Therapy Diary for May 31, 2020

Okay. So. I usually try to write coherent articles for this blog, but I can’t find much coherence in my mind today. But I also know that writing my thoughts out often helps me understand them better, and settles some of the internal chaos, so I’m just going to write. I usually hope that people read my posts, of course, but this one may not be worth your time. 

My thoughts around my BPD, my therapy, my recovery process, and my life have been very confused and active for weeks. ‘Internal chaos,’ as I said in the first paragraph. For instance, I’ve started reading a book called Transcend – The New Science of Self-Actualization, by Scott Barry Kaufman. The first part (which is all I’ve gotten to so far) is talking about issues like what it means to be human, how to find your purpose, fear and belonging, the human need for community… 

…and I started thinking about how many anguished conversations I read on Twitter from other folks with Borderline Personality Disorder diagnoses. What I am contemplating is how much of what we struggle with, discuss in therapy, and are confused about isn’t really a disorder so much as it’s just… living. It strikes me that life is hard. It’s very likely that people with no disorder struggle with these exact questions. I’m not saying, not for a second, that BPD isn’t real. It’s so real that folks with our Dx kill ourselves at a far higher rate than people without it. But I’m starting to think that most of what we struggle with isn’t a matter of content but of degree. Maybe even more accurately, what’s going on is that (due at least partly to trauma) we don’t have the skills or perspective to deal with life. It’s as if we live on a steep hillside and keep getting swept away by floods and landslides, not realizing that there are ways to deal with loose soil, excess water, and bad terrain. As I was contemplating all of this, I picked up my long-ignored copy of The Expanded Dialectical Behavior Therapy Skills Training Manual, and started re-reading it (I bought this book right after I got my diagnosis in late 2018, read the first couple chapters, and put it on the To Be Read shelf, never to be seen again until this week).

Right away, I found the section called ‘DBT Beliefs About Skills Training.’ The listed skills you’re supposed to agree with (while studying DBT skills) are: 

  1. You are doing your best.
  2. Skills help you to do better.
  3. Skills apply to all areas of your life.
  4. No matter how a problem happened or who caused it to happen, you are responsible for a skillful response.
  5. Skills work when you work the skills.

If you’re a fellow BPD person, you probably know that my initial reaction to this list was not one of warm acceptance. My inner voice sounds something like “What the hell do you mean, I’m doing my best, I’m a complete failure! You don’t know anything about my life!” 

When I re-read the list, I noticed the ‘Skills help you to do better,’ and I realized that it was really close to what I’d been trying to formulate on my own. 

The comment on that skill reads ‘Even though we are all doing our best, sometimes our best is not enough to be effective. We all have room for improvement, and skills help us to be better.’ One of the things the authors point out is that graduates of their DBT skills program often say later that they wish these skills had been taught to them as children. I want to really stress this; these are not skills for sick or broken people! These are skills for humans. Remember? Life is hard. You really can’t expect to just be good at it without help. It would be like wandering onto an airfield one day and expecting to be able to fly a Cessna with no training. 

I’ve seen people on Twitter bitterly complaining about getting a Dx of BPD. They feel that it’s a trap, a categorization that they’ll never escape, like some stain that’s been marked in their skin. I’m not going to say you’re wrong if you feel that way; your feelings are your feelings, and I don’t know your circumstances. But I feel that Borderline has gone from being classed as ‘the untreatable disorder’ in the 1980s to ‘most treatable’ now. Sure, some parts of our BPD might be physical. We might not be able to affect those parts. But a whole bunch of BPD is related to injuries (trauma) done to us, and I believe that it’s possible to heal from those injuries. Healing doesn’t mean we become magically new. The scars are going to be there. But I think we can strengthen the structures around those scars, which will minimize the limits those scars put on our day to day lives. If you’re deep in crisis right now, this all may sound impossible. If you’re in that situation, I wish only the best for you. This also may not be the right time to read this blog.  

I’m encouraged when I learn that many people have gotten so much better through therapy and skills training that they no longer fit the criteria for a diagnosis of BPD. That is awesome. I know that therapy and things like DBT aren’t successful for everyone. Nothing in this life is successful for everyone. But (some) people are getting better. Many of us can benefit from practice and getting better at skills. I’ve never heard that about many other mental illnesses. Man, give me a problem to tackle any day. I know a lot about problem solving. I’m even aware that I sometimes use problem solving as a way to try to earn acceptance, but that doesn’t mean I’m going to give up on it. Geez, brain. 

When my therapist raised the idea of my having a diagnosis, the first thing I asked her was “Is this just a label, or does having a diagnosis help us find tools that we can use to improve things?” and she assured me that she does not see a Dx as just a label. I’ve mentioned what she said next: ‘I don’t treat the diagnosis. I treat the person.’ 
As a result of all this, as I continue to read the Transcend book, I’ve also resolved to start working through the DBT Skills book. I think that I’m in a place now to be able to read it with an open mind. I wish that there was a DBT skills group in my area, but the only one near me has an age limit of something like 22 years old. How that makes sense, I’m not sure. But in any case, this won’t be the first time I’ve tried learning something from a book, and I know that I can bring issues up in therapy; I’m incredibly fortunate to have that resource available (and affordable).

More later. My brain is still all full and confused, but I gotta get back to life stuff.