I don’t wanna go!

It’s Monday, which means I am meant to see my psych this afternoon. 

I have blown off the last 3 weeks because I don’t understand what is going on in these sessions, all I know is that I come away feeling like crap, and kinda stupid because I don’t know what just happened.

Because it’s psychoanalysis, not psychotherapy, she and I are meant to be building towards 3 or 4 sessions a week. She has been treading lightly on getting me to decide when this happens – and rightly so as I am not capable of deciding what I have for dinner or get it together long enough to do my laundry, let alone sort out what my larger needs are.

I am also meant to have put her bills into Medicare so she can be paid and haven’t even done that because it’s a whole thing with going into a large shopping area and a large government agency and taking a ticket and waiting for my number and just the thought of it makes me dizzy.

I have 2 voices in my head: one of them is telling me that it’s really important to do this and to try to sort out some type of professional support for myself, the other one is saying that therapy is just futile and I just have to give myself more time and I will get it together on my own.

If I could just be transported to her office and not have to go through the train-taking and line waiting etc, that would be fine. But all I want to do is crawl back into bed yet again and just be left alone.

More therapy

I have seen my new psychiatrist 3 times now. That’s almost a record for me. 

She is a psychoanalyst as opposed to a psychotherapist. There is nothing DBT-esque about what we are starting and so far, I am hopeful.

In order to undergo psychoanalysis, the patient/client needs to agree to do a set amount of sessions per week – usually more than one and it can be 5. Yes, 5.

My T and I have been negotiating if I think that psychoanalysis will be beneficial, what that actually looks like (you DO actually get to lie on the couch!!) and how many sessions I am going to commit to.

As she is a psychiatrist, this is basically extremely expensive. However, in Australia psychiatry is covered in the same way that GP’s are covered and it won’t cost very much really, even if I do decide on 5 sessions a week.

However, the issues of meds is still in the air because she does not want to be both my therapist and my prescribing doctor, she wants me to see another psychiatrist for that .. yes, my shrink wants me to see a shrink .. go figure.

She is a quiet woman and i get the sense that she is treading very, VERY lightly with me – and I appreciate that. She has listened to my disjointed rantings and sat through my tears a and hasn’t offered solace or advice or anything of that nature … she is treating me a bit like a feral cat who could be scared off by any sudden movement, and she is not wrong to do so.

Today I told her that I feel like a balloon floating through a cartoon strip; untethered, vulnerable to outside forces and without true direction. She just nodded and let that be.

That is a good start.

Paging Dr Freud

Given that DBT is not working out for me at this time,

I touched base with the Sydney Institute of Psychoanalysis a few weeks back and got a call this morning for 2 initial sessions with a psychoanalyst.

I have no experience with psychoanalysis and I have limited experience with therapy in general.

I think I exhibit what the pros call “therapy resistant behaviour”, but in all honesty, therapists just usually manage to piss me off pretty damn quickly for a variety of reasons:

1: They can be so damn patronising – any therapist who listens and nods and then asks me “how I feel about that” is just asking to be repeatedly stabbed with a blunt spoon …

2: They can also be seriously invalidating. The few times I HAVE tried therapy, I have been told very early on that given ‘my circumstances’ I am coping/managing extremely well and I am obviously intelligent, resourceful .. blah .. blah .. blah .. as soon as they start with this schtick, I know it aint gonna work.

3: I yearn for a therapist like Tony Soprano’s Dr Melphi or, The Gabriel Byrne character from In Treatment … a T that will see into my soul and make insightful analyses (yes, I realise that this is unrealistic but .. just once, I would like a T to acknowledge that the fact that I can hold down a career – for a while – and am reasonably well-read – does not preclude the fact that the rest of my life is a series of spectacular messes).

I ALREADY have some doubts about the new therapist – I googled her and she has a degree in social work, not psychology … this raises a red flag immediately because my current hospital T is a social worker and she is lovely and all but she wants to spend time on practical, applicable stuff. So, it is be really important that I find new accommodation right now, and I know that. I know what I have to do, I am not an idiot, the problem is that I am completely shut down and just can’t push myself to do it … so, her giving me practical advice on the steps to take is just plain patronising … (see #1). I don’t need help with figuring out HOW to find a place to live, I need help with figuring out WHY I am unable to push myself to do it, or anything that is pressing, without my head imploding.

So, the fact that the new T is a social worker is a bit of a worry.

I have done some rudimentary (read googling) research on BPD and psychoanalysis and the results seem to be inconclusive … but, given the fact that my PD makes the most sense to me when considered through the lens of PSA, I am hopeful.

I am going in there with as much of an open mind as I can. I would really like to find a therapy that has impact.

To be continued …..

YA (Young Adult)

I just re-watched the film “Young Adult” and I am terrified that the character played by Charlize Theron is me; just, you know, better looking.

The film isn’t funny or, uplifting or even poignant. It;s just a rather raw tale of what it is like to live with BPD.

OUCH.

Really?

I have been doing a lot of thinking about PD’s, the effects of PD’s and what it actually feels like to have a ( seemingly) limitless emotional spectrum.

My psych told me in our original chat that for someone like me, a break up, or other traumatic event, is more significant because, unlike most people, the emotional pain truly is unbearable; akin to life or death – and I have to agree. But, nobody seems to be able to tell me why.

I know that there are well researched and documented theories about failed/faulty primary (parental) bonding and the consequences of that, but, after reading through much of this, I am still no better informed as to ‘why’ I cannot deal with extreme emotions and/or ‘why’ I have them in the first place.

To be honest, I am not sure that there is an explanation that accounts for the fact that I cannot see the world as whole place within which I should find purpose and meaning. Nor can explanations account for why I would rather end it all than face living with the emptiness I feel or the pain that comes from losing somebody I love.

Everybody goes through loss. Most people feel acute pain with that loss. But not ‘everyone’ feels it to the extent that some of us do – and I want to know why.

I have been re-reading some literature by Slavok Zizek – a cultural theorist with a psychoanalytical bent. Zizek comes via way of Freud and Lacan and has much to say about psychoanalysis and the contemporary, often popular landscape that we inhabit.

I don’t really want to get into the background of this stuff too much; it’s not necessary or relevant to my little diatribe here. But, I think that Zizek (and therefore Lacan) is onto something with his delimitations and descriptions of the human psyche, and this is where he comes both useful and interesting.

Lacan (20th Century psychoanalyst/theorist who came after Freud and re-worked some of Freud’s ideas) suggested that our psychological landscape is made up of 3 divisions: The Imaginary, The Symbolic and The Real.

I’m going to keep discussion/s of what these are (or are not) to a minimum because the purpose of this post is not to discuss these, but to highlight some of the idea/s about them that pertains to PD’s. And, in particular, BPD. So, I will be very brief with my descriptions and then, I will tell you all how I think some of the ideas raised seem to me to have relevance for BPD.  My definitions below are lacking (bit of a psychoanalytical joke there … geddit?) but hopefully will give a reference point to anybody who is unfamiliar with the terms.

Lacan’s divisions of the psyche:

The Imaginary:

When a child realises that it is separate to its mother (previous to this, the child knows the world only through its own self/perception – there is no recognition that there is an external world), there is a sense of fragmentation – the child must re-orientate its sense of self to accommodate being both itself and part of a larger world, This is a traumatic experience and one that is never fully resolved.

The Symbolic:

The world of language. When we ‘enter’ the world of words and signs, we do not ‘simply’ learn to communicate with neutral signs that adequately convey what we think/mean. Language is a shared system that was created, it is not natural.

Entering the symbolic teaches us how to relate to each other, how our social and cultural world functions, how it describes itself and how we are expected to know, understand and describe it as well.

However, language is system for communication, it is the process whereby we enter into community.  It does not and cannot come from within (express our thoughts/ideas) fully because it is a system that comes from outside ourselves.

Further, language does not neutrally ‘describe’ our internal experiences, thoughts or feelings, it helps create them because we take abstract ‘sensations’ and turn them into language that can be used to communicate with others – language actually ‘creates’ us, and our experience of the world because we are bound within a finite set of signs (words, phrases) within which to express or know it. Language creates the rules, social order and  understanding of what ‘the world’ is – and once we enter the symbolic, we cannot un-enter, we are enmeshed within.

The Real:

The Real is where we were before language, it is the state whereby we know nothing but need – when we are babies (before we enter the Imaginary or the Symbolic). The Real is both pleasure and pain based in need – the child yearns for the mother’s breast to quell the need for hunger, it does so without thought to what its needs ‘mean’ or what the mother’s own needs may be, the baby is complete in its desire, without thought or regard for others (it has not learned to consider itself as part of a wider community or others with need, but rather its entire existence is based only around the sensation of the self).

Most importantly (for me), The Real is pre-language – The Real is known/experienced without the filter of language to construct it, The Real is where things that defy language reside – and these are traumatic or pleasurable in the extreme.

For example, natural disasters, high school shootings, 9/11. When these occur, we can see that there is no language to adequately describe or convey what we experience or feel upon hearing about or witnessing these events – they demonstrate cracks in the symbolic order – a trauma that we cannot describe – and we are reminded of The Real, reminded that language (and therefore our entire existence, and how we make sense of ‘the world’) is not ‘true’, but rather a system overlays The Real.

OK.

What has all this to do with BPD/PD’s?

Well, traditionally/ideally/whatever, an infant is ushered from The Real into the Symbolic (although there remains the problematic Imaginary by a primary and ever-present caregiver who is able to allow the infant to experience the shift/trauma in a relatively safe and consistent environment. The infant adapts to the loss of self (The Real) and adapts to the dominant, symbolic order of society.

 

For those of us with primary caregivers who were abusive, absent or neglectful … well, this doesn’t happen, or, it happens in a dysfunctional way. We are never fully enculturated into the Symbolic order and hence, never truly leave the Real and/or are trapped more fundamentally in the Imaginary.

I think that those who have a PD don’t fully come through from The Real, through The Imaginary and into The Symbolic effectively – we are moored in The Real, and The Symbolic is never fully integrated or accepted. Over time, what others come to accept as ‘real’ or ‘true’ about ‘the world’ remains outside of our grasp. We can see, process and understand the socio-cultural norms – we can understand law, community, sexuality, but we were not completely immersed into them by a primary caregiver and so, they remain foreign, confusing and often absurd, left as outsiders looking in.

We ‘know’ the rules, legislations and expectations of our respective cultures, but we see them at a meta level – we see the structure and artifice that underpins them precisely because we have been left behind – we are like infants.

Being moored in the Real or the Imaginary keeps us forever on the axis of pleasure/pain – we only feel alive, real and whole when we are experiencing extreme emotions – to be anything else, to live in the Symbolic is tantamount to a death sentence because it feels fake, constructed an unreal in the very literal sense of that term.

I think this is why people with PD’s are so sexual – because sex is one of the few playing fields within which language is not the primary mode of communication. It is also a space/place where intense emotive responses are not only acceptable, but celebrated. It is home.

I also think that suicidal ideation is linked in here. The Real is about the absolute of pleasure/pain. We seek pleasure (sex) knowing it will bring pain, and we seek pain (cutting, slicing) knowing it will bring pleasure. The two are intertwined in some fundamental, albeit disturbing ways.

For me, sex allows the merging/enmeshment that I crave, for someone like my ex, it allows for pleasure and the expression of intensity without the necessity of relational tropes. We have different pathologies/PD’s, but our weapon of choice was/is sex. And this makes perfect sense really.

It also explains why I lack an adequate vocabulary about my ‘feelings’. If I am extremely upset, angry or otherwise emotionally engaged in a situation, I am all-but mute. I know that I feel ‘bad’ or ‘mad’ or ‘upset’ but quite often, I cannot find the words to express WHY I am feeling that way or what has caused it. So many lovers have expressed frustration at my inability to describe WHAT is wrong with me … because I cannot describe adequately what I am feeling, all I know is that I am feeling it.

Doesn’t this mirror the Real? A time where (as infants) we didn’t ‘know’ we were hungry or tired, we just knew that we felt ‘bad’. We hadn’t as-yet ‘learned’ what hungry or tired meant, we just knew it made us feel bad.

For me, I think of death as unemotively as I do life. Words such as personality disorder, depression, suicide … these are products of the Symbolic – I struggle with them because they have negative connotations – but perhaps the possibility that they are more neutral can be explained here.