firstly my ability or rather lack thereof to write well. Second the fact that I struggled as both a child and an adult to keep a diary. I have always wanted to, but never seemed to stick at it for very long. I think my inherent laziness has something to do with it. Which brings me to my final reason, a blog to be considered a proper blog needs to be updated at least once a week, if not once a day. My hardcore all or nothing attitude means I may struggle to do this in which case I shouldn't do it at all. I find it hard to tolerate failure on any level.

Still, between me and you, even though I am no good at it (and I do so hate doing things I'm not good at) I secretly enjoy writing. It was my best subject at school and ever since I've graduated I have genuinely missed writing essays.

Clearly, these ramblings thus far are an indication that I have decided, at least for the time being, and against my better judgement, to give it a go. Time then, to introduce myself; my name is Holly and I have a borderline personality disorder.

The beginning

I don't plan on spending a lot of time on my back story, such as there is one. Needless to say I have struggled most of my life with the feeling that there was something wrong with me, without ever knowing what that was. For a long time, I admitted to no one (although on some level, definitely to myself) that I was struggling or that I felt I had a problem. My first overdose in 2010 was the beginning of my realisation that a) definitely something wasn't right with me and b) I needed to admit this and ask for help. For me, there is nothing more difficult than asking for help. Those trapped within the current mental health system in the UK will know that the difficulties don't end with asking. You have to beg, loudly, consistently and unceremoniously.

The best thing to come out of my initial overdose was my frank discussion with my new job about my mental health. I was referred to see our occupational therapist and in doing so met the person who would go on to save my life. Both metaphorically and literally.

My therapist (with some help from a counsellor I was seeing for my needle phobia) first floated the possibility of BPD in July last year. It would take a very serious overdose ( with time spent in both hospital and a psychiatric setting) for me to be officially diagnosed and exactly a year for me to start specialised treatment.

The middle

I figured getting the official diagnosis would be the most difficult part, and once they realised how serious my condition actually was, I would be 'home free' and able to start the enviable task of getting better. Oh, how naive. I won't bore you with the hoops I had to jump through, but suffice so say they were numerous and each one more ridiculously bureaucratic than the last.

My least favourite part of this process was interaction, or usually lack thereof, with the community mental health team. For me, this place was hell on earth. Full of staff who constantly seemed harried and uncaring ( the socialist in me wants to believe that this is due to cuts in the service making their positions increasingly untenable), a building that seemed to mirror it's inhabitants, crumbling, broken and grey and finally my fellow 'patients'.

At this stage I should point out that whilst I have a serious mental health condition and I am no longer under any illusions as to how ill I am, I am a functioning member of society. I have a full time job, an ever decreasing but firm set of friends, and more recently the most wonderful relationship.

My condition at times can be quite severe; I have had four overdoses, the last of which was in only March this year. Without going into the boring details there are 9 sets of criteria which categorise BPD. To receive an official diagnosis you need 5. I myself have 8. The one that I don't have is, unfortunately, the trait that most at the community mental health team seemed to suffer with and that is psychosis.

I would sit in the waiting room, desperate to be called in and inevitably being left to sit there ages after my appointment time, trying to avoid eye contact with anyone else. I really needn't have bothered. Most of the people there were either talking loudly to themselves, to the voices in their head or aggressively with each other. It terrified me. For someone who has desperately craved to feel 'normal' for most of my life, it was the most cruel reminder yet that I wasn't. Usually an incredibly empathetic person, I felt completely detached from my fellow human beings in this setting. I have never felt more alone or abnormal than during those tumultuous visits.

The rest

Still, the purpose of me attending these meetings was to secure a referral on to specialist treatment, something I had come to see as a holy grail. Eventually, and with a lot more heartache and stress, I was referred on to a hospital which offered something called Mentalisation based therapy (MBT). This is a treatment programme specifically for those with BPD and consists of group therapy and one on one sessions weekly. The programme is to last for 18 months. I started it in June and my intention is this blog will chronicle my treatment programme. This allows me to update it, hopefully weekly to coincide with the group sessions and hopefully chart my progress ( or lack thereof, I myself am still skeptical that this will 'make me better'). I am starting two months in, with a month break ahead of me before we resume in September. I will use this break to 'catch you up' on the first 8 sessions. Lucky you.

Being devoid of any creativity the blog is currently nameless. Hopefully, when my boyfriend wakes up he will have a brilliantly, witty name for me.

Until next time, over and out.