Breaking through and the emotional power of music.

This is what’s going on with me now.

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PTSD is a real physical injury.

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Distraught, depressed, and confused.

In spite of the hopeful, positive dream I had early this morning where I seemed to discover my own power over my inner demons, I actually have been feeling very bad.   For the past week or two, I’ve been much more stressed than usual, more depressed, more nervous, more negative, quicker to anger, less mindful, and generally just feeling a lot more triggered by small things.   I feel like I’m on the verge of tears a lot too, even though I can’t actually cry. People at work have noticed too, and I got asked a couple of times this week if I was “alright.”   I hate the fact that people can tell and I’m so bad at hiding the way I feel (it pisses me off–but am I pissed at them for noticing or am I pissed at myself for being unable to maintain a false front of good cheer?  I don’t know).   People have always thought I was a little “off.”  But they are right.   I am not “alright.”

The only explanation that makes sense is that because I’ve been looking more closely at my early life, and at my family’s behavior toward me, it’s triggering a lot of unpleasant feelings and making me feel dangerously vulnerable and also angry at the same time.   All this negative emotion could mean I already dived into the void and if so, then that’s a huge step toward healing (which the dream seemed to be about).    I don’t know.  I always email my therapist what I want to talk about and have him print a copy so I can remember (I like doing things that way), but I think I might have to talk about this instead.   Thank God I see him tonight.   I’m going to ask if I can see him twice a week while I’m going through whatever emotional crisis  I’m in right now.   I’m just feeling really…bad right now.  Is it normal to feel better at the beginning of therapy and then start feeling a lot worse later on?   I know we’re starting to dig up things I wanted to leave buried before.   Maybe its sort of like giving birth–and these are emotional “labor pains.”  I don’t know.

Circling around the maelstrom.

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Credit: Jim Carson Design

I’ve been thinking a lot more about my parents and my nightmarish upbringing as a hybrid scapegoat/golden child (I was raised as an only child, so I had to be both). It’s worse in some ways than just being a scapegoat, because it’s a topsy turvy hall of mirrors where you can predict nothing. There’s no stability. There’s no security. There’s no consistency in a childhood where you have to serve two roles, and never know which one you’re going to be next, and where both roles you play are a lie.

I started blogging because of my sociopathic NPD/ASPD ex. I was trying to deal with my feelings about going VLC (very low contact, since we have children) with him and cope with being on my own for the first time. Blogging introduced me to myself.

I’ve been through a lot since the day I sat down and started to write. As I progress in my journey, I’m spiraling ever closer around the emotional vacuum that lives in my center, the maelstrom that was born from hurt and pain. I liken it to a black hole in space or a maelstrom in the ocean, because everything disappears there never to return. Falling into it prematurely could obliterate me. But if I’m ever to heal from my disorders, I need to dive into that maelstrom and explore its terrors and maybe its wonders. I’m a lot more courageous now than I ever was before. I think I can do this.

I’m realizing the problem wasn’t really my ex after all. What I mean by that is that we came together because I was programmed almost from birth to become codependent to someone like him. Yes, he made me worse, but I was in bad shape long before he came on the scene. In therapy, I’m beginning to talk more about my childhood, and the pain inflicted on me by disordered parents. I’m still at the point where I explore it from an emotional distance, as if I’m watching a movie. I can’t really internalize and surrender to the pain yet. I feel a vague sadness and anger, but I’m dissociated from it, as if it’s someone else it’s happening to and I’m just watching.

But it’s beginning. I’m starting to trust my therapist enough to take the plunge. He is using reparenting techniques on me, which is what I wanted. He’s empathetic, which is what I needed. I’m thinking about my past a lot, and making some connections. I have some tools to protect me when the time comes to go in. I’m scared but excited. I’m gaining courage.

I’m swirling around the edges of the maelstrom, looking down into an opaque blackness that looks empty but is full of unseen mysteries. I won’t fall into it. I’ll willingly dive into it, just like when I was eight and first jumped into the deep water at the community pool.

Once I dive in, I’ll either disappear forever, or rise from it triumphant. I’m banking on the latter.

When your therapist rejects you.

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I just read a post from a blogger who describes how her therapist suddenly terminated her without warning.  She writes,

I spend pockets of time here and there throughout the days just wracking my brain trying to figure out what went so wrong. I replay our conversations in my head and try to decipher what this meant or why she said that. I try to figure out what the fuck I did wrong.

It’s devastating and crazymaking.  Unfortunately, being suddenly rejected by a mental health professional seems to be pretty common.   People who have never been in therapy sometimes have trouble understanding how devastating this can be.  We become extremely attached to our therapists through a process known as transference, especially when the therapy is of the psychodynamic type (as opposed to behavioral/cognitive methods like CBT).  The therapist acts as a surrogate parent and for a therapist to terminate a patient without warning is akin to a parent rejecting their child. It’s extremely traumatic and the victim often develops PTSD from the rejection, especially if they already have attachment or trauma-related issues due to rejection or neglect by caregivers when they were children.   The problem is that many people with mental disorders themselves become therapists, often to work out their own emotional issues by proxy.  They may not be aware they are doing this, but it happens all the time.  That’s why therapists are encouraged and even required to be in therapy themselves, in order to address any counter-transference issues that may come up with their patients.

If my therapist ever rejected me like that…ugh, I don’t even want to think about that. I think I would just want to crawl into a hole somewhere and die.  I know he would never suddenly terminate me without good reason and without explaining why, but because I worry about everything, sometimes I worry about that too.

I’ll give you an example of how ridiculous this worry gets.   In my last session, toward the end, I asked my therapist if he had any children.    I don’t think I had any reason to ask other than simple curiosity.   But after I asked I felt liked I’d somehow overstepped his boundaries (he did answer me).   I don’t even know why, really.  He asked me what made me ask him that.  Maybe he thinks this is significant.   I imagined I saw an angry or concerned look on his face after I asked.   But I always imagine negative looks on people’s faces even when their expression is actually neutral.   I feel like I should apologize.    I don’t even know if he was upset by my question but I still feel like it might have been a boundary invasion.    I know he wouldn’t terminate me for this, but I still worry that he might like me less because I *might* have invaded his boundaries.

It’s so dumb that sometimes I feel like I have to be perfect even for my therapist.

Further reading:

50 Warning Signs of Questionable Therapy  (red flags you should know about):

There are over 700 comments under the above post. I was shocked at some of the stories I read about horrible therapists who make their clients even worse.

Infatuation and Transference:  Please be aware that I wrote this post over a year ago and my views about transference, which were mostly negative at that time, have changed.

 

I’m only 6 years old.

Therapy was more productive tonight…

Always waiting for the other shoe to drop…

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I think I made a kind of breakthrough in my therapy session tonight. For years one of my problems has been this overwhelming fear that something bad will happen to one of my kids. (I don’t like to even say the D word because I irrationally believe if I say it, I’ll somehow make it happen, by putting it out into the universe or something).

Of course all parents worry about their adult kids, especially when they know they’re out there somewhere in cars, which we all know are dangerous hunks of metal capable of the most ghastly and gory deaths you can imagine and operated by countless idiots and drunks on the road who can’t drive. I think my apprehension about something bad happening to my adult children edges into OCD-type territory though, because of how overpowering and pervasive these thoughts are, intruding where and when they are not welcome, even though I know that in all likelihood, something bad will NOT happen and even if it does, worrying about it excessively is like living through it twice. I think about my hypothetical reaction to such an event and wonder how I would retain my sanity, if not my will to live. I always marvel at people who have lost a child in a sudden manner like a car accident (a long illness is more bearable because you have time to prepare for it and process it) and wonder how they can still go on with their day to day activities–going shopping, paying bills, working at a job, watching a movie, hell, even having FUN sometimes. I know that wouldn’t be me and I obsess over how I might react.

I’ve been so haunted by the remote possibility of getting THAT life-changing phone call late some night (you know the one), that it’s even been a recurrent theme in my writings. I had a dream over a year ago about losing my son, and wrote a post about it, called Losing Ethan.

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Anyway, I decided to bring up this problem because it doesn’t exactly make my life happier and it annoys the hell out of my kids. The first thing my therapist did was tell me to stop BEING those feelings, but just OWN them. In other words, he’d noticed that when I talk about bad feelings that make me ashamed or anxious, I always use the term “I am….” Instead he told me to practice saying, “I feel…” or “I have…” In this way, you create a bit of a distance between yourself and the bad feeling. That doesn’t mean you don’t feel it, but with a little distance, the emotion can be explored, almost from the viewpoint of a third person. Ironically, what happens is you feel the emotion MORE (I can’t really explain why that works but it does).

His advice was brilliant, because a few minutes later, I made a connection. In 1998, with my then-husband in jail, I was forced to learn to drive his stickshift truck. I had to teach myself and never learned to park the truck properly. So after picking up my kids from their after school program and pulling into our driveway, I set it to Neutral and the truck began to roll downhill–containing both my kids, then ages 5 and 7, straight toward a TREE. The events that played out next are described in this post, called The Tree.

The important thing is, I’d connected this traumatic event in August of 1998 to my current obsessive thoughts about tragedy striking and generally always feeling like I’m about to receive some devastating news–and I knew immediately that these unpleasant thoughts are based on guilt and shame. I started to tell my therapist that I always felt guilty that the truck had rolled and that I *could* have killed them. For about 10 years I couldn’t even talk about it, because any time I did, I’d start feeling very dissociated and anxious. My ex knew how to press all my buttons, and knew this was my biggest one. If he wanted to upset me all he had to do was remind me what a rotten mother I was to almost kill my kids that night because he knows I’m still struggling with guilt over my failure to protect them, my failure to be smart enough to know how to park a stickshift.

I’m always very mindful of my body language, voice and gestures when I’m in session, probably as much as my therapist is. These things can tell you a LOT about yourself, not just about others. And I realized as I was making these connections that my body relaxed and I leaned back but my voice became softer and sadder. I was opening up to him in a way I hadn’t before. He just listened, with what appeared to be a great deal of empathy.

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And at some point I felt tears come to my eyes. My eyes just barely glistening, tears not overflowing, but there, making the backs of my eyelids feel warm. I looked off to my left like I always do when I get deep into stuff, and kept on talking. I felt myself opening up and feeling some kind of generic emotion that wasn’t sadness and wasn’t guilt and wasn’t gratitude or joy but was none of these things and yet all of these things. I wanted to share all this with him. I heard myself speak and my voice became thick and my eyes burned again.

There was more, much more, but I’ll end this here because I’m getting emotional writing this. The important thing is, I almost shed tears in front of my therapist tonight. That might not seem like such a big a deal, but for me it was a huge deal because I haven’t been able to cry in front of another human being in about 15 years–which I realized is when THAT happened. (It might have been longer than that though–my memories of the time I was in my horrible marriage are gray, shadowy and even have yawning gaps in places).

What happened tonight is only the proverbial tip of the iceberg–I was seriously fucked up for a very, very, VERY long time, at least since age 4 or 5–but it’s significant because it means the wall in my head that prevents me from really being able to connect to my emotions is developing a few weak spots.

Are BPD and complex PTSD the same disorder?

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Me at age 3 in the zone. Was the template for my BPD already laid down?

Ruji, a new commenter on this blog, made an interesting observation–that BPD should be divided into at least two subtypes: Empathy Challenged/Character Disordered (closer to NPD/ASPD) and Highly Sensitive Person with Emotional Dysregulation (closer to the type I have, although at different times in my life or when extremely stressed I have displayed the more character-disordered subtype). I agree with her. Ruji’s idea is remarkably similar to The World Health Organization’s two subtypes of BPD:

1. F60.30 Impulsive type
At least three of the following must be present, one of which must be (2):

–marked tendency to act unexpectedly and without consideration of the consequences;
–marked tendency to engage in quarrelsome behavior and to have conflicts with others, especially when impulsive acts are thwarted or criticized;
–liability to outbursts of anger or violence, with inability to control the resulting behavioral explosions;
–difficulty in maintaining any course of action that offers no immediate reward;
–unstable and capricious (impulsive, whimsical) mood.

2. F60.31 Borderline type
At least three of the symptoms mentioned in F60.30 Impulsive type must be present [see above], with at least two of the following in addition:

–disturbances in and uncertainty about self-image, aims, and internal preferences;
–liability to become involved in intense and unstable relationships, often leading to emotional crisis;
–excessive efforts to avoid abandonment;
–recurrent threats or acts of self-harm;
–chronic feelings of emptiness.
–demonstrates impulsive behavior, e.g., speeding, substance abuse

Psychologist Theodore Millon has gone even further, proposing that BPD should be divided into four subtypes:

1. Discouraged (including avoidant features): Pliant, submissive, loyal, humble; feels vulnerable and in constant jeopardy; feels hopeless, depressed, helpless, and powerless.

2. Petulant (including negativistic features) Negativistic, impatient, restless, as well as stubborn, defiant, sullen, pessimistic, and resentful; easily slighted and quickly disillusioned.

3. Impulsive (including histrionic or antisocial features) Capricious, superficial, flighty, distractible, frenetic, and seductive; fearing loss, becomes agitated, and gloomy and irritable; potentially suicidal.

4. Self-destructive (including depressive or masochistic features) Inward-turning, intropunitively angry; conforming, deferential, and ingratiating behaviors have deteriorated; increasingly high-strung and moody; possible suicide.

Millon’s Types 1 and 4 would correspond to the Highly Sensitive Person/Emotional Dysregulation type mentioned above (and therefore closer to the Avoidant/Dependent PDs); Type 2 sounds very much like NPD; and Type 3 seems closer to ASPD or Histrionic PD.

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BPD symptoms are almost identical to those of Complex PTSD.

There are so many diverse–almost opposite–symptoms that can appear with this disorder that one person with BPD can be very different from the next. In fact, you can take 10 borderlines and they will all seem very different from each other, with barely any similarities in their behavior at all. One will be shy, fearful and retiring, never making waves, acting almost like an Aspie or an Avoidant; while another may break the law, lie constantly, and act obnoxious and rage whenever things don’t go their way. A borderline could be your raging boss who drinks too much and ends every annual Christmas party with one of his infamous rages, or it could be the sweet and pretty schoolteacher who goes home every night and cuts herself. She could be the come-hither seductress or the nerdy computer programmer. He may have few or no friends or a great many.

This diversity is not the case with the other personality disorders, which have more cohesiveness in the symptoms their sufferers display. So I wonder–is BPD really a personality disorder at all? Does it even exist, or is it really just a group of trauma-caused symptoms the experts in their ivory towers stuck in a single box called “BPD” because they didn’t know how else to classify them?

In fact, all these diverse subtypes have one thing in common–they are all very similar or identical to the symptoms of someone with complex PTSD (C-PTSD). People with C-PTSD are often misdiagnosed as Borderlines because their behaviors can be just as baffling and manipulative, and both disorders also include dissociative, almost psychotic episodes. Extrapolating from that, I wonder if ALL borderlines actually have C-PTSD.

Earlier today I posted an article outlining 20 signs of unresolved trauma, and I was struck by how similar these were to the symptoms of BPD. And there is also this article that Ruji just brought to my attention that also describes how remarkably similar the two disorders are, but that the idea of fear of abandonment (which is recognized as the root cause of BPD) is not recognized as a factor in causing PTSD and that may be part of why they have been kept separate.

The BPD label, like any Cluster B label, is very damaging to its victims because of the “evil and character-disordered” stigma it carries. One psychologist has even included us, along with narcissists, among the “People of the Lie”!

Yes, it’s true some borderlines do act a lot like people with NPD or even Malignant Narcissism or ASPD, but most probably do not, and are really much more similar to people with Avoidant or even Dependent personality disorders, which hurt the sufferer more than anyone else. But if you have a BPD label, people start backing away from you slowly due to the stigma. Therapists are reluctant to treat you because they assume you will be either difficult and hateful in therapy sessions, or will never get better. Insurance companies won’t pay claims where there is a BPD diagnosis, because it’s assumed there is no hope for you. I’ve had this problem when I’ve tried to get therapy. I remember one therapist who I had seen for the intake session, who told me he needed to obtain my psychiatric records before we could proceed. The session had gone smoothly and I felt comfortable with him. A few days later I received a phone call and was told he did not treat “borderline patients” and wished me luck. So that’s the kind of thing we’re up against if we’ve had the BPD label slapped on us.

Also, as an ACON blogger who works with a lot of victims of narcissistic abuse, my BPD label sometimes makes people wary of me and they begin to doubt that my motives here are honest. At first I was reluctant to talk about my “Cluster B disorder” here, because I knew it might be a problem for some ACONs, who think borderlines are no better than narcissists. But I eventually decided that to hide it away like an embarrassing family secret would be misleading so I “came out” about having BPD (I never actually lied about it, but played it down in the beginning and rarely mentioned it). I’m glad I fessed up, but there have been a few people who left this blog after I came out about it or began to doubt my motives. So there’s that stigma and it’s very damaging.

Both C-PTSD and Borderline PD are caused by trauma. Both are complex defensive reactions against future abuse and both involve things like splitting, dissociation, psychotic episodes, self-destructiveness, wild mood swings, and behavior that appears to be narcissistic and manipulative.

The way I see it, the only real difference between C-PTSD and BPD is that the traumatic event or abuse happened at an earlier age for someone with BPD, perhaps during toddlerhood or infancy, while all forms of PTSD can happen at a later age, even adulthood. But the symptoms and defense mechanisms used to avoid further trauma are the same for both.

20 Signs of Unresolved Trauma

Here is a fascinating article about how trauma due to abuse can lead to a post-traumatic condition that resembles Borderline Personality Disorder in almost every aspect. I wonder if this could mean I don’t actually have BPD. I have a lot of these symptoms, although they’ve improved over the years. I was diagnosed with BPD twice but maybe my therapists were wrong. These are symptoms of C-PTSD (which I have seen compared with BPD which it closely mimics). I thought I had recovered from my PTSD but maybe I have not. I’m still going to assume I’m borderline for now, but this makes me wonder. Borderlines have most of these traits, including dissociation.

I am also adding this website to my blogroll because I think it could be of great help to survivors of trauma and abuse. A social worker friend of mine just told me about it. She does not think I’m borderline. Now I’m REALLY confused.

Discussing Dissociation

Unresolved Trauma

Many people enter the therapy process with minimal awareness of their trauma history.  When the trauma survivors are dissociative, they have the ability to block out an awareness of their trauma.  They may know that their family had problems, or that their family was dysfunctional, etc, but they may believe they were never abused.

child abuse child abuse (Photo credit: Southworth Sailor)

However, blocking out conscious awareness of trauma does not mean that the survivors have no effects of that trauma.  Using denial and dissociative skills does not mean that the abuse did not happen.  Denial means that the person simply is refusing to acknowledge or accept the fact that they were traumatized.  They are pretending they were not hurt, when they were actually hurt very badly.

Even if the memories of abuse are hidden from the survivor’s awareness, blocked trauma / unresolved trauma creates very noticeable and obvious symptoms that…

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