Over the past few months, I’ve been opening up more and more to professionals about my experiences and my emotions. Despite the fact that I’ve been in services for over 6 years (!), I have always been deemed as ‘difficult’ and ‘resistant to therapeutic engagement’. The reason for this isn’t that I’m rude, or that I’m lacking social skills (well, to an extent anyway), but because the emotional overflow that comes with articulating traumatic events and painful feelings is often all too much. This is one of the biggest problems with BPD: you have to talk about things to get better, but it hurts so very much to talk about it in the first instance.
I guess I’m growing up. Time is a fantastic healer, and as I’m moving further away from things that happened when I was younger, I’ve found that I’m coming to a point where I’m more ready to talk about where all these confusing emotions are coming from, and how that can help me to remain emotionally stable now. Even more so, I’ve realised that nobody is going to force me to get better. Nobody can. If I become determined in my own mind that I don’t want help from services, then I have the right to that decision no matter how costly it is to me, with the exception of being sectioned of course. But even still, nobody can force me to talk and nobody can dig up painful, razor-sharp memories for me. It’s got to come from me.
So, thank goodness, I am finally making some kind of ‘therapeutic’ progress which feels amazing. I’m getting on well with my psychiatric nurse which is a first, and we are going over more DBT (Dialectal Behavioural Therapy) skills, whilst I wait to have a place with a psychologist for more specialist and specific treatment tailored to my individual needs. And I feel better. Just by telling her things and working on them together, I’ve realised that nope, I’m not alone. These things aren’t ridiculous and they are not my fault.
The first thing that we have looked at, and I’ve considered on my own, is the cost of self-harm and other ‘coping strategies’ that actually make issues that I have a lot worse. Of course, I know that self-harm is pretty awful for you, but I had never thought about it in such a systematic way. Although difficult to talk about, it’s important to not reinforce these behaviours positively, and hence to be able to shift away from them.
I am going to discuss the generic self-destructive ‘coping strategies’ associated with BPD. Some of these things may, as you know or may be able to guess, be applicable to me, but others won’t. I want to be able to help other people with their journey with BPD as I go through mine, but also preserve my own privacy to an extent. I want this blog to be about helping and supporting other people.
Self-destructive behaviours associated with BPD:
- Dwelling over mistakes
COST = Lack of productivity, missing out on future opportunities, spiralling into depression, focussing on the problem rather than the solution, blaming yourself or others, twisting the problem out of proportion
IDEAS FOR SOLUTION = Accepting mistakes as part of the past and trying to learn from them in a productive way, apologising to others, taking time to practise self-care and look after yourself, making a plan to avoid this from happening again and to deal with any consequential problems
- Isolating yourself from others to avoid distressing situations
COST = Missing out on precious memories and happy times with family or friends, a monotonous life, reinforcing the distressing situation and thus making anxiety/panic worse, becoming more depressed as more time spent alone
IDEAS FOR SOLUTION = Dissecting why the situation is so ‘distressing’, using friends or family to support you into the situation, practising rational thinking and radical acceptance, using anxiety medication as a short term solution, not permanently writing off the situation, remaining hopeful and optimistic
- Dependency on alcohol or drugs
COSTS = Financial problems, issues with relationships and domestic problems, risk of mental health deteriorating further, addiction, violence, health problems, contracting transmitted diseases, accidents and injuries, poisoning
IDEAS FOR SOLUTION = Seeking professional help for alcohol or substance abuse, talking about the issue with family or friends, surrounding yourself with other people, turning to more ‘positive’ coping strategies such as exercise or self-care
- Becoming excessively angry at others
COSTS = Temporarily or permanently ruining relationships with other people, self-hatred, violence which could lead to problems with the police, unemployment, loneliness
IDEAS FOR SOLUTION = Removing self from the situation when you feel your emotions becoming overwhelming, explain to those around you that you struggle with anger and that sometimes you just need Time Out, using breathing techniques, exercise, rational thinking skills
- Dangerous, physically self-harming behaviour
COSTS = Life changing injuries, scars, risk of infection, disfigurement, risk of death, hospitalisation, serious and long-term physical health problems
IDEAS FOR SOLUTION = Caring for your body by practising self-care, minimising the severity of self-harm, using digression techniques to lessen the urge to hurt yourself, seek medical advice for any injuries, keep wounds clean to avoid infection, keep professionals updated on any resultant problems, using distraction techniques
- Unsafe sexual activity
COSTS = Unwanted pregnancy, infections, physical health problems, deterioration in mental health, unhealthy perception of relationships, potential violence, self-hatred
IDEAS FOR SOLUTION = Contraception, regular medical checks, discussing issues with mental health professionals, avoiding states where this is more likely to happen e.g. being intoxicated, try to practise healthy and balanced relationships
- Using food to punish or control
COSTS = Significant weight loss or gain, anemia, heart problems, chronic pain, hair loss, malnutrition, risk of early death, organ damage, dehydration, low self-esteem, loneliness, depression
IDEAS FOR SOLUTION = Reward yourself for achievement rather than punishing for failure, maintaining a balanced diet, using light exercise, avoiding counting calories, discussing why you feel the need to punish yourself
- Attempting suicide
COSTS = Death, hospitalisation, severe ongoing physical health problems, physical pain, emotional distress from family and friends, Mental Health Act Assessment, feelings of failure and continued hopelessness
IDEAS FOR SOLUTION = Don’t let it get to that point. Take your medication, attend sessions with professionals. Talk to your family, friends and the people around you. Keep them in the know. Write down how you’re feeling if you can’t tell them. Write down why you want to disappear so much, and try to rationalise it. Write down happy memories. Call a suicide hotline number. Text a friend. Get dressed in the morning. Spend time outside. Try and make plans for the future.
So, what next?
Of course, there are many other self-destructive factors that people with BPD suffer with. Every individual is different and suffer in a different way. But it’s so easy to resign yourself to a miserable and painful existence because of the fact that you may be struggling with these things, and that’s not alright. You shouldn’t have to live in misery. All too often these behaviours become comfortable. They become what we know and what we accept. They become normal. We forget the incredible long-term damage we are doing not only physically, but to relationships with others.
Recovery is a long path, but from the moment you accept that these ‘coping strategies’ are actually the enemy, the things actually hurting you, you have made incredible progress.
Hopefully I will be writing more blog posts as I go along with my BPD journey and try and make sense of DBT skills. I hope this is useful not only for those also cursed with such a problematic personality disorder, but those who struggle with emotional intolerance of any kind, or know somebody else who does.