Words cannot express...

This blog is turning into a pain and trauma-fest, which was not my intention. At the moment, my life revolves around therapy, self harm, trying not to self-harm, emotional suffering and the struggle to survive it all. I wish I had something positive to say but the past week has been difficult with two major incidents of self harm, and I am feeling overwhelmed.

I am not sure if I can use words to convey exactly how I feel. They seem too detached, too controlled, too trite. I have tried using art; there is an art therapy group at the Day Unit once a week, and it's one of the most helpful groups for me. But although the painting I did in the group yesterday was full of emotion, it looked too "nice" and another patient said that she liked it and could see it being made into a textile design.

Maybe self harm is the only way to reflect how I feel. My outside looks like my inside feels. I am covered with open wounds and scars. I look like the freak that I am.

I'm still trying to think of something positive to say. There is one thing - I am trying to practice mindfulness. It has been suggested by my therapist that it may help me, and one of the groups at the Day Unit is focussing on learning mindfulness skills. I am aiming to do a mindfulness exercise every day, and then to gradually integrate the concept into my everyday life.

The Largactil shuffle

I've been meaning to post for the last few days, but my messy brain wouldn't let me. I had a case conference on Tuesday and although it was intimidating to sit in a room with all five therapists from the Day Unit plus Superstar psych, I felt that a few helpful suggestions were made. I now have to actually take action but at least I feel that there are things I can do that may help. And even if they don't, I will have tried.

One of my meds has been increased (Chlorpromazine, otherwise known as Largactil) which has reduced the feelings of anxiety and agitation. My head is a bit fuzzy and I feel slowed down but at least I feel more relaxed. And I sleep really well. This medication is a temporary measure - ultimately, it will be the therapy that will improve my state of mind. Although I am worried that it won't. And what then?

I have been at the Day Unit for three weeks, and it has been intense and hard work. It is difficult to explain the therapeutic process. Here is a site with some definitions and description of MBT: http://www.mentalising.com/index.html As a person who is experiencing it in a group and individual setting, the theory doesn't seem apparent and the the dialogue between therapists and patients feels natural and exploratory.

My head is not clear enough to descibe it more at the moment. I am struggling with the weekends and the emptiness of them. I have absolutely nothing to do today, just and empty day to fill and it stretches ahead of me. This is a dangerous time, when I am less strong to resist the urge to harm myself.

Please can someone help me to organise my messy brain?

What is wrong with me? My head is messy, I have thoughts that jump from one idea to another with no connection. It is an effort to perform simple tasks and to make sense of things.

I have thoughts and ideas that I don't want and they seem to come from nowhere. I am looking for signs that will help me to decide whether to self harm or not. So far, there have been about the same of each. I don't know what the signs are until I notice them. They may be words that stand out at me on an advert on a bus shelter or a newspaper someone is reading. Or events or situations that happen.

How will self harm help? It has to be something major, like another burn, as only extreme pain will snap me out of my confusion back into reality. I feel out of sync with my surroundings; the world seems faster, louder and brighter than it should be. When I'm outside, I am fearful and nervous. At home, I am more easily disturbed or irritated by small things.

Being at the Day Unit today helped. It is quiet there, but I'm not on my own. I am trying to use the therapy and be hopeful that it will help. It's all I have. If it doesn't work, then I don't know if I have any more options.

First day

First day at the Day Unit. Only one group today as they are running a reduced timetable over the Christmas period. There were 3 other patients in the group; I think in total there are 6 or 7 patients at the Day Unit at the moment, but attendance fluctuates and it's rare to have a full group.

It was an "Exploratory Group" today. Not exactly sure what we are meant to be exploring or how we are meant to explore it. I am a group therapy veteran, having done two and a half years previously at the Day Unit, plus other therapy groups since. So I know what to expect. But it was still draining, even though I didn't talk much.

So I won't write much today as my head feels so full, and yet I feel empty at the same time.

Am I doing the right thing? That is the question that keeps coming into my mind. What the hell am I doing back at the Day Unit? It's all happened too quickly and it wasn't my idea. I just went along with what Superstar psych thought was for the best. Now I'm not sure. But what else is there?

Back to the Day Unit

I met with my psychiatrist (who I shall now refer to as Superstar psych, due to his reputation and status in the field of PD) and he has arranged for me to start at the Day Unit next week. Initially, I was relieved as at last, something was being done and I needed something intensive and immediate. But I am also disappointed in myself and see it as a kind of failure, as I have not been a day patient for seven years and hoped that I would never need to return. Yes, it is better than being an inpatient, which would be pointless and would have limited therapeutic value. And if I continue self-harming in this way, the consequences could be serious.

The Day Unit is a specialist PD service, based on group therapy following the Mentalisation Based Therapy model. It runs from 9 to 2.30 on weekdays, with 2 groups a day and one individual therapy session a week. It has changed since I was last there - there are much less patients now, probably only about 6 rather than 12. I know two of the staff quite well, and my therapist is someone I have had groups with in the past.

There is an art room that I can use outside of group times, and although my creativity has waned during this depressive period, maybe I can start to do some art again.

The therapy can be intense and difficult at times, and there is often conflict and tension in the groups, as we are encouraged to explore the impact we have on other group members, and the impact they have on us. Most of the patients are in their 20s and 30s and have the diagnosis of BPD. I hope I am not the oldest, at the grand old age of 36.

I start on Wednesday, after the Bank Holidays. Unil then, I have to manage by myself as the service is closed from Friday, and Superstar psych is on leave for a couple of weeks.