MBT Week 6: Individual session

Today I ended up talking with my individual therapist for ages about gender stuff, even though I didn’t really want to. I’ve left feeling a bit fed up about that but maybe I should trust her that she knows what’s important? I mean, it is important, I just didn’t want to talk about it. I don’t know.

One thing she said that was awkward was when I had mentioned that I bind my chest sometimes, and later she brought it up and said that I bind my breasts. Urghh

Then we talked a bit about how I expect my feelings to be dismissed as me ‘making a fuss’, as this has repeatedly been my experience, especially within my family.

I’ve been thinking about that more and I think it goes even further for me. I have been told so many times that I’m making a fuss about nothing when I talk about my feelings that I have started to believe it. I have started seeing myself as attention seeking. I find it hard to trust that my own feelings are genuine (though they sure as hell feel it!). In short, I have believed my own bad press.

This dismissiveness is linked in with guilt. I’ve been made to feel bad for making other people feel bad or uncomfortable due to me showing my thoughts or feelings. This is also especially true of my family relationships, and the guilt is especially true with my mother.

At the end of the session I asked my therapist with whom she’d share the information about my gender confusion, and she said she would tell the group leaders. Aargh! How awkward and embarrassing! I feel bad enough with her knowing. One of the only reasons I told her was because my GP said that I should. Gah.

Thankfully there’s no group session next week, it’s on hiatus between the psychoeducational sessions and the therapy proper. I’ll still be having an individual session next week. But I know I’m going to feel hyper uncomfortable in the group knowing that the group leaders know about it.

Why do I feel so exposed and ashamed about this? I think part of it is because I feel so unsure, it makes me feel particularly vulnerable about it. Also, gender can be such a taboo subject, a lot of people have very rigid and judgemental ideas about it and I’m aware of that.

Gender GP Appointment

Holy crap. My head is a whirlwind right now. I just went to my GP and talked about gender stuff. I have been holding this in forever. I was so nervous before I went in, I thought I was going to die. I was tapping my feet in the waiting room and my hands were shaking, my heart was racing. I told her I was nervous right away (thanks to the advice of Cat). She said take your time – I am so grateful that she was patient like that. It was so hard to get started.

 

“It’s about my gender”, I said…. “I don’t feel like a woman. Basically that’s it. I don’t feel like I’m a woman. I’ve felt like this for as long as I can remember.” She asked me about when I could first remember feeling this way. “As a kid. I never wanted to wear skirts or dresses. I hated school cause we had to wear skirts.” Of course, I know that you can be any gender and wear skirts and dresses, but for me as a kid this was one of the things I noticed that made me different to girls I knew.

Now things are more complicated – I didn’t mention this. I feel like I’m in drag when I dress as a woman. (No, there’s nothing inherently wrong with drag; I just think it’s something different to performing your gender.) Sometimes I enjoy dressing up though. I don’t feel like myself, but sometimes it’s nice to be someone else. Someone socially accepted at face value.

She asked about partners. I said I’d had relationships with women. I said I never felt like they were relationships between two women.

She asked about now. I said that I bind my chest sometimes. I said that I asked my partner to call me a different name but he always calls me honey anyway.

We talked a bit about the help I’m getting from the CMHRS. I told her about my fear that my gender confusion will be passed off as identity disturbance associated with BPD. She said she recognises it is an issue in itself. She said I should try to be honest with my therapist about it. I said I’d try. I said I had tried to talk to my social worker about it but I didn’t explain it very well and she didn’t know much about it.

I¬†said I was scared the CMHRS was going to try to ‘fix’ this, to try to make me feel like a woman again and that I’d lose all the progress I’ve managed to make so far, by myself. She said that they shouldn’t do that, that it wouldn’t be right for them to do that, which I found reassuring.

She says she’s going to find out about the nearest specialist services and see if she can refer me. She mentioned counselling to help me figure out where I am and where I want to go with this. She’s going to write to me in the next couple of weeks.

Oh my god, I just feel so excited, relieved, scared, embarrassed, overwhelmed. Now I have to talk to my partners and I’m worried they’re going to be freaked out. I think one will be okay and the other will be freaked. He’s very heterosexual. He likes me as a woman even though he understands I don’t necessarily feel like one.

I said that when I’d talked to my women friends about it they say “oh but there are lots of ways to be a woman”. But I feel like this goes beyond that.

Update:

The partner I thought would be freaked out was indeed a little freaked out. But he didn’t run for the hills or anything, so I suppose it could have been worse. I think it makes it hard that I don’t really have his support, though I can understand him being a bit alarmed about it I suppose.

MBT Week 6: Final week of psychoeducation

So today’s group marks the end of the initial six week psychoeducational period, in which we have learnt the basics of MBT including what mentalising means, about anxiety and depression and attachment theory. This session focused on the rules of the group and what is expected of us.

Next week there is no group, there is a break, and the group following that will be our first proper session of MBT itself. I’m nervous, and they said today that there will be no table between us, which has filled me with dread. Like I said in the group today, the table is a bit of a security blanket for me. Everyone will be able to see my awkward body language now. Gah.

Today was a little tense but I found it okay. One of my fears for the group therapy is that I won’t get much chance to talk, I’m not as pushy as other people when it comes to trying to get a turn to speak. I wasn’t able to admit this in the group as I was worried that other people would be offended and think I was saying that they talk too much.

I will take that thought to my individual therapy on Thursday and perhaps it is something I can mention in the group when we reconvene.

One weird thing about today was that one of the therapists and two group members were missing, so we felt a bit thin on the ground. This really cemented the group guidelines we read today about committing to attend the sessions. It was clear that when people miss the group it does really change the atmosphere.

MBT Week 5: Individual Session

This week I told my therapist about how I had found it easier to talk in the group due to the calmer atmosphere and the increase in structure that the group leaders had established for the next couple of weeks.

She had set me the homework of writing down what I am currently struggling with the most and what I would most like to work on. My three main points were as follows:

1. I would like to have better relationships with other people.
– This includes needing to feel that I exist and that I know who I am.
– At the moment I find I am always very afraid of what people will think of me. I worry that they’ll be angry with me or think badly of me.
– I always expect that people are trying to manipulate or hurt me.
– Splitting – I can easily see someone as all good or all bad and not the more complicated truth of a situation.

2. I would like to have less extreme emotions, and to cope with my emotions in better ways.

3. I would like to gain closure and move on from my past.

We talked about 1. in detail and will be talking about 2. and 3. in more detail next week.

She said she was really impressed with the effort I had put in and that what I’d told her was really helpful. It fit in well with what she’d had in mind to work on too.

It made me feel great that she was pleased with me. I’m always so desperate for approval…

MBT Week 5: A Calmer Group

Trigger warning: Discussion of self injury and suicidal ideation

After the conflict of last week’s session, the group leaders decided on a different approach. For the remaining weeks of the psycho-educational part of the group (that’s this week and next week) they’ll be focusing on the psycho-education and not getting people to participate as much. This definitely made for a calmer group but it was a bit like a lecture, with the group leaders talking a lot and us having to sit and listen (which is pretty much what I do most of the time anyway!).

I was tired and hungover and found it hard to concentrate. Last night I got involved in a discussion with someone in a group I was out with and got upset. I ended up having a panic attack outside the pub, coming home and self-harming. My partner is away at the moment so there was no one to stop me, and my inhibitions were lower because of the alcohol. I’m lucky I didn’t do more damage, but I’m disappointed because it has been a year since I last cut (before my short hospital stay almost exactly a year ago).

I was glad of the calmer group, and I managed to share some things about when I was very depressed and I got admitted to hospital because I was suicidal. It felt like a totally different environment to speak in with a gentler atmosphere, and I was glad because I was feeling vulnerable today.

I felt that I was looked at in a sympathetic way when I shared my experiences and other people agreed that they had felt similarly when I talked about something, which was really nice. I’m left feeling a little bit more at home in the group and a bit less intimidated.

We talked about how even when someone appears angry, it is often because they are defensive and worried about opening up and making themselves vulnerable. This contributed to helping the group move on from last week and be forgiving and non-judgemental to the people involved in the upset. I hope seeing this resolved will make me less scared of saying anything in future, but I know it will be something that will continue to challenge me.

This week we learnt about anxiety and depression and a bit about how these relate to mentalisation. As usual, I didn’t feel like it added to my knowledge of mental illness, but it gave me the chance to think about these issues in relation to my own experiences and to hear how other people have experienced these things.

We also talked about medication and the experiences people have had with that. This is when I said that I have been on various anti-depressants but I found that they made me numb and that made my impulsivity worse. (This kind of shows an interaction between my BPD and my depressive/anxious symptoms.) Other people shared that they had a similar experience of being made very numb by medication too. I know it is a common reaction to anti-depressants but it was nice to have people speak up and agree with me because I am always scared to talk and worried that people will tell me I’m wrong and judge me. In fact the opposite happened today.

MBT Week 4: Individual Session

This week my session with my individual therapist felt a little incoherent. It felt like the subject moved around a lot and I was worried we hadn’t achieved much.

I talked in some more depth about my fear of being involved in conflict in the group following the arguments and upset of the session on Tuesday (see previous post).

My individual therapist has asked me to write a short list of what I think I struggle with the most, what I would like to work on in therapy.

I guess this might fit in well with the group homework, which is to think about which of our personality traits we have been struggling with this week. I’m finding it tricky to know what counts as a personality trait.

One of the things I’m really struggling with this week is being alone and trying to comfort myself. It is a challenge to fill my time, to stay motivated and not to feel empty a lot of the time. I suppose this could in general be called dependence on others for emotional support, or a failure to self comfort.

Readers, I have a question for you! Has there ever been anything you didn’t want to tell your mental health professionals because you were too embarrassed and/or worried about it being written down about you somewhere?

You don’t have to tell me what it is, but I am I interested to know how you dealt with that. Did you tell them? Did you keep it to yourself? If you told, how did you broach the subject? How did you contain it so you didn’t feel the information had gotten out of your control?

MBT Week 4: A Dramatic Group

Hard to believe it is week 4 already! I am writing this part on Tuesday afternoon after my MBT group this morning. I’m tired because group was very dramatic today, and immediately following it I had an hour of occupational therapy. Thankfully that’s not my usual schedule – I don’t think I’ll be planning in 2.5 hours of therapy in one go again any time soon!¬†

This week in the group we learn about personality disorders. Personality disorders, roughly speaking, are diagnoses which attempt to describe when someone’s distress is organised as patterns of thinking and behaviour which seem to align with particular traits. Examples of traits associated with BPD include impulsivity, paranoia and anger. More information about the criteria for the diagnosis of BPD is widely available online. Bear in mind that the criteria will be changing slightly soon, with the release of the DSM-V (a book containing classifications of mental health problems).

We went round and talked about our experiences of getting our diagnoses. I felt like what I said didn’t make sense, or I didn’t explain it very well. This is probably a little paranoia. Personally, I had the diagnosis of bipolar II initially, I was on mood stabilisers for about a year. After that I had the diagnosis of BPD traits with anxiety and depression. Later, I met all the criteria for the full BPD diagnosis but my social worker and psychiatrist felt that the diagnosis would not benefit me in any way, so my diagnosis went unchanged until my therapy was coming to an end and they felt that I could access different therapies if they did give me the full diagnosis. This is basically what I said to the group, but less detailed. I felt like one of the therapists was like “huh” and now I’m worried she thinks they just gave me that diagnosis to get me into the group, like maybe I didn’t make it clear that I met the full criteria even before then? I also said that I already knew a fair bit about the diagnosis of BPD before contact with services (this is through my education). Talking about when I was diagnosed was the most nervous moment of this therapy so far for me. I think I was worried about bursting into tears and I was nervous about talking in front of everyone.

After that we did an exercise where we had to think of some positive traits we had and some negative ones. I made a deal with myself that I’d put down a positive one for each negative one I wrote so I only ended up writing three of each! That made it easier when reading them out though because the list was short!

Shortly after that everything kicked off. Some people got very angry and there was shouting and tears and literally half of the group ended up walking out. I ended up shaking because I think I got scared when people were angry. I had to try really hard not to burst out laughing – nervous laughter is a real issue for me, I think it’s like a defence mechanism. I also nearly cried when the therapist sitting near me raised his voice – which I was able to say to him after things had calmed down. He said he just has a loud voice.

After things had calmed down a bit, a couple of people came back into the room though others had left completely. We talked about what had happened and for some reason then I felt a lot more able to speak. Perhaps because so many emotions had been expressed it then felt like it was ok to say what I thought? Or maybe it was just nervous energy that made me talk? I was certainly still shaky after when I saw my occupational therapist. I think it was partly adrenaline and partly that I was hungry cause it was lunch time.