So as some of you reading this may already know – I suffer from Anxiety, Depression and Borderline Personality Disorder (also known as Emotional Intensity Disorder). So if you see references to BPD and EID they are one in the same.
So to put a face to the words and this particular disorder experience, this is me.
Do I look like I have a million issues with my brain? (To some people maybe…) but the point of this is, that you can’t tell who has mental health problems. Most people I meet day to day have no idea of the intense pain I face every second of every day inside my head.
It took me a LONG time to get that last diagnosis (BPD) as most GP’s don’t know much about it and aren’t qualified to officially diagnose you. You have to be referred to mental health teams an secondary units, which drains NHS funding so they avoid it at all costs…
However I managed it after 3 and a half years of pushing, and after struggling with the NHS services in The Midlands for a further year I moved to London and finally found myself being heard. The Merton IAPT (Improving Access to Psychological Therapies) service acknowledge my emotional struggles and referred me for a programme I’d never heard of, called STEPPS.
This stands for: Systems Training for Emotional Predictibility and Problem Solving.
I’m not going to talk about my past* so much in this blog as my present and how this course is working for me so far. I will be doing a second blog at week 12, but this one so far covers my experiences with sessions 1 – 6 of the STEPPS Programme.
*If you want to read about other experiences, I have written a number of previous pieces further back within my blog.
So to begin with – confidentiality is key, so I won’t be discussing the issues of anyone else from my session, just the outline of the course and a couple of my own experiences to explain some forms/logbooks.
For the last 6 weeks we have met every Monday for two hours to discuss a different subject within the medium of managing our emotions.
This is the overall schedule of the full programme:
So as I have previously mentioned, I will be writing about my experience so far with sessions 1 to 6, and the Reinforcement Team evening information session.
I think one of my favourite parts of this group so far is the ‘Emotional Intensity Continuum’ – it’s incredible how we don’t realise how much our emotions and reactions form patterns until we analyse them.
So before this is explained it looks confusing as hell.
But it actually helps SO MUCH with trying to keep my intense emotions at a level and not rise to them.
So the top section is where I record the percentage of intensity I feel I’ve been at during the week.
‘STARTED AT’, ‘HIGHEST’ and ‘FINISHED AT’ – is simply to record how our intensity in a particular situation fluctuated.
You do not have to fill in all sections 1 – 5 if you didn’t feel you reached a level 5.
So I use this grid every week to record and learn within specific situations. Here is an example of my reaction when we moved into our new house, and the neighbours had put a note on my car about my parking within less than 24 hours of us living there…
So as you can see, most people’s reactions would probably be “oh, what a bunch of dicks” or “that doesn’t really matter to me, I’ll move on”. But nope, my brain won’t let things be that simple! Just check out the intensity of emotion I go through in just a small amount of time with what some would consider to be a really small issue.
This should highlight the pain and overwhelming feelings we endure daily over the smallest of things.
The best description I have gained from STEPPS is that we are like car alarms.
Some cars you just brush past and the alarm goes off, others you have to shake for them to go off. We are like the former, even the smallest things can trigger us.
Another incredibly important thing I’ve learnt is that the ‘old’ part of our brain, referred to as the Amygdala is where our ‘fight and flight’ mode resides, and the bit that triggers our reactions etc is far more heightened than the average brain. Hence why we are always told we are “too sensitive” or “too emotional”. Once the amygdala is triggered and our reaction mode is sky rocketing, the forefront of our brain is pushed out and we lose logical thought processes and rational behaviour. Our instincts become so intense that we believe them and get overwhelmed with emotion.
The ‘Backpackers Analogy’ helps to explain a little more about what STEPPS is and provides an interpretation from another EID/BPD sufferer:
So leading on from this, and to give you more of an idea of my experiences so far, not only do we use the Emotional Intensity Continuum (EIC) but we also have a skills card to fill in every day. It may sound like a lot, but when you fit it into your daily life it truly helps to identify which skills you are utilising, which are helping and which aren’t needed or used.
Again, it looks a little complicated but once you get to grips with it, it really helps!
We are also encouraged to put together a reinforcement team, or identify the one we already have.
I’m fortunate enough that my boyfriend is incredibly supportive, as is my extended family and a tight knit group of girls who all suffer from similar issues.
What we musn’t forget is that our reinforcement team aren’t perfect, and they are learning with us.
I wrote down goals in the first session, it’ll be interested to see if I have achieved these within the 20 weeks, or whether I end up adding any goals I’ve never considered before.
Now, we come to the subjects and learning.
This is my favourite one, something I’d never ever heard of and never been taught before.
Simply put, these are lenses that come down in front of us when we experience situations which remind us of others, and make us relate the present to the past. Which can not always be a good thing.
For example; if someone is negative towards me and criticises me, I instantly resort in my head to:
EVERYONE HATES ME
I DON’T DESERVE TO BE ALIVE
I AM DISPOSABLE
I HATE MYSELF
etc etc etc
It may seem a little extreme to some people, but again, this is about educating the world that having intense emotions is totally acceptable, we aren’t attention seeking and we CAN learn to adjust.
So here is some of the paperwork provided on filters, if you are relating to anything I have said or have struggled with emotions previously then take a second to read through and see if you can identify any filters of your own…
Being able to identify which filters we use, we can learn to remove them from future situations. This will enhance recovery and also give us relief from any pain when new situations trigger the feelings and negative emotions of old ones.
Distancing is also an incredibly important tool, it’s hard to do at the beginning, but also including your reinforcement team in knowing what’s going on is good.
For instance voicing “I can’t handle this moment, I need to take a step back so I don’t get more angry/upset” can mean that the person you are potentially clashing with knows to give you time to cool off.
Distancing is fairly self explanatory but I’ve added some key parts of the paperwork if you feel that you want to read more about this!
Sounds simple, it isn’t, the course is great for helping you devise ways of telling others how you feel – whether that’s through describing a place, a colour, using music or even a familiar memory. We can use other methods other than labelling if we find our reinforcement team doesn’t respond well to that.
Communication is KEY when it comes to recovery!
Similar to feelings, but we often forget that feelings and thoughts are separate. It can be hugely validating to communicate both and have others hear you.
So you’ll have noticed I have mentioned this previously, some of you may be shrugging off talking to others, or you may feel so alone that you don’t have anyone you can make into your reinforcement team. But trust me, there will come a day when you will find someone. And they will probably be someone you never even realised you’d be able to confide in.
The STEPPS programme runs a one off session in which you can invite your ‘reinforcement team’ to come and sit with the course leaders and have the programme explained to them. They also sit them down and from a third party explain how they can help you, how they NEED to work alongside you to aid recovery and also explain key things such as filters, distancing etc.
This has been a invaluable to me as my boyfriend is now aware that when I switch between “I love you, you’re amazing” and “I hate you, go away from me” it’s nothing to do with him, and everything to do with a situation, my emotions, the intensity and any filters or triggers. He is now able to see a bigger picture and this takes a hell of a lot of pressure off me!
This next piece was given to him as a hint of how to maybe help me work out intense periods of emotion:
It’s amazing what happens when it’s not only you having to think about your behaviour and emotions! You can work at it as a team, which if you’re anything like me with abandonment issues, being a team is a HUGE thing. Feeling alone is a big trigger for me.
STEPPS also provide both the sufferer and the reinforcement team with ‘quick cards’, that we can keep on us as quick references in times of need. We don’t always have to remember everything in the folder.
Now comes to today’s session, session six – challenging thoughts. This is a big one for me, because we are inundated with thoughts every second of every day, some we don’t even know we are having. Some are just decisions about what to have for dinner, or when we should go to bed. Others can be terrifying, morbid and haunting memories of the past that trigger deep emotions.
What does challenging mean?
How do we challenge these thoughts?
Where do these distorted thoughts come from?
Unhelpful thinking patterns!
How to challenge unhelpful thinking patterns:
IMPORTANT WAYS TO CHALLENGE NEGATIVE THINKING:
So a lot of the last few bits I’ve just slotted in without much annotation – but that’s mainly because they are self explanatory and it’s filters that stick out for me the most.
Considering I have only done 6 weeks of this course so far I’m pretty damn impressed that the NHS has allowed their funding to stretch to something so beneficial when it comes to personality disorders.
So many of us are told we are a lost cause, or unable to be helped, but this is proving the opposite. With a little time, care, love and understanding we can overcome these intense episodes, we can work together and feel less alone. Acknowledgement is key.
I will be writing further blogs about sessions 7-20 and a conclusion about how I’ve found this entire programme has worked for me. My partner will also be writing a piece about how it is to live with someone with BPD, how to deal with us, and also whether or not he feels the STEPPS programme has made a difference to both myself and our relationship.
If you would like to talk to me further about any of my recovery, or how I got involved with the STEPPS programme please don’t hesitate to drop me an email at: firstname.lastname@example.org