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I got a comment this week which has pulled me back to my blog (thanks, Ivy!). In full, she asked:
“I’m curious about your experience of DBT and how you’ve written that you have ‘built a life worth living’ and yet seem to still be despressed and struggle with suicide, etc. I tried DBT – you could call me a “dbt dropout”. I found the classes patronizing and I found the skills were, well, not effective… For me, it was not an effective way to treat a client with BPD to tell them you won’t speak to them if they do not “do this”. That screams of abandonment, in my opinion, and that’s one of the main symptoms of BPD.
Obviously, your DBT experience is much different, yet your struggles with suicide and depression seem to be similar to mine, therefore I am intrigued.”
These are all interesting and important points, and I think it’s going to take two separate posts to do them justice. I’m going address the questions about the effectiveness of DBT first, and tackle the question of how clients experience the delivery of DBT (the feeling of being patronized and the abandonment that comes from the 24 hour rule) in another post. Phew!
So: does DBT really work? After all, I’m still not the happiest bunny on the planet. Yet the difference between my life before and now is immense. Prior to starting DBT, I was chronically suicidal. I mean every day. I was inching closer and closer towards completed suicide, with increasingly frequent hospital stays. I was leaving my twice weekly (undirected) therapy so distressed I’d hurt myself. I was drinking more and more and had some near misses with accidental death. I was in a job far below my capabilities, and frequently off sick. The only friends I saw were the ones who broke their way into my home, because I cancelled any plans I’d made- overcome by an inexplicable dread. It’s hard to describe the constant noise in my head. Now? My dangerous behaviours are gone. I have a fab job, see my friends, ’live’ well, even on the days when depression and suicide creep back. I guess their occasional guest apperances may sound disappointing. It doesn’t feel disappointing to me. I have been battling with them for 20 of my 28 years. I never expected this to be the final round. In the last few months, the event that’s had the biggest impact on me has been my partner’s decision to relocate, putting us in the longest-distance relationship you can have on this earth. It’s been hard. I’ve faltered. Has DBT failed me? The only thing DBT has ‘failed’ to do is to control other people’s (e.g. my partner’s) behaviour, and it never promised that…
Some other random thoughts in no particular order:
*What most people talk about as ‘DBT’ is only Stage 1 of four stages. Stage 1 doesn’t promise to get you to a point where life feels worth living. All it claims to do is bring target behaviours down under control. When Marsha Linehan talks about ‘quiet desperation’, she is acknowledging up front that bringing dangerous behaviours under control is not enough- it just traps us in a life of quiet despair. Stage 2 of DBT addresses the underlying trauma which got us so stuck in the first place. Stages 3 and 4 address ordinary problems of living and developing the capacity for joy.
*DBT incorporates a huge range of skills. These include: various ways to be interpersonally effective so you get what you want, maintain the relationship, or retain your self respect; a wide variety of ways to help you manage your distress; many different ways to regulate your emotions; various strategies to build mindfulness into your life. I don’t believe for a second that every skill will work for everyone. There are some skills which don’t do it for me, and a couple which make me worse. However, I also find it very hard to accept that there are any people for whom none of the skills are effective. The skills are not bizarre or crazy or even particularly unusual. Many of the skills are explicitly teaching us what ‘normal’ people learnt naturally to do as they grew up, because their environments gave them a chance.
*Not even the best treatments work for everyone. I’m training to be a psychologist. We use an evidence base to decide what is likely to work. DBT has such an evidence base. However, the evidence (yes, more evidence!) suggests even the most ‘effective’ treatments- the ones with the best evidence- do not work for up to 1/3 of clients. When this happens, it doesn’t matter how ’effective’ the intervention was in theory, it’s back to the drawing board as far as that particular client is concerned.
*I wanted and needed DBT to work. I chose to do DBT, and went to great lengths to track down a therapist. I was invested. I guess DBT might call this ‘willingness’. I am absolutely *not* saying that DBT doesn’t work for others because they are not trying hard enough or don’t want to get better. Even DBT itself refuses to say this, as one of its core beliefs is that the client cannot fail- only the therapy and the therapist can fail. However, I am saying that I wasn’t sectioned and thrown into a DBT programme against my will, or told that DBT was all that was on offer when I actually wanted a different kind of treatment. And I’m sure that makes a big difference. However, I certainly do not think that I- my attitude, investedness or any other characteristic of mine- was the only or even the main factor which made DBT work for me. I think a lot of it was down to the therapist I had. Over and over again, in so many different kinds of therapy, the quality of the therapeutic relationship has been shown to be the main predictor of success, and I got very very lucky with my therapist. I’ll talk about this more in my next post on how DBT is experienced by clients…
*DBT only works if you use the skills. And I’m talking about me here, not ‘you’. I know that many of the DBT skills work well for me. That doesn’t mean that I always use them. Sometimes I forget, slipping automatically back into old habits. Sometimes it feels too hard, perhaps because there’s a new situation I haven’t had any practice applying them to. And yes, sometimes I just plain choose not to. Some days, I choose to wallow in pain rather than help myself. I don’t always realise that’s what I’m doing, but the next day, when I pick myself up and try again, I can see that’s what I did. I think this says more about my less than perfect willingness than about DBT’s effectiveness.
*Building a life worth living. That’s what my blog’s called, and that’s what I’m doing. It is not yet built. I will be building it each day for the rest of my life. Sounds tiring? It is. But there is so much satisfaction and even some joy in the building. Every time I succeed in soothing instead of escalating my distress, every time I get out of bed and make it into work, every time I see my friends instead of cancelling, that’s building a life and living a life all at once.
Somebody once told me that if you can wonder whether you’re going mad, you’re not going mad. I can’t picture their face, but I know it was a mental health professional, and I know they thought they were clever.
I disagreed then and I disagree now. I suspect that even on the descent into madness there are flashes of insight, moments when we observe ourselves and our behaviour as if catching a reflection in a mirror, and in that moment we ‘know’. This is certainly consistent with reports by people whose loved ones lose their minds to dementia or Alzheimer’s.
I have never wasted much time on the concept of madness. My thoughts and behaviours have always made sense to me, even when they seem seriously ‘disturbed’ by this world’s standards. My partner and I disagree almost daily over her insistence on asking whether I’m likely to ‘do something crazy’. I feel strongly that even if I had gone ahead with suicide on one of the hundreds of occasions I’ve considered it, it would have made sense.
But this time, I feel afraid. I see myself driving to find vodka in the middle of the night. I hear myself shrieking louder and louder, alone in the car, until the windows start to shake. I feel the force of raw emotions which have taken me over. I notice that things do not really make sense the way they always have before. And I wonder whether this time I really am losing it.
And then I wonder if maybe, actually, this is the closest to normal I have ever come: feeling my feelings, letting myself hurt. Screaming and crying and raging all fall within the range of ‘normal’ human experiences. Yet they are anything but normal to me, and I am terrified.
On hearing that my partner is moving to Australia (more on that when I can think about it without my head exploding…), one of my stranger acquaintances suggested that I should accompany her as a ‘professional surfer’. We all had a good laugh because I can barely lug my body around a 10k course, let alone repeatedly raise it up to balance on a board which itself is balancing on water. Of the possible ways I could keep myself gainfully occupied in Australia, surfing is most definitely not one.
But today, I’d like to call him back. And tell him I am fast becoming a professional surfer.
But the ‘waves’ I ride are urges to cut up my arms and drink litres of vodka and eat all the food in the world and bang my head against the wall and tear my hair out and die and die and die. Too much detail, I suspect. Both for random real life acquaintances (who glance tactfully at my scars but don’t ask- I love being British!) and for online readers (cardinal rule of mental health sites seems to be ’don’t trigger others’). But when I try to describe the battle of today, ‘target behaviours’ doesn’t cut it.
I don’t know when ’urge surfing’ crept into DBT, or where it came from. It’s not in the ’official’ skills. But my therapist likes it, and I’ve been trying it. The idea is that urges to engage in destructive behaviour will come and go, like waves. If you can ‘ride out’ the urge it will naturally peak and subside. Only engaging in the behaviour will prevent the urge from subsiding.
To me, this is similar to ‘remember when you have felt differently’- a component of mindfulnes of emotion. Which itself is similar to ’This too shall pass’. On the notepad in my car, I have pages and pages where I have written that sentence again and again, trying to hold off from harming myself. Knowing this won’t last forever is helpful and believable to me. How I feel can change considerably over a short period of time, and I am very aware of this.
Being able to categorise the compulsions as ‘urges which must be surfed’ does also help me to get some distance. It separates them out from me, rather than them consuming me as something I must do right now. Rather like the ‘you are not your emotion’ stuff.
To make full use of the skill, I think I’m going to have to find out a bit more about surfing. There’s something about the analogy that doesn’t quite sit right with me. I think it’s that surfers aren’t just there to endure the wave- they don’t go out hoping that they’ll survive each wave. They are actually there for the exhiliration of riding, to harness the power of the waves to raise themselves up and propel them forward.
With some work, I feel hopeful that I can somehow make the analogy fit. But today, I feel like ‘keeping my head above the waves’ would be a more accurate description. And now, exhausted at the end of the day, I still have to swim back to shore.
If only I had a surfboard, and the waters were calm enough that I could rest on it until the morning.
Today I felt my feelings. It was utterly exhausting and I desperately need to sleep. And I didn’t get much else done. But I did manage this, the hardest thing.
I observed my feelings and named them. I sat with them all day. I noticed when they morphed into secondary emotions. I experimented with expressing them- the not so nice ones too.
I didn’t act on the urges to escape them by cutting or drinking or eating and eating. I didn’t even slip with just ‘one drink’ or ‘just one bar of chocolate’.
I was skilful, using just enough self-soothing and just enough distraction to keep the situation manageable. I asked my partner for help when I needed it.
I wish I’d practised on a smaller situation before this one- the day that my therapist left for three weeks. But I wanted to acknowledge that I managed today.
I am not a priori anti psychiatry. Hell, I even did two years of a PhD in psychiatric research before deciding it wasn’t for me. I struggled in the parallel universe where people spent their lives researching autism or bipolar disorder without ever having met- let alone lived or worked with- an autistic or biopolar person. People who then published their findings in esoteric jargon in pay-to-access journals where only people exactly like themselves would ever read them. People who planned where their reserach could take them career wise, but never whether or how it would actually apply to people who lived with these conditions day to day.
The research institute was a beautiful shiny new building which towered over a mental hospital. When we opened our state of the art windows, we sometimes heard them crying out of their windows- the ones that only open an inch. It was an uncomfortable crossing-over of my lives that I sat with every day- the knowledge that it was only luck and grace which kept me from being a patient and instead allowed me to be someone who studied them. I couldn’t play the game, couldn’t live with the juxtaposition, and I felt so unhappy in that environment that I left.
Still, I’m not anti psychiatry, or even psychiatric drugs. I think it helps that I live in the UK and not the US, so psychiatry isn’t so dominated by big pharma (or at least, it’s better hidden). When I was hospitalized two summers ago, I resisted three whole weeks before caving to the pressure to take the drugs. I had a relatively open-minded psychiatrist, and a partner who was a research chemist, and so was able to convince them briefly of the benefits of taking 5-htp (a natural precursor to seratonin) rather than SSRIs (a set of anti-depressants which delay the reuptake of seratonin, leaving it for longer in the synaptic cleft). Nothing was changing and- aware of my insurance dwindling- I decided to take a chance on prozac. When the psychiatrist went on holiday, her stand in (one of the Old School of psychiatry) came to check on me. I told him I wanted off the prozac. His response was to draw me a synapse. In the middle of a PhD programme, a strong component of which was neuroscience, my response was to want to punch him in the face. Instead, I smiled politely and switched off.
I was lucky. I had an internet connection, a debit card, and a hospital which didn’t check my post. I bought books about natural alternatives for healing depression. Books about diet and yoga and acupuncture and reflexology and cranial massage and fish oils and light boxes. When I came out of hospital I tried all of these things. None was very effective. I suspect this was because I. Did. Not. Have. Depression.
Over the next year, I became increasingly suicidal. The psychiatrist hiked the prozac dosage up again, saying that high dosages of prozac combatted OCD, and she thought there was a compulsive/obsessional component to the suicidality. On prozac, I shook and twitched constantly. My face was contorted. I blinked continually. My hands flexed themselves several thousand times a day. I could have lived with this, but suicide did not recede. Instead, it got worse, more compulsive. I developed ‘magical thinking’ I’d never had before- when a man passed me in a tshirt that said ‘Today’s the day’, I thought it was a message just for me, that the Universe had decided the date of my death. When I tried to come off the drugs for my own sanity- just to see whether I might feel better- my family and partner freaked. They called me irresponsible, accused me of dicing with death. The psychiatrist called me ‘non-compliant’, said I was failing to help myself. Actually, I was trying to save my life.
I came off the prozac very early into DBT, with minimum discussion or fuss. I stopped twitching, and obsessed less about suicide. Now I look back on that time, and wonder how it could have been allowed to go on for so long- the misdiagnosis, the damaging drugs, the ineffective therapy, the useless psychiatric input. I have BPD, which means I find it hard to identify my emotions. But today, sitting at my desk in the psychiatric institute, trying to write up the research paper so that my half-completed PhD wasn’t for nothing, even I know that I am very very angry.
Before DBT attempts any kind of emotion regulation, it gets you to examine the myths you believe about emotions. Mine was:
“EMOTIONS ARE DANGEROUS”
It was sort of true; two years of being continually immersed in grief and all the other feelings associated with my past had left driven me to a whole variety of maladaptive coping mechanisms and left me suicidal. However, by the time I came to DBT, I had to admit that the methods I was using to manage my feelings were even more dangerous, and if I was going to die anyway I may as well give emotions a second chance.
Over this year of DBT I would say I’ve got better at identifying what it is I’m feeling, but not significantly braver about actually feeling it. I still feel my brain reaching out for suicide as a comfort blanket and wrapping it around me when my feelings start to hurt too much. And in this last episode, the trigger was so significant that I didn’t even experience that as a conscious choice or action- I just skipped straight to suicide. And once there, it was to dangerous to try to engage with the triggers. I had to try to manage, to distract and soothe, to live from moment to moment.
Those strategies worked, and suicide retreated. I realised yesterday that I hadn’t yet engaged with the triggers themselves and that I had a limited time in which to do so. So I sat down with a pen and paper and tried to work out what the real thoughts and feelings were underneath suicide. Within minutes, suicide was back.
Here is the dilemma:
1. I must manage my distress without committing suicide, because the distress will pass.
2. Managing my distress does nothing to deal with the trigger, which is not going to just ‘pass’.
3. Attempting to deal with the trigger makes me so suicidal that I have to revert back to the strategy of managing my distress.
What to do?
Suicide has subsided. It happened more slowly this time. Excluding brushes with accidental death (due to alcohol use), this has been the nearest miss with deliberate suicide.
A week ago I had written the letters and the will and the funeral instrutions. For the first time, I had contacted a haven for the suicidal which you can only use once. However bad things have been before, I’ve always been conscious that things could be worse next time and I’d regret having used my ‘last resort resource’. This time, I realised that there would be no ‘next time’ if I didn’t do something fast. When my partner left the house for several house in the middle of the night to take her sister to the airport, I took the only other step I could think of to try to save my life: I texted the therapist telling her where I planned to jump from, and the colour and registration number of my car so she could contact the police if I tried to say bye.
Unable to tolerate the uncertainty of whether the haven would take me, I came to the sea. Going to the sea itself was too painful, and for several days I stayed in my room. Strangely, what turned things round was a big box of craft stuff. On Tuesday afternoon I carried it into the art room and slowly I began to make things which helped me to come to terms with the situation. A card for my friend’s new baby. An album for my partner to take to Australia. A mini DBT skills book I can keep in my bag. As I crafted I made lists. Things I want to do with my partner before she leaves. Things I can look forward to doing in my new life on my own. As I felt a bit stronger, I made plans. I went back to our home on my own. I spent two days at a charity I volunteer for, dreaming and planning for a career I really want. Indirectly, I was using skills throughout this time: radical acceptance, mindfulness of emotion, mastery, reducing physical vulnerability, self soothing, pleasant events, contributing, distracting activities. They worked.
Yesterday evening I returned to the seaside retreat. As soon as I arrived I went to walk on the beach. As it got dark I walked and walked, knee deep in the waves. Everyone else had gone home. I blasted worship music in my ears and sang my heart out. A massive surge of wellbeing poured into me. I finished a text conversation with the therapist, steeled myself to manage the feeling of being entirely alone, and turned to walk back. And just then, further down the beach, fireworks burst out. I wasn’t alone; the universe was throwing me a ‘how wonderful you’re still here’ party. And I stopped and watched and cried and used mindfulness to describe and store away everything I could see and hear and smell and feel, as a precious memory I will be able to use later.
I survived. And just seven days later, I already feel so very glad that I chose to stay. I know it will probably happen again, and the truth is that I simply don’t know whether I will survive next time. On one hand, every experience of surviving gives me confidence and skills and experience that I can use to survive the next episode. But on the other hand, every encounter with suicide leaves me increasingly terrified, drained and hopeless- the effect is cumulative. It is a constant balancing act between the incredibly hard work ahead, and the odd unpredictable moments of utter wellbeing like last night, which no amount of ‘work’ can achieve. The party replenished my reserves- thank God.
The more I think about the self soothing issue, the harder I find it to manage my feelings.
The truth is, I feel desperately cheated that noone ever did the soothing for me, and now it’s too late. I feel so sad and jealous when I think of the therapist soothing her young daughter, and explaining that she does this because ‘if noone does it for her, how she supposed to learn how to do it herself?’ I struggle to understand why this very good question applies to her daughter but not to me- I am expected to skip the part where someone does it for me and somehow learn to do it for myself. She tells me it’s a ‘developmental process’ but I suspect that age trumps stage in this process. Developmentally, there may be little difference between her daughter and me in our abilities to soothe ourselves. But her daughter isn’t yet 2 and I am 27, and that’s the real difference. She will not be able to learn unless someone shows her first, and I have to learn without someone showing me first, and both of these things can be true (dialectics again…) and this is something to radically accept. But even though I wrote last week about a new willingness to soothe myself rather than seeking it from others, it seems to be stronger in some relationships (e.g. with my partner) than in others (e.g. with the therapist).
I’ve also been thinking about how for half my life I’ve been diagnosed with and treated for ‘depression’. Actually, I’ve never really struggled with the motivational deficits which are so key in depression. I’ve felt desperate, hopeless, even utterly suicidal, for long stretches of time, but I always had goals and could organize and motivate myself to achieve them. The problem was always managing my feelings, and today I am so angry that ‘Borderline Personality Disorder’ is called what it is. Not because of the stigma that comes with it (though I’m often angry about that too) but because it is such an utterly unhelpful, untransparent name. The name gives no clues at all as to the difficulties people actually experience. I never knew what it was, and never bothered to find out, because the name seemed so utterly irrelevant to any of my difficulties. If it had a descriptive name like ‘Emotion Regulation Disorder’, I might have recognised myself in it years ago. Or others might have done so. I might have received soothing when I was still a young teenager, when it wouldn’t have been totally inappropriate for others to do it for me. I might now have some experience of how it feels to be soothed, so that I know what it is I’m aiming for when I attempt to soothe myself.
So, there are still more obstacles than I thought in just being able to come to self soothing with willingness and without heavy baggage of sadness and anger and regret. Or maybe the task is to come with all the baggage and yet still be willing.
Today, the panic over not knowing how to soothe myself took over. The therapist and I have recently tightened up the boundaries around phone contact (they had blurred to the point where she was soothing me) and I think this, together with the fact that previously I wasn’t really willing to try anyway, was covering up a desperate lack of even basic skill. Now my skill deficits are fully exposed, and I am despairing over whether I will be able to learn. Is it all about scented candles, art books and hot chocolate, as the DBT skills workbook seems to claim, or is it less of an external thing and more in the way that we speak to ourselves and think about ourselves, as compassion focused therapy seems to say?
In an attempt to push away the panic, today I am committing to trying. I have some cheerleading statements for self soothing. And I have a chart of sorts. Over the next week or so I’m going to deliberately experiment with things which might soothe me. I’m going to try to describe how I felt before and how I felt after. I can work this out, like I worked out radical acceptance and mindfulness.
PS To add your voice to a campaign to rename BPD in DSM-V, visit the site of the BPD Awareness Campaign
After many months of meaning to (and then another two weeks deliberating between a cupcake box and a butterfly box!) I’ve finally put together my skilful toolbox for surviving a crisis.
This is what’s in it:
- Glow sticks (they glow for 4-6 hours, so when I first open the box I snap one and set myself the task of managing well for as long as it glows)
- Manicure/pedicure set (soothing touch, distracting activity)
- Peel off face mask (distracting sensation and activity)
- Bath oil (soothing scent and touch)
- Colours and colouring book (soothing and distracting activity)
- Bubble wand (soothing sight)
- Legally Blonde the musical CD (create opposite emotions)
- Book of wedding cakes (soothing/beautiful sight)
- Fruit tea bags (soothing taste and one-mindful activity)
- Scented candles (soothing scent and sight)
- Sudoku (distract with other thoughts/activity)
- Extra strong mints (distract with other sensation)
- Joke book (create opposite emotions)
- Photo album of ‘Times I have been blissfully happy’ (remember when you’ve felt differently)
- Hot chocolate and marshmallows (soothing taste)
- Silly putty (distraction)
- Spinning magnets (distraction)
- Stress ball (distraction)
- Lavender essential oil (soothing scent)
- Mindfulness CD (variety of mindfulness and relaxation exercises
I’ve also got a wordle of emotion names inside the lid of the box, so I can have a go at picking the one which best matches how I’m feeling, and I’ve got some emotion identification forms stashed in the box. I’ve also put a ‘today’ form, something I invented when I came out of hospital pre-DBT, which helps me focus on taking it one day at a time by identifying what I’ve noticed and done well and enjoyed in the day.
Other things I want to add, but need to hunt down, are: sherbert dip dab (distract with other sensation), small chocolate bar (soothing taste, but I ate the one I originally bought for the box), and origami papers and instructions (distracting activity), and a list of fun and distracting websites (need to get some ideas from people for this). Also, the liquid in my bubble wand is running a bit low… well, I had to try it out extensively in the park to check it would work in an emergency!
Each item has a fun coloured label on it describing what skills it’s relevant for. This may sound strange but it helps me to focus on the meaning of what I’m doing- otherwise I just open the box and think ‘how the hell is a tea bag going to help in this life or death crisis?’.
The other thing that’s important to me is that each item is complete in itself- the candles have matches, the sudoku book has a pencil stuck to it, the tea bag has a mug. In a crisis, the smallest challenge feels overwhelming, and if I had to go hunting for these things, I’d give up.
So, that’s my crisis survival box. What’s in yours?
I’m sorry I swore at you. I’m sorry I said that I hated you and your family. I’m sorry I said I wouldn’t be here when you came back. I would desperately like to explain away this last horror by saying that I said it out of fear that I would commit suicide, and indeed I was afraid that night, but I suspect that I said that out of sheer anger, because I wanted you to suffer just a fraction of what I was suffering, and honesty will not let me claim otherwise. This is a new low.
When I apologised, you told me to make a skilful plan about managing anger. My plan is not to feel anger, not to feel anything, anymore. One day I made a deal with the skills trainer. The topic was myths about emotions. Mine was ‘emotions are dangerous’, but I agreed to try them and see. For a few months my feelings towards you have been hard to manage and very painful, but I couldn’t fairly call them ‘dangerous’. Saturday was dangerous. Dangerous for my safety, because I became too dysregulated and my behaviour became risky. And dangerous for a peaceable collaborative relationship with you.
So I’m giving up all feelings towards you for Lent. Well, there’s still a long time to go before Lent, but that’s good, because it’s probably going to take a lot of practice to separate these feelings from me. Or maybe it won’t? At the moment, the prospect seems relatively simple, but that’s probably because at some point I consciously chose to detach from you. Sure, I still get the urge to randomly tell you I love you every hour or so, but I don’t actually feel very loving or attached. Mainly, I feel confused because although I do indeed feel remorse and I appear to be going to some lengths to repair (“I’ll do whatever you want and be however you want”), I think I’m actually still quite angry and upset with you (though I have no idea why) and I don’t especially want to feel closer to you again.
You didn’t seem very impressed by the new No Feelings plan. You had a better plan: I could continue to feel things, and just express them skilfully instead. I could say ‘I am angry with you because…’, or express action urges by saying ‘I want to send you an angry message’. Or I could act nice instead of angry. But I wanted to tell you: I’m new to this anger thing. Until you named it on Saturday I didn’t know what to make of the urge to attack you that ripped through me. I probably would have called it fear. If pushed, I might have gone for ‘feeling abandoned’. From the age of 11, I grew up in boarding schools, in hospitals, and in other people’s homes. All places where you’re on your best behaviour, or you’re out. If I ever felt angry (and I truly don’t remember this), I swallowed it. So this is my first time trying on anger for size, and what you’re taking to be wilfulness is actually a desperate lack of skill and practice.
You vetoed the No Feelings plan because you want our relationship to continue to be genuine. But I want out of this relationship altogether. If I tell you this, you will think it’s a reaction to you having set limits. Truly, it’s not; I’m actually quite relieved to have met a limit you set down clearly and in real time. So, no tantrum because you won’t let me treat you like dirt. Just horror at how out of control my feelings and behaviour became that night. I don’t want to be that person, so I can’t stay in this relationship.
You will say that the therapeutic relationship is grist for the mill- a good chance to practice what happens in all other (real) relationships. But to me, this relationship is nothing like my real relationships. For a start, I don’t feel like an adult with you, and I struggle to behave like one. In my real relationships I don’t repeatedly swear at people, I rationalise feelings of abandonment, I’m really very polite. With you I have the emotional control of a 2 year old. You told me not to say anything to you that I wouldn’t say to anyone else I respect, but often you are not ‘you’- you are all the people who hurt me and left me- at other times you are the ‘one’ who is different from everyone else that ever was. Whether I’m telling you I love you or swearing at you, I don’t think I’m really interacting with ‘you’, but with whatever I am making you into (perfect mother, cold abandoner). Acknowledging this makes me sad because I do want to believe that there was an element of something real about you and me and how we interacted.
You told me once that developmentally, it’s important for parents to be able to tolerate a child’s anger. I think you are trying to tell me that you can tolerate my anger, you just won’t tolerate the swearing. Another time, you said that there was nothing I could do which would make you stop caring about me, because you didn’t care about me based on my ‘good behaviour’. I think this might be what you are trying to show me now, telling me before you left on Saturday that you would still be there on Monday, saying that you’re glad I’m ok. But I do not understand what this means, cannot wrap my head around it. All I can see is that I tried being angry and it was awful and now I must promise to feel less and behave better. I feel very frightened and shocked by what happened and I’m not brave enough to try again.
I want to tell you I can’t come tomorrow, or next week, or any week. But again, I’m scared that it will look like a tantrum because you told me off, or seem like I want you to chase me. And besides, we both know I almost certainly will come, because I just can’t stay away from you. Which makes me hate myself so much I want to die.
You told me to tell you what I think. These are the things I think, but there is too much room for you to think the worst of me. And at the same time, there is too much capacity for you to really understand and for us to fix this properly, and truly I don’t want to because I can’t cope with the feelings of being attached to you. So instead I will tell you ‘Yes, whatever you think is best, it won’t happen again’, and I will tell the rest to the anonymous blogosphere.
