BPD, or not BPD: that is the question?

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BPD isn’t a new ‘thing’ on my radar, it’s something that’s been circling in the background of my mind (where the cobwebs and half-eaten biscuits are) for about four years now. When I read the descriptors for BPD all that time ago, I was like, ‘Omg that’s so me!’ Rather inconveniently I made this discovery once I had actually finished my period of therapy with Em and so never really thought much about it. But it’s back in my mind, front and centre, at the miniute and so I wanted to have a waffle about it, a bit, before I go to therapy on Monday – stinking cold permitting, of course (thanks kids!).

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Christmas break 2016 was an emotional disaster zone for me. Oh but what did you expect?! ha! ‘Tis the season to be jolly’, or rather I feel, more accurately ‘Tis the season for pretending that we all like each other and actually want to spend time with one another whilst re-enacting outdated and weird family dynamics’. But maybe that’s just my family!

I largely survived Christmas day by spending a great deal of time in the kitchen cooking dinner! Don’t get me wrong, the time before my mum and husband arrived was completely wonderful and relaxed. My wife and I were happy despite the 5am wake up call. Our little family unit was full of joy as we slobbed in our onesies.

Christmas morning was all that it should be with small children: smiles, laughter, ripping off wrapping paper fast enough to set a world record.  They had no idea that this one day had resulted in Santa maxing out his credit card and that January would now mean lots of pasta meals!

By Christmas night I felt like I was going to have a breakdown and took myself off to bed to hide, cry, shake, get swallowed up in unexplained misery. I suppose it’s not really surprising that things felt difficult having spent the majority day with my mum playing ‘happy families’ and yet feeling emotionally cut off from her, not getting a hug (not that I want one anymore), and feeling like there is a huge distance between us.

I know I need to let it go and move on but there’s just so much unprocessed hurt in me still and it’s only really coming to light now. My adult gets on well with my mum and can see her for the flawed human she is, but my little ones feel unseen and abandoned just in the way they were 30 years ago by someone they idolise.

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Just to be clear, one of may favourite places to be is my bed but it’s also where I seek refuge. I like sleep and am currently working on about a three year sleep defecit since having my children. I see way too much of 6am and cannot believe that 7am feels like a lie in! As a result of ALWAYS feeling tired and/or emotional I take to my bed like a neurotic heroine from a Victorian novel whenever the opportunity arises, i.e the kids are at school or are in bed.

Suddenly, that evening, as I lay curled up in a ball under the duvet, in a way that hadn’t really happened before, all the little parts made themselves known and caused complete havoc. I was all over the place. I felt so lost, lonely, and uncontained. I was scared. In that moment of abject misery my thoughts went to one place. I wasn’t sad about my mum, instead I was distressed about not having my therapist nearby. Yay. Lovely maternal transference my old pal! ha!

I absolutely longed to see Em and yet at the same time I wanted nothing to do with her. I missed her so much that it physically hurt and yet part of me was raging and hated her. I desperately wanted the break to end and yet part of me couldn’t care less about seeing her again. I needed her but I didn’t want to need her. I craved closeness and proximity but needed to isolate myself and protect myself. I wanted to let her in and yet I didn’t want her to have the power to hurt me. It was an exhausting emotional dance, two partners pushing and pulling against each other rather than working together. I really struggle with this inner conflict and often feel like I am tearing myself in two.

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Towards the end of the therapy in 2013 my therapist told me that I struggled with emotional intimacy. Which I thought was funny because I had never really noticed. I think because I feel things so intensely I kind of assumed that emotional intimacy must be part and parcel of that. It wasn’t until I really thought about it that I knew she was completely right. I feel things, I ache, I have huge emotional dialogues…with myself. It all takes place internally.

I care a great deal about people, when I love someone I really love them, but I don’t necessarily show it or really let anyone in. On the outside I can appear cold and stand-offish, particularly if I care about how someone views me. Even my wife says there is a part of me that she just cannot get to, that there’s a part of me that is so heavily defended that she has no idea how to reach it.

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I know that my struggle with emotional intimacy stems from being hurt and childhood trauma.  The feeling I have about needing to protect myself and being wary of trusting people hasn’t ever been on a conscious level, I don’t think, it’s my innate survival relational pattern. It’s only now I am able to understand why I am the way I am. I still don’t fully know how to change it but what I do know is that much of it will come from repeatedly playing out things in the therapeutic relationship, until I reach a point where I realise and trust that she isn’t going to deliberately hurt me, abandon me, or make me feel like I am too much.

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After the Christmas break, I returned to therapy and the first thing I said as I sat down was, ‘do you think I have BPD?’. I mean seriously, most people would surely have asked, ‘so how was your Christmas?’ or perhaps said something along the lines of ‘it’s really nice to see you again. Christmas was tricky and I have loads I want to talk about’. Yeah, that’s just not me!! I can talk around the edges for ages and then every now and then I just launch straight at it – picture a running dive bomb!

So, my therapist sat for a moment, and then said, ‘Not necessarily. What makes you think that?’ Hmm is that a cop out of not? I don’t know. I talked a lot about how I operate in my relationships and this push/pull thing that goes on in my head, but she never said what she thought when I had finished. I still don’t know what she thinks because I haven’t returned to that question since.

She often says things about how she doesn’t want to pathologise me and that given what’s happened to me how I behave is understandable.  We’ve spoken a lot about my being a ‘highly sensitive person’ and I certainly more than fit the criteria for that: http://hsperson.com/  but I think my behaviour since Christmas would indicate that there’s a strong case to be made for a BPD diagnosis but hey, who knows, I’m a mixed bag of nuts!

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Actually, this whole post has come about because I’ve just seen a video on my Facebook feed (see below) and I wonder if the reason my therapist didn’t say ‘yes’ when I asked her about BPD is not because I don’t fit the criteria but rather the label is not always helpful. At the core of it all are significant issues with attachment and trauma. Diagnosis or not it wouldn’t change the therapy and perhaps it is easier to view things from a perspective of having a difficult childhood rather than labelling. I don’t know.

I thought it was an interesting perspective. What do you think?

Author: rubberbandsandchewinggum

Mid-thirties. Mum of two. Procrastinator. Therapy and mental health blogger.

20 thoughts on “BPD, or not BPD: that is the question?”

  1. It’ very hard to say from hat you’ve shared whether you have BPD or not because most of what you’ve said could be depression/relational issues/anxiety OR you could have BPD traits. When I say that I mean that most people at some point have been scared of abandonment to some degree, most have had mood swings etc. The BPD diagnosis can be VERY unhelpful. It is a dustbin diagnosis – meaning anyone who psychiatrists/therapists find hard to deal with gets labelled as having BPD. I would ask your therapist if she has experience of BPD, because if she doesn’t and you DO have it, then it may be somewhat of a shock. It is fair to say that people with BPD have big relational issues (attachment trauma, engulfment vs isolation dilemmas etc) and as such your therapist needs to be able to handle that and experienced enough to handle (assuming for a moment here that you DO have BPD) when you will inevitably struggle to trust her when you behave in a yo-yo fashion; one minute hating her and lashing out, the next clinging and needing her like mad. Also, she needs to be able to handle strong emotions that switch at the drop of a hat and if you have parts that come out and talk to her, she needs to be able to handle that too.

    What you need to remember is that PTSD exists on a continuum. Complex PTSD falls around BPD as does DDNOS. You could have C-PTSD, or PTSD. So what I would ask you to think about is if you had chronic, enduring trauma as a young child. By trauma I mean anything; physical abuse, verbal abuse, sexual abuse etc. Trauma such as being in a car accident may produce PTSD but won’t produce anything like CPTSD or BPD.

    Your therapist seems to be working very ethically with you. She can give you her experience of you, but she should not give her opinions on diagnosis nor can she actually diagnose. That is the realm of psychiatrists only. If you think you have it, and want the label (bearing in mind it is very stigmatising, very hard to get rid of and VERY stereotyped – it is not uncommon for lay people to try to label us as psychopaths – I wish I was exaggerating – and unfortunately it makes finding appropriate help VERY hard and maintaining relationships with “normal” people even harder) then the way forward is to approach your GP and ask to be referred to the community mental health team’s psychiatrists. However, I warn you now, GPs do not like to do this. As you are in therapy you may be told that you don’t need to see the CMHT, you have help already. They tend to think it may be bipolar and try to get you to see it that way. You’ll have to be VERY persistent and confident… or not in therapy. That was my experience anyway.

    If you do get a referral to the CMHT you will probably wait around 3 months for an appointment and will be seen by a Junior psychiatrist who will rotate out of your life every 6 months. They have a tendency towards not giving a full diagnosis (I got told BPD traits for a long time) and if you sound like you’re too informed, they won’t diagnose you with anything, just tell you to stop asking Dr Google for help (a friend’s experience).They are medically trained so do not expect to be sat in front of a pseudo-therapist you are there for diagnosis and medical treatment only (drugs). Of course it will feel like a therapy session but as you get more into it, no, it becomes more medically (drug) focused. I am warning you really that you may (and probably will) find the whole thing disappointing, invalidating and frustrating as you battle to get the result you need. Again, this is my experience.

    I would say, that as someone who has gone down this road and been where you are… if your therapist is experienced in BPD then you have the help you need, unless it is drugs you are after. Diagnoses are only useful to inform effective treatment. If you have effective treatment then you don’t really need a diagnosis, so it is worth exploring in therapy WHY you want one that is so stigmatising and may end up frustrating and upsetting you more than you need.

    A friend and I were discussing this last night. There is a need/want to get labels such as this for validation of experience, to belong somewhere, to fit in, to find like-minded people… to have an identity. Those with BPD sometimes need the label and are loathed to give it up because it forms part of their identity. Get rid of it, or not have one and there’s a sense of ‘who am I without it?’ The answer is you. You are who you are, even if right now you feel blank and nothing but a collection of parts and trauma and weird emotions… that is you and your journey and one day, with or without the label, you will find yourself again. You will feel like your experience is valid (it is), you will feel your trauma is worthy of being acknowledged (it is) but you won’t need the labels. They will be like lead weights around your ankles, weighing you down and hard to shake off. Think carefully and talk to your therapist if any of what I have just said rings true for you somewhere in your heart.

    You are worth the label if you want it, but equally you are MORE than that and you are just as worthy of NOT having that label .

    I hope my essay makes sense and helps in some way

    Take care my lovely

    Mel
    x

    Liked by 1 person

    1. Thanks, Mel.

      I’m not looking or wanting an official diagnosis. I am the way I am and essentially I am in therapy working through my issues. I don’t think a diagnosis would change that. That’s why I found the clip from the psychologist so interesting. Basically her saying it isn’t helpful to label BPD and how it can be a negative thing when actually much of the problem comes from problems with attachment and trauma that can be worked through.

      Sadly I am all too familiar with the picture you paint of the mental health service. I spent 15 months being shoved about with the crisis teams, CMHT, baby psychiatrists, etc. I never really seemed to talk to anyone for very long and no one ever told me what they thought was wrong until one day towards the end a psychiatrist told me he wanted me to take lithium and it was fine because as I was gay I wouldn’t be having kids. I was flabbergasted.

      I went to my GP and said, ‘I’m fine. I no longer want any interventions by the psych team. I have no idea what’s been going on and am frankly insulted that a professional would make a judgement about a 26 year old woman having kids based on sexuality. I need talking therapy not more pills that just make things worse.’ And so she agreed, I came off the antidepressants that were making me even more crazy and I was put on the waiting list for psychotherapy.

      My therapist is qualified to deal with BPD – if that’s what it is.

      I’m sorry you’ve had such a rough run of it all. I do think to some extent diagnoses are helpful if it leads to the correct treatments but I do also believe they can be very damaging and stigmatising. I really think that psychiatrists get things wrong a lot too. They just don’t have enough input and I honestly can’t see how twenty minutes every 6 months is enough to label someone.

      Take care and thanks for your essay! x

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  2. my therapist doesnt like labels either. she always says we are more than our diagnosis and labels arent that helpful. I tend to agree. bpd comes with a lot of stigma, its a tricky diagnosis to have. I hope between you both you can work this out. xx

    Liked by 1 person

    1. Ha! Do you really want a label? I’m not sure I want an official diagnosis but sometimes I’d like to have more of an idea of what my therapist thinks is going on with me. We never say anything ‘technical’ it’s just feelings and how I am…which is basically a mess. That could be my diagnosis! 😝 I think if you’re in therapy then you’re working on yourself and essentially that’s the important thing. X

      Liked by 1 person

      1. Hmmm…. I don’t want an official GP style diagnosis no, but I think it would help me if my therapist agreed so that I could perhaps read more into it and traits without feeling I’m labelling myself incorrectly, does that make sense? It’s just since she explained the whole paranoid-schizoid and the depressive thing, it’s helped me to understand… I think if she told me she thought I had BPD it might help me when I’m having episodes of panic or depression or crying fits etc not to be so harsh on myself?

        X

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      2. I totally get what you’re saying. Yes. I think getting a bit of clarity from her perspective would be good. That’s essentially what I would like from my therapist, i.e ‘you exhibit these traits so let’s remove that big stick you beat yourself with and realise that this is part of who you are.’ Mind you maybe working on not being so harsh on yourself should be happening regardless! Not easy. Critical voices are so bloody strong aren’t they?

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      3. You’re totally right that I/we should be doing it regardless but… 🤷‍♀️ I dunno maybe I’m using the idea of it in the wrong way, but I just think it would help me to understand myself better…. I know my T enough to know she probably wouldn’t agree or disagree! I asked her once if I had cptsd and she said “you will read yourself in that because it’s all about the struggle with attachment” xx

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      4. Oh I didn’t even see the video! I must go and look at that! Yes, they are MASSIVE!! I’m currently reading about the push and pull and the fear of intimacy all of it makes sooooooooo much sense and it helps to ground me so much! Xx

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      5. I think the video only comes up on my actual page not on the reader. I’m glad it makes you feel more grounded having more insight. I feel largely frustrated- I know what the score is but me and my therapist don’t seem to be on the same page right now. I think it’s me. She’s the same as she always is. Ugh!

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      6. Yep. Well. I keep taking my laptop in a dumping my blog posts on her so she does know. I just can’t talk about it. I’m not sure which part has been going to sessions but I’m beginning to think it’s the older teen part who trusts no one and is so badly damaged that it’s impossible to reach her. Oh joy! Lol.

        Liked by 1 person

      7. Well from what I’m reading right now, that’s exactly what you’re meant to be doing! Have you seen my last blog on paranoid schizoid and the depressive position? That really helped me to understand turning the therapist “bad” and the whole projection/splitting stuff. For me, I definitely want closeness and fear abandonment but yet it’s ME that will sabotage my relationships or leave …. that’s exactly what’s playing out in my therapy right now xxb

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