Tag: DBT

Constant anticipation of the next error – and consequential disaster: Part #1

I try hard to look for good things to appreciate. I’m trying to counteract my anxiety and overwhelming emotions by looking for the positive, hopeful things that can come from a situation. (It’s something of a DBT technique which I’ll elaborate on in another post.) I’m told I’m not yet very good at finding positive things about myself. I think gradually I’m getting better at seeing positive things in the outside world.

However in some areas it’s hard not to not only feel overwhelmed by both emotions and external negative events and also to expect them.

Benefits is a case in point right now and it has been for years, every single time I’ve needed to claim a Benefit when I haven’t been able to work / haven’t been able to work full time, because of my health.

Today, I received a letter from the Tax Credit Office about an error made in my tax credits earlier this year, when I was working at the department store. I was aware of that mistake. They had incorrectly recorded the income figures I had given them and given me only partial information about eligibility. Consequently they paid me tax credits I wasn’t entitled to. The letter I received today was rather confusing but essentially confirmed that. So far, that wasn’t too bad – I will have to pay back the overpaid money when they ask for it but I already knew that.

Next, I opened two letters from the Housing Benefit Department. The first contained two award notices both almost the same but with completely confusing dates, entitlement and income figures. What’s that about, I wondered. One of them was marked “change in personal circumstances”. What change in circumstances? I haven’t had a change recently. I opened the second letter from Housing Benefits, with a certain sense of foreboding!

Yup, disaster again. The letter told me that the Housing Benefit Department had been informed by the tax office that I am in receipt of working tax credit, therefore I am working and my housing benefit has been suspended until I give them details of my new job and current income.

Oh my days. I assume they have received a copy of the letter I got from Tax Credits. If they took time to actually read the letter, they would have seen it was saying that I am not entitled to tax credits. If they had looked at the dates in the letter (not to mention previous documentation I’ve supplied them and previous discussions I’ve had with them about my receipt of tax credits) they would have seen that it referred to a period earlier this year, not to now. They also know that I am not working – I have given them proof that I am currently in receipt of Employment Support Allowance because I am not working because of my health.

So, my housing benefit has been stopped. I will have to contact my landlord on Monday to explain why the benefits payments have stopped. I will have to contact Housing Benefits and try to prove to them that I am not working. This will probably involve chasing around the tax office and the other oxus involved in my employment support allowance. I have to make a written statement and gather together copy documents from my employment support allowance claim and tax credits. Quite probably I will have to take this in to the housing office, queue for a long time to see someone, which physically I cannot cope with at the moment as I can walk so little. My anxiety has skyrocketed because of the financial problems this suspension in my housing benefit will cause. Worse, from my past experience, once one benefit gets stopped, all the other benefits get stopped too. I am anticipating that I’ll be contacted by the employment support allowance office next week saying they’ve received information I’m working so my benefit has been stopped. Then I’ll have nothing coming in.

This may sound like an exaggeration but it has happened to me and to friends of mine before. And it could all so, so easily have been avoided. How easily the housing benefit office could have seen that the correspondence referred to months ago. How easily they could have checked with the tax office to see if I was working. How easily they could have made a quick phonecall to me or my support worker, if something wasn’t clear or they needed a particular piece of evidence. Wouldn’t this have cost them less, as well as me? The situation would have been resolved in minutes. Instead they have sent out a letter, required a statement, someone has to take copies of this, take copies of documentation, probably see me for an appointment, restart everything, set up payments to my landlord again (God willing!). Even without counting the cost and distress and anxiety caused to me, it is a hive waste of resources and confusion for nothing.

Since I first had to claim Benefits in something like January 2015, I reckon I have been paid the correct amount I was entitled to for a maximum of one month at a time, before the next error or mess-up has occurred and at least one of my Benefits has been cut, stopped or refused incorrectly – and completely avoidably. Last year when I rented as a lodger in a private landlord’s family home, this array of errors left me so very close to being on the street; if it were not for an extremely generous friend who paid my rent one month, I would have been out with nowhere to go. It is hugely fortunate that I now live in a housing association flat where I will not be thrown out immediately if there is a problem with my housing benefit. It is hugely fortunate I have the expertise of my support worker who will help me get this resolved as fast as possible and stop me going to pieces in the meantime. Most people don’t have those two blessings.

I don’t want to complain and whinge and expect money for nothing. I don’t think I deserve other people’s constant support. I could very well have nothing. I need to try to become independent and able to support myself. Support doesn’t come for nothing and I should expect to take responsibility, not have everything handed to me.

I think one thing that makes it so hard is when you have been through every process as well as you can, given all the information asked of you, taken all the steps you can, and despite this everything still crumbles. My experiences over the years tell me as soon as there’s any stability, it gets taken away again through error or miscommunication, despite all your best efforts. And the error seems to have an effect like tumbling dominoes on all the other areas of your life there is any stability. Losing stability has immediate big consequences when you have very little to live on. It also drains all your energy, time and emotional resources, which go into trying to correct the error before disaster point (losing your home, no money for food, etc) rather than leaving you any strength to recover, contribute something to your community in your day to day life, benefit from opportunities that might make your situation better (and even maybe less dependent on social and state support, not that needing it is a bad thing). When you are constantly using all your resources fighting the next mistake and next disaster, trying to ensure that you have the basics you need to get by, in a state of anticipation of the next disaster so you can try to minimise or allow for its impact; when you feel as if you’re being knocked back, kept vulnerable, denied any security, despite your hardest work to set things right; then there is no way you can do more than just get by, in a constant state of strain.

So, I’m wondering what I can change. It seems I cannot change the fact that mistakes constantly occur, despite me trying my hardest to do the best I can for my part and to take steps to pre-empt the problems. I don’t want to feel so spent, trapped, angry, vulnerable and at risk as I do at the moment as a result of the repeated cycle of mistakes.

So, what can I change?

[Part 2 to follow, not that I have any answers yet! Thoughts are most greatly welcome, as ever.]

Ginny xxx

 

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Not my day off

Today has been demanding. It’s one of those days that seems too much to have been only one day. I got big stuff done but also I’m losing time in unsettling ways and I know I was dissociating a lot between the different tasks and meetings I had to do, slipping out of being engaged with what’s going on and what I’m feeling and struggling to come back. Nevertheless I got through quite a few challenges.

Last night I knew I needed to tidy and clean my flat. My support worker was coming today. Also I hadn’t been on top of the housework since my operation and it was bothering me more and more. Recently I’ve started to find a greater sense of order and calmness if I don’t have too many things disorganised around me. This is interesting because til now, I’ve tended towards accumulating things I don’t need and not being able to keep my house ordered, not exactly hoarding but not being able to face items and paperwork and household tasks without going into panic.

Yesterday I was very anxious about today but put some of the physical drive from the anxiety into cleaning and then went on to clearing out some of my cupboards. By late evening I’d cleared 7 big bags (between rubbish and charity shop) and set 3 more big bags of things to try to sell at a car boot sale. The fact I don’t have a car for the boot element of that plan is potentially problematic 🙂 but there are the odd few table-top, largely indoor, sales in community centres / church halls here in the summer and I’m hoping I can find one to join in.

Today was a struggle to get up. Everything hurt. Still, I got together the papers I needed to show my new support worker (more on this tomorrow), then it was off to my care coordination appointment with my CPN. This wasn’t easy to go to because, although my last appointment was okay, in the two previous appointments I’d been really distressed and felt I didn’t get heard when I was desperate and at risk. Today’s appointment was actually really good. We looked at some DBT skills and we did a review which was overdue (every 6 months or so is a review appointment). I’ve not yet felt able to discuss with my care coordinator exactly what went wrong in the difficult appointments earlier this year when everything was going to pieces. I’m scared I’d lose control and the feelings of anger and not being believed would return and I’d do bad things and be back where I was. However my care coordinator and I have managed to move forwards having 2 positive appointments. I was scared after what I’d done – how upset and angry I’d got – he wouldn’t believe me or want me anymore and they’d know how bad I am and that I didn’t deserve help. That hasn’t happened. That’s something that I don’t usually get to experience.

Straight after my care coordination I met my support worker, H., who is from a housing support charity I was referred to recently. He is going to help me sort out my benefits like Housing & Council Tax Benefit, Tax Credits and disability benefits,  as well as liaising with my landlord about the rent arrears that I got into when I lost my job last year. It was a long appointment. We went through the background to how I’d got here, financially and in terms of my health, and we looked at lots of documentation, my income and my benefit and Council Tax notices. This took a lot out of me and I came so close inside to panic and losing it and emotions shooting too high. H. was very calm and non judgemental, which helped a lot. (More on this in the next couple of days.)

Then I had to rush to my GP appointment, which was the first since I’d been very distressed and angry at the surgery a couple of weeks ago;  also the first since my operation and finding out endometriosis isn’t actually the explanation for my pain and gynae issues. I’m still working through what happened in today’s appointment. I was dreading going into the surgery because I’m still terrified of what I did and how much I lost it. I was ashamed and embarrased and knew that they probably didn’t want me around again. I knew I’d really upset and inconvenienced and disturbed people. I’d scared people. That’s the worst thing,  the harm I caused, the bad I’ve always feared getting out of me. Talking to the GP  and discussing what happened and then also talking about my physical health was really emotionally charged.  It’s hard trying to deal with a lot of uncertainties about my physical symptoms. I know not having endometriosis is a really good thing but not having any explanation for all the things I thought it explained, and the fact the doctor isn’t really interested any more in investigating what may be wrong – well, that’s hard and triggers all my fears that it’s all in my head, I’ve made it up or I’m mad, it’s my fault. …

After the GP it was off to the pharmacy with my prescription, then finally home.

It’s been quite a day. I had a soothing bath tonight. Today was the first day I could have a bath since the operation (don’t worry I promise I did still wash 😉 !). The doctor sealed the wound with dissolvable stitches so it was important not to soak them in water too soon or they could have come undone. Also it was not safe to try to get in and out of the bath whilst my mobility was further reduced with post op effects. Falling is a risk for me anyway because of the problems the fibromyalgia and arthritis cause in my legs. So, tonight was a good little relaxation and refreshment. The little things do help!

How has your day been?

Ginny xxx

 

What do you hold onto in the darkest times?

I’ve posted before about how, like many people with Borderline Personality Disorder, one of the things I find hardest when I feel really bad is to hold on to any knowledge that it will not always be this way. The overwhelming emotions – especially fear, sadness, loneliness, anger, pain, frustration, self hatred, self disgust, hurt, distress, longing or needing, or the feelings I can’t yet name that come with flashbacks – they eclipse everything else and become all that exists.

I wonder if their power is greater if I fear the emotion I sense. But the totality of the experience, their consuming nature, makes them the more frightening.

Descriptions of this emotional experience in BPD often term the feelings intolerable or unbearable. It is that but it isn’t quite either; it’s not all of it. Intolerable, more than I can stand, yes… but it’s not something I can’t stand because it’s me. In that state there is nothing but the emotion and there is nothing of me but the emotion. I cannot stand it but neither do I exist apart from it.

I hate it so I hate myself. I must get rid of it, purge it, so I must get rid of myself and cut away the bad – so I cut.

I can name some of the emotions afterwards. Maybe the therapy is helping me to do that. But in the experience, I cannot. I cannot recognise anything but hurt and pain and hate and evil (me); I cannot hold in mind anything but the impulses to cut, run, scream, end it, reach back for numb. .. and I am gone. ..and I spin between cut off and unable to feel and any attempt to engage being painful, and the state of total emotion, of only existing as that pain.

I cannot control it. I cannot bridge that gap. Therapy is helping me identify what feelings are. But it doesn’t separate them from me, from time, from permanent reality, from right and wrong. It doesn’t tell me how to feel, rather than be, the emotion. It doesn’t tell me how to bridge the gap between the different people I become – the cut off numb one;, the one that hides everything to cope day to day and do what I’m meant to and fulfil my responsibilities and pretend and hope I could ever be good but knowing all the time that everyone really knows how fake it is and how evil I am deceiving everyone; the frightened needing child; the angry, vengeful and impulsive one. More and more they seem to be separate personalities. I am fragmenting. I am more unstable. I lose more periods of the day – when I’m in one state I cannot “access” the other and I can’t remember things that happened (though I may remember the state). I flick so quickly between states without being able to engage my rational mind and try to employ any grounding techniques or DBT techniques to control my behaviour or my experience.

I guess it’s good that I can start to be curious about the process, from the temporary relative stability of my “coping” state. It must show I do have some ability to learn to mentalisa about what’s going on in my mind. Usually my “coping” state would be trying to suppress what I’m exploring right now. Perhaps eventually I’ll be able to build a more curious and stable personality at least alongside these others.

What do you hold on to when your whole reality, your whole existence, is unbearable sensation and emotion? It sounds utterly stupid. It sounds utterly out of proportion. It sounds self centred and I am forced to admit that though it’s the very last thing I want and one of the things I most hate in myself, in a way it is, though at the same time self has got totally lost in the feeling and emotion coming from everywhere.

What do you hold on to when you can’t access your coping strategies or even your most rooted beliefs and deepest cares? I love my God and know God is mercy and compassion, but in the bad states I can only conceive of a vengeful God or a God casting me out. I love my godchildren, I care about keeping my commitments at work,  but in those states I can conceive only that I do everyone harm and everyone knows I’m bad really and would rather I weren’t around. The centre of my beliefs and values warp according to the state I’m in.

What to I hold on to?

Ginny xxx

Walking this Borderland #3: Good things happen over tea

 

 

Please read Walking…#1: Introduction before this or any other post in this Series. Thank you.

 

Good things happen over tea. I saw that quote on a gift mug today. It’s true. Perhaps I’m particularly English 😉 though it’s my coffee I really can’t get through a day without!

This one follows quite well from#2 and is another way of practising grounding and mindfulness.

If it’s not too wet a day, I like to sit outside for a few minutes with my tea. I don’t mind if it’s cold – I wrap up well and the nip in the air adds to the sensations that keep me rooted in the present.

I hold the cup. Enjoy the smell. Watch the delicate progress of the steam wafting upwards and maybe feel it on my cheeks if it’s a particularly cool day. I sip slowly and really enjoy the flavour and the comfort the warm milky drink brings inside.

Then I turn my attention further outwards. A good place to start, I’m told,  is to name 3 things you can see, 3 things you can touch, 3 things you can hear, 3 things you can smell. Sometimes I start there and then go on to appreciate in detail something in my familiar surroundings. For example, how many different shades of green / gold / brown are there in the big tree opposite my flat? Count them. What shape are its leaves? Are there fewer today,  if it has been windy?

By this time, if I was feeling okay when I started I may be feeling calm enough to try some slow breathing exercises. If I was in a state of very high emotion, turning my attention outwards in this small way may have been enough to just slightly take me away from the extreme, to a place I can be a bit further from acting on dangerous impulses.

Ginny xx

Goldilocks and the three bears (with a sore head – or three sore heads I guess)

Goldilocks and the three bears (with a sore head – or three sore heads I guess)

[Artwork is not my own.]

Q “Why are you chasing after a giggling fortune teller with a crystal ball?”

A “Well, my therapist told me that I have to try to reach a happy medium…”

Yeah okay sorry about that one…

In therapy recently we’ve talked about different concepts of an emotional thermometer.

One view could be a bit like a normal thermometer which can read positive and negative temperatures (ie plus and minus zero, not positive and negative in the sense of value). When we reach a very extreme emotional state either side of the middle, it is a bad time for us and we are not able to use coping techniques or mentalise, because of the extreme we are at.

At the high, hot, “red” extreme, where the thermometer has “shot up”, we are experiencing very intense emotions – extreme anxiety, distress, hurt, anger etc. I guess it could also be an extreme of a positive emotion although I wonder if this would make coping as difficult? I probably should think more about that.

At the low, cold, “blue”, frozen extreme, we also aren’t able to manage because we feel so low, cut off from our emotions, maybe as if we are in a numb state.

It might, perhaps, be more possible for us to function in the low extreme than the high extreme – we might be more able to get through the day better than when we are in an extreme of eg distress and crying – but it is not a place we are calm or happy.

In the middle of the two extremes, so a range around the imaginary zero, is a mid-ground where we can have calm and balance and where we are able to mentalise about our thoughts and emotions and be curious and reflective about what we and others are experiencing. So the zero is not a zero in the sense of zero = no emotion, but it represents the mid-ground.

This happy middle ground is the “Goldilocks state”*- where we are not too hot, not too cold but “just right”. (Sadly the term just works with reference to Goldilocks and the porridge part of the story. It is not the emotional state one frequently reaches when finding someone else sitting in your seat on crowded trains and I’m not even going to touch on what happens when you find an unexplained person sleeping in your bed 😉 [joke!]…)**

In order to be able to employ coping strategies, the aim may be to find ways to bring ourselves away from either of the two extremes to this happy “Goldilocks” middle ground. No end of different factors, including our personality, what we have learned about regulating our emotions as children, the role models that we have had, and so on, can affect our ability to return to the middle ground and the extremes we go to in the first place. I guess this something I’m going to find my way through in therapy. Someone said to me that they find the term “emotionally unstable personality disorder” more accurately descriptive than “borderline personality disorder” because it better represents these extremes of emotion.

I think there are lots of ways the thermometer metaphor could be used. Perhaps instead of imagining a plus and minus end of the thermometer, it is more helpful to imagine a thermometer from 0 – 100 degrees and that the happy medium is around the middle of this range, too much is going towards 100, etc.

Personally I can identify with the metaphor that involves the minus temperatures because I definitely feel I slip into a state that’s like sub-zero, when I am so numb and cut off from my emotions (and others’) and can’t engage with anything. Sometimes I can’t even talk to anyone. It is not the heightened emotional arousal of my extreme distress but it is by no means good either. It may allow me to give the impression of functioning for a while, but I feel I am operating in a dream world, not really present. And it is very dangerous because of where it can quickly lead me to, or switch to.

Which brings me on to the thought that for me, as well as the thermometer there is a cyclical path that does not involve going vertically up and down the thermometer, but oscillates straight from one extreme to the other. My “sub-zero” state can very quickly flip straight to the high, hot, red end. My numbness can flick straight to anger, hurt, agitation, even thoughts of violence or fury which I would never normally experience let alone act on. I can flick straight into the compulsive need to self-harm and self-punish to turn the anger and emotional energy on myself. It feels like a frightening loss of control. I can oscillate in the other direction too. Overwhelming sadness and distress can suddenly plunge into numbness and disconnection and dissociation from the world into what feels like one of my other personalities and my memory of what has happened will go very blank. It feels very out of control afterwards.

I don’t know yet how I will start to learn how to some how get off this dangerous oscillating circle to get back to the happy middle ground or how to get control of the extreme emotions, especially managing anger.

Does anyone else switch or spin through emotions like this? I’d be really curious to hear other people’s experiences.

[Note – *and** : as in the children’s story of Goldilocks and the Three Bears, a famous children’s fairytale in the UK / USA. I know some readers are not from the UK so please ask if this reference is puzzling to you!]

Ginny xx