Sunday, May 23, 2010

May 23rd - 30th, 2010

I hope everyone enjoyed our mid-week post, I look forward to expanding that aspect of our peer support, I would love to hear from you guys on what you thought of it.

So last Sunday we looked over our checklist for when to ask for something from another person and when not to. When to say "no" and when to say "yes". That sums up what we can do about indecision. Recall that we are going through factors that can reduce your effectiveness; 1- lack of skill, 2- worry thoughts, 3- indecision and finally 4- environment. Let's discuss our environment.

Our environment has a lot to do with how effective we can be. As I eluded to at the end of last weeks post, our partners have a major impact on our environment. What does one do if their partner seems to be making it exceedingly difficult to be effective? Can we truly train them? Can we change them?

Who wouldn't want to change something your mate does? Or perhaps a support person could do something differently that would produce a much more effective environment for you to blossom in your recovery. Wouldn't it be wonderful if we could make some of these changes for the person? It is important to note, I am not in any way implying that the behavior of others will make or break your recovery, because that simply is not possible. You make or break your own recovery.

The reality though is that actions on the part of your support persons, whether they be your mate, immediate family or whomever, can make it slow going at times. In fact, for some of us, someone we would not consider to be a support person can deeply impact your recovery. Sadly, sometimes that person is a mate. I refer mainly to the role of a partner because that is the most difficult to overcome, in that you are living with the person and you have a committed relationship that you both made; a verbal or non-verbal agreement to love and support one another through anything. When that mate behaves in a way that isn't necessarily defined as abusive or neglectful in the typical sense, yet their actions are damaging, it can be very confusing and frustrating. A deep sense of betrayal starts to seep in. Now, if this person cannot be relied upon to be a support person because of these behaviors the situation becomes even more desperate for the mate with the mental illness. Doubt is a strong, strong enemy of recovery. Since we do understand that although we may not be able to make the changes for our mate, we can affect that change in them. Which, in the end, can be more satisfying than doing the changing for them.

I would like to take a moment to briefly validate the nightmare that exists for those of us out there that are in a situation I mentioned about mates who cannot be relied upon for support. There is a lot of work that you are responsible for doing on your own anyway, and it is devastating to come to the realization that your mate cannot be relied on for support I strongly recommend something more. If you are not already doing so, I would encourage you to seek professional help to deal with that situation. Plain and simple, if your mate is not supporting you, then it will be exceedingly difficult for you to take the approach of the “in the same boat” because in effect your mate is not in your boat at all. Something to understand though, and this is why I encourage professional help, is that just because your mate cannot be considered a support person, do not conclude that he/she does not love you, or that your partnership must be terminated. This often times is not the case. When a mate can make that commitment to you, yet is unable to support you, odds are that they are dealing with something much deeper than what appears to be on the surface. Your mate may very likely be dealing with other forms of mental illness and is unaware of the depths of it because it is overshadowed by your own. This is not all that odd of an idea when you consider the human tendency to gravitate toward persons with like dispositions. The old adage is at work here, misery loves company. Not in the traditional sense, perhaps you didn't consciously seek out someone with mental challenges, but it wouldn't be surprising if you did it subconsciously.

If mental illness is not at play in your mate, maybe he/she is scared senseless, or if suicidal tendencies are present in your behavior, your mate may feel betrayed as well. They may be taking it personally, as you trying to get away from them. Maybe, they are afraid every time they come home as to whether or not they will have to call an ambulance, these are very real and validating possibilities that may be preventing them from showing empathy for you. So once, again, I would deeply encourage you to get more help on board to cope with this hurdle.

Moving onto affecting change in your mates behavior. This will start with some education, I will devote this week to information that if at all possible you can share with your mate. Use last weeks 'checklist' to determine whether this is a request that you should or should not make of your mate, at this time. If it is not a good time, please read it yourself, get acquainted with it, and maybe do a little homework on what parts you think you and your mate could benefit from. Then when it becomes a time you can request your mate to read it, you will be more prepared to discuss its material. For this weeks post we will be using 'she' for the person with the mental illness, not because it does not occur in men, but rather because the majority of BPD sufferers are female. Also, we will be basing our discussion on BPD, not because other mental illnesses are less problematic, rather because the majority of persons seeking DBT skills are in fact persons with BPD. For those reasons we will say that 'she has borderline personality disorder' even though we do recognize that this can easily be a male suffering and it is his mate that can benefit from some of this information, as well as we recognize that any one of the many mental illnesses that people suffer from can benefit from this too.

Dear Support Mates:

Some of the challenges you face when your mate suffers from BPD, and she feels (whether real or imagined) that your behavior makes it more challenging for her to progress are distrust, betrayal, frustration, and extreme confusion. For her, her wise mind tells her that you are doing the best that you can, that you love her and want her to be handled with care. That you do in fact have empathy for what she is going through, and that you would give your left leg to 'make' things better for her. However, the darker evil side lurking in the depths of her mind, which can attack from either her logic or her emotion mind, tells her that you cannot possibly love her, if only she were better then you would be better towards her, that she must not deserve for someone to love her unconditionally, the list is endless. . .

Another killer is, self doubt. She'll question herself; 'Is this experience real or is it imagined? Is he really behaving in a way that is making it harder for me, or am I charging him with it because I am not accepting something? Would his behavior be better if my behavior were better? If I didn't have these 'problems', then he wouldn't have any cause for behaving the way he does.' Again, the list is never ending. These types of questions will plague her continuously.

The reality? A reality that she won't often be capable of seeing is this: You are not her ineffective behavior just as she is not your ineffective behavior. Another reality that may be more difficult for you to grasp than for her: Whether your behavior is real or imagined to her, both of you will still benefit from it being addressed and changed, to some degree. She deserves you to give her as much empathy as you can and even more, as unfair as that may sound. Reflect on what empathy means.

A good friend of mine said, "Empathy is your pain in my heart".

This would be a good time for me to point out the damage the terms “fair” and “unfair” can produce. We must eliminate them entirely from our vocabulary, they are invalidating and undermine the efforts on both of your parts. Something important to note, assuming that you do not have a mental illness of your own, you bear a larger responsibility when your conflicts escalate to an all out blow out. I know that sounds harsh, and I am not saying you are at fault for it. What I am saying is that life with a person with BPD is hard.

Take a look at some of the symptoms below and just imagine feeling them. For example, can you imagine in your heart, how terrifying it would be to live life daily with the fear of being abandoned lurking around every corner? Maybe to you when someone walks out of the room while you are having a conflict with them is slightly agitating or it may make you  mad, but to her you have left her. Not the literal sense of packing your bags and leaving, that can be dealt with. No, rather she feels it deep inside, a basic need that is being met in everyone around her, yet for her it isn't, she is being rejected, left behind, discarded. Her worth is wrapped up tightly inside of this action of you walking away from her, you may be legitimately creating space for some "cool down" time, but doing so without an exit graceful line, can have dire consequences. You can leave her feeling as though she is worth no more than the mud on the bottom of your shoe that you so easily wipe off and never give a second thought to.  Notice the wording it uses: Frantic Efforts to AVOID. That means she will be capable of outrageous things, not to make your life hard, not to get 'attention', not to 'win' an argument; no, all because she wants to avoid the feeling of being abandoned.

Or, have you given much consideration to what life would be like on a daily basis if your sense of self were unstable? What would life look like for you? Getting out of bed and showering one day would be no problem, but then for no apparent reason,  a trigger way off the monitor has caused you to not be able to take a shower at all, simply for being too disgusted to be alone with yourself naked. Or perhaps, going to the mall is too overwhelming because there are entirely too many mirrors as you walk through the stores and you cannot deal with seeing yourself that many times. Basically you would not like being with, you.

Imagine for yourself a world that when you wake up every morning and you go to bed every night, your mind ruminates over anxiety that you may be feeling, or might feel, or had felt last night. Thoughts of your sickness race through your mind and you wonder who's life did I mess up today? did I say something wrong to someone? will I engage in target behavior today? did I yesterday? can I find something to reduce the suffering without engaging in a target behavior? (granted, these symptoms do drastically reduce with treatment, but these are in fact what your loved goes through when her symptoms are raging)

Going back to the bold statement I made earlier, you bearing a larger responsibility: the difficulties that come along with her BPD are deeply painful and it will require that both of you work as hard as you humanly can AND; when you boil things down, she has a mental illness and you do not (in most cases). This reality means you bear the larger responsibility when things go south. If she had lost her legs in an automobile accident, as her mate would you not be responsible for caring for her needs? Wouldn't the responsibility of organizing the house so that she can maneuver inside the home fall on your shoulders?  If she were having a 'bad day' coping with the loss of her legs, and she became snappy or rude, would you not have compassion and empathy for her loss that would lessen or dull the sting of her words? You better believe it would be her responsibility to learn how not to use unkind words, but wouldn't it be a safe and loving environment if she could go through the steps of grieving the loss if you had extra patience? It is her responsibility to learn how to work through the symptoms of the illness that is paralyzing her, yes. It is also her responsibility to learn skills so that she is not engaging in target behavior or is not maxing out the credit cards, screaming and yelling, etc. AND (here is the dialectic) you can give her more patience. It is exhausting for you, it hurts, and certainly you are valid in feeling overwhelmed because honestly, you do love her, but this no doubt has been going on for years. The two of you have years of  ineffective experiences to pave a very volatile temperature in the home; and yet, she deserves more patience.

So take a look at this list below one more time and make an honest consideration of them, meditate on what that would feel like for you. Perhaps you could write out a list of how you would perceive your life if you reacted that way to your world. Share this list with your mate. Talk about it without judgments.

Thank you for your time with this weeks post, the efforts you go through to assist your mate will go a long way to her recovery and ultimately your happiness too.

Next week we will get back on track about what the person with BPD can do to affect change in their environment, with you working on your stuff and her working on her stuff . . . you'll go far!

Again, I must add. It is very important to say that we are very much aware that men also suffer BPD. These men do have a greater struggle yet, they are being treated in an environment primarily for women. They have a stigma surrounding their mental illness that us women do not have. Mental illness is hard for the general public to accept, let alone accept from the men of our society. Men have an image to uphold, as do women, yet their image does not accept weakness, frailty, let alone mental illness. Add all that with a healthy dose of abandonment? I couldn't even imagine how hard it is for you men out there. Hats off to you who have come forward and have begun to get help, you have tremendous courage.

MJ

COMMON SYMPTOMS OF BPD: (as found at:  http://psychcentral.com/ ; personality disorders; borderline personality disorder)

A person with this disorder will also often exhibit impulsive behaviors and have a majority of the following symptoms:

  • Frantic efforts to avoid real or imagined abandonment

  • A pattern of unstable and intense interpersonal relationships characterized by alternating between extremes of idealization and devaluation

  • Identity disturbance: markedly and persistently unstable self-image or sense of self

  • Impulsivity in at least two areas that are potentially self-damaging (e.g., spending, sex, substance abuse, reckless driving, binge eating)

  • Recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior

  • Affective instability due to a marked reactivity of mood (e.g., intense episodic dysphoria, irritability, or anxiety usually lasting a few hours and only rarely more than a few days)

  • Chronic feelings of emptiness

  • Inappropriate, intense anger or difficulty controlling anger (e.g., frequent displays of temper, constant anger, recurrent physical fights)

  • Transient, stress-related paranoid ideation or severe dissociative symptoms