harasgenster
07-10-13, 11:33
Hi there
There was once a time I looked forward to being able to post in this section of the website, so I thought I'd give myself a quick break this morning and tell you of my success.
A brief history
I first became unwell when I was 13. I am now 27. Here's a bullet point list of what I dealt with inbetween:
Anorexia
Bulimia
Agoraphobia
Social phobia
Depression
Panic disorder
General anxiety
Not all at the same time. Anyway, these are the worst things that happened as a result of my being unwell:
Much lower than expected GCSE results
...which led to me not being invited to visit Oxbridge after all...
...this broke me and I stopped working...
Much lower than expected A Level results
Go into university through clearance
Defer exams due to nervous breakdown
Forced to leave MA due to illness
Unable to hold down job
Lose boyfriend, friends and become homeless
Am given several opportunities to succeed in my chosen career but am too ill to take them
My behaviour became erratic. At one point, I slept only on alternate nights, and tried to hold down a full-time job throughout (badly, I must admit). I did think at a few points that I would never be well.
What helped
The biggest helps to me were person-centred counselling and schema therapy. Both of these types of therapy are quite humanistic in their approach and were refreshing after having been told for so many years that there was something wrong with me. These therapies do not use diagnostic criteria in their approach and treat clients (not patients) as 'people struggling' rather than 'people who are disordered'. In my case, this was very helpful.
It was identified that my core issue was dissociation and detachment from my emotions, which meant that I could not really tell you how I felt at any one point and that when relaying 'sad' stories from my childhood etc, I had no feeling about them. The therapists (particularly the schema therapist) went back to basics with me, and we discussed what kind of 'core needs' people have as children - and thus continue to have throughout their lives. Once we'd pinned these down we went through my history to see whether I had always had my needs met. I was quite defensive of my family at first, but recognised that due to my parents' lack of resources (mother was quite severely mentally ill and dad exhibits behaviour and characteristics similar to Aspergus disorder), I had not received a variety of core needs, although I maintain that this was not their fault (which is apparently quite healthy).
We did some work where I imagined I had a child and talked about how I would care for them. I was told I had good parenting skills and told to use those skills on myself to ensure my needs get met.
Gradually I found that my frame of reference changed, and where once I would have taken all criticism as read, I now started to question whether people were always right when they criticised me or made me feel uncomfortable, or whether they were feeling insecure in themselves, or perhaps relieving stress. I remained compassionate towards their problems, but learned to draw a line at allowing myself to become a punchbag for them. I could still care for their needs while ensuring they did not take their stress out on me, and that my needs were not ignored (well...I say this...I'm getting there, but I'm not 100% perfect at this yet!)
When it came to identifying my emotions, I learned a lot of mindfulness techniques and began to identify when I was feeling something, even if I couldn't name the emotion. I found this very grounding and helpful, as I was able to begin experiencing emotions and understanding that they were natural. One of my schemas is emotional inhibition, which began when I was a toddler and is likely to have been a major factor in the development of eating disorders (apparently it's quite common for those with ED to also inhibit their emotions and appear 'doll-like', or slightly unreal because they appear not to have strong affect....as my friend describes it, "sometimes you seem dead inside"). So shaking that grounding schema and beginning to recognise emotions, then learning to identify which emotions are which, and then learning to sit and observe them rather than trying to fix them, was very helpful just in and of itself. This was probably my biggest step.
I also became used to a different frame of reference when it came to what I expected from other people. It had never been revealed to me before, but I found that my expectations of how other people should treat me and what life should offer me were much lower than the kind of 'benchmark' normal. I found descriptions of what a 'well-balanced' person expects from life made me much more optimistic and I felt that there was much more scope for my future than I thought there was. It took a bit of getting used to to up my expectations, but I've found that it's helped in all sorts of ways, including being more assertive, because I now feel that it's ok to have certain needs met and not feel selfish or unrealistic for wanting them (things such as physical affection and respect).
As for everything else, it just seems to have organically fallen into place. I find that I now feel 'behind the wheel' of my own life and have much more perspective about what people say to me and what happens to me. I'm able to look after my needs more effectively, so I'm a little more assertive than I was, and I find that I am treated much better as a result of that. I'm also much more organised and observant than I used to be, and much more productive, as a result of my mind being more clear and focused.
I'm not quite there yet but I'm definitely well on my way and believe I will be 100% recovered in the next few years.
What didn't help
Some interventions weren't helpful for me, but this doesn't mean they won't be helpful for others. I write this bit because it's easy to feel dejected if certain interventions don't help, but some people are just suited to different things than the usual frontline offerings of the NHS
SSRIs, SNRIs and Mood Stabilisers - these were not effective in any kind of a long-term way and my quality of life was not significantly improved by them. Although I did find them helpful in the short-term during breakdowns/crises.
CCBT (computerised CBT) and CBT - no long-term effectiveness for me, although I found CBT (but not CCBT) perfect for eliminating behavioural symptoms of anxiety, such as going outside and speaking to other people. Didn't touch the root of the problem, though, I'm afraid, and I really needed to do the groundwork, such as learning what I'm feeling and identifying when I am experiencing emotion.
Pure psychotherapy - schema therapy is sort of a mix of CBT and psychotherapy but I found the techniques used in pure psychotherapy and little too agressive and, in my case anyway, it was expected that I would already know what emotions I was experiencing. Again, more groundwork was needed for me before I could gain anything from psychotherapy, but this may have just been a bad therapist.
What I still need to work on
I still can't work full-time because I have problems with exhaustion and I burn-out very quickly. We're trying to work out at the moment to what extent this is stress and what extent this is the effects of my medication (still on a low dose) which does make me very drowsy (I comfortably sleep for 15 hours at a time).
I also still do not have any emotions about 'bad' things that have happened to me and feel completely detached from them - as if they happened to someone else. At the moment I don't see this as a priority, but I think it would be helpful for me to be able to process emotions about these times.
I have found that the 'effective interpersonal skills' I have learned through DBT (which I was doing alongside schema therapy) are not particularly effective after all. It turned out that I was already using all the effective interpersonal skills apart from assertiveness, so there was only minor tweaking to be done. But speaking to people kindly - as I always have done - often only appears to get the message across in the short-term and people generally revert back to their ways. I'm tempted to just have an argument, because I sometimes feel that if I used shouting as a way to get my point across (have done this only a few times in my life because was previously very uncomfortable with it) it might have more effect and people might respect me more. This is not encouraged in DBT, but to be honest, I find that people still think they can get away with things around me and appealing to their emotions and their compassion does not really get me anywhere! But I want to work on this and see how I can be more effective socially so that people do not see me as a target.
Problematic schemas
For anyone interested is schema therapy, here's my 'profile' if you like:
Major ones:
- Emotional inhibition
- Emotional deprivation
- Social alienation/isolation
- Self sacrifice
- Unrelenting standards
Minor ones:
- Vulnerability
- Subjugation
- Defectiveness
There was once a time I looked forward to being able to post in this section of the website, so I thought I'd give myself a quick break this morning and tell you of my success.
A brief history
I first became unwell when I was 13. I am now 27. Here's a bullet point list of what I dealt with inbetween:
Anorexia
Bulimia
Agoraphobia
Social phobia
Depression
Panic disorder
General anxiety
Not all at the same time. Anyway, these are the worst things that happened as a result of my being unwell:
Much lower than expected GCSE results
...which led to me not being invited to visit Oxbridge after all...
...this broke me and I stopped working...
Much lower than expected A Level results
Go into university through clearance
Defer exams due to nervous breakdown
Forced to leave MA due to illness
Unable to hold down job
Lose boyfriend, friends and become homeless
Am given several opportunities to succeed in my chosen career but am too ill to take them
My behaviour became erratic. At one point, I slept only on alternate nights, and tried to hold down a full-time job throughout (badly, I must admit). I did think at a few points that I would never be well.
What helped
The biggest helps to me were person-centred counselling and schema therapy. Both of these types of therapy are quite humanistic in their approach and were refreshing after having been told for so many years that there was something wrong with me. These therapies do not use diagnostic criteria in their approach and treat clients (not patients) as 'people struggling' rather than 'people who are disordered'. In my case, this was very helpful.
It was identified that my core issue was dissociation and detachment from my emotions, which meant that I could not really tell you how I felt at any one point and that when relaying 'sad' stories from my childhood etc, I had no feeling about them. The therapists (particularly the schema therapist) went back to basics with me, and we discussed what kind of 'core needs' people have as children - and thus continue to have throughout their lives. Once we'd pinned these down we went through my history to see whether I had always had my needs met. I was quite defensive of my family at first, but recognised that due to my parents' lack of resources (mother was quite severely mentally ill and dad exhibits behaviour and characteristics similar to Aspergus disorder), I had not received a variety of core needs, although I maintain that this was not their fault (which is apparently quite healthy).
We did some work where I imagined I had a child and talked about how I would care for them. I was told I had good parenting skills and told to use those skills on myself to ensure my needs get met.
Gradually I found that my frame of reference changed, and where once I would have taken all criticism as read, I now started to question whether people were always right when they criticised me or made me feel uncomfortable, or whether they were feeling insecure in themselves, or perhaps relieving stress. I remained compassionate towards their problems, but learned to draw a line at allowing myself to become a punchbag for them. I could still care for their needs while ensuring they did not take their stress out on me, and that my needs were not ignored (well...I say this...I'm getting there, but I'm not 100% perfect at this yet!)
When it came to identifying my emotions, I learned a lot of mindfulness techniques and began to identify when I was feeling something, even if I couldn't name the emotion. I found this very grounding and helpful, as I was able to begin experiencing emotions and understanding that they were natural. One of my schemas is emotional inhibition, which began when I was a toddler and is likely to have been a major factor in the development of eating disorders (apparently it's quite common for those with ED to also inhibit their emotions and appear 'doll-like', or slightly unreal because they appear not to have strong affect....as my friend describes it, "sometimes you seem dead inside"). So shaking that grounding schema and beginning to recognise emotions, then learning to identify which emotions are which, and then learning to sit and observe them rather than trying to fix them, was very helpful just in and of itself. This was probably my biggest step.
I also became used to a different frame of reference when it came to what I expected from other people. It had never been revealed to me before, but I found that my expectations of how other people should treat me and what life should offer me were much lower than the kind of 'benchmark' normal. I found descriptions of what a 'well-balanced' person expects from life made me much more optimistic and I felt that there was much more scope for my future than I thought there was. It took a bit of getting used to to up my expectations, but I've found that it's helped in all sorts of ways, including being more assertive, because I now feel that it's ok to have certain needs met and not feel selfish or unrealistic for wanting them (things such as physical affection and respect).
As for everything else, it just seems to have organically fallen into place. I find that I now feel 'behind the wheel' of my own life and have much more perspective about what people say to me and what happens to me. I'm able to look after my needs more effectively, so I'm a little more assertive than I was, and I find that I am treated much better as a result of that. I'm also much more organised and observant than I used to be, and much more productive, as a result of my mind being more clear and focused.
I'm not quite there yet but I'm definitely well on my way and believe I will be 100% recovered in the next few years.
What didn't help
Some interventions weren't helpful for me, but this doesn't mean they won't be helpful for others. I write this bit because it's easy to feel dejected if certain interventions don't help, but some people are just suited to different things than the usual frontline offerings of the NHS
SSRIs, SNRIs and Mood Stabilisers - these were not effective in any kind of a long-term way and my quality of life was not significantly improved by them. Although I did find them helpful in the short-term during breakdowns/crises.
CCBT (computerised CBT) and CBT - no long-term effectiveness for me, although I found CBT (but not CCBT) perfect for eliminating behavioural symptoms of anxiety, such as going outside and speaking to other people. Didn't touch the root of the problem, though, I'm afraid, and I really needed to do the groundwork, such as learning what I'm feeling and identifying when I am experiencing emotion.
Pure psychotherapy - schema therapy is sort of a mix of CBT and psychotherapy but I found the techniques used in pure psychotherapy and little too agressive and, in my case anyway, it was expected that I would already know what emotions I was experiencing. Again, more groundwork was needed for me before I could gain anything from psychotherapy, but this may have just been a bad therapist.
What I still need to work on
I still can't work full-time because I have problems with exhaustion and I burn-out very quickly. We're trying to work out at the moment to what extent this is stress and what extent this is the effects of my medication (still on a low dose) which does make me very drowsy (I comfortably sleep for 15 hours at a time).
I also still do not have any emotions about 'bad' things that have happened to me and feel completely detached from them - as if they happened to someone else. At the moment I don't see this as a priority, but I think it would be helpful for me to be able to process emotions about these times.
I have found that the 'effective interpersonal skills' I have learned through DBT (which I was doing alongside schema therapy) are not particularly effective after all. It turned out that I was already using all the effective interpersonal skills apart from assertiveness, so there was only minor tweaking to be done. But speaking to people kindly - as I always have done - often only appears to get the message across in the short-term and people generally revert back to their ways. I'm tempted to just have an argument, because I sometimes feel that if I used shouting as a way to get my point across (have done this only a few times in my life because was previously very uncomfortable with it) it might have more effect and people might respect me more. This is not encouraged in DBT, but to be honest, I find that people still think they can get away with things around me and appealing to their emotions and their compassion does not really get me anywhere! But I want to work on this and see how I can be more effective socially so that people do not see me as a target.
Problematic schemas
For anyone interested is schema therapy, here's my 'profile' if you like:
Major ones:
- Emotional inhibition
- Emotional deprivation
- Social alienation/isolation
- Self sacrifice
- Unrelenting standards
Minor ones:
- Vulnerability
- Subjugation
- Defectiveness