A Memory (c.2004)

That day, I had a sudden, nervous, sick feeling towards the end of period 5 (History).  I had to leave because of the nausea and (hidden) the sudden, unexpected shaking of my hands.

When G told me she was leaving, I could have said this to her: that I had been feeling nervous all day, which was completely unusual before one of our sessions.  I could have expressed surprise.  At that moment, several choices were open to me and what I chose to say, when she told me she was leaving, was “oh.  OK.”

She tried to discuss it further, talk around my feelings about it, but I didn’t want to.  When she pushed too much I said “well, what do you want me to do?  Cry about it?”  At that moment, I actually saw hurt on her face.  Although I wanted to be clear that I wasn’t remotely bothered by her departure, I definitely didn’t want her to feel bad.  I felt guilty- but I was a teenager.  The stone had been cast, I could not take it back.  It was far too late to make amends.

As I write this, I suddenly remember the other conversation, two weeks or so prior.

She: So, I suppose what I want to say about what I said before, is that maybe I said it wrong, because I knew I was leaving…

As I write this I remember, clearly, what she said “before.”

She had told me that she was thinking about my “needs as an individual” and wondered whether I might be more comfortable seeing a black therapist.  I remember, clearly, my outrage at the time.  In retrospect, I can almost understand what she meant (or I hope this is what she meant): that, given my predominantly white school, it might be good to have someone “of colour”, outside of my family, to relate to?  Or was she just fobbing me off?

A couple of years before, I had a black counsellor for a few sessions.  “It’s hard to be mixed race,” she told me with all the authority of knowledge, but none of the honesty of experience.

I reacted to G the same way I reacted (on the inside) to the black therapist, though I respected G enough, and had been seeing her long enough, to at least partially explain my reaction.  What would be the point, I asked, in trying to “match my colour”?  Did she plan on looking for a specifically mixed race person for me to see, or would she just settle on any non-white?  Although I didn’t say this, I was quite upset because G was Irish- like my grandfather- and yet seemed to think I would feel more of an affinity with any black person, over a white person who shared my roots.  G backed off quite quickly after my outrage was expressed, saying it “wasn’t what she meant” but the feeling of being unsettled, the vague rage, was already there.

It’s funny, because this was going to be a brief piece about the way in which I chose- or chose not- to say goodbye to someone.  In the memory I had, I had skimmed the surface, overlooked the genuine and justified outrage I felt towards G as she said goodbye.  I had minimalised my anger, my real experience, and turned the situation into one that makes me feel bad.

It’s odd, the way memory works.

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“Indecision”

I still remember clearly my own struggles when I was perceived to have BPD (EUPD).  How hard it was to get people to listen and how often, when they did listen, they simply put whatever I said into a box that was already neatly awaiting my words.  I am aware that people who have, or are perceived as having, PD are routinely given this same treatment.  I am aware of this because of the experiences of my friends on-and-offline, and also because of my interactions with professionals, as a professional.  It’s amazing what people will say to you when they have no idea who’s listening.

So, from multiple angles of experience, here is another thing I have noticed about the ways in which people with PD are often viewed.

Professionals often think that one of the markers of PD (and, to a lesser extent, of mood disorders) is wanting to change care providers (whether care-coordinators, therapists or entire care teams) frequently.  This is seen as evidence of the fickleness unfairly attributed to people with BPD; or as evidence of a wilful desire to destabilise the team dynamic of professionals involved in their care; or of ambivalence, uncertainty, and the inability to make important life decisions.  Or this old chestnut- it’s a sign of being manipulative.  Of course.

Here’s another way of thinking about it.  In what other situations are we expected to put up with a service that is inadequate or, for whatever reason, simply unsuitable for us?  I’m planning to change my mobile phone service provider when my contract is up this winter.  In the grand scheme of things, my data allowance is of minimal importance (even to me).  Yet it is accepted- even expected- that if I experience even the least dissatisfaction with the service after several times of trying to “make it work” (if that!)- then I should change it.

Given this widespread acceptance of people changing services when a service doesn’t suit them, why does a similar understanding not then apply to people experiencing severe and enduring distress?  Surely, by contrast with me finding my phone company unsuitable, it is much more crucial for a person needing help to ensure (within the limits of what is available) that the service is appropriate.  Changing care-coordinators isn’t always an expression of “liking” or “disliking” someone (come on, let’s not take things so personally!) but a matter of finding someone it’s comfortable- or the least uncomfortable- to be supported by.  Granted, this can be frustrating for care providers when needs/ wants have to be accommodated by overstretched teams of overstressed people.  That’s understandable.  I empathise.  But that is absolutely not the fault of the person seeking help that it appropriate and suitable for them.

I also understand that, as within any group of people, with or without any kind of “disorder”, there will always be those (extremely few) who “play the system”; those who actually are indecisive, and those who can be straight-up disruptive.  But associating these behaviours or attitudes solely to those with a diagnosis of PD, based on your subjective experience of what you perceive to be their “manipulation/ splitting/ indecision”, is unhelpful, discriminatory and often inaccurate.

Further, people who have experienced trauma (which many people with a PD diagnosis have) may experience issues with trust towards those in a position of either “authority” or “care.”  Considering that trauma quite often involves the abuse of authority by someone who is supposed to care, it isn’t actually difficult to comprehend that someone who has experienced trauma might display a confused (and confusing) attitude to those that they perceive to be in a similar position.  So yes, the desire to change care providers might be symptomatic of trauma (with or without a diagnosis of personality disorder)- but not because the traumatised person has some perverse desire to manipulate, cause chaos or upset people.

When I notice these negative attitudes towards people with PD, I try to challenge them.  When I notice a negative myth about PD affecting my own views, I stop myself in my tracks and correct it.  It’s impossible to offer positive and meaningful support to someone you have already second-guessed as being obstructive, manipulative, or unwilling to work with the (limited, sometimes inadequate) resources that you have.

Resources

Recently, I was speaking with someone about what it’s like to know you’re not doing the things you feel you “should.”  We discussed the feeling that another version of you (an old one?  A future one?) is looking at you and judging you in your current state, thinking “what are you doing?”  I mentioned my own experience of unemployment, the ways that it impacted upon my self-perception.  I explained that although it’s hard, sometimes you have to remind yourself that you’re doing the best you can with the resources that you have.

As we thought about that idea, she told me it can be even more daunting to think about it that way.  Within the context of not doing what you feel you should, it’s a struggle to see what your best should even look like.  You start to doubt yourself.  Example: I usually cook proper meals.  At a low point (mentally, emotionally and financially) all I had was dried pasta and a jar of pesto.  And because I wasn’t feeling great, I didn’t even use those things.  So in a sense, I was not “doing my best” even within the confines of limited resources.  I wasn’t using those resources at all, but instead wasting them.  She told me it can be stressful to think about how you have so many resources but struggle to use them.  I had to agree.

What I realised then, at the exact same time as it came out of my mouth, is this: even if you have the material resources (that pesto in the jar, that pasta on the counter), your inner resources might not match them. You might have many things available to you: people to talk to, a safe environment, food on the table (or in this case, in the cupboards).  But if you lack the inner resources- motivation, confidence, self-belief- then these material, external resources, quickly start to seem useless.  At the same time that this is happening, you may begin getting upset with yourself, for having all this stuff and yet not making use of it.

Yet, in the same way that depression can strike a billionaire, with more material resources than most, you can lack the resources inside yourself to make use of the external resources the way you feel you should.  That word again.  Should.  The truth is that what you “should” do is your best.  What I am coming to believe more and more, is that more people are doing their best, every single day, with the resources- both inner and outer- that they have.