Intimacy Fears

I don’t talk about romantic relationships very often on my blog. To be fair, I don’t talk about them much in therapy either. It’s on the list of topics that feel shameful and difficult to address.

In my whole life, I’ve only been in one relationship. It was during college, and I dated a woman who was my best friend for almost a year. For awhile I thought I was bisexual, but I ended things with her when I realized that there was little physical attraction. That relationship was confusing as hell because I spent half the time hiding it from my friends and the other half feeling judged for it.

I’ve never been in a long-term relationship with a guy.

For a long time, I assumed that if someone (the “right” someone) showed interest in me, then I would be all gun ho about moving forward with them. I thought it was simple; if they liked me, I’d like them back. Things would feel natural and easy.

Until I really started aiming for a relationship, I didn’t realize how much effort this process would require. And how much it would really feel like work.

Because grad school really consumed the bulk of my time, I have used the summer months for the last three years to try to meet someone. I’d use the common dating apps to connect with guys and dive in. The first year, there were one or two people I talked to and pursued. The second, a handful with whom I dated between 1-4 times. All of those fizzled out, whether I stopped pursuing it or they did.

This year, there have been four that I’ve actually made it to a date with. One I nixed immediately. Another fizzled out after a few weeks. A third I went on six dates with. Another, perhaps the most promising, I just came back from my fourth date with.

I always start out excited. Motivated. Ready to go. I tell myself this time around things could really happen. I would say I’m actually pretty good at the first dates now, where the pressure is low. We’re still learning about each other, maybe we’ve exchanged some texts, but there’s no expectation for things to get intimate yet, emotionally or physically. So that’s all fine and dandy.

Starting with the second date, nerves kick in. I’ll start to wonder: are they going to kiss me (if they haven’t already)? Will there be pressure to do more? Do I want any of that yet or am I just going to let myself be pressured? So many questions.

If we make it beyond date number two, and there’s any sort of notion I have in my head that maybe I could like them or even enter a relationship with them, you better know that I’m itching to run far and fast from that relationship.

Which is about where we are at with the one I’m seeing now. Fighting every impulse I have to flee from a kind guy who has treated me well so far and seems to actually take an interest in the things I say. It was where I was at with the one before him too, with whom I finally terminated things after we went on six dates and I still had little interest in him romantically.

I can never tell if I’m putting a stop to things because I really don’t like them, if we really aren’t compatible or if I’m just scared.

I can come up with reasons why we don’t work: I want someone who is more outgoing, we don’t have enough in common, he talks about himself too much. However, I  question whether or not those reasons are good enough. Am I actually trying to even develop a connection or am I looking for the first excuse to cut and run?

Like I said, I always expected dating to feel invigorating and be something I looked forward to. This fear, this dread of the situation, came as a shock. I hate the associated anxiety I feel.

Relationships are work for anyone, but for me they are a whole other kind of work.It takes me longer to feel comfortable making physical contact. I’ll push myself to do it, but to me it feels awkward. Today, as I went on a walk with that guy I’m seeing, I felt myself naturally move away every time he moved close. I don’t know why. Later, I did let him put his arm around with me, but I couldn’t seem to let him hold my hand.

Sharing more personal aspects of myself is on another thing I struggle to do, to be honest and open and risk rejection. Or worse, risk sharing all of that and still not feeling an emotional connection to them.

The spark, that real feeling of attraction, isn’t created over two or four dates. I need time.

A couple years ago, I even let myself get sucked into a situation with a guy that I probably wasn’t ready for after only two dates, because I felt such an internal pressure to prove to myself I could be physical with another person. Then I propelled myself into something even more physical the following year, again just to get it “over with” instead of due to any real emotional attraction.

So those memories get all tied up in any relationship I try to pursue now.

I was not the kind of high school or even college kid who had boyfriends. I assumed that I wasn’t likable, and while I was no “popular” kid, that’s not true. There were one or two who expressed interest, where things could have blossomed.  But I always panicked and made sure to keep a fair distance. Friends. I was running, even then, but I assumed the situations were beyond my control.

Sometimes I wonder if I’ll ever be able to be a part of a true romantic relationship where I feel comfortable and at ease. Obviously, it is easy for me to catastrophize and see a negative future, but the fact that I’ve never had a long-term relationship with a guy before makes me wary. I was never that boy-obsessed teenager. I had a few crushes, but school and friends were always prioritized. So now, I feel somewhat out of my element trying to make up for lost time. I’m never sure of what to do.

I wonder if I should be continuing to trudge head-on into the dating world, trying to commit to opposite action and engage instead of withdraw. Or should I be holding off until I’ve learned a little more about myself and made more progress?

Relationships are hard.

Advertisements

A DBT Flowchart

A few weeks ago, I posted about my confusion and frustration with figuring out when to use the abundance of new skills I was learning through my Dialectical Behavior Therapy workbook. I have tons and tons of notecards that simplify all of the information the book is spouting at me, but I needed something more comprehensive so that I can have an idea of where to go in the moment when a wave of emotions hits me hard.

I’ve been in a wonky place again for the last couple days and have pretty much been withdrawn from the blog world and the real world whenever I have the choice. The positive thing about that is while I’ve been hiding away from people, I’ve put all my energy into developing that needed flowchart.

I’m pretty happy with the results. Obviously, this is not a perfect system, as no issue is so black and white that it can be resolved by some arrows guiding you. However, I feel that it’s a worthy starting point for me that can replace some of that helpless feeling.

Hopefully you can read my handwriting. It’s broken down into color by unit (the colors I used when highlighting my book). Green is distress tolerance, blue is mindfulness, purple is emotion regulation, pink is interpersonal effectiveness.

img_82711.jpg

As anyone using DBT knows, there are many things that crop up when you’re trying to use skills which block you from being successful. I couldn’t fit all of that in one diagram, so I ended up with a second flowchart that specifically highlights some of the issues I typically run into.

IMG_8265

I don’t know if these will be helpful for anyone, but I wanted to share them. In a very rocky period as I look towards the beginning of my first real job, this has brought me a sense of calm and peace. There’s something about getting organized that makes me feel so empowered.

Receiving Pain

One of the many confessions I made to J when everything came flooding out last week was that I see self-harm as a way of communicating pain. As in, when I’m feeling really really awful, one of the reasons I feel desire quelling within me to hurt myself is that I feel it clearly shows to her just how much hell it has been to live in my own mind that week.

I’ve nearly removed self-harm from my list of habits in about the last 2.5 months. There have been some slips, and what might be categorized as an “almost” harming event, but on the whole I’m not grabbing for my razor every other day (mostly because I threw it out). I’m working really hard at making better choices.

As such, I’ve noticed that when I am really fighting the urge, one of my recurrent thoughts is that I have to cut myself because if I don’t, how else will J understand just how deep and intense my pain was over the week? It’s like I believe words will not be enough to truly tell the story.

I’m not sure exactly where this need comes from. It’s not like J does anything over the top when I admit to her I’ve hurt myself. Typically, she’ll ask when and what triggered the incident. She may ask where I’ve cut. Often, we talk about replacement behaviors. Sometimes, we discuss safety. These are all run of the mill and none of them feel particularly validating. Not that they’re bad strategies, just that they don’t support me in a way that would encourage me to keep cutting to receive the attention.

When I wrote about this before, a fellow blogger who I really respect left me a comment that stated she was in a similar situation. What she and her therapist decided was to replace self-harm as a means of expressing severe pain with the urge to self-harm as an indicator of the same level of pain.

This idea seemed remarkably simple, but effective. I shared it with J. That strategy had been her first recommendation too. However, she wondered if I would truly be able to feel like my pain was understood or if the distinction between cutting and wanting to cut would still feel obvious to me. Would cutting still rank highest no matter what?

She’s probably right, I’m sure it would be a process to make the shift. But obviously continuing to hurt myself isn’t an option, so I think that I’m willing to try using “tempted to hurt myself” as the high point on a continuum of describing emotional pain.

J obviously doesn’t want me to relapse back into self harm. She doesn’t want this to be another factor contributing to that behavior. So she asked me how she can receive the information from me that I wanted to cut in a way that feels as validating as if I told her I did cut?

I’m having so much trouble developing a response. Since I don’t know the source of the need, I don’t know what she can do to help me suppress it.

So what can she do? How can she make me feel supported and understood? I’m still not entirely sure. I don’t have an end-all, be-all solution.

Validation is the golden rule of working with people like me. When in doubt, find some way to legitimize my feelings. Make sure I know that you’re supporting me amidst them. Say it 10 different ways. Say it again and again and again until it sticks.

“I believe you when you tell me how intense your emotions are.”

“I hear that you are in a very difficult place right now.”

“I understand how much you feel you need to hurt yourself. I’m glad you’ve chosen to be safe, despite all that pain.”

“What do you need? How can I help you right now?”

“Tell me more about what’s going on. Let’s work through these challenging feelings together.”

“I’m still here.”

I need to hear the validation. I need to hear it 100 times, using the same calm patience and empathy with each repetition. I need to hear it from J, and I probably need to say things like this to myself. To believe myself when I’m tempted to dismiss my own pain, as if not cutting means that I’m somehow healed and not allowed to feel negative feelings.

I need to hear that she’s still there, because maybe there’s a part of me that thinks not hurting myself means I’m on a path to being better – but does being better mean an end to therapy?

Will this work? Once, I’m sure it will not be sufficient. Over time? I’m hopeful.

Because what’s the alternative? Hospitalize me? Refer me to an IOP? We’re in agreement that I don’t need a higher level of care. What I really want when the pain has been that bad is to be held, but that is unfortunately beyond the therapy relationship.  So in lieu of that, I just want to know that she believes me, that she has as much of an understanding as she can without living the experience.

That’s so, so hard when I can’t know for sure what she’s thinking.

Has anyone else been in a similar situation? How does your therapist convey to you that they recognize the  depths of your struggles in a way that makes you feel like they really get it? I’ll take any suggestions.

 

 

Emotions Are Part of the Package

Acceptance. I’m continuously talking about it. I’m continuously working towards it. Acceptance of past mistakes. Acceptance of things I can never have in my life. Acceptance of just so many things pertaining to therapy.

This post isn’t about those. It’s about a different, and maybe even more difficult, kind of acceptance.

I describe myself as being on a path to healing and I have all sorts of ideas what being ‘healed’ might look like. As such, I judge my progress in therapy based on the frequency and intensity of my low moods, assuming that I’ll be healed when they taper off consistently. When I’m ‘happy’, whatever that means, I’ll be better.

The truth is, I think that my greatest fantasies on what being healed will look like may be slightly off base.

My intense emotions aren’t going to just go away.

Maybe later there will be a reduction in intensity. Over the course of a few years or hopefully at least by the time I’m into middle adulthood. Right now though, my disorder is still very active and intense emotional experiences are one of the biggest pieces of BPD. Add to that all the transition and changes I’ve been taking on (new job, trying to date, thinking about trying to move out, etc.) and it only makes sense that I’ve been so prone to sudden and extreme mood shifts.

That isn’t something that just lifts right out of my life.

As a consequence, therapy isn’t aimed at completely vanquishing my negative moods. It’s aimed at helping me tolerate them. The intention is to enhance the process of identifying the emotions, sitting with them, refraining from judgment, and self-soothing so that they pass faster.

Let me tell you something, each time I remember this it’s like being sucker punched.

You know why? Because realizing this means realizing that for me to reach a place where I can tolerate pain, I’m going to have to endure that pain. I think this realization also involves reframing my idea of what helpful therapy is for me.  Therapy needs to mean discussion of the topics that will ultimately trigger these emotions so that I can practice coping with them. It needs to be a little be difficult and there needs to be vulnerability, otherwise the emotions stay concealed and then definitely no progress is made.

Worse, living my life means engaging with the emotions all the time all by myself! That’s what we’re working for, which I’ve known all along but feels so much more isolating when I remember that supporting myself means supporting myself not just through minor bumps in the road, but through deep pain.

Even when the intensity ultimately fades, I’m still going to have periods of sadness, anger, fear, shame, etc. Humans have emotions, I can’t just get rid of them.

Which sucks, because those feelings are really uncomfortable for me. I’ve been associating having them with doing something wrong, with not doing enough hard work, and avoiding them at all costs. Especially in therapy, I’m been projecting this image of myself as fine and getting stuck behind a barrier for fear of what talking about what is really bothering me will stir up.

So when a really challenging topic came front and center last night and I was in a sea of my own scary and intense emotions, I wanted the ground to swallow me up.

Sometimes after nights like that, the minions come out with their routine doubts of J. She doesn’t care. Obviously, she doesn’t care because if she did she wouldn’t leave me to deal with all these emotions by myself.  These are the same doubts I’ve had about friends time and time again when I’m in a bad place. How could they leave me to handle this by myself? Why aren’t they trying to help?

But really, we can only experience emotions on our own. Others may be present, but the experience is ours alone. J can’t erase the emotions. My friends can’t erase them. They can support me within the boundaries of their respective roles, but beyond that it’s a waiting game for me that can only be supplemented by my own self-care.

That’s the biggest radical acceptance part. That therapy is going to draw out the demons and I will have to slay them on my own after I walk out the door. That this is going to keep happening as we discuss the trigger topics. That this is perfectly normal and isn’t indicative that J doesn’t care or that I’m doing therapy incorrectly.

It’s just part of the battle. Hopefully, accepting this and participating with the emotions will help them subside more quickly and maybe not even hurt so badly one day.

I know this means I have to talk to her about all the other stuff that’s eating at me, even though it’s almost definitely going to feel like utter hell.

In my fantasy world, being healed meant that nothing ever bothered me. Unfortunately, that is not reality. I think I need to work on accepting that negative emotions will be part of my life sometimes instead of striving for longer and longer stretches of positivity. Feeling well isn’t a reflection of progress, being able to cope with feeling unwell is.

Emotions are part of the package. Not just for someone with mental illnesses, but for everyone! It is not shameful to feel negative emotions. It is not a failure. It is not wrong to let them exist and sit in them for a little while.

Fighting them only gives them power. I can’t go around them, I have to go through them.

 

What I’m Not Talking About In Therapy

J is going on vacation next week. While I never look forward to a therapy break, I’m almost relieved that she will be gone.

Therapy has been weird in the last couple weeks. I have a sort of ambivalence towards going. On one hand, I yearn to see her because she’s kind and safe. She encourages me and reinforces my hard work, which I both appreciate and need. I’m happy when we work in the DBT book because I like talking about skills and I have been able to comfortably discuss some of the issues that have come up in my life.

On the other hand, I’m holding back. There are a few topics I’ve been going to great lengths not to talk about. When she asks me what’s on my mind, I shrug and look away. Then I bring up something else, literally anything. I spent fifteen minutes talking about the girls I babysit during a recent session just because I didn’t want to admit what was really bothering me. J went along with it. She either hasn’t noticed that I’ve withdrawn or she isn’t asking about it.

Of course, the minions think she has noticed and just hasn’t mentioned it because she doesn’t want to deal with me. Always worst-case scenario with them.

Here’s what I’m not talking about:

Relationships. A huge trigger for me right now is seeing other people in relationships. Whether it be pictures on social media, a relationship on television, or couples out in the world, it immediately floods me with emptiness and envy. The immediate thought is: I will never have that. 

I don’t feel pretty or interesting enough to attract someone, which makes it hard enough to meet someone as it is. I fear rejection. I’ve been trying online dating for about the past month and a half, but dating is scary to me. Relationships are a rarity for me, so I’m not well versed on how they operate. Intimacy is even scarier. The second anything seems like it could be a budding relationship, I find a reason to shut it down. I don’t trust myself enough to know if I ghost people because of valid reasons or my own fear.

J and I have discussed this in the past, when I have previously tried venturing into the online dating world. It hasn’t been brought up in a long time and she has no idea that I’ve seen someone four times and gone on first dates with a few others.

Attachment This is perhaps my least favorite topic in all of therapy, talking to J about my relationship with her. I always feel all of six years old, a little girl whining for her comfort item. Recently, I wrote and sent J this letter, which she read in between sessions. If you don’t feel like reading it, it pretty much just outlined my difficulty with accepting her positive reframes and how that was impacting my motivation to continue with therapy and how much progress I thought we could continue to make.

This topic is nothing new to J. Even though I absolutely hate talking about it, I do occasionally. She knows that my negative transference creates thoughts like she doesn’t care enough and feelings of anger at her for being so “together”. She also knows I’m simultaneously very attached to her and I dread the end of therapy. She knows I struggle with containing my feelings once I leave the room.

Yet, I can’t think of a single time that talking about it has left me feeling like the issues were any bit resolved. Maybe this is negative filtering, but I have no recollection of us developing any real solutions. When the job hunt process began, I frequently expressed the fear that I would get hired somewhere too far away from her and it would end our work. She was often quiet when I said this, mostly because, as she later admitted, there wasn’t much she could say that would be helpful.

Even that letter I sent her, we barely discussed. She encouraged me to continue coming to therapy, and she validated a few things I said. She told me there was a lot in it we could address, but I stayed pretty quiet since I was riddled with shame, so we never addressed it. And we haven’t since.

Right now, there’s a lot of transference happening. It’s part of the reason I don’t want to discuss relationships, because every time she offers up a suggestion I want to reject it because she’s married so how the hell can she understand that no one will want me. There’s frustration with her for appearing so perfect and put together, as if because of that she could never possibly understand.

I hope I’m not painting J badly. She does the best she can. She’s a good and competent therapist. Whenever I ask, she’s always willing to remind me that she’s there for me. I have plenty of posts documenting that she cares.

Yet the attachment issues continue to linger.

SuicideI mentioned in the letter I wrote to my suicidal self that I’d actually made suicidal gestures while I was at one of my recent low points. Namely, the skeleton of a plan and three notes. I admitted this to J only after I asked her what I would have to say to make her involuntarily hospitalize me. Because I needed to know where the line would be, how much I could share without getting myself in hot water.

When we discussed this, J did make me assure her that I could be safe in the time between sessions . However, she’s not asked about it since. As much as I think she’s really good at her job, I find this surprising.

I know that suicidal ideation is a characteristic common to sufferers of BPD. For me personally, it is a common product of intense sadness, anger, shame, fear, or jealousy. I’ve expressed the thoughts repeatedly in two years, so J is quite familiar with them.

I wonder, does she assume the thoughts have subsided since the job offer? Or does she assume they’re still there, but that I’m not acting on them?

For over a week, I’ve been having suicidal thoughts each night. Over the weekend, a small trigger saddled me with them for a good portion of time. Even though I’m not actively suicidal at this moment, I’ve been quietly planning. Continuing with the notes. Considering other details. The how, the where. The conditions under which I might give in. I limit myself to how long I’m allowed to do it; only half an hour at a time. Then I must do something kinder. But regardless, it’s been a comfort to know I have it in my back pocket if need be.

Why am I choosing not to talk about these things anyway?

 That’s the million dollar question, isn’t it? Truthfully, there are different reasons depending which topic you’re talking about.

As far as the relationships go, I just really don’t want to talk about it. The intimacy conversation brings up a lot of shame. Plus, like I mentioned, there’s a transference issue there. Despite that we’ve discussed this in the past, and despite that I know I need to face this to have even a chance of moving past it, I don’t really feel confident that anything we could discuss will change the fact that I feel destined to end up alone.

Maybe if this were my only guarded topic right now I’d be more willing to just run right into my fear by talking about it, but there are some other things clouding my thoughts at the moment. Namely, the attachment and suicide stuff.

In consideration of the attachment issues, and this pains me to say, but it seems almost like my complex attachment is a burden to her. She’s never directly said this of course, she’s always kind, so maybe my anxiety is causing me to read into something that’s not there. Still, I feel like her body language changes whenever I say something that is needy or childish. A gaze in her eye, a change in her tone. Whether or not she understands the roots of the issue, it feels almost as though it is uncomfortable for her to hear me talk about how attached I am to her.

I sense this reservation, the tendency she has to subtly disengage, and it immediately makes me back off. It no longer feels safe to talk about in the room. What if I mentioned this fear to her and she confirmed it? I couldn’t even imagine how gutted I’d feel.

She encourages me to talk about it, but her actions don’t always align with what she’s saying. For example, after I wrote her that long letter, she asked what I needed to help me feel more comfortable with our relationship. After some time passed, I got up the courage to ask her if she’d be willing to write me a short letter that I could refer to when I was  having difficulty maintaining a connection with her between sessions. I hoped that I could use it as a resource to keep me motivated to attend therapy. Even better, I thought it could be used as a resource when I’m in a difficult emotional place in lieu of me texting her for extra support. At the time, she said she’d consider it.

Well, it’s been two weeks now with probably four sessions in between, and she’s made no mention of the letter. Has she considered it and decided that she won’t do it, but doesn’t want to tell me? Is she writing it and just has yet to finish? Or has she just forgotten?

The latter seems most likely. Which, if true, really bothers me because it was not easy for me to advocate for myself in this instance. I knew I was risking rejection. Whatever the answer, can you please just give me one?!

Part of me hopes that maybe she’s just going to give me the letter tomorrow as a parting gift before she leaves on vacation, but a more rational part is telling the other part not to get her hopes up. This seems implausible.

The forgetting has been an issue multiple times in the past. I’d ask to table a topic until the following week and she wouldn’t remember to get back to it. I’d feel rejected that she seemed to have no memory that we left a discussion half-finished. She’s told me sometimes she just can’t recall from week to week certain things that I’ve asked of her. I’ve done my best to accept this, because she does have tons of clients and I can’t expect her to be perfect. Plus, I do have accountability in bringing up what I need to talk about too.

Fine. So as a solution, I made her a list of topics I’d like to try to circle back to from time to time. Attachment issues in therapy is on it. Only she continues not to ever address it. 

So either she doesn’t want to meet my needs or she can’t be bothered to remember to meet my needs! Either way, I’m frustrated. Why would I want to keep subjecting myself to this?

Because the boundaries will always need to stay in place and because there are some things about our relationship I just need to radically accept, I honestly don’t know if there is anything that she could say that would help. Even if it is valid for me to want a different response from her, is it realistic to expect one?

Part of me thinks it is not what she would say, but how she would say it. Validating the neediness effectively without the slightest hint of judgement. Checking in throughout the conversation to see how I’m feeling.

Yet how many times have I left a session feeling worse after talking about attachment? Is it worth it to bring it up and continue feeling disappointed?

Then there’s the topic of suicidal thoughts. Which, I admit, is a big one. She should know about what’s going on, but she doesn’t. If she asked, I wouldn’t lie, but I’m having a lot of trouble being upfront about it in session.

It’s the fact that she doesn’t ask. She asks only if I say certain buzzwords: dark place or struggling badly or really, really low. Even then, she rarely asks directly.

Yes, I should be telling her when I have suicidal thoughts…but with an issue as important as this one, shouldn’t she also be following up? She knows that my suicidal thoughts have been chronic in our time together, so why doesn’t she ask?

Is it that she doesn’t want to know?

I don’t want to make assumptions, but my mind will not shut up about it.

There’s a reason I need her to check in with me about whether or not I’ve had thoughts and even made gestures. The topic of suicide is a very severe one. It’s admitting that you’d like to or have even taken steps to remove your existence from this Earth. Talking about it, admitting it, feels dramatic. I’ve been having suicidal thoughts for so long, surely if I were actually going to kill myself I would have done it already, right? It’s like I don’t feel I have a right to my feelings anymore and I fear J feels the same way. Like she thinks I’m being dramatic too. Other people clearly have it so much worse. I just got a new job. I shouldn’t be continuing to feel this way.

It doesn’t matter if that thought is rational or not. I can believe with some certainty that she is not judging it, but the minions are louder. They tell me that she doesn’t ever bring it up because she thinks I’m being ridiculous and I believe them too. I need her to ask about it on her own because then it feels to me like she genuinely wants me to talk about it, that it’s not something she’s just saying because she’s supposed to. If initiates the conversation, I’ll feel like it’s okay.

Right now, I don’t.

I know that some of this is just me testing her. If she checks in, about the suicidal thoughts, it proves she cares.

But at the same time, it’s not a test, because I’ve been very honest and direct about that need with her in the past. I need her to check in about the suicidal thoughts. I need to have the pain validated. I need to be reassured that it’s okay to talk about this. I need to be reminded that it is not going to scare her off. I don’t need all of these things every week, but I need her to make an effort to do them sporadically. I need it to be a priority.

Hopefully, I will not always need these things. Right now, I do.

The concept of “checking in” has been a huge battle between us throughout out work together. Her therapeutic style is very client-centered, while I benefit from a little more therapist-led guidance. We’ve waged many wars about it. Although I think I’ve made the majority of the compromises, she has tried to take the reigns a little more now and then. I see that and appreciate it.

If I were to bring this issue up, I know she will listen. That’s not the problem. I have no doubt she will respond in the typical therapist way, governed by calmness and recognition of what I am saying.

However, if you’ve been following me long enough, you know I’ve been in this place before. J wasn’t checking in about whether or not I’d self-harmed. I worried about the reasons why she wasn’t asking and I wanted her to start. So I brought it up and it felt like a big deal to do that.

Well, it didn’t go well. She got defensive, which of course sent my emotions skyrocketing as I tried desperately to feel heard. We stood on either side of the argument and by the time I left, I felt hurt, invalidated, and unsure of our relationship. We discussed that later and she admitted, albeit somewhat indirectly, that she felt unjustly accused of something. So much so that she wasn’t really able to process what I was asking.

I’m learning effective communication, but I don’t know how to do this without making her feel I’m blaming her for how I feel and like she’s doing therapy wrong. I’m terrified of repeating history.

I’m afraid to bring it up and have it turned around on me as my problem, a figment of my disorders. I’m afraid J will be unwilling to even consider that there might be something she could do differently. This is a pattern I’ve played out again and again over the years with friends and family. I get upset about something, it becomes a fight, they refuse to accept any part in it.

I can’t even tell you how much that would kill me. Our conflict would be settled eventually and we’d move forward, but I believe it might begin to erode some of the trust I have in her.

I can feel one way: that I need something, that my feelings may have some validity, even if they may be influenced by BPD or depression or anxiety. But if she does not agree, it hardly feels like it matters because she’s the one in a position of power. Whether or not I feel like it’s a valid request to have her check in, she holds control over whether or not she will actually make the change.

But I also can’t bear to have a whole long conversation again, have J agree to compromise and commit to trying to adjust to my needs, only to have things end up the exact same way they were before. 

So what am I going to do about it?

Great question. While this stuff is important obviously has been looming in my mind, it’s not completely impacting our relationship. We are still working through the book and I am learning skills. I still trust her and feel safe. There are many times in session that I genuinely smile or laugh at something she says, because she can be quite humorous in a very sweet way.

However, there is an invisible barrier between us right now. She may not be cognizant of it, but I feel it. Sometimes, in the minutes before she comes out to get me, I feel intense anxiety about how our session will go. Once I’m in the room, I feel somewhat more at ease, but I am actively refraining from going too deep or showing too much emotion. I don’t discuss the big feelings, I just handle them independently outside of the room.

Right now, I’m going to do nothing. I have my last session with her tomorrow and then we’ll have a short break. There’s no point in bringing this to her the day before she goes away from vacation with the potential that it could blow up and I would have to go into the break with a shitload of unresolved feelings. I’d just resent her more for leaving me with that.

So tomorrow we will talk about whatever I decide I can handle so that I can at least go into the break feeling stable.

After that? Well, it’s just about getting up the courage. I don’t know how long that’s going to take because I feel like I’m walking into a situation that will not go the way I want and I don’t want the outcome of that to impact my ability to connect and feel safe with J.

In theory, I’d like to have addressed this before I start my new job. At that point my schedule will require I switch back to once weekly sessions. Right now, I’m still seeing her twice a week, so if things were to turn sour at least I wouldn’t have to sit with the feelings for a whole seven days.

I don’t know.  The therapy relationship is a complicated one. I just want things with J to go back to feeling as strong as they did before.

Whenever I finally get around to this, wish me luck.

 

Communicating Pain

*Trigger warning, mentions of self-harm*

Nights have been a challenge for me recently. During the day, I’ve had an easier time maintaining a neutral emotional state. But once we hit the late night hours, the dark thoughts come out to do their bidding. Small triggers release them into the air.

With them, a forceful temptation to break my nearly 2 month streak.

I’m not sure why it is that I feel like I need to self-harm to get the level of support I require. Cutting is a coping tool, but I’m also realizing that I use it as a marker in therapy to describe the emotional place I’m in. By some sick logic, cutting myself helps me communicate to J just quite intense the pain was in the moment, because obviously pain must be severe to drive someone to drag a knife across their skin. It’s like I fear if don’t self-harm, she won’t grasp the depths of the turmoil that’s eating me alive.

There are many other reasons that I cut. Escape from mental anguish. Punishment for myself. It’s not all about expressing pain to J. In fact, it’s barely about her. But I’m noticing that she’s a factor.

I’ve only realized this recently, when I cut harm out of the equation by throwing out my razor. I ached for it, and I began paying attention to some of the thoughts that arose from that ache. How will she understand if I don’t do it? She will think I’m getting better, because I managed not to do it, but she will be wrong because the pain is so strong. 

Like I’ve said before, cutting manifests an emotional pain into a visible mark. It’s evidence of suffering. Even if J doesn’t see the cuts, she’ll know they are there. Their presence speaks the language of how I hurt, even if I can’t articulate it.

As if not cutting means she won’t believe my pain? Or will think I’m just being dramatic? It sounds ridiculous, saying it aloud. Of course she will believe me. Yet holding off from this destructive coping mechanism creates tension in my chest, a fluttering of desperation in my stomach, because I feel like I need to do it.

I see her tomorrow and I’m dying to do it before that. Even though, to complicate it more, if I harmed I would feel the immediate urge to withdraw and not tell her. For reasons that I’ll get to in a post in the coming days.

The urge is hanging around, I even found an old pocket knife that I’ve been cradling in my hands all night. For hours, that was all I did, opening and closing. Tried to replace the urges by naming the emotion, watching it, confronting it with affirmations and coping thoughts. I watched a comedy special. Then, with almost curiosity, I dragged it across my wrist about 1 centimeter in length. No blood, no broken skin, barely a mark. A tiny patch of skin tinted light red.

Did I break my streak? I’m not sure. I’m inclined to say no, but the intentions were there. Either way, I immediately put the knife away, out of sight in a drawer. I’m really trying not to do it. I don’t want to deal with the guilt that would follow.

J says I can be safe within my thoughts and feelings and still behave in a positive way. I don’t want to hear this, because these feelings that spring up at night really suck. She’s right though, I know she is. It can be terrible and still, they don’t control what I do.

Still, I don’t feel that she truly knows the measure of this pain. If she did, she wouldn’t make that statement on repeat like it was the only thing they taught her in school.

Maybe another reason I feel such temptation to do it, to make her understand, is to get something more from her than the standard “you can be safe” line. Look how much I hurt and what it pushed me to do. Look how much I need your support. Help me, care for me, take the pain away. Show me you care and tell me to stop. It’s attention-seeking, in part, but its misguided. Same as everything else I do, thank you BPD.

I wonder if the urges will ever go away. Will I be 40 years old and still taken right to this place every time the emotions get heightened? Will I find a way to communicate my pain that does not involve a razor and my own skin?

I don’t know, but I know that I need to find a way to get through the night without it. Get to tomorrow, where hopefully they’ll subside under the weight of a new day. She’ll see and validate my pain just fine without harming.

The struggle never ends.

 

 

Confusion and Frustration with DBT

For almost four months now, J and I have been reading from a Dialectical Behavior Therapy skills workbook. I bought the book after seeing that there was a research base supporting the effectiveness of DBT in alleviating symptoms of Borderline Personality Disorder. Since I can’t quite afford (money-wise or time-wise) to invest in attending an actual group just yet, it seemed like a great place to start.

I’ve completed the worksheets, developing a safety plan and looking at the big picture with my emotions. We’ve done some of the meditations in session together. I’ve written notecard after notecard with radical acceptance statements and coping thoughts and self-affirmations.

We’ve slowly been combing through each chapter and discussing ways to infuse those skills into my life. At this point, we’re just about done with the emotion regulation unit.

Can I tell you guys something? IT’S SO MUCH STUFF!

I mentioned the notecards. I have made probably about 20 of them. A notecard with a Relaxation Plan. A notecard on Effective Communication. A notecard on Opposite Action.  I’m trying so hard to take all this material and jam it into my brain. To make it fit in a way that I’ll be able to recall it. The notecards have become almost like a study strategy, and I’ve always been good at schoolwork.

When I’m well, it’s easy for me to go through and organize the material. I find that the information between units connects more naturally in my mind; I can see the skills holistically. Plus the rationale of DBT makes more sense to me; I feel invested in the skills because I believe in the outcome.

But when I’m not well, when BPD creeps in, it’s like I’m standing over a toolbox without a single clue of which tool to grab for. I have so many questions. Do I need a distress tolerance or a mindfulness tool? I might know I need to use an emotion regulation skill, but am I identifying emotions or am I problem solving? Or maybe both? If I choose wrong, will it be like trying to screw in a nail with a hammer?

The units overlap. We aim to identify our emotions and the urges they evoke as one part of the process in regulating them, which requires using distress tolerance skills to cool the emotion’s intensity by distraction or relaxation. To do any of this, can’t be judging ourselves. We need to accept our current emotions and ground ourselves through mindfulness. By tolerating distress and focusing on the present moment, we aim to see that we can behave more effectively in coping with the emotions, instead of making destructive choices.

I’m sure interpersonal effectiveness will tie in there too, when I get there.

Because all the skills play off of one another, I think that doing something would better than tapping out when the emotions intensify. But that also complicates things for me. If I’m spinning out in a frenzy of emptiness and guilt, do I need to use a distraction plan strategy to shift my focus or do I need to use emotion exposure to sit in the feelings?

Like I said, there’s so much information. So often when I actually need to use the skills, I’m overwhelmed to the point of paralysis. I use none of them and then I’m angry with myself and think that I’m not making any progress at all. I’ve said to J so many times in the last couple months: I just never know where to start.

I wish they had a little flow chart or something.

J reminds me that it’s okay, that if all of this stuff came easily then I’d be doing it already. Even she thinks that it’s a lot to learn.

Now I understand why people in DBT will run through the units multiple times before graduating from the program. It takes long for this overflow of information to sink in!

Speaking of which, I’m sure it doesn’t help that J is not trained in DBT. It’s not like she’s teaching me these skills. We’re both reading a book and discussing them, determining how to generalize them into my life. So obviously there’s a bit of a knowledge gap there. I look forward to the time that I can really immerse myself in it a verified DBT group.

The confusion is just one part. I mentioned that when I’m in a good place, I truly believe in the skills. When I’m not, when my disorder is running me ragged, that perspective changes.

It’s not that I stop believing that DBT could work, but I resent the skills. Radical acceptance feels like invalidation; like I’m just supposed to move on and ignore my pain. Effective Communication feels much the same way Tit feels like I’m expected to sweep my emotions and problems under the rug just for the good of the order. It even tells says in the book that effective communication isn’t “selling out” or “caving in” to other people; but sometimes, in the moment, all I can focus on is that I have to suppress my feelings to keep a relationship strong.

It’s super frustrating.

I see the reasoning behind it. Radical acceptance limits suffering and effective communication is used to remove the blame and accusations from peer interaction so you can reach your goals. Totally makes sense.

Same with meditation. Mindfulness makes sense too, and I think it can be helpful in observing and letting go of thoughts. However, sometimes when I’m most escalated I just want to scream that it’s not that simple, that sitting quietly and focusing on my breathing for five or ten minutes doesn’t eliminate all the feelings that have overhauled my body!

The skills are good, and their intentions are great, but they don’t adequately take into consideration how intense the highest points of the tidal wave can be.  How complex. It makes me feel like I’m just another borderline that they’re trying to fit into a box of “normal” without really paying attention to my unique neuroses.

So I resent DBT for existing, because it feels isolating that I’m supposed to figure it all out myself, to contain it. Like my problems don’t deserve to exist for the eyes others and need to be squared away quickly and quietly. It feels invalidating. Like I’m not allowed to lose it sometimes.

The voices of the minions in my head tell me these things. Of BPD. I want the pain to go away, but I struggle with the idea of being told to take it away. I want to be able to manage it, but I want to be cared for and supported by others.

Then I resent myself for needing skills. More voices, perfectionist ones with impossible expectations. Of course the minions fight back, they always will. They want to remain, even as I’m trying to kick them out the door.

This is the struggle. Knowing which skills to use and wanting to use them. And it is a struggle for me.

Yet, I’m very thankful that I have undertaken this self-help project. Even when I want to fight back against DBT, I’m happy that I’ve found it. Because it’s something. It’s hopeful. While I don’t always know which tool to use, or even remember all the tools at my disposal, I am learning. Storing away resources for when I’m ready to use them.

I’ll continue to work with the skills, to push through feeling indignant, defeated and confused. Hopefully, there will be payout. Hopefully, the path to follow becomes easier to see even in the middle of a storm.

I can handle each challenge that comes my way. I will focus on what I can change.