#if it works for you: KEEP DOING IT. cbt is not inherently harmful for MANY people and it's a good and valuable tool for many

[uncanny-tranny]

I recently had to do a project in one of my psych classes, and man, I knew that CBT was used for every little thing, but seeing over and over, "do CBT! CBT is the best for every mental illness!" was so jarring. I'm absolutely biased because of my own experiences, but I just don't think it's as universal a treatment model as it's touted.

If you didn't benefit from CBT, it's not because you're lazy or didn't try hard enough or lacked intelligence or foresight into your own needs. Frankly, it's a therapy model that (I think) shouldn't be the only readily-accessible model and among the only therapy models covered by insurance. Some of us should not be treated in a CBT model and that's okay. It's not a sign of poor character or unreasonable demands, and if you don't think it's a model that works for you, then it's your right to express that!

[amphtaminedreams]

Mental Health Awareness Week: My Story

Hi to anyone who’s reading this!

My name is Lauren and this is my first personal post on my Tumblr (which I’m using because I am a granny who can’t be arsed to work out the basics of Wordpress). My intention in making this blog was ultimately to talk about mental health and fashion and things that interest me and I suppose I knew that ultimately I was going to make a post like this but I just didn’t realise it would be so soon. But then Theresa May lit up Downing Street and it was Mental Health Awareness week and Borderline Personality Disorder Awareness month and I realised, best to just get this out of the way before I can start making excuses to put it off until the end of time. It’s a hard post to make because I don’t exactly know who the audience will be; I’m writing it for the mental health community and anybody who’s interested in what Borderline Personality Disorder is/looks like but I’m also conscious of the fact that one day my family and friends and even potential employers could be reading this. How much detail am I supposed to go into? A lot of people still feel uncomfortable discussing topics like this; they start seeing you a different way when they know you suffer from a mental illness, even though you’re the same person you’ve always been. It’s also hard to know where to start when I’m talking about my mental health. I feel like other posts of a similar nature tend to have a clear start, beginning, and end. A clear cause or inciting incident, one self-explanatory, well-understood diagnosis, and a clear pathway to recovery. I don’t have a single, defining trauma I can pinpoint anything to, and I don’t think I have complex PTSD (which is often conflated with BPD but as I understand it, not always the same thing). I have a family history of mental illness and a series of less significant events that in hindsight might have affected me more than I originally thought, but until I became able to think about concepts such as “mental health” and self-image and relationships in the abstract, I believed that I generally had a pretty happy childhood. My family did their very best and they loved me and we always had a roof over our heads and food on our plates. When I did start to conceptualise my mental health, I kind of thought of it as a wave of depression and insecurities and anxieties that hit me when I was in my early teens. I think this is the same for a lot of people. Only when I got a diagnosis of Borderline Personality Disorder (which I will shorten to BPD for the purpose of making this easier to read, lol!) in October 2018 did I question that.

I’ve done a lot of questioning since I got the diagnosis, the same kind of questions that make this post hard to write. Am I really that ill? Am I not just being dramatic? Do I have any right to feel like this given the privilege I have? When in reality, this deep-rooted gut instinct to doubt who you are and what you have a right to feel is an intrinsic part of BPD.

There are 9 key symptoms involved in the disorder, 5 of which must be experienced to a degree that is severe enough to affect your day to day functioning in order to receive a diagnosis. My formal assessment which took place during my stay at an inpatient psychiatric ward in October 2018 revealed I was just on the cusp of receiving a diagnosis; in 5 of the 9 categories I scored highly enough that the symptom was impairing my ability to function, thus I only just qualified (lucky me!). That’s what mental illness is really, a collection of ingrained and/or inherited behaviours that are inhibiting one’s day to day life. With regards to BPD, these 9 behaviours or symptoms are as follows:

1. Fear of abandonment (check).

2. Unstable relationships.

3. Unclear or shifting self-image (check).

4. Impulsive, self-destructive behaviours (check).

5. Self-harm (check). 

6. Extreme emotional swings (check).

7. Explosive anger.

8. Dissociative experiences (check).

9. Chronic feelings of emptiness (check, check, CHECK).

See, when the diagnosis was first suggested to me informally by a community mental health nurse in June of 2018, I was a bit like…what?! That can’t be me! I don’t have outbursts (it’s okay if you do and you’re working on it)! I don’t scream and throw things (again, okay if you do and are working on it)! And I’m definitely not manipulative (any person can be manipulative so I don’t even know where this one comes from)! That was, like, all I knew about BPD. Stereotypes. Think Glenn Close in Fatal Attraction type bullshit, we’re talking the woman that coined the phrase bunny boiler. I didn’t know that BPD can present in a million different ways, based on the person who’s suffering with it, because I thought BPD was the person. The widespread consensus on BPD isn’t the most humanising. So I hope me explaining how it’s affected my life and the way its presented itself over the years helps in turning the tide, which so many amazing people have already begun to do by sharing their stories. My aim is to do the same.

I’ve had a lot of time to think about the areas in which BPD has affected my life since my formal assessment, in which I felt I learnt a lot more about the disorder. In particular, the idea that I was always this happy child that got hit by a wave of inexplicable, crippling depression once I hit my teenage years. I remember during the assessment, the doctor asking me to talk about my early relationships and it kind of struck me at that moment that I’d been going through this pattern of switching between extreme attachment towards versus extreme devaluation of my relationships with the closest people in my life for as long as I could remember. My first real best friend of several years basically stopped speaking to me (and in hindsight, I do not blame her, lmao!) when we were about 12 because I can only imagine she was sick of me either picking a fight or desperately seeking her reassurance every time she dared to hang out with another friend. I remembered how it felt when she did choose to spend time with somebody else rather than me: “oh my god, she likes them more, she finds me boring, she hates me and she doesn’t want to be friends with me anymore! Everything’s over! I’ll never find anyone who loves me like she does because why would they? I can’t go on with my life until I know that she isn’t going to leave me!”. I think at that age, everyone has that shrill inner voice that doesn’t exactly consider logic or react in the most sensible way, but instead of my shrill inner voice going away, it just faded to more of a constantly niggling monotone that continued to affect the way I behaved around other people for years to come. This was just one of the signs that things weren’t as they should be from an early age. I think I was around 13 when the Child Adolescent Mental Health Services (otherwise known as the dreaded CAMHS), whom my parents had initially got me referred to for sleeping problems, diagnosed me with generalised anxiety and social phobia. Social phobia, despite this being its DSM name, is more commonly known as social anxiety. This came about after I had undergone successful CBT for said sleeping problems and thought I’d just drop it in, as you do, that basically, every social interaction felt like I was putting on a desperate show to keep the few remaining people left in the theatre from walking out. I told them that school was emotionally exhausting me. Whilst after the first couple of rocky years of transitioning from primary to secondary school I had developed a close group of friends, I still felt like aside from the closet few of them, absolutely nobody liked me. That was definitely true of some people, but likely not to the extent I envisioned it. I had come to feel, I suspect due to a combination of genes and a few environmental factors, like I was inherently unloveable and annoying, and even though I’m in a good place right now, these are things I continue to struggle with. When you’ve believed these things for so long, to act according to them is second nature.

The thing about BPD is that it’s hard to determine what is a co-morbidity and what is part of The Disorder™. I’m still not quite sure whether my social anxiety was in and of its own issue or if it was driven by the borderline symptom of fearing abandonment. Even recently, during a period of relative stability, I went back to my GP about dysmorphic thoughts concerning my body and appearance as I believe they go beyond the threshold of what is to be expected as part the unstable self-image facet of BPD. Whilst I can accept, for example, that the self-harming and binge eating I began indulging in around the same time I received my anxiety diagnoses were my way of coping with the mood swings and chronic feelings of emptiness I was also experiencing (get me working in the checklist of symptoms here, I imagine this is how film writers feel when they namedrop the movie in the characters’ dialogue), I have a feeling the image issues I have would exist regardless of the influence of the unstable self-image part of BPD. I mean, would perfectionism alone take me to the extremes of punishing myself for missing out on all A*s by an A or two at GCSE and A-level, forcing myself to do a degree I had no particular interest in just because the university was in the single digits in the international league tables, or at one point eating only apples for 10 days until I could barely stand up because I wanted to look like those girls on 2013 emo black and white Tumblr? Probably not. But you don’t need to have an unstable self-image to latch onto the idea that only the very best will do in today’s world, lol (typed with a totally straight face)! Yeah, if the niche that is socialist twitter has taught me anything it’s that, that’s like, late-stage capitalism for you. It’s hard to look at myself and know what is a good quality, or just a character trait, and what is disordered. I think when you call a mental illness a personality disorder, the people who are labelled with it are inevitably going to have that problem.

Surprising absolutely no-one, trying to fit into these ideals I had created and emotionally detaching myself from my friends and family didn’t do any good for my wellbeing. I gave into self-destructive impulses with increased frequency and as I went into sixth form and drifted even further away from the few people I did feel close to, I began to experience derealisation (not depersonalisation, though this is something a lot of people with BPD do experience). This would come under the dissociative experiences symptom of the BPD. It was like my eyes were glass windows and I was just watching life unfold in front of me from the other side. It’s not as if I didn’t have control of my actions, I did, I threw myself into revision, but it all just felt slightly unreal, like I was going through the motions, almost robotically, detached from everyone around me. Everything was muted. Generally, I find that my mood swings between 5 different states: lethargic depression, extreme distress, anxious irritability, an almost mania like sense of confidence and purpose, and a more pleasant calmness. The best way to explain how I experience this switch is that I can almost physically feel the gear of my brain shift, with this change of energy then flowing down to the rest of my body. My thoughts take on a different tone of voice, my body feels heavier, or if I’m going up, it’s like I can feel electricity running and crackling through me. It can happen in a split second, and it can be random, though often it’s triggered by something as small as a phone call or how much I’ve eaten. If multiple plans fall apart at the same time, it can be enough to make me angry at the world and distrustful of everyone in my life, closed off and weighed down. However, back when I was experiencing this derealisation, I remember only really switching back and forth between feeling numb and feeling passively suicidal; I feel like I lost my teenage years to this big, grey cloud of meh-ness that fogged up my brain and obfuscated my ability to regularly feel any positive emotion. To use a cliche, there was this void inside of me that nothing would fill and I had learnt that trying to use relationships to do this was dangerous for me because without sounding melodramatic, it hurt too much when I felt they weren’t reciprocating my love (what a John Green line, lmao).

My fear that people didn’t like me morphed into paranoia that even the people I was supposed to be friends with were ridiculing me the second I left the room; please don’t laugh when I say my greatest pleasure during this time was to go home at lunchtime to avoid having to spend an hour sat with them so I could eat Dairy Milk Oreo, nap and listen to The Neighbourhood (careful, don’t cut yourself on that edge!). I put on a lot of weight due to binge eating, would often leave sixth form early or skip it altogether, and saw my GP, who reestablished my anxiety diagnoses now with an exotic side order of depression. When it comes to NHS services where I live, I’ve kind of won the postcode lottery. There’s a large, conservative elderly population which I’m assuming is the reason our area receives a lot more funding than other, debatably more deserving other areas, and this meant that along with prescribing me the first of many SSRIs I was to try, I was also referred back to CAMHS. I’d been discharged from them about 2 years prior, and what had back then been about a 1 or 2-month waiting list to be seen had doubled in longevity since. I say I won the postcode lottery because, in a lot of places, it’s not uncommon for people to still be waiting to be seen by their local mental health team over a year after they’re first referred. Even so, the help I was offered was very minimal; I met a counsellor once every couple of months that didn’t really specialise in any particular kind of therapy and would kind of just talk at me for the hour I saw her. This was in spite of me expressing suicidal feelings and regularly self-harming.

That being said, by the time I left sixth form, I had finally found an SSRI that worked to blunt the intensity of my social anxiety. I was attending my “perfect” university with my “perfect” grades and (prepare yourself for the twist of the century) I finally managed to get my lazy arse to the gym, and get to that “perfect” weight. I was forming emotional connections with people for the first time in years. On a shallow level, in my first year of uni, things were finally beginning to look up, and yet I was experiencing worse mood swings than ever, becoming more dependent on drugs and alcohol to function through these, and throwing myself into intense friendships where anything less than utmost enthusiasm on the other end of the relationship would send me back into that “oh my god, I’ll never make another friend in my life, I’ll always be alone, I can’t deal with this, the only way to deal with this pain is to end it!” mode. I don’t know why things got so drastic so suddenly. Maybe it was being away from my parents, or maybe it’s just that late teens/early twenties are a time when negative emotions do tend to get more serious after being repressed for years and consequently accumulating. The whole having to be the smartest person in the room to maintain a sense of self shtick was also taking a bit of a hit because university is bloody hard and everyone’s bloody smart and bloody passionate and here I was not even understanding what the assigned reading was trying to say let alone having any brilliant ideas about it to contribute; I was so quiet in one of my seminar groups the lecturer forgot I existed in a class with a grand total of 9 students. Big fish in a little pond to little fish in a big pond syndrome or maybe just more simply put, imposter syndrome, is a real thing and when you struggle with your identity anyway, it’s enough to throw you off completely. I finished that year with a first but I told myself it probably wouldn’t happen again. A couple of days later, feeling shit and overwhelmed, I did what I’d taken to doing to manage my emotions, and got high. The delusional episode ended me up in A&E for self-harm, and when they let me go the next day, I travelled back to my family home and pretended nothing was wrong.

The whole “act like everything’s fine” approach doesn’t work in the long term. 10/10 would not recommend. Without my parents around, when I went back to uni in September, everything fell apart again. I was using drugs every day, either not eating at all or binge eating, self-harming, binge drinking regularly, skipping all my lectures. Honestly, when I think back to that time it’s like I’m watching myself from outside my body. I was feeling very done with the dumpster fire (how very American of me) that was my brain. I was done with the constant 100mph up and down internal monologue. I was done with trying to cope and to hold myself together. I intentionally overdosed multiple times and after one sent me to A&E, my dad brought me home from university. It was a horrible shock for my parents: they knew I was a worrier that could be a little closed off and miserable sometimes, and they were the ones who’d first taken me to CAMHS when I was younger, but they’d struggled with that, and so from then on I’d tried to keep my issues to myself. To be honest, I don’t blame them at all for not realising anything was drastically wrong. I did a pretty good job of hiding my problems; everyone had their own things to deal with and so I became quite adept at internalising my feelings and acting “inwards” rather than outwards. It was also definitely a case of things escalating whilst I was away. With all this in mind, the overdose kind of came out of nowhere for them, but I was so detached from reality I didn’t even consider this at the time. Thankfully, I can’t really remember how they actually reacted either. Benzodiazepines do that to you, a little tidbit of information that all these teen rappers and social media personalities hyping up Xanax fail to mention. I think my dad made the decision to bring me home rather than have me stay in hospital in London, as was offered, because he thought that would be better for me. However, a few days later, after numerous, distressing visits from the crisis team (another name that will be regrettably familiar to anyone who has experienced severe mental health problems before), where I can only assume a lack of time and recourses on their part forced me to repeat what had happened over and over again to the revolving door of staff members, I took another overdose. I had become paranoid that they were out to get me and falsely believed that I was too much of a burden on my family, who were having to take time off work to look after me. This time from A&E, I went on to stay in a psychiatric ward where I was given the formal diagnosis of Borderline Personality Disorder I mentioned earlier. And it’s here that my life changed forever, I believe for the better.

It changed my life for many reasons. Firstly, it was incredibly validating. To learn that I didn’t have a plethora of different problems but rather one problem, the different facets of which can present themselves in many different ways and affect multiple areas of your life, was so, so reassuring. It not only gave me a clear treatment path but helped me to understand that there was a reason all this was happening. Additionally, the events forced me to open up to my parents and for them to grasp the severity of the situation. After all these years, I finally felt like I had a support system. My parents had always been there before but I had emotionally distanced myself from everyone, and being a “typical teenager” I believed they didn’t understand me (get that angst). I think in retrospect they didn’t understand me because I wasn’t using the right words. I didn’t want to sound dramatic so whenever I spoke to either of my parents about how I felt, I downplayed it a lot. My mum, who works so incredibly hard and has a lot on her plate herself, had a tough upbringing so her approach to me being miserable was pretty much telling me to be grateful for what I had. Had she known what I was really getting at, I know that she wouldn’t have reacted like this to what I was saying. The minute I got my diagnosis, she went out and bought every (mildly offensively titled) book on how to support someone with BPD out there and I learnt today has even been trying to bring an emphasis on mental health into her workplace! She is a wonderful person.

With all this being said, my main piece of advice for other people who are newly diagnosed with BPD or just suffering from any kind of mental health condition is to be brutally honest with the trusted people around you about what you’re dealing with. It will be uncomfortable but I can promise it’ll be worth it. With something like BPD, having a support system who know exactly what you’re dealing with, minus the vagueness and the bullshit, is so, so important. I say this because, despite Theresa’s green lights, neither she nor her party are doing much in the way of providing the funding for professional help. When I first came out of hospital, I had a lot of nights where I felt incredibly depressed, almost as depressed as I did before I went in. Prior to my family knowing about my BPD diagnosis, I would have dealt with these feelings in unhealthy ways but this time, I could go to my mum and stay with her and just cry it out until the feeling passed. That is also a useful sentiment to remember, that the feelings will pass. It’s in the nature of BPD to swing around, when I’m not experiencing a period of depression, and that’s something I find it helpful to remember. I personally really like the Youper app to track my moods because when I do get suicidal, feel anxious or wired, I have something to look at objectively to remind myself that I did feel like this before, in fact, I felt like this yesterday, but a few hours later I told the app I felt okay again. It also helps you to dissect your irrational thought processes and identify “thinking traps”. Meditation, ASMR and CBD are big parts of my life and stability, though I would recommend doing some research into the latter before trying it yourself.

On a less subjective, more physiological level, I notice that my medication really aids my emotional stability; when I have been off it, my mood swings are a lot more intense. So whilst medication isn’t for everyone, it can be something to consider talking to your GP about to see if it could be beneficial for you. Another help is the DBT skills course I completed in March, DBT being the abbreviation of dialectical behavioural therapy, the treatment specifically developed for BPD by Marsha Linehan. If you have time, she’s a great person to do some research into. She herself was diagnosed with what doctors called an “incurable” case of BPD yet she’s gone on to do the most incredible things and help so many people also suffering from the disorder. Not only did DBT provide me with a skill set of more functional coping mechanisms for both interpersonal insecurities and individual struggles, but I liked the fact that once a week I got to be with a group of people who really understood what I’m dealing with and didn’t judge. Even if you can’t find a DBT group, it’s worth checking to see if there are any mental health peer support groups in your area for this reason. I found that being around people who are dealing with similar issues helped me to see my own struggles more objectively; it reminds you that what you’re experiencing is not about you personally and that whilst you may feel isolated, you’re not. The world hasn’t got it out for you. It’s a condition that many people experience. In terms of the feelings of emptiness BPD causes, I have found that since my diagnosis, I’ve actually had more of a sense of purpose in life. On a practical level, having therapy along with a year out of uni and the presence of a constant support system has had me time to get back into writing properly. What I’ve found to be even more rewarding, however, is my participation in the online mental health community.

Something I wasn’t made aware of prior to my diagnosis was the amount of stigma there is still towards mental health issues, Borderline Personality Disorder especially. It really is one of the most demonised mental health issues in and outside of the healthcare system and that’s a hard fact to learn, because it’s a difficult enough condition to learn to manage already without knowing that there are people out there who think you’re a monster for it and are going to judge everything you do through a certain lens. Whilst we are a lot more accepting as a society of conditions like depression and anxiety, conditions such as bipolar, schizophrenia and personality disorders are still greatly misunderstood by wider society who have largely taken their understandings of these illnesses from ill-informed media portrayals and shallow, surface-level observations of a sufferer’s behaviour. I doubt the name “personality disorder” helps matters; it’s hardly the most flattering description of what we’re dealing with I’ve ever heard. I’ve found that even mental health professionals and other mental illness sufferers have a negative bias towards BPD. There’s a widespread view that we are dangerous, manipulative individuals who choose to be difficult and act erratically, that our behaviour is not “organic” like that produced by other mental health problems. I have no idea where the latter assumption comes from. Most experts on the condition tend to agree that the mood swings, impulsive, destructive behaviour, and irrational thinking originate in the hypothalamus and come from a faulty fight-flight response or other atypical brain structures; in other words, BPD has a biological basis. Whilst I agree that we can learn to change our coping mechanisms, the idea that they are as a result of anything other than pure desperation and mental anguish is incredibly puzzling and dehumanising. Simply looking the causes of the condition up online or doing a small amount of research from a credible source debunks all the common BPD stereotypes, yet people like to speak about it as if they know everything about the condition just because they’ve heard a few horror stories. There are nasty people in the world. Some of them have BPD, but that doesn’t mean everyone with BPD is a nasty person, and the bottom line is that most people suffering from Borderline Personality Disorder will hurt themselves before they hurt anyone else. We are so hypersensitive to any changes in our relationships in the first place that the last thing we want to do is damage them. When we say something feels like the end of the world, that’s because the emotional dysregulation part of BPD really makes it feel like it is. We’re not being dramatic or trying to get your attention. In fact, I can say for certain that despite feeling this way on a daily basis for about 7 years, I rarely actually voiced the sentiment. I still don’t. But I should be able to. To give the example of one person suffering from physical illness and one suffering from a mental illness, where both publicly talk about the pain they’re experiencing, why is only the latter of the two called an attention seeker? If the former tweeted about how much pain they were in, nobody would bat an eyelid. Why is this? When so many people experience mental health problems? When the gender who are typically expected by society to repress their feelings accounted for over 70% of suicide victims in the UK last year? It’s clear that keeping our feelings to ourselves and suffering in silence doesn’t do us any good, so why are so many so eager for us to continue doing so? I think being open about mental health simply needs to be normalised, and that once it is, hopefully, this sentiment will die out. I find that by being open about my mental health on social media (still quite selectively, I must admit! I can’t see myself making a post about BPD on Facebook any time soon!) has given me a sense of purpose because I do feel like I’m helping to normalise this kind of honesty. With regards to the stigma that surrounds BPD specifically, I feel that my presence online and my support of others helps to show that we’re just human beings who are struggling, not the awful mythos that surrounds us.

To finish, one of my main goals in my recovery is to be more compassionate to myself. BPD is a hard enough diagnosis to have without constantly internally doubting and questioning it. I find that as the months go by, I am feeling more and more stable, and this leads me to question if I was ever sick, especially since I only displayed 5/9 of the borderline traits in the first place, which meant that I only just met the diagnostic criteria. I don’t have psychotic rage or complete blackouts and tend to act inwards rather than outwards. I am what is considered within the mental health community to be a “quiet” borderline. I know theoretically that this doesn’t make my condition any less valid, but for this reason, part of me fears moving towards being “well”. Because if I’m well, then I feel like I’ve lost part of an already fragile identity. Of course, I’d rather not have BPD. But because I’ve been expressing symptoms for so long, I worry what’s left of me without it. At the same time, I fear going back to a place where my BPD is so severe that I have to go back to hospital. So really, it’s like you’re stuck between a rock and a hard place. It’s a double-edged sword. Is that enough cliches? The thing that I wish more people could understand is that mental illness in itself is traumatic and that even when you’ve moved on, what you experienced will always be a part of you. You still need that support. I’m not going to lie, resisting the urge to indulge in old coping mechanisms and habits is hard, and whilst the sense of pride I feel every time I don’t, or every time I use responsibly something I’m used to abusing is rewarding, there are days where waiting for the need to use them to pass is very long and very hard. I need to stop telling myself that just because I am feeling better than I did, I don’t deserve that support anymore. I do. I still deserve compassion. I still deserve a safety net. I still deserve a sense of understanding from the people around me. I deserve all of it, as does everyone else. I also deserve to be proud of how far I’ve come already instead of berating myself for not having come far enough. As I write this I haven’t self-harmed in 169 days, have been at my current job for coming up to 6 months, have an interview for a psychology course at the uni I came to love in a week’s time. I’m finally somewhat healthily managing my weight for the first time in years! I have also decided that once I do return to university, my reason for being there is not contingent on me maintaining firsts; my mental health, and what I do with the degree is much more important. I would ultimately like to go into clinical psychology and do as much as I can in that area to help people going through similar issues. With the current state of the mental health (and healthcare, in general) system in the UK, it’s definitely easy to get disheartened that the services it provides will never be adequate due to funding issues. However, in the meantime, I think the more of us with lived experience that can get into mental health care, the better the service that eventually is provided can be. Every week I’m thinking of new things I’d like to research once I have the footing, epigenetic and intergenerational trauma and the use of psychedelics and the benefit of peer support groups. There’s always a way to turn the negative into a positive, even if it takes time to learn how to do so and I think after all these years, I’m finally getting the hang of it. If my brain has been a “dumpster fire” for the last however many years, then I don’t want to let the ashes go to waste. I’m going to make them into some really morbid confetti! As I sit here writing this, I can firmly say I am happier than I’ve ever been. Game of Thrones is pissing me off (might do a post how identity and attachment issues lead to a correlation between BPD and obsessive character fixations at some point because BOY has that been driven home to me this week!) but tomorrow I’m going to an ABBA party with uni friends, Yvie Oddly is smashing drag race, and my cat is lying next to me purring. It gets better. The hard days become less frequent and they get easier to cope with too; you can learn to ride the waves and find reasons to continue doing so, regardless of how tiring it might be sometimes.

My pipe dream for this time next year is that we have people in government who really care about the invisibly ill of this country. That Downing Street can do more than turn green. I hope that we get to see more realistic and sympathetic portrayals of BPD in the media that draw attention to the issue without glamourising or romanticising it and that we get more portrayals of queer, disabled and POC experiences of mental illness too as it’s not just skinny caucasian girls that deal with this shit! Most importantly, I also hope that I continue to flourish, and wish the same for everyone struggling with mental illness/any kind of turmoil. Anybody who reads this ’til the end, wow! Thank you! It was a bit of an essay but what do you expect coming from an ex-history student and wannabe author, lol! Please let me know if there is something you’d like to see me post about on this Tumblr, such as any specific BPD symptoms and how they might present, how I deal with social anxiety and body image, or even anything completed unrelated to mental health! God knows I love the sound of my own…prose? Is that the right word to use?

I hope you enjoyed reading!

Lauren x

[eroticcannibal]

Please stop telling people to “just do CBT”

CBT, like medication, can be valuable and life-changing to an individual. And like medication, it can also be devastating if it’s not the right treatment to you. It seems a lot of people seem to think that because it’s accessible and you can get free PDFs online, that it’s safe to just hop on any post and tell complete strangers to try it.

That is dangerous and irresponsible behavior. 

CBT is suited to those who are having trouble specifically with their thought patterns around things that do not justify those kinds of thought patterns, to the point where it impacts their life. CBT is not suited to just anyone having problems with their mood or anxiety or their thought patterns. And yet it is frequently pushed on people by strangers, by doctors (because it is relatively quick and cheap, thanks capitalism!), even forced on patients who aren’t suited to the treatment, causing worsening situations, even trauma. 

I can’t link to any of the wonderful conversations I’ve witnessed in private groups by those harmed by CBT, unfortunately. To summarise, I have seen fair comparisons to ABA, gaslighting, victim blaming, brainwashing, neglectful parenting that dismisses the feelings of the child (have fun with that one if that’s the source of your problems), grooming the patient to be receptive to coercion and institutional abuses, But from my own perspective as someone who had to stop CBT before I killed myself as a result of it, HERE is some highlights of the more damaging parts of a typical CBT workbook (and there's some great contributions in the notes). For those with issues caused by abuse or oppression or other situational factors, CBT becomes gaslighting. CBT is routinely weaponized against the oppressed and the abused, when our understandable reactions make others uncomfortable. CBT is used to make us into “good victims”, who don’t hurt or cry or complain or blame anyone. CBT is a therapy that can sever the connection between a person and themselves, it can be compassionless and cold. Not to mention that CBT inherently shifts the blame for feelings and behaviors entirely onto the individual rather than acknowledging the true role of triggers. 

In addition to this, CBT and how it is implemented is not only criticized by those harmed directly by it, but by professionals too. 

“this model appears to confuse the symptoms (i.e., negative self concepts) of depression with its cognitive causes...  In many cases, clients' appraisals and reports of their negative or distressful experiences are quite rational, realistic, and accurate. For example, their experiences of sexual or physical abuse at the hands of another or the tragedies of their loved ones have left enormous scars in their life. In such circumstances, cognitive-restructuring exercises, with their emphasis on reframing reality and not on changing it, do not deal with the true problem...  research has shown that positive self-evaluations may be dysfunctional and maladaptive...  the self-focused cognitive model puts a strong emphasis on examining the association between negative thoughts and mental dysfunction, but it has not answered the question of why individuals choose to focus on their negative attributes when the positive evaluation of the self is more accurate. “

“ Opponents have frequently argued that the approach is too mechanistic and fails to address the concerns of the “whole” patient...   the specific cognitive components of CBT often fail to outperform “stripped-down” versions of the treatment that contain only the more basic behavioral strategies... patients with major depression improved just as much following a treatment that contained only the behavioral strategies and explicitly excluded techniques designed to directly modify distorted cognitions... “

“Some critics argue that because CBT only addresses current problems and focuses on specific issues, it does not address the possible underlying causes of mental health conditions, such as an unhappy childhood...  CBT focuses on the individual’s capacity to change themselves (their thoughts, feelings and behaviours), and does not address wider problems in systems or families that often have a significant impact on an individual’s health and wellbeing. “

“ Seek a therapy referral on the NHS today, and you’re much more likely to end up, not in anything resembling psychoanalysis, but in a short series of highly structured meetings with a CBT practitioner, or perhaps learning methods to interrupt your “catastrophising” thinking via a PowerPoint presentation, or online...   CBT doesn’t exactly claim that happiness is easy, but it does imply that it’s relatively simple: your distress is caused by your irrational beliefs, and it’s within your power to seize hold of those beliefs and change them...    Our conscious minds are tiny iceberg-tips on the dark ocean of the unconscious – and you can’t truly explore that ocean by means of CBT’s simple, standardised, science-tested steps...  Examining scores of earlier experimental trials, two researchers from Norway concluded that its effect size – a technical measure of its usefulness – had fallen by half since 1977...  For the most severely depressed, it concluded, 18 months of analysis worked far better – and with much longer-lasting effects – than “treatment as usual” on the NHS, which included some CBT. Two years after the various treatments ended, 44% of analysis patients no longer met the criteria for major depression, compared to one-tenth of the others. Around the same time, the Swedish press reported a finding from government auditors there: that a multimillion pound scheme to reorient mental healthcare towards CBT had proved completely ineffective in meeting its goals...

 A few years ago, after CBT had started to dominate taxpayer-funded therapy in Britain, a woman I’ll call Rachel, from Oxfordshire, sought therapy on the NHS for depression, following the birth of her first child. She was sent first to sit through a group PowerPoint presentation, promising five steps to “improve your mood”; then she received CBT from a therapist and, in between sessions, via computer. “I don’t think anything has ever made me feel as lonely and isolated as having a computer program ask me how I felt on a scale of one to five, and – after I’d clicked the sad emoticon on the screen – telling me it was ‘sorry to hear that’ in a prerecorded voice,” Rachel recalled. Completing CBT worksheets under a human therapist’s guidance wasn’t much better. “With postnatal depression,” she said, “you’ve gone from a situation in which you’ve been working, earning your own money, doing interesting things – and suddenly you’re at home on your own, mostly covered in sick, with no adult to talk to.” What she needed, she sees now, was real connection: that fundamental if hard-to-express sense of being held in the mind of another person, even if only for a short period each week.“I may be mentally ill,” Rachel said, “but I do know that a computer does not feel bad for me.”...    

In the NHS study conducted at the Tavistock clinic last year, chronically depressed patients receiving psychoanalytic therapy stood a 40% better chance of going into partial remission, during every six-month period of the research, than those receiving other treatments...  Alongside this growing body of evidence, scholars have begun to ask pointed questions about the studies that first fuelled CBT’s ascendancy. In a provocative 2004 paper, the Atlanta-based psychologist Drew Westen and his colleagues showed how researchers – motivated by the desire for an experiment with clearly interpretable results – had often excluded up to two-thirds of potential participants, typically because they had multiple psychological problems...  Moreover, some studies have sometimes seemed to unfairly stack the deck, as when CBT has been compared with “psychodynamic therapy” delivered by graduate students who’d received only a few days’ cursory training in it, from other students...  But the most incendiary charge against cognitive approaches, from the torchbearers of psychoanalysis, is that they might actually make things worse: that finding ways to manage your depressed or anxious thoughts, for example, may simply postpone the point at which you’re driven to take the plunge into self-understanding and lasting change. CBT’s implied promise is that there’s a relatively simple, step-by-step way to gain mastery over suffering. But perhaps there’s more to be gained from acknowledging how little control – over our lives, our emotions, and other people’s actions – we really have?...        

Many neuroscience experiments have indicated that the brain processes information much faster than conscious awareness can keep track of it, so that countless mental operations run, in the neuroscientist David Eagleman’s phrase, “under the hood” – unseen by the conscious mind in the driving-seat. For that reason, as Louis Cozolino writes in Why Therapy Works, “by the time we become consciously aware of an experience, it has already been processed many times, activated memories, and initiated complex patterns of behaviour.”...  This doesn’t mesh well with a basic assumption of CBT – that, with training, we can learn to catch most of our unhelpful mental responses in the act. Rather, it seems to confirm the psychoanalytic intuition that the unconscious is huge, and largely in control; and that we live, unavoidably, through lenses created in the past, which we can only hope to modify partially, slowly and with great effort.  “

“ after completing low-intensity CBT, more than one in two service users had relapsed within 12 months.”

“ the overwhelming majority of CBT still operates through Becksian principles of normalisation, fitting a governmental agenda of producing good, quiet, working subjects who contribute to the economy and shut up. “

“To make this analysis, let’s imagine you are a therapist who is given the task of providing therapy for Ariel Castro (the recent accused kidnapper and rapist) to help him deal with suicidal thoughts over being universally hated and most likely condemned to a life sentence or the death penalty. Now think about the absurdity of doing CBT in this situation; that is, analyzing his negative thought patterns to help him deal with his one-sided thinking so he can better adjust himself to his (not so nice) life conditions.

Even better, imagine you’re given the task of providing therapy for Dr. Joseph Biederman (the key promoter of children’s Bipolar diagnoses) who perhaps is dealing with a severe depression related to negative public opinion regarding the enormous damage his work has done to tens of thousands of children (unfortunately his depression is a made-up scenario). Again you have the assigned responsibility to use CBT to help him see beyond the “negatives” in his thought patterns to find the “positives” in his career in order to help relieve his depression so he can get on with his work with great enthusiasm.

And even more controversial, let’s say you have the task of providing therapy using CBT for President George Bush several months after he launched the Iraq war; imagine for a moment that he has become quite depressed related to the growing mass demonstrations and the grief displayed by the parents of dead American soldiers coming home in coffins on a daily basis. Your job is to help him overcome his depression so he can get back to being The Commander In Chief...

CBT, being part of the “idealist” school of thought, tends to sever the relationship between the specific nature of the material conditions in the environment that gives rise to a person’s thoughts, and leaves it up to the interpretation of the listener (often a therapist) to determine whether or not the environmental source of those thoughts was actually traumatic or oppressive or more positive and humane. “

[Let me be clear, this is not me saying that CBT is bad, should never be used, or that it can’t be helpful to you. If it works for you, use it. It is the attitude that damn near everyone has, laypeople and professionals alike, that it’s a magic fix it that works for everyone, that I am challenging here. I’ve had issues with professionals not believing me recently when I expressed that I was unwilling to go through CBT again because it is a danger to me, because “oh it’s just changing how you think, that can’t be dangerous!”. Recommending particular treatments without a complete understanding of someone’s situation and without the proper clinical knowledge is dangerous, and when it comes to CBT it happens all the time. Recommending CBT without considering situational factors is dangerous, and it happens all the time.]

[briidunviing-a]

[ May is BPD ( Borderline Personality Disorder ) awareness month, & I wanted to drop this here, for my followers — & whole tumblr — to see. Why am I posting this ( again ), you might ask ? Because yes, I have BPD, & BPD awareness is close to my heart. I’ve had it for at least 10 years in various levels of severity. BPD isn’t the only personality disorder nor mental disorder I have either, & I’m not scared to admit it.

As I said, BPD awareness is important to me. I see myself as an unaffiliated BPD advocate — I educate people on BPD matters, I defend & support fellow survivors. I try to make sure I tell to every single person I plan to become a closer friends with that I have this disorder, & ask them to try to understand me the best they can if my emotions get the best of me. Hell, even I sometimes don’t understand myself. Because of this ( or these ) disorders I have always been more or less misunderstood, & I have never really “fit the norm” how people should behave. I just didn’t understand how emotions work, like many other BPD survivors. I didn’t know how to voice my emotions out in other way than anger or over-reacting, that stems from neglect & trauma I had to endure ever since I was a toddler — that is how I learned to survive in the middle of abuse, that is how I learned to defend myself — by attacking back when I feel threatened, like an abused dog. I am not saying this as an “understand me because I am a special snowflake”, no, everyone should try to understand  each other regardless.

How can you become better at understanding BPD survivors ? By listening. By asking us questions & not second guessing. I dare to say, we survivors actually like to enlighten our disorder to those who are curious & want to  learn, to make people try to understand us better. Educate yourself on the subject — if you have a friend, a family member or anyone close to you that suffers from BPD, or, educate yourself even if you don’t, the more knowledge the better. Knowledge counters stigmas.

Some people are confused what ‘personality disorder’ actually means. In short, it’s as simple as this: personality disorders are disordered  versions of normal & common personality traits. Most people meet at least some kind of symptoms of any personality disorder at healthy levels ( because many traits are normal ), but when these traits become overwhelming & severely disturb one’s functionality in life, then it becomes a problem – a disorder. If you meet the symptoms it doesn’t necessarily mean you actually have a disorder. Many of these traits are fine at healthy levels, but the keyword is “overwhelming” when figuring out if any of the traits are literally disordered, & meet personality disorder criteria. For example, fear of abandonment. I dare to say that nobody wants to be completely alone, humans are social creatures, & the fear of losing someone we care about is completely normal — but when you obsess, get excessively jealous, possessive, & use hundreds worth of money in a month on someone to bribe them so they won’t leave you, that’s when it becomes — you guessed it — overwhelming.

Now to the stigmas. I’m tired of people stigmatizing this disorder, & I want to debunk the following stigmas from a fellow BPD survivor’s perspective. Sometimes we stigmatize without even realizing we’re doing it, which we should try our best to break free from. Stigma 1: We’re not selfish. Being selfish isn’t an inherently evil thing — sometimes it’s good to be healthily selfish, to put yourself first & take care of yourself. I, & many other BPD survivors, have too many things we need to deal with every day, so we might not be the best people to put other people’s needs first as well as someone that isn’t dealing with extreme mood swings that can last from literally 15 seconds to couple of hours. We do care about you, we promise. We just sometimes don’t have the strength to carry both of our burdens. We won’t & shouldn’t sacrifice ourselves, sabotage our own mental well-being, & set ourselves on fire so you’ll stay warm — that is called healthy selfishness. Stigma 2: We’re not manipulative. We’re afraid you’ll abandon us in a blink of an eye, throwing us away like we’re trash, just like we feel everyone else in our lives have. We just don’t know how to voice our excessively strong emotions right without sounding hostile or pushy. We’re not down-right abusive & evil, we don’t mean to be abusive & lash out at you, but what can we do when we’re on the edge all the time, scared, when we’re constantly being tortured by our own minds ? What else can we do than scream from pain ( sometimes unfortunately at you ), if we simply don’t have any other way to cope ? Stigma 3: We’re not attention seekers. Once again, we just might not know how to voice our emotions out early enough before we’ve bottled everything up, then everything just explodes because we become so overwhelmed, & it seems like we’re making the situation a horrible shit storm of drama. Due to the abuse we had suffer, we don’t feel like we’re anything, our self-esteem is extremely low, we just need someone to love us, we crave the validation we were deprived of before. We’re desperately crying out for help, unfortunately most of the time in a very inappropriate & overly dramatic way. Stigma 4: We’re not treatment resistant — from a personal perspective: I thought I was, but my medications are set & suit me — actually I feel so well I’m working on weaning myself off of them. I attend CBT trauma therapy, & have for 2.5 years, & it helps so much. I do not abuse alcohol, drugs, or sex, I am actively combating self harm & suicidal thoughts every single day. I will never be completely cured, but I will get better. There is recovery. Stigma 5: Only thing in this list I can agree with is BPD people being difficult, because being difficult is subjective. We as humans don’t have an “one size fits all” base for our tolerance — all of us tolerate certain things to certain extents. Some tolerate yelling, swearing, & lashing out fairly well, & some don’t tolerate it at all. Neither are inherently wrong.

I am not a monster.

Unless you really know me & we have a mutual understanding between each other you have no right  to even try to determine what kind of a person I am. So many people start to abuse me, hurl drama, & tell how horrible person I am because I’m behaving in a certain way — because I just might not know better. I might not know how else to behave. & I know it’s wrong when I behave badly, I’m not perfect — but neither are you, & you still have no right to verbally abuse me. You have no right to do that to ANYONE.

My disorders do not determine me. My disorders are not ME.

Stigmas just make everything worse, for everyone. These stigmas surrounding us make us BPD survivors AFRAID to admit we have BPD. We are AFRAID to seek for help. We’re AFRAID to even talk about the subject in any way & we keep suffering, feeling alone in this hellhole of a world that might never understand us.

Don’t succumb to the stigma. Don’t be afraid of someone with BPD, because some of us suffer in silence & struggle internally, & some of us voice our emotions out in a very immature way — we’re not all the same. Imagine someone whose most outer layer of skin has been peeled completely off. You are red & raw. Even a soft breeze of wind hurts, even the smallest touch can make anyone scream from pain. That is what BPD emotions are like. We know how we behave is not right, but most of the time we just can’t help it. We learned these ways to behave from trauma — we had to do SOMETHING to survive, & now we are stuck with a certain way of behavior, a survival method that might get triggered by even the smallest things that remind us of the abuse we had to endure. We feel like we are in serious danger & we need to defend ourselves at least somehow. We know how we have learned to survive doesn’t work anymore, some of us are in so much better place than we were before, but we just can’t break free without professional help or dedicated self treatment, such as mindfulness, yoga, betterhelp.com, & meditation.

Not all of our bad behaviors are BPD based, but it’s very likely most of them are. Try to remember, that our bad behaviors stem from intensive pain. You don’t need to understand us & you never fully can unless you’re in our shoes, but just at least try to. Sometimes even trying is more than enough.

We are not perfect. You aren’t perfect either. We all make mistakes, some just more than others. Deep down inside we BPD survivors are just like you, just more sensitive. We are human, we are flawed, & we feel emotions. We are trying our best to be “normal” & not hurt anyone.

To other BPD survivors — there is hope. You’re not a sufferer — you’re a survivor. Someone loves you, & you should love yourself, too.

This has been a PSA. Thank you for reading. Thank you for trying to understand.

Still got some questions left ? Need support from a fellow BPD survivor ? Feel free to IM me. ]