Archive for the ‘therapeutic community’ Category

Black and white thinking towards therapy

October 6, 2008

I’ve somewhat stupidly signed up to take part in some research on Therapeutic Communities, having spent a year at one myself. I thought it would consist of filling out forms, which for some strange reason I get a real buzz out of, but it’s going to take place over the phone. The downside to this is that I have to be spontaneous (eek!) and can’t plan my answers in advance. Any other borderlines reading this will know that we thrive on control, especially when it comes to authority figures, so this is starting to stress me out big time.

My main concern has been a fear over how I will come across. But of course, it doesn’t matter! I’ll never meet this person face to face, and my name won’t be published in her research. So why is it so important that I don’t come across as a whingeing bpd’er?

This has obviously led to much introspection of my time at the TC, and whether my own feelings about it are valid. I could very easily come across as angry and negative about my experiences, but I don’t want to be so one sided. There must have been some positives surely? But I don’t want to think about them. Why not? Because then the blame for my decline over the last year, once more falls squarely on my shoulders, and it’s much easier to blame my therapist. The problem is that I’m really struggling to think of any positives. I’ll try making a list, and I’ll start with the negatives because that’s much easier, and it makes me feel better lol.

Negatives

I gave up a longstanding full time job to attend the TC and haven’t managed to cope with work since.

I now self harm frequently, despite not having done so for years before I went there.

It has reinforced my mad status, rather than removed it. I am much more of a professional mental patient than I ever was, and having being deemed nutty enough to need to be in a TC, my gp now sees me as someone with severe mental health problems, rather than someone who suffers from occasional depression.

Discovering what feelings are has made my mood swings so much more painful. It’s not just about anger anymore, and after a year of being told that I am to blame, I have no one to shift those feelings onto. I’ve never felt suicidal for so long.

Being around people day in day out made me need human contact. Now that I am isolated again, apart from one friend and one family member, I find it much more difficult to cope with being alone. Yet the motivation to change that is still missing.

Positives

I made a good friend at therapy and we are still in touch.

I can eat in front of other people without feeling ashamed.

I can usually realise the triggers behind my moodswings.

I am back in touch with my Dad, after two years of not speaking. Something which the therapists pushed me to do.

Hmmm, well I guess there are some positives after all. The trouble is that a huge part of me is glad to be out of work and staying at home on benefits. I don’t want to get better and I don’t want to get a job. I’ve never wanted that. So there really wasn’t any chance that a TC was going to work for me. I either wanted to be 100% cured, in a fantastically well paid job, with a new partner and a great sex life, 2.4 kids, a size ten body, no dark feelings ever again, or constantly ill, dependent on others, preferably locked away for life, wasting away of starvation (didn’t manage that one lol), no expectations from anyone.

I guess the only thing I’ve learnt from therapy is that black and white feelings exist, and my life is ruled by them.

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Therapeutic Communities. Do they work?

September 11, 2008

 

It’s nearly two years now since I finished group therapy and sometimes I wonder just what, if anything, I learnt from my experiences there. If you’d asked me a few years ago whether I would ever have considered giving a year of my life to full time introspection I would have laughed and replied ”Of course not, I’m not that mad!” Indeed that’s what I said to the community manager during my first assessment. You see, I’d asked for a referral for counselling to help with my longstanding depression. I was expecting to receive the bog standard hour per fortnight with a psychologist, so I was quite angry to sit there 8 months later and be told I should give up my job, go on benefits for a year, and attend a centre 4 days per week. I was horrified that anyone should think I was that ill and I returned to work and forgot about therapy. A year later, after a winter spent feeling suicidal and wanting to murder my work colleagues, I capitulated and found myself back in the same office, pleading for a second chance.

And so began the strangest, most frustrating, yet often most rewarding year of my life. Sitting in a room with up to 16 strangers and being expected to talk about your feelings is absolutely terrifying at first, especially when you wouldn’t recognise a feeling if it smacked you round the head and said ”hello i’m angry, now fuck off.” It took me quite a few months to settle in and stop staring at the floor. At first the staff encouraged me to speak, then they cajoled me, and eventually they threatened me with eviction from the community. At some point, and I’m not sure how, I started to talk.

I loved the weekly art therapy sessions. A chance to be a child again and splash paint around. Even better, a chance to criticise other people’s work afterwards, albeit it ahem constructively. Art therapy always brought the bitch out in me. Actually group therapy in general brought the bitch out in me, and I started to see that I had a nasty bullying side to my nature. But slowly, over time, I began to care about those other people. I formed friendships in the smoking area, one of which has lasted since leaving the community, and become one of the best friendships I’ve ever had. I finally managed to eat in front of the other members (it took 6 months) and after a few relapses, learnt to control my urge to self harm.

But it wasn’t all a bed of roses. The protective wall of self reliance and extreme independence I’d carefully constructed over the years was  beginning to develop holes. Being alone and managing my feelings during the days off was increasingly difficult. I had no crisis support, no medication, no friends other than those in the community, and the weekends stretched longer and longer. There were some issues which I never managed to talk about in group, sexual abuse being the main one. The one time I managed to bring it up I received a negative response from the therapists and I clammed up again after that. There was a huge emphasis on staying in the present, and moving on from the past. That’s all well and good, but sometimes you just desperately need someone to say ”That’s awful and it shouldn’t have happened to you”. Instead we heard a lot of ”You only have yourself to blame” and whilst they may not have meant the abuse, that’s how my mind interpreted it.

In the latter months I began to feel the pressure of being seen to have succeeded. The therapists thought I had turned a corner because I stopped fighting and started being positive about life. The reality was that I felt a huge responsibility to the newer group members and didn’t want anyone to know how frightened I was of leaving. So I put a smile on my face, shut off the part of my mind which still mourned the past, and sailed out of the centre on my last day with huge plans to get a job and report back to the follow up group as the most successful member ever!

5 months later I walked out of my new job. A few months later I was in hospital following a suicide attempt. I had pleaded with my doctor for help from the CMHT but that request was blocked by the community therapists, who felt I should be encouraged to be responsible for myself. They failed to understand that after 20 years of mental illness I knew how to recognise the signs, and I knew the difference between a blip and a serious slide into depression. I’d stopped opening my mail and paying my bills. I was close to being evicted from my home, and couldn’t even get dressed most days, let alone wash my hair or eat properly. The worst of it was that after a year of learning coping strategies, I knew I was fully to blame. So I hated myself even more. The therapy had been a last resort for me. Lets face it, if a year of full time treatment from the NHS doesn’t fix you, what will? And they sure did rub it in every day how lucky you were to have a place there.

Before I started therapy I had managed to hold down a full time job for 6 years, albeit with a lot of sick leave. Now I sit at home, on benefits, becoming more and more isolated as the weeks go by. My confidence is shot to pieces. I feel guilty for not acheiving a happy life, for not being ‘fixed’. I have a new (to me) diagnosis of emotionally unstable personality traits, which comes with the knowledge that I’ll be left to get on with it on my own now. It turns out that the therapeutic community was specifically for people with personality disorders, yet that term wasn’t used once the entire time I was there. None of us had been told about our diagnosis. Imagine being a depressive and going somewhere where you are constantly told off for feeling low. That’s how it is when you have a PD, because suddenly you’re not allowed to have ‘real’ depression anymore. You’re just acting out or being non compliant. If they’d just been honest with me from the start, I could have worked with them to overcome this condition. Instead I spent months in a state of confusion, wondering why I was being blamed for being ill.

To sum up, when I think about the TC I often have very angry feelings. Their biggest failing was the follow up care once you leave. To go from 4 days per week to one hour per month is a big wrench and something they really should consider changing.

However, there are positives too. I have learnt how to articulate my feelings. I recognise the triggers for most of my mood swings and I know they won’t last for ever. I’m in contact with my family again for the first time in several years, and I’ve learnt not to judge them in such black and white terms. If I could start that year again I would put so much more into my time there. I would make myself speak up about the past and work through it, rather than shut it away. And lastly, I would have taken the issue of boundaries more seriously and not got drunk and slept with another group member a few months after finishing the programme. Oops. I’ll just blame that bit on being borderline lol.