[!] What's My Problem?

[Helen]

For many years I've thought I must have some kind of mental problem. I've been vaguely diagnosed with anxiety and depression in the past but I'm sorry to say I feel let down by the healthcare system here in the UK. I've seen a number of counsellors over the years, some of them more helpful than others, but nothing ever really helped enough even though I always went in with an open mind and stuck with it a while to give it a proper go.

I think there is probably something more wrong with me than anxiety and depression and I've been reading about personality disorders and can't help but wonder if I'm borderline. I'll try and explain why but there are so many things that are significant to say that I'll probably miss out a few.

Close relationships are a huge problem for me and the others involved and are very all or nothing. I pull people close to me, often more close than is really appropriate, because (I guess) it makes me feel safe and secure that someone is there no matter what. I need someone who is totally and completely there for me whenever I need them, and I need to be needed by them in a similar way. When things are going like this it's great, but inevitably it doesn't stay like this for long. I'm very sensitive to rejection and in hindsight sometimes see it when it was never there but by the time I've seen that it's too late and has already caused a problem. If I get the slightest hint that for whatever reason the other person is not as "there for me" as I thought they were, I start to feel very insecure and have a strong urge to push them away before I can be hurt any more by them. I ignore them, am insenstive and offensive towards them, and I don't care because I want to punish them for how they have been to me. Then after a while I see light and am truely sorry for how I've behaved. I'll do anything to make it up to them and wonder why I was so stupid to behave in such a way. I feel guilty and I'm angry with myself and then relieved when they accept my apology and things can go back to being great again. This cycle is repeated over and over with everyone I've ever been close to, until they usually get fed up of me and then they really do reject me for good.

On top of this my moods tend to change quite rapidly from happy to anxious to frustrated to depressed and sometimes I feel nothing at all, which also messes up relationships because I think this confuses people and causes my friendship with them to be inconsistent. It also makes me not want to plan anything because the things I want to do and the amount of things I can cope with vary so much depending on how I'm feeling at any given time.

I realised I'm like this (and others have told me I'm like this) a long time ago but knowing and accepting it alone doesn't help me stop being this way because I just don't see it at the time, and even if I do see it the emotions involved are so strong that I can't stop it. I think being rejected by someone for good or for a long time after I've been abusive to them is the worst thing about it, it's complete hell. I feel sad, anxious, lost, hate myself for it and really struggle to cope with it because the way I am means I have very few friends (if any) at any given time. I often self harm when I feel this way which of course just pushes people even further away because they find that hard to cope with, and that makes me want to self harm some more.

I've been wondering lately whether to find and pay for a psychologist myself (which I cannot really afford) just to know whether or not I am borderline or if not then what exactly my problem is. It's been going on so long I'd just like to know. But I'm not sure whether it would be worth my while doing this since I cannot afford to pay for ongoing therapy.

Any opinions on anything I have said would be appreciated. Thankyou.

[Mark]

You're describing many symptoms that are characteristic of borderline personality disorder or something in that spectrum. The need for intensity in relationships - the fear of abandonment when the intensity seems to flag - the lability of emotion - the black and white idealization and then devaluation of your partners - the difficulty regulating your emotion, and the self-injury behavior. All of that is consistent with borderline personality disorder. Which isnt' to say that is what you have - it's not a disease - it's a sort of syndrome or behavior pattern - but it very well could fit you.

It's less important if it does fit you or not, and more important that you make sure that your next therapy round addresses the significant features of this pattern you're in. I'd strongly recommend you seek out a therapist who can offer you Dialectical Behavioral Therapy - this is a therapy originally designed for self-injurious women diagnosed with borderline personality disorder - but it has been found to be useful for people with emotional regulation issues more generally.

by the way - You've got a good self understanding of your pattern, if you are as aware of what you do as you describe. Not everyone can see the patterns they fall into. This sort of self-knowledge should be helpful to you as you go forward. You know what you are vulnerable to do and now you need to learn how to manage your emotions (what we therapists call "self-sooth") while maintaining awareness through the process so that you don't act out of emotion and anger and anxiety but rather out of awareness.

If you cannot afford or find DBT therapy, (or even if you can), seek out a group that can teach you mindfulness meditation and practice it on a daily basis. This sort of meditation can be a core self-soothing skill for adults who haven't already learned how to do that (which, to one extent or another, is most of us).

Mark