I’ve had a quiet couple of weeks since I last wrote. I am currently in the middle of a 3 week break from therapy as my therapist is away. It seems to be passing by really slowly. As difficult as my EMDR sessions are, I do miss the routine of having that to go to and also the weekly space to share whatever might be my pertinent issues. It has been made all the more tricky by the fact that my care coordinator has told me that he is leaving his job in a few weeks so I will no longer have his support, which is a real loss.
The combination of these two circumstances (no therapist and him leaving) has been very illustrative to me just how much my EUPD still affects my thinking. I don’t expect it to ever truly go away, in the same way that I don’t ever expect my Anorexia to stop rearing it’s head to some extent whenever I eat, but it has surprised me how ‘textbook’ my response to these situations has been in terms of abandonment.
According to DSM-5 (the manual used to diagnose mental health conditions published by the American Psychiatric Association), one of the nine core symptoms of Borderline Personality Disorder (known in Europe as EUPD) is a “frantic effort to avoid real or imagined abandonment”.
My immediate thought when I heard my care coordinator was leaving was “oh great, now everyone is abandoning me at once” followed swiftly by “how can he just leave me?” and “How can my therapist think it’s ok to not have any sessions for the next three weeks, knowing that he’s going to tell me he’s leaving?”.
In fact, I voiced something entirely different and congratulated my care coordinator on his new job (that’s what ‘normal’ people do right?! and I am pleased for him really...).
In my head though, things were going into overdrive. Rationally I KNOW that his leaving has nothing to do with me, I haven’t done anything wrong and he’s not doing it just to upset me. I also know that as a professional involved in my care, our working relationship would have to end at some point. However, what it FEELS like is entirely different; the world is ending. He is one of very few people in my life who I have learnt to trust, he has been there for me through some extremely difficult times over the past few years and - although I can’t say this in front of him for fear of having got it wrong - he cares about me and my future. The fact that he is leaving mid-journey and won’t be able to see things through with me feels like the world’s biggest disappointment and yes, outright abandonment.
It makes me question everything I thought I knew about our relationship. “Has he really ever cared?”, “I knew I should never trust anyone” and “Sooner or later everyone in my life will screw me over”. And all of these thoughts (and many more besides) come instantaneously.
In this situation, it is also all compounded by the fact that my therapist is away at the time when I, and she, knows my symptoms are going to be triggered. “She doesn’t really care either.”
Of course I know in reality that her being away now is just a (bad) coincidence but it’s not about what I know.
I always feel ashamed about how attached I become to important people in my life. And when they leave, I inevitably try to hide my distress because to everyone else it would just be mildly disappointing and they can’t understand the degree of my pain. I feel ridiculous likening someone leaving my life to a bereavement but that is exactly how it feels to someone with BPD/EUPD.
I think it hurts more too, when you have no control over the leaving. This is, for people involved with mental health services in some way, in fact a fairly common occurrence. Yes I knew that we would have to part ways eventually but then it would have been a mutual thing. In the system though, professionals move on, get new jobs, have babies - none of which the patient can predict or thereby prepare for. That is what makes it feel even more like abandonment.
I guess that if I were looking at things positively, I might say that although I FEEL the abandonment deeply right now, I haven’t acted in any way to try and avoid it. Part of me is saying not to contact my care coordinator now (so I get to push him away first), or to do something to make him hate me (so that I can, in turn, hate him and make the leaving easier to bear). However, I’m not going to.
Leavings are immensely hard for me but, emotional as it will be, I am going to face this one head on as a recognition of how far I have come in my journey over the past few years and how this working relationship has helped me achieve that.