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A few months ago, my relationship of seven years broke down. For a long time, I had struggled to be the person my partner deserved me to be. Seven years is a long time. We were engaged to be married. We had wedding and house-buying plans. We argued good naturedly over names for the children we would have. I was confident that I knew what was ahead.
Last autumn, she chose to move to the other side of the world for work. I knew there were tough times ahead, but I believed we’d make it. I was due to fly out to see her just three weeks after she left. The day I was due to fly, it snowed. How simple. And random. It snowed, and no planes flew that day. If I had gone one day earlier. If it had snowed one day later. These are the thoughts I catch, and put away. Over and over again, some days. And other days, they come faster than I can notice or catch them. The days when I am surrounded by people with partners and children.
“We must be willing to let go of the life we have planned, so as to have the life that is waiting for us”
It’s not a DBT phrase. I don’t even remember where I saw it. But I think it captures the spirit of DBT perfectly. The magic word ‘willingness’. The concept of ‘letting go’. Radical acceptance. Flexibility.
The snow didn’t help. And it’s very possible that things would have gone badly even if we had seen each other at Christmas. But the truth is: my partner suffered and my relationship ended because I am broken. And although I work so very hard in therapy, I am not sure whether I can mend myself. I know that until I am mended, I cannot be in a relationship. So here I am, with the permanent lump of loss in the back of my throat, fighting to accept that the children whose names we so hotly debated will never exist. That my engagement ring sits in a box in my bathroom. That I will never again go to sleep beside her.
Letting go. But trying to hold on- to hope, that there might be a life which is waiting for me.
Recently, I’ve been struggling to see the choices in the situation. I know that the suggestion that we have choices at all can feel very invalidating, even insulting. But I keep looking for choices, because the reality of having choices is utterly liberating.
I looked through an old folder tonight for some diary cards. I have fallen hard off the DBT wagon, so hard that I’m being dragged along the ground behind the wretched wagon, and the skills diary card is my first step back on. In the folder, I found this:
there are five choices:
1. Change the trigger (= solve the problem)
2. Change your feelings (= your response)
3. Use radical acceptance
4. Keep suffering
5. Make things worse (= engage in target behaviour)
I’m not sure where I saw this and scribbled it down from. But I’m so very glad I did. I can see I have made progress; I rarely choose number 5 any more. But I am choosing number 4 all too often. These wise words will be written on my phone and stuck on my mirror. I couldn’t see any choices, and now I have five. Well, three, hopefully!..
At some point, I seem to have stopped writing about the skills and started living them. Sometimes I don’t even notice that I’m doing it. My training course involves techniques from brief solution-focused therapy. As part of this, we ask clients we consult with what their best hopes are for our work together. DBT did not start like this, probably because I couldn’t have felt or articulated any hope at that point. My goal was not to die by suicide, and some days I wasn’t even totally committed to that. Yet eighteen months in, I realise that DBT has changed my life beyond my best hopes. I’m finding that I want to preach the skills to everyone I talk to, because they work. And the result is that there are more and more days when I do not have to fight the noise in my head to get up and go out and live. The noise of suicide and self destruction and suffering. There is still pain, but I am not suffering in the same way. Until I met radical acceptance, I didn’t even know that pain and suffering were different. Mostly, these days, it is quiet enough in my head for me to be able to hear life. I never expected this; I realise now that my best hope was to find a way to live over the noise.
… realising, after I’ve written the suicide note, that it’s not quite true- I haven’t tried everything. Remembering the attachment the skills trainer sent me last week which suggested using ice to tolerate distress. And so turning back from my suicide drive to struggle into my swimsuit at 9pm on a cold August night ready to jump into the outdoor pool. Finding the pool closed so driving instead to the sea. Plunging into the freezing water, while others in their warm coats and even gloves stop to stare.
Love is holding the towel, like she did last night. Trusting that I am going in not to drown myself but to try one more thing that might work. Sobbing from the pain she cannot alleviate.
Desperation is clinging to each other, her in her waterproofs and me in my swimsuit, and asking her to remember this night, to remember- when it happens- that I had truly tried everything. And hoping she understands, and knowing that she can’t, really.
Irony is the jellyfish sting from those five minutes in the water that blew up my foot and caused me a night of acute pain when I needed a rest more than ever before.
It is hard to stay willing when everything I sincerely try brings more pain.
I know that this feeling will not last forever. I know that these obsessional self destructive urges will pass. I know these intrusive thoughts won’t torment me forever. But today, yesterday, probably tomorrow, I am up to my neck in misery, and pain is everywhere. These are the days when the world seems to be tuned wrong. Everything is too loud and too fast and too bright. Nothing that anyone says is right. I am so unhappy in my head that I would sign up for a full lobotomy if they were being offered. And so uncomfortable in my skin that I would like to rip it off.
All I have to defend me in battle are the DBT skills. I have pushing away, a form of thought blocking that feels pathetic and oh so very tiring against the constant heavy onslaught. I have observing and describing, but putting words on my reality is making me more desperate. I have letting go of judgements by putting them on leaves. I have used all the leaves in South West England, and I do not feel better; maybe I have clogged the river downstream. I have radical acceptance, but this doesn’t address the need to start to change my situation in some small way. I have distracting activities which today are not distracting. I have comparisons, which are dangerous because it’s so easy to fall into making the wrong ones. I have sharp physical sensations, and today these are the ones that can get through to me. Jumping into freezing swimming pools. Orgasms. Ru running and running. This is my first experience with a distress which prefers to be shocked than soothed away.
Today I am throwing every skill I can think of at this misery. Not just once but second by second from the moment I wake up until I finally fall asleep. Sometimes by 3pm I cave and have a drug induced rest. I feel so very small, and the skills so very inadequate, against the forces I’m battling. And to complicate matters, I am essentially fighting against myself, and I’m not always on the right side.
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.
My education taught me that Fence Sitting was a Bad Thing. People should have Opinions. We should know how we feel, decide one way or the other.
DBT is un-teaching me these things. It is teaching me that I may have more than one feeling or thought, that these may be contradictory, and that this is ok.
This is the heart of dialectical behaviour therapy: finding the nugget of truth in conflicting sides, synthesizing opposite poles to come to a position which is real though it may never be comfortable. I like to think of it as saying that sometimes the only way to make sense of the world or ourselves is to acknowledge that sometimes we do not make sense.
Today, without realising, I found a fence. I told the therapist that I wished she could be my mother. I’ve told her that about 22,000 times before (it’s fun being my therapist- please form an orderly queue for the role!) and behind the words have always been a solid wall of pain. But this time there was another bit. It said “But this is good too 
“.
Where did that come from, the ability to wish for one thing while acknowledging the benefits of something else? Not from the therapist- she has always acknowledged my wishing, and never doggedly replied ‘I can’t be your mother but I can be your therapist’. She has never tried to convince me of the benefits having her as a therapist rather than a mother.
Is it the three months of radical acceptance I have under my belt- the walking away from the wish? I think that has certainly helped me to see beyond the pain, but it doesn’t fully account for what happened tonight when the wish was fully there.
When I tried later to describe what had happened, I hit against the choice between ’AND/but’. And realised that the fence is both.
“I wish you were my mother AND I’m glad you’re my therapist”
“I wish you were my mother but I’m glad you’re my therapist”
Here’s the fence:
“I wish you were my mother AND/but I’m glad you’re my therapist”
Tomorrow I may fall off, firmly onto the side of wishing, back in front of the wall of pain. But how good it is to be balancing up here, just for tonight.
I’m a convert! Whoever would have thought that saying a few positive sentences like you mean them could have such a strong effect? Not me. But they did. My interpersonal effectiveness cheerleading statements have enabled me to do several things differently this week, including dealing with the situation rather than fleeing the scene when the therapist expressed negative emotions about me, and being able to accept that I wouldn’t get what I wanted from my partner and deciding to meet my own needs.
So, I thought I’d try the same magic for my self-soothing difficulties. Here they are:
- It is not too late to learn
- It’s ok if it takes time to figure out what works
- I can tolerate not having my needs met by my partner
- I can tolerate not getting what I want from the therapist
- I am highly motivated to learn to self soothe
- Learning will give me power and strength and leave me less at the mercy of others
- Learning will give me more options in crises
- It’s ok if I sometimes fall back on old ‘soothing’ habits. These things aren’t ‘bad’, just ineffective
- Its ok to feel sad that noone helped me with this, but the effective thing is still to help myself now
Results of the self-soothing experiment so far:
Bingeing is not helpful; Vodka just plays tricks with your brain; Fairy lights are surprisingly and consistently effective.
I suspect that everyone else knew this already…
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
Today was difficult from the moment I woke up. I struggled desperately, lost my skills, engaged in an old problematic behaviour and (more worryingly) a new one, and spent the rest of the day fighting urges to engage in all the others. I gave up on a big project I’d undertaken and ended up handing it over to someone else to do. I survived a very difficult therapy session only to argue with the therapist an hour later. I got home at 10pm hoping so much that my partner would see me, see the day I’d had. Hug me or commiserate with me, spend a bit of time being gentle with me. It didn’t happen.
I wanted my partner to acknowledge that today I fought against BPD, against suicide and terror and shame and I’m still here. But there are no prizes for these things. This world doesn’t give out stickers saying ‘I’m proud of you for not dying today’. It says ‘Why didn’t you do the washing up?’. My partner doesn’t say ‘I’m so sorry you had a bad day’, she says ‘I need a few months where everything is ok’. God, so do I. Tonight I feel that I would trade everything for one day where everything is ok.
I guess DBT says that self-validation is the ‘prize’. So here I am to say: I had a bad day and I controlled my behaviour. I dealt directly with conflict and made attempts to repair. I was mindful of how my rigid expectations of how she should behave would influence our interaction. I radically accepted that I was not going to get what I wanted from her. I used a cheerleading statement to motivate me to soothe myself. I identified a crisis, and I opened my butterfly box. I lit the candle. I can do this, and I choose to keep doing it.
