MBT: Week 2

Group session: Recognising emotions

This week we learnt about basic emotions and the functions they serve. We thought about recognising emotions in ourselves and what actions from other people can make us feel better.

It’s Tuesday afternoon, so I’m writing this right after the group session this morning to try to capture some of my thoughts and feelings about it.

Well, I feel really angry after the session today. There’s a woman who asks lots of questions of people very intensely, and then talks over people with her own opinions when people try to answer. She talks over people all the time actually. Even the psychotherapists, when they’re explaining things or moving on to what we’re going to talk about next, she’s saying “yeah, yeah, mmm” over the top and chipping in. It annoyed me so much because it’s distracting and I find it rude. It also makes it seem like she fancies herself as a bit of a therapist, like she thinks she knows better than everyone else.

I felt really annoyed in the session and I felt like I was holding in all my feelings. I’m put off talking because I know she’ll do the same to me – bombard me with questions then talk over my answers – and I feel like I’m going to lose it and get angry at her, or get upset at least. I’m scared of that happening. I’m worried then that I’m not making the most of the group because I’m so held in and not saying my thoughts. I’m not contributing.

I think she’s trying to help people by giving her opinion, and I think she doesn’t realise quite how vocal she is all the time. I suppose this should make me less angry but I just get annoyed when people aren’t self aware about such things. I want to learn to be more compassionate and I guess mentalising about where other people are coming from is something I need to learn and my reaction to this woman shows that. Everyone interacts in therapy in different ways. It’s possible that silence irritates her as much as her constant vocalising irritates me.

I know I’m going to have to find a way to sensitively broach the subject and that fills me with dread. I know I’m going to be shaking and struggling to hold it together. I’m worried I’ll hold my feelings in until I get angry and explode at her.

Individual Session: Thursday

Holy crap, it’s been a tough day. My sports team training finishes late on Wednesday nights and then getting up at 8 on a Thursday is a challenge in itself. I felt sick and nervous and very tired this morning on my way to therapy. My therapist said I didn’t seem nervous, and I explained that I often feel strongly but hide my emotions well. I guess Tuesday was a good example of that. No one in the group would have known I was feeling irritated.

I was worried about being honest with her about my experience of the group this week. I know that she and the group leaders talk to each other since MBT is meant to be one therapy consisting of two sessions a week – the group and the individual work together to form the therapy. So they need to know what’s going on with me. I was honest with her about my worries – that she’d report back and that they’d force me into a confrontation in the group.

We talked about my fears of confrontation and where they might come from. I got very upset talking about my alcoholic father’s unpredictable temper, his shouting and his violence, but especially when I talked about how I feel blamed for the confrontations by my mother and sister. I feel to this day that they always think I’m making a fuss about nothing. They don’t like to talk about feelings. They prefer that you pretend not to have any/that everything is fine and always has been.

I guess I’m scared not just that a confrontation with another group member could be scary but I also fear the judgements of the group if I get upset or angry, or that they will feel that I am causing a conflict. I cried in my individual session this morning. I felt like my therapist was so understanding and sympathetic but not coddling, and I am feeling grateful and still hopeful about our work together.

This afternoon I worked at my volunteering job and felt extremely tired and quite hungry towards the end of the day.

The bus ride home seemed endless. When I got in, my boyfriend gave me a hug and I felt tearful and he made me a cup of tea, bless him. Then I ended up sobbing in his arms and I’ve given myself a headache. A lot of painful things have been stirred up and I’m tired and feeling tender and broken. It’s hard to see how it helps to have it all stirred up but I suppose the only route to recovery is through the shit.

I’m nervous for next week’s group session because of my fears that I will be pressed into a confrontation. My individual therapist doesn’t think that will happen.

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MBT: Week 1

So, the structure of my mentalisation based treatment (MBT hereafter) is as follows:

Group sessions (8 members plus 2 psychologists) Tuesday mornings 1.5 hrs

Individual sessions Thursday mornings 50 mins

Every week for the next 18 months. Intense, right?

Last week was the first week. We all sat in the waiting room ignoring each other until we got called through and filed into the group room awkwardly. I was shaking. They explained that for the first 6 weeks we’ll have having psycho-education about concepts that are relevant to MBT. Then we’ll have a week off before the therapy begins for realz.

Week 1

Group: What is mentalising?

Mentalising is thinking about what is going on inside other people, their thoughts and emotions, and also what is going inside ourselves. What are we thinking and feeling? How does this affect our behaviour? How can we choose to behave differently if we want to? Mentalising about other people is hard because you can never know for sure what other people are thinking or feeling. We can try to keep an open mind and use their words and behaviour as clues. Asking someone how their feeling can act as a guide, though they may not wish to tell you, or they may also find it difficult to pinpoint and vocalise their own feelings.

I found it really strange being in a room with seven other people who I know to have BPD. It was especially interesting to me to meet three men with BPD, as I have mostly talked to and known women with BPD. I think I’m glad that our group is quite balanced: three men, four women and me (genderqueer). I am hoping I will feel less left out about being genderqueer if there is a gender mix compared to if it was women only and I felt like the odd one out. I’m still worried about talking about my gender at all though, because I feel like people won’t understand.

The first group session was quite dramatic, even though we technically haven’t started the therapy side of it yet. Tensions were running high because everyone was nervous and there was an argument, a few tears and someone nearly walked out. It has made me wary and scared of opening up, I know it could have been me and I’m scared of conflict and of getting upset or angry in front of everyone. I don’t know if these fears are normal or part of why I’m in the group – maybe both.

Individual session: Meeting my therapist for the first time

While I had met with the group leaders prior to the group, I’d only spoken briefly on the phone with my individual therapist to arrange the meeting. I was nervous and worried that I wouldn’t like her. I really wanted us to get on so that we could work well together over the next eighteen months and I can get the most out of my therapy. I couldn’t manage to eat anything before going. I felt sick.

I was relieved to find that she seems quite nice. She was understanding about me being non-monogamous and seems open minded. She pounced on it a bit when I said that I felt like I might have to rush to the toilet when she asked me about my childhood. I just have IBS that is triggered by stress and it had been bad all morning. It’s so annoying when psychologists get inappropriately excited when they think they’re getting to something juicy. Having said that I never talked much about my childhood in the session, so if I was avoiding it (which I don’t feel I was, I just didn’t know where to start) it appears I did so successfully. Perhaps next time we’ll have more time to talk about that stuff.

In general:

I’m feeling hopeful about MBT, I know it’s a big commitment but I really hope it can help me.

My MBT Evaluation

My first MBT group session is today. I’m really nervous even though I think we’re just starting with some basic sessions to explain what MBT is and what the aims are. I’ve woken up early and I can’t go back to sleep, so I thought I’d write about what the evaluation was like yesterday. The evaluation isn’t necessarily for me, it is mostly for the NHS trust to take a before measure of my mental health so that they can take an after measure at the end of the 18 months of therapy and decide if MBT is worth the cost. I suppose it also gives me an idea individually if I’ve improved but since it was done based on the last week or two and I feel like I’ve been doing okay for the last couple of weeks, relatively speaking, I’m not sure they’re representative. I tried to be totally honest anyway.

The person before me overran so I was stuck in the stuffy new waiting room for ages. It’s a small internal room with lots of windows like an airless fishbowl, I hate it. Eventually I got shown through by a typical assistant psychologist with a patronising voice. Unfortunately she reminded me of a friend that betrayed me last year, I tried to ignore the likeness.

The evaluation consisted of several questionnaires measuring my responses on a scale to lots of statements. Some were about my mood and some were about my behaviour. I found these quick and easy to fill in, there were just lots of them! One of the statements was very heterocentric, asking if I felt uncomfortable around the “opposite sex”. I pointed this out to her but she blamed the questionnaire people rather than the team’s decision to still use a scale that includes such an item. So that wasn’t very reassuring.

After that we did a semi-structured interview mostly about impulsive behaviours and abandonment issues. She recorded this and said another psychologist would probably listen to it, it wasn’t clear who. It finished within the hour despite the late start, she said I was very quick at filling in the questionnaires so perhaps that’s why.

Hopefully this is informative for anyone going for a similar appointment. I plan to write about my experiences with MBT on this blog going forward so subscribe for updates and follow me on Twitter @borderlion for the latest.