Maria Bamford

My best friend sent me a track today from Maria Bamford’s album Ask Me About My New God. My friend sent it to me via Spotify, but here’s part of it on youtube.

Unfortunately this cuts off what I think is the best part, but I couldn’t find a longer clip. Bamford goes on to point out that people don’t get help because of stigma and that 7,000 veterans commit suicide each year. She says, “You’d think they’d die over there. But they come home and die.” Then through exaggerated fake laughter she says, “I figured it must be funny since no one seems to be taking it very seriously.” (I’m paraphrasing here).

So after listening to that I read a little about Maria Bamford and it turns out she is pretty public about her personal struggle with mental illness. She also uses her comedy to fight the stigma surrounding mental illness. She has been on The Nerdist podcast as well as The Mental Illness Happy Hour podcast. She has a live album called Unwanted Thoughts Synrome which is on youtube. Bamford has also done some voice work on Word Girl, Adventure Time, and CatDog.

Here is a link to an article about her that I enjoyed, and another cool youtube video. Yay for stigma fighters!!!

http://splitsider.com/2013/03/maria-bamford-and-the-cathartic-comedy-of-mental-illness/

 

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Balancing Self-Compassion and Self-Discipline

I’ve been a self-improvement nut pretty much since I hit puberty. There’s a journal entry from the summer before I started 7th grade (so I’d just turned twelve) in which I wrote detailed plans for mastery of several virtues. I was going to focus on one each day of the week. I’m not sure how long that whole thing lasted, but the mindset remains.

I’m also pretty hard on myself, like a lot of people. It seems like people have always told me to quit being so hard on myself. Mental health professionals tell me to practice self-compassion. One of the social workers at the partial hospitalization program repeatedly told us all to give ourselves grace.

It wasn’t until fairly recently (like the past 6 months or so) that I recognized and accepted that I can’t just push through my mental illness. In some ways I knew that. I’ve always known that just snapping out of it wasn’t an option and that it couldn’t be cured by sheer force of will. But I think I sort of thought that if I attacked it hard enough–got therapy, took meds, used coping skills at home–that I could annihilate it without having to alter my life in any significant way. I didn’t have a realistic idea of exactly how much practice and work it was going to take to recover from borderline personality disorder.

The past 4 months in particular have shown me that I have to make recovery my top priority even if that means sacrificing some other things. I had to take time off work. I’ve put the process of applying to/selecting a grad school on hold. I’ve adjusted my expectations of myself.

I think that this is a good, smart thing. But I don’t want to stop moving forward. I want to give myself space to rest and not expect too much of myself, but I don’t want to quit accomplishing things. Right now I’m working 30 hours a week, and I’m happy about it. I’m making enough money to pay for stuff and I get to keep my insurance. I also don’t feel overworked. However, most days when I get home I don’t feel like doing anything else that I feel like I “need” to do. I don’t want to exercise, make good eating choices, or clean up around the house.

I don’t know how to balance giving myself grace and making progress. Am I taking care of myself by deciding to read, play video games, spend time reading about/talking to people online about recovery instead of exercising or cleaning? Or am I just being lazy? Would I be protecting myself by staying home from a close friend’s wedding because it’s 5 hours away and travel and crowds make me very anxious? Or would I be a shitty friend to miss it?

I don’t want there to always be a reason I can’t do things. But I also want to take care of myself, focus on recovery, and not drive myself into the ground.

Feels like backsliding…

As I’ve mentioned in previous posts, I recently took about 5 weeks off work due to a severe depressive episode. I returned to work last Monday, and when I did, I moved to a new team. This means new coworkers, a new supervisor, and new kids to work with (I work with toddlers with ASD). I’m also learning a new intervention model, so there’s that. For now I’m working 30 hours a week instead of 40 so I can take the transition slowly.

When I went to work last Monday I felt anxious and fragile, but also happy and excited. I missed work while I was gone, and I was looking forward to learning the new treatment method (for those interested, I switched from a model centered on discrete trial teaching to the Early Start Denver Model). My bosses are incredibly patient and understanding. They didn’t pressure me to switch teams and they have always done as much as they can to work with me and my situation. I knew they wouldn’t just toss me into the deep end and expect me to know the new model and new kids within a few days.

Then last Tuesday during a tornado my boyfriend’s cat escaped and ran away. My boyfriend has had his cat for five years, since the cat was weaned as a kitten. He is heartbroken. We’ve posted on social media, put up fliers, gone to the animal shelter, searched for him on foot, everything we can think of. It hurts me to see him in pain and I want to do anything I can to make him feel better (contrary to popular belief, a lot of borderlines are extremely empathetic). I’m trying to be positive and strong for both of us.

So now stress is starting to build up. I need a root canal but had to do a round of antibiotics first. Now I’m too broke to get it done until I get paid. My tooth stopped hurting during the antibiotics but now the pain is coming back even though I’ve been extremely careful about my dental hygiene. Someone I was very close to moved a couple of months ago and isn’t responding to my attempts to contact her. It’s been bugging me for a while, but the past 10 days or so it’s been making me feel awful (if you have BPD you understand anxiety surrounding abandonment). I don’t understand why she won’t talk to me. I don’t know what I did to make her not want to know me anymore. I feel like our entire connection before was false. I’ve cried at least once a day over this for the past week.

Until yesterday morning, I felt like I was holding up pretty well despite all this stuff. I woke up to a text from the project manager saying that one of my coworkers was sick and asking if I felt okay running a session on my own. I said yes. I was pretty excited about it and I felt like it went well. My new supervisor is very encouraging and supportive. I had a break in the middle of the day that I spent going to the bank and checking the animal shelter for our lost cat.

Then I started getting extremely anxious. I think part of it was caused by taking immediate release buproprion on an empty stomach. When I start to experience anxiety I have racing thoughts about pretty much everything that could possibly go wrong in my life, so it is sometimes difficult to identify what originally triggers the anxiety. I forced myself to go to my afternoon session anyway, and I made it through it, even though my head, hands, and feet were tingling from fear the whole time.

I spent the time between work and bed comforting my boyfriend and using distraction techniques. I really don’t want to subject him to my emotions right now since he’s already down. I tried a couple of DBT worksheets but got frustrated and stopped. I barely slept.

This morning I woke up to a text saying there was another schedule change. This is a typical part of my job and when I’m feeling well it doesn’t bother me. Today it did. I’m doing the last bit of weaning off escitalopram and I was feeling a buzz in my head when I got up. Then I spilled a bottle of pills and the button came off my pants so I had to change. When I opened my car door my bag of toys fell out and blocks, puzzle pieces, plastic animals, and about 87 other things went rolling down the driveway. On the way to my first session someone in a huge truck with no muffler followed too closely behind me (this makes me quite tense), then I made a wrong turn. There was a constant stream of negative self-talk going in my head. Do other people call themselves things like stupid/idiot/loser 12 times before they even get to work?

Of course the kid’s mom was extremely nice and didn’t mind at all that I was 2 whole minutes late and my supervisor wasn’t irritated that it took me a few minutes to get the session set up and get online for remote supervision (or if he was irritated, he didn’t show it). But you guys know how anxiety is. You know how self-loathing works. I’d convinced myself that everyone hated me because I was running a couple minutes behind. My heart didn’t stop pounding until about 20 minutes into the session. I felt light-headed and jittery the entire time.

On my lunch break I saw my boyfriend. He was sad and having a rough day at work. I did my best to be there for him and then did some lesson planning. I had a pretty bad stomach ache and had to take my second dose of buproprion without eating again (I take it 3 times a day). I ended up having to cancel my afternoon session because my stomach got worse and I had a sort of prolonged anxiety attack. The project manager was understanding, of course, but I felt guilty and weak.

Tonight has been a lot like last night, only I’ve been sinking lower and lower all night. I want to be strong for my boyfriend and be there for him. He is always there for me when I need him. But it’s been hard the past two days. It’s hard to be animated and focused at work and then be upbeat and comforting at home while hiding my feelings and trying to be a good listener/supporter. I feel like such an asshole for thinking that; I’d fall apart if I lost one of my cats. But I am struggling.

The online work schedule showed my day ending at noon tomorrow, so I planned to hang out with my best friend and her son tomorrow afternoon. We don’t get to see each other very often because she lives an hour away. I checked the work schedule again at 9:25 pm and now it shows that I am doing a session in the afternoon. My best friend can’t hang out in the evening because it’s her husband’s birthday and they have plans.

When I saw the schedule my mood plummeted. I’m disappointed about not getting to see my best friend. For one thing I miss her and want to spend time with her. For another thing, I thought it would be good for my mental/emotional state to spend time with someone I truly connect with. Also the unexpected change is frustrating.

So now I am very discouraged. I felt like I was doing all right, and now I am back to feeling overwhelmed by my emotions. Cancelling a session because of anxiety was what I was doing before I took time off and was in the partial program. That’s not where I should be now. When I started this job three years ago, my training was more high-stress than the situation I’m in now and I handled it just fine. Why am I having so much trouble this  time? I don’t want to go back to the way I felt 6 weeks ago. I don’t want to be depressed and anxious, dreading waking up in the morning, dreading every human interacting, dreading trying to sleep at night.

Sorry for what is essentially a giant pile of whining. I’m scared and I don’t know how to keep myself from falling apart again.

What’s Working for Me

Here are some of the things that are helping me lately, things that I am benefiting from, that don’t need a post all to themselves.

  1. Before bed each night I’ve been writing 3-5 things I’m grateful for. This is something people write a lot about and I’ve previously been kind of scornful of the practice. I’ve never had trouble feeling gratitude, so I didn’t think listing specific things would make a big difference for me. However, I changed my view while reading The Gifts of Imperfection by Brene Brown. She talks about the myth of scarcity and it resonated with me in a way that other things I’d read about gratitude hadn’t.
  2. I have serious self-esteem problems. There are times when I can’t think of a single good thing about myself. Once a therapist asked me something I like about myself and my answer was, “I’ve never punched anyone in the face.” That’s the best I could come up with, and it’s a pretty typical response. So for the past couple of weeks I have been keeping two lists–one of things I like about myself and one of things other people like about me. My goal is to write down things I can’t argue with. For example, instead of writing “I’m good at picking out presents,” I wrote, “I got Mom things she was excited about for Mother’s Day.” The first statement would be easy for me to argue with when I’m feeling bad about myself; I’ll think about all the times I should’ve gotten someone a cooler/more personal/nicer gift. The second statement I won’t be able to argue with that when I’m in a low mood because my mom’s reaction made it clear that she was very happy about the things I picked out for her. On my other list I am writing down compliments people give me verbatim.
  3. I’ve been reading more. I’ve always loved reading, but sometimes I get out of the habit. I start watching TV more or spending more time online. I’m not saying there’s anything wrong with that. There’s often an ebb and flow with interests. But I made an effort to start reading more a few weeks ago and I think it helps in a few different ways. It’s a good distraction (distress tolerance) technique. It’s also a pleasurable activity. Plus, it’s aiding in recovery since I am reading books on self-esteem and other relevant topics.
  4. I’m using a sort of daily DBT checklist. It’s similar to  couple of diary cards I’ve seen. It has different components of DBT listed on it, like connecting with your higher power, committing to valued action, using coping thoughts/skills, using opposite action, etc. There are boxes to check off for each skill on each day and an area to elaborate on how some of the skills were used. It’s very useful for me to think back over the day/week and note which skills I’ve been using or not using. The list came from a book called The Dialectical Behavior Therapy Diary by Matthew McKay and Jeffrey C. Wood. There is a DBT workbook by the same authors that the diary kind of goes along with, but they both can be used independently as well.
  5. This song. All of this guy’s stuff is great, but this song never fails to make me happy. And the video is just so funny and awesome. I try to save this song for very sad times so it doesn’t lose its power. It’s very wonderful.

So there are some things that are bringing me some good feelings lately. Maybe they’ll help someone else, too (I can only hope)!

My Feelings Go Up to 11 (or BPD & Overwhelming Emotions)

So, overwhelming emotions are a big part of borderline personality disorder. Marsha Linehan, the creator of DBT, has said that people with BPD “feel the mental squalls of rage, emptiness, and anxiety much more intensely than most people do.”

I’ve always felt things pretty strongly. Even as a kid I remember that my emotions were often overwhelming and people called me sensitive. They became much more of an issue when I was in college, which is when I was first realized something was actually wrong and sought out help.

Since then, my emotions and regulating them has always been an issue. I am constantly aware that I am feeling–that I’m experiencing emotions. They are too powerful and distracting to filter out. I might get small breaks, like for an hour or two at work if I’m absorbed in something, or if I’m home alone playing a video game. But as soon as something pushes one of my 523 million buttons, my feelings are back in my face again.

Anyway, this is the way I have lived for the past 10 years at least. It has varied in severity, and some emotions have been more intense and more constant at different times in my life. And I hate it. It makes me tired. It feels like I’m fighting all the time. Sometimes it makes me cry. Sometimes I feel like I can’t possibly go on dealing with my dumb feelings erupting over every single tiny stimulus.

However, lately this particular part of BPD has been particularly awful. About 5 weeks ago I became suicidal and severely depressed. I kind of slowly declined over a few months and then crashed very quickly in about a week. I took some time of work and spent 2 weeks in a partial hospitalization program, as I’ve mentioned before. Then I had about 2 more weeks off while I adjusted to med changes and rested. I started back to work again today.

Since becoming suicidal 5 weeks or so ago, I truly feel that I have spent every waking moment actively attempting to regulate my emotions. Once the overwhelming urge to hurt myself abated, I started feeling extremely hopeless or achingly hollow or angrier than I can remember feeling in years. I had to get up and leave groups during the partial program a few times because I was so angry about things other group members said or things I was thinking about. That is not typical for me.

Slowly other feelings came into the mix, but they were just as intense and difficult to handle. I had trouble doing regular life stuff like housework or grocery shopping or exercising because I couldn’t think about anything except my dumb feelings. One afternoon I was in the backyard working on the garden with my boyfriend and a song lyric touched a nerve. I went inside to try to deal with my emotions before they escalated and ended up pacing in the kitchen while crying and flapping my hands.

Even emotions typically considered positive were often overwhelming to the point of being unpleasant. One afternoon I felt hopeful about the future and confident that I could make progress in several areas of my life, and that very quickly escalated into feeling determined to solve all my problems and my significant other’s problems. I was so sure everything would be better once I got to work that I couldn’t hold still and I felt physically uncomfortable with how slowly time was passing. I felt as if I couldn’t possibly deal with living through the next 6 months if time was going to keep taking as long as it does. A few other times I felt something like happiness and laughed uncontrollably in a way that kind of freaked me out. I wanted to stop laughing but couldn’t.

During one 36 hour period, I experienced 1) the determined, impatient feeling described above 2) utter self-loathing because I believe I am worthless and bad at the core of my being 3) euphoria/being in love immediately followed by the fear abandonment 4) misery over the revelation that the best thing I can do for everyone in my life is to leave them alone and not subject them to my illness 5) anxiety that I couldn’t reach my boyfriend on the phone 6) anger at myself for worrying 7) guilt for the way my illness and emotions affect others 8) self-loathing because I can recognize the irrationality of  a feeling and still not stop it 9) suicidal thoughts and 10) a disconnected, empty feeling, like the world was getting farther away from me and I was watching it from space. There are actually 23 more emotions I wrote down that I felt during that 36 hour period, but listing them all would make this post way too long.

It was also very strange to realize later that during each one of these emotions, I believed/felt them with all of my being. It’s part of the intensity of it and part of what makes it so exhausting. I feel like I haven’t been at a resting point in weeks; I’ve just bounced from one out of control emotion to the other. I’m ready for this to slow down. I’m so tired and I need my feelings to chill out a little so I can work on some CBT and DBT skills.

 

 

 

Book Review: The Gifts of Imperfection by Brene Brown

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I just finished a book called The Gifts Imperfection: Let Go of Who You Think You’re Supposed to Be and Embrace Who You Are. It was written by Brene Brown. One of the social workers at the partial hospitalization program talked about her books a lot, so I decided to read one.

Brene Brown is a researcher and professor. She is part of the research faculty at the University of Houston graduate school of social work and does qualitative research on concept like shame, fear, and vulnerability.

I’ve never written a book review before; it is definitely not my forte. However, I think it might be useful for others to get a little info on the book past what’s written in Amazon customer reviews.

The theme or main focus of this book is living authentically while believing that we are enough as we are. Brown calls this “Wholehearted living.” “Wholehearted living” is necessary for a true sense of belonging and real, deep connection with others.

At the beginning of the book Brown discusses developing feelings of worthiness through courage, compassion and connection. She also talks about how worthiness, love, and belonging will help while working on Wholehearted living. A chapter is spent talking about obstacles to Wholehearted living (shame, shoulds, beating ourselves up, etc).

The rest of the book–the majority of it–is about the 10 Guideposts to Wholehearted living that Brown has identified. Those guideposts are authenticity, self-compassion, a resilient spirit, gratitude & joy, intuition & trusting faith, creativity, play & rest, calm & stillness, meaningful work, and laughter, song & dance.

I enjoyed this book. I am not really into terms like “loving-kindess” and using Wholehearted with a capital letter, but I know sometimes it’s easier to pick a word or two and stick with it to summarize a concept. I liked that this book didn’t make crazy claims like a lot of self-help books; the author didn’t write as if she was going to change my life. I thought it was a nice overview of a lot of different things (the guideposts) because it gave me several things to think about.

Reading this book made me want to read more about Brene Brown’s research on shame. She talked a bit about shame and shame resilience. Shame is a big issue for me right now, and I got the idea from this book that the author has a lot of knowledge on working through shame.

My favorite part of the book was the chapter on gratitude and joy. Brown talked about the “myth of scarcity.” She points out that we are constantly fixated on what we lack. This isn’t exactly a revolutionary idea; tons of self-help books and articles preach the importance of being grateful. However, Brown comes at it from a slightly different angle, one that resonated with me more.

I have a habit of not letting myself enjoy good things/moments because I am afraid they won’t last. It’s like I’d rather not be happy than have to feel bad when things go wrong. In some ways this is a self-protective behavior, but it doesn’t always benefit me. I usually just end up missing out on happiness. Brown talks about this in her book. She says:

Most of us have experienced being on the edge of joy only to be overcome by vulnerability and thrown into fear. Until we can tolerate vulnerability and transform it into gratitude, intense feelings of love will often bring up the fear of loss.

Also, going back to the mindset of scarcity, she notes that we are often thinking and talking about all the things we don’t have enough of. Didn’t get enough sleep the night before, don’t have enough time to do whatever, aren’t smart enough, etc. Our default is to think that we don’t have enough of things. The concept of “not enough” is a huge part of our outlook and the way we function. We are convinced that we should always be doing more. If we have enough money to eat and pay our bills, we’ll just think about the fact that we don’t have enough money to travel. If we’re working a job we’re satisfied with, we’ll think about how we should be pursuing our passions or living our dreams. Our whole society is kind of driven by “not enough.” That truly eats away at loving ourselves, feeling worthy, and true connection with other people.

The author’s tone was very pleasant and this book flowed nicely. I’m glad I read it. It was definitely worth the time and money.

This book is available in paperback on Amazon for $9.50 and on Kindle for $8.52.

BPD Stigma in Psychology Today

I recently read an article on the Psychology Today website that made me pretty angry. I’m not in the habit of reading Psychology Today. I prefer to get information about BPD (and mental illness in general) from peer-reviewed scientific journals. I came across this while looking up something else.

Here’s a link to the article for those interested, but if you’ve got BPD this will probably make you angry (the comment section is even worse).
https://www.psychologytoday.com/blog/matter-personality/201109/the-family-dynamics-patients-borderline-personality-disorder

This article ticked me off because of the way the author, David M. Allen, MD, talked about people with borderline personality disorder. I found his language to be stigmatizing and some of the things he said were just flat out wrong. I tweeted angrily about this but then I decided I should write a thoughtful response. After all, I’m trying to fight stigma, and if someone who buys into the stigma just sees a pissy tweet about the article, that’s not going to change their mind.

First of all, Allen refers to BPD as the “‘jack of all trades” of personality dysfunction.’ I think that’s a bit of an overstatement, but whatever, bro.

In the fifth paragraph, he talks about splitting. He gets it wrong.

They engage in behavior referred to by therapists as splitting: Everyone else is treated either like a god or a complete pile of manure, with nothing in between.

This isn’t exactly accurate. Splitting doesn’t occur 100% of the time with 100% of people. In my experience, and from what I understand, the experience of many others with BPD, splitting often refers to the way we feel about another person, not the way we treat them. So he’s simplifying it in a way that makes it sound more negative than it is. This contributes to misconceptions about BPD because it creates an image of us arbitrarily treating people in irrational extremes. That’s not what happens.

Next comes the “borderlines as manipulators” trope.

Interestingly, patients with BPD are often described by therapists as being superb manipulators.  One must wonder how anyone who cannot simultaneously evaluate another person’s strengths and weaknesses could possibly be a good manipulator.  Simple answer:  They could not.  While the tendency of thes individuals to “split” others into all good or all bad does derive from the bewildering contradictory behavior of the patient’s parents or primary caretakers, usually it is just an act.

Okay, so right there he says that splitting is usually just an act. An act. I’m not even sure how to address this. Why would someone pretend to experience splitting? What could be gained from that? I guess one could argue that maybe it’s easier to categorize people into groups of “all bad” or “all good,” but if a person were doing it for that reason, I think it would be because they genuinely thought that way, thus making it NOT an act.

Another thing: the thing he says about a person who can’t evaluate a person’s strengths and weaknesses at the same time not being a good manipulator? He’s right, and that’s EXACTLY what happens. People with BPD often think in black and white; it’s very difficult for us to see multiple truths in the same situation. We have problems with interpersonal effectiveness, and that makes it difficult for us to be good manipulators. Are there people with BPD who are manipulative? Yeah, I’m sure there are plenty. But it’s not an inherent part of having borderline personality disorder.

One of the crappy things about this myth that all borderlines are manipulative is that people who believe that aren’t going to believe us when we say that we aren’t. That’s why articles like this make me so angry. This guy has an audience and gives the appearance of credibility (by being an MD and a published author) and he’s spreading the stigma.

In the seventh paragraph, Allen says that people with BPD can turn most of their symptoms on and off very quickly.

I noticed that patients with BPD could turn most of their symptoms off and on like a faucet – and at a moment’s notice.

Nope nope nope. Maybe borderlines can hide/alter behaviors in public or in the presence of certain people, but that is NOT the same as turning off symptoms. And this ability is not exclusive to BPD. If everyone with a mental illness were incapable of hiding symptoms/behaviors, the world would be a very different place. People wouldn’t wait until they got home to binge and/or purge. People with depression would no longer be able to force smiles or fake happiness around co-workers or classmates. The majority of those suffering with mental illness have the burden of trying to hide our symptoms and change our behavior in certain circumstances.

If he’d given an example of what he’s talking about, that would help, but he doesn’t. He says “most” symptoms. Which ones? The unstable sense of self? The chronic feelings of emptiness? Recurrent suicidal attempts and/or self-injurious behavior? A pattern of unstable relationships? Those by definition can’t be switched on and off because they chronic and persistent. So does he mean the impulsive behavior? The mood swings that might last only a few hours? Well, it makes sense for those things to change in a matter of moments. That takes care of 6 of the 9 diagnostic symptoms there.

I’m not even going to get into this guy’s whole “spoiler” role theory. I’m not interested in that. However, I do want to point out that he refers to the movie “Thirteen” as “almost an instruction manual on how to create patients with BPD without abusing them.” I’m sure he was being a little tongue-in-cheek when he was saying this, but it comes across as unprofessional to me.

Also, later in the post when he is discussing the “spoiler” child he says that the child “will figuratively piss all over everything the parent does for them.” Again, pretty unprofessional.

This whole piece reads like an op-ed to me. It’s not based on real research, just on the guy’s interactions with patients with BPD and their families. If it were just posted on his blog, it would be annoying and I’d still think he’s wrong. But it’s not on his personal blog; it’s on Psychology Today, where the impressionable and uneducated masses are going to read it.

We got a long way to go, stigma-fighters.