Dealing with an imperfect goodbye

I didn’t say goodbye to my one-on-one MBT therapist properly in our last session, because I knew I’d be seeing her a couple of weeks later at my care plan assessment meeting. I did cry lots and I did get angry over feeling abandoned and I did say thank you for all the help she’s given me. (She said “you’re very welcome”.)

During the care plan assessment meeting that followed, I was so aware that it was the last time I’d ever see her. I was distracted, hung on her every word and kept staring at her though there were several other people in the room. She didn’t say that much at the meeting and I was disappointed.

At the end of the meeting they all left in one go and I didn’t get the chance to say goodbye to her. I don’t know how to deal with that. I wish I had the chance to say goodbye properly. I feel so heartbroken.

Why am I focusing on what the last moment with her was like rather than the entirety of our relationship? Why should that moment have so much importance simply because of it’s chronological place? It was not the most important moment of our therapeutic relationship, surely.

What will I remember of her? Her sense of humour. Her words echo in my mind “but you were just a child” – that’s an invaluable gift she’s given me, her voice saying those words when I blame myself for my past.

Her listing good qualities she sees in me – kind, clever, funny. Her disagreeing when I feel disgusting and saying she doesn’t see that at all. Her belief in me, “you CAN do it”, “I think you’re more capable than you realise”, and “I think you’re very articulate”.

I’m scared of forgetting what it was like, what she was like, what have I learnt? What of the relationship can I carry with me? I can’t put it into words that I can come back and reread. I can’t think of anything. It’s not tangible.

I don’t have the answer. I’m not dealing well with it being a goodbye at all, let alone an imperfect one. I’d love to hear other people’s experiences in the comments or on twitter.

My first steps in anorexia recovery

A couple of things happened this week that have really shifted my mindset.

I am losing my hair. It has been falling out more than it used to for a while now, but I was sort of in denial about it. I sat up in the bath and there was a row of hair where my head had been resting against the end of the bath. It was alarming. This is as a direct consequence of anorexia and malnutrition.

The other thing is something someone said in group last week and they touched on it again this week after I’d had the chance to mull it over for a while. Having the gap between it being stated and reiterated made me more receptive to it.

They said that when they were referred for eating disorder treatment, they started eating proactively by themselves, as a way of maintaining control but in a positive way. These words have been echoing round in my head.

I have been feeling so desperate for someone to help me and I think it’s really disempowering. I know I do need outside help with it but maybe I can channel my fears of treatment and my fears of control being taken away from me into gaining control over my eating again and being proactive in taking a few first steps to eating and recovery.

I know my mindset has shifted because i used to look around and see thin people everywhere. Now I look around and see people who are my old size (uk 12-14) and I think they look happy and healthy with the energy to live their lives and I crave that. I think they look fine, they look good because they are healthy.

I’m still scared I will start eating and not be able to stop and I’ll become obese. Since I’m currently a UK size 6 this danger is a way off yet.

It is the fear of being out of control though. When I eat after being hungry/I eat a meal (normal size to me, probably small by regular standards) I feel full. When I feel full I feel panicky and overwhelmed and I want to react to the panicky overwhelmed feeling by eating more, I guess to numb the anxious feelings.

Why does feeling full make me feel panicky? I’m scared I will keep eating and not be able to stop, but that is because the feeling full leads to anxiety which leads to wanting to numb the anxiety with food. What is the original source of post eating/fullness anxiety? Is it guilt? Do I feel guilty and like I don’t deserve to eat? Do I feel like eating any amount of food is a failure and a sign of weakness in me? Because it’s not. Did I just so rarely feel full as a child that the full feeling is still unfamiliar and overwhelming to me? Is it just the association now with past episodes of bingeing after meals especially in the evenings and the fear that will happen again?

I need to learn to ride out these feelings and recognise the feeling of fullness as satisfaction (no further action required) and to wait because sometimes craving further food is residual hunger from before when I ate and it takes a while for your body to process the calories and stop telling you you are hungry.

I started attempting to eat last night. I feel like it was a binge but actually it was not excessive, just an understandable amount given that I have been starving myself for so long.

Today I am going to try to eat more normally, in a meal pattern with healthy snacks. When I feel full I need a plan:

1. It is okay to feel full. It means you have given your body what it needs and you will be happier and healthier as a result and more able to achieve the things you want in life.

2. After eating, know that the panicky feeling starts to subside after 60-90 minutes, so
Reassure self as above
Don’t reach for something else to eat, use distraction if necessary
Could have a cup of coffee or herbal tea as a post meal ritual? Would this soothe some of the anxious feelings
Try not to focus on when the next meal or snack is. I want to stop agonising and over planning food as it has taken over all of my thoughts and is exhausting.

3. Notice feelings of fullness and try to coach myself that these are feelings of satisfaction/not needing anything further and that it is OK to have eaten. Try to notice feelings of hunger and to distinguish between being ‘mouth hungry’ which is usually an emotional/bored craving for food and ‘body hungry’ which is a genuine hunger and a signal from my body to eat. Maybe okay to stick to a more rigid food plan/routine until I am better at recognising the differences/tolerating full feelings, to avoid binges and subsequent guilt ridden relapses into starvation. If I’m mouth hungry for a particular food maybe have a vague plan to eat it another time, remind myself it’s not off the menu forever, but I have the whole rest of my life of meals to eat, I’m not going to be starving myself any more, so I don’t need to eat like a starving person!

Defensiveness & BPD

(Group week 15, individual therapist still away.)

Group this week was largely on the topic of defensiveness. The way a lot of us react in group is described as defensive and the therapists want us to question this response. To be open to the idea that someone is not trying to hurt us, or that the hurt caused would be bearable.

I’m definitely defensive, in group and in my every day life. I think this is a way of surviving; a lot of my BPD is the response of a traumatised person attempting to protect themselves from further pain.

I think this is encouraged in part by how strongly those of us with BPD feel emotions, we know that pain and we know how devastating and overwhelming it can get for us. It makes sense for us to become hypervigilant about avoiding it.

How much does your defensiveness, in its various forms, protect you? How much does it hold you back or even cause you more pain? Is it possible to hold on to what works and work to eliminate what doesn’t?

I’d like to become more nuanced and careful about how and when I use defensive strategies:
-Find out for sure if I need to defend myself before I go into attack mode on someone who is not really a threat.
-Don’t push everyone away when I am feeling awful, it seems like I’m protecting myself but really I’m isolating myself and making my life more difficult.
-Continue building my assertiveness and confidence in conversation so that I have better skills to simply say if something is making me feel uncomfortable or uncertain before it leads to a meltdown.

I’d love to hear your thoughts on this in the comments. Do you have the same difficulties? Perhaps you’ve found what works for you?

MBT Group Week 10

Trigger warning: Self injury

It’s really embarrassing walking around with recent cuts on my arm and having people stare. These memories of my dad are haunting me more than I can explain.

Today in the group I managed to say what I wanted to say, namely that:

  • I was discharged from hospital last Tuesday afternoon
  • Not before having a blazing row with my partner when we stopped to get food on the way back to the hospital.
  • I’ve been feeling horrible since coming home, so I’ve just been trying to get through each half an hour or so at a time.
  • I’m starting to feel a little bit better now, but I’ve been cutting myself again, so that’s kind of shitty.

I think sharing this was a big achievement for me. I also talked about what my dad was like when I was a kid, and how I always talked back to him/acted up.

One of the group leaders said it was important to see where my dad was coming from and that perhaps my dad perceived me as hostile and that’s why things escalated.

Other members of the group launched into talk about their kids and how it’s so hard to handle badly behaved kids and kids that talk back.

One person said that they could understand where I was coming from and that he was the adult after all. One of the group leaders tried to say something to a similar effect.

The sum total of the group today was that I feel more blamed than ever. I feel more at fault than ever. I feel like it is affirming my view of myself as a naughty, badly behaved child, unworthy of love and deserving of the physical and verbal abuse I got from my dad.

I feel wretched and horrible. I feel unworthy of love now, as an adult. I feel gawky and ashamed. I feel uncomfortable in my own skin.

I feel angry and like the group have let me down, I opened up and I didn’t feel safe with their response.

I felt totally detached when I was talking about my dad. I found it hard to talk and mostly just answered questions. I used to be so scared of people asking me questions in the group but I actually found it helpful. I couldn’t have said half so much without being asked things specifically.

I feel exposed now though. Are they judging me?

Another upshot of this is that I am so glad I don’t already have kids yet. It also makes me apprehensive. Will I ever be ready to have kids? I don’t want to screw them up with my own issues. (That’s aside from the practical aspects of me having a child in the first place.)

Lots to take to my individual therapist on Thursday…