Sonia Neale's lived experience
Keynote talk given at the 9th Treatment of Personality Disorders Conference, 6th November 2015 at the University of Wollongong, on "The importance of the BPD therapeutic relationship."
Much psychological literature will state that it is the therapeutic relationship that is the most important part of therapy, regardless of the modality. Never is this truer than for the person with Borderline Personality Disorder. If you are in therapy long enough, certain unconscious dynamics and repeat patterns of dysfunctional relating emerge.
My twenty year therapy was extremely difficult. It has been the hardest, longest, most painful journey I have ever been on. It was like hiking to base camp Everest without acclimatising to the atmosphere and oxygen levels on the way up. There were many times when I could not breathe properly, and I floundered on the wayside. Sometimes my therapist rescued me and sometimes she didn’t. Eventually, I learned to acclimatise myself with mindfulness and yoga.
I have the greatest respect for my therapist. She was able to help me neuroplasticise my brain and become emotionally self-sufficient. She turned my unpredictable world into a predictable one. She was always consistent, reliable and honest. During our twenty year relationship my therapist and I exchanged thousands of texts and emails, argued, fought, apologised and debriefed. We also loved and laughed, merged and unmerged, bonded and attached, healed and hugged, and exchanged many gifts. There were frequent highs and lows, transference and counter-transference and much dependency on my part.
When my third child was eight months old, I ended up in a psychiatric ward at Sir Charles Gairdner Hospital in Perth. I was thirty three and felt abandoned, misunderstood, cheated, burned out, angry, homicidal and suicidal. This was where I met my newly minted therapist. I had so much self-loathing, I felt toxic and was sure I would contaminate her with my presence. Her greatest achievement during that time was her ability to not piss me off. I started to look forward to therapy because I enjoyed her undivided attention, even though all she wanted to do was talk about my mother.
For a long time in therapy I did not have a coherent narrative. My stories were long, rambling, confused, boring and disordered. This gave my therapist a pretty clear idea of what sort of attachment process was going on in my head. Heinz Kohut, Austrian born psychoanalyst who developed Self-Psychology believes that empathic mirroring is an essential part of the mother-child therapist-client bonding experience. One day it dawned on me that my therapist was mirroring my movements. I leaned forward and rested my hand on my chin and so did she. When I ran my fingers through my hair, I waited for her to do the same. My foot would jerk upwards when I mentioned my mother, and it was very enlightening to watch her foot kick up occasionally as well. I would also swear increasing frequency, and was bemused to hear her mirroring my language as well. Although this was perhaps not quite the reflective experience Kohut had in mind. In hindsight, I realised she had been doing this for a long time. It resonated with my unconscious long before I became cognitively aware of it, and it felt empathic and bonding. I felt known, understood and validated. I was also very attached and dependent on her. I was clingy, regressed and child-like but I wanted to find out more about myself. I spent my days and nights reading heavy academic journal articles on transference and counter-transference.
It is believed “chronic feelings of emptiness” comes from missed developmental milestones and a lack of learned social skills. My therapist displayed deep empathy and taught me what I had missed out on growing up. This is not to say my mother did not try to model this for me, but at the time I was not capable of learning from her. I was also unable to learn from teachers and friends at school either. I did not learn what children are supposed to soak up from their environment.
My therapist partially filled the emptiness for me and the rest I had to learn how to do myself without alcohol, food, cigarettes and drugs. To encourage me to exercise, she invited me to go for a walk instead of sitting in her office. It was surreal to see her outside her office, out of context, especially when we got chatted up by two men and their dog in the street. To keep the momentum going, we decided to exchange photos of interesting things we had seen on our separate morning walks. This created a beautiful feeling within me, which is still with me today.
I knew she had feelings for me. Not as intense as the feelings I had for her, but one day, out of the blue it seemed, she told me that she loved me - in the context of therapy that is. It was a strange moment for me, and one that I will always treasure. She didn’t hate me one day and love me the next like I did with her. She had a better grasp on her feelings. It embedded in me that not only was I loved, but that I was lovable. This is a long way from how I felt about myself when I first met her.
Most of all she has helped me connect with my mother whom I know has concerns about how I have represented her in therapy. The therapist is not there to split up mother-daughter relationships, it is to help one another connect at a level both parties are comfortable with. It is to help me enjoy my mother’s company in the present moment, rather than seeing her through thirteen year old eyes. This is neuroplasticity at its finest.
It takes courage to do an archaeological dig on yourself, examine the material and understand and come to terms with your history. It is frightening to find, face, confront, overcome and transform your demons. Yet nothing worthwhile in life comes without a cost. I can look back on the last twenty years and realise just how sacred our relationship was. It is one that that will remain in my heart forever, it is now part of who I am.
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