Where would I be today if I hadn’t had access to talking treatments within the mental health sector? I would probably not be alive or be in residential care long term. I wouldn’t be a woman with insight, empathy towards others and a range of coping skills.
Therapy has been a gift to me, particularly my current psychodynamic work with my community psychiatric nurse (CPN). It has taught me much about myself. Boundaries have been set and while at times I couldn’t accept them, now I realise why they are there. I have made myself vulnerable and told another person about my life in intimate detail but I have become stronger through the reflection. I have discovered how being honest will not cause her to be shocked or give up on me. Where problems have arisen in the therapeutic relationship we have worked through them.
In the past, therapies have had different rates of success with me. Treated as an outpatient at a private clinic I saw one of the top cognitive behavioural therapists in the country. But I didn’t do the homework which was worksheets on negative thinking. I saw the sessions as a threat to my life as a patient. Despite these therapies not working I was given space to talk so they served a purpose. I also had an excellent eating disorders therapist and a clinical psychologist at different times when I was an in-patient and they were vital as they could feedback the work we were doing to ward staff who I felt didn’t understand me.
The basis of therapy should be a commitment to change. There is a high drop-out rate in therapy with those diagnosed with borderline personality disorder because change is frightening and relationships difficult for us. It is also common for practitioners to burn out because we can be demanding and progress is at our own pace.
One problem I have is difficulty in keeping the therapist in my mind when they are not with me. This is less of an issue now as my CPN has been consistent and gives me feedback which I remember. Someone doesn’t have to be very articulate to benefit from therapy there have been times when I was monosyllabic due to depression and found it hard to name my feelings. But a skilled practitioner can read how you are feeling by more than just your words.
The understanding I have with my CPN is that we cannot work at the same level if I am depleted through cutting or my body mass index drops below 20. She says it would be an abuse to make me do work that challenges me. Our work has not created dependency and she tells me she is merely steering me while I am doing all the hard work. I value her as she is a very real and human therapist rather than someone who sits in silence and I feel is judging me.
The most difficult aspect of therapy is the ending. The answer for me has been to discuss these fears and realise that at its end I will have created a more full life through the tools it has given me. As one door closes another opens. CC
Alex Williams is a volunteer and service userThis article appeared in the 12 April issue under the headline “Life after therapy”